THE COMBINED CASES: DUANG PRATEEP & THE AIDS COUNSELLING AND TRAINING CENTRE Discussion Question 1: What do you see as the major differences and similarities between the AIDS programmes of Duang Prateep and ACT ...
in terms of:
(a) Programme planning and design:
- Duang Prateep already had experience with and the trust of the community before they began working in the field of HIV/AIDS prevention; ACT was an externally-based organisation with no previous background in Klong Toey.
- As soon as Duang Prateep decided that it should be concerned about HIV/AIDS, it involved the community in meetings to jointly learn about the epidemic and to begin to identify the needs within Klong Toey. ACT came to Klong Toey with its own agenda. However, both organisations ended up with similar objectives.
- Duang Prateep's background with the community, based on the perceived success of their other social service programs, allowed it to focus immediately on interventions related to HIV/AIDS. Given the sensitive nature of HIV/AIDS, together with some level of denial that it was even a problem for Klong Toey residents, ACT felt it first had to build an entry to the community through the clinic.
- Duang Prateep was clearly experienced in carrying out surveys and used these as means of learning about the groups it had targetted for attention; ACT simply started offering medical services, piggybacking HIV/AIDS counselling, information and testing on to these.
(b) Reach into the community:
- Both organisations used volunteers: Duang Prateep used mainly Klong Toey residents; ACT had to search for volunteers outside of Klong Toey due to its lack of relationship with the Klong Toey communities.
- Duang Prateep's roots in Klong Toey allowed it immediate access; ACT had to work slowly to build up trust through the clinic.
- Duang Prateep had targetted specific groups and its staff went out to learn and interact with them. ACT'S programme was not specifically targetted at any one group; rather the programme aimed at providing services to the general community (except for their approach to the brothels).
(c) Assessing the effectiveness of the programmes:
- Duang Prateep regularly checked changes in community knowledge, attitudes and practice through surveys; ACT tended to count outputs as a measure of effectiveness.
- ACT set itself clear output objectives; Duang Prateep's objectives were vaguer, although they did try to deal with impact.
- Duang Prateep used regular assessments to change programme strategies; there is no information in the case which indicates that ACT did the same.
- Duang Prateep seemed to have a difficult time in making an impact in any of their programmes, but the staff kept searching for new ways to influence the situation.
- Duang Prateep changed its approach several times (from mass campaign to small group presentations and discussions; from ex-IDUs as peer educators to Duang Prateep volunteers; from promoting condom use at all times among motorcycle taxi drivers to providing them with the information upon which they can make an informed decision for themselves).
- ACT'S major constraint was legitimacy - but this appeared to be growing with the clinic's contribution.
- major constraint for both organisations was that it was difficult to measure whether either of them were achieving their goals of HIV prevention.
(e) Other Issues:
- ACT is a Christian organisation, which has a strong mission to spread Christianity as well as to provide support and services to the needy. Those reading the case may have strong views on the rights or wrongs of ACT's approach. However, a more fruitful focus for discussion might be the possible strengths and weaknesses of trying to provide both doctrinal and health promotion messages at the same time - particularly in relation to HIV/AIDS prevention.
- ACT is a U.S.-based organisation, although it had been working in Thailand for more than 10 years. Duang Prateep was clearly 'owned' by the Klong Toey communities. Participants might wish to explore some of the advantages and disadvantages of these two situations as related to, for example: the degree of freedom that an international NGO enjoys locally versus the need to work within the policies of the parent organisation; access to funds, expertise, supplies and materials; perceptions of the client community of the NGO'S programmes and intentions; etc.
- There is little mention in the cases of the relationship, if any, of these NGOs to Government programmes or policies. Participants might wish to discuss the ways in which the Government could support NGO initiatives in HIV/AIDS prevention.
- Participants have been guided to consider the differences between the approaches of the two NGOs as described in the cases, and to suggest ways in which these NGOs might collaborate. It might also be useful for participants to reflect on some of the barriers to such collaboration and strategies that could be used to overcome these where collaboration would clearly benefit the clients. For example: the time it takes; possible differences in organisational philosophy and programme objectives; competition for funds or other resources; etc.
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