Mbn hiv/aids evaluation final report Team of consultants

4.4.2.2. Efficiency

It was difficult to collect information on the efficiency and sustainability of the generalist organisations due to (1) the limited time available for these visits, (2) the complex structures and programmes these organisations are involved in and (3) the fact that most of the processes have only just started. However the evaluators did collect some information on the factors that might influence the efficient contribution of these general counterparts to the fight against HIV/AIDS.

The 19 generalist organisations have integrated HIV/AIDS in the way that suited them best (AIDS work, integrated AIDS work or mainstreaming). One could not say that one option is preferable to another. It certainly enhances efficiency if counterparts stick close to their core business and use their (human) resources in an appropriate way. When activities have been integrated that are different to the core business, counterparts have trained their staff (PCRD, SCLC, Jekesa Pfungwa, ASHA, INSA, NISAA, SEF, BERDO) and/or have looked for complementary partnerships (BERDO). Due to their success, some counterparts are unable to respond to the increasing demand. They do not have enough counsellors, HVC volunteers or VCT services (PCRD, Mulanje hospital, ASHA, INSA, SCLC, BERDO) or staff is investing more than 40% of their time in HIV/AIDS-related activities (BERDO). This can challenge their efficiency, also for the whole programme. Partnerships with AIDS-focussed organisations should therefore be stimulated.

Regarding awareness building and prevention, the generalist organisations visited are able to efficiently transmit information on HIV/AIDS to their constituencies. Evaluators have seen interesting examples of awareness building activities integrated in social gatherings, school activities, and community meetings without needing extra funds or personnel (SWEAT, NISAA, Jekesa Pfunga, Mulanje hospital). Also regarding the generalist organisations, the effectiveness and efficiency of the awareness raising activities will depend on the HIV/AIDS competence of staff of the generalist organisations.
Some of the generalist organisations are involved in research and are developing appropriate methodologies and approaches regarding HIV/AIDS prevention to certain constituencies. The aim of these methodologies is to replicate them within the larger, broader organisations (APSA, SEF, JOPM, NISAA). This multiplier effect will have to be analysed in the coming years in order to be able to conclude to what extent this has been an efficient response to HIV/AIDS.