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close this bookHow do Communities Measure the Progress of Local Responses to HIV/AIDS (Technical note no.3) (UNAIDS; 2000; 9 pages)

How do Communities Measure the Progress of Local Responses to HIV/AIDS (Technical note no.3)

Local Responses to HIV/AIDS

Date of publication: 1 September 2000

To be reviewed 1 December 2000 for possible updating


This Technical Note aims to describe a synthesis of global learning on methods whereby local partnerships measure the progress of local responses to HIV/AIDS.

To assess their HIV/AIDS situation and understand how AIDS affects their lives, people and communities need to create local partnerships. The collective action following from this enables them to act and learn.

Local partnerships on HIV/AIDS result from people-centred interactions between three groups of actors: key social groups (at an individual, family or community level) service providers and facilitators/catalysts.

How do communities know they are becoming AIDS-competent? By engaging in partnerships that measure progress along three dimensions:


1. Assessing progress in owning the problem and trying to find solutions.
2. Measuring the reduction of HIV incidence and monitoring behaviour change.
3. Assessing an improvement in the quality of life of affected individuals and groups.

Key Concept

In an AIDS-competent society, people deal effectively with AIDS because they have accepted the reality of HIV/AIDS. They have assessed how HIV/AIDS affects their lives and work, and they have adapted to living positively with HIV/AIDS.

Local monitoring of HIV/AIDS is defined as the routine tracking of priority information about HIV/AIDS, either quantitative (eg mapping, surveillance and the Health Management Information System, quality of life assessment) or qualitative (eg indicators of progress developed by social groups).

Measuring Progress

Local partnerships measuring the progress of Local Responses to HIV/AIDS follow key common operating principles:


• Local monitoring = action. When they are able to assess their own situation, partnerships take charge of the responses

• Partnerships utilise qualitative and quantitative information and, through their link with service providers, merge community and service-generated information

• Local monitoring of HIV/AIDS is part of a broader involvement of communities

• Appropriate presentation methods, surveillance and monitoring data used are presented to communities and local policy makers by the facilitators/catalysts, if possible in a joint effort with the key social groups and/or service providers.

Owning the Problem

Current strategies


• The extent to which communities ‘own’ the problem and take charge of the solution is assessed

• There is also an assessment of the environment under which local partnerships take charge of the problem

Status of development for measuring progress

Local partnerships develop their own indicators that are measurable, achievable and practical. They collect, analyse and interpret the data, and take decisions accordingly.

One effective participatory tool is the mapping of behaviours (‘risk mapping’), which enables communities to reduce social vulnerability (see reference below). Based on the experiences in Magu District, Tanzania, community sub-groups (women, men, youth, specific groups) identify areas in the village that present high risk for contracting HIV. By discussing how to deal with such risk areas, the community ‘owns’ the problem, converts awareness into action and creates a supportive environment for behaviour change.

Monitoring Changes

Current strategies


• Communities that are seen to be making progress emphasise an ongoing use of surveillance data

• HIV testing is more available and accessible to local areas

• Wider confidentiality is assured

• Training in participatory approaches takes place

• Relevant epidemiological and statistical support is considered essential

• Health centre staff provide regular supportive supervision

Status of development for measuring progress

A mix of quantitative and qualitative methods can best measure progress with a combination of various surveillance systems (biological and behavioural). These should be part of health management and information systems. The range of methods outlined is available in the background papers listed below.

Quality of Life (QOL)

Current strategies


• People concerned are asked for their own perception of quality of life
• All people infected and affected by HIV/AIDS respond
• Questions are culturally sensitive and available in the local language/s

Status of development for measuring progress

The Division of Mental Health at the World Health Organisation (WHO) developed both a generic and an HIV-specific ‘WHOQOL’ questionnaire for the measurement of quality of life of ill or HIV-infected people. (See attached paper). This instrument is not yet designed for use at local level but it may be adapted and simplified for the purpose of measuring Local Responses.

Next Steps


• A review of risk mapping procedures

• Testing WHOQOL and applying it to Local Responses

• Availability of testing in all districts

• People trained to become Aids competent

• New indicators developed to assess the sustainability of local responses, and to assess and monitor the progress of social and cultural factors and the effectiveness of local partnerships

• Due to the rapidly changing situation in Local Responses, this Technical Note will need updating in the near future


(These will shortly become available on our website:

1. Assessment of autonomy of individuals and communities involved in HIV/AIDS


Dick Schapink, Venence Nyonyo, Japheth Ng’weshemi, Francoise Jenniskens and Gabriel Mwaluko, TANESA Programme, Tanzania and Royal tropical Institute, The Netherlands, 1999

2. Process Approach Guide to HIV/AIDS risk behaviour mapping: Magu District experience 1996-1998 (TANESA) Tanzania


V. Nyonyo, D Mayunga, C Pervilhac, J Ng’Weshemi, G Mwaluko, June 2000

For more information:

3. Local Monitoring of HIV/AIDS: a review of selected experiences and indicators for measuring HIV/AIDS epidemic and behavioural change at local level


Halima Dao, May 2000.

For more information: schwartlanderb@unaids

4. Evaluation Guide to Monitoring and Evaluation for National AIDS programmes



For more information: schwartlanderb@unaids

5. Guidelines for Second Generation HIV Surveillance


UNAIDS/WHO, WHO/CDS/EDC/.200.5Measure, 2000

For more information:

6. Measuring Quality of Life in HIV and AIDS, 2000


Suzanne M Skevington and Kathryn A O’Connell, WHO Centre for the Study of Quality of Life, University of Bath, BA2 7AY, United Kingdom

For more information:

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