The building blocks of the AIDS Control and Prevention (AIDSCAP) Project's comprehensive HIV/AIDS prevention programs in 17 countries are carefully targeted projects carried out by nongovernmental organizations (NGOs) and other local groups. Each of these 465 "subprojects" is based on a detailed document called a subagreement, which outlines the project's objectives, each organization's responsibilities in meeting those objectives, the products to be delivered by the implementing agency and the indicators for measuring whether the objectives have been met.
Because it is at the same time a proposal, a contract, a detailed implementation plan and a monitoring and evaluation guide, a subagreement is a complex document that requires contributions from program managers, local officials, researchers, financial analysts, and specialists in technical fields such as communication, STD treatment, condom logistics, and evaluation. AIDSCAP country and regional staff work closely with each implementing agency to review and strengthen every subagreement.
AIDSCAP's rapid project development method, field tested in Tanzania and Honduras in 1995, accelerated this process by bringing together staff from implementing agencies and AIDSCAP country and regional offices in one place. As a result, AIDSCAP and its partners were able to write, review and complete most of the subagreements for each country program in just two weeks. In both countries, representatives of the implementing agencies spent the first week receiving a one-week crash course in subproject development using a methodology called the logical framework (LogFRAME).
In Tanzania, after consultations between AIDSCAP and the NGOs, 25 NGO representatives and ten AIDSCAP staff met in Dar es Salaam and wrote proposals for nine different subprojects for the Tanzania AIDS Project (TAP), which is sponsored by the U.S. Agency for International Development (USAID) and implemented by AIDSCAP. In Honduras, representatives from 26 local public and private sector organizations first participated in a one-week training workshop on project design where they were introduced to the strategies and plan for the USAID-supported AIDSCAP program in Honduras. Ten of these organizations were invited to the second project development workshop, where they worked with six AIDSCAP staff and two consultants to complete ten subagreements.
Both programs were operating within a month of the workshops. In Honduras, the initial funds for the subprojects were presented to implementing agencies at the end of the workshop at a signing ceremony attended by the minister of health.
Below Gail Goodridge (GG), AIDSCAP's associate director for country programs, describes the rapid project development process in Tanzania and compares it to AIDSCAP's experience with subproject development in other countries. Then two participants in the project development workshop in Honduras, Juan Ramón Gradelhy Ramirez (JGR) of Comunicación y Vida (COMVIDA), an AIDS prevention program sponsored by the municipality of San Pedro Sula, and María Luisa Gonzáles (MLG) of COCSIDA (Centro de Orientación y Capacitación en SIDA), an NGO based in the northern coastal town of La Ceiba, give their impressions of the process.
Tanzania
What actually happened at the rapid project development workshop in Tanzania?
Gail Goodridge: Over a two-week period, we trained representatives from nine different NGO clusters in HIV/AIDS project design and helped them finalize comprehensive proposals. We conducted the training the first week and then in the second week, we helped each of those clusters refine their ideas based on the training they had just received.
What's a "cluster"?
GG: The strategy in Tanzania is to build cohesive teams of NGOs to work together to prevent HIV in targeted geographic areas. A cluster will typically have between nine and 12 different NGOs led by what we call an "anchor" NGO, which is responsible for program coordination and financial management of the whole cluster. This cluster strategy reduces the possibility of competition for funding among NGOs and encourages them to develop coalitions and linkages so that they work more as a team. (See page 35 for an article about the NGO clusters in Tanzania.)
So the workshop participants were from the anchor NGOs?
GG: From the anchor NGO and at least one other NGO in each cluster. But before they came to Dar es Salaam for this training exercise, each of the clusters had done quite a bit of group planning. So the NGO representatives who came to the training were prepared to speak for the other NGOs in their cluster back home.
What was the purpose of the training?
GG: The purpose of the training was to strengthen the NGOs' design skills in a way that would lead to solid plans and subprojects.
Who were the trainers?
GG: This was a joint effort. Three trainers came from AIDSCAP's Africa Regional Office, and the TAP staff in Tanzania served as cluster facilitators. I was the one trainer from headquarters. We also had a presenter from the Ministry of Health and one from the condom social marketing team in Tanzania. The trainers, facilitators and participants all shared in the responsibility of making this work.
What did the training address?
GG: The training covered the basics of comprehensive HIV/AIDS program design and the general components of proposal development. We tried to focus on generic proposal development so in the future the NGOs would be able to develop proposals for any donor agency.
How does this process differ from the way AIDSCAP usually develops subprojects?
GG: Normally, what AIDSCAP does is work individually with representatives from each implementing organization -- or in this case, cluster -- to help them develop their proposals. Each proposal is reviewed at the AIDSCAP country office and put in the format of an AIDSCAP subagreement. Then the draft subagreement is sent to the AIDSCAP regional office for further review and comment. These comments are sent to the NGO for further revision.
The process was similar, but because we were all in the same place, the subagreements could be reviewed and revised much more quickly. It was a useful way of training people in subproject design and ending up after two weeks with nine strong subagreements.
How was that possible?
GG: I must say there was a lot of preparation before the two-week training. For example, the country office staff went to every cluster and conducted what's called a "SWOT" assessment -- strengths, weaknesses, opportunities and threats -- and got the clusters to do a lot of preliminary thinking about what they wanted to do. So the cluster representatives came to the training with an understanding of the strengths and weaknesses of the various partners in their cluster. Some of the clusters even brought draft proposals.
What was the experience like?
GG: It was very exciting. Each day we'd discuss an area of proposal development and then the groups would go home at night, work on that section and come in the next morning with a rewrite. Our classes would end at six in the evening, but the trainees often would stay for the next hour or two to consult individually with the trainers, and then they'd go back to their rooms and work. We had a tremendously motivated and very responsive group.
Is this something AIDSCAP would like to do again?
GG: Yes. In fact, we might have an opportunity to use this process in Indonesia, where AIDSCAP is helping the USAID Mission and the Ministry of Health implement a five-year HIV/AIDS prevention project.
So you consider the field test of this methodology in Tanzania a success?
GG: Yes. We thought it was very successful for a number of reasons. One is that it helped us launch the country program quickly. And it enabled us to transfer project design skills that will be useful to the implementing agencies regardless of which donor they work with in the future.
Finally, and perhaps most importantly, because all the clusters were participating together, they could appreciate the fact that each subproject is part of an integrated country program. They worked with PSI [Population Services International] condom social marketing folks, and they were linked up to the STD component of the Tanzania program. A lot of valuable team building was achieved.
What did AIDSCAP learn from this experience?
GG: I think we learned how to use a very effective team-building tool. And we maximized the benefit of the training by pairing it with practical, specific subproject design. Participants didn't just learn the theory of effective AIDS program design. They really had a chance to put it into immediate practice.
Honduras
What was the project development process like?
María Luisa González: It was a tough job, and time was our worst enemy. It was everyone's wish to design the best possible project based on our particular organization's strengths. We managed to formulate projects in a short time with good results.
How was the rapid project development process different from your previous experience in project development?
MLG: What made it unique was 1) the time allowed to develop the project; 2) the degree of interaction with the technical team from AIDSCAP's regional office and office in Honduras; 3) the exchange of experiences among implementing agencies in the design of strategies; and 4) the strengthening of the ties and coordination between NGOs and the Ministry of Health (MOH).
It's the first time that a project of this magnitude has been developed where the MOH, through four priority health regions, and local organizations have worked together to define strategies for intervention. The MOH actions to improve STD services, including diagnosis and treatment, will complement the prevention projects which are being implemented by the NGOs and public sector agencies.
Juan Ramón Gradelhy Ramirez: In my previous experience, there was always an uncertainty about when projects would be approved. In the process with AIDSCAP, the developers of the projects knew that if it was a good project, it would be approved at the end of the workshop.
What made it possible to accomplish so much in such a short time?
MLG: The high level of commitment and motivation of each implementing agency to work with the beneficiary population (in our case sex workers and their clients) to reduce HIV/AIDS. In addition, the technical team from AIDSCAP was prepared for the process.
JGR: The cohesion of the participants enabled us to help each other and created a solidarity that is still present.
What types of problems did you face and how did you overcome them?
MLG: The problems were technical. It was the first time we had worked with the LogFRAME. Also, our lack of knowledge about the computers made our work very tedious. But this was overcome, and now we have an experienced computer user working on the project.
JGR: The problems we faced were external. Due to our responsibilities and commitments to our own organizations, we were not able to concentrate 100 percent. Also, some participants' lack of knowledge about methodologies caused delays, but this was solved with help from the participants and from the AIDSCAP team.
What are the strengths and weaknesses of the process? How could it be improved?
JGR: Perhaps there was lack of unity about the criteria for subagreement content between local facilitators and the regional office, but this is understandable given that the AIDSCAP office in Honduras office had just been created.
Among the strengths was a facilitating team with high expectations and dedicated to the work, a group of participants anxious to learn and do the best for their own institutions, and a blending of ideas and experiences among the whole group.
What suggestions would you have for improving this process in the future?
JGR: After the introductory workshop and selection of institutions, more time should be allowed to gather baseline information. There was only two weeks between the project development workshop and the first workshop, where AIDSCAP regional office staff presented the strategy for AIDSCAP's program in Honduras and introduced the LogFRAME and subagreement format.
What did you learn from the process? What do you think your AIDSCAP counterparts learned?
JGR: We learned how to use a methodology to develop projects that is clear and precise from the development phase through implementation, monitoring and evaluation. Also, the exchange of ideas within the group enabled me to learn about the evolution and direction of prevention activities in my country because all the principal actors in the fight against AIDS were present.
This process enabled the host agency to learn firsthand the strengths and weaknesses of each institution through its representatives and proposals.
What lessons does the experience offer for other program planners?
JGR: The interaction among all the institutions involved generated a search for better responses and strategies for the projects' interventions. All of those involved in this common effort shared experiences and helped each other.
An important lesson learned from this experience is the enormous importance of coordination between the MOH, NGOs and other institutions working in the control of HIV/AIDS. Only this effective coordination and complementary actions by the institutions can have an impact on diminishing the incidence of HIV/AIDS.
