USAID Global Health Learning
Box 2 Examples of Critical Enabler Activities and Indicators
|Critical enabler |Rationale |Responsibility |Activities- Examples |Indicators – Examples |
|interventions | | | | |
|Social Enablers: |
|Political commitment and |Enables political leadership to |Head of state’s office, |Setting up events for the head of state to address HIV |Output: Number of events where HIV |
|advocacy |engage and raise awareness about |parliamentarians and lawmakers, |transmission; Increasing commitment to address HIV through |addressed by head of state |
| |HIV; |national political parties. |multisectoral responses by including HIV in social | |
| |Supports reducing HIV-related |Ministries of Health, Ministries |protection programmes, poverty reduction, education and | |
| |stigma; |of Law/ Justice, heads of province|gender empowerment initiatives | |
| |Unhindered service provision to |and municipal leaders. | | |
| |those in need | | | |
|Stigma reduction |Reduction in discrimination |Key populations and people living |Engaging community, religious and political leaders to |Output: Number of stigma reduction |
| |against people living with HIV and|with HIV, local community leaders,|challenge stereotypes and norms, values and culture that |sessions held with religious |
| |key populations at higher risk; |activist and religious leaders, |fuel stigma; increasing knowledge about HIV transmission |leaders |
| |Enables uptake of HIV prevention |employers and workers’ |and its causes and impact | |
| |and treatment services |organizations, HIV caregivers, | |Outcome: Percentage of sex workers |
| | |relevant government agencies – | |reporting stigma |
| | |health, interior, criminal | | |
| | |justice, prison administration | | |
|Laws, legal policies and |Enables a favourable environment |Human rights groups, journalists, |Conducting a thorough review of existing laws to identify |Output: Number of improved national|
|practices |for the protection of rights of |academia, international |laws that impede HIV response and advocating for repeal of |laws regarding criminalization of |
| |key populations, such as |organizations, rights |laws such as criminalization of HIV transmission, |HIV transmission or same-sex |
| |accelerating HIV-related law |organizations, bar associations, |decriminalization of male-to-male sex, etc., or amendment |relations |
| |reform, amending existing legal |legal aid cells, human rights |of laws such as narcotics laws, trafficking laws, criminal |Number of grievances made due to |
| |frameworks that are |commissions, ombuds offices |procedure laws etc.; |violations |
| |counter-productive to effective |Networks of people and women |Promoting laws against gender-based violence and gender |Number of grievances addressed |
| |HIV responses |living with HIV and key |equality; Promoting the development and adoption of | |
| | |populations at higher risk, |anti-discrimination legislation in all areas, including in | |
| | |Relevant government agencies – |access to health services, education and employment |Outcome: Percentage of sex workers |
| | |interior, criminal justice, gender|Strengthening accountability mechanisms to curb abuse of |jailed in the past 12 months |
| | |and women |laws by law enforcers, creating accessible and effective | |
| | | |mechanisms for aggrieved individuals to access and obtain | |
| | | |justice | |
| | | |Building epidemiological + legal literacy into curricula | |
| | | |for judges, law makers, implementers, community groups, | |
| | | |people affected, etc. | |
|Community mobilisation |Enables the mobilization and |Community leaders, activists, |Identification of key populations at higher risk that need |Output: Number of sex worker |
| |organization of groups such as sex|local government and networks of |HIV services and key hotspots through which information and|networks |
| |workers and other key populations |people living with HIV, key |services will be disseminated; Establishing networks of | |
| |at higher risk, as their |populations at higher risk, health|people living with HIV and other key populations for | |
| |participation in HIV prevention |coalitions, trade unions, youth |sharing information, education and communication; Engaging | |
| |services is essential |groups etc. |the family members of key populations at higher risk, |Outcome: Percentage of sex workers |
| | | |health coalitions, trade unions youth groups and wider |reached by networks/community |
| | | |community to support information, education and |empowerment interventions |
| | | |communication initiatives; Community empowerment and | |
| | | |violence reduction strategies among key populations at | |
| | | |higher risk | |
|Local responses to change |Enable positive changes at the |Traditional leaders, local |Data about local HIV prevalence and mapping of local HIV |Output: Number of local government,|
|the risk environment |local level by addressing norms, |decision-makers, religious leaders|service providers; Engagement of local government, |religious and traditional leaders |
| |values, culture and religious |and caregivers |religious and traditional leaders and networks of people |that participate in gender equality|
| |beliefs that negatively influence | |living with HIV and key populations at higher risk; |interventions |
| |risk behaviour, such as through | |Engagement of local government, religious and traditional |Outcome: Percentage of local |
| |community conversations | |leaders to promote gender equality and reduce harmful |government, religious or |
| | | |gender norms |traditional leaders that report low|
| | | | |levels of stigma towards key |
| | | | |populations |
|Programme Enablers: |
|Community-centred design and|Enables community participation |Community leaders, activists, |Participatory needs assessments and planning of the |Output: Number of needs assessments|
|delivery |and ensures the sustainability of |employers and workers |programme activities to identify key high-risk behaviour |in which individuals from key |
| |prevention and treatment |organizations, local government |and its causes and consequences; |populations participated. |
| |programmes |and networks of people living with|Participatory monitoring of programme activities to | |
| | |HIV and key populations a higher |identify bottlenecks, lessons learned and corrective | |
| | |risk |actions | |
|Programme communication |Enables galvanization of support |Media, journalists, local |Developing strategic information about programme |Output: Number of radio or TV spots|
| |for the behaviour change programme|community, donors, government and |achievements and impact |aired |
| |activities |programme staff |Sharing information about the impact through brochures, | |
| |Possible replication and scaling | |radio, TV and local community meetings |Outcome: Percentage of key |
| |up of programme activities | | |populations aware of programme |
| | | | |activities |
|Health education |Develops healthy attitude and |Ministry of education, schools, |Incorporating skills-based activities for HIV into |Output: Number of schools that that|
| |skills so learners and youth |teachers, teachers, training |information, education and communication and curricula; |include skills-based activities for|
| |reduce their HIV risk; Help |institutions, private and public |Train and support teachers; Regular assessment of |HIV in curricula |
| |reduces stigma and discrimination |schools, formal and non-formal |knowledge, attitudes, skills and behaviour |Outcome: Percentage of teachers |
| |of key populations at higher risk |education providers such as | |reporting low levels of stigma |
| |and people living with HIV |religious schools, community-run | |towards key populations |
| | |schools and civil society | |Percentage of youth with |
| | | | |skills-based HIV knowledge, |
| | | | |attitudes and behaviours |
|Gender equality and |Enables promotion of safer sex |Community leaders, women, men, |Empowerment of women and transgender people through gender |Output: Number of transgender |
|gender-based violence |negotiation and behaviour by |microfinance institutions, |equality and HIV training; Community mobilization, |individuals that participate in |
|interventions |transforming harmful gender norms |schools, police, sex workers, |peer-based participatory education challenging harmful |gender equality and HIV training |
| |and empowerment of women and |media |gender norms, particularly among men, boys and girls | |
| |transgender people, including key | | |Outcome: Percentage of transgender |
| |populations at higher risk such as| | |individuals reached by gender |
| |sex workers | | |equality and HIV training |
| | | | |Percentage of transgender |
| | | | |individuals reached by peer-based |
| | | | |participatory education challenging|
| | | | |harmful gender norms |
Adapted from: UNDP/UNAIDS (2012). Understanding and acting on critical enablers and development synergies for strategic investments.
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