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Building in Times of HIV & AIDS
Regional AIDS Initiative of Southern Africa/VSO
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HIV & AIDS does not mean development business as usual. The
HIV & AIDS pandemic leads to specific challenges for development
agencies and for their partner organisations. In high-prevalence
countries, civil society organisations and governmental institutions
are all affected by HIV & AIDS and need to address the ever-changing
challenges around the pandemic. This forces development organisations
to analyse how the demands and effects of the HIV & AIDS pandemic
determine the needs of their partner organisations and what implications
this has for their capacity-building interventions. They are challenged
to look at capacity building ‘through an HIV & AIDS lens’.
is based on external evaluations of capacity-building interventions
within the Regional AIDS Initiative of Southern Africa (RAISA),
a programme of the international development agency Voluntary Service
(VSO). The RAISA
programme is a clear statement of intent to start on a learning
curve of responding to the spread and impact of HIV & AIDS and
to tackle the development management challenges that HIV & AIDS
presents to development practitioners, development organisations
and technical assistance agencies in particular. The programme supports
both organisations that have HIV & AIDS as their main focus
(e.g. AIDS service organisations or ASOs) and organisations working
in different areas that are challenged to adapt their external service
role to deal with the effects of HIV & AIDS.
Eight case studies
are presented, giving examples of the work of some RAISA partners,
their capacity-building needs, the support provided by VSO-RAISA
and the lessons learnt.
Based on these
lessons learnt, general organisational and institutional challenges
faced by partners are identified, with regard to their back-office
work, their front-office work, and going to scale:
with the impact of HIV & AIDS on their own workforce
& AIDS is affecting not only beneficiaries of partner organisations,
but also their own staff. A lot of partner organisations face
growing direct organisational costs for sick and compassionate
leave, medical expenses, funeral expenses and management time.
At the same time, work performance is inhibited by emotional stress,
stigma and sickness; and knowledge, learning and experience are
lost when staff members stop working or pass away. These challenges
are driving organisations to strengthen such responses as HIV
& AIDS workplace programmes, the training of additional staff,
adjustments to medical care packages or the addressing of stigma
and denial within their own institutional set-up and in its core
businesses. At the same time, the nature of and opportunity for
capacity building comes into question.
The functioning of the back office is not only challenged directly
by an impact on the workforce. HIV & AIDS is also changing
the scale and way of working of these partner organisations, requiring
organisational change and development of the back office.
that front- and back-office operations are synchronised and mutually
rapidly expanding HIV & AIDS organisations struggle to keep
their houses in order and ensure that front- and backoffice operations
are synchronised and mutually supportive. As a result of the growing
need for their services, many HIV & AIDS organisations experienced
rapid growth in terms of their service delivery, number of staff
and the funds that need to be managed. These organisations need
to strengthen their finance and administration systems to keep
up with the workload and the size of the organisation. The expansion
of services is not sustainable if there is not a strong supporting
constant pressure to deliver and expand services also brings challenges
with regard to the strategic positioning of HIV & AIDS organisations.
These organisations are confronted with needs and expectations
beyond their capacity and capability; they are occupied with 'doing'
and they struggle to find time and capacity for strategic planning,
monitoring and evaluation, reflection and learning and for acting
on these. Yet the capacity to position oneself strategically and
to keep innovating are crucial elements if an organisation is
to be strong and able to respond effectively to the pandemic.
Organisations need to strengthen their capacity to face their
limitations, to find their niche, to focus on certain aspects,
to decide what can be done better by other organisations, to keep
in phase with the pandemic and to proactively position themselves.
They must develop good systems for reflection, learning, and planning
to support these strategic decisions.
expanding, improving and/or adapting front-office services
& AIDS organisations face challenges in improving, expanding
and adapting their front-office services to changing and growing
needs as a result of the pandemic and this is closely linked to
the above-mentioned 'positioning and innovating' and 'going to
scale' capacities of the back office. HIV & AIDS organisations
need technical support in developing new or better services, and
in developing models that have a built-in multiplier mechanism.
impact of organisations on the pandemic depends both on the quality
of interventions (and their effectiveness) and on their coverage.
The challenge to organisations is to find ways to replicate models
of good practice at the lowest possible cost. This can include
expanding their operations, developing new models of good practice
and creating multiplier mechanisms; these include sharing models
of good practice (which are then adopted by other NGOs and/or
by government), horizontal learning, twinning, introducing cascade
models, setting up networks and influencing changes in the policies
and actions of governments and donors. For 'going to scale' to
be effective, it needs to be backed up by a lot of organisational
and institutional capacities mentioned under points 2 and 3 above:
for example a solid administrative and management system, a clear
vision on the role of the organisation and the way going to scale
fits in that strategy and a system for learning.
The five general
needs areas described above are relevant for both HIV & AIDS
organisations and organisations that don't have HIV & AIDS as
their main focus. The latter group faces similar challenges. They
need to deal with the impact of HIV & AIDS on their own workforce
as well. They also face challenges with regard to positioning and
innovation, as they have to find ways to deal with and adjust to
the pandemic in a way that is congruent with their core business.
As a result of their changed role, they may face sustainability
challenges as their services expand and their organisation grows,
and the need for back-office–front-office synchronisation increases.
Also, the need to find ways to adjust their services to the pandemic
may require technical support for the front office.
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