Understanding what works and why in peer and community based programs for HIV and HCV

Dr Graham Brown andDaniel Reeders

www.w3project.org.au

latrobe.edu.au/arcshsMelbourne, Australia

Peer Based Programs

• Peer programs underpin the partnership approach in HIV and HCV

• Programs are inextricably linked to constant changes in communities and context

• Complex relationship between activities and the broader social impact – difficult to demonstrate

• A simple linear approach assuming a stable environment is blind to reality of the programs

Traditional program logic struggles to reflect the complex role of PBP in the HIV/HCV response

Inputs Activities outcomes

Peer-based programs engage with peer interactions, social networks, communities, politics and culture

None of which are linear or independent of each other

Led us to systems approaches as a tool to elicit what is really going on

What Works and Why

Using systems approaches to: • develop a more sophisticated understanding of the role of

peer based programs and how and why they work;• help community & peer based organisations evaluate what

really matters to their work; and• articulate how peer based programs add critical value to

HIV and HCV programs and policy

• Systems approaches – set of tools to improve understanding of the whole, its components, and in particular the relationships and interactions within and between them.

What Works and Why

• People who use drugs – WASUA and AIVL• Gay men – VAC and AFAO• PLHIV – NAPWHA and the Poz Action Group• Sex Workers – Scarlet Alliance and members

• Funded by the Commonwealth Department of Health

What Works and Why

• Combine mental models of practitioners to develop a more sophisticated theory of peer based programs and investments

• Developed system dynamics maps showing how interventions are embedded in and engage with communities-as-systems

• Identifying strategic considerations and key functions within the system maps

• Identifying draft indicators to demonstrate influence

+ a LOT of trust

Peer network targeted health promotion

2015 – Practical Indicators

To help answer key questions such as:

•Are programs doing what they’d need to do to improve their influence on communities and policy environments (understood as complex systems)?

•Are the programs’ understandings of those complex systems close enough to reality to sustain effective action within them?

•Can we explain how the program works to stakeholders and justify their investment and trust?

•Are program activities, other programs in the sector, and policy enhancing or diminishing each others effectiveness?

2015 – Practical IndicatorsFlexible use of the functions and indicators

• As objectives in strategic planning for program activities

• As topic guides for sharing program and organisational knowledge – such as team meetings or planning workshops

• In combination - to craft for stakeholders coherent, politically effective narratives of the complex relationships that the program is seeking to influence or activate

• To plan how different programs or activities could better work together

Visit us on the web at www.w3project.org.au

Understanding What Works & Why (W3) is a project of the Australian Research Centre in Sex,

Health and Society at La Trobe University.

Authored by Dr Graham Brown and Daniel ReedersFunded by the Commonwealth Department of Health

Copyright © 2015 La Trobe University

Function Description

Engagement How well the program engages with the diversity and dynamism of the affected community, including its different networks and cultures.

Learning and adaptation

The practices through which the program learns about its environment and adapts its approach according to what it learns.

Influence How effectively the program influences its target communities and its policy and funding environment (including indirect influence).

Alignment The extent to which different programs in the organisation or sector adapt to achieve ‘value add’ from a coordinated approach.