Evaluating the effects of community-based organization engagement on HIV and AIDS-related risk behavior in Kenya

Abstract

International donors have increasingly shifted AIDS funding directly to community-based organizations (CBOs) with the assumption that responding to the epidemic is best achieved at the community level. The World Bank, ICF Macro, and the National Council for Population and Development in Kenya, conducted a study to evaluate the community response in Kenya. The study used a quasi-experimental design comparing seven study communities and seven comparison communities in Nyanza Province and Western Province. We examined the impact of CBO activity on individual and community-level outcomes, including HIV knowledge, awareness and perceptions, sexual risk behavior, and social transformation (gender ideology and social capital). The study consisted of two components: a household survey conducted in all 14 communities, and qualitative data collected in a subset of communities. Individuals in communities with higher CBO engagement were significantly more likely to have reported consistent condom use. Higher CBO engagement was associated with some measures of social capital, including participation in local and national elections, and participation in electoral campaigns. CBOs provide added value in addressing the HIV and AIDS epidemic in very targeted and specific ways that are closely tied to the services they provide (e.g., prevention education); thus, increasing CBO engagement can be an effective measure in scaling up prevention efforts in those areas.

A systematic review of components of community-based organisation engagement

“…The majority of studies ( n = 13) in this review were case studies. The remaining studies included quantitative design (Bloom et al., ; Chandra et al., ; Geist, ; Glik et al., ; Goytia et al., ; Patterson et al., ); qualitative design (Boutain & McNees, ; Burkhalter et al., ; Collignon, Men, & Tan, ; Honeycutt et al., ; Johnson et al., ; Radermacher, Karunarathna, Grace, & Feldman, ; Taras et al., ); systematic review (Frew et al., ); and mixed‐method design (Houston et al., ; Kakietek et al., ; Kelaher et al., ; Laborde, Brannock, Breland‐Noble, & Parrish, ; Riehman et al., ).…”

“…Generally, engagement of CBOs creates and encourages trust, builds alliances, mediates relationships and improves health outcomes in the target community (Akintobi et al., ; Bloom et al., ; Burkhalter et al., ; Collignon et al., ; Houston et al., ; Johnson et al., ; Kakietek et al., ; Kelaher et al., ). Unlike outcomes for a research study, where the main focus is meeting the specific aims of that study, CBOE goes beyond the desired results of a research project and includes the product of the partnership (Caldwell et al., ; Darling et al., ; Johnson et al., ; Riehman et al., ).…”

“…For example, a CBO that served abused Latina women engaged in a partnership that led to the development of a workplace intervention that increased the access and use of intimate partner violence (IPV) services that were culturally appropriate and incorporated into daily routines (Bloom et al., ). Other reported benefits to target communities were: removal of soda/vending machines, increase in colorectal cancer screening, creation of jobs, availability of HIV/AIDS prevention services, reduced HIV risk behaviours, stress management for Latina women with breast cancer and reduction in air pollution (Boutain & McNees, ; Caldwell et al., ; Kakietek et al., ; Kelaher et al., ; LoConte et al., ; Napoles et al., ; Riehman et al., ).…”

“…In the articles, descriptions of CBOE were elicited in different ways. Some examples are: evaluation of research partnerships with CBOs (Bloom et al, 2009;Honeycutt et al, 2015;Riehman et al, 2013), process of engagement of CBOs (Akintobi et al, 2012;Boutain & McNees, 2013;Chandra et al, 2013;Chaskin et al, 2006;Goytia et al, 2013;Johnson et al, 2006;Radermacher et al, 2011;Singer et al, 2015;Taras et al, 2015) and experiences/lessons from research partnerships with CBOs (Darling et al, 2015;McFarlane et al, 2014;Napoles et al, 2014;Taras et al, 2015). The components that were discovered from the articles were synthesised and categorised leading to the emergence of four salient themes: Need, Partnership Dynamics, Resources and Outcomes.…”

Mobilizing civil society for the HIV treatment cascade: a global analysis on democracy and its association with people living with HIV who know their status

“…These organizations typically serve as “gatekeepers” and possess expertise and knowledge of the individuals in the communities that they serve . Past studies have shown that community mobilization and CSO engagement in communities was associated with greater knowledge of HIV/AIDS, changes in attitudes towards HIV risk behaviours, access to HIV/AIDS‐related services, and greater health‐seeking behaviours that include HIV testing, and the uptake of HIV prevention methods among community members .…”