Presented by Mary Freyder, Tory M. Taylor, Apollo Nkwake, Thomas Miles, and Katherine Andrinopoulos at the 2016 AEA conference.

1. MEASURE Evaluation
EvaluatingHIVPolicyAdvocacy:
TheLocalCapacityInitiative
Mary Freyder, Tory M. Taylor,
Apollo Nkwake, Thomas Miles,
Katherine Andrinopoulos
Tulane University School of Public
Health and Tropical Medicine
MEASURE Evaluation
American Evaluation Association
October 27, 2016

2. LCI is innovative because it focuses on building
the advocacy capacity of civil society
organizations (CSOs).
The premise is that fostering an enabling
environment for CSOs, supporting their role as
health advocates in their communities, and
catalyzing their active engagement in local
and national health systems will lead to improved
delivery and uptake of quality HIV/AIDS services.
About LCI

3. About LCI
• Fourteen country/regional projects
• Local CSO consortia with iNGO TA
• Three-year projects staggered
across 5 years (2015 to 2019)
• PEPFAR 3.0 Human Rights Agenda
• 7 CDC offices
• 7 USAID missions

4. Where is LCI working?

5. What is LCI trying to do?
Legal and policy structural barriers to
a quality HIV response
Stigma and discrimination directed at
key populations
Enabling policy, financing, and
revenue environments for CSOs
Transparency and accountability in
national commitments/planned results

6. Project activities
• CSO and citizen coalition building
• Policy tracking and analysis
• Community planning/advisory group
meetings
• Communicating with officials about
policy priorities
• Releasing research and reports
• Mass media outreach

7. What makes LCI complex?
• The projects generate feedback that
affects their performance
• Pathways to policy change are long,
non-linear, and sensitive to context
• Many factors have to be present in
the right, hard-to-predict combination
• LCI project characteristics and
outcomes may both be emergent

8. LCI logic model (original)

9. LCI logic model (revised)
CSOs contribute to the
policy advocacy
environment when:
• Public officials use
information and other
policy advocacy
resources provided
by CSOs
• The general public
receives information
about policy relevant
issues from CSOs
• The organization of
constituencies, be it
groups of CSOs or
individuals about
systems-level issues
takes place with the
help of CSOs.
CSOs actively:
• Build coalitions and
partnerships
• Communicate with
officials
• Track and analyze policy
process
• Support community
planning/advisory group
meetings
• Release research and
reports
• Encourage community
members to contact policy
makers
• Support mass media
campaigns/advertising
• Testifying during policy
hearings
• Write editorials or letters
to the editor
• Provide HIV services to
priority populations
• Protest and boycott
HIV policy advocacy
environment is changed by:
• Increased accountability
and transparency of
government’s national
commitments and
planned results
• Reduced legal and
policy structural barriers
to quality HIV response
• Reduced stigma and
discrimination for key
populations
• Enabling policy,
financing, and revenue
environment for civil
society organizations
Increased uptake
of quality services
by key populations
and vulnerable
groups
Capacity Building for
CSOs to:
• Track, monitor, address
barriers and advocate
for policy development
and implementation
• Engage in each stage
of HIV program
development and
implementation
• Engage civil society
networks/ coalitions
• Engage citizens in
recognizing, and
advocating for quality
services
• Run a sustainable
organization beyond life
of USG funding
Sphere of control
Sphere of
influence
Sphere of
interest
Improved health for
key populations
and vulnerable
groups
Capacity building
implemented
Policy advocacy
activities
implemented
Policy barriers
reduced
Impact

10. Evaluating LCI
The evaluation’s purpose is to describe the
mechanisms by which policy advocacy
engagement supports uptake of quality HIV
services by key populations and vulnerable
groups, in order to foster learning across
HIV policy advocacy capacity-building projects.

11. Design considerations
• Multiple projects, many components
• No standard classification of policy
advocacy activities
• Limited understanding of how built
capacity leads to other changes
• Intermediate outcomes poorly defined
• Long causal chain, short evaluation
period, limited resources

12. Evaluation approach
• Complexity-aware
• Enable triangulation
• Tailor to context
• Accommodate emergence
• Participatory ethos
• Foster learning across LCI projects
• Balance depth with breadth
• Address intermediate outcomes

13. Research elements
• Systematically identify and define the
intervention components
• In-depth case series in one or more
countries/regions (Uganda, others?)
• Intensive qualitative inquiry, including
Most Significant Change method
• Surveys to yield descriptive statistics
about projects and outcomes over time
• Cross-sectional and longitudinal

14. Study design: Uganda
Instrument
development
Translation
Piloting
Public official survey
CSO network survey
CSO worker survey
In-depth interviews
Focus groups
Observations
Public official survey
CSO network survey
CSO worker survey
|-----------------2016--------------|----------------2017--------------|-------------2018------------|
Final
participatory
analysis
workshop
In-depth interviews
Focus groups
Observations

15. Quantitative methods
• Cross-sectional surveys of
workers at LCI-affiliated CSOs
• Network analysis completed by
each CSO
• Panel survey of public officials
• Surveys examine work activities,
task self-efficacy, policy priorities,
perceived sociopolitical control…

16. Qualitative methods
• In-depth interviews with project
stakeholders
• Focus groups with CSO staff and
healthcare providers
• Guided observations of
Community Score Card processes
at model HIV service facilities

17. MEASURE Evaluation
MEASURE Evaluation is funded by the U.S. Agency for
International Development (USAID) under terms of
Cooperative Agreement AID-OAA-L-14-00004 and
implemented by the Carolina Population Center,
University of North Carolina at Chapel Hill in
partnership with ICF International, John Snow, Inc.,
Management Sciences for Health, Palladium, and
Tulane University. The views expressed in this
presentation do not necessarily reflect the views of
USAID or the United States government.
www.measureevaluation.org