The Role of Civil Society

Conclusion and Recommendations

In summary and concluding with the national strategic objectives and the evaluation questions, this qualitative component of the evaluation found:

• 
  IEC was the most often utilized method to raise awareness of HIVSTIs, through one off events, training, workshops and mass media, such as printed and campaign advertisements. Although information was not tailored to the KAP and they were not satisfied with this aspect.
  
• 
  IEC was effective in raising awareness of HIV, but it did not place enough emphasis on STIs and hence knowledge of STIs signs and symptoms was very weak.
  
• 
  Based on feedback from the KAP it appears that the response to meet the prevention needs of most KAP was insufficient, although there were some very strong examples of responsive programming to SWs.
  

• 
  Any conclusions in the reduction of HIV/STI transmission must come from robust surveillance data through the quantitative evaluation of the NSP. However the perception of KAP is that people are not adopting safer behaviours and that transmission continues to increase as vulnerable people are not being adequately engaged.
  
• 
  There is some evidence of behaviour change among SWs as a result of BCC interventions to this population, but this was not seen with any other group.
  
• 
  With the exception of the SWs, the shift from IEC to BCC has not been far-reaching.
  

• 
  The treatment centre at LRU with associated support services should be seen as a best practice model for the Caribbean. PLHIV spoke of improved attitudes among staff, improved treatment regimens and an improved quality life. From the perspective of the KAP this was undoubtedly one of the strongest elements of the HIV response and they are keen that decentralization of HIV treatment does not reduce the quality care.
  

• 
  There was evidence that programming has been developed to address the socio-cultural and economic determinants of vulnerability. However extensive engagement of KAP was shown to be very weak, and this appears to be the reason why few persons have benefitted from these initiatives.
  
• 
  Stigma and discrimination in the general population and in the health sector does not appear to have improved and continues to hamper HIV prevention efforts. This enquiry showed very little evidence of structural interventions, such as policies or legislative reforms to address this issue, although IEC tackling S&D in schools was mentioned by youth. Therefore this was one the weakest areas in the HIV response according to KAP.
  

Recommendations

1. 
   Effective Programming-The National HIV/AIDS Commission (NHAC) needs to conduct a needs assessment of KAP and align its national strategic framework for HIV/STI based on expressed need.
   
2. 
   BCC with IEC –. More prominence should be given to providing the technical expertise and support to programmes in developing and implementing BCC interventions to KAP. To achieve high impact programming, theoretical frameworks and evidence based models should be utilized along with IEC material to support BCC programmes that include imagery of and messages to KAP.
   
3. 
   Civil Society Strengthening- the NHAC must key identify CSO and develop a strategy to build the capacity of these organizations to respond to the needs of KAP in HIV/STI programming and in order for them to deliver effective interventions.
   
4. 
   Enabling Environment, Stigma and Discrimination-Advance the human rights and gender equality agenda in national debates on HIV/STI prevention and infuse human rights and gender equality education and advocacy in interventions.
   
5. 
   On the Outside Looking – Governance structures of HIV/STI programmes should be examined with a view to strengthening and making meaningful the participation of KAP in decision-making.
   

Appendix I
Caribbean Public Health Agency (CARPHA)

Barbados National Strategic Plan 2008-2013 Evaluation

Focus Group Discussion Protocol

Prepared by Audrey Brown MSc, DLSHTM

Submitted August 19, 2014

Contents

Acronyms 5

Acknowledgements 7

Executive Summary 8

Introduction 11

Background 13

Methodology 15

Utilization-Focused Evaluation 15

Results-Based Monitoring and Evaluation 15

Appropriateness of Approach 16

Learning by Doing Approach 16

Data Collection Methods 17

Limitations 19

Evaluation Findings 20

Programme Area 1: Prevention and Control of HIV Transmission 23

Programme Area 2: Diagnosis, Treatment and care of PLHIV 33

Programme Area 3: Impact Mitigation and Support of PLHIV 44

Programme Area 4: Programme Management and Institutional Performance 51

Programme Area 5: Surveillance, Monitoring, Evaluation and Research 63

Conclusion 71

Appendices 73

Appendix 1 – Evaluation Protocol and Matrix 0

ACRONYMS 5

INTRODUCTION 6

EVALUATION PURPOSE 7

EVALUATION OBJECTIVES 7

EVALUATION QUESTION 8

EVALUATION DESIGN 8

Theoretical Framework 8

Learn by Doing Approach 9

Local Evaluation Team 9

External Evaluation Team 10

Evaluation Matrix 10

Evaluation Protocol 11

METHODOLOGY 12

Data Collection & Analysis 12

Proposed Timetable 13

Final Report 14

Dissemination of Findings 14

Barbados HIV/AIDS NSP EVALUATION MATRIX 15

Appendix 2 – External Evaluation Team Biographies 1

1

Appendix 3 – Focus Group Discussion Study 1

CARPHA EVALUATION OF BARBADOS NATIONAL HIV STRATEGIC PLAN 1

2008-2013 1

FINDINGS FROM FOCUS GROUPS DISCUSSIONS 1

Acknowledgments 2

List of Acronyms 6

Executive Summary 6

Overview 8

Methods 8

Limitations 9

FINDINGS FROM FOCUS GROUPS DISCUSSIONS AND INTERVIEWS 10

People Living With HIV 10

People with Disabilities 13

Sex Workers 16

Men who Have Sex with Men 17

Transgender People 19

Adolescents 21

Discussion 22

Programme Design 23

IEC versus BCC 23

The Role of Civil Society 24

Enabling Environment and Stigma and Discrimination 24

On the Outside Looking In 25

Conclusion and Recommendations 25

Recommendations 26

1. Background to Barbados National Strategic Plan 2008-2013 Qualitative Evaluation- Focus Group Discussion Protocol 31

2. Aims and Objectives 31

3. Consent and Ethics 32

4. Methodology and Approach 33

5. Data Analysis Plan 37

6. Activity Timetable 38

APPENDIX I-CONSENT FORMS 39

APPENDIX II-DRAFT FGD GUIDES 44

Appendix 4 – List of Documents Reviewed 0

Appendix 5 – List of Persons Interviewed 1

1. Background to Barbados National Strategic Plan 2008-2013 Qualitative Evaluation- Focus Group Discussion Protocol

The Research, Evaluation and Policy Development Unit (REPDU) of the Caribbean Public Health Agency (CARPHA) is the principal regional health institution charged with providing support to countries in the monitoring and evaluation (M&E) of national HIV and AIDS responses. In partnership with Barbados National HIV and AIDS Commission (NHAC), the REPDU will undertake a comprehensive end-of-term evaluation of the Barbados National Strategic Plan for the period 2008-2013 in September 2014.

The evaluation is underpinned by utilization focused (U-F) and results-based monitoring and evaluation (RBM&E) approaches. U-F evaluation concentrates on the evaluation questions which are of interest to stakeholders and promotes the use of findings through stakeholder involvement in the evaluation process (Patton, 2008).

In this instance in order to conduct a robust assessment of the impact of the NSP, it is critical to incorporate the views of the key affected populations (KAP) who have been the beneficiaries of services and interventions throughout the life of the NSP. In this way the real life experiences of KAP can provide the necessary contextual value to the evaluation findings.

Download 0.92 Mb.

Share with your friends: