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    "From me to HIV": a case study of the community experience of donor transition of health programs

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    Author
    Rodriguez, DC; Tripathi, V; Bohren, M; Paul, A; Singh, K; Chhabra, V; Singh, S; Bennett, S
    Date
    2015-08-19
    Source Title
    BMC Infectious Diseases
    Publisher
    BMC
    University of Melbourne Author/s
    Bohren, Meghan
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Rodriguez, D. C., Tripathi, V., Bohren, M., Paul, A., Singh, K., Chhabra, V., Singh, S. & Bennett, S. (2015). "From me to HIV": a case study of the community experience of donor transition of health programs. BMC INFECTIOUS DISEASES, 15 (1), https://doi.org/10.1186/s12879-015-1068-8.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255844
    DOI
    10.1186/s12879-015-1068-8
    Abstract
    BACKGROUND: Avahan, a large-scale HIV prevention program in India, transitioned over 130 intervention sites from donor funding and management to government ownership in three rounds. This paper examines the transition experience from the perspective of the communities targeted by these interventions. METHODS: Fifteen qualitative longitudinal case studies were conducted across all three rounds of transition, including 83 in-depth interviews and 45 focus group discussions. Data collection took place between 2010 and 2013 in four states: Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. RESULTS: We find that communication about transition was difficult at first but improved over time, while issues related to employment of peer educators were challenging throughout the transition. Clinical services were shifted to government providers resulting in mixed experiences depending on the population being targeted. Lastly, the loss of activities aimed at community ownership and mobilization negatively affected the beneficiaries' view of transition. CONCLUSIONS: While some programmatic changes resulted in improvements, additional opportunity costs for beneficiaries may pose barriers to accessing HIV prevention services. Communicating and engaging community stakeholders early on in future such transitions may mitigate negative feelings and lead to more constructive relationships and dialogue.

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