Identifying HIV and AIDS Service Delivery Gaps in Addressing the “Three Zeros”:

How to Use the Local AIDS Governance Barometer

Phoebe M. MachereAIDS 2012 - JulyWashington DC.

Introduction Local AIDS Governance Barometer (LAGB)

Model LAGB Purpose LAGB Application – Kabwe district, Zambia LAGB’s Contribution to the “Three Zeros”

Overview

To assist in making progress towards meeting the goals of:

Zero new HIV infections Zero discrimination Zero AIDS-related deaths

Idasa applies a Local AIDS Governance Barometer to address the fact that bad governance leads a waste of resources and energy intended to fight HIV and AIDS

Introduction

Local: Local community/district, local government AIDS: Focus on AIDS sector Governance: Good/Democratic AIDS Governance – “a set of

values, policies, and institutions by which a society manages its multi-sectoral response at all levels through interaction among state and non-state actors” (Cheema: 2000/Idasa: 2012). Values of governance include: Effectiveness & Efficiency; Transparency & Rule of Law; Accountability; Participation & Agency; and Equity.

Barometer: Tool to measure the perception of the quality of

governance and to identify bottlenecks If the score is below a certain minimum level,

urgent action is required to prevent further deterioration

What is the Local AIDS Governance Barometer?

To assess & strengthen HIV/AIDS governance in service delivery at local level

Promote accountability among all stakeholders engaged at various levels of the response to HIV & AIDS

Provide opportunities for multi-stakeholder dialogue to develop creative solutions to challenges in HIV & AIDS service delivery

Improve citizen participation in Local AIDS Governance

LAGB - Purpose

Effectiveness Efficiency

Key Question: To what extent do the implemented

activities contribute to achieving the

objectives as defined in the National AIDS

Strategic Framework?

Key Question:Are the HIV/AIDS activities by the

district multi-sectoral response

implemented in such a way that they yield

maximum results from available

resources?

Effectiveness & Efficiency

Transparency

Key Question: To what extent are all actors sharing information and

transparent in their decision-making

processes?

Key Question: To what extent do all

actors in practice adhere to the

rules/regulations/principles/guidelines as set out in the NASF and

other statutory instruments?

Rule of Law

Transparency and Rule of Law

Key Question: To what extent are the internal controls of the district multi-

sectoral response in place and effective to ensure that

money is used for the intended

purposes?

Key Question:To what extent

are the executives (office of the

Mayor or Chairperson) in

the district willing and able to justify their decisions to

the council (councillors)?

Key Question:

To what extent is the district multi-sectoral response willing and able to justify and explain their decisions to the citizens in the

district?

Social Accountability

Accountability

Administrative Accountability

Political Accountability

Key Question:

To what extent are citizens actively engaged in the district multi-

sectoral response’s decision-making

processes?

Key Question: To what extent are citizens directly or indirectly able to

express their HIV/AIDS needs and

interests to key players in the district

multi-sectoral response?

Participation & Agency

Claimed Space

CreatedSpace

Equity

Equity in Service Provision

Key Question: To what extent is the multi-sectoral

response successful in achieving equal access to HIV/AIDS

services and decision-making for

all citizens in the district?

Stakeholder Category Stakeholders in CategoryNumber per Stakeholder

Group

Government Employees

Employees from line ministries and departments, administrators of the local

council, National AIDS Council and representatives from the district &

community levels

21

Civil Society Organisations

NGOs, faith-based & community-based organisations, traditional leaders,

traditional healers, youth groups etc.21

Elected Local Representatives

Councillors and members of parliament 22

Private SectorPrivately owned businesses & business

associations5

People Living with HIV and Caregivers

Individuals living with HIV & AIDS and volunteers who provide them with care

services

37

LAGB Application in Kabwe District, Zambia

1. Workshop with each stakeholder group separately on HIV & AIDS governance and LAGB scoring process

2. Filling in of questionnaire and discussion 3. Score analysis and conversion into governance

index; discussion with representatives of all stakeholders

4. Identification of 3 most important governance issues related to HIV & AIDS service delivery

5. Collaborative drafting of an Action Plan to resolve identified bottlenecks

LAGB Application Cont.

Governance index

Government staff

Councillors Civil Society Org.

PLHIV and caregivers

0

20

40

60

80

100

52 54 5146

58

Overall Governance Index Scores LAGB Kabwe 2012

Governance Index

Effectiveness & Efficiency

Transparency & Rule of law

Accountability Participation Equity0

20

40

60

80

100

52 53 51 48 52

65

Main Governance Criteria Scores LAGB Kabwe 2012

Poor planning and coordination of HIV & AIDS activities between various service providers in Kabwe district

Lack of administrative, political, and social accountability of all service providers

Low HIV & AIDS rights awareness and lack of participation in the HIV & AIDS response by citizens

LAGB Application Kabwe – Core Issues

“Basically the workshop was of help because it personally made me realise the need for my organisation to fully participate as a multi-sectoral [player] and be transparent in the funds used in HIV activities.”

– Participant in Choma “The tool should be presented to the full Council to

enable the participation of the councillors in HIV & AIDS activities in the district” - Mayor of Choma

“Now that I understand my HIV & AIDS rights better, I will complain in a more constructive manner” – Citizen, Kabwe

“It was a good platform to share and learn about issues related to HIV/AIDS in the district” - Participant in Choma

Quotes from Stakeholders

Identifies and addresses capacity gaps in service delivery

Establishes mutual accountability – all key stakeholders are held accountable based on the decisions made during LAGB implementation

Enhances community knowledge and voice and the capacity to engage with sub-national government

Institutionalisation of LAGB at regional level, i.e. the Alliance of Mayor’s Initiative for Community Action on AIDS at the Local Level (AMICAALL)

Above all, it improves dialogue between elected leaders and the community to allow for common problem definition and resolution

How LAGB Contributes to Achieving the “Three Zeros”

To Contact Us:

Email: info@idasagap.org.za

Tel: +27 (012) 392 0500

Fax: (012) 320 2414/5

Ms. Machere: pmachere@pta.idasa.org.za

Thank You!