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EVALUATING HIV
AND AIDS:
WHY CAPACITY DEVELOPMENT
Professor Desmond Cohen HIVDEV Consultant August, 2000
Not to be circulated in altered form without the permission of the authors
1. UNDERSTANDING CAPACITY DEVELOPMENT The core of UNDP's mandate is the achievement of sustainable human development, and the instrument for doing this is capacity development. The term capacity development can be defined as follows: - Capacity is the ability of individuals and organizations to perform functions effectively, efficiently and sustainably. The term 'capacity development' is preferred to 'capacity building'; while capacity strengthening is important so are the retention of existing capacity, improvements in the way in which existing capacity it being utilized, and the retrieval of capacity which has been eroded or lost. Thus capacity development does NOT take place only through the training of additional staff or the creation of new organizations, but requires an enabling environment to ensure that people are used effectively, retained within organizations and structures that need their inputs, and are motivated to perform their tasks. All projects and programmes need to develop a capacity development strategy and should be evaluated on the basis of whether they addressed the key issues that this involves. Central to evaluation of the project or programme is whether in the formulation of a capacity development strategy it undertook a capacity assessment, and on the basis of this assessment put in place conditions relating to capacity that ensured that the project was both feasible and sustainable. A capacity assessment involves an analysis of capacity issues such as the following: - * The overall context: an examination of relevant economic, social and political conditions. Factors would include political commitment to capacity development; the functioning of labour and asset markets; the standards of tertiary and professional training institutions, and the extent of the HIV epidemic. Unless a supportive overall environment is available then resources will inevitably be wasted; identifying and addressing the policy and programme constraints to capacity development are critical first steps in ensuring that objectives will be achieved.
What would be the main areas of focus of capacity development strategies in the light of the capacity assessment? These might include at each level the following: - * The overall context: sustained investment in human resource development; the strengthening of institutions that mediate and prevent social conflict and build social capital; increased participation of communities in the design and implementation of development programmes, and mechanisms for ensuring that public policy and programmes are delivered in ways that are efficient and respond to the needs of sustainable development.
It is self evident that donors have a clear interest in supporting the capacity development strategies of national governments through the full integration of their programme activities with those already underway or planned at country level. This makes it essential that donors formulate their activities for capacity development within coherent frameworks that ensure consistency with what each other is planning to do, and also consistent with national needs and capacities.? It may be necessary for donors to support the establishment of coordination machinery, and the strengthening of national capacity to effectively coordinate donor activities. Now donors need also to avoid those activities that are destructive
of national capacity, such as agency recruitment of key staff
away from national uses, and the distortion of national pay scales through
excessive payments to some nationals. The objectives of donors
should be that of supporting national capacity development through human
resource investment, and the strengthening of the policy environment
for a more effective delivery of projects and programmes that are relevant
for sustainable development. Achieving these objectives may
in some cases require that donors through their activities seek
initially to strengthen the capacity to undertake capacity development
as a prior first step towards more effective general performance.
How does one ensure that capacity development is integral to projects and programmes? It is clear from research that putting in place a capacity development strategy and activities for its implementation at the design stage of projects is a sine qua non for more? effective performance. It follows that unless the capacity development issues noted above are addressed at the design stage, and relevant activities identified and implemented as integral to projects and programmes, then there will be only very partial and weak overall performance. Monitoring and evaluation benchmarks will need to be developed at the design stage of projects and programmes. These benchmarks would reflect the priorities selected for interventions based on an analysis of critical constrains, taking into account the fact that project and programme objectives and modalities will require adjustment during the life of the project [and not be left to end of project evaluation]. The review and evaluation processes would examine the quality, timeliness and quantity of services provided in relation to organizational goals and client needs. It would examine these within the broader context: of capacity assessment and follow-up, organizational management, structures and performance, and in terms of the availability and utilization of human resources. It follows, of course, that capacity development for undertaking relevant
project and programme evaluation may itself have to be supported
through specific activities in order to ensure that the capacity for effective
monitoring and evaluation is brought into existence. This is
the familiar problem that capacity may have to be strengthened so as to
have the capacity to do what is required for better development
outcomes. It also follows that once such capacity has been developed that
mechanisms will be needed to ensure that it is effectively
utilized.
2. CAPACITY DEVELOPMENT, THE HIV EPIDEMIC AND EVALUATION Section 1 sets out the reasons why capacity development is the critical instrument for achieving development objectives, and it reviews those factors relevant to its full integration in projects and programmes. The important question seems to be not whether the principles and criteria for effective capacity development as described earlier are changed in a world of HIV and AIDS.? If anything these guiding principles continue to be just as apposite, and the need for capacity development is enhanced rather than diminished.? Rather the important issues relate to the way in which the epidemic changes the context within which capacity development strategies are expected to function, and the difficulties of sustaining capacity in the face of the epidemic. It is worth reviewing those factors which change the context and feasibility
of capacity development and the ways in which these affect
the criteria that are important for evaluation of projects and programmes.
The issues are complex and the particular situations are very
diverse, therefore the following discussion should be seen as illustrative
rather than definitive. The aim is to increase understanding
of the effects that the HIV epidemic has on capacity development
strategies and the effects on implementation and thus on evaluation of
projects and programmes.
How is the stock of Human Capital affected by HIV and AIDS? HIV prevalence is concentrated amongst those in the key social and working age groups ñ between the ages of 15-45. If anything young women seem to get infected at earlier ages than young men and thus lose more years of healthy life. There is evidence that in mature epidemics in many countries of sub-Saharan Africa that more women are infected than men [with a ratio of 6:5]. There is also evidence that at the early stages of the epidemic that HIV infection seems to be if anything greater for those in higher educational and occupational groups, with important implications for the maintenance of both the stock and the flow of those human resources that require substantial social investment. While HIV prevalence may be highest in urban areas it is nevertheless the case? that absolutely the largest numbers of those infected are in rural areas in sub-Saharan Africa. Rates of HIV prevalence amongst adults in many countries in SSA are now in the range 15-35%, with even higher rates in some locations and cities. The severity of the epidemic affects all social and occupational groups, including both men and women, those with higher level skills and experience and those who are supposedly 'unskilled'. Amongst the latter category are most of the rural population who in fact have very valuable and hard to replace task-specific experience and skills. Since HIV is concentrated amongst the core of the working population
who have important social roles, the support and socialization
of children in particular, then there are bound to be effects both on this
generation and on subsequent generations. It follows that not
only is the structure within families changed by its experience of the
epidemic, including gender roles, but that there are also very
important issues to do with maintaining households as productive enterprises.
What can be concluded from the losses of human resources that are critical for capacity development? Most obvious are the losses of human capital due to the epidemic ñ skilled, educated, unskilled men and women, in both urban and rural locations. So one important issue is how to sustain production in circumstances of high morbidity and mortality across wide swathes of the active labour force. All programmes and projects have to deal with this fact: how can production be maintained in the face of ongoing and often severe losses of labour? In situations where losses are disruptive precisely because they are not confined to categories of labour that may be 'easily' replaceable, but also affect many categories of labour including supervisory and managerial. It follows -
What does this mean for Evaluation of Projects and Programmes ? There is perhaps no need to detail what the implications of the foregoing are for capacity development and for the evaluation of projects and programmes for this ought to be more or less self-evident. Not only are the kinds of projects and programmes that need to be implemented changed so as to meet the new priorities of those countries that are deeply affected by the epidemic, but projects and programmes have now to deal not only with issues of how to strengthen capacity but also how to maintain it in the face of multiple forces that are systematically reducing existing capacity. This is occurring in conditions, where as noted above, the capacity to address and solve problems is itself diminished by the losses of human resources and the associated reduction in problem-solving capacity within social and economic organizations. It follows that it is even more essential that all of the factors and
principles identified in Section 1 in respect of designing
and implementing capacity development be integral to all projects and programmes.
It is not that the principles for effective capacity development
are intrinsically changed by the epidemic but rather that sustaining
capacity becomes an even more central objective for all projects and programmes,
along with the aim of ensuring that projects and programmes
address how best to achieve their objectives under conditions where both
direct and indirect factors are undermining capacity.? This
must also include the capacity of other organizations [such as what is
happening to relevant networks] and of public administration
and other state institutions [and thus the public production of goods and
services].
What are the Strategic Evaluation Questions where the Objective is Capacity Development? What follows is intended to provide some guidance to those undertaking
evaluation of projects and programmes in countries with high
rates of HIV prevalence. It is not intended to be complete but aims instead
to generate some insight into the kinds of strategic questions
that need to be addressed by evaluators if capacity development as described
above is to be realized. It is more of a check-list, as an instrument to
ensuring that these important issues are addressed by projects
and programmes, and do in fact become an important part of the overall
criteria used by evaluators.
Thus: - CONCLUSION Capacity development in the circumstances of the HIV epidemic is significantly more difficult to achieve but simultaneously the objective becomes even more important for the successful outcome of projects and programmes. Thus ensuring that projects and programmes at the design stage take account of the many ways that the HIV epidemic undermines capacity in all of its dimensions, both directly and indirectly, and responding to this challenge in ways that lead to effective outcomes become important evaluation criteria. Did the project or programme set out to achieve capacity development, and was it successful in doing so in a sustainable way, becomes perhaps the most important criteria by which to evaluate performance.?
Select Bibliography There is a large literature on the HIV epidemic and on generic issues of evaluation but relatively little that addresses issues of capacity development and HIV in the context of evaluation. The following are some suggestions for follow up and web sites are given as the most easily accessible way of finding sources. Capacity Assessment and Development In a Systems and Strategic Management Context [Technical Advisory Paper No.3, Management Development and Governance Division, UNDP Jan 1998]. [ Home to http://www.hivdev.org.uk ] |