Evaluating the effects of community-based organization engagement on HIV and AIDS-related risk behavior in Kenya

Abstract

International donors have increasingly shifted AIDS funding directly to community-based organizations (CBOs) with the assumption that responding to the epidemic is best achieved at the community level. The World Bank, ICF Macro, and the National Council for Population and Development in Kenya, conducted a study to evaluate the community response in Kenya. The study used a quasi-experimental design comparing seven study communities and seven comparison communities in Nyanza Province and Western Province. We examined the impact of CBO activity on individual and community-level outcomes, including HIV knowledge, awareness and perceptions, sexual risk behavior, and social transformation (gender ideology and social capital). The study consisted of two components: a household survey conducted in all 14 communities, and qualitative data collected in a subset of communities. Individuals in communities with higher CBO engagement were significantly more likely to have reported consistent condom use. Higher CBO engagement was associated with some measures of social capital, including participation in local and national elections, and participation in electoral campaigns. CBOs provide added value in addressing the HIV and AIDS epidemic in very targeted and specific ways that are closely tied to the services they provide (e.g., prevention education); thus, increasing CBO engagement can be an effective measure in scaling up prevention efforts in those areas.

Keywords:

• HIV
• community
• community-based organization
• prevention
• Kenya

Acknowledgements

The evaluation was supported by the World Bank, and the National AIDS Control Council (NACC) as part of the Evaluation of the Community Response to HIV and AIDS. It was conducted by ICF International in cooperation with the National Coordinating Agency for Population and Development in Kenya.

Notes

1. For the purposes of this paper, CBOs include the following: (1) CSOs, (2) CBOs, (3) nongovernmental organizations (NGOs), (4) international NGOs, (5) faith-based organizations, and (6) other organizations that play the role of coordinating and/or funding a cluster of other organizations that may be branches of the umbrella organization, which may have a common activity focus, or which may fall within a geographic demarcation.

2. CBO funding flow and resource allocation data were also collected, and the results are reported elsewhere (Krivelyova et al., 2013).