Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 43502-43506 945

epidemiologist reviewers noted that the quality of epi profiles submitted with most
of the prevention plans in the second and third years (1995 and 1996) was much
improved, links between the epi profile and needs assessment, priority setting,
and prevention planning were not clearly defined. For example, in 1996, CPGs
from only 5 of 13 (38%) project areas sampled for in-depth review clearly used
the epi profile to identify target populations and select and prioritize interventions.
The most recent review of prevention plans (1997), however, found that 48 of 59
(81%) plans were based on an epi profile.
Lessons Learned: The quality and use of epi profiles in HIV prevention planning have improved substantially with increases in epidemiologist participation, TA
provision, and CPG competency in understanding data. The goal of data-based
decision making by all CPGs may be achieved by continuing to provide TA and
support epidemiologist participation in planning, and strengthening the emphasis
on linking data from the epi profile with subsequent steps in the HIV prevention
planning process.
43502 Organizational characteristics of reputationally strong
HIV prevention programs
Jane Mezoff', B.F. Seals', E. Sogolow', R.M. Kohmescher', G. Wooden2,
L. Bye3, B. Tjugum3. 1CDC, 1600 Clifton Rd., NE Mailstop, Atlanta GA;
2Washington, DC; 3Communication Sciences Group, San Francisco, CA, USA
Issue: Many HIV prevention programs are viewed as reputationally strong because of their innovation, organizational characteristics, field experience, and
contribution to our understanding of intervention. Most programs have not been
formally evaluated and many have limited opportunities to assess and share their
lessons learned.
Project: In 1997, the US Centers for Disease Control and Prevention (CDC)
developed a set of criteria to identify "Reputationally Strong Programs." Program
nominations were solicited from national prevention partner organizations and
CDC staff. Detailed program profiles were developed, based on interviews with
staff and clients, reviews of program background documents, and observation
of activities. Nine programs were selected, ranging from needle exchange to
outreach in public sex environments. Selected programs had diverse target populations ranging from women in drug treatment programs to youth in homeless
shelters.
Results: In site visits, common organizational factors observed across the
nine programs included clearly defined target audiences, goals, and interventions; flexibility among administrators and a willingness to make changes in programs based on client and staff recommendations; comprehensive, multi-modal
strategies for delivering prevention messages; audience-centered approaches;
intervention components that are based in behavioral/social science theory and
research; and sufficient program resources. Examples from the nine case studies
will illustrate these factors.
Lessons Learned: Programs viewed as strong by prevention partners had
many common factors associated with organizational mission, leadership and
program delivery. Program managers may want to consider these characteristics
when enhancing their programs and engaging in strategic planning. Researchers
may find such characteristics important in the implementation and evaluation of
intervention models.
43503 EVALUATING capacity building of implementing agencies
in the AIDSCAP Brazil project
Luiz Antonio Dangelo', Joseph Amon2, M.E. Fernandes Lemos3, M.A. Rebeiro,
W. Gitcheus4, K. Kotellos4. 1Au. Heitor Penteado 47 Casa 3 Sao Paulo
05437-000, Brazil; 2Family Health International, Washington, DC, USA;
3Associacao Sahde Familia, Sao Paulo SPR Brazil; 4Family Health International,
Arlington, VI, USA
Objectives: One of the main objectives of the AIDSCAP project was to increase
local capacity to respond HIV/AIDS epidemic. In order to assess this increase
at the end of the project a survey was conduced with AIDSCAP/Brazil implementing agencies (IAs). The survey assessed: (1) technical skill building of the
staff; (2) organizational and management skill building; (3) organizational system
development.
Methods: Data was gathered by a structured and semi-structured questionnaire applied by an independent consultant familiar with the AIDSCAP/Brazil
project to sub project managers from 4 NGOs and 3 governmental agencies. The
project managers were asked to assess the IA's ability as: none, minimal, good
and excellent to evaluate the managerial and technical skills.
Results: Technical skill building was assessed in 5 areas: behavior change
communication, condoms, STD, evaluation and policy. Organizational & management skill building was assessed in planning, finance, monitoring and human
resources. The baseline level of technical, organizational and management skills
expertise varied considerably between the different implementing agencies. A
considerably increase was referred in all areas by most of the IA. Both technical skill and organizational & management skills improved from an average
that vary from minimal to good in the beginning of the project to an average

of good to excellent by the end. Skills in condom promotion and logistics had
the highest increase. Human resource had the lower assessment among the
skills development. The organization system development was assessed in the
areas of financial management, human resource management and administrative
management system and monitoring system. A great improvement was referred
by all NGO that received AIDSCAP/Brazil financial management training. A special software for the management was developed and offered the IA. Monitoring

system was developed by all the NGO. Most of them referred that their reporting
system improved due to the AIDSCAP, however, few IA referred that the monitoring system collected too much unnecessary data. Human resource system
had the least improvements: Job description, performance appraisal were seldom
applied by the IA.
Conclusions: 1) The measurement of organizational strengthening is possible
in both quantitative and qualitative terms and provides an important information
on the success of a project. 2) the enhancement of institutions responding to the
AIDS epidemic is a significant independent outcome to measure in the evaluation
of the intervention projects 3) Improving institutional capacity leads to sustainable efforts and, consequently, a greater possibility of long-term impact. 4) the
organization system development was less successful than the technical and
management skills.
Funded by USAID
435041 The national strategic planning process for
HIV/AIDS/STDs in Tanzania
Leonard J. Kikuli1, Rowlando Swail, J. Timberlake2, R. Machaba3. INational
AIDS Control Programme, Dar Es Salaam; 2US Agency for international
Development, Da Es Salaam; 3Consultant-National AIDS Control Prog., Dar Es
Salaam, Tanzania
Issues: Need to mobilise a multi-sectoral national response for HIV/AIDS/STDs
Prevention and Control in Tanzania.
Project: Participatory development of a National Strategic Plan for
HIV/AIDS/STDs. Given limited success to mobilise government and private sectors in the fight against AIDS under its Mid-Term Plan II (MTP-II), the National
AIDS Control Programme (NACP) committed to multi-sector participatory planning process to develop its MTP Ill. The development consisted of a three phase
approach carried out by multi-sectoral partners that began with a situation analysis and national programme review to identify present issues and programming
gaps. The final phase culminated in a series of participatory strategic planning
workshops whereby public ministries, non-governmental/religious organisations
and the private sector developed their own strategic plans to address HIV/AIDS
within their respective organisations/sectors.
Results: The MTP II process produced a framework that begins with mission
statements for national, sectoral and NACP levels and defines goals, objectives
and strategies that reach from national, community, household to individual levels.
MTP III also includes an important recognition of advocacy strategies for approval
and implementation of a National HIV/AIDS/STD Policy and the formulation of a
multi-sectoral working committee to supervise the process.
Lessons Learned: A participatory process for the development of a National
Strategic Plan, while costly and time consuming, is an imperative for national
mobilisation efforts as it adds to involvement, commitment, understanding and
ownership for finding solutions to the epidemic.
S43505 Towards the development of a child-focused HIV/AIDS
prevention and care program
Michele Felix, I.F.F. Fonacier-Fellizar. 1#18 Unit 5 21st Avenue, Cubao Quezon
City; 2Children's Laboratory Foundation Quezon City, Philippines
Issue: An HIV/AIDS Prevention, Care and Support Program for children must be
child-focused.
Project: A two-year project which sought to assist organizations and funding
agencies to set-up "child-focused" HIV/AIDS Programs and Services was initiated
in 1996. Beginning with a nation-wide study of on-going efforts of child-serving
organizations including those without but with HIV/AIDS interventions, it moved
on to experiment on the propositions raised as a result of the research with
partner NGOs.
Result: Policies of an international funding agency was influenced in terms of
providing support, monitoring and evaluating HIV/AIDS projects of sub-grantees;
a number of partner organizations adopted changes towards child-focused programs and services; indicators of a child-focused/child-sensitive HIV/AIDS programs and services established and applied.
Lessons: Developing a Child-focused/child-sensitive HIV/AIDS programs and
services go through a process of unlearning and undoing socio-cultural constructs brought about by norms in designing so and the status and regard for the
population being served.
358*/43506 | Medical supply for HIV/AIDS in developing
countries: Thailand experience
Chaiyos Kunanusont, P. Satasit, W. Phoolcharoen. AIDS Division Dept. of CBS
MOPH, Nonthaburi, Thailand
Issue: Rapid advancement of HIV therapy accompanies high drug cost which
is not affordable to people in developing countries. Facing with expanding AIDS
epidemic and economic set back, Thailand has to adapt its program to fit scientific,

ethic, and economic situation.
Project: Thailand started anti-retroviral program in 1992. Budget increases but
coverage decreases due to large number of cases requesting supply. Cost effectiveness review in 1995 encouraged program change from "supply for service"
to "supply for research". The program now extends to (1) adapting regimens, (2)
developing new drugs and (3) natural history of people with HIV/AIDS who received anti-retrovirals (ARV), anti-opportunistic infection (01), or alternative care.