A Technical Meeting to Identify Priority Actions to Strengthen Measurement of and Response to HIV/AIDS Impacts in the Social Sectors

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Published on: May 14, 2004

Social Science Research Council, USAID/Africa Bureau, Education Division (AFR/SD/ED), USAID/Policy and Program Coordination (PPC), Health Economics AIDS Research Division (Natal)

The Social Science Research Council, USAID Africa Bureau Education Division, and USAID Program and Policy Coordination Bureau and the Health Economics AIDS Research Division of the University of Natal will explore ways to identify and coordinate priority actions to deepen the critical knowledge base for AIDS impact assessment and mitigation. This effort is being supported with the overall goals of (1) strengthening institutional management and delivery of key development services at district and national levels and (2) strengthening community level understanding and response to HIV/AIDS impacts. A one-day technical meeting is proposed to explore possible priority actions and the development of an operational research agenda in the following areas:

Survey of existing impact assessment and mitigation measurements of social transformations associated with HIV/AIDS in and across key service sectors such as education, health and transportation
Development of new methods and models, appropriate for district-level data collection, to delineate the interactive relationship between health and development in ways that are meaningful to local communities and district-level service providers
Identify countries where multi-sector development activity and HIV/AIDS impact mitigation are coordinated and favorable to collection and analysis of simple proxy data across sectors. Identify how such activities could (or could not) facilitate comparative sector and epidemiological assessment, and further national and/or regional mitigation planning
Identify ways to strengthen African capacity for HIV impact monitoring and analysis at national and regional level; within ministries, statistical bureaus and offices of monitoring and evaluation, and in university and non-university based research institutions

Background

In spite of continuing advances in prevention and treatment, the HIV/AIDS epidemic remains one of the most serious and consequential health crises facing developing and transitional economies today. The devastating effects of AIDS on morbidity and mortality rates are the most obvious consequences of the virus, but the subsequent effects on socioeconomic development will be the larger legacy of the epidemic. These effects will likely include community-level impacts, changing structures of families and the division of labor in households, altered livelihood strategies and reorganization of the formal and non-formal economy, new urban-rural migration patterns, and transformations of educational systems, among other impacts.

Although researchers and policy makers have begun to collect and analyze relevant HIV impact data-from estimates of infection rates among teachers to the impact on agricultural production-systemic weaknesses in key social sectors means that available sources of data are incomplete and remain of limited quality and coverage. Single cases or regional studies on specific consequences of HIV/AIDS, such as on population, economies, or regional school systems, are available. However, robust comparative data capturing even basic social trends-such as changed educational opportunities and outcomes among children orphaned by AIDS, or shifts in attitudes toward education among families and youth as they react to and respond to infection and illness-do not yet exist. Further, there is a conspicuous absence of research on the variables that determine what types of responses will be adopted and whether they will be effective in mitigating these deleterious effects.

The challenge for policy makers is not only to design health interventions to respond to HIV/AIDS, but also to understand how the disease is impacting all the dimensions of social, political and economic life and to design development policies across sectors to support growth and quality of life concurrently with combating an epidemic. Policy makers at every level are hampered by the lack of even basic data available to them. It is a particularly salient problem at the sub-national or district level, where the potential impact of targeted interventions is the highest. Even though district-level policy makers are closest to the problem at hand, they have an enormous gulf between them and the information they need to intervene effectively.

Adding to these challenges, there are very few models and theories of the expected patterns of different institutional and socio-economic outcomes in the presence of HIV/AIDS, making it difficult even to know what data would be most helpful to policymakers working to strengthen government and NGO delivery of key development services, as well as strengthen community-level management of the epidemic. This compounds the challenges for researchers and policymakers of moving beyond approaches to data collection centered on individuals and households, to operational models that provide credible community level data meaningful for mitigating the impact of morbidity and mortality within the community's overall development context. Thus one of the primary goals of the SSRC-USAID/HEARD partnership will be to explore ways to conceptualize and measure community-level impacts, and to design systems to integrate district-level decision-making with the these measures designed to match the scope of their activities.

Both government ministries in Africa and development agencies are increasingly concerned with the systemic failure to access the key data necessary for decision making. This failure results not only from the deficits in availability and suitable methodology, but from the lack of information systems designed to support their work. Specifically, we may need to rethink methods for measurement and monitoring HIV/AIDS impacts at community level, and build capacity to connect those data to those who need them. Continued progress in mitigation of HIV impacts in HIV/AIDS epidemic areas of Africa may depend directly on our ability to refine and improve the way we measure and describe district and community-level impacts