Evaluation of a multi-sector HIV capacity-building program in Nairobi informal settlements Open Access
Purvis, Danielle (2016)
Published
Abstract
Background: HIV incidence remains high in informal settlements of Nairobi informal settlements compared to the rest of Kenya. Many HIV interventions do not address the causes and the consequences of HIV concurrently, and most programs in informal settlements are not sustainable due to reliance on external donors. The current study is an evaluation of a leadership development program designed to mobilize community assets, develop collaborations, address social structural determinants of HIV, and improve HIV prevention and care practices.
Methods: Eight multi-sector teams based in Nairobi informal settlements participated in the Faith, Health Collaboration and Leadership Development Program (FHCLDP) from February to August 2015, which utilized a pedagogy that enhances community mobilization through participatory learning, action planning and implementation, and the engagement of stakeholders from multiple sectors. Researchers conducted a thematic analysis of workshop documents, team reports, and site visit field notes to determine the influence of the program on team practices following workshops.
Findings: Teams effectively mobilized community assets, formed and strengthened collaborations, addressed most social structural determinants of HIV, and implemented HIV prevention and treatment interventions. However, it is unclear how the program influenced HIV prevention and treatment practices, and no teams addressed structural determinants of HIV (e.g., poor infrastructure).
Interpretation: The FHCLDP demonstrates potential to build capacity in teams in low-resource communities to implement interventions that address the causes and consequences of HIV. Teams alleviated donor dependency by mobilizing local resources and strengthening local stakeholder relationships. In addition, they addressed pressing determinants of HIV while reinforcing care infrastructure in their informal settlements. Recommendations for the FHCLDP are provided.
Table of Contents
Executive Summary 1
Problem 1
Aim of the Current Study 1
Approach of the Current Study 1
Findings 1
Conclusions 2
Recommendations for the FHCLDP 3
Introduction 4
Problem Statement 4
Program Overview 4
Statement of Purpose 4
Background 5
Overview of HIV in Kenya 5
HIV in Nairobi Informal Settlements 6
Determinants of HIV in Nairobi Informal Settlements 9
Limitations in HIV Interventions in Informal Settlements 18
Recommendations for HIV Interventions 19
Purpose Statement 21
Research Questions 21
Methods 23
Program Overview 23
Study Population 28
Data Collection 30
Definition of Variables 32
Data Analysis 34
Results 36
Participants' Perceptions of the Program 36
Influence of Determinants on Team Practices 39
Influence of Curriculum on Team Practices 44
Barriers to Team Practices 58
Discussion 60
Public Health Implications 66
Limitations of the Current Study 67
Recommendations for the FHCLDP 69
Conclusion 69
References 71
Appendix 75
Appendix A: Call for Applications 75
Appendix B: Curriculum Overview 78
Appendix C: Case Studies 86
Appendix D: Community Asset Maps 89
Appendix E: Network Maps 90
Appendix F: Post-Workshop Surveys 92
Appendix G: Community Action Learning Guidelines 100
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