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Transitioning a Large Scale HIV/AIDS Prevention Program to Local Stakeholders: Findings from the Avahan Transition Evaluation.

Bennett S, Singh S, Rodriguez D, Ozawa S, Singh K, Chhabra V, Dhingra N - PLoS ONE (2015)

Bottom Line: Service coverage outcomes were sustained at least six months post-transition.The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage.Five key lessons for transition design and implementation are identified.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, International Health Department, 615 North Wolfe St, Baltimore, MD, United States of America.

ABSTRACT

Background: Between 2009-2013 the Bill and Melinda Gates Foundation transitioned its HIV/AIDS prevention initiative in India from being a stand-alone program outside of government, to being fully government funded and implemented. We present an independent prospective evaluation of the transition.

Methods: The evaluation drew upon (1) a structured survey of transition readiness in a sample of 80 targeted HIV prevention programs prior to transition; (2) a structured survey assessing institutionalization of program features in a sample of 70 targeted intervention (TI) programs, one year post-transition; and (3) case studies of 15 TI programs.

Findings: Transition was conducted in 3 rounds. While the 2009 transition round was problematic, subsequent rounds were implemented more smoothly. In the 2011 and 2012 transition rounds, Avahan programs were well prepared for transition with the large majority of TI program staff trained for transition, high alignment with government clinical, financial and managerial norms, and strong government commitment to the program. One year post transition there were significant program changes, but these were largely perceived positively. Notable negative changes were: limited flexibility in program management, delays in funding, commodity stock outs, and community member perceptions of a narrowing in program focus. Service coverage outcomes were sustained at least six months post-transition.

Interpretation: The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage. Notwithstanding, there were substantive program changes post-transition. Five key lessons for transition design and implementation are identified.

No MeSH data available.


Related in: MedlinePlus

Sustained outcomes: High risk groups contacted by peer educators.
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pone.0136177.g003: Sustained outcomes: High risk groups contacted by peer educators.

Mentions: Figs 3 and 4 show trends in services before and after transition in a pooled sample of TIs that transitioned in 2011 and 2012. Service coverage is captured by the average percentage of HRGs contacted by peer educators per month (Fig 3) and the average number of condoms distributed per HRG per month (Fig 4). Data were standardized around the same transition date, and pooled as there was no clear difference in trends in services between TI programs transitioning in 2011 and 2012.Overall, it appears that service coverage was sustained at least up to six months post transition.


Transitioning a Large Scale HIV/AIDS Prevention Program to Local Stakeholders: Findings from the Avahan Transition Evaluation.

Bennett S, Singh S, Rodriguez D, Ozawa S, Singh K, Chhabra V, Dhingra N - PLoS ONE (2015)

Sustained outcomes: High risk groups contacted by peer educators.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556643&req=5

pone.0136177.g003: Sustained outcomes: High risk groups contacted by peer educators.
Mentions: Figs 3 and 4 show trends in services before and after transition in a pooled sample of TIs that transitioned in 2011 and 2012. Service coverage is captured by the average percentage of HRGs contacted by peer educators per month (Fig 3) and the average number of condoms distributed per HRG per month (Fig 4). Data were standardized around the same transition date, and pooled as there was no clear difference in trends in services between TI programs transitioning in 2011 and 2012.Overall, it appears that service coverage was sustained at least up to six months post transition.

Bottom Line: Service coverage outcomes were sustained at least six months post-transition.The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage.Five key lessons for transition design and implementation are identified.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, International Health Department, 615 North Wolfe St, Baltimore, MD, United States of America.

ABSTRACT

Background: Between 2009-2013 the Bill and Melinda Gates Foundation transitioned its HIV/AIDS prevention initiative in India from being a stand-alone program outside of government, to being fully government funded and implemented. We present an independent prospective evaluation of the transition.

Methods: The evaluation drew upon (1) a structured survey of transition readiness in a sample of 80 targeted HIV prevention programs prior to transition; (2) a structured survey assessing institutionalization of program features in a sample of 70 targeted intervention (TI) programs, one year post-transition; and (3) case studies of 15 TI programs.

Findings: Transition was conducted in 3 rounds. While the 2009 transition round was problematic, subsequent rounds were implemented more smoothly. In the 2011 and 2012 transition rounds, Avahan programs were well prepared for transition with the large majority of TI program staff trained for transition, high alignment with government clinical, financial and managerial norms, and strong government commitment to the program. One year post transition there were significant program changes, but these were largely perceived positively. Notable negative changes were: limited flexibility in program management, delays in funding, commodity stock outs, and community member perceptions of a narrowing in program focus. Service coverage outcomes were sustained at least six months post-transition.

Interpretation: The study suggests that significant investments in transition preparation contributed to a smooth transition and sustained service coverage. Notwithstanding, there were substantive program changes post-transition. Five key lessons for transition design and implementation are identified.

No MeSH data available.


Related in: MedlinePlus