Navigating the swampy lowland: a framework for evaluating the effect of community mobilisation in female sex workers in Avahan, the India AIDS Initiative. (3rd July 2012)

• Record Type: Journal Article
• Authors: Galavotti, Christine; Wheeler, Tisha; Kuhlmann, Anne Sebert; Saggurti, Niranjan; Narayanan, Pradeep; Kiran, Usha; Dallabetta, Gina
• Is Part Of: Journal of epidemiology and community health. Volume 66(2012)Supplement 2
• Page Start: ii9
• Page End: ii15
• Publication Date: 2012-07-03
• Subjects: Community participation -- community mobilisation -- HIV prevention -- female sex workers -- evaluation methodology -- empowerment PR -- health behaviour -- HIV -- methodology -- social factors in -- socioeconomic -- social inequalities -- social science -- social capital -- sexually trans disease -- alcohol -- effectiveness -- anthropology -- education; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech-2011-200465
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: Few models of how community mobilisation works have been elaborated in the scientific literature, and evaluation of the impact of these programmes on HIV and other health outcomes is extremely limited. Avahan, the India AIDS Initiative, has been implementing community mobilisation as part of its prevention programming with groups of high-risk individuals across six states since 2005. Purpose: To articulate a programme theory and evaluation framework for evaluation of Avahan's approach to community mobilisation among female sex workers in four southern states in India. Methods: The authors use a goal-based evaluation approach to describe the programme goals and an underlying programme theory that specifies how the programme is expected to work. Using multilevel structural equation modelling with propensity score matching, the evaluation will compare what is observed in the data with the predicted relationships specified by the model. Results: The Avahan model of community mobilisation posits that meaningful participation in high-risk group intervention, structural intervention and organisational development activities leads to identification, collectivisation and ownership, which in turn leads to improved programme outcomes. Strong community groups and an enabling environment reinforce social norm and behaviour change outcomes and lead to sustained impact. Discussion: Specifying an explicit programme theory can aid in the evaluation of complex interventions, especially when the evaluation design is observational. In addition to articulating Avahan's community mobilisation approach in a model that can be tested, we recommend some specific measures and methods that could be used to improve evaluation efforts in the future.