This case study has been prepared by MPact to analyze community approaches used to increase meaningful engagement in Global Fund processes to ensure access for key populations.
Being implemented in 23 countries and across 6 regions, the Global Fund (GF) technical assistance program aims to increase meaningful engagement of Key Populations communities in GF processes through a series of community meetings and consultations/training workshops; peer-to-peer coaching; tools development; watch-dogging HIV program implementation; facilitating partnerships between community actors and national decision makers; and integrating human rights-based strategies into national AIDS plans.
This program aims to achieve:
- Well-supported key population membership on County-Coordinating Mechanisms (CCMs);
- Stronger community engagement in concept note development;
- Development and implementation of HIV-related programs tailored to the needs of gay men and other men who have sex with men, transgender people and other key populations;
- Ongoing monitoring of Global Fund-funded program implementation to ensure alignment with normative guidance issued by UN agencies, including the WHO; and
- Transition and sustainability readiness.
The following summary was the result of in-depth questionnaires, interviews, and reviews with our partner at Lighthouse in Hanoi, Vietnam
Lighthouse, Vietnam hosted meetings to gather opinions from sub-sub-recipients and CBOs working under Global Fund grants. The aim was to develop recommendations on program management relevant to principle and sub-recipients. Participants included nine representatives from four CBO sub-sub recipients. The meetings provided an opportunity to have in-depth conversations with CBOs, listen to their experiences with project implementation, and gather their opinions on the way to empower communities.
Overcoming Communications Challenges
Doan Thanh Tung of Lighthouse noted that the initiative took place in the context of decidedly poor communications between the CCM and PRs in Viet Nam and community organizations and key populations groups. Community organizations have considerable difficulty accepting the idea that their opinions are valid and should be considered by the CCM and implementing PRs and SRs. The CCM in Viet Nam is a very formal structure and KP representatives do not have the capacity to speak in these fora. They are only allowed to speak in the meetings for a few minutes and have limited understanding of the Global Fund and its processes.
The Lighthouse project served to help empower CBOs and KP groups and build their confidence in advocacy. The information-gathering exercise and field training was designed to document genuine feedback from the community to influence the way the CCM and implementing PRs and SRs interact with KP groups and CBOs. Numerous recommendations, which, if taken into consideration by the CCM and implementing PRs and SRs, would have a positive impact on KP programming:
- Information about the Global Fund must be made accessible and kept up to date and shared regularly with all KPs networks and CBOs – minutes of CCMs, changes in Global Fund policies, and reports of visits to Viet Nam by Global Fund staff should be disseminated broadly. Lighthouse suggests that this information could be shared thought a Facebook page in Vietnamese that is accessible and promotes dialogue.
- An increased focus on community system strengthening (CSS) would improve the capacity and sustainability of communities and KP engagement in the response. Tung noted that currently the reporting and information exchange is limited to implementing SRs sharing their results with PRs. Communication among CBOs in all the provinces is not supported. An annual information sharing meeting of all implementing SSRs would lead to better programming and a more sustainable response.
- Capacity-building for the community was also noted as a priority by participants in Lighthouse analysis. The report calls for increased support in M&E, organizational development, fundraising, use of social meeting, data collection, and research methods. At the moment, the training provided by implementing PRs and SRs is project-specific and does not help CBOs and KP groups move forward to become sustainable entities. Training on stigma elimination or the harm reduction package is useful, but not sufficient in building a strong community response.
- There is insufficient attention paid to the safety and security of CBOs and community workers. Outreach workers and peer counsellors, for example, are often in danger, particularly if they are working in high-risk settings at night. Training on how to protect themselves is needed, and guidance on self-care would be an added advantage.
- Mapping quality services would improve access. It is also important that the services be monitored to ensure they are KP-friendly.
- Management reporting and monitoring systems used by PRs and SRs should be more flexible and responsive to changing circumstances. A small amount of money should be set aside to ensure that innovations and new initiatives suggested by CBOs can be supported. The current system is too rigid to allow for the changing reality in the community.
Lighthouse will submit the report to the Vietnamese CCM in early 2019. It may take some time to overcome the communications challenges between the various stakeholders, but this comprehensive and well-documented report will be an important step.
In terms of lessons learned, Lighthouse notes that building alliances across CBOs and KP organizations is essential. There is a need to focus beyond HIV and KP concerns to engage the broader community to ensure all voices are heard, especially with wider global discussion about Universal Health Coverage. This will mean expanding beyond a limited number of CBOs close to Han Oi to engaging community voices in all the provinces.
To follow up, Lighthouse will develop issue-specific fact sheets. If sufficient funding is available, they will host community meetings and information sharing opportunities with the broader community.