Section three: Tool sheets

The following tool sheets are designed to help managers and their staff reflect upon HIV/AIDS issues within the context of their project. They provide a list of key questions to ask during each stage of the project cycle, and practical suggestions and tools for incorporating HIV/AIDS-related concerns.

The purpose is not to add a new set of management tools, but rather to modify the existing project cycle methods so HIV/AIDS-related issues may be addressed. Some of the key questions may also be adapted for use as simple indicators during monitoring and evaluation.

IDENTIFICATION & PREPARATION

Key questions

How is HIV/AIDS an issue in the area? (Consider HIV prevalence, number of orphans, prevalence of opportunistic infections, number of affected households, etc.)
How is HIV/AIDS recognized as an issue by local people and institutions? (Consider general awareness, as well as policy, programme and project context.)
What local HIV/AIDS-related knowledge exists and who transmits it? (Consider information related to the recognition of symptoms, home care, local treatment, taboos, myths, etc.)
Who are the important institutional stakeholders in relation to HIV/AIDS? (List those involved in prevention, care and mitigation of impact. Indicate the level they are operating at; their coverage; their activities relating to nutrition and household food security; their constraints; and their collaborators.)
Who are the important community stakeholders in relation to HIV/AIDS? (List those involved in prevention, care and mitigation of impact. Indicate who participates in terms of gender, socioeconomic status, age, etc.)
Who is affected by HIV/AIDS, in what ways and why? Consider:

- people (e.g. orphans, the elderly, chronically ill adults, adolescents);

- households (e.g. sex and age of household head, households fostering orphans, socio-economic status, access to assets);

- communities (e.g. urban, peri-urban, rural, access to resources, farming systems, market opportunities);

- institutions (e.g. schools, extension services, health care, orphanages, extended family, community organizations, financial service providers).
How does HIV/AIDS contribute to poverty, food insecurity and malnutrition?
How do poverty, food insecurity and malnutrition affect the development of AIDS in people who are HIV-positive?
How do poverty and food insecurity affect the spread of HIV/AIDS within the community?

How to get answers

Contact the national and local AIDS committees and meet with informed people in local institutions.
Make an inventory of organizations, programmes and projects related to HIV/AIDS.
Review area-specific studies, reports and data using a general and sector-specific checklist for HIV/AIDSrelated issues to be considered.
Organize a workshop with local stakeholders to discuss local food and livelihood security needs. Feature a session on HIV/AIDS and ensure that:

- local organizations working with HIV/AID-affected households are involved;

- if possible, organizations of people living with HIV/AIDS are involved;

- all workshop participants are encouraged to participate in the session.
When carrying out field appraisals, make sure to identify who is affected by HIV/AIDS, how and why. Ensure that:

- appraisal tools are adapted to capture HIV/AIDS-related issues;

- local HIV/AIDS-related knowledge, attitudes and practices are considered;

- community-based stakeholders and others reflect on how HIV/AIDS affects them directly and indirectly;

- constraints and opportunities of HIV/AIDS-affected households in achieving nutrition and food security are assessed.
Design the institutional analysis in such a way as to capture present and future human resource constraints of local institutions and service providers due to HIV/AIDS-related sickness and death.
When analysing the information from the field appraisal, prepare problem trees showing how different types of people, households, communities and institutions are affected by HIV/AIDS. From these problem trees, develop objective trees and outline intervention strategies that address HIV/AIDS-related problems and opportunities. This approach will also help in developing a set of HIV/AIDS-related process and impact indicators.

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FORMULATION & DESIGN

Key questions

How do intervention strategies address the specific problems faced by HIV/AIDS affected groups? Do they build upon existing opportunities? If so, how?
What synergies, linkages and partnerships are envisaged with stakeholders working on HIV/ AIDS from other sectors (health, education, communication, etc.)?
How can the impact of the epidemic undermine the assumptions of the proposed interventions? (For example, in a highly HIV/AIDS-affected area, the assumption that training will lead to increased institutional capacity may not be valid, since institutions could suffer from increasing staff attrition due to HIV-related sickness and death. HIV/AIDS may therefore be a risk factor that could jeopardize the success of the project.)
What is the likelihood that intervention strategies will directly or indirectly aggravate the HIV/ AIDS situation? (For instance, will interventions contribute to the spread of HIV/AIDS or stigmatize people living with HIV/AIDS? Consider whether project staff are being posted without their families, the effects of increased mobility, decreased access to HIV/AIDS-related information and services, inclusion or exclusion of HIV/AIDS-affected people, etc.)
Have any activities been proposed by the project or in partnership with local organizations which could assist in counteracting these negative effects?
How does the institutional framework for project implementation account for the potential impact of HIV/AIDS on institutions? (Consider the loss of staff due to illness, funeral attendance and death, in addition to the loss of institutional memory, increasing costs, etc.)
What will be the impact of HIV/AIDS on the sustainability of the project? (Consider the impacts on people’s vulnerability and resource base, including natural, physical, financial, human, social, infrastructure and policies.)

How to get answers

Review the intervention planning methodology and/or the “logical framework planning” approach to ensure that the particular food security and nutrition needs of HIV/AIDS-affected households and communities are being addressed.
Review the project’s targeting strategy for possible negative impacts on HIV/AIDS-affected people and households, as well as for measures that will ensure their participation and improve their benefits.
Review the project’s institutional framework to ensure that HIV/AIDS-related human resource constraints are considered, including those affecting local partners and implementing organizations.
Prepare a scenario to show how proposed interventions may affect the spread of HIV/AIDS, stigmatization and households’ ability to cope with consequences of the epidemic. This will also help to reflect on how HIV/AIDS poses a risk to the success of the project.

APPRAISAL & REVIEW

Key questions

Have the HIV/AIDS-related issues that were identified during the project’s formulation and design been adequately addressed? (HIV/AIDS should be considered in various project document sections, including: description of the sector; country strategies; prior and ongoing assistance; problems to be addressed; target beneficiaries; institutional framework and support capacity; logical framework; risks; and sustainability.)
What changes in the HIV/AIDS context will affect the ongoing project activities? (Consider negative and positive changes, such as staff attrition, increasing numbers of support groups and local committees and new policies.)
Have partnerships been established with other organizations that carry out complementary work on HIV/AIDS? If so, at what level?
How are field activities of different organizations and sectors coordinated?
To what extent does the project build on and strengthen the capacity of existing formal and informal local institutions?

How to get answers

Once formulation is near completion, it is common for the proposal to be reviewed by a special project and programme committee within the organization in charge. Check the terms of reference for the review committee and ensure that they explicitly include an appraisal of the project’s relevance and responsiveness to the HIV/AIDS context of the country or region.
To help the review committee with this task, you may have to prepare a standard and/or sectorspecific checklist on HIV/AIDS-related issues that should be considered in the proposal.
Review the institutional framework for linkages with other organizations that carry out complementary HIV/AIDS work.

IMPLEMENTATION & MONITORING

Key questions

What HIV/AIDS-related activities have been included in the plan of operations and how will affected households and people participate?
What process and impact indicators have been included in the monitoring framework in order to adequately capture the changes in nutrition and food security among HIV/AIDS-affected households and people? How will these indicators be verified and by whom?
What indicators have been included to capture the impact of the project’s interventions on the HIV/AIDS epidemic?

How to get answers

Review the plan of operations and monitoring framework and make sure that they include specific HIV/AIDS-related activities and indicators. The indicators should include measurements for changes in nutrition and food security as key livelihood outcomes.

MID-TERM REVIEW & EVALUATION

Key questions

What effects has the HIV/AIDS epidemic had on people, households and institutions? (Consider this question independently of whether the project was designed to address HIV/AIDS-related issues.)
How has the epidemic affected the project’s ability to achieve its objectives and outputs, and how has the project addressed such issues?
How has the project contributed to mitigating the impact of HIV/AIDS on nutrition and household food security and to the prevention of the disease?
In what ways and to what extent has the project targeted HIV/AIDS-affected households and people?
What has been the epidemic’s impact on the participation of the project’s beneficiaries? In what ways did HIV/AIDS lead to an inclusion or exclusion of specific groups?
How may the project have encouraged the spread of the epidemic, increased the stigma of people living with HIV/AIDS or aggravated the impact of HIV/AIDS on nutrition and household food security?
How sustainable are the outcomes of the project in view of the HIV/AIDS epidemic? (Consider the outcomes at all levels - people, households, communities, local and national institutions.)
How can the project extend support to HIV/AIDS-affected households in a cost-effective way? (Consider costs in the short, medium and long term.)
What is the potential for replicating or scaling-up the project’s interventions?
What lessons have been learned about mitigating the impact of HIV/AIDS on nutrition, household food security and livelihoods?

How to get answers

Review the terms of reference for the mid-term review and evaluation team and ensure that they explicitly assess HIV/AIDS concerns.
If you are conducting a participatory beneficiary assessment prior to the evaluation, review the methodology and ensure that the assessment considers the role of HIV/AIDS in the participation of beneficiaries (e.g. active, average, poor participation).
Building on the findings of the evaluation, review the project design and reformulate or adjust it to adequately reflect the HIV/AIDS context.