B Assessing needs and resources – the local environment

Before making a decision about what specific HIV/AIDS-related treatment work to do, an organization needs to understand what others are already doing in the area. This can help to avoid duplication of effort and to address people’s treatment needs more effectively.

An assessment can provide an opportunity to analyse which other organizations are involved, what they are doing and how well they are doing it. This will help the organization to decide where it might make the biggest difference.

An assessment of the local environment might involve some or all of the following: • other NGOs • government • hospitals • doctors • pharmacists • donors

• groups of people living with HIV/AIDS.

It could focus on three key questions, each of which can form the basis of both focus group discussions and participatory group activities:

• Question B.1: Who is involved in providing treatment for people living with HIV/AIDS

in your community?

• Question B.2: What HIV/AIDS-related treatment services are other organizations

providing in your community?

• Question B.3: How effective is the HIV/AIDS-related treatment work being done by

other organizations in your community?

Question B.1: Who is involved in providing treatment for people living with HIV/AIDS in your community?

Questions for focus group discussions:

• How many other organizations are involved in HIV/AIDS-related treatment in your community, and what type of organizations are they?

• What type of HIV/AIDS-related treatment work are they involved in? • What is the quality of their HIV/AIDS-related treatment work – effectiveness,

acceptability, efficiency, attitude to clients?

Participatory group activity

To identify which other organizations are involved in HIV/AIDS-related treatment work in your community.

Instructions

1. Ask participants to draw a map that shows the other organizations in HIV/AIDS-related treatment work in your community as different parts of a universe. Examples might

2. Ask participants to explain why different organizations have been drawn in different ways and what it shows about their work and their relationship to each other. 3. Discuss what can be concluded about who is involved in treatment work for people

living with HIV/AIDS.

Facilitators’ notes

• Encourage participants to use the parts of the universe to communicate their feelings about an organization. For example, if they feel positive about it, they might draw it as a sun.

• If participants are not comfortable with drawing a universe, ask them to draw the organizations as any other shapes that communicate how they feel about them.

Example

Question B.2: What HIV/AIDS-related treatment services are other organizations providing in your community?

Questions for focus group discussions:

• What HIV/AIDS-related treatment services are other organizations offering to people living with HIV/AIDS in your community?

• What scale of HIV/AIDS-related treatment services are other organizations providing? • Where and to whom are other organizations providing HIV/AIDS-related treatment?

Participatory group activity

To assess what HIV/AIDS-related treatment services other organizations are providing in your community.

Instructions

1. Explain the aim of the activity.

2. Ask participants to select an HIV/AIDS-related treatment that is available in your community. Ask them to brainstorm about the organizations that are providing it. 3. Ask participants to draw a diagram with the treatment in a circle at the centre and the

organizations in circles around it. If the organization can provide a lot of the treatment, ask them to put it in a circle close to the treatment. If they can only provide a little, ask them to put it at a distance.

Handbook on access to HIV/AIDS-related treatment

Red Cross clinic Ministry of Health Groups of people with HIV/AIDS Other local NGOs Donors • local • international UN3F89 p95-113_CAG 8.5.2003 9:26 Page 102

4. Repeat the activity for two to three other examples of HIV/AIDS-related treatment. 5. Discuss what can be concluded about the HIV/AIDS-related treatment services offered

by other organizations in your community.

Facilitators’ notes

• Encourage participants to select a variety of HIV/AIDS-related treatments – from simple drugs (such as paracetamol) to complex ones (such as antiretrovirals).

• Ensure that participants include both formal sources of the treatment (such as hospitals) and informal sources (such as markets).

Example

Question B.3: How effective is the HIV/AIDS-related treatment work done by other organizations in your community?

Questions for focus group discussions:

• What are the strengths of the HIV/AIDS-related treatment work done by other organizations?

• What are the weaknesses of their work?

• What are the significant gaps or duplications among other organizations involved in treatment?

Participatory group activity

To assess the effectiveness of the HIV/AIDS-related treatment work carried out by other organizations in your community.

Instructions

1. Explain the aim of the activity.

2. Ask participants to select an organization involved in HIV/AIDS-related treatment in your community. Write each type of treatment that it provides on a separate piece of paper.

3. Draw a ranking line with ‘not effective’ at one end and ‘very effective’ at the other. 4. Ask participants to place the pieces of paper along the ranking line, according to

TB DRUGS Hospital Church home-based care team Market traders Government clinic NGO clinic

5. Repeat the activity for another two or three organizations.

6. Discuss what can be concluded about how effective the HIV/AIDS-related treatment work is by other organizations in your community.

Facilitators’ notes

• Encourage participants to look at a broad variety of organizations providing treatment, including government, nongovernmental and traditional.

• Support participants to offer honest and constructive criticism about the work of the organizations, rather than being too negative.

Example