Evaluating the effects of community-based organization engagement on HIV and AIDS-related risk behavior in Kenya

Kara S Riehman,Jakub Kakietek,Brigitte A Manteuffel,Rosalía Rodriguez-García,Rene Bonnel,N'Della N'Jie,Lucas Godoy-Garraza,Alloys Orago,Patrick Murithi,Joseph Fruh

doi:10.1080/09540121.2013.778383

Abstract

International donors have increasingly shifted AIDS funding directly to community-based organizations (CBOs) with the assumption that responding to the epidemic is best achieved at the community level. The World Bank, ICF Macro, and the National Council for Population and Development in Kenya, conducted a study to evaluate the community response in Kenya. The study used a quasi-experimental design comparing seven study communities and seven comparison communities in Nyanza Province and Western Province. We examined the impact of CBO activity on individual and community-level outcomes, including HIV knowledge, awareness and perceptions, sexual risk behavior, and social transformation (gender ideology and social capital). The study consisted of two components: a household survey conducted in all 14 communities, and qualitative data collected in a subset of communities. Individuals in communities with higher CBO engagement were significantly more likely to have reported consistent condom use. Higher CBO engagement was associated with some measures of social capital, including participation in local and national elections, and participation in electoral campaigns. CBOs provide added value in addressing the HIV and AIDS epidemic in very targeted and specific ways that are closely tied to the services they provide (e.g., prevention education); thus, increasing CBO engagement can be an effective measure in scaling up prevention efforts in those areas.

Highlights

Civil society organizations (CSOs) and communitybased organizations (CBOs)1 have been identified as essential to the global response to the AIDS pandemic (Schwartlander et al 2011)
Significant associations found between the key independent variables Á higher or lower community-based organizations (CBOs) engagement Á and measures of HIV knowledge, attitudes, perceptions, behavior, service utilization, and social transformation are in bold in the tables
Respondents in the study group had about three times higher odds of knowing that the chances of vertical transmission of HIV can be reduced by prevention of mother-to-child transmission (PMTCT)

Summary

Introduction

Civil society organizations (CSOs) and communitybased organizations (CBOs) have been identified as essential to the global response to the AIDS pandemic (Schwartlander et al 2011). CBOs have been engaged in providing services to infected and affected people worldwide (UNAIDS, 2005). CBOs are a key partner to governments in developing, implementing, and monitoring national responses to AIDS (UNAIDS, 2005). International donors have increasingly shifted their AIDS funding in sub-Saharan Africa toward activities and programs implemented at the community level, in low- and medium-income countries with a high HIV prevalence (UNAIDS, 2011). In addition to providing services such as care, support, and treatment, CBOs engage in local communities through other programs, such as conditional and unconditional cash transfers, income-generating activities, and microcredit schemes, especially the ones targeting marginalized groups with limited access to services and financial resources (Mohanty, 2006)

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Results

Conclusion