Study Details

Committing to Results: Improving the Effectiveness of HIV/AIDS Assistance

Author(s)

Ainsworth M.  Vaillancourt D.  Gaubatz J. 

Date

 2005

Reference

None 

Web Link

View PDF

Organisation

World Bank
World Bank's Operations Evaluation Department (OED)

Keywords

HIV/AIDS services, health systems strengthening, human resources, Governance, access, vulnerable groups, funding, civil society

Study Type

An internal evaluation and assessment.

Aims

To evaluate and assess the development effectiveness of the World Banks country-level HIV/AIDS assistance. To identify lessons from this experience and make recommendations to improve the relevance, efficiency, and efficacy of ongoing and future activities.

Methods

A combination of desk reviews, which included compiling an inventory of analytic research; surveys of and structured interviews with Africa MAP Task Team Leaders (TTLs) and Country Directors; self-administered questionnaires; and field-based studies.

Findings

The principal findings of this internal evaluation of the World Bank are: National AIDS strategies were not always prioritised or costed; supervision, and monitoring and evaluation (M&E), were weak; civil society had not been engaged; political commitment and capacity had been overestimated, and mechanisms for political mobilisation were weak; and bank research and analysis, whilst perceived to be useful, was not reaching policy makers in Africa.

  • National AIDS strategies were not always prioritised or costed.
  • Supervision, and monitoring and evaluation (M&E), were weak.
  • Civil society had not been engaged.
  • Political commitment and capacity had been overestimated, and mechanisms for political mobilisation were weak.
  • Bank research and analysis, whilst perceived to be useful, was not reaching policy makers in Africa.

Conclusions /
Recommendations

The report recommends that the Bank continues to exploit its comparative advantage in institution-building, improve the local evidence base, and help governments to prioritize and cost AIDS strategies.

It concludes that:

  • Lack of political commitment was the most important constraint to actionnot only in Africa, but in all low income regions.
  • The assumption that past efforts to control the epidemic in Africa had been unsuccessful was not substantiated.
  • There was no evidence to support the assumption that lack of success in controlling AIDS in Africa had been caused by a failure to get resources to communities.
  • The assumption that there were many pilot activities that had been locally evaluated, found effective, and were suitable for wider replication was not well supported in TTL interviews.

Sponsored by DFID, Danida, Irish Aid