The True Cost of Stigma

April 15, 2011

Posted by Liza Tong

Alliance Programme Manager: Planning, Evaluation & Knowledge Management

An external evaluation of the Alliance’s Africa Regional Programme Phase 2 (ARP 2) found it has helped reduce HIV related stigma. The evaluation included calculating the social return on investment.

The ARP 2 ran from April 2008 to March 2011 with funding from the Swedish International Development Agency (Sida) and the Nowegian Ministry of Foreign Affairs. A total of 20 countries participated in the ARP 2 at national and regional level. Alliance Country Offices and Linking Organisations implemented activities in one or more of the programme components, which are:

•    to reduce stigma,
•    increase access to effective HIV prevention, and
•    strengthen networks of people living with HIV.

    The evaluation, conducted October 2010 – January 2011, will enable lessons learned to feed into the next phase of the programme. While the evaluation has found the programme to be an overall success, it also documents the challenges, which Phase 3 can build on, for example around programme design and monitoring.

    Positive change

    Positive changes resulting from the programme include:

    •    better attitudes and behaviours of service providers and communities towards people living with HIV and other vulnerable populations,
    •    examples of overcoming barriers to effective prevention for people at higher risk of HIV, including men who have sex with men, adults and children living with HIV, and sex workers,
    •    and better approaches to the use of research and evidence for advocacy and policy change related initiatives.

    Interestingly the evaluation has added to the recent internal debates around “what is the added value of regional programmes compared with national programmes?”– the Alliance’s more commonly applied  mode of programme delivery. The evaluation was clear that the regional nature of the programme has allowed knowledge sharing and activities to take place across the ARP countries that would not have otherwise happened. The programme has broken new ground and enabled the establishment of different relationships with major regional development stakeholders such as the South African Development Community (SADC), and the joint UNAIDS think tank around HIV for West and Central Africa, enabling the Alliance to bring community and national issues and the direct experience of Linking Organisations to the table at these regional events. In addition national networks of people living with HIV have been empowered to have a greater voice in decision-making, however the evaluation concluded it is too early to measure specific impact and policy change from this work.

    As an additional part of the methodology the evaluators analysed the cost–benefit of the stigma component of the programme, using the social return on investment method across two sites, Mumbwa and Mazabuka in Zambia.

    A return of 1: 21  and 1: 14 was calculated for each site i.e. for every $1 invested $21 of social and health related value was generated.

    Read more: Download the Evaluation of the Alliance’s Africa Regional Programme Phase 2 (ARP 2)

    The True Cost of Stigma: Evaluating the SROI of the stigma and discrimination component of the Alliance’s ARP 2

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