Improving the Education Response to HIV and AIDS: Lessons of Partner Efforts in Coordination, Harmonisation, Alignment, Information Sharing and Monitoring in Jamaica, Kenya, Thailand and Zambia

"Education contributes toward the knowledge and personal skills essential for the prevention of HIV, and the mitigation of the impacts caused by AIDS. Education also helps to overcome the conditions that facilitate the spread of HIV, including poverty, ill health, violence and abuse, particularly against girls and women. Beyond this, education can create the conditions of understanding and tolerance that contribute to reduced stigma and discrimination against people living with HIV."

Produced by the Joint United Nations Programme on HIV/AIDS (UNAIDS)'s Inter-Agency Task Team (IATT) on Education, this 77-page report synthesises case study exercises undertaken to examine the quality, effectiveness, and coordination of the education sector's response to the HIV epidemic in 4 countries - Jamaica, Kenya, Thailand, and Zambia. In each country, stakeholders assessed: critical achievements and gaps in the education sector response to HIV and AIDS; the evolution and effectiveness of coordination mechanisms and structures; progress toward harmonisation and alignment; information-sharing on HIV & AIDS and education; key resources for the response; and monitoring and evaluation. This report presents the overall findings from the study and makes recommendations for the IATT on Education and its partners to improve coordination in support of country level and to facilitate global actions. Details about the findings for each country - as well as the methodology used in this research project - are included in appendices of this report.

An excerpt from the Executive Summary follows:

"...The purpose of this study was to document how external partners coordinate and harmonise their efforts at the country level, to identify areas of overlap and significant gaps in country responses, and to formulate recommendations for improving synergy and alignment across IATT member agencies and other actors operating at the country level. The case studies were conducted between March and May 2007...

The study was carried out by an international consultant with the support of four local consultants....Data for the study were collected through a comprehensive documentation review and interviews with key stakeholders from the education sector and the overall HIV and AIDS response...

Findings:
The study was guided by six research questions...

• What have been critical achievements in country-level education responses to HIV and AIDS and what challenges persist? - ...The response in [Jamaica, Kenya, and Zambia]...was credited with having contributed to increased knowledge and awareness, as well as to enhanced visibility and to reduced stigma and discrimination. Stakeholders emphasised the key role of HIV and AIDS policy development for the sector and of support to the implementation of these policies. Stakeholders equally highlighted the importance of the integration of HIV and AIDS in curricula, the establishment of structures for implementation, the improved access to voluntary counselling and testing and to antiretroviral therapy, and the existence of good pilots and examples of best practices. In Thailand, the response has been carried almost exclusively by the health sector, and the education response was widely seen as weak. A number of common challenges were identified, including: the lack of commitment to policy dissemination, enforcement and monitoring; an absence of clear priority agendas; continued negotiable and non-compulsory nature of curricula; the diffuse nature of prevention efforts and the existence of conflicting messages; the limited scope of teacher training and support; weak links to non-education actors, services and support; inadequate funding and resources; and the absence of accountability mechanisms.
• What coordination arrangements exist, how have these evolved and how effective are they? - Most of the countries were found to have made progress around coordination.....The study established, however, that in most settings there are relatively few opportunities for specific thematic discussion around HIV and AIDS....Progress has been greater in countries with Sector Wide Approaches (SWAp) (Kenya and Zambia) but challenges remain in terms of prioritisation, joint action and reporting, and monitoring of the response..."
• What efforts have been made in harmonisation and alignment? What remains to be done? - ...In countries with an education SWAp, progress has been better but this has still not resulted in increased funding or priority for HIV and AIDS. Major areas of challenge continue to be: the lack of true commitment to reviewing business as usual; the absence of agreed-upon indicators to review progress on harmonisation and alignment; the fact that key players are not part of coordination and harmonisation efforts; limited decentralisation by development partners, constraining commitment to alignment with government priorities and agendas; and insufficient staff...
• What arrangements for information sharing exist? What resources are critical to success? - ...[A]lthough resources are developed and are being used across the case study countries there is a need to work towards more structured information-sharing and dissemination of resources and to promote thematic discussion among stakeholders. Greater emphasis also needs to be put on support to the use and implementation of recommendations emerging from key studies and on developing a priority agenda at country level for resource production, dissemination and monitoring.
• How are outputs, outcomes and impact being monitored and fed back to decision-making? - ...The absence of strong and comprehensive systems for monitoring and evaluation was widely seen as hampering the capacity for learning from experience and also has a negative impact on the capacity of the system as a whole to plan for an improved response."

Recommendations:
...The recommendations for the IATT on Education are grouped under five areas:

1. Advocacy - Intensify lobbying efforts for a strong and recognised role of education within the overall AIDS response, and for increased funding to education stakeholders; [s]upport the documentation, dissemination and discussion of evidence of the impact of the education response within the overall response; [and] [d]isseminate and discuss the IATT objectives and strategies at bilateral and multilateral regional technical meetings.
2. Research, advancing the evidence base and monitoring - [For example,]...[p]lay a strong role in channelling resources for research toward emerging priorities in country and that research results are shared, disseminated and discussed.
3. Coordination, harmonisation and alignment - [For example,]...[c]ontinue to monitor the case study countries to assess progress on coordination, harmonisation and alignment and use this to inform decision-making by the IATT and its members.
4. IATT functioning - Establish mechanisms that enable the IATT to be periodically informed by evolving issues and constraints at country level.
5. IATT support at country level - Promote and support good practices for the integration of HIV and AIDS into curricula [and] [a]dopt guidelines for decision-making on country-level action by the IATT.

Recommendations for development partners at country level include to:

• Lobby and advocate for a multi-sectoral response to HIV and AIDS among the leadership of the country...
• Commit to longer-term strategic responses..
• Address the real constraints to harmonisation and alignment and monitor progress in this respect.
• Ensure that the response of the education sector moves beyond policy development to...assist teachers and other education staff in their role.
• Continue to strive for greater flexibility in funding.
• Ground support in national strategies on HIV & AIDS and education and agree on priority actions...
• Support countries in implementing and disseminating policies, through advocacy, training and support to teachers, and involvement of parents and communities.
• Give priority to capacity-building...
• Strive to ensure that the response in the education sector is inclusive by actively involving stakeholders.
• Consider temporarily revising staff allocations within agencies...
• Strengthen links between different sectors within development agencies, support joint planning, and build capacity on elements of a comprehensive HIV and AIDS response.
• Give priority to enhanced monitoring and evaluation and to accountability.

Click here to access the full report in PDF format. Hard copies can be requested by contacting: info-iatt@unesco.org