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|END OF CONTRACT EVALUATION FOR ROYAL NETHERLANDS EMBASSY/AIDS FOUNDATION OF SOUTH AFRICA |
REPORT COMPILED BY:
CREATIVE CONSULTING AND DEVELOPMENT WORKS
COMMISSIONED BY:
AIDS FOUNDATION OF SOUTH AFRICA
DRAFT 1
APRIL 2012
CREATIVE CONSULTING AND DEVELOPMENT WORKS
developmentworks.co.za
Email: lindy@developmentworks.co.za
Tel: +27 21 448 2058/ Cell: +27 82 770 8626/ Fax: +27 21 448 0380
Address: PO Box 43311, Woodstock 7915, Cape Town
COMMISSIONED BY:
AIDS FOUNDATION SOUTH AFRICA
NOVEMBER 2011
RESEARCH CONDUCTED BY
CREATIVE CONSULTING AND DEVELOPMENT WORKS
REPORT PREPARED BY:
LINDY BRIGINSHAW -DIRECTOR
SUSANNAH CLARKE –RESEARCH CO-ORDINATOR
JOAN LEAVENS –RESEARCHER
KHAYELITHLE MDAKANE -RESEARCHER
PAUL DUBE -RESEARCHER
CREATIVE CONSULTING AND DEVELOPMENT WORKS
developmentworks.co.za
Email: lindy@developmentworks.co.za
Tel: +27 21 448 2058/ Cell: +27 82 770 8626/ Fax: +27 21 448 0380
Address: PO Box 43311, Woodstock 7915, Cape Town
EVALUATION OF TERMS OF REFERENCE
In November 2011, the Aids Foundation of South Africa (AFSA) commissioned Creative Consulting and Development Works (CC&DW), to undertake an evaluative study on the end of contract for Royal Netherlands Embassy/AFSA for AFSA’s Culture and Health Program. The specific instructions given to CC&DW, which were signed off in the original proposal, were to:
1. Identify and analyse the progress, results, outcomes and impact of the CHP for the period 1 April 2009 – 15 December 2011, against the approved plan and budget, through review of available documentation and site visits to selected project partners.
2. Analyse the implications of the possible closure of the CHP for the organisations it supports and their beneficiaries, through interviews with key informants from each of the 5 CHP target groups.
3. Define the nature and size of the ‘market’ in which the CHP competes for funding ie.,
similarly situated organisations utilising research, funding, capacity building and rights based advocacy to campaign improve health outcomes of culturally marginalised people.
4. Carry out an analysis of opportunities for and problems with domestically sourced funding for a programme such as CHP, including sources such as the National Development Agency, and corporate social investment. This to be achieved through: desktop review of research and publications; interviews with relevant officers in up to 10 donor agencies/ South African corporations.
5. Investigate attitudes of selected foreign government and private foundation donors with offices in South Africa to investment in NGOs whose focus is on health, culture, gender and human rights, through: desktop review of research and publications; interviews with relevant officers in key donor agencies, to be selected in consultation with AFSA.
TABLE OF CONTENTS
Executive Summary.............................................................................................................................6
Introduction
Context................................................................................................................................................13
Methodology......................................................................................................................................14
Section 1: AFSA CHP Progress, Outcomes, Impact, Sustainability
1.1 Progress of AFSA Culture and Health Programme....................................................................18
1.2 Outcomes and impact of AFSA Culture and Health Programme..........................................31
1.3 Implications of AFSA CHP closure on partner CBO...................................................................47
Section 2: Analysis of Domestic and International Funding Markets
2.1 Context.........................................................................................................................................60
2.2 Nature and size: competitiveness of organisations seeking funding.....................................62
2.3 Analysis of domestic funding market.........................................................................................66
2.4 Analysis of international funding market....................................................................................72
Section 3: Recommendations
3.1 Recommendations for Culture and Health Programmme....................................................80
3.2 Recommendations related to funding.....................................................................................86
Annexure 1.........................................................................................................................................91
Annexure 2.........................................................................................................................................95
Annexure 3.........................................................................................................................................96
LIST OF ACRONYMS
AIDS Acquired Immune Deficiency Syndrome
AFSA Aids Foundation of South Africa
CBO Community Based Organisation
CCE Community Capacity Enhancement
CHP Culture and Health Program
DoH Department of Health
DoSD Department of Social Development
EC Eastern Cape
ECD Early Childhood Development
HIV Human Immunodeficiency Virus
KPA Key Performance Area
KZN KwaZulu-Natal
NC Northern Cape
NGO Non Governmental Organisation
SASI South African San Institute
STI’s Sexually Transmitted Infections
LGBTI Lesbian, Gay, Bisexual, Transgendered and Intersex people
RNE Royal Netherlands Embassy
TCF Traditional Circumcision Forum
THP Traditional Health Practitioners
VCT Voluntary Testing and Counseling
WC Western Cape
EXECUTIVE SUMMARY
Report Overview
The Culture and Health Programme (CHP) of the AIDS Foundation of South Africa (AFSA) aims to reduce marginalization and promote behavior change through supporting CBOs in South Africa to increase access to services; catalyse changes in attitudes and practices; and strengthen health-promoting values and behaviours. The Royal Netherlands Embassy (RNE) ended its bilateral support to South Africa and therefore terminated funding for the CHP in March 2012. As a result, the CHP closed down 2 years and 9 months into the 5 year planned implementation period. The RNE subsequently called for an external evaluation of the CHP to examine its impact and evaluate the potential for sustainability of the programme.
Creative Consulting and Development Works implemented a mixed-method research design for the evaluation of the CHP. Through qualitative data collection techniques, our team developed an in-depth understanding of the objectives in relation to the assessment of impact and sustainability. The evaluation incorporated fieldwork site visits at the locations of 12 CBOs in total (with one target group consulted per CBO). Findings were generated through desktop literature review, key informant interviews and observations. The research approach was emphatically based on participatory and appreciative inquiry and outcome mapping.
The report begins with a brief INTRODUCTION that provides an overview of the context in which the evaluation was called. This is followed by a description of the METHODOLOGY used for the evaluation, including an outline of the data collection instruments.
SECTION 1 of the report describes the AFSA CHP’s progress, outcomes/impact, and implications of closure.
SUB-SECTION 1.1: PROGRESS
This sub-section gives an introduction that outlines the objectives of the CHP, and then details the progress of the CHP toward achieving its intended outcomes. For clarity, the progress section is divided in two parts; firstly, progress made in terms of capacity-building, networking and organisational development, and subsequently progress made with regard to the five beneficiary groups.
Significant progress has been made by AFSA CHP in terms of capacity-building, networking, and organisational development. Capacity-building has resulted in the exposure to new ideas, the development by some CBOs of research projects, and skills-building in important areas such as financial management and accountability to donors. Through networking opportunities, CBOs have entered into formal and informal alliances with other civil organisations and with government institutions. CHP-facilitated organisational development has precipitated the formation of some CBOs into independent organisations with clearly defined agendas, and the development of organisational structures such as financial management systems.
Progress has been made to varying degrees by CBOs in terms of achieving outcomes and results for beneficiary groups. For CBOs targeting Rural Men as Partners and Fathers, the establishment of local men’s groups, workshops, boys’ clubs in schools, community theatre dialogues, radio shows, and microenterprise programmes has served to create a safe space for male-to-male dialogue and begun to challenge gender stereotypes. For Initiation Schools, the CBO visited has created a database of THPs and schools and established a bush tracking programme to ensure accountability; established peer education teams and circumcision forums; and cultivated partnerships with government and biomedical institutions. For San people, the CBO visited had established a successful radio talk show, and a life skills programme with door-to-door visits, information and training sessions. With regard to LGBTI people, CBOs had conducted a baseline study and started up a new project in a community based on the baseline findings, held workshops and training sessions, and cultivated relationships with stakeholders. For all beneficiary groups, the least progress has been made toward establishing microenterprise programmes, due to high start-up costs.
SUB-SECTION 1.2: OUTCOMES & IMPACT
This sub-section gives an introduction into the nature of impact, and thereafter delineates key outcomes and impact for each beneficiary group. The analysis is based on qualitative data gathered through key informant interviews and focus groups, as quantitative data was generally not available. Outcomes and impact for each beneficiary group are as follows:
For Rural Men as Partners and Fathers, key outcomes and areas of impact include creating safe spaces among men for discussion of cultural practices and attitudes; increasing acceptance of formerly marginalised people such as HIV positive patients and LGBTI; improving relations between males of different generations, and increasing respect for elders; increasing awareness of and interest in health issues such as HIV/AIDS; promoting adherence to treatment and visits to the clinic for VCT; and challenging gender norms, as demonstrated by a reduction in cases of domestic abuse in tribal courts. Economic empowerment has not yet been achieved, and behaviour change has generally been a slow process, as expected.
For Initiation Schools, key outcomes and areas of impact include increased awareness among THPs of how to treat HIVs and STIs and when to make referrals; a reduction in harmful outcomes for initiates undergoing circumcision, including botched circumcisions and mortality; improved conditions within initiation schools, with fewer young boys undergoing circumcision; increased cooperation between THPs and biomedical practitioners, particularly in the form of referrals; and the establishment of partnerships with government. A key barrier was the lack of a transport vehicle. For THPs, key outcomes and areas of impact include encouraging respect for traditional healing in communities through the promulgation of culturally sensitive curricula; increased cooperation with biomedical practitioners in the form of referrals and joint workshops; a reduction in the incidence of harmful practices used by THPs; increased uptake of VCT services, and increased usage of Anti-retroviral drugs; and a reduction in the prevalence of harmful beliefs such as bewitchment.
For San people, key outcomes and areas of impact include personal growth of peer educators, improvements in the understanding of HIV/AIDS on the part of some elders and THPs; and the promotion of nutritional outcomes through the establishment of 22 home food gardens as part of the ECD programme. Behavioural change has remained slow. For LGBTI, CBOs have established safe spaces for LGBTI people and visibility for previously anonymous groups such as intersex people; provided vital support to hate crime victims; and achieved some (at least short-term) transformations in myths and stereotypes through workshops. Evidence of long-term behaviour change has not been established. The development of relationships with traditionally hostile groups (i.e. police, clergy, tribal chiefs) has resulted in some notable changes in attitudes and behaviour.
SUB-SECTION 1.3: IMPLICATIONS OF CLOSURE
This sub-section provides an overview of potential implications of closure for CBOs and staff, beneficiaries, and the larger community.
For CBOs and staff, it was found that CBOs will for the most part will likely remain open (at least in the short-term), but will operate in a significantly reduced capacity. Many staff members will continue to work on an unpaid basis until ‘volunteer fatigue’ hits. Staff members fear that reduced programme operations will result in a negative backlash from beneficiaries. Wherever relationships with government are strong, CBOs hope to rely on these relationships to secure them access to funding and support; approximately 60% of CBOs visited have established some connection with a government institution. Around 70% of CBOs have applied for or are planning to apply in the near future.
For beneficiaries, much of the momentum gained with regard to incipient transformations in attitudes and behaviours will be lost. Support groups, workshops, and other programmes (particularly those in outlying areas) will likely shut down, and therefore there will be a reduction in safe spaces for discussion. Beneficiaries may be discouraged, and there could be an outpouring of frustration on the part of community members. THPs entering into practice may lack access to education programmes, initiation schools may deteriorate, and biomedical practitioners may drop their involvement with workshops. Developing microenterprise programmes will likely shut down.
In the larger community, marginalised and/or culturally vulnerable groups of people will have diminished access to appropriate sexual health education and care. People will likely continue to engage in risky behaviours and cultural practices that contribute to HIV transmission in South Africa, which may have negative implications for society as a whole,
SECTION 2: ANALYSIS OF DOMESTIC AND INTERNATIONAL FUNDING MARKET
There is an extremely competitive funding climate in South Africa. Organisations seeking funding have increased in numbers. This is mainly due to the diversity of backgrounds from which organisations emerge. The increase in numbers of organisations working in the areas of culture and health has created enormous pressure on the donor community against the backdrop of harsh global economic conditions.
Organisations seeking funding are under immense competition from each other as they seek to access funding from limited available sources. Application for funding is very competitive and difficult to secure. The number of organisations that respond to calls for proposals and those that apply for funding is large. Another factor indicating that the funding climate is competitive is the level of compliance to mandatory funding selection criteria. In addition, the manner in which organisations attempt to out-class competitors through the innovative designing of intervention and projects goes beyond expectations of donors.
Corporate donors in South Africa award funding to any organisation that conforms to the funding criteria governed by the company’s corporate social investment policy. There is no discrimination of organisations that may apply for funding.
Similar to the majority of foreign donors with offices located in South Africa, domestic donors create opportunities to fund organisations that are national and have a national impact in a bid to increase confidence in South Africa’s development organisations, showing commitment to South African investment and capacity building with the aim to relinquish dependency on foreign donors.
Domestic and foreign donors are confronted with challenges as well as successes. The most significant challenge is providing sufficient financing to organisations. Donors expressed that there is not enough money to fund organisations. It was gathered from the donors interviewed that both the local and international community have people that are desperate to help but the problem is that there are insufficient funding opportunities.
AFSA’s Culture and Health Programme management was also approached to provide their view. It emerged that management believes that in the current domestic funding environment, donors are showing a strong focus on biomedical interventions or for interventions that are going to yield quantifiable or measurable results in a fairly short time frame. Donors are currently shifting interest towards interventions that do not yield impact per se but those that yield outcomes. The CHP believes that donors are showing less interest in behavioural change interventions, which in essence are mainly long-term interventions, which are meant to affect relationships, assist people and help them make wiser choices about their health care.
SECTION 3: RECOMMENDATIONS
The recommendations are divided into two sections: recommendations for the CHP, and recommendations with regard to funding.
SUB-SECTION 3.1: RECOMMENDATIONS FOR CHP
➢ Enhance capacity-building, networking, and organisational development activities for CBOs, as these activities are highly valuable.
➢ Continue to use workshops to achieve intended outcomes. Workshops are effective for a number of reasons; they promulgate culturally sensitive curricula, create safe spaces for discussion, and examine the root causes of negative behaviours.
➢ Expand the use of innovative and participatory educational methods, such community theatre dialogues and radio programmes. These methods promote local ownership and sustainability, generate substantial interest, reach a wide audience, and are cost-effective.
➢ Strengthen and expand income-generating activities. These activities enhance economic independence and build enthusiasm, group cohesion, and local ownership.
➢ Encourage CBOs to develop and formalise partnerships with government and civil society. These partnerships have the potential to increase impact and promote sustainability. They could be formalised through the development of MOUs.
➢ Invest in transport vehicles. Infrastructure is poor outside of cities and there is a dearth of public transport options. Independent transport is integral to widening project scope.
➢ Encourage CBOs to gather and collate qualitative and quantitative evidence of impact.
➢ Develop and strengthen systems for tracking behaviour of beneficiaries in order to promote accountability.
➢ Publicise examples of best practice. CHP programmes have achieved notable successes, and these could be promoted as an avenue to secure access to alternative funding.
➢ Encourage CBOs to diversify funding base and separate individual programmes from organisations as a whole. CBOs with a diverse funding base and multiple programmes running simultaneously are most likely to survive the funding crisis intact.
➢ Implement exit strategy, and ensure that this strategy is communicated widely to partner CBOs. The exit strategy should prioritize CBOs most in need, and include assistance with proposal preparation and submission.
➢ Address disconnect between CBO objectives and actual activities, particularly to avoid a situation whereby a community comes to view the CBO as a funder and general provider of community needs rather than as a partner in development.
➢ Strengthen monitoring of CBO activities and governance to avoid isolated cases of financial and programme mismanagement.
SUB-SECTION 3.2: RECOMMENDATIONS RELATED TO FUNDING
➢ CBOs should submit proposals for long-term interventions or programmes that address culture, health, gender and human rights needs.
➢ Proposals can be strengthened by comprehensively providing history and prior achievements of the organisation.
➢ Donors are generally impressed with proposals that reveal the internal structure of the applicant organisation, particularly with regard to accountability and human resources.
➢ Proposals should indicate a contingency plan.
➢ Organisations seeking funding should provide proof of their Broad-based Black Economic Empowerment status in their proposals.
➢ Proposals should include an impact assessment mechanism.
➢ Budgets should provide clarity and transparency around areas that require financial support, and should not include operational costs
➢ Prior to submitting a proposal, organisations should conduct comprehensive research concerning areas that a potential donor will fund, and the donor’s funding criteria.
➢ Proposals should showcase human element.
➢ Proposed interventions as outlined in proposals should allow for a certain degree of flexibility with regard to interventions.
➢ Proposals should demonstrate that an intended intervention will actively engage with the target community.
ANNEXURE 1 provides the data collection instruments used to gather qualitative and quantitative data during the evaluation. ANNEXURE 2 lists the organisations visited by fieldworkers in accordance with the sampling framework. ANNEXURE 3 provides an overview of funding criteria used by domestic and international donors.
INTRODUCTION
CONTEXT
Stigma and gender-based violence have been important drivers of the HIV/AIDS epidemic in South Africa. The prevalence of stigma surrounding HIV/AIDS makes people less likely to share their status with others and secure access to vital treatment services, and this is particularly the case in rural areas where HIV/AIDS awareness tends to be lower. The links between HIV/AIDS and gender based violence are becoming increasingly apparent based on the findings of various studies conducted primarily in the United States and Sub-Saharan Africa, which have clearly shown an increased risk of HIV/AIDS among women victims of gender based violence and also that being HIV positive is a risk factor for violence against women. This vicious cycle has grave consequences for global health and human development, and has contributed to the ‘feminization’ of AIDS in regions like Sub-Saharan Africa. In addition, rural areas in particular are characterized by a continued reliance on traditional healing methods; it is estimated that over 60% of the population in rural South Africa seeks health advice and treatment from traditional healers before visiting a health care professional.[1] These realities demonstrate that any comprehensive and targeted campaign against the HIV/AIDS epidemic should address the cultural drivers of the epidemic and social determinants of access to health care services; and that these cultural programmes should involve men as key partners in the fight against the epidemic.
The Culture and Health Programme (CHP) of the AIDS Foundation of South Africa aims to reduce marginalization and promote behavior change through supporting CBOs in South Africa to increase access to services; catalyse changes in attitudes and practices; and strengthen health-promoting values and behaviours. Creative Consulting and Development Works recognizes the importance of the groundbreaking work pursued by AFSA, and our team shares the commitment to providing a comprehensive and sustainable solution to the HIV/AIDS epidemic in South Africa. At the same time, Creative Consulting and Development Works understands that changed political realities, including the economic climate in Europe and South Africa’s status as a middle income country, has dictated that the Royal Netherlands Embassy (RNE) end its bilateral support to South Africa; and therefore terminate funding for AFSA’s CHP by March 2012. As a result of this decision, the CHP closed down 2 years and 9 months into the 5 year planned period.
The RNE has subsequently called for an external evaluation of the CHP to examine its impact and to ensure the programme’s sustainability. Creative Consulting and Development Works conducted a rigorous and directed evaluation to address the objectives as outlined in the Terms of Reference (ToR). This final report of the evaluation includes research results, analysis of results, and key recommendations that will delineate the two broad indicators of impact and sustainability.
METHODOLOGY
Creative Consulting and Development Works implemented a mixed-method research design for the AFSA Culture and Health Programme (CHP) evaluation. Data collection incorporated a period of rigorous desktop reviews that informed subsequent field research. The research approach was emphatically based on participatory and appreciative inquiry and outcome mapping. Through qualitative data collection techniques, our team developed an in-depth understanding of the objectives in relation to the assessment of impact and sustainability as outlined in the ToR. The evaluation incorporated fieldwork site visits at the locations of 12 CBOs in total (with one target group consulted per CBO).
During the course of the evaluation, in-depth insight was generated through a desktop review and background research, key informant interviews, and observations.
As outlined in the ToR, the evaluation accomplished the following tasks:
✓ Identifying and analyzing the progress, results, outcomes and impact of the CHP for the period 1 April 2009 – 15 December 2011, against the approved plan and budget
✓ Analyzed the implications of the possible closure of the CHP for the organisations it supports and their beneficiaries
✓ Defined the nature and size of the ‘market’ in which the CHP competes for funding i.e., similarly situated organisations utilising research, funding, capacity building and rights-based advocacy to campaign improve health outcomes of culturally marginalised people.
✓ Carried out an analysis of opportunities for and problems with domestically sourced funding for a program such as CHP, including sources such as International Development Agency, and corporate social investment.
✓ Investigated attitudes of selected foreign government and private foundation donors with offices in South Africa to investment in NGOs whose focus is on health, culture, gender and human rights.
To accomplish the above mentioned objectives, participatory and appreciative inquiry approaches incorporated the following parties:
✓ Project stakeholders (AFSA)
✓ Project partners, i.e. NGOs and CBOs working in the HIV/AIDS sector in South Africa
✓ Key informants from each of the 5 CHP target groups: Rural Men as Partners and Fathers; Traditional Healers; Initiation Schools; Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) people, and San peoples.
✓ Interviews with relevant officers in up to 10 donor agencies/ South African corporations, international development agencies, foreign private donor foundation were selected in consultation with AFSA.
Data collection tools were developed following a desktop review and background investigation. The tools were carefully selected to ensure that the evaluation responded to the key objectives in a comprehensive manner. Background research was necessary prior to developing the research tools and methods so that the tools were able to efficiently and purposively capture relevant information. Key informants were carefully selected on the basis of their potential to contribute to the evaluation objectives, with the aim of ensuring that a sufficiently diverse range of perspectives and expertise was taken into account from different levels within government and civil society. AFSA was closely involved and updated throughout the process.
The table below is a brief summary of data collection methods:
Table 1: Overview of Data Collection Methods
|Method |Details |Purpose |
| |Internal AFSA documents and progress reports, monitoring and evaluation |Provide background information about|
|Document reviews and |plans, meeting minutes, and any other relevant documents from the period|the nature and impact of AFSA’s CHP |
|background research |1 April 2009 to 15 December 2011 |Familiarize with market for |
| |Collection of background information and review of publications on |non-profit funding and trends in |
| |funding market, with a focus on domestic funding sources |domestic social investment |
|Routine Data Collection |Outcomes and results furnished by members of AFSA and project partners |Collection of key data and |
| | |indicators relevant to progress and |
| | |impact |
|Structured and |Interviews with key informants from selected partner CBOs, including |Gain in-depth perspective on the |
|Semi-structured Interviews |informants from 5 CHP target groups; and with relevant officers in up to|impact and sustainability of the |
| |10 donor agencies/South African corporations. |CHP; |
| | |Analyse domestic funding |
| | |opportunities |
|Structured and unstructured|Wherever possible, i.e. if the evaluation coincides with a relevant |Ascertain supplemental qualitative |
|observations |meeting, forum, etc. |data |
Fieldwork was conducted in four provinces across South Africa in total: Western Cape, Northern Cape, Eastern Cape and KwaZulu-Natal. These locations were selected in consultation with AFSA. Creative Consulting and Development Works completed a total of 12 site visits to a sample of CBOs, with one target group consulted at each site location. Below is a more detailed description of the primary data collection tools that will be utilized for the evaluation:
Interviews
Fieldworkers conducted interviews with key informants selected following the desktop review and consultations with AFSA. These interviews were structured and semi-structured and framed by an appreciative inquiry approach.
Interviews were conducted with key officials of selected partner NGOs and CBOs, including key informants from 5 target groups; key informants from up to 10 prospective donors; and with selected AFSA representatives as needed. Routine data on the impact of AFSA’s CHP was collected from staff members.
Interviews formed the bulk of data collection and responded to the objectives outlined in the ToR. In particular, interviews with AFSA representatives helped identify the progress, results, outcomes and impact of the CHP against the approved plan and budget for the period 1 April 2009 – 15 December 2011, and furnished information needed to define the nature and size of the ‘market’ in which the CHP competes for funding.
Secondly, key informant interviews with representatives from selected CHP partners provided information about the impact of the CHP, and enabled our team to analyse the implications of the possible closure of the CHP for the organisations it supports and their beneficiaries. These interviews were conducted with an eye toward evaluating the potential for sustainability. Included amongst the key informants selected were representatives from each of the 5 CHP target groups. These interviews were integral to ascertaining the impact of CHP and implications of the possible closure of the CHP for the programme beneficiaries.
Lastly, key informant interviews were conducted with representatives from up to 10 donor agencies. These interviews served as the basis for the analysis of trends in corporate social investment, attitudes of potential investors, and, generally speaking, opportunities for and problems with domestically sourced funding for a programme such as the CHP. This analysis served to make key recommendations as to the financial sustainability of the CHP and prospects for obtaining domestic funding that will enable the continued existence of the programme. These key informants were selected following a background investigation of the funding market and consultations with AFSA. Telephonic interviews were conducted with key informants who are not available for face-to-face interviews. Interviews were recorded for back-up purposes and, in addition, interviewers took notes.
Focus Group Interviews
Semi-structured focus group interviews were conducted with CBO beneficiaries.
Routine Data
Routine data was collected during fieldwork and key informant interviews where needed. Some examples of routine data included progress reports, monitoring and evaluation reports, etc.
SECTION 1: AFSA CHP PROGRESS, OUTCOMES/IMPACT, AND IMPLICATIONS OF CLOSURE
1.1 PROGRESS
INTRODUCTION: ROLE OF AFSA’S CULTURE AND HEALTH PROGRAMME
The Culture and Health Programme (CHP) was designed as a five-year intervention, starting in June 2009,[2] and fully funded by the Royal Netherlands Embassy (RNE). The programme funds 20 CBOs across 8 provinces, with a common purpose of exploring, reflecting and responding to the ways in which cultural practices affect health in both positive and negative ways. The overarching goal of the CHP is to improve measurably the health and well-being of culturally vulnerable and marginalised populations by:
← Increasing access to appropriate sexual health education and care,
← Strengthening health-promoting cultural practices, and
← Challenging cultural attitudes and practices that negatively affect health behaviours, as well as mental and physical well-being.
The CHP deals with critical issues related to HIV/AIDS by engaging with stakeholders at different platforms and levels of civil society and government. The core function of the CHP is the mobilisation of funding to equip CBOs and non-governmental organisations (NGOs) with financial resources and appropriate skills to implement primary health care and development programmes, which limit the spread of HIV/AIDS and mitigate the impact of the HIV/AIDS epidemic on vulnerable communities in South Africa.[3] In this regard, AFSA acts as an interface between donors and CBOs and NGOs working in the HIV and AIDS sector, placing donor funds with strategically selected organisations and providing them with ongoing mentoring, technical support and capacity-building.[4] Engaging with stakeholders in the manner described above, AFSA creates a platform that enables partner organisations to implement relevant and effective interventions to improve the health status and well-being of communities and target populations.[5]
AFSA’s philosophy entails implementing interventions through working with organisations located and operating within close proximity to target communities and groups. AFSA believes in working with organisations that work hand-in-hand with target communities and groups, because these organisations are made up of local people who understand and experience the needs and challenges of the communities they serve. For the organisations mentioned above, AFSA strives to provide capacity-building for these as a means of providing support.
The main objectives are;
✓ to equip CBOs and NGOs with the necessary resources and support to implement programmes for the effective prevention of HIV and the mitigation of the impact of AIDS,
✓ to develop the skills base within target CBOs and NGOs to enable them to plan, implement, monitor and evaluate their work effectively and
✓ to build the organisational capacity of partner organisations for good governance and long-term sustainability.[6]
In order to achieve these objectives, AFSA provides financial grants over an allocated number of years to selected CBOs and NGOs for programme implementation. In addition to providing grants, AFSA builds the organisational strength of the selected CBOs and NGOs. AFSA has been engaged with community level organisations since 1994 when the Foundation moved beyond simply grant making to provide a comprehensive package of support services to CBOs.[7] AFSA recognised that if the work of CBOs was to have a meaningful impact on health and development outcomes, CBOs required more than just funding. AFSA recognised that CBOs needed to have organisational systems and skills in place to support their activities and service delivery.
Due to the RNE’s decision to end its bilateral support to South Africa, the CHP is to close midway through its implementation, with two years and 9 months out of the five-year programme having been completed. The following section will report on the progress of the CHP in achieving its objectives. The section has been divided into two parts, namely; progress made in terms of capacity-building, networking and organisational development, and progress made with regard to the five beneficiary groups. The choice to divide the progress section into two parts was made in recognition that the CHP’s ongoing support of CBOs in terms of capacity-building, networking and organisational development has profoundly transformed these CBOs and should not be left out in a comprehensive analysis of progress.
PROGRESS: CAPACITY-BUILDING, NETWORKING AND ORGANISATIONAL DEVELOPMENT
Capacity-building:
AFSA had the insight to recognise that if the work of partner CBOs was to have a meaningful and sustained impact on health and development outcomes in marginalised, culturally vulnerable populations, CBOs required more than just financial support. In addition to funding, CBOs also needed;
← to be capacitated to develop and monitor their own programmes,
← to ensure that these programmes responded to intended outcomes and were modelled on best practice in the industry,
← to produce the reports and documentation necessary for donor support,
← to develop and maintain organisational structures and programmes such as financial planning, and
← to package their programmes in such a way that access to alternative sources of funding was a possibility for the future.
AFSA’s CHP has carried out capacity-building programmes for CBO staff through workshops and training sessions for CBO management and staff members in a variety of areas, including but not limited to counselling, monitoring and evaluation, organisational development and project management. For nearly every organisation visited, these workshops and training sessions were described as “highly valuable” and “one of the greatest benefits yet.” AFSA’s support, furthermore, is more than a once-off capacity-building exercise; interviews revealed that the support is often ongoing, in the form of quarterly monitoring, site visits, phone calls and a structured mentoring programme. Some CBOs described the CHP as both a “funder and mentor,” noting AFSA’s continuous assistance in responding to questions and issues that arose throughout the funding cycle.
AFSA-run workshops proved valuable both in terms of skills-building for staff members as well as for the exposure of members to new ideas, which were then transferred to the beneficiary base and the larger community. One CBO working with initiation schools described how AFSA’s workshops exposed its staff members to concepts and ideas they had little experience of, such as homophobia. These concepts were then subsequently discussed through the appropriate platforms in the CBO programming and then also conveyed to beneficiaries. Another CBO dealing with Lesbian, Gay, Bisexual, Transgender and Intersex people (LGBTI), described how AFSA-run training sessions of eight youth members in 2011 resulted in the CBO employing four of these youths on a permanent basis; they are now integral members of the organisation.
Networking:
In addition to capacity-building, the CHP provided networking opportunities for its partner CBOs. Multiple key informants from CBOs commended the fact that partnering with the CHP enabled them to enter into networks and alliances, both formal and informal, with other CBOs and NGOs from both inside and outside of the AFSA funding network and with influential individuals. A key informant from a CBO working in a rural community, where few or no other organisations operate, spoke of the importance of belonging to a network of other CBOs, supported by CHP, that pursue a similar line of work. Such networks, which were sometimes referred to as a “family of organisations” by CBO key informants, provided a platform upon which CBOs could engage, share evidence of best practice and coordinate events and programming.
AFSA’s capacity-building programme also connected CBO management with other individuals, sometimes resulting in the fruitful exposure to new ideas. A key informant from a CBO described how her relationship with AFSA resulted in an invitation to attend a multinational traditional health practitioner conference abroad, where she was able to network with other individuals and learn about the development of the new Traditional Health Practitioners Act in South Africa. Upon her return, she was involved in the creation and distribution of a pamphlet to disseminate information about this policy to the broader community. Another key informant described how, as a result of support from AFSA, he was able to attend a conference hosted by the Department of Education, where he met a professor who presented his research findings on successful educational programmes. The key informant, who had run educational programmes as part of CBO programming, was inspired to develop a similar research project to investigate the impact of his programmes. The professor’s presentation, he maintains, taught him a great deal about how to plan a controlled study to develop evidence of the effectiveness and impact of NGO programming, which could then be used as a basis to secure access to funding. The only problem, the key informant noted, was that he did not currently have the funding for such a research project.
Organisational development:
Considerable progress has been made in providing CBOs with a platform to pursue organisational development. Key informants from numerous partner CBOs attest to the fact that entering into a partnership with the CHP enabled them to develop into fully-fledged organisations. Before having ever received funding, many of the CBOs had no organisational strategy or defined structure, many operating on a part-time basis with a skeleton structure. It was the process of obtaining funding and particularly the requirements of funding that often precipitated the formation of CBOs as independent organisations with clearly defined agendas. According to one key informant; “Before the funding cycle, our organisation was just an idea. We attended some meetings and events, but we just ‘piggybacked’ off the work of other organisations.” Funding enabled CBOs to purchase office space and essential equipment such as telephones, computers and, for a few organisations, transport vehicles. Moreover, it also allowed CBOs to pay staff members and therefore incorporate new skills and ideas into their organisation. More staff members also meant that CBOs could expand their organisational visibility and programming in outlying areas.
Furthermore, CHP training sessions and the requirements of funding led to an increase in understanding amongst CBO management of what it takes to maintain an organisation and how to be accountable to donors. One key informant described how, prior to working with AFSA, the CBO did not have any financial planning, budgeting and monitoring and evaluation systems in place. Financial support, training sessions and mentorship from the CHP facilitated the development of such structures.
Areas of improvement:
Despite these successes, there is still progress to be made in terms of capacity- and skills-building, as well as organisational development. Creative Consulting & Development Works found that some CBOs are run by a dynamic, experienced and knowledgeable leader, but often those skills are concentrated in that particular leader alone. The leader may have a base of other staff members, but no other staff member within the organisation approaches the level of knowledge and skills concentrated in that leader. This in turn leads to a situation where organisational and leadership boundaries are blurred, such that the organisation is no longer separate from its leader. Furthermore, this leads to long-term problems with organisational sustainability.
In addition to these obstacles, for those CBOs that developed into independent organisations as a result of CHP funding, a situation may have arisen whereby a CHP-funded programme has become confused with the organisation as a whole. This situation also has the potential to lead to negative implications if alternative funding cannot be obtained, which is explored further in section I.3.
PROGRESS: FIVE BENEFICIARY GROUPS
The CHP identified the following groups of culturally vulnerable and/or marginalised populations, chosen because they have been previously excluded, neglected or inappropriately targeted in terms of efforts to address health concerns and the risk and impact of HIV and AIDS:
1. Rural Men as Partners and Fathers
2. Initiation Schools
3. Traditional Healers
4. San Peoples
5. Lesbian, Gay, Bisexual, Transgendered and Intersex people (LGBTI)
The CHP conducted research from August 2009 to May 2010 to explore perceptions among and towards the five target groups in relation to HIV risk, health promotion, gender and sexuality and to test the assumptions underlying the planned CHP. The baseline study was carried out in 20 communities, with prospective CBO partners in each target group. It is noted by Creative Consulting & Development Works that the results of this study closely informed CHP programming, which is described below. What follows is an outline of progress in terms of the five chosen groups of marginalised populations.
1. Rural Men as Partners and Fathers
Although programmes are in their developing stages, significant progress has been made in laying the groundwork for achieving the objectives of the Rural Men as Partners and Fathers programme.
A primary key performance area is the establishment of local community men’s groups and workshops to accomplish the objective of engaging men in dialogue and action around issues of gender, sexual and reproductive health, parenting and the prevention of sexual and domestic violence, in order to create a safe space where the sensitisation of men can take place. These training opportunities and workshops are designed to encourage discussion of issues like HIV/AIDS, traditional circumcision and masculinity in a culturally sensitive manner.
The establishment of training opportunities and workshops required the development of carefully thought-out, evidence-based, culturally sensitive curricula, modelled on the research findings of the CHP baseline studies. Creative Consulting & Development Works found that, by and large, organisations met their 2011/2012 targets in relation to the establishment of these men’s groups. Progress in this area is demonstrated at the CBO level through the creation of forums such as men’s support groups and boys’ clubs in schools.
One CBO visited has set up over 10 men’s support groups in various communities, which are viewed positively by the beneficiaries interviewed. While local ownership of these groups has not yet been achieved, the groups have certainly created a safe space for male-to-male dialogue. Another CBO has reached six schools thus far through boys’ clubs, which hold debates involving both boys and girls about topics such as safe sex, transactional sex and coping with unemployment in positive ways. This CBO has also made progress toward creating safe spaces for men through Community Action Teams, which are groups of trained volunteers that travel to outlying areas to talk to people in taverns about safe sex and HIV/AIDS. It is unclear, however, how much action is actually taken by these teams; according to one CBO informant, much of the work of these teams involves gathering information about activities in the community and reporting back to the organisation. As part of this programme, a number of teachers have been trained in life skills and have become “partners” who now assist with conveying positive educational messages to boys in schools.
Other educational methods are employed by CBOs to create a safe space where the sensitisation of men can take place. One CBO has recently begun to use community theatre dialogues, a particularly successful educational method that has been enormously well-received by beneficiaries. By recruiting beneficiaries to act out scenarios designed to challenge stereotypes and change people’s behaviour, theatre enhances participation and local ownership. Another CBO uses radio programmes to engage beneficiaries, particularly in the rural areas. This CBO runs on-air drama shows and implemented a new children’s programme in April 2011 that has resulted in a 35% increase in listenership, bringing the total number of listeners to approximately 80 000.
Progress toward the second key performance outcome of stimulating debate and facilitating learning to promote change in knowledge, attitudes, and behaviour of men toward women and girls – thereby challenging entrenched patriarchal attitudes and gender roles and catalysing behavioural change – has occurred through activities that include the establishment of men’s forums and the operation of imbizos, where instruction on cultural and gender sensitivity is administered. Progress toward this intended outcome varies widely across CBOs. One CBO visited evidently made little progress, as it had not yet established men’s forums nor held its own imbizos on cultural and gender sensitivity. Instead, it provided catering and educational programmes at Sunday imbizos already organised by the community.
Lastly, some progress has been made toward providing motivational and skills training for men to enhance personal and economic empowerment, but these programmes are very much still in their infant stages. A key activity toward this outcome is the establishment of income-generating activities to build enthusiasm, group cohesion and local ownership. CBO progression toward the creation of income-generating activities varies somewhat, with one CBO not having made any progress toward the objective and another having begun to roll out the activities, but not yet having developed any local ownership to ensure sustainability. CBOs have generally given beneficiaries significant leeway in choosing income-generating projects for themselves, which serves to promote local ownership and sustainability. The activities include, but are not limited to gardening, leatherworks, handicraft and rearing poultry. This approach has a particular focus on improving the economic situation of rural men such that they can be better providers for their families.
The CHP has also supported some research initiatives of its partner CBOs. For instance, one CBO is now planning to conduct a study, with AFSA funding, to examine what role could be played by men in terms of making progress toward achieving Millennium Development Goals 4 and 5 (which are, respectively, to reduce the child mortality rate and maternal mortality rate by two-thirds before 2015). While it is not clear how the funding cut will impact the project, it is noted that this could be a self-sustaining component of the CBO that could potentially bring in more access to funding for the CBO, particularly because maternal and child mortality has been a particular focus in South Africa and internationally of late.
2. Initiation Schools
CBOs targeting initiation skills aim to equip traditional healers (otherwise known as Traditional Health Practitioners (THP)) with the knowledge, networks and training they need to provide for the health and well-being of initiates. These CBOs aim to enhance the knowledge, skills and practices of traditional healers with regard to harm reduction, infection control, Sexually Transmitted Infection (STI), HIV transmission and prevention strategies, thereby enabling THPs to practice infection control and harm reduction procedures. From the visit to Ubuntu Bethu, it was deduced that significant progress has been made in terms of achieving this objective. Ubuntu Bethu has provided training sessions for a number of traditional surgeons and nurses and now has a database of 23 traditional surgeons, each of whom brings two traditional nurses to workshops. Before funding from the CHP, the CBO informally knew about four traditional surgeons and no nurses. The establishment of a database is an important monitoring tool that enables Ubuntu Bethu to hold THPs accountable for their behaviour. The workshops are normally run by doctors, who teach THPs how to identify life-threatening conditions and how to practice circumcision safely, so as to reduce botched circumcisions. For those boys who do experience amputations, counselling is provided by Ubuntu Bethu.
To ensure the safety of initiates and to regulate conditions at initiation schools, Ubuntu Bethu has established a bush-tracking programme whereby CBO volunteers visit initiation schools to ensure THPs are in a good state of mind and initiates are treated humanely. These visits occur twice a year. Progress toward the expansion of this programme is inhibited by the lack of a transport vehicle.
Peer education teams serve to promote a holistic approach to HIV prevention and to promote and facilitate the review and extension of cultural teachings in initiation schools to include gender transformative messages around cultural expectations, social roles and responsibilities and safe sexual practices. Several teams have been established and are continuously monitored and advised by Ubuntu Bethu. These teams hold peer education indabas, where they take about 90 peers to a secluded location to conduct dialogues. According to the CBO director, these teams aim to “teach men how to be ‘good men’ and to redefine manhood to produce responsible men.” They give young boys a platform to resist peer pressure and wait to get circumcised until they are of an appropriate age. Boys are also counselled on how to adhere to treatment and seek voluntary counselling and testing (VCT) . Traditional Circumcision Forums (TCFs) have also been established to increase awareness about HIV/AIDS and to ensure that proper procedures are followed during initiation procedures.
Ubuntu Bethu has developed an impressively wide range of relationships with various stakeholders that include health advisory committees, biomedical health care providers and governmental institutions such as the Department of Health, the Department of Social Development and the Department of Justice. These relationships are still in their developmental stages and require ongoing cultivation, but significant progress has been made considering the fact that, prior to AFSA funding, the Ubuntu Bethu had not yet developed its own identity as an independent organisation. According to a Department of Health spokesperson who was present on the day of Creative Consulting & Development Works’s visit, the workshops involve a range of stakeholders such as the Departments of Health and Justice, SAPS and traditional leaders. Biomedical health care providers have been relatively receptive to working with THPs, but progress in this realm is primarily hindered by the fact that many doctors are demanding pay for conducting THP workshops.
3. Traditional Healers
Significant progress has been made by CBOs targeting traditional healers, although this progress is uneven across the board and local ownership of the programmes is not yet established. Three intended outcomes are to enable THPs to practice infection control and harm reduction procedures; promote the health and well-being of HIV-positive clients and reduce morbidity and mortality; and ultimately, equip THPs to play an enhanced role in the national response to HIV/AIDS. The number of workshops held is one quantitative benchmark by which progress toward this outcome can be measured and in this respect it becomes apparent that progress has been made across all CBOs visited.
One CBO visited ran 12 workshops in a year (with one workshop per month) and trained about 130 THPs in total within that year. That is a relatively standard outcome across CBOs. These workshops, furthermore, were valued by THPs in accordance with intended outcomes. According to one beneficiary:
“Nyangazezizwe has trained us traditional healers on health, the importance of HIV screening, adherence to treatment and how medicines conflict with each other on patients’ [bodily] systems. As a result, we have graduated – and clinics and hospitals now acknowledge us and we can work professionally.
This same CBO held approximately eight meetings in the last year with THPs and biomedical practitioners from a local hospital. During these meetings, issues such as the identification of life-threatening illnesses and methods of dealing with mentally ill patients were discussed.
Two of the three CBOs visited have successfully encouraged some of the THP beneficiaries to maintain gardens. In line with the intended outcome of equipping THPs with the knowledge and skills to treat their patients effectively (particularly their HIV-positive patients), these gardens have served to provide a small income for THPs and have also benefited the client base, particularly HIV-positive clients requiring food to adhere to treatment.
One CBO has made progress toward promoting correct HIV prevention messages to clients (in line with key performance area 1) by holding Community Capacity Enhancement (CCE) forums to lead community conversation gatherings, which focus on emphasising prevention strategies (incorporating testing and counselling, and circumcision) and demonstrating traditional instrument use, rituals and cultural surroundings. These are led by facilitators trained by AFSA, who subsequently identify and cultivate community leaders that emerge from these conversations. These leaders then liaise with the CBO, increasing organisational visibility and impact on communities. Although these forums help communities identify and develop solutions to relevant problems, they have not yet reached the point of local ownership. According to the CBO director, communities still expect the CBO to do things for them.
Progress has been made toward achieving the second intended outcome of managing the health and well-being of THP HIV-positive clients through home visits. Through home-based care programmes, facilitators trained by AFSA in counselling conduct door-to-door check-ups on families, making referrals to clinics and often providing transport as well.
Progress also has been made toward the intended outcome of facilitating the development of local networks between THPs and biomedical institutions, as well as other stakeholders, to ultimately equip THPs to play and enhanced role in the national response to HIV/AIDS. This progress, however, has been uneven.
One CBO visited was very well-connected with a range of stakeholders, including the Departments of Health and Social Development. This CBO director described how the municipality, which previously undermined and disrespected THPs, had come to invite THPs to training sessions as a result of the CBO’s work. The CBO has also received invitations from the Department of Social Development to participate in training sessions. Its THP beneficiaries are now more connected with biomedical institutions and can go to hospitals and clinics for essential supplies. They make referrals using a referral form that was developed by the CBO.
Another CBO visited developed strong relationships with the municipality and a local AIDS council, but failed to develop a relationship with the Department of Health due to “political interferences.”
San
The San CHP programme has been implemented by only one CBO, the South African San Institute (SASI) within both the Platfontein and Kalahari San communities. The overall goal of SASI is to improve the health status and well-being of culturally vulnerable and marginalised populations, through increased access to better sexual health education and care services and through a positive change in cultural attitudes and practices.
Specifically, SASI aims to reduce the vulnerability to HIV infection and the impact of AIDS in the San communities, through providing increased socio-sexual health education, improved care and nutrition of children at ECD sites and the increased awareness and utilisation of Indigenous knowledge. SASI, within the period of implementing the CHP programme, has made significant advances towards achieving these desired objectives.
The provision of socio–sexual health education, improved child care and nutrition and the increased awareness of indigenous knowledge have been promoted through various activities performed by the programme’s peer educators, including household door-to-door visits within the San communities, the hosting of information sessions, focus group discussions and training sessions with community members and through the development of information booklets, brochures, CDs/DVDs and radio talk shows. However, within the Platfontein San community, workshops or focus group discussions were discontinued and replaced by household door-to-door visits, due to the friction within the community, which is exaggerated by open community forums. Comparatively, the delivery of education and awareness through workshops and focus group discussions within the Kalahari community has been deemed a successful medium to transfer knowledge.
The use of CDs/DVDs and radio talk shows aired on the community radio station are additionally a strong medium through which to transfer knowledge within both communities. This medium has been identified as strong, due to the high illiteracy rate within the Platfontein and Kalahari San communities. The airing of the talk shows has significantly increased the reach of the CHP programme in comparison to the door-to-door visits, workshops, focus group discussions and training sessions. At the time of conducting this evaluation, only radio talk shows with the subject of nutrition had been aired.
The improved care and nutrition of children, in addition to undertaking the above educational activities has further been promoted through the initiation of 22 home food gardens within the Platfontein San community. Within the Kalahari San community, limited progress has been made. This is due to the extreme weather conditions experienced in the Kalahari, which have repeatedly caused the gardens already initiated, to fail.
Progress towards increasing the awareness and utilisation of indigenous knowledge has been further promoted through producing audio recordings focusing on San culture, knowledge and values. These recordings have been narrated by elders in the community, as a means to preserve this knowledge and further create cultural awareness. Additionally, a colouring-in book for children entitled ‘ek is spesiale’ has been produced. This colouring-in book graphically documents the cultural history of the San, for example, with illustrations to be coloured in of childhood games played by the San elders as children.
LGBTI
CBOs targeting the LGBTI community have generally progressed in good measure toward implementing the key performance activities intended to achieve the desired outcomes, but these programmes are for the most part still in a developmental stage.
The development, publication and dissemination of research reports, pamphlets and other informational materials is a key measure in which these CBOs have made some initial headway toward the first key performance outcomes, namely, of integrating LGBTI needs within policies and practices of government and civil society, as well as providing information, training and services to ensure the well-being of LGBTI people. In this area, CBOs have generally accomplished their intended goals. One CBO visited was able use AFSA funding to print pamphlets in four different languages, which were disseminated amongst partner organisations and distributed to beneficiaries to increase organisational visibility and awareness of important issues. Another CBO developed a large number of pamphlets and brochures detailing the organisation and publicising its various programmes. These pamphlets are often distributed at workshops and training sessions.
Furthermore, AFSA funding has enabled some of the CBOs targeting the LGBTI community to complete baseline research on community needs and attitudes, which is subsequently used by CBOs to tailor their programmes and workshop curricula to the community of interest. Prior to commencing implementation of its outreach programme in a specific area, one CBO conducted a baseline research study in the area of interest with 50 gays and lesbians to determine prevalent problems amongst this beneficiary group, so that programmes could be created to address the issues that arose. Another CBO conducted community consultations in three provinces as a platform for its evidence-based programmes. These consultations were conducted to establish a relationship with local constituencies, including partner organisations and to source feedback from constituencies regarding their needs and expectations. This CBO has tailored its workshop curricula in accordance with its findings.
Workshops, training sessions and support groups comprise the bulk of progress made toward achieving several key intended outcomes, including;
• the integration of LGBTI needs within policies and practices of government and civil society,
• improving the health status and well-being of LGBTI people through ensuring access to appropriate information and services in a non-discriminatory environment, and
• reducing stigma, discrimination and violence against LGBTI people.
One particularly successful CBO holds a range of workshops; one type of workshop is used to empower and support victims of hate crimes, while another type of workshop is designed to challenge prevalent myths and stereotypes regarding LGBTI people to instigate behaviour change. These workshops are normally facilitated by current CBO staff members who are also former programme beneficiaries. Hence, these staff members often have a very personal stake in the programme outlines. Victims of hate crimes receive counselling and therapeutic assistance, as well as support in the form of rape kits, visits to their local health clinics, legal and police referrals. Workshops with community members use surveys administered before and after the workshop to assess prevalent myths and stereotypes about LGBTI people and to then assess whether changes have been made in these views by the end of the workshop. This CBO has also developed several family support groups in the area of interest for the purpose of reconciling LGBTI people with their families, so as to reduce the number of LGBTI people on the street. Another CBO visited has a small outreach programme that has provided support services to the transgendered constituency in WC, KZN, EC, NC.
While workshops, training sessions and support groups have been implemented to some degree, local ownership has not yet been established. For one CBO, AFSA funding has helped the organisation pilot its newly formed outreach programme in an area of interest, but at this point only the groundwork has been laid. This CBO hopes to establish a local committee in the area of interest to carry out workshops and awareness campaigns, which in turn can become a satellite office with ongoing monitoring, displaying a high level of local ownership. They ultimately hope that this model can be replicated elsewhere, but at this point, the committee has not yet been formed.
All CBOs visited have networked to some degree with other organisations or with government. One CBO has trained approximately 200 staff members within other service provider organisations. Establishing relationships with key stakeholders, including government, service providers and other organisations, is a key mechanism by which CBOs are making progress toward several key intended outcomes. These outcomes include;
• creating a facilitating environment for the provision of services to prevent STIs and ensure testing, treatment and care for HIV/AIDS,
• the integration of LGBTI needs within policies and practices of government and civil society, and
• the reduction of stigma, discrimination and violence against LGBTI people.
The CBO has made progress toward achieving the first intended outcome by providing training sessions for Sisters at local clinics on how to treat LGBTI patients in a non-discriminatory manner. This is necessary in order to create a facilitating environment that will encourage rather than discourage LGBTIs from seeking treatment at health facilities. Although the results of these trainings could not be determined, the trainings nevertheless represent progress toward achieving this outcome.
With regard to the second and third outcomes, one CBO has made a small amount of progress toward ensuring the integration of LGBTI needs within policies and practices of government and civil society, and toward reducing stigma against LGBTI people, through networking with political and civil organisations. These organisations include the ANC Women’s Caucus, Lovelife, Justice and Women, TEACH, in addition to traditionally hostile groups such as tribal chiefs, church clergy, and local police stations. Through establishing partnerships with key stakeholders from government and civil society and spreading positive messages about LGBTI people, this CBO has made progress toward achieving the second and third outcomes. Partnerships have enabled the CBO to ‘piggyback’ onto the workshops and programming of other CBOs to reach audiences that they otherwise would not have reached due to hostility toward LGBTIs. One tangible result of these efforts is that some church clergy who used to preach hostile messages about LGBTI people to congregations have begun preaching positive messages about the LGBTI community. Because these relationships are in developmental stages, it is too premature to measure other results that have come out of these partnerships.
1.2 OUTCOMES AND IMPACT
This section will explore both the outcomes and impact of AFSA’s CHP. Following an introduction to the nature of impact, analysis will be given for each of the five beneficiary groups, in recognition that programme outcomes and impact vary according to each beneficiary group.
In the world of funders, there is an emphasis on short-term, quantitative outcomes, such as the number of condoms distributed, the number of workshops held, etcetera. This shifts emphasis away from more qualitative outcomes and impact, particularly relating to long-term behaviour changes. This is largely due to the fact that changes in behaviour are more difficult to measure. Techniques for measuring nebulous outcomes, such as the amount of male involvement in discussions of social norms and turning qualitative outcomes into quantitative data are not well-developed. The lack of consensus for how such outcomes can be measured and quantified makes it easy for donors to neglect these outcomes when funding projects.
Quick, quantifiable outcomes are also reinforced by the current emphasis on short-term projects with one-year funding cycles. This emphasis is transmitted from donors to CBOs as well, affecting how programmes are structured and how outcomes are viewed. According to one CBO staff member:
“The worrying thing is that we work with a year-on-year plan; we do not have a five-year plan, where goals and targets are all documented in detail. In a way we are short-sighted in working this way and we always end up talking about when our funds will come to an end.”
Outcome selectivity and the emphasis on short-term projects with packages of heavy demands of evaluation and reporting of auditable activities is an approach that often undermines a focus on long-term behaviour change. Questions such as whether distributing condoms actually leads to an increased practice of safe sex and whether workshops result in long-term shifts in behaviour amongst workshop recipients are frequently neglected. Creative Consulting & Development Works recognises the political realities of funding, yet also understands the value of long-term outcomes that are often difficult to measure. We thus make every attempt to place equal importance on both short- and long-term outcomes.
1. Rural Men as Partners and Fathers
Outcomes and impact for CBOs targeting Rural Men as Partners and Fathers can be loosely divided into the three following areas;
• outcomes relating to the education of men in terms of general and sexual reproductive health, so that men can be sexually responsible partners and caring fathers (as outlined chiefly under key performance area 3),
• outcomes relating to men’s attitudes and behaviour towards women and girls, particularly the challenging of entrenched patriarchal attitudes and gender roles and the catalysis of behaviour change in terms of gender sensitivity (as outlined chiefly under key performance activities 1 and 2), and
• outcomes relating to the enhancement of men’s personal and economic empowerment through the provision of motivational and skills training for men to build self-esteem, set goals and develop sustainable livelihoods (as outlined chiefly under key performance area 4).
As discussed in section 1.1, progress toward achieving these outcomes has been realised through a range of interventions, including workshops, training sessions, radio programmes, theatre productions, support groups, youth programmes (in and out of schools), community action teams, home visits, public events (such as men’s marches and micro-enterprise programmes).
While these interventions have made significant inroads toward achieving the outcome of empowering men to become sexually responsible partners and caring fathers, this outcome is both difficult to measure and not always achievable within two years. Yet, CBOs seem to show success in reaching a wide range of beneficiaries and in promoting awareness of relevant issues amongst them. One CBO in particular estimates that it has reached approximately 1926 beneficiaries in total and 800 of that amount since they began receiving funding from AFSA in 2009. Another CBO has established more than 10 male support groups in various communities. A CBO that runs a radio show has added HIV/AIDS programming to its line-up due to support from AFSA and also established a children’s programme in April 2011, which resulted in an 35% increase in listenership (a total of approximately 80 000 listeners). This CBO estimates that AFSA funding has enabled the station to develop a more personal relationship with people (and particularly males) in rural areas, who often have no other access to information. Educational programmes have reached many beneficiaries and have been successful in creating safe spaces where men feel comfortable enough to engage in discussions of culturally sensitive issues which they otherwise would not have discussed. These programmes have generated much interest and excitement on the part of beneficiaries.
However, it is less clear whether these programmes have resulted in behaviour change – and particularly long-term behaviour change. Testimony from CBO staff and beneficiaries revealed that educational programmes may have resulted in improvements in relations between divergent groups of people in the community, with increased acceptance of formerly marginalised people such as HIV-positive patients and LGBTI people. This is an important and potentially long-term area of impact. According to one CBO staff member, “people are more receptive of others, especially those living with HIV/AIDS, as well as gays and lesbians. People are living more peacefully and are more tolerant of each other.” Furthermore, relations between males of different generations seemed to have improved somewhat in one community where a male support group was established. According to a beneficiary, youth more often approach elders in the community to seek advice about problems, indicating that the support group may have empowered beneficiaries somehow, at least in the eyes of the younger generation.
CBO staff and beneficiaries also maintain that educational programmes have enabled men to be more interested in their own health and wellbeing. One beneficiary described how, as a result of CBO interventions, “Men are interested in their health, while previously they were not. There has been a steady increase in adherence to treatment, due to the organisation’s messages.” Several beneficiaries and staff members also noted that more men have started visiting the clinic for VCT and treatment for a range of illnesses. According to one beneficiary:
“Men now visit clinics; they go there early before their illnesses become serious. Also, the importance of adherence is taught. Now people know that alcohol for instance, affects the working of medication.”
Furthermore, CBOs that have engaged with the Department of Health to increase the frequency of mobile health clinic visits and provided transport to clinics for people unable to afford it, have likely increased admittance rates at least slightly in the communities of interest.
These claims, however, are not verified by statistics. In most cases, it was found that CBOs did not have access to up-to-date statistics on indicators such as admittance rates, VCT uptake and the incidence of HIV/AIDS, because they had not obtained these statistics from relevant institutions. Some CBOs have attempted to obtain information from the Department of Health and have been unsuccessful. Where available, these statistics have generally shown no reduction in the incidence of HIV/AIDS. This does not come as a surprise; as such an outcome is unlikely to be achieved within a two-year and 9 month time frame.
The second outcome relating to the catalysis of tangible transformations in attitudes and behaviours involving patriarchal attitudes and gender roles may have been partially achieved through educational programmes, but, similarly, there is a lack of reliable statistics to prove this quantitatively. Testimony from CBO staff and beneficiaries reveals that progress was made toward achieving this aim for at least some of the beneficiaries. Staff and beneficiaries from several CBOs argued that gender-based violence has been reduced in communities as a result of CBO programming. According to one CBO staff member, who was formerly a beneficiary:
“Izinduna (traditional leaders) have benefited from our work. Now they have fewer cases of domestic abuse in their izinkundlas (tribal courts). In schools we are building role models who do not idolise the societal evils of crime, women abuse and bad behaviour in men.”
Several CBO staff members also described how they were able to overcome beneficiaries’ initial resistance to gender-related messages due to their training from AFSA:
“Prior to the intervention, men used culture to argue their unfair stance towards women. Through support from AFSA, fieldworkers are now able to talk about gender roles, challenge stereotypes and dispel misconceptions about gays and lesbians. AFSA enabled this through numerous workshops which exposed fieldworkers to issues surrounding gays and lesbians and helped to better understand where they were coming from.”
Several CBO staff members estimate that reductions in gender-based violence have been achieved through promoting awareness of some of the root causes of violence, particularly alcohol and drug abuse. One beneficiary suggested this when he explained how more people in the community are now aware of the connection between alcohol and family negligence and domestic abuse. Whether that awareness has translated into behaviour change is unclear, as there is a lack of reliable statistics on the incidence of gender-based violence in the communities visited.
The outcome of enhancing men’s personal and economic empowerment through motivational and skills training has largely not been achieved due to the fact that micro-enterprise programmes are still in their infant stages. Most (if not all) of the projects therefore have not yet been able to generate any income for the beneficiaries involved. One CBO staff member described how his organisation trained men and youth in income-generating skills such as welding, mat-making and art skills, but these men did not appear to be engaging in such activities, most likely due to the lack of funding for materials and no ongoing support for project development. Another CBO was in the process of purchasing seeds and other materials tor income-generating activities currently being implemented.
2. Initiation schools
Outcomes and impact for CBOs targeting initiation schools can be divided into three areas in accordance with key performance activities;
• firstly, outcomes relating to the training of traditional surgeons and nurses in harm reduction, infection control and STI and HIV prevention strategies and the promotion of a holistic approach to HIV prevention (as outlined under key performance activities 1 and 3),
• outcomes relating to the enhancement of referral and co-operation between traditional surgeons, local clinics and other role players to ensure the well-being and education of initiates (as outlined under key performance area 2), and
• outcomes relating to the promotion of gender transformative messages around expectations, social responsibilities and sexual practices among initiates (as outlined under key performance area 4).
As discussed in the section 1.1, progress toward achieving these outcomes have been realised through interventions that include workshops, TCFs, peer education indabas and bush-tracking programmes.
Firstly, the education of traditional surgeons and nurses in harm reduction, infection control and STI and HIV prevention strategies have been carried out primarily through workshops led by biomedical health practitioners and TCFs. The CBO visited, Ubuntu Bethu, now has a database of 23 traditional surgeons, each of whom brings two traditional nurses to workshops. Following the training sessions, behaviour change is monitored partly through the bush-tracking programme, where CBO volunteers travel twice yearly to a total of 208 initiation schools in outlying areas to ensure that operations and procedures at these schools are running smoothly.
CBO staff members and beneficiaries described how these programmes have resulted in a significant reduction in harmful outcomes for initiates. One traditional surgeon beneficiary described how, as a result of Ubuntu Bethu’s “talks on everything such as blood transfusion and HIV stigma in schools, churches and other gatherings, we are taught how to deal with HIV-positive people.” According to the CBO director, anonymous traditional healers are nearly always the culprits of botched circumcisions and the mortality of initiates. By creating a database of traditional healers and initiation schools through initial training and ongoing monitoring efforts, Ubuntu Bethu has reduced harmful practices among THPs. According to the director, there have been fewer botched circumcisions, a decreased mortality rate among initiates and increased admissions to hospitals due to more referrals by THPs. According to a local Chief, “there are definitely fewer deaths related to circumcision because people are trained to take better care of their initiates.”
The bush-tracking programme has also evidently led to some tangible improvements in initiation school conditions. According to a local Chief:
“Previously, initiations would just happen, it was not regulated and extremely young boys would steal themselves into the schools. In these initiation schools, students would be abused through dehydration, not given food and be beaten for no reason by drunken principals. As a result, initiates would die. [The CBO] intervened to ensure that proper procedures were carried through and unethical behaviours obliterated.
According to CBO staff and beneficiaries, there has also been a reduction in the number of inappropriately young boys seeking to become initiated. According to key informants, this has been due to peer education indabas, which have equipped young boys with the knowledge and tools to resist social pressure to undergo initiation early and to the bush-tracking programme’s monitoring of initiation schools.
Statistics showing quantitative data for the improvements described by staff and beneficiaries, however, were not available. Furthermore, behaviour change among THPs seems to be due in part to the CBO’s organisational visibility, continuous monitoring and increased accountability of behaviour, i.e. the threat of punishment for wrongdoing. If the CBO were to close, it seems unlikely that this behaviour would continue because of a lack of ‘local ownership.’ A sustained, long-term impact is, according to the CBO director interviewed, impossible to achieve within a two-year time frame. He estimates that long-term impact through local ownership of behaviour would require at least another two years of work.
There have been some tangible areas of achievement with regard to the second outcome of enhanced referrals and co-operation between initiation school role players and biomedical health care providers to ensure the safety and education of initiates. This is primarily demonstrated through the fact that biomedical health practitioners have taken the time to lead workshops for traditional surgeons and nurses, which in itself demonstrates a basic level of acceptance of and respect for the practice of traditional healing. This indicates an improvement on the past, as interviews revealed that previously biomedical health practitioner attitudes toward traditional healers were characterised mostly by hostility and disrespect. The CBO director maintains that, as a result of increased co-operation between biomedical doctors and traditional surgeons and nurses, THPs have made more referrals to clinics and hospitals.[8]
Ubuntu Bethu has succeeded in establishing a relatively robust relationship with the Department of Health, which is a pre-requisite for achieving the second outcome of ensuring the safety and education of initiates over the long-term. According to a Health Department spokesperson:
“Ubuntu Bethu gave the government a chance to get closer to the people and not interrupt their traditions. This has happened well because now trust exists where there was mistrust. The Department of Health now trusts Ubuntu Bethu to ensure that things will happen smoothly; there won’t be as many casualties, botched circumcisions, dehydrated and sick people who previously had to be rescued from initiation schools.
At the same time that it reveals progress toward an outcome, this quote also reveals the limits of the CBO’s current relationship with government, whereby Ubuntu Bethu provides a service in the vacuum of government action. The expectation on the part of government that the CBO will continue to provide this service is itself testament to the impact of the CBO and may help it secure alternative funding. However, as long as this service is seen by government as the responsibility of civil society, sustainability of impact is difficult to achieve.
Lastly, the visit to Ubuntu Bethu revealed that the outcome of catalysing behaviour change through the promotion of gender transformative messages around expectations, social responsibilities and sexual practices amongst initiates has likely not yet been achieved and is, moreover, exceedingly difficult to measure. Some inroads have certainly been made through TCFs and peer education teams, and boys are apparently now more likely to discuss the issue of HIV/AIDS with their peers. According to the CBO director, there have been some fluctuations in gender roles since the CBO started working, as women are now more able to discuss initiation with men; previously, it was completely prohibited for mothers to discuss initiation. Single mothers can also now come forward to seek help from the CBO if they want their sons to be initiated.
3. Traditional Healers
Outcomes and impact for CBOs targeting traditional healers can be divided into 3 areas in accordance with the 4 key performance activities (with two key performance activities grouped together);
• firstly, outcomes and impact relating to the training and education of THPs to enable them to practice harm reduction and infection control and reduce susceptibility to HIV/AIDS, so that the health and well-being of HIV-positive patients is managed appropriately and mortality rates reduced (as outlined under key performance activities 1 and 2),
• secondly, outcomes and impact relating to ensuring that the health and well-being of THP HIV-positive patients is managed appropriately, thereby reducing morbidity and mortality rates,
• thirdly, outcomes and impact relating to cultivating co-operation between THPs and biomedical institutions to ensure patient access to treatment and support (as outlined under key performance area 3), and
• lastly, outcomes and impact relating to the development of partnerships and dialogues with stakeholders, so that THPs can be trained and mentored on an ongoing basis in order for them to play an enhanced role in the national response to HIV/AIDS (as outlined under key performance area 4).
As discussed in section 1.1, CBO interventions include workshops, training sessions, community meetings, support groups, home visits, micro-enterprise programmes and relationships with key stakeholders.
Firstly, the training and education of THPs to enable them to practice harm reduction and infection control and to reduce susceptibility to HIV have been carried out through workshops, Community Capacity Enhancement programmes, support groups, home visits and micro-enterprise programmes, which build cohesion and interest among beneficiaries. Through these interventions, CBOs have reached a large number and wide range of beneficiaries. One CBO provided routine data demonstrating that it reached 15 952 people, including management, facilitators, THPs, clients and patients, support groups, networks and collaborators. It has also accomplished its intention of becoming active in all wards within the local municipality. The director of another CBO estimates that it has reached about 800 beneficiaries since 2009.
Furthermore, interviews revealed that workshops and other educational programmes have been highly successful in changing both attitudes and behaviours amongst the beneficiary population of THPs. This has often required overcoming significant barriers. One dynamic CBO director described how she overcame obstacles in the form of ‘AIDS fatigue’ and traditional gender attitudes to pursue educational programmes involving THPs. In her words:
“At first, we found that people were hesitant to be at workshops because there was AIDS fatigue in the communities. The men also didn’t want women training them and talking about sensitive issues like HIV/AIDS. But eventually, we won over the target group with our workshops and now they always request more information.”
For this director and her largely female support staff, winning over the beneficiary group required normalising the idea of women as both educators and power brokers. According to the director, the workshops were so effective at avoiding ‘AIDS fatigue’ because rather than relegating traditional culture and practices to the sidelines, the workshops integrated traditional teachings into the curriculum and incorporated training in traditional herbs and healing with biomedical teachings. This encouraged THPs to “respect themselves and revere their ancestors.” Furthermore, the workshops did not focus solely on training in HIV/AIDS, but rather incorporated a primary health perspective, covering a range of diseases and symptoms.
The instruction at workshops has been successful at garnering interest and instigating behaviour change, although again there are no statistics to prove this quantitatively. Important areas of impact include increased co-operation with biomedical practitioners, particularly in the form of referrals from THPs to clinics, a reduction in the incidence of harmful practices used by THPs, increased uptake of VCT services and increased usage of Anti-retroviral drugs (ARV), increased awareness about HIV prevention and the diminishing of traditional beliefs contributing to negative outcomes for HIV-positive patients, such as bewitchment. According to one beneficiary:
“[The CBO] has enlightened the community about HIV/AIDS; the community has received in-depth knowledge of how to deal with someone who is HIV-positive. The education covers areas such as safety (the importance of using gloves in washing the person living with HIV/AIDS), counselling to deal with depression and the importance of adhering to treatment. The knowledge has silenced a lot of beliefs on witchcraft; few people believe that they have been bewitched when ill and now people go for testing.”
A staff member from a CBO described in detail how, prior to the workshops, THPs would often tie down patients with mental illnesses and human rights were abused widely. As a result of CBO activities, THPs now treat these patients more humanely. Ongoing monitoring of THP behaviour takes place partly through home visits, where trained facilitators conduct door-to-door check-ups on families, many of which have visited traditional healers. These home visits also serve to provide basic care for the sick and identify those who need transport to clinics or hospitals. The CBO is thus directly engaged in referring patients to the biomedical health system.
The first outcome of ensuring that the health and well-being of HIV-positive patients are managed and mortality and morbidity rates reduced, is also carried out through Community Capacity Enhancement programmes, albeit in a more indirect manner. These programmes involve facilitating dialogue to identify prevalent problems and helping communities find solutions to these problems, partly through cultivating community leaders who arise through these forums. According to a CBO director, these forums make people more willing to disclose and increases utilisation of VCT, although no evidence was provided to prove this.
Along with home visits, these forums also provide a time wherein the CBO is able to make referrals to health clinics, mobile police stations and the Departments of Home Affairs and Social Development, thus increasing access to governmental services within communities. According to a CBO staff member:
“The community workers have reached a lot of sick people and assisted the neglected elderly through referring them to social workers. Orphaned children were also reached through the CBO and got registered for birth certificates and those eligible for support grants are now receiving it. Our work encompasses many things, for instance, we help HIV-orphaned children access their grants and talk on their behalf when necessary. ”
Micro-enterprise programmes are also used by CBOs to promote cohesion and provide an income for THPs. However, like the other CBOs visited, these programmes are still in their infant stages, requiring ongoing financial support to purchase materials and provide training sessions for income-generating activities.
Progress toward the second area of outcomes and impact, the cultivation of co-operation and networking between THPs and biomedical institutions, have been made to a varying degree by CBOs. One CBO interviewed has been largely unable to establish a working relationship with the Department of Health, citing “political interferences” as the primary obstacle. They described working with the Health Department to be a “nightmare.” That said, this CBO has held approximately eight meetings between biomedical health practitioners and THPs at a local hospital where the organisation is based; but the connection between THPs and biomedical practitioners appears tenuous and unsustainable and therefore this outcome has largely not been achieved by this CBO.
At the other extreme, another CBO has evidently made a tangible impact relating to the cultivation of co-operation and connections between THPs and biomedical institutions to ensure patient access to treatment and support. This has been achieved by forming a relationship with the Department of Health; by educating THPs about co-operation and referrals and by educating the larger community about both systems. THPs have evidently been receptive to the idea of co-operation. A CBO staff member described how THPs now make referrals to clinics and can go to clinics to obtain gloves and other basic essentials. They also “work hand in hand with the Sisters.” This is impressive, considering the previous situation, where THPs were frequently humiliated at hospitals and clinics, encountering a high level of disrespect. According to a beneficiary:
“[The CBO] has taught us traditional healers the importance of promoting HIV testing on our patients when they come to us for help. We take our patients to clinics and hospitals for testing and from there, we see what medication they have been given, if any, to see if there would be any conflict between traditional medicine and Western medication prescribed by clinic. The impact of this approach has been tremendous; it has dispelled a lot fears and misconceptions about use of either Western medicine or traditional medicine. People now know that both can be used, provided that they have tested and seen both a traditional healer and a medical practitioner.
This CBO has also provided education to the community about how traditional and biomedical systems relate, so people are more aware of when it is appropriate to visit a hospital or clinic. According to a beneficiary:
“People are more aware of the importance of adhering to treatment. Also, people are encouraged to go to the clinics to test for HIV/AIDS; they know that even if they do see a traditional healer, they will have to go to a clinic at some stage anyway.”
It is acknowledged that cultivating sustainable networks between biomedical institutions and THPs is a long-term project and these relationships are likely still in their developmental stages; nevertheless, this testimony reveals that impact has indeed been made in this regard.
Some piecemeal progress has been made toward the final area of outcomes and impact relating to equipping THPs to play an enhanced role in the national response to HIV/AIDS through stakeholder dialogues and ongoing training and mentorship. While two of the three CBOs visited had not made much of a sustained impact in this area, one CBO began to cultivate relationships with stakeholders such as the municipality and the Department of Social Development. While the municipality previously did not respect THPs, the municipality now invites THPs to its training sessions. The Department of Social Development also invites the CBO to any training sessions involving THPs. These relationships, however, are still in their infant stages and would likely falter if the CBO were removed from the picture.
4. San
Outcomes and impact for SASI targeting the San community can be divided into four areas in accordance with the four key performance areas, including;
• firstly, outcomes and impact relating to the facilitation of life skills training, targeting adults and young people to address social problems, risk behaviours, domestic and gender-based violence,
• secondly, outcomes and impact relating to the promotion of San community health through supportive health services and safer traditional healing practices,
• thirdly, outcomes and impact of the establishment and management of ECD sites, and
• lastly, the promotion of the conservation of indigenous knowledge systems and the undertaking of biodiversity training for sustainable livelihoods, along with the cultivation of indigenous medicinal plants.
The facilitation of life skills training to address social problems, risk behaviours and domestic and gender-based violence within the San community has been undertaken through various activities performed by the programme’s peer educators, including household door-to-door visits within the community, the hosting of information sessions, training sessions and focus group discussions with San community members. The intended outcome of the life skills training is for community members to exhibit an improved sense of identity and self-esteem and make healthier lifestyle choices. Although the SASI has reported some progress towards achieving this goal, it is challenging to measure the impact of the life skills training within the community, given the premature stage of the programme life cycle. Change, however can noticeably be seen among the peer educators performing the various activities which support this goal. The peer educators’ confidence has grown since their induction into the programme, in addition to their knowledge of social problems, risk behaviours and domestic and gender-based violence. As reported by a peer educator, this in turn influences their individual lifestyle choices;
“As a person I have grown, both in knowledge and confidence. I believe in the work I do and value the knowledge I have been given. I am now able to protect myself.”
A further key outcome of the programme has been the promotion of San community health through supportive health services and safer traditional healing practices. This outcome has been promoted through various activities performed by the programme’s peer educators. The activities include household door-to-door visits within the communities, the hosting of information sessions, training sessions and focus group discussions with the San community members. The expected result is that health service providers and peer educators are responsive to the specific health needs of San communities and in turn, THCs will adopt accepted health care standards and regulations. Unfortunately, although activities have been performed by the peer educators who promote this outcome, the communities change in behaviour towards this goal has been slow. The incidence of teenage pregnancy and infants born with Foetal Alcohol Syndrome has increased in the Platfontein San community[9]. As a participant commented:
“The community understand how HIV/AIDS is contracted, but the youth don’t want to practise safe sex and they don’t want to change their behaviour…”
However, a change in behaviour and attitudes among three traditional healers, post a workshop hosted by the peer educators was noted. On the conclusion of the workshop, the traditional healers acknowledged that they could not cure AIDS, but could treat the ‘sicknesses’ presented by AIDS. It was further reported that the San elders in the past would not engage in HIV/AIDS conversations or discussions, now as explained by a participant:
“Elders in the past were difficult to talk to about HIV/AIDS, but this is slowly changing and we are seeing some reception from the elders towards the information we
provide on HIV/AIDS... the elders now also attend the workshops we host, where previously they were dominated by youth participants.”
The third key performance area of the programme has been the establishment and/or management of ECD sites with the result of children and families benefitting from quality care, protection and nutrition in ECD sites and/or home gardens. This outcome has been successfully implemented in the Platfontein San community where 22 home food gardens were planted. Children of these homes maintain food diaries in order for the peer educators to track their nutritional in-take and guide the children and their families accordingly. However, the child malnutrition rate within Platfontein community remains at 100% and it is expected that the positive impact of the food gardens will only be realised later in the programme’s life cycle.
The promotion of the conservation of indigenous knowledge systems and the undertaking of biodiversity training for sustainable livelihoods along with the cultivation of indigenous medicinal plants forms the fourth key performance area of the programme. The outcome of this goal is for San culture, knowledge and values to be affirmed, the environment conserved and sustainable livelihoods strengthened. The CDs/DVDs and publications produced have, according to staff, been well received by community members. SASI staff report that community members have begun to internalise the knowledge transferred through the CDs/DVDs and publications. However, as with the measure of impact of previous programme objectives, the measure of long-term behaviour change is limited at this early stage in the project life cycle.
5. LGBTI
Outcomes and impact for CBOs targeting LGBTI people can be grouped into three areas in accordance with the three key performance activities;
• firstly, outcomes and impact relating to the integration of LGBTI needs within policies and practices of government and civil society, so that LGBTI people can realise their rights (as outlined under key performance area 1);
• secondly, outcomes and impact relating to ensuring that LGBTI people have access to appropriate information, training and services in a non-discriminatory, supportive environment, ultimately to improve their health and well-being (as outlined under key performance area 2), and
• thirdly, outcomes and impact relating to the reduction of stigma, discrimination and violence against LGBTI through increasing public awareness and reducing culturally-based stigma and prejudice (as outlined under key performance area 3).
As discussed in section 1.1, CBO interventions include workshops, training sessions, support groups, advocacy and relationships with key stakeholders.
Prior to discussing the outcomes and impact of these interventions, it is important to note that programmes for the CBOs visited were still in their infant stages of development. Hence, it is still too early at this point to measure impact in terms of statistics and medium- to long-term behaviour change. One CBO underwent, at the time of receiving AFSA funding, significant organisational structuring and collapsed its four programmes into two broad programmes. AFSA funding allowed for the development of one of these programmes (Outreach). Hence, while the groundwork for achieving impact has been established, the lack of full implementation of the Outreach programme makes it very difficult to discuss impact.
Another CBO visited had only begun to receive funding from AFSA in 2011, which also inhibits discussions of impact. A third CBO visited was primarily involved with publishing and disseminating information and advocacy and impact for this type of work can be very difficult to establish – particularly with two years and 9 months of funding.
LGBTI needs have, for the most part, not yet been integrated into the policies and practices of government and civil society, in accordance with the first intended outcome. However, some tangible impact has been made with regard to this outcome through the establishment of meaningful connections with some key stakeholders in civil society and government. Although these relationships are still immature and not yet sustainable, one CBO is making headway in changing the attitudes of traditionally conservative realms such as tribal chiefs and the Church clergy. According to a staff member and former beneficiary:
“The clergy and tribal chiefs are receptive once they are given the information about LGBTI individuals and always ask for additional information from us about these groups of people. The clergy admits that they used to demonise gays and lesbians during their sermons because of what the Bible says, but now they are more accepting and want us to talk about ourselves during their church services, because they don’t know what to tell their audience now that their views on us have changed.”
This CBO also works with a wide range of other organisations, in addition to some police stations, teachers, biomedical health professionals and some political institutions, such as the ANC Women’s Caucus. According to key informants, hostile attitudes towards LGBTI people are common amongst these groups, particularly teachers and police officers. Therefore much of the CBO’s work involves seeking out individuals who are receptive to positive messages and recruiting these individuals to work on behalf of the CBO to reduce hostility toward LGBTI people and create safe spaces in civil society. This work is thus laying an important foundation for the integration of LGBTI needs in the policies and practices of government and civil society.
Significant measures of success have been achieved in terms of the outcomes relating to ensuring that LGBTI people have access to appropriate information, training and services in a non-discriminatory, supportive environment, in accordance with the second intended outcome. Inroads have been made primarily through the publishing and dissemination of informational and advocacy materials and through workshops. While materials have been published, translated into the local languages and disseminated in communities, it is impossible at this point to assess the exact impact of these materials on those who have received them. Nevertheless, it is important to recognise that disseminating information and simply having an organisational presence, has led in some instances to the formation and legibility of a beneficiary group. This was particularly the case for a CBO targeting intersex people. Intersex people have been historically marginalised and invisible due to a lack of awareness and safe spaces in society, which makes it difficult to “come out.” Interviews with CBO staff and beneficiaries revealed that the presence of a CBO dedicated to intersex people and the dissemination of positive messages around this designation has “made it possible to begin steps to uncover intersex people to allow them to have a platform.” This has laid an important foundation, as a visible and legible beneficiary group is a prerequisite for achieving any outcomes and impact with regard to this group.
Furthermore, it is possible to speak of tangible impact in terms of educational workshops. The importance of these workshops should not be underestimated, particularly for the LGBTI individuals these workshops have reached. As discussed in section 1.1, one CBO runs workshops called “Rivers of Life,” which are meant to provide counselling, support and a safe therapeutic environment for victims of hate crimes. A CBO staff member and former beneficiary described the profound impact these workshops have had on her own life:
“Before I found this organisation, I was a violent and angry person. It’s hard for me to even explain it. I wouldn’t hesitate to pull a knife on someone. This all came from my past; I had been gang raped…I was beat by my school principle at an assembly in front of everyone for my sexual orientation...I had been abused by my husband. I then went to Rivers of Life and it helped me work through my problems. I got a divorce, I charged my ex-husband with abuse. I now work to educate others. It changed my life.”
In the absence of other social support structures, particularly in low-income communities, workshops like these provide virtually the only safe space and means of support for LGBTI people. Another CBO staff member described how vital Rivers of Life are, because otherwise LGBTI victims would have no assistance, even while their jailed offenders frequently receive access to educational enhancement programmes in prison. In addition to providing psychosocial support, these workshops connect victims with legal providers and health clinics, and administer rape packs.
It is still too early to discuss any sustainable impact or quantitative statistical changes with regard to the last intended outcome of reducing stigma, discrimination and violence against LGBTI people. Nevertheless, small but not insignificant transformations have been instigated as a result of interventions such as workshops and advocacy campaigns. One CBO has, through AFSA funding alone, reached approximately 1900 beneficiaries through workshops, the bulk of which are of the “myth-busting” variety that aims to increase public awareness of LGBTI people and reduce culturally-based stigma and prejudice. This CBO uses pre- and post-workshop surveys to assess changes in attitudes as a result of educational programmes presented at workshops.[10] While it is difficult to track people’s behaviour once they leave the workshops, according to multiple CBO staff members who facilitate these workshops, dramatic shifts are seen in the target audience as a result of these educational programmes. Pre-workshop surveys assess prevalent myths and stereotypes held by workshop beneficiaries prior to the administration of the educational programme, while post-workshop surveys reveal “a dramatic turnaround in terms of tolerance, acceptance and respect of LGBTI people.”[11] Facilitators maintain that most people are very receptive to positive messages around LGBTI people once they are provided with information and that the workshops give people an important platform upon which they can resist social pressure and stand up for the human rights of LGBTI people.
1.3 IMPLICATIONS OF CLOSURE
IMPLICATIONS OF CLOSURE FOR CBOs AND STAFF
This sub-section will examine the implications of closure for organisations and staff members involved in the CHP. Questions that will be examined include: whether CBOs will close down completely, how staff members will cope with the situation, what methods CBOs have of sustaining themselves, and whether CBOs may secure access to other sources of funding.
Will CBOs shut down completely?
Visits to selected partner CBOs revealed that most CBOs will most likely not close down, at least not in the short-term, over a period of a few months to a year. The reality is that CBOs have not been funded by AFSA for an inordinately long period of time, so the time when the CBO was not supported by AFSA is not too distant of a memory for management. Some CBO managers speak of a “graduate regression” to a pre-AFSA situation, to the organisational structure and programmes that characterised the organisations prior to when AFSA funding was received. There is also a high level of uncertainty amongst CBOs as to how the CHP closure will affect the organisations as a whole. According to one key informant, “the only specific implication is that the CHP will not continue in its current form after the funding has ceased. We still need to decide upon how to proceed. There is much uncertainty.”
Impact of closure on staff
While CBO managers will for the most part remain employed, at least in the short-term, other staff members face the prospect of either retrenchment or working on an unpaid basis. Staff members who had been made aware of the situation repeatedly described their fear, nervousness and apprehension at these prospects. Managers and consultants interviewed estimated that most staff members will continue their work unpaid, without stipends for airtime, travel, etcetera. One CBO manager was adamant that her staff members will keep working on an unpaid basis because the organisation have tried to cultivate a mentality where staff consider themselves “volunteers with stipends,” rather than paid employees with the right to a salary. Before too long, however, ‘volunteer fatigue’ will hit for many of these staff members and programmes may crumble as a result.
The elimination of stipends will place considerable stress on staff members, both personally and professionally. On a personal level, staff members will no longer have access to the small income from which they had benefited prior to the funding cut. One staff member stated that he felt as though he has not been capacitated enough:
“We need to have sustenance, like skills improvement. This is currently for beneficiaries only, but staff members also need skills development, so that they don’t depend too much on the organisation.”
On a professional level, staff will likely find it stressful to face a reduction of operations and the anger and confusion from beneficiaries that they expect will result from the situation. While some staff members were satisfied with the stipend amount they have received thus far, most staff members interviewed stated the need to expand CBO programmes into other areas out of a genuine desire to help out in the community. According to one facilitator:
“There are many rural areas that we are yet to reach. Although we broadcast on radio, people still need us to be out there. Our stipend is too little to cover transport and we try to save costs by walking, but many places are too far to walk to.
Eliminating the stipend altogether will thus add a considerable amount of stress for staff involved.
Many staff members interviewed expressed fear of the reaction from beneficiaries that they believe will result from the scaling back of CBO operations. One staff member believes that communities may become “enemies” if the CBO has to serve fewer people in communities or pull out of communities altogether a s a result of funding cuts. He believes that people will come to consider staff members as “traitors, because communities do not understand that NGOs need funding and cannot always get the funding they need.” Another staff member questions, “How will we be able to go into such poor communities empty-handed? People have needs.”
It is important to note that, while some staff members were informed about the situation regarding CHP funding, a significant number staff members were left in the dark with regard to the funding cut. AFSA’s CHP did an excellent job of keeping open lines of communication with CBO management, who were all aware of the situation. The lines of communication between management and staff members about the situation, however, were not always in existence. Many staff members did not entirely understand the purpose of the Creative Consulting & Development Works’ visit, which made for a rather delicate situation during some of the interviews.
Self-sustaining mechanisms
CBO staff listed a number of mechanisms for sustaining their organisations in the short-term. Common mechanisms listed were a reduction of working hours, some staff retrenchments where possible, salary reductions and ‘piggybacking’ off the work of other CBOs, NGOs and governmental institutions to eliminate the need for catering, accommodation, etcetera. For instance, one CBO plans to attend imbizos organised by the community to pursue its awareness campaigns and network with its beneficiary base, rather than organising its own events. A common theme that emerged from conversations with CBO managers was a slide toward a skeleton organisational structure.
While some CBOs are already operating out of directors’ homes, CBOs that have rented out offices, if funding cannot be secured in March 2012, will have to move to a less expensive location or to a staff member’s home. One CBO manager believes that, depending on if and when funding can be obtained, his CBO may have to move to back to the space the organisation occupied prior to 2009. This space was located in a rural area without network access. Not being able to use the internet will leave the CBO less connected and negatively impact organisational operations and efficiency.
Staff from nearly every organisation visited noted that one of the most significant changes that will result from the funding cuts will be to confine operations to a smaller area. Transport is one of the most significant financial burdens for these organisations, particularly for those located in rural areas where infrastructure is poor. Fewer staff members and little money for transport will result in a situation where certain communities cannot be reached. While programmes may continue, this programming will, in many cases, be limited to the CBO’s immediate surroundings.
Other self-sustaining mechanisms include, for some CBOs, income-generating activities that provide a small source of income for organisations. 3 of 13 CBOs visited (23%) had some sort of income-generating activity for the purposes of organisational support. One CBO uses small micro-enterprise programmes such as renting out public phones from their office to generate income that is sufficient to purchase small items for the office, such as soap and toilet paper. One CBO director proposed potentially trying to enter into consulting work and do workshops at a charge for participants, to generate an income. Another CBO runs some income-generating activities that include a drama group and an occasional catering service. He plans to potentially scale up the catering service as a future income generator for the organisation. While helpful and resourceful, these income generating activities do not produce the necessary amount of financing to completely cover organisational costs.
Some CBOs also cited their relationships with key stakeholders, particularly government, as a self-sustaining mechanism that will help ensure the sustainability of programmes. Based on the sites visited, it is estimated that approximately 60% of AFSA-supported CBOs have been able to cultivate some type of relationship with government. Many of the CBOs that have cultivated such relationships plan to rely in some way on this to continue operations. One CBO plans to use its relationship with a local municipality as a platform to secure access to funding. According to the director:
“I do not think this CBO will be paralysed by the funding cut. In X [the location where the CBO works], we have been networking with the Department of Health and municipality structures and we’ve had meetings with the mayor and municipality manager. They have asked us to assist with their training sessions. We are also linked with the X AIDS Council and in March [when funding is cut], I plan to negotiate with X Municipality to get access to funding.”
Despite its successes in establishing partnerships with key government stakeholders, this same CBO have found it difficult to establish a relationship with the local Department of Health. This, according to the key informant, was due to “political interferences,” which has meant that trying to work with the Department of Health has been a “nightmare.”
Difficulties in establishing relationships with certain government institutions were cited by a number of CBOs visited. The sources of these problems have been due to issues such as maladministration of funds, which creates resentment on the part of the CBO and its beneficiaries. A few CBOs have cited that they have found the local Department of Social Development to be “unreliable” or “unstable.” At times, CBOs have found that their activities have brought them into competition with local government. According to one CBO:
“Local government is not working with us, instead the municipal officials would make the usual empty promises. There is a Special Programmes unit in the municipality, but it does not act on any communication initiatives we make to get them involved. Instead, the municipality demands reports and usurps the limelight when the Provincial Department of Social Development makes its visits. When we organise presents for children in need, the municipality will ask us to wait before we can hand out these gifts until there is some function that they have. This way, it works for their popularity.
The inability to establish relationships with key government institutions, particularly at the local level, is a hindrance to organisational sustainability.
The reality is that, for organisations and staff members involved, negative consequences will arise in the long-term if alternative sources of funding cannot be obtained. While CBOs generally have mechanisms to sustain themselves in the short-term term, eventually “volunteer fatigue” will hit and programmes will be forced to shut down if financing cannot be secured. This is particularly a challenge for organisations whose management and staff members are not experienced in writing successful project proposals and are not well-connected to the funding realm.
And even for organisations that have received funding from other institutions in the past, dangers arise when programmes funded by AFSA become confused with the organisation itself. For example, an interview with a consultant (hired with AFSA funding) revealed that a CBO in question have allowed its AFSA-funded programme to become undistinguished from the organisation itself. This situation arose partly due to a lack of financing from other donors during the AFSA funding cycle. The consultant sees his role as helping to ensure that the mission of the AFSA-funded project aligns with that of the whole organisation, which requires redefining and repackaging the organisational mission into one that could appeal to potential donors. The AFSA-funded project, he maintains, is currently consuming the entire organisation, which would obviously be disastrous for the organisation as a whole if the project were to collapse due to lack of funding. (Sadly, with AFSA funding cuts, the consultant will no longer be able to work on a paid basis for the organisation, but he does plan to continue volunteering on a part-time basis). The issue is thus partly one of ensuring that CBOs rely not on yearly funding cycles but rather have long-term strategies in place, such that if one programme is forced to shut down due to lack of funding, the organisation as a whole will not be threatened.
Impact of AFSA’s capacity-building, networking, and organisational development
Organisational sustainability and viability has been enhanced by the capacity-building, networking, and organisational development activities provided by the CHP. Capacity-building programmes for CBO staff through workshops and training sessions have increased the number of staff members employed within CBOs and equipped staff members with valuable professional skills. These skills range from counselling to monitoring and evaluation and project management. Skills related to maintaining an organisation, including staying accountable to donors through report submission and the satisfaction of funding requirements; financial management; monitoring and evaluation; and proposal writing, have placed CBOs in a better position to sustain themselves once funding is cut.
In addition to capacity-building and organisation development, networking opportunities provided by AFSA may also contribute to organisational sustainability. As a result of AFSA-facilitated networking opportunities with government and key individuals in civil society, some CBOs have plans to commence research projects, which may be fruitful in terms of securing access to alternative funding. One CBO plans to conduct a study related to the impact of an educational programme on schoolchildren, while another CBO plans to conduct a study related to men’s contribution to the achievement of Millennium Development Goals 4 and 5 in South Africa. Both CBOs hope that these research projects will enable them to secure funding in the future.
Securing access to alternative funding
The CBOs visited generally were not hopeless about the future and the managers interviewed maintained that their organisations would not close down in the short-term. Based on the site visits, it is estimated that approximately 70% of CBOs had submitted proposals for funding, or had short-term plans to do so. Potential donors included both domestic and international institutions. A few of the potential donors listed included the U.S. Embassy, the Lotto, the Foundation for Human Rights and the South African Department of Social Development, although considerable frustration was expressed about encountering bureaucratic red tape with the Department of Social Development.[12] One CBO listed online donor sites, such as Give and Gain, as a potential source of funding.
Across CBOs visited, there was a wide range of capacity regarding writing and submitting proposals to donors, as well as access to information about funding opportunities. Both of these had some correlation with whether the CBO received funding from other donors in the past. Organisations that received funding from multiple donors in the past had the capacity and know-how to write proposals to donors and package their programmes in a form that appealed to funders. Other CBOs that relied exclusively on AFSA CHP funding seemed, for the most part, less networked in the realm of funding opportunities.
At one extreme, a particular CBO visited had won or was nominated for multiple national and international awards for its work. This recognition has helped secure this CBO funding in the past and will undoubtedly assist with this in the future. Although the CBO director was overwhelmed with having to write proposals, which require considerable background research, while simultaneously having to manage the organisation, the key informant wrote a significant number of successful proposals in the past. He had several proposals in the pipeline and identified several potential funding opportunities. Chances for securing access to alternative funds are very much in this organisation’s favour.
At the other extreme, some CBOs visited had not developed and submitted proposals to potential donors and did not have any concrete plans whatsoever to do so. Several rationales were put forward for this. The most common complaint involved a lack of networking in the funding realm and particularly a lack of access to information about funding opportunities. Creative Consulting & Development Works was repeatedly asked for assistance with locating websites and other materials with information about funding opportunities. One such CBO noted; “I don’t have the contacts of funders. AFSA have capacitated my organisation so we can produce reports about programmes and finances and meet donor requirements – but where are the funders?”
The CBOs that have relied exclusively on AFSA funding will likely struggle the most in terms of obtaining access to alternative sources of funding. If funding cannot be obtained for these organisations, they will also be the most likely to close completely in the shortest amount of time, given that these organisations tend to be smaller and less developed, with less access to funding opportunities and fewer skills amongst their staff members.
It is acknowledged that the CHP’s efforts to capacitate CBOs in terms of proposal writing, which formed part of the CHP’s exit strategy, have contributed to the fact that well over half of CBOs have submitted proposals or had immediate plans to do so. AFSA has provided trainings on fundraising strategies and proposal writing skills, and has provided one-on-one assistance with drafting funding proposals. AFSA has also compiled resource packs with policy documents and updated donor directories.
IMPLICATIONS OF CLOSURE FOR BENEFICIARIES
This section will explore the implications of the closure of the CHP on the five groups of beneficiaries. The analysis will be broken down in accordance with these five groups in the acknowledgement that the impact of closure varies in accordance with the beneficiary group.
Firstly, it is important to recognise that the lines of communication between CBO staff and beneficiaries about the closure of the CHP were, for the most part, not well developed. When beneficiaries were queried about the implications of the certain closure of the CHP (and the possible closure of the CBO programming in question), they often expressed considerable confusion and apprehension about the situation and wanted to know more.
It is clear that most CBOs will reach fewer beneficiaries as they confine their programmes to a smaller geographical area due to a lack of funding. What is less clear, however, is how exactly the CHP objectives will be affected by the scaling back or complete closure of programming. Many CBO staff spoke of having built up a “momentum” in terms of programming and its impact, particularly with regard to transformations with regard to cultural attitudes and behaviour. With a lack of funding and the subsequent scaling back of programmes, this momentum will be lost, with a potential reversal of positive gains made. The three primary objectives of AFSA’s CHP – to increase access to appropriate sexual health education and care; strengthen health-promoting cultural practices; and challenge cultural attitudes and practices that negatively affect health behaviours, mental and physical well-being – are long-term objectives that require appropriately long-term programmes and support.
For instance, increasing access to appropriate sexual health education and care often requires the cultivation of relationships between beneficiary groups and relevant providers of health care and education services, which is certainly a long-term project that requires establishing relationships with both parties and then connecting the two parties somehow. It requires continually encouraging beneficiaries to access these services, through mechanisms such as increasing awareness, increasing the availability of such services and continually encouraging service utilisation. Challenging cultural attitudes and practices that negatively affect health behaviours and strengthening health-promoting cultural practices, requires continuous dialogue and educational programmes with beneficiary groups supplemented by ongoing support and cohesion-building programmes, such as income-generation. These are not short-term projects.
CBO staff members often spoke of the delicate nature of relationships with beneficiaries and the need for ongoing support. “Gaining people’s trust, exposing them to new ideas, instigating behaviour change and ensuring that these ideas and behaviours are sustainable and ‘owned’ by the beneficiary group, requires several years of work.” One CBO staff member drew a particularly telling comparison when he called relationships with beneficiaries “a delicate flower that will wilt without water.” The implications of closure on the five target beneficiary groups are explored in further detail below.
It is important to acknowledge not only the negative implications of CHP closure, but also the benefits of the programme for beneficiaries that can be expected to outlast the CHP closure.
1. Rural Men as Partners and Fathers
CBO programmes targeting Rural Men as Partners and Fathers run a range of educational and awareness programmes and micro-enterprise initiatives designed to respond to the key objectives. While educational and awareness programmes will for the most part not shut down completely, many CBOs will need to scale back their programming, resulting in a reduction in the number of men’s support groups and a reduction in the number of communities with access to such groups. While some groups may close down completely with the scaling back of operations, interviews with beneficiaries revealed that some groups will remain in existence even if CBO support is ended.
Beneficiaries involved in those groups that do shut down, however, will no longer have access to the “safe spaces” created by the groups, resulting in less dialogue (and therefore action) around issues of gender, sexual and reproductive health, parenting and the prevention of sexual and domestic violence. The entrenched patriarchal attitudes and gender roles in society will remain entrenched and any behaviour change begun to be catalysed by such groups will likely be reversed, as noted by CBO staff. According to a CBO beneficiary, if the organisation were to close down, there will be no health education and “men who have been encouraged to take care of their health and visit the clinic perhaps will be discouraged.” According to one CBO staff member:
Unemployed men who stay at home – these men who through this initiative have learned that it is completely acceptable for them to do the laundry, clean the house and feed the kids – will feel discouraged. We are currently working in communities creating awareness for such men to be accepted, if there is no funding, the progress made will be reversed. Also, for women, in Xhosa culture it is not permissible for them to enter a kraal, so we have also worked with those notions in consultation with older men, now women are not limited in their households. This also is true with regards to their rights to land, the work has just begun we want to reach other areas that oppress women.
The relatively abrupt pull-out of funding, exacerbated by the lack of a clear exit plan, will mean that CBO micro-enterprise programmes will likely falter, or worse, shut down completely. Micro-enterprise programmes are meant to provide motivational and skills training for men to build self-esteem and to enhance men’s personal and economic empowerment and beneficiaries have expressed much enthusiasm for these programmes. The implications of closure may be more stark for these programmes because income-generating activities require high start-up costs, as sites for activities need to be obtained and materials such as beads, gardening seeds and tools need purchasing. These programmes are just getting off the ground at some of the CBOs involved. Ensuring the programmes are sustainable, moreover, is a long-term project, as beneficiaries need to be given training and need to be connected with a market.
Programming clearly would have benefited with an exit plan to ensure sustainability and benefits for beneficiaries. According to one beneficiary, the CBO’s departure would “be like my own wife departing; I won’t know how to do the basic things that need to be done.”
Moreover, some CBOs have pursued activities beyond their mandate in response to community needs, becoming a “one-stop shop” that provided a range of interventions for community members such as assisting with social grant applications, helping people obtain birth certificates, providing food and uniforms for orphans, etcetera. The CBO have stepped up to provide services under the mandate of government, due to government’s neglect. If the CBO were to shut down, one beneficiary estimates that “orphans will no longer get food parcels. School uniforms will run out and kids will laugh at these orphans, who may then drop out of school.”
Acknowledging the negative implications of closure on Rural Men as Partners and Fathers, it is important to also mention the positive and potentially lasting benefits that the programme has had on this group of beneficiaries. These benefits include improved relations in some communities between males of different generations, and more respect for elders; increased acceptance of formerly marginalised people such as HIV-positive patients and LGBTI people; increased awareness of and interest in health issues such as HIV/AIDS; and increased adherence to treatment and more visits to the clinic for VCT.
2. Initiation Schools
CHP funding cuts will have a set of negative implications on CBO programmes that support initiation schools and in turn on initiation schools and their clients. CBOs targeting initiation schools run a set of programmes to achieve CHP objectives that include training workshops for traditional surgeons and nurses; traditional circumcision forums; peer education teams; and partnerships with key government stakeholders, particularly clinics and hospitals (i.e the Department of Health). While these programmes are not expected to fold completely, there will be a significant scaling back of activities due to funding cuts. The CBO visited may have to move its office to a more outlying location, where there is no internet service. In addition, the CBO will limit its work to nearby areas, reaching fewer initiation schools and focus more on cost-effective work that ‘piggybacks’ off other organisations. Fewer workshops with traditional healers will be held; peer education programmes will likely have to be reduced or stopped completely due to a lack of money for transport and accommodation; and relationships with biomedical health practitioners may falter.
As a result of a scaling back of traditional healer workshops and forums, healers will have reduced access to important information regarding HIV/AIDS, STIs and the identification of key conditions that affect their clients, such as sepsis, particularly in those areas where CBOs can no longer work due to funding cuts. While those traditional healers who have undergone the workshops will still have that knowledge, one CBO director believes that their behaviour will still regress. Behaviour change, he maintains, requires physical presence and organisational visibility. Without this, there will be no accountability for THPs and “their conscience will die.”
In areas where the CBO will no longer be able to work, new entrants to the traditional healing practice will have no access to educational programmes that enable them to practice infection control and harm reduction procedures, such as practicing circumcision safely so as to reduce the risk of infection, amputations and deaths of initiates. They will not be taught when and how to make referrals to clinics and hospitals.
One CBO’s “bush-tracking programme” requires transport to outlying areas to monitor initiation schools, to ensure THPs are sane, that initiates are of an appropriate age and that initiates aren’t being abused through dehydration and starvation. This programme currently requires continuous financial support, as the CBO does not have its own vehicle for transport to outlying areas. Hence, conditions at initiation schools will likely deteriorate.
Ultimately, initiates will bear the brunt of the negative implications of closure. The CBO manager interviewed estimates that child mortality and amputations will increase as a result of the situation described above. He also believes that more boys who are too young to undergo circumcision will do so anyway, without the monitoring structures that are integral to long-term behaviour change.
Lastly, it is important to acknowledge the positive and potentially lasting benefits that the programme has had on THPs. These benefits include decreasing the incidence of harmful health procedures in initiation schools and enhancing cooperation between biomedical health practitioners and THPs.
3. Traditional Healers
Similar to the beneficiary groups discussed above, it is expected that the funding cutback will result in fewer workshops for THPs. Most organisations stated that the primary implication of the CHP closure will be cutting workshops and training sessions at distant locations, while still maintaining workshops in localised areas. Traditional health practitioners in outlying areas will have diminished access to training in infection control and harm reduction procedures. In addition, workshops in localised areas may also be affected by funding cuts, as the CBO will be less able to secure essential supplies such as plastic bottles, gloves, razor blades, dildos and first aid kits.
Because workshops have focused on cultivating relationships between biomedical practitioners and traditional healers, partly through educating THPs on the importance of working with hospitals and clinics, these budding relationships may falter. Fewer referrals may be made by THPs to biomedical institutions. One CBO staff member estimates that the there may be an increased reluctance to go to the clinic, an increased reliance on traditional healing in general and perhaps an increased number of deaths from minor illnesses.
The micro-enterprise projects currently being implemented at many CBOs will likely collapse due to the funding requirements of such projects in the beginning stages. This will mean fewer income-generation opportunities for traditional healers.
Nevertheless, it is important to acknowledge positive and potentially lasting benefits that the programme has had on THPs. These benefits include a decreased incidence of harmful health procedures and enhanced cooperation between biomedical health practitioners and THPs.
4. San
SASI as an organisation runs several other programmes alongside the CHP. Given the nature and size of SASI, it has been able to incorporate the CHP programme objectives and activities within other organisational programmes. Thus the CHP will not be closing within SASI, but rather undergo a process of restructuring. The SASI CHP staff and peer educators will continue to implement the programme activities at the end of the funding cycle in March 2012.
5. LGBTI
Like other CBOs, organisations targeting LGBTI people will likely have to shrink their programmes, entrench some or most of their staff members and run on a skeleton basis if alternative funding cannot be secured soon after March 2012. One CBO director estimates that, if funding stops, “the work would simply come to a halt.” This will mean cutbacks in programming for LGBTI people, involving fewer workshops, training sessions and support groups and possibly a faltering of relationships with key stakeholders. This in turn will have a negative set of implications for the LGBTI beneficiary group.
Fewer workshops, training sessions and support groups will mean that LGBTI people will have diminished safe spaces to “come out” with their status and make themselves visible in the community. They will have less access to therapeutic spaces in which they can discuss their conditions and to vital support services. For instance, one CBO that provides workshops for victims of hate crimes may have to reduce the frequency of these workshops if staff retrenchments are made. With fewer workshops, victims of hate crimes will experience a reduction in the number of forums in which they can engage in therapeutic discourse and seek help in the form of rape kits and referrals to legal and health institutions. In addition, staff retrenchments may result in fewer family support groups in communities involving families and their LGBTI loved ones. With fewer support groups, LGBTI people may find that they have less means whereby they can reconcile with their families. This in turn could potentially result in more LGBTI people on the street.
Furthermore, there could be a diminished number of workshops intended to reduce culturally-based stigma and prejudice amongst community members. By depriving the larger community of information and “myth-busting” curricula, LGBTI people could be indirectly affected. There could potentially be an increase in incidents of violence against LGBTI people, although this would also be very difficult to measure.
Reduced organisational capacity for CBOs involved may result in a diminished amount of networking with other stakeholders in the community. These stakeholders include a range of actors, such as other NGOs and CBOs, government, health clinics, clergy, traditional leaders and the police. One CBO is currently making some inroads in terms of achieving attitude and behaviour change within traditionally conservative circles, such as the clergy and the police. This CBO is also working with political groups such as the ANC Women’s Caucus, biomedical health professionals at local clinics and teachers within local schools. The CBOs have identified and tried to capacitate teachers within schools who have demonstrated receptivity to positive messages about LGBTI people. These relationships are in their infant stages for the most part and require continuous support and effort on the part of the CBO to maintain. Without the necessary organisational capacity to maintain these relationships, the relationships may falter. This could also have an indirect impact on LGBTI people, who will be less capable of realising their constitutional rights if society becomes farther from the goal of sensitising government and service providers to positive information about LGBTI people.
While acknowledging the negative implications of closure, LGBTI programming has also had positive and potentially durable areas of impact. In some communities, intersex people have been given a voice and a group identity. Myths and stereotypes surrounding LGBTIs have been broken down, which could have a long-term impact on behaviour. Important inroads have also been made with regard to transformation of attitudes in traditionally hostile realms, such as the police, clergy, and tribal chiefs.
IMPLICATIONS OF CLOSURE FOR LARGER COMMUNITY
It is expected that the closure of the CHP will bring about a situation where fewer beneficiaries and members of the community will receive access to educational programmes in areas such as health, HIV prevention and gender transformation. Marginalised and/or culturally vulnerable groups of people will have diminished access to appropriate sexual health education and care. With reduced organisational visibility and the closure of CBO programmes, any achievements involving transformations in cultural attitudes and behaviours that negatively affect health behaviours, mental and physical well-being will likely be reversed due to a lack of ongoing support. Furthermore, there will be fewer avenues whereby grievances from marginalised populations can be addressed; for instance, LGBTI victims of hate crimes may not have as much access to support and redress, while boys who experience botched circumcisions may not have access to appropriate counselling and support services. The budding relationships between various key stakeholders in government and civil society that have formed as a result of CBO interventions and networking, because these relationships require ongoing maintenance and nurturing, may falter and society may become more disconnected as a result. Overall, the closure of CBO programmes will jeopardise the sustainability of the impact that has been made thus far and future generations will lose out.
Furthermore, people will likely continue to engage in risky behaviours and cultural practices that contribute to HIV transmission in South Africa. This may have negative implications for society as a whole, as wider delivery of effective behaviour change strategies is central to reversing the global HIV/AIDS epidemic. Even when biomedical HIV prevention tools finally emerge, human behaviour will remain critical because new prevention strategies are unlikely to be 100 per cent effective in preventing transmission. Research to date clearly documents the impact of numerous behavioural interventions in reducing the number of people living with HIV/AIDS and it is widely known that in all cases in which national HIV epidemics have reversed, broad-based behaviour changes were central to success.
SECTION 2: ANALYSIS OF DOMESTIC AND INTERNATIONAL FUNDING MARKETS
2.1 CONTEXT
BACKGROUND OF THE DOMESTIC FUNDING MARKET
At this juncture the report shall define the nature and size of the market in which the Culture and Health Program (CHP) competes for funding in South Africa. This section focuses on organisations or programmes that utilise research, funding, capacity-building and rights-based advocacy to campaign for improved health outcomes of culturally marginalised people. It is within the areas of culture, health, gender and human rights assistance to South African communities that defines the ’market’ in which the CHP competes for funding with similarly situated organisations or programmes.
Ten programmes/organisations that utilise research, funding, capacity-building and rights-based advocacy to campaign for improved health outcomes of culturally marginalised people, were initially identified for the evaluation.[13] The programmes/organisations are involved in conducting research, providing financial support to CBOs, capacity-building and/or human rights advocacy. Beneficiaries of the programmes include rural people (men), traditional healers, San peoples, traditional circumcision initiation schools and LBTI people. Creative Consulting & Development Works acknowledges that the ten programmes/organisations initially investigated are not exhaustive. However, the ten programmes/organisations identified serve as a snapshot of some of the programmes/organisations involved in work similarly conducted by the CHP and thus competing with the CHP for funding opportunities. An analysis of the programmes identified shall provide a glimpse of background aspects of the market within which they operate.
The identified programmes/organisations have similar foci with the CHP. Careful analysis shows that all programmes are competing in a context where HIV/AIDS has been identified as a threat to vulnerable groups in society. Although not all the programmes have a diversified approach towards the five target groups that the CHP focuses on, the majority of the programmes focus on at least one of the five target groups that the CHP supports. Capacity, location, age of the organisation and funding reserves are factors influencing targeted groups. The CHP and the programmes/organisations identified are all working against the backdrop of realising that South Africa has vulnerable and marginalised members within its society that require assistance and support.
With regards to background on funding, local donors such as the National Development Agency (NDA) provide grant funding to organisations, which implement development interventions in poor communities. The NDA communicates funding opportunities to NGOs through calls for proposals via media platforms such as newspapers.
The NDA invites proposals from CBOs and NGOs based on pre-set policy criteria and process. In some instances the NDA requests proposals for projects that require capacity-building of other smaller NGOs that provide services in target communities. In some cases, the NDA requests proposals for programmes that have an in-built capacity-building approach and provides primary research data on care-based organisations. Submitted proposals are then reviewed and selected. Subsequently, a decision and approval to grant funding is provided by the Board.
Other sources of funding for the programmes/organisations utilising research, funding, capacity-building and rights-based advocacy campaigns to improve health outcomes of culturally marginalised people mentioned above, include;
← Membership fees from partner organisations,
← Grants from international development agencies such as the European Union, UNAIDS, German Foundation for World Population (DSW),
← Grants from the South African government. Government Departments providing funding for culture and health interventions include the Department of Social Development, the Department of Social Services and the National Department of Health,
← Private donations from members of society and/or from the international community,
← The sale of goods. This entails sales of goods for “a cause”,
← Donor partners from various sectors of the economy i.e. businesses e.g. retail service chains such as commercial banks,
← Corporate-social investment grant packages from various industrial players and firms, and
← Fundraising activities and events.
AFSA’s CHP is located in an environment where other competing programmes and organisations are looking to provide culture, health, gender and human rights solutions to vulnerable and marginalised groups through;
← Provision of education and promotion of understanding across all stakeholders. (i.e. workers across the organisations, affected or targeted communities, groups of vulnerable and marginalised people, clinics, community-based workers, community-based organisations (CBOs), social workers, leaders of communities, medical officers, political and influential members of society,
← Provision of improved access to increased awareness, prevention and care,
← Prevention of new infections through early prevention campaigns to the younger generations of the targeted vulnerable and marginalised groups,
← Employing interventions to improve the quality of national health care and education across the vulnerable culturally marginalised target groups by increasing capacity-building training initiatives,
← Aggressive awareness campaigns through workshops and road shows.
← Publication of materials focusing of health, culture, gender and human rights, and
← Utilisation of media platforms to distribute messages of health awareness, prevention and support for affected or infected groups.
Examination of information obtained from the programmes/organisations, reveals that these interventions have committed themselves to capacity-building initiatives, health promotion initiatives, cultural incentives aligning different societies to modern practices of health and health awareness especially in the context of HIV/AIDS awareness, prevention and treatment. Therefore, the CHP is competing for funding opportunities in a context where other programmes/organisations harness knowledge and insights obtained from extensive research on culture and health issues in at least one of the target groups of vulnerable and marginalised people that the CHP focuses on.
2.2 NATURE AND SIZE: COMPETITIVENESS OF ORGANISATIONS SEEKING FUNDING
NATURE OF FUNDING OPPORTUNITIES IN SOUTH AFRICA
Ten donor agencies with offices in South Africa were approached by Creative Consulting & Development Works on behalf on AFSA’s CHP to investigate competitiveness of organisations seeking funding. Selected donor agencies that were approached specifically fund health, culture, gender and human rights organisations operating in South Africa. Creative Consulting & Development Works explored the perceptions of four domestic corporate donors, four international development agencies, one local development agency and one international private funding foundation.
In South Africa today there is a variety of organisations that seek funding from the donor community. There are large, well-established organisations that have been operating for many years such as Sonke Gender Justice and AFSA. There are also middle-sized organisations and small or beginner organisations operating in the country. Domestic and foreign donors confirmed that they receive proposals and applications for funding from both large and small organisations. It is evident that organisations of any dimension require financial support for the services they provide communities. Therefore, it was drawn that organisations of various sizes depend on donor funding and seek funding opportunities.
The majority of domestic corporate donors and foreign donors interviewed utilise the “call for proposals” mechanism. This mechanism creates equal opportunities for organisations to submit proposals for funding health, culture, gender and human rights programmes and projects. As a result, organisations of various sizes, age and capacity respond to calls for proposals. The call for proposal mechanism attracts organisations from all the nine provinces of South Africa to submit proposals for funding from the donors, ranging from micro- to macro- players in the market. Domestic and foreign donors that do not use the call for proposal approach accept applications from organisations.
Corporate donors investigated have corporate social investment programmes that focus on social spending. Only corporate donors that provide funding to organisations that focus on health, culture, gender and human rights related work were approached by Creative Consulting & Development Works for the purposes of this evaluation.
Corporate institutions welcome numerous opportunities that build relationships with clients, employees and communities in order to make a meaningful difference in the lives of South Africans from all walks of life. These corporate institutions form partnerships with organisations that have a specific focus on a social development area.
Some of South Africa’s corporate donors make use of corporate social investment agencies. The agencies design social investment packages for corporations. The agencies also facilitate the implementation of corporate social investment in communities on behalf of corporations. Tshikululu is an example of a corporate social investment agency within the health sector. It supports a holistic approach when addressing health and HIV/AIDS issues. Tshikululu supports projects running in the areas of home-based care, HIV/AIDS prevention, programmes promoting voluntary HIV counselling and testing, programmes supporting orphans and vulnerable children, community primary health care programmes, secondary and tertiary levels of care for disadvantaged communities. In partnership with their clients, Tshikululu has championed a range of health care related interventions from primary health care to tertiary levels of care and has promoted prevention, care and support for people living with HIV/AIDS.
Corporate donors in South Africa award funding to any organisation that conforms to the funding criteria governed by the company’s corporate social investment policy. There is no discrimination of organisations that may apply for funding. A corporate donor informed this study that the company accepts applications from locally established NGOs, as well as international NGOs operating in South Africa. The corporate donor revealed that established international organisations such as Oxfam have applied for funding. Therefore, it is evident that organisations from the international community at different development stages, capacity and operational experience seek funding from both domestic and foreign donor agencies and foundations.
Domestic and foreign donors indicated that organisations sourcing funding are applying for funding very broadly. In the current financial climate, organisations seldom send proposals and applications for funding that only focus on a single issue, such as HIV/AIDS. In the present funding climate, organisations incorporate linked activities and have a more holistic approach to HIV/AIDS and other health interventions. Some organisations submit proposals with three tiers, for example a proposal for funding will be focused on children’s health, aftercare and working with families in an impoverished community. As a result, this increases the scope of work that funding is sought for. For a stated amount of funding, organisations compete against each other by offering more services. The nature of the funding climate consists of organisations applying a value for money approach to entice donor funding.
Organisations in South Africa are aware that HIV/AIDS, health, gender and human rights are emotional agendas. As a result, organisations appeal to the donor community to fund projects that carry the agendas mentioned above. In today’s funding climate one can observe that innovation in programme design plays a critical role in seeking funding. The holistic approach to programmes and projects creates and intensifies competition for other development organisations because more comprehensive and broader services are being offered for community target groups, albeit limited funding resources and money available from donor agencies.
SIZE OF FUNDING DEMAND
There is currently an extremely competitive funding climate in South Africa. Organisations seeking funding have increased in numbers. This is mainly due to the diversity of backgrounds from which organisations emerge. Organisations have emerged from community co-operations, community churches, individuals that wish to make a difference in society and others from a community development perspective. The increase in numbers of organisations has created enormous pressure on the donor community against the backdrop of harsh global economic conditions.
To substantiate the point mentioned above, a donor remarked that in light of the present economic difficulties, competition between organisations for donor funding has become more than just competitive, and has reached an extreme level. It is evident that, on the one hand, donors are experiencing the impact of the global financial crisis, and on the other hand, a large number of organisations make efforts to source the limited funds available. As a result, there is immense competition between organisations to access funding opportunities available.
Organisations seeking funding are under immense competition from each other as they seek to access funding from limited available sources. Funding is very competitive and difficult to secure. The number of organisations that respond to calls for proposals and those that apply for funding is large. One foreign donor noted that their latest call for proposals received over 100 responses from organisations for a maximum of ten organisations that would be awarded the funding. This shows that there are hundreds of eligible organisations in South Africa that focus on health, culture, gender and human rights, competing against each other. Organisations that responded to the call for funding proposals all met the criteria stipulated by the donor agency. This situation created great difficulties for the donor in selecting ten beneficiary organisations. In depth proposal/application assessments and elimination criteria are established by donor organisations in selection procedures that separate unsuccessful and successful organisations.
The four corporate donor companies investigated each receive approximately 150 to 200 funding applications a year from organisations that focus on culture, health, gender and human rights. Organisations in South Africa apply to the corporate companies investigated for funding in great numbers, because these corporations consider applications and proposals throughout the year. All four domestic corporate donors only fund health, culture, gender and human rights projects on a long-term basis. The minimum number of years is three and the maximum number of years is five. However, approval of proposals is subject to availability of funds or budget allocated to corporate social investment projects, the company funding criteria and feasibility of the proposed intervention.
In conclusion of this subsection, one can observe that application for funding is very competitive, as shown by the number of organisations responding to calls for funding. Another factor indicating that the funding climate is competitive is the level of compliance to mandatory criteria. Last but not least, the manner in which organisations attempt to out-class competitors through the innovative designing of interventions that goes beyond expectations of donors.
2.3 DOMESTIC FUNDING MARKET
ANALYSIS OF OPPORTUNITIES FOR DOMESTICALLY SOURCED FUNDING[14]
Domestic donor agencies insist that funding opportunities are available for programmes that focus on culture, health, gender and human rights. The main issue that affects securing funding opportunities is satisfying criteria/requirements/ specifications/conditions that render applications for funding successful. Domestic donors place substantial weight on the ultimate objective of an organisation that applies for funding. Pioneer Foods stated that the overall mandate of the organisation applying for funding is of great importance. They believe that a focused organisation is one that is experienced in forecasting challenges, has implementation plans that have been tried and tested, and is familiar with cost effective ways in which services may be provided.
Organisations that are known to be specialists or experienced in delivering services to communities in areas other than health, culture, gender and human rights that apply for funding for health programmes are often second-guessed. Domestic donors such as Pioneer Foods, ABSA, Tshikululu and Afrox assess the background of the applicant organisation and previous programmes they have offered communities. Some donors expressed that, due to the competitive climate for sourcing funding, some organisations are venturing into areas they are inexperienced in and source funding as a survival tactic. As a result, there is now much emphasis placed on the ultimate aim of the organisation and not the programme that funding is applied for.
ABSA stated that they create opportunities based on need, while Pioneer Foods emphasised that they only create opportunities for funding where they have reviewed an organisation’s structure in terms of people and delivery of services. The name and reputation of the organisation alone does not warrant success. Furthermore, ABSA and Pioneer Foods have a vetting process where they assess the applicant organisation’s internal management and core team. The core managers, project co-ordinators and other technical staff are carefully assessed. Each person in the organisation’s profile is assessed and evaluated amounting to whether the core team has the right expertise, qualifications and experience to deliver the projected outcomes of the programme. Domestic donors have become very critical and careful about the organisations that they provide funding opportunities to. Organisations are under immense pressure to not only hire staff that add value to their organisation and deliver the services they aim to provide, but also staff that will increase the attractiveness of the company staff profile to donors.
Four out of four domestic donors interviewed stated that they only fund interventions that fit into their business profile. Donor corporations assess the company’s internal business structure, activities or products and shape their corporate social investment programme in a manner that portrays the essence of the business. For example, one of the donors approached in this evaluation (Pioneer Foods) is a large food processing company. The company only provides funding opportunities for health programmes. However, the health programmes they fund are confined to nutrition. As a result, organisations that successfully receive funding or sponsorship from this company are provided with money to establish feeding scheme projects in communities of their choice. The donor company also provides the organisation with branded food products and will task the organisation with distributing and utilising the food donations in their nutrition programmes.
The example above shows that some donor companies will only create funding opportunities for organisations prepared to implement interventions that fit into the donor company’s agenda. Usually the funding agenda is set company policy - agreed upon by the board of directors and shareholders. Thus, such donors have a set agenda and do not fund any organisations outside their prescribed areas. To derogate from the specified area towards funding organisations that focus on other areas of development is non-negotiable.
Domestic donors are reluctant to create funding opportunities that cover salaries, overhead costs and travel expenses for organisations. Three out of four donors considered only funding the actual services provided by an organisation (Pioneer Foods, Afrox and ABSA). One donor stated that apart from funding the activities or services of the organisation, they fund 15 per cent of overhead costs. However, generally one can observe the attitude of donors towards funding personnel and overhead costs. Linked to this point is the issue of budgets submitted to donors.
Donors are very cautious when they assess budgets submitted by organisations. As mentioned above, some donors will not consider organisations that budget for personnel costs (Pioneer Foods, ABSA and Tshilkululu). Other donors for example will allow for a 12 per cent administration fee (Afrox). Special attention is required with regards to focusing on donor’s budget expectations, as well as areas funded. For example, Pioneer Foods does not fund marketing of the applicant donor organisation at all. Therefore, as demonstrated above, opportunities for funding have become very specific and programme focused. Donors have become prescriptive around budget and the allocation of budget.
Similar to the majority of foreign donors with offices located in South Africa, three out of four domestic donors create opportunities to fund organisations that are national and have a national impact. Domestic donor corporations interviewed were explicit about only funding local organisations that aimed at improving the lives of people living in South Africa.
Asked to comment on why there were no funding opportunities made available to foreign organisations, Pioneer Foods, Tshikululu and Afrox implied that funding local organisations increases confidence in South Africa’s development organisations, shows commitment to South African investment, capacitates and aims to relinquish dependency on foreign donors. However, to the contrary, international development agencies that were interviewed indicated that they create opportunities for foreign organisations working within South Africa.
The domestic donor community is showing signs of commitment to local organisations. Such an approach is beneficial to local organisations seeking funding for culture, health, gender and human rights programmes. Competition for available opportunities for funding made available by domestic funders is reduced to the extent that it is limited to local organisations competing against each other rather than also competing with foreign organisations, which tend to be more established.
Domestic donors have an appreciation for culture, health, gender and human rights interventions. Two of the donors (Tshikululu and Pioneer Foods) specifically focus on providing funding opportunities to interventions that support marginalised communities per se. Pioneer Foods made reference to the point that they make funding opportunities available to organisations that have programmes directed towards culturally marginalised and vulnerable people. Donors believed that through funding culture, health, gender and human rights interventions, they fill gaps where government does not necessarily deliver services such as in the rural areas. The domestic donors were specific about the areas that they fund and societal problems they aim to tackle.
Although donors specified the duration of funding, no information was provided around outcomes. Donors spoke passionately about areas they wanted organisations to work in. Donors also spoke passionately of the need to have proper and efficient systems of monitoring and evaluation i.e. how they are going to measure their success and their impact, reporting and accountability. However, only Tshikululu mentioned the outcomes they expected. The donor mentioned that they expected organisations they funded to have realistic objectives and to deliver the stipulated results within the time frame specified.
The rest of the donors only mentioned they expected organisations to deliver the services being funded. There was no indication as to whether there was pressure on organisations to deliver results in specific time frames or how many people received the services or assistance. The impression given by donors is that once an organisation secures a funding opportunity from a donor, the organisation should deliver the specified services as per contract agreement.
CHALLENGES CONFRONTING DOMESTIC DONORS
It follows that there are challenges that the domestic funding community experiences with providing funding opportunities to organisations that assist culturally marginalised and vulnerable people. The most significant challenge is providing sufficient finance. Domestic donors interviewed expressed the point that there is not enough money to fund organisations. It was drawn from the donors interviewed that both the local and international community have people that are desperate to help but the problem is that there are insufficient funding opportunities.
In addition, most donors have very small budgets allocated towards community programmes and interventions. Donors realise the issues affecting the communities and are willing to provide assistance in the form of funding opportunities. However, because of the economic difficulties experienced globally, there are not enough funds to cover the entire scope of programmes or projects presented in proposals. As a result, donors are not able to provide sufficient funding to implement interventions fully.
Some donors stated that in situations where they find a suitable organisation to fund, they may approach the organisation to downsize the proposed project. In certain instances, donors have deployed technical experts to applicant organisations. The technical experts then assist the organisation with restructuring and make the necessary methodological changes and budget, which the donor will be able to fund successfully.
Another challenge that the domestic funding community is experiencing is that donors tend to actually provide funding opportunities to larger and well-established organisations. Established organisations are favourites for securing funding, because they have established networks and are well connected within communities.
As a result, such organisations are deemed to make a difference in very short period of time. Domestic funders have far greater confidence in organisations regarded as the “bigger players”. The networks and the connections they have within various communities and in the service provision sector they operate, places them on an advantageous platform. Such organisations would be in a position to efficiently implement the funded programme.
Donors believe that more established organisations are successful and know how to deliver their services. As a result, smaller organisations are in an unfavourable position. They have to put in greater effort when they compete for funding opportunities against the larger and more established organisations whose reputation precedes them.
In contrast to the view of donor organisations’ preference to fund established organisations, some domestic donors felt that some organisations are not fully networked into structures that alert them to opportunities for assessing funding. Donor organisations conduct research in the areas they wish to fund. They investigate the work that has been done and areas that need to be improved.
Donors also investigate potential organisations that provide specific services in the areas they wish to invest. Some donors expressed that some organisations are not aware of funding opportunities available, and therefore never apply or submit proposals for funding.
Some organisations only respond to funding opportunities advertised in newspapers as tender notices and calls for proposals. Donors have expressed concern as to whether smaller organisations conduct research in corporate social investment newsletters, company websites and funding portfolios.
Another challenge faced by domestic donor funders is that they are trying to establish new partnerships with government, in order to increase funding for current beneficiary organisations. Some organisations perform very well and impressive results are evident in the communities that work. However, donors may not have further funding to increase the outreach or work that performing organisations will be undertaking.
As a result, domestic donors approach government to establish partnerships that can facilitate the injection of further funds towards the work being done. The challenge for donors lies with successfully forming partnerships with the government, in order to stretch the outreach of organisations. Very few partnerships have been successfully formed.
A challenge for newly established organisations is that the lack of programmatic and financial track records works to the disadvantage of such organisations. Donors are generally more comfortable with creating funding opportunities for organisations that are in a position to produce valid evidence that they have financial responsibility and accountability. Funds and money allocated to organisations require effective and productive use to produce desired outcomes and results in communities and donors have a tendency to prefer awarding funding opportunities to organisations that have a record of quality management of funds, effective use and accountability mechanisms. Partnerships are built on trust, but trust is built on records or evidence. Organisations with proven financial records have greater opportunities of securing funding from domestic donors than organisations without.
The domestic donor environment has acknowledged the limited opportunities of funding in the current harsh global economic climate. Regarding the limited funding opportunities that are available, donors are welcoming culture, health, gender and human rights interventions that incorporate a more holistic approach.
Donors are impressed by interventions that integrate sport and education in health agendas. Three donor organisations expressed their interest in availing funding opportunities to programmes that focus on grass roots sports initiatives and HIV/AIDS education. Some donors believe that sport is the medium through which the younger generation can learn about health aspects, gender issues and human rights. Therefore, Innovative programmes are strongly encouraged.
Domestic donors encouraged organisations to carefully analyse and research the nature of corporate social investment programmes offered. Donors want organisations to incorporate the agenda of the company and include and integrate their programme aspects and sport as a means of attaching culture, health, gender and human issues from an early age. It was observed, however, that opportunities for funding such types of programmes are available to the extent of company budgets for corporate social investment projects.
AFSA CULTURE AND HEALTH PROGRAMME RESPONSE
AFSA CHP management believes donors are currently shifting interest towards interventions that do not yield impact per se but those that yield outcomes. The CHP management believes that donors are showing less interest in behavioural change interventions, which in essence are mainly long-term interventions meant to affect relationships, assist people and help them make wiser choices about their health care.
Behavioural change interventions may not yield immediate outcomes. Results of behavioural change interventions are only recognised over a number of years as behavioural patterns change. For AFSA’s CHP management, perceptions are that it has been increasingly difficult to source funding for domestic donors, as there are fewer current donors that are willing to fund interventions whose results are not immediate. In the current economic climate there is pressure to deliver measurable outcomes rather than impact.
In addition, the CHP management recognises that currently, domestic corporations implementing corporate social investment funding programmes have an interest in investing in programmes where they can receive recognition and publicity for the number of people that have been assisted in a particular area of social development. In other words, corporations tend to invest and channel funds directly towards communities in order to boost their company images and demonstrate their awareness of corporate responsibility. The publicity associated with compliance to corporate social responsibility legislation is a growing area with regards to best business practice.
In terms of government being a source of domestic funding, the CHP has experienced difficulties in sourcing funding from government departments because, firstly, the government falls under enormous pressure if it seeks to outsource services, which it struggles to provide. Secondly, the government is interested in service delivery programmes that can yield immediate quantifiable results.
AFSA CHP views domestic donors as having developed a strict attitude towards the organisations they approve funding to and the specific programme that the organisation is running. Donors are very particular about the types of programmes they will fund and have become rigid with their requirements. It has become difficult to source funding from domestic donors who are dedicated to funding that can be used for behavioural change and social determinants programmes. As a result, the CBO supported under AFSA’s CHP are in direct competition with hundreds other organisations, church groups and sporting bodies to find available funds.
2.4 INTERNATIONAL DONOR FUNDING MARKET
INTRODUCTION
International development agencies with offices in South Africa whose focus is on health, culture, gender and human rights have a country development programme framework. The development framework is based on an agreement between the international development agency and the government of South Africa in which an international development agency becomes a bilateral donor.
An international development agency’s funding entry point is via the government. The government of South Africa informs the international development agency of the area of development where support is required. In addition, the government informs international development agencies of priority areas where they require support. The priority areas that are noted by the government are the areas that are given support by the international development agency.
Therefore, the development agency and the government agree on the criteria for funding opportunities. As a result, the funding that is made available to South Africa by the international donor agencies will be specifically aimed at funding various funding categories. For example, funding that comes from a country such as Canada will state the allocation of funding in Canadian Dollars per organisation for the specific project that the organisation will implement.
International development agencies approached by Creative Consulting & Development Works were providing support in the area of HIV/AIDS and institutional strengthening and governance. An example of support rendered by an international development agency was the provision of an HIV/AIDS response fund. The HIV/AIDS response fund was applied for by AFSA. AFSA’s entry point was HIV/AIDS with a human rights perspective.
As previously mentioned in the report, the majority of international donors operating within South Africa interviewed call for proposals. In response to calls for proposals, organisations submit proposals that have projects that address numerous issues around culture, health, gender and human rights. Due to the innovative projects organisations formulate, most international donors are flexible in accepting proposals that integrate other areas of social development. For example, one international donor has provided funding to an organisation’s project that focuses on socio-economic empowerment. The proposal was accepted because it addressed the impact of HIV/AIDS.
NATURE AND SIZE OF INTERNATIONAL DONOR FUNDING MARKET
Similar to domestic donors, international donors receive around 100 proposals from organisations within South Africa in response to a call for proposals. This indicates that organisations are attentive to opportunities for funding. The fact that organisations respond in great magnitude reflects the high demand for funding in the country. The South African government and domestic donors cannot sustain the demand for funding organisations in the country. As a result, organisations increase their scope of funding opportunities and respond to potential funding made available from foreign agencies.
The nature of organisations that respond to calls for proposals from international donors has no distinct disparity to those seeking funding from domestic donors. Likewise, international donors receive responses from large, medium sized and small organisations, established and new organisations. International donor agencies also receive responses from organisations that vary in their development, experience, age and reputation. In the same way, again one can observe that the domestic and foreign funding market is receptive to the same organisations. Organisations are seeking funding opportunities from domestic and foreign donor sources, because those are the options or avenues available. Due to the limited availability of funding and the high demand for funding opportunities, organisations utilise both domestic and international donor avenues to secure funding. They are not at liberty to be selective.
In terms of competiveness for funding, international donors view applications for funding to be very competitive. This is attributed to the number of organisations that respond to calls for proposal and the number of organisations that blend into the criteria set. This makes the selection process very difficult for international donors, as various projects proposed have distinct impacts and strengths. Innovations of proposed projects create further selection difficulties, as organisations aim to impress donors with project designs that go further than the donor’s expectations.
Successful organisations that are funded by international donors are mostly funded for a period of one year and a maximum of three to four years. International donors approached during the evaluation revealed that the average lowest number of organisations they provided funding for at any one time is three and the largest is nine.
As mentioned above, approximately plus or minus 100 organisations respond per one call for proposals. For instance, if 100 organisations respond to calls for proposals of which only 10 organisations will be successful, this implies that only 10% of the total number of organisations will be successful. This shows the competitive funding climate, which places the international donor community under enormous pressure due to high demand.
Therefore, the domestic and international donor community cannot meet the demand for funding the entire community of organisations working in areas around health, culture, gender and human rights. In terms of nature and size of funding opportunities, there are limited funding opportunities available from both donor sectors for a large number of organisations (hundreds). Competition for the limited funding available in both sectors is therefore fierce.
ANALYSIS OF ATTITUDES OF INTERNATIONAL DONOR ORGANISATIONS/FOUNDATIONS
This section of the report investigates attitudes of selected foreign government and private foundation donors with offices in South Africa to invest in NGOs whose focus is on health, culture, gender and human rights.
The issue of funding criteria is of critical importance to both domestic and foreign government and private donors. Foreign donors will only fund organisations that conform to the conditions of funding. As a result, organisations require precision in the formulation and writing of funding proposals.
Organisations should pay special attention to funding criteria. Similar to the attitude demonstrated by domestic donors, it can be concluded that all donors will only fund organisations that meet the criteria set. However, foreign donors (foreign government donors), in contrast to domestic donors, have criteria agreed upon with government. Domestic donor (corporate) funding criteria is defined and regulated by company policy, shareholder or board of directors. The source of funding criteria is different for domestic and foreign donors, however both funding communities have in common the fact that they will only provide funding opportunities to organisations that conform to their requirements.
In addition to conformity to set criteria, foreign donors investigated have stricter selection policies than domestic donors. Domestic donors appear to place greater emphasis on criteria conformity and prefer to provide funding to established organisations with sound financial records. This is not the case with foreign government donors. Some foreign donor agencies such as the Canadian International Development Agency (CIDA) indicated that they greatly consider issues such as due diligence.
Other international donors such as CIDA and Carl and Emily Fuchs Foundation pay special attention to gender composition. CIDA indicated that gender equality in the organisation is of great importance. CIDA considers the composition of the board of directors within the organisations. The donor prefers to fund organisation that have women involved in decision-making processes. The donors that value gender equality indicated their preference for organisations that have women who would be able to have a say in the accessing and utilisation of resources in decision-making.
The composition of a board is an area that domestic donors did not emphasise. In a global environment where women’s human rights and gender equality are promoted, it is without question that foreign government donors adopt the gender equality attitude. The composition of a board is important in that if there are women, female perspectives influence the way in which decisions are made. The gender equality approach implemented by foreign donor agencies encourages organisations to empower women. This preference creates pressure for organisations to include women in influential positions and not follow global trends of female empowerment in the workplace.
Foreign government donors are promoting gender equality through opportunities for funding, as organisations will make the necessary strategic changes in order to place their application for funding in a better position. Presently in South Africa, foreign government donors’ attitude is that if a board of an applicant organisation is equal in gender terms, then decisions are likely to be made from the gender equality framework. This makes the organisation more favourable for funding.
Foreign government development agencies tend to relate to “like-minded” organisations or organisations that have a similar focus to those that they are funding already, rather than exploring new areas to fund. This attitude is attributed to the agreements made with the government. Foreign government development agency funding is responsive to government’s call for assistance in a specific area such as HIV/AIDS. A bilateral agreement between the foreign government development agency and the government will have been made and the foreign donor will proceed with the agreed conditions. The foreign government development agency then makes a call for proposals. Any organisation that is willing to submit a proposal that can fit into that agenda has an equal opportunity to apply.
However, some the Canadian International Development Agency and the Swedish Development Agency explained that they prefer organisations that show similarities to organisations that they have had successful partnerships with in the past. Past funded organisations are used as precedent and influence funding decisions for the future. As a result, the donors will strongly consider applicant organisations that show likeness or share similar ideas or philosophy with either current or past beneficiary organisations. In addition, if more than one organisation were to be funded, organisations that share similarities will be selected to receive funding opportunity.
Similar to domestic donors, foreign donors consider project management skills. These skills are showcased in an organisation’s portfolio. References from previous funders also strengthen an organisation’s application. Project management skills are therefore assessed and confirmed. The manner in which the proposal is written is of paramount importance to donors. If a concept or proposal is weak, donors will not afford funding to an organisation. Donors search for a clear set of objectives and clear outputs and outcomes that are realistic and can make a difference in society. In addition to a realistic project proposal, donors require a realistic budget that accompanies the proposal.
In terms of budget aspects, unlike the majority of domestic funders, most foreign government donors ( CIDA, SIDA and Soros Foundation) were of the opinion that overhead costs should be funded. These donors value the importance of supporting an organisation fully. Compared to domestic donors, foreign donors empathise with organisations and are prepared to fund salaries, travel expenses and other overhead costs that facilitate the running the organisation. The foreign donors that fund organisation overhead costs apply a holistic funding approach where all expenses are covered to ensure successful implementation of projects. However, organisations are encouraged to provide a budget that correctly depicts all their costs and expenses. Budgets should be presented concisely.
Increasingly, donors are enquiring after and insisting on information about an organisation’s plans for financial sustainability. A foreign private donor foundation (Soros Foundation) expressed the need for organisations seeking funding to have a clear resource mobilisation strategy, which not only includes sourcing funds from external sources but also from within the organisation. The private donor expressed the importance of a self-sustainability attitude. According to the private donor, organisations seeking funding who display mechanisms of self-sustainability or subsidisation strategies to meet overhead costs are more attractive for funding. The private donor stated that during selection, a strong impression is made when certain technical expertise can be built internally within an organisation. In such cases, the organisation will have a corporate section that generates funds, applies for consultancies in their areas of strength and generates money for the organisation.
Foreign donors are beginning to have a tendency to favour organisations that can indicate that the organisation is not entirely reliant on the particular foreign donor’s funding. The attitude displayed by the foreign private donor foundation leans towards an attraction to organisations that have a resource mobilisation strategy. The donor foundation is greatly impressed by self-sustainability aspects. Donors like CIDA and SIDA have developed an attitude where they wish to fund organisations that do not have their operations at a standstill where there is no external funding. Ideally, it appears that donors wish to fund organisations that already have income generating initiatives and have the ability to support themselves. From an external point of view, organisations that strive for the survival of their operations and interventions appear to have a strong commitment to their cause.
Commitment is proven by organisations that find other avenues besides donors to generate money. The money can either be utilised to sustain small scale interventions implemented in communities or in some cases, the money may be used to sustain large interventions after an external donor ceases to fund an intervention. The ability to be self-sustainable proves an organisation’s commitment to the work carried out in communities. A strong impression on donors would surely build confidence in a donor to afford an organisation funding opportunities. Therefore, Creative Consulting & Development Works has observed that the existence of a reserve may now in fact count in an organisation’s favour when applying for funds on the basis that the organisation shows that it is likely to be in existence for the duration of the programme.
On the other hand, foreign government development agencies investigated during this evaluation (CIDA and SIDA) noted that culture, health, gender and human rights are all key priorities of the South African government. As a result of the foreign government development agency’s agreement with the South African government to be a bilateral donor, funding opportunities are available for culture, health, gender and human rights programmes. All that is required is for organisations to apply for funding when there are calls for proposals. Currently, the most popular projects that are funded are related to gender, institutional capacity-building and HIV/AIDS.
Foreign donors’ attitude also includes the fact that they seem to relate specifically to formal organisations because these have the capacity to understand and perform within foreign donor bureaucratic frameworks. Established organisations that work within the framework of highly bureaucratic institutions such as government departments and large corporations are at an advantage. Such organisations have existing knowledge of how to conduct their operations within their required framework. Such organisations will have to familiarise themselves with proper communication channels, reporting structures and adhere to agreed deadlines. Established organisations also have built-in bureaucratic channels in their organisational structure.
As a result, such organisations understand underlying operation systems such as communication channels, reporting and accountability. Large foreign donors sometimes prefer organisations of such stature because such organisations know the technical expectations required from them. Donors that uphold this view, mainly CIDA and SIDA value efficiency and reliability of organisations to deliver technical requirements at a level that is satisfactory to them. Less established or beginner organisations may face complications in their attempts to meet the level of service that highly bureaucratic donor entities may require.
Creative Consulting & Development Works’ desktop research has revealed that some organisations have highlighted that foreign government donor institutions have devised burdensome and time-consuming procedures surrounding funding applications, project proposals and the monitoring of funded projects. Similar to domestic corporate donors, some foreign donors have become prescriptive. Projects are required to meet certain requirements and designed in a manner that conforms to set criteria. However, the degree of prescription of foreign donors is less than domestic corporate donors. Foreign donor policies are not uniform. Others are open ended while others a close ended. However, corporate donors have prescribed requirements that are underpinned by shareholders and influential company role players. All domestic corporate donors noted the issue of conformity of funded projects to company activities, needs and policy.
Other organisations have been observed to no longer have flexible relationships with the foreign donor institutions. Foreign donors now appear as no longer highly accommodating to local demands as in the past years. They have become more receptive to government’s appeals to areas that require assistance as opposed to the voice of organisations. Unlike some domestic donors such as corporate firms that accept applications for proposed projects, foreign government development agencies are restricted to support organisations that conform to the call for proposal requirements. Organisations in this case compete in terms of budget as opposed to innovative projects or programmes.
The report shall now focus on challenges foreign donors have experienced with providing funding opportunities to organisations that assist culturally marginalised and vulnerable people to improve their health outcomes. The Swedish International Development Agency expressed that some organisations encounter challenges in adhering to the business plans or funding proposals as presented and agreed upon. The majority of cases involve circumstances where organisations fail to complete projects in the specified period of time. Time is an important aspect for both domestic and foreign funders. Donors expect to see pledged results in the allocated organisations. Therefore, both domestic and foreign donors face a similar predicament with regards to organisational delivery of desired results in the allocated time frame.
Foreign donor foundations such as Soros and Carl and Emily Fuchs require potential recipient organisations to command a strong sense of accountability, transparency and good governance over the funds they will receive. Some donors like CIDA feel that organisations do not take accountability and reporting seriously enough. CIDA complained of receiving financial reports and monthly expenditure reports late. As mentioned earlier, numerous foreign donor agencies are large entities that have bureaucratic structures.
As a result, the management chain within the donor organisation requires feedback in the form of reports at specified times. Inefficiency in delivery of reports of any nature agreed upon, results in an inconvenience to the donor. CIDA and SIDA both felt that the level of professionalism of some beneficiary organisations is questionable and has changed the attitude of many foreign donors. Donors prefer established organisations that understand the importance of delivering feedback documentation and reports on time.
AFSA CULTURE AND HEALTH PROGRAMME RESPONSE
AFSA CHP management acknowledges the prescriptive nature of funding opportunities afforded to organisations in the current funding climate in South Africa. AFSA management feels that if international donors are committing money into culture, gender, human rights or an area such as health, then they need to provide some flexibility to organisations in the country.
In response to the issue of results and outputs, AFSA management carried a similar message to foreign donors. If a foreign donor invests in a programme focused on a behavioural change issue that is not to say that there will not be any immediate or prompt results. There have been cases where there have been an increased number of people going for VCT, as well as an increase in awareness workshops and the distribution of published material. The question that AFSA CHP directed to foreign donors is how to make the results obtained durable. The question is directed at how to make the quick results attained contribute to ongoing strengthening of community capacity and behaviour change after funding has stopped.
In addition, AFSA CHP management expressed concern about the issue of sustainability of organisations, and about the focus on and interpretation of NGO/CBO sustainability. ‘Sustainable’ was often used as the opposite of dependent and yet all service provision is dependent on resources – whether in the form of a salary, skills, grants, inheritance, or other source. Even government is only sustainable because it can generate revenue in the form of taxes. Therefore, there needs to be more focus on sustaining the work of community organisations rather than requiring them to become sustainable in the sense of self-financing.
SECTION 3: RECOMMENDATIONS
Based on sections 1 and 2 of this report, a set of key recommendations have been compiled. These recommendations are divided into two sections, namely: recommendations pertaining to AFSA’s CHP, and its partner CBOs, and recommendations relating to international and domestic funding opportunities. These recommendations are intended to compile the lessons learned from this evaluation and to inform any future programmes.
3.1 RECOMMENDATIONS FOR THE CULTURE AND HEALTH PROGRAMME
➢ Enhance capacity-building, networking, and organisational development activities
It was found that the CHP’s capacity-building, networking, and organisational development activities, particularly in the form of workshops and trainings for CBO staff, were highly effective and highly valued by CBOs involved. These opportunities served to build valuable skills such as financial bookkeeping, report writing, and organisational management among CBO staff members. These activities were particularly invaluable in rural areas where staff members are more likely to be deficient in such skills.
Networking opportunities also had significant benefits for CBOs involved. The CHP enabled CBOs to network firstly with individuals (as a result of attending conferences, for instance), which often led to the exchange of important ideas and information. Secondly, CBOs developed networks with other organisations. These organisations included other AFSA-supported CBOS, which became a “family of organisations,” as well as other organisations within the community.
Because these activities had such a positive impact, it is recommended that, for any future programming undertaken, these capacity-building, networking, and organisational development activities be highlighted as a fundamental component of programmatic success. It is important that a wide range of staff members within CBOs be included in these skills-building exercises, rather than just at the managerial level.
➢ Continue to use workshops to achieve intended outcomes
It became evident that workshops with target beneficiaries are an effective method of achieving intended outcomes. Workshops create safe spaces for target beneficiaries and promote discussion and behaviour change. Workshops have been successful for a number of reasons. Firstly, trained facilitators promulgate culturally sensitive curricula that have been carefully developed in accordance with the findings from baseline studies of community needs and attitudes. These curricula often achieve success because they respect traditional culture rather than relegating it to the sidelines, at the same time that they promote transformations in unhealthy cultural practices. This was particularly evident in the case of workshops involving THPs. Workshops also appear to have achieved success because they examine the root causes of negative behaviours, for instance the connection between gender-based violence and drug and alcohol abuse.
➢ Expand the use of innovative and participatory educational methods, such community theatre dialogues and radio programmes
Some CBOs employed innovative educational methods that proved highly successful at achieving intended outcomes: namely, community theatre dialogues and radio programmes. Community theatre dialogues generate substantial interest and excitement on the part of beneficiaries. They enhance community ownership and therefore programmatic sustainability through direct participation by beneficiaries. Having community members act out scenarios seems to have a particularly powerful impact on both the actors and the audience. These dialogues are also potentially cost-saving, because catering costs may be avoided if the community is seen as putting on the show.
Radio dramas and other on-air educational programmes offer another highly successful method of achieving intended outcomes. Radio programmes were used by 2 CBOs visited, and were found to have reached large numbers of listeners. This medium is able to communicate messages widely because it is relatively inexpensive to own a radio, and in rural areas illiteracy rates are often high.
➢ Strengthen and expand income-generating activities
Income-generating activities enhance economic independence of beneficiary groups and serve to build enthusiasm, group cohesion, and local ownership of programmes. Income-generating activities are for the most part still in their infant stages for CBOs, as these activities require a relatively high initial investment in addition to ongoing support. Even after activities have been implemented (which requires investing in materials and trainings), ongoing support is required for problem solving and maintenance, in order to overcome issues such as drought. That said, these activities appear to be worth the investment. They have generated much excitement and interest from beneficiaries. It is important for educational programmes to be supplemented with economic empowerment in the recognition that cultural practices are often influenced by economic circumstances.
➢ Encourage CBOs to develop and formalise partnerships with government and civil society
CBOs should be encouraged and supported in their efforts to develop relationships with government institutions such as the Department of Health, in addition to other NGOs and CBOs in civil society. These partnerships increase project scope and the potential for broader impact. They are also key to long-term project sustainability, and such networks were repeatedly cited by CBOs as important means by which organisations will sustain themselves once funding is cut. Long-term programmatic success often depends on establishing close relationship with government institutions such as the Department of Health, so that ongoing support can be obtained. Once partnerships are established, it may help to formalise them with a Memorandum of Understanding (MOU).
➢ Invest in transport vehicles
CBOs most often cited the lack of a transport vehicle as their primary unfulfilled need. Those CBOs that had received transport vehicles from the CHP viewed these vehicles as absolutely integral to programmatic success. Owning a private transport vehicle affords flexibility and independence, and enables CBOs to widen project scope by reaching more communities. Infrastructure is poor in rural areas, public transport is often simply not available; drivers of public transport vehicles may refuse to drive to certain areas due to poor infrastructure, or a CBO will need to enter a community when the only available public transport runs out of the community. Transport vehicles should be prioritized for CBOs that have demonstrated a high need.
➢ Gather and collate qualitative and quantitative evidence of impact.
The realities of funding dictate that tangible (and often quantitative) evidence of impact be demonstrated by organisations in order to gain access to funding. It was discovered that most CBOs could speak with fluency about impact in qualitative terms, and it was clear that programmes were indeed having a positive impact. For the purposes of monitoring and evaluation, it would be immensely helpful for CBOs to track impact, so that transformations in attitudes and behaviours can be clearly demonstrated. One CBO had successfully implemented a method to track changes in attitudes as a result of workshop curricula by administering pre- and post-workshop surveys. There was, however, a relative dearth of quantitative measurements of impact across CBOs visited. This is partly a reflection of the prematurity of measuring impact at this project stage. Despite this, CBOs should be encouraged to request statistics from relevant institutions in order to gather quantitative evidence of impact.
➢ Develop and strengthen systems for tracking behaviour of beneficiaries
Related to the above recommendation is the need to track the behaviour of beneficiaries following their participation in educational programmes. In other words, a system of monitoring needs to be established between the CBO and its beneficiaries, so that a degree of accountability is ensured. Ubuntu Bethu (UB) provides an example of how this can be done successfully. UB has created a database of THPs and initiation schools, and monitors behaviour partly through the bush tracking programme, where UB staff visit initiation schools twice yearly to ensure that operations are running smoothly and safely. This system serves to hold THPs accountable for their behaviour, and has resulted in the adoption of healthier practices and a decreased incidence of botched circumcisions and deaths.
➢ Publicise examples of good practice
It was discovered that the CHP and its partner CBOs have made many remarkable achievements in a time span of only two years. It is therefore recommended that a report be developed and published that shares examples of good practices in the sector through case studies. This report should document the value and extraordinary achievements of some or all of the CBOs supported by the CHP, showcasing the human element and demonstrating impact through both numbers and narrative. This could potentially serve as an important educational tool for the industry, and for assisting partner CBOs in their efforts to secure access to alternative sources of funding.
➢ Diversify funding base and separate individual programmes from organisation as a whole
It was discovered that those CBOs that had a diverse funding base were for the most part those most likely to manage the closure of the CHP most effectively, and sustain themselves in the long-term. These CBOs were in a better position because obtaining funding from multiple donors had allowed these organisations to build skills in terms of proposal writing and fulfilling donor requirements. Secondly, having a diverse funding base meant that these organisations frequently had multiple programmes running at once. This avoided a possibility whereby the AFSA-funded programme became confused with the organisation as a whole, such that boundaries between an individual programmes and organisations as a whole sometimes became blurred – as was the case for a few of the CBOs visited.
It is noted that CBOs located in rural, isolated areas were more likely to rely solely on AFSA funding, due to less access to funding information and networks in these areas. Therefore, it is recommended that, throughout the life of a programme, CBOs, particularly those in rural areas, be encouraged and supported in their efforts to diversify their funding base, build skills, and ensure that their programmes are separate from the organisation as a whole.
➢ Implement exit strategy, and ensure that strategy is communicated to partner CBOs
It is recommended that comprehensive exit strategies be implemented for each partner CBO. Ideally, exit strategies should be individualised for each partner CBO, in the acknowledgment that each CBO has its own challenges and occupies a unique context and stage in programmatic implementation. An essential element of an exit strategy is to provide capacity-building in terms of proposal preparation and writing. This could be done through a workshop focusing exclusively on proposal preparation. Particular attention should be paid to ensuring that CBO staff members are more aware of how and where to find out about proposal opportunities. A lack of knowledge about where to locate funding opportunities was the primary complaint of many CBO directors interviewed.
Efforts and resources for developing and implementing exit strategies should be focused on those organisations identified as most in need, particularly those that do not have a diverse funding base and have no proposals in the pipeline. As discussed in the preceding recommendation, small CBOs located in rural areas, for the most part, require the most assistance.
It is acknowledged that AFSA has put in place an exit strategy in the relatively short time frame available to do so. This strategy has included briefing CBOs at trainings, M&E visits and policy events since March 2011, after the RNE gave notice of its withdrawal. AFSA included training on fundraising strategies for CBO project managers as part of an orientation workshop for 2011 plans and budgets. In addition, AFSA sends out a fortnightly newsletter with information from the HIV/AIDS sector, resources for training, and calls for funding proposals. AFSA has also provided one-on-one assistance to partners to draft funding proposals, and has scheduled additional training workshops to ensure partners are equipped with skills prior to the closure. AFSA has also put together resource packs with policy documents, organisational development materials, and updated donor directories for the close-out ceremony, at which time letters of recommendation highlighting contribution will also be supplied to partner CBOs. These efforts are highly commendable.
➢ Address disconnect between CBO objectives and actual activities
It was found that several CBOs visited had become engaged to varying degrees with providing for community needs, such as birth certificates and other documentation, transport to clinics, food parcels, uniforms for school children, etcetera. This is comprehensible in light of the fact that CBOs are working in extremely impoverished areas, where community needs are high and urgent demands are subsequently made on those viewed as brokers of power and influence. While these activities may have been important in terms of fulfilling basic and essential community needs, some of these activities extended beyond intended programme activities and objectives. This meant that some CBOs became slightly sidetracked from achieving their primary programme objectives. It also meant that the CBO became viewed by the community to some extent as a general provider of needs.
The community provider role is a temptation for any CBO or NGO working in impoverished communities, and therefore it is important that CBO staff members receive specific instruction and guidance on which activities are appropriate to pursue, and what should be avoided, right from the start of programme implementation.
➢ Strengthen monitoring of CBO activities and governance
It is noted that AFSA’s CHP for the most part, instituted effective monitoring and governance programmes to track CBO activities and progress toward objectives. This monitoring took the form of phone calls, quarterly site visits, reporting requirements, and occasional mentorship. It is acknowledged, moreover, that comprehensive monitoring of CBO activities is made difficult by financial constraints, distance, the rural/urban divide, and lack of appropriate infrastructure and office equipment, particularly in rural areas.
However, there were some important gaps in monitoring that became evident through isolated cases of financial and programme mismanagement in two of the CBOs. These cases were identified through the CHP M&E process and AFSA suspended the partners concerned immediately upon discovering the breach of contract. Strengthened monitoring and financial management and governance training are recommended for weaker CBOs.
3.2 RECOMMENDATIONS RELATED TO FUNDING
➢ Proposals
It has been deduced that foreign and domestic donors offer long-term funding. Donors do not fund short-term interventions. Creative Consulting & Development Works recommends that CHP partner CBOs submit proposals for long-term interventions or programs that address culture, health, gender and human rights needs. In terms of number of years, the range of funding interventions for both domestic and foreign interventions is between one and five years. Therefore, CBOs should strive to design interventions that are not shorter than one year or longer than five years in order to secure funding.
CBOs are also advised to submit proposals that conform to the criteria of funding sought. CBOs are recommended to design interventions that meet the requirements of all specifications made by the donor. In addition, proposals can be strengthened by comprehensively providing history and prior achievements of the organisation. Organisations should exhibit the work previously completed, as this allows the donor to acknowledge an organisation’s strengths and ability to deliver services to communities. CBOs market themselves to the donor if they can showcase successes and calibre of interventions they have been able to implement in the past.
Donors expressed general interest in organisations that have accountability measures in place. Donors are generally impressed by proposals that reveal the internal structure of the applicant organisation. Each member of the organisation should be included the organisation’s profile, stating positions and qualifications. Every organisation should include a profile in addition to sections detailing the proposal and budget. Donors want to assess the human resource composition of an organisation as this will assist the donor in identifying key strategic individuals whom they may establish communication with and most importantly, for accountability.
Linked to the issue of sustainability of the proposed intervention, CBOs are recommended to indicate a contingency plan in their funding proposals. Donors appreciate to be furnished with information on how organisations would cope when unexpected situations arise. For example, donors want to know what would happen to the proposed intervention if a core member of the organisation left. In other words, donors want to assess the risks and counter risks associated with the project. This information helps the donor to examine possibilities of successful implementation of the project. A proposal that has a section of risks and counter risk mechanisms also demonstrates that the proposed project has been well thought through and analyses from both positive and negative perspectives.
Domestic donors are particularly interested in conforming to regulatory norms and business practice. Corporations are under pressure to meet equity requirement and to improve equity ratings. As a result, domestic donor corporations require proof of Broad-based Black Economic Empowerment status of the organisation. Chances of securing funding are increased if the organisation is able to show or confirm that more that 75% of the intervention’s beneficiaries are black. Therefore, CBOs are recommended to provide proof of their Broad-based Black Economic Empowerment status in their proposals.
The final recommendation Creative Consulting & Development Works would like to make to CBOs in terms of writing proposals is that an impact assessment mechanism should be included. Donors require organisations to provide general evaluation criteria for proposed projects. It was gathered from donors that they prefer organisations that stipulate from the onset that reporting is taken seriously. Organisations are therefore advised to include in the proposal monitoring and evaluation of the proposed intervention.
➢ Budgets
Regarding budgets, CBOs are recommended to provide clarity and transparency around areas that require financial support. CBOs are advised to clearly state their funding requirements and to document these in a clear and concise manner. CBOs are advised to make use of software packages such as Microsoft Excel spreadsheets, which would allow organisations to clearly list the areas where they require financial support and the exact amount of money allocated for that purpose.
Linked to the issues of areas that require funding, organisations are not recommended to include operational costs in their budgets. This recommendation is subject to donor instructions and position regarding operational expenses. As discussed earlier in the report, donors’ stance on operational costing varies. The majority of domestic donors investigated do not fund operational costs. A few foreign donors fund operational costs, or will consider providing finance for an organisation’s service fees. However, due to variations within the funding sector, organisations are required to conduct comprehensive research concerning areas that a potential donor will fund. Again the importance of background research into a potential funder is brought to surface. Therefore, organisations are strongly recommended to pay special attention to the areas domestic and foreign donors will and will not fund.
➢ Criteria and scope of Funding Opportunity
An important recommendation for CBOs seeking funding is that thorough research on funding criteria has to be conducted. In terms of domestic donor corporations, CBOs should make use of publications around corporate social investment opportunities. Examples of useful publications include The CSI Handbook series published annually by Trialogue. The City of Cape Town published the Donor Directory for Development, which was researched by Creative Consulting & Development Works. Publications assist organisations to obtain in depth information about funding criteria and conditions attached to funding. As discussed earlier, some donor organisations wish organisations to market their corporations and to promote the donors services or products. Prior research into the corporation activities will allow CBOs to design interventions, which will not only carry the organisations objectives, but also incorporate the needs of the donor. The donor’s corporate agenda needs to be visible in proposals submitted. Chances of success are greatly increased if donors review proposals that meet the demand of the donor corporations.
➢ Showcasing the human element in proposals
The report highlighted the immense competition between organisations seeking funding. The report has also brought attention to the fact that donors receive hundreds of applications and funding proposals. As a result, donors have become detached from proposal submissions. In order to capture the attention of donors and to make proposals appeal to the emotional side of donors, organisations should exhibit or showcase the human element in their proposal submissions. One of the donors mentioned the use of photographs in proposals. Photographs depict the situation on the ground and the issues affecting communities. Photographs show the suffering and pain experienced in targeted communities or groups of people. Photographs tell the story and help the donor to realise the change which the proposed intervention seeks to achieve. Photographs are likely to leave a lasting impression on the donor if combined with a good proposal and budget recommendation. CBOs are recommended to include photographs of the work they do, or of problems affecting the communities they intend to resolve through a proposed intervention. Showcasing the human element and the human face of issues affecting society or communities is very powerful. Organisations should refrain from only making use of numbers and statistics.
➢ Flexibility of proposed interventions
The donor funding climate has become prescriptive. Domestic donors are regulated by corporate social investment policies and foreign donors by bilateral agreements with the government.
As explained earlier, funding opportunities are subject to shareholder and other stakeholder agreements. Corporate domestic donors also indicated that they only fund long-term organisations. An organisation may be awarded funding for a period of one to five years. However, long-term funding is problematic in that donors may change conditions after a certain period of time. Organisations may be required to make certain changes to community interventions. Stakeholders decisions determine the scope and direction in which funding is supplied to beneficiary organisations. It is recommended that upon application for funding, organisations allow a certain degree of flexibility of proposed interventions. CBOs need to demonstrate in proposals that the intervention is flexible and not rigid. Flexible interventions allow donors to envision a situation where the proposed intervention will cease to operate if certain strategic decisions are made. Interventions must be prepared for expansion or have their scope reduced and still be able to produce the desired outcome.
Therefore, it is important that CBOs demonstrate that the proposed intervention will be able to buffer and absorb strategic changes implemented during the course of long-term funding.
➢ Community participation
Organisations are recommended to submit proposals that demonstrate that an intended intervention will actively engage with the target community. Involving communities in an intervention is an impressive approach to empower affected communities. Engaging with communities prior to submission of the proposal and allowing community input to shape the intervention demonstrates that communities would take ownership of the intervention. If an organisation can demonstrate that the proposed intervention is approved by the target community, this would be very impressive to the donor.
However, Creative Consulting & Development Works acknowledges the difficulty of obtaining community approval and overall community consultation process. Nevertheless, an organisation can demonstrate that the intervention will actively involve the community. Involving the community enhances sustainability of the intervention in terms of local ownership. Communities assisted by the proposed intervention will not want the intervention to fail. Hence CBOs are recommended to design interventions and submit proposals that demonstrate that target communities will have an integral role.
References
AFSA.2010. Culture and Health Programme. Living a Healthy Lifestyle-It’s my Culture. What Does it Mean to be a 'Real Man? Issue 1. Aids Foundation of South Africa.
AFSA.2011. Culture and Health Programme. From Boys to Men. Issue 2. AFSA
AFSA. 2011. Culture and Health Policy Paper 2. Circumcision and Initiation Policy Report. Traditional Initiation and Circumcision: Seeking Good Health for Safety, Prevention and Health Seeking Methods. AFSA
AFSA. 2011. Charter of Good Practice for Circumcision to Promote HIV Prevention.
AFSA. Culture and Health Programme. 2010. Traditional Healers Research Summary Report.
AFSA. Culture Health Programme. 2010. Traditional Health Practitioner’s Policy Forum. Culture and Health Policy Forum Paper No.1. AFSA
AFSA. Culture and Health Programme. 2011. San Baseline Research Report. July 2010. AFSA
Malan . R. 2011. The Young Gay Guy Guide to Safer Gay Sex. Junkets Publisher.
Websites Visited:
Aids Foundation of South Africa. Attitudes of Men Towards Male Circumcision in the Context of HIV/AIDS and Gender Based Violence. Retrieve from:
AFSA Website.
AFSA website. . retrieved 10/01/2012
Culture and Health Programme website. . Retrieved 11/01/2012
Trading Economics website. 2012. . Retrieved 09/01/2012.
ANNEXURE 1: DATA COLLECTION INSTRUMENTS
Foreign Government and Private Foundation Donors Interview Guide
1. Please could you comment on the competitiveness (in terms of nature and size) of organisations whose focus is on health, culture, gender and human rights in seeking funding and aid from your agency/foundation?
2. How many applications for funding do you receive from organisations whose programs focus on health, culture, gender and human rights? Roughly, how many organisations within this category are funded by your agency/foundation and over what period?
3. When considering applications for funding, what aspects of an organisation and their respective programs are considered? Besides non compliance with your agency/foundation’s funding criteria, why else could an organisation be declined funding.
4. How would you describe the funding opportunities your agency/ foundation makes available for organisations (which are South African) that assist culturally marginalized and vulnerable people to improve their health outcomes?
5. What are the problems or challenges that your agency/organisation/corporation has or is experiencing with providing funding opportunities to organisations that assist culturally marginalized and vulnerable people to improve their health outcomes?
6. What recommendations would you give to organisations running a programme such as the CHP with regards to successfully sourcing funding? (probe: referrals to other sources , agencies and organizations; program change/adaption etc).
7. What opportunities exist for organisations whose focus is on health, culture, gender and or human rights in seeking & securing funding?
NOTE FOR RESEARHER CONDUCTING THE INTERVIEW
Website based questions per agency/organisation/corporation before an interview is conducted (answers to be recorded as part of interview notes)
1. Please describe the key areas in which this agency makes available funds to organizations within the country?
2. Please could you comment on funding made available by your agency/ foundation since 2009.
3. Does your agency/ foundation recognise the work conducted by locally based organisations focusing on health, culture, gender and or human rights?
4. Are there any prior agreements made with the applicant organisation in terms of funding?
5. Do you have any specific terms of funding?
6. How are organisations preselected and later classified as successful?
7. Are there any limitations (i.e. certain criteria)to the granting of funding from your agency/foundation.
Donor Agencies/Organisation/Corporation Interview Guide
1. Please could you comment on the competitiveness (in terms of nature & size) among organisations, whose focus is on health, culture, gender and human rights in seeking funding and aid from your agency/organisation/corporation?
2. How many applications for funding do you receive from organisations whose programs focus on health, culture, gender and human rights? Roughly, how many organisations within this category are funded by your agency/organisation/corporation and over what period?
3. When considering applications for funding, what aspects of an organisation and their respective programs are considered? Besides non compliance with your agency/organisation/corporation’s funding criteria, why else could an organisation be declined funding.
4. How would you describe the funding opportunities your agency/organisation/corporation makes available for organisations that assist culturally marginalized and vulnerable people to improve their health outcomes?
5. What are the problems or challenges that your agency/organisation/corporation has or is experiencing with providing funding opportunities to organisations that assist culturally marginalized and vulnerable people to improve their health outcomes?
6. What recommendations would you give to organisations running a programme such as the CHP with regards to successfully sourcing funding? (probe referrals to other sources , agencies and organisations; program change/adaption etc).
7. What opportunities exist for organisations whose focus is on health, culture, gender and or human rights in seeking & securing funding?
NOTE FOR RESEARHER CONDUCTING THE INTERVIEW
Website based questions per agency/organisation/corporation before an interview is conducted (answers to be recorded as part of interview notes)
1. Please describe the key areas in which this agency/organisation/corporation makes available funds to organisations within the country?
2. Please could you comment on funding made available by your agency/ foundation since 2009.
3. Are there any prior agreements made with the applicant organisation in terms of funding?
4. Do you have any specific terms of funding?
5. How are organisations preselected and later classified as successful?
6. Are there any limitations (i.e certain criteria)to the granting of funding from your agency?
Project Beneficiary Key Informant Interview Guide
1. How long has the CBO been working in your community?
2. Can you describe the role of the CBO in your community?
3. Do you believe that the CBO has positively or negatively impacted your community? Please explain.
4. Can you please describe some of the changes that have come about in this community as a result of the CBO?
4. Please describe the CBO’s impact on the following areas in your community:
➢ Access to services, including health care and health education
➢ Health-related attitudes (i.e. stigma, awareness of HIV/AIDS, etc.)
➢ Health-related behaviours
5. How would it affect you if the CBO had to close down due to lack of resources? Please discuss the following areas, referring to both the short- and long-term:
➢ Access to services, including health care and education
➢ Health-related attitudes and behaviours
AFSA CHP Management Interview Guide
1. Please could you comment on the competitiveness (in terms of nature & size) among organisations, whose focus is on health, culture, gender and human rights in seeking funding and aid from domestic donor agencies/organizations/corporations?
2. Please could you comment on the competitiveness (in terms of nature & size) among organisations, whose focus is on health, culture, gender and human rights in seeking funding and aid from foreign donor agencies/organizations/corporations
2. How many applications for funding do you send to foreign and domestic donor organizations each year? Roughly, how many funding applications have been successful and over what period does the funding cover?
3. When composing applications for funding, what aspects of the CHP do you think should be considered? Besides non compliance with donor agency/organisation/corporation’s funding criteria, why else could an organization like AFSA be declined funding.
4. How would you describe the funding opportunities domestic donor agency/organisation/corporation makes available for organisations that assist culturally marginalized and vulnerable people to improve their health outcomes? How about foreign donor agencie/organisation/corporations?
5. What opportunities exist for organisations whose focus is on health, culture, gender and or human rights in seeking & securing funding?
6. What are the direct implications of possible closure of the CHP /AFSA?
7. What are the direct possible implications of possible closure of the CHP for your current beneficiaries?
8. What are the problems or challenges that your agency/organisation/corporation has or is experiencing with funding opportunities made available to the CHP to assist culturally marginalized and vulnerable people to improve their health outcomes?
9. What message would you give to the domestic and foreign donor community with funding opportunities for a programme such as the CHP with regards to successfully dispersing funding? (probe behavioral change aspects/program changes/adaption/ sustainability, exit strategy)
ANNEXURE 2: SAMPLE OF ORGANISATIONS
1. RURAL MEN AS PARTNERS AND FATHERS (RMAPF)
➢ Umdoni Vulamehlo HIV AIDS Association
➢ Thusanang Youth Activity
➢ Radio Riverside (telephonic)
➢ Sophila Sonke
2. INITIATION SCHOOLS
➢ Ubuntu Bethu
3. SAN
➢ South Africa San Institute
4. TRADITIONAL PRACTITIONERS
➢ Mwelela Kweliphesheya
➢ Nyangayezizwe Community Information Centre
➢ Siwela Sonke
5. LGBTI
➢ Gay and Lesbian Network
➢ LEGBO
➢ Intersex South Africa
➢ Gender Dynamix
ANNEXURE 3: OVERVIEW OF DOMESTIC AND INTERNATIONAL DONOR FUNDING CRITERIA
A: Domestic Donors
1. ABSA Foundation
Programme Areas of Investment
← ECD
← Maths
← Science and Technology Education
← Health and HIV/AIDS
← Job creation and contingency funding for welfare organisations
← Educational equipment
← Community education campaigns and
← Capacity building in NPOs.
Intended Recipients of Funding
← NPOs and CBOs involved in education, job creation and health.
Criteria for Funding
← Submit a written proposal. The project will be assessed on viability and sustainability by conducting on-site assessments and bi-annual evaluation.
Exclusion from Funding
← No sponsorship
← Sports events or tours
← Academic research or tours
← Individual student bursaries
← Support for branch projects
2. Tshikululu Social Investments
Programme Areas of Investment
← Welfare and community development
← Health
← Education
← Skills development
← Job creation
← Arts
← Culture
← Environment
← Sports and children.
Intended Recipients of Funding
← NPOs
← CBOs
← Schools
← Churches
Criteria for Funding
Registered as PBO or NPO and follow the usual proposal guidelines.
Exclusion from Funding
← No sports tours or events
← Individual bursaries or scholarships
← Conferences or galas
← Church buildings
← Profit organisations
← Publications
3. Pioneer Foods
Programme Areas of Investment
← Training, literacy, ECD, social awareness and employment
← Education
← Sport
← Arts and culture
← HIV/AIDS
← Science and technology
← Rural women’s entrepreneurship and empowerment.
Intended Recipients of Funding
← Organisations that have HIV/AIDS projects, early childhood development and job creation
← Established NGOs.
Criteria for Funding
← Support national government priorities
← Facilitate partnerships and sharing of resources, in-line with vision of Pioneer Foods. Project can be accomplished within a specific time frame.
← Sustainable projects.
← Broad community impact.
← Carried out preliminary feasibility studies.
← Can demonstrate that project is/will be favourably received by beneficiaries.
← Not for profit projects
Exclusion from Funding
← No start-up organisational costs
← Building, infrastructure and equipment outside of the project.
← Tours
← Overseas trips
← Conferences
← Projects that benefit commercial organisations.
← Projects with beneficiaries outside of South Africa.
4. Afrox
Programme Areas of Investment
← Education
← Skills training
← Job creation
← Community care and HIV/AIDS safety.
← Culture and art
Intended Recipients of Funding
← NPOs working towards development and empowerment of the broader community.
Criteria for Funding
← Need information on organisation and project
← Constitution
← Proof of registration
← Good references from community leaders.
Exclusion from Funding
← No sporting tours or events
← Salaries
← Conferences
← Bursaries or scholarships
← Fundraising circulars
← Church building
← Profit making organisations
← Individual schools
← Endowment funds
← Building projects
← Computer and office equipment,
← General operating and salary costs.
B: International Donors
1. Canadian International Development Agency (CIDA)
Programme Areas of Investment
← HIV/AIDS
← Education
← Vulnerable and orphaned children
← Sustainable development
Intended Recipients of Funding
← Educational and charitable organisations
← Must be involved in work that fits into the fund’s programme areas, wide applicability, lasting impact
Criteria for Funding
← Call for proposals
← The project has to respond to the HIV and AIDS criteria
← Due Diligence
← Organizational structure
← Institutional assessment
← Gender composition
Exclusion from Funding
← Individuals
← Profit organisations
2. Carl & Emily Fuchs Foundation
Programme Areas of Investment
← Sports
← Arts (performing arts)
← Culture (including people with disabilities)
← Personal development
← Health
← Children, youth at risk, youth development, special education needs
← Science and maths education and academic excellence promotion.
Intended Recipients of Funding
← Non-profit organisations
← Private welfare organisations
← Non-governmental organisations
← Community-based organisations (CBOs)
← Educational institutions
← Charitable organisations
← Developmental projects
Criteria for Funding
← Routine donations have been structured to include the following focus areas
← Child care and youth development
← Health
← Counselling services and frail care
← Poverty alleviation
← Culture
← Community development
← Trauma management and services to people with disabilities;
← Higher education and promotion of excellence, arts and research.
Exclusion from Funding
← Private profit oriented organizations
← Political party initiatives
← Individual bursaries
← Government departments or State responsibilities
← Promotion of religious denominations except for charitable/welfare/community outreach activities of religious institutions
← Discriminatory initiatives.
←
3. Swedish International Development Agency
Programme Areas of Investment
← Human rights
← Health clinics
← Schools
← Water treatment
← Culture and Health
← Prevention interventions
Intended Recipients of Funding
← Support organizations that are rights based
← Support HIV/AIDS specific projects
← Supports organisations that fit into the SA national HIV and AIDS focus and health and gender based violence
← Supports local organisations only
Criteria for Funding
← No call for proposals
← The Swedish Embassy will ask organizations to submit a proposal and then look at what they are offering.
← The Swedish embassy does not want organizations to fit in with what the embassy is doing. This allows organizations to become creative.
← Swedish IDA first sources the organization and asks them to do a proposal afterwards.
Exclusion from Funding
← The Swedish International Development Agency does not fund any organizations outside HIV and AIDS, gender based violence, gender and human rights.
4. Soros Foundation
Programme Areas of Investment
← Education
← Health
← Agriculture
← Culture programs informing development
← Improving access to and quality of primary education, transforming African universities.
Intended Recipients of Funding
← Programs promoting arts, humanities and cultural institutions the Creativity & Culture program
← Supports individual artists, humanists and cultural organizations improving the health of poor and marginalized people.
Criteria for Funding
← Should be in line with mission and vision – building required human and institutional capacity and effective approaches to improving livelihood of the poor.
Exclusion from Funding
← Personal aid to individuals or, except in rare cases, fund endowments, or contribute to building and operating funds.
-----------------------
[1] AMREF: Better Health for Africa. Traditional Healers, South Africa. 2011.
[2] AFSA Annual Report 2009
[3]AFSA Website. . Retrieved 06/01/2012.
[4] AFSA Website. . Retrieved 06/01/2012
[5] Ibid.
[6] Ibid refer to 1.
[7] AFSA Annual Report 2009.
[8] Increased cooperation in the form of referrals was not verified by biomedical health practitioners through interviews or statistics, as the evaluation did not include visits to local clinics.
[9] This information was obtained through a key informant interview. No statistics were provided by the CBO to show the increased incidence.
[10] It is not known whether pre- and post-workshop survey findings can be quantified, as copies of these surveys were not obtained.
[11] Behaviour change subsequent to the post-workshop s[pic])*+,-M§¨©ª¼½çè÷ø! ïãÊ»°¡‘?»°r_O_ ................
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