Learning about scale, measurement and community mobilisation: reflections on the implementation of the Avahan HIV/AIDS initiative in India

• Published in: Journal of epidemiology and community health (1979) 2012-10, Vol.66 (Suppl 2), p.ii16-ii25
• Main Authors: Wheeler, Tisha, Kiran, Usha, Dallabetta, Gina, Jayaram, Matangi, Chandrasekaran, Padma, Tangri, Annie, Menon, Hari, Kumta, Sameer, Sgaier, Sema, Ramakrishnan, Aparajita, Moore, James, Wadhwani, Alkesh, Alexander, Ashok
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Civil society; Communities; Community health; Community life; community mobilisation; Community Networks - organization & administration; Community participation; Community service programs; Community structure; Condoms; Disease prevention; Empowerment; evaluation methodology; female sex workers; Foundations; Health Plan Implementation - organization & administration; Health Promotion - methods; Health Promotion - organization & administration; HIV; HIV Infections - prevention & control; HIV prevention; Human immunodeficiency virus; Humans; India; Logistic Models; Nongovernmental organizations; organisational development; Participation; Program Development; Program Evaluation - methods; Public health; Research reports; Sex workers; sexually trans dis; social capital; social inequalities; social science; socio-economic
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2012-201081

Debates have raged in development for decades about the appropriateness of participatory approaches and the degree to which they can be managed, scaled and measured. The Avahan programme confronted these issues over the last 7 years and concludes that it is advantageous to manage scaled community mobilisation processes so that participation evolves and programming on the ground is shaped by what is learnt through implementation. The donor (Bill & Melinda Gates Foundation) and its partners determined a standard set of programme activities that were implemented programme-wide but evolved with input from communities on the ground. Difficulties faced in monitoring and measurement in Avahan may be characteristic of similar efforts to measure community mobilisation in a scaled programme, and ultimately these challenges informed methods that were useful. The approach the programme undertook for learning and changing, the activities it built into the HIV prevention programme, and its logic model and measurement tools, may be relevant in other public health settings seeking to integrate community mobilisation.