Mbn hiv/aids evaluation final report Team of consultants

4.2.2. Assessment of the achievements

4.2.2.1. Effectiveness

The majority of the counterparts have struggled reacting openly and transparent to the problem of HIV/AIDS among staff and were not active managing HIV/AIDS in the workplace by the elaboration of HIV/AIDS workplace policies. Therefore the CFAs reacted to organise workshops, to fund pilot projects and to elaborate donor guidelines for funding of overhead costs. In fact due to the joint focussed work in the SAN! project “Managing HIV/AIDS at the workplace” the CFA’s understanding of this issue deepened and their vision changed. As long as HIV/AIDS is not managed at the workplace, it will remain unmanageable in the community. The workplace is a good place to start “de-stigmatizing” HIV/AIDS. If staff thinks that HIV/AIDS happens only in the community and not among colleagues, it contributes to “othering” the HIV/AIDS epidemic.

All counterparts in Southern Africa have become aware of the importance of internal mainstreaming and are in the process of drafting an HIV/AIDS workplace policy (except 4). 11 of the 32 counterparts are implementing their workplace policy. A few of them have managed to cover treatment costs for staff (and relatives). No action plans and monitoring systems have been developed so far, hence it is too soon (no information available) to assess the impact of the implementation of these workplace policies. In a few organisations staff reported a breaking of the silence on HIV/AIDS among the staff and the creation of a more open and supportive culture within the organisation. But in the majority of the organisations fear for disclosure of the status was still apparent.

In India, the understanding of internal mainstreaming is still poor, due to the stage of the epidemic and the recent start of discussions on mainstreaming (limited acknowledgment of the importance of a workplace policy among senior staff but not materialised by all staff). There are no processes to adapt existing human resource policies to the changing context, such as the inclusion of non-discrimination clauses.

CFA’s do their best to get internal mainstreaming (workplace policy development, with attention to the personalizing of HIV/AIDS) on the agenda of Indian counterparts as can be seen by the linking and learning initiatives.

The following can explain the difficult and sometimes slow process of internal mainstreaming:

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  Development of workplace policies is of a recent date (since 2003-2004)
  
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  In low prevalence regions especially, people have not yet internalised the causes and consequences of HIV/AIDS in their personal lives and organisations as a result of the low(er) visibility of HIV/AIDS compared to sub-Saharan Africa
  
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  Many organisations have developed draft workplace policies. The implementation of the policies was confronted with some bottlenecks, such as the lack of funding and/or ethical discussions on the content of these workplace policies within boards.
  
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  The pilot SAN!project in Ethiopia¹³ showed that workplace development is not an easy process and is not just hampered by a lack of funding. The outcomes of the pilot showed that the process of developing an HIV/AIDS workplace policy and program strongly depended on the institutional strength of the counterpart, the commitment at a senior level and the mandate and time allocation given to focal points.
  

All (generalist) counterparts made the link with external mainstreaming and responded to the HIV/AIDS epidemic mainly by adding HIV/AIDS-related activities to their core activities. Staff do know how HIV/AIDS affects the people with whom they work and their efforts to escape from poverty. The latter is based on daily experiences, and not as such on in-depth community research.

To support these processes, the CFAs have challenged their counterparts through partner consultations and the organisation of workshops mainly in mainstreaming, starting with internal mainstreaming. All of the counterparts appreciate these efforts but are demanding a more challenging dialogue with their respective programme officers. Programme officers were not enough involved in strategic discussions on HIV/AIDS, or in discussions on linking gender and HIV/AIDS, or how the counterparts could scale up the HIV/AIDS competence of its staff and organisations. Reasons for the sometimes low quality of the dialogue can be found in the following:

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  The co-financing system is result-oriented; consequently this put pressure on the monitoring task of programme officers while visiting their counterparts. They have to get a precise picture of the outcomes of the organisation. Apparently there is not enough space or time for in-depth discussions and reflections. One should investigate how the limited overhead costs (9%) in the co-financing system affects the burden on the programme officers. Besides, the impact of the HIV/AIDS epidemic on the results is clear, however a new paradigm that takes into account issues, like lost capacity, is not yet found. Consequently this puts psychological pressure on programme officers while visiting their counterparts.
  
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  The programme officers are not HIV/AIDS specialists (recently changed at Hivos) and do not necessarily feel competent to discuss HIV/AIDS with counterparts; in most cases these counterparts can be regarded more as a specialist than the programme officer of the CFA. The programme officers should have skills to be competent in the discussion, although not knowing all the details or being a medical specialist on HIV/AIDS.