AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #70 - A new look at HIV/AIDS NGOs and their service delivery (SD) impact on politics: Insights from rural Uganda
Authors: Presenting Author: Mr Badru Bukenya - The University of Manchester
Additional Authors:
Aim: The overall aim of this study is to investigate the impact of HIV/AIDS service delivery (SD) by NGOs on the processes of state building and citizenship formation in Uganda. It’s guided by three questions. 1. How can SD NGOs structure their programmes to positively affect states’ capacity to deliver services to their citizens? 2. How does SD affect the legitimacy of state institutions? 3. How does SD influence the citizenship status of service users?
Method / Issue: Their humanitarian role in aiding the hapless people experiencing economic deprivation and diseases notwithstanding, AIDS service organisations and service-providing NGOs generally have come under heavy criticism for (a) encouraging the state to abrogate their obligations of SD to their citizens (b) exacerbating socioeconomic inequalities in the communities where they work (c) promoting technical solutions to address issues that essentially call for politically-tuned interventions, among others. Drawing from the work of one of the prominent HIV/AIDS service organisation in Uganda, this study seeks to critically interrogate some of these accusations mated against NGOs. This mixed methods study is based on 9 months of fieldwork in two rural Ugandan districts. It considers a case of one NGO which has implemented a 7 years program aimed at enhancing SD among district local governments. The study traces the implications of this program on the citizenship status of People with AIDS (PWAs) as well as its effect on the capacity of the targeted institutions to provide services to their citizens. Qualitative data from Focus Group Discussions, key informants and interview guides is analysed with NVIVO 8. On the other hand, quantitative data is analysed with Epi Info.
Results / Comments: 1. The program provided a platform where ordinary PWAs have began to understand and directly engage with the state. 2. It has opened opportunities for PWAs to link with other agencies in the community for socioeconomic and political ventures. 3. Where SD has improved, PWAs have dully awarded credit to government and where it has not, they have held government workers and politicians accountable. 4. In areas where SD didn’t improve, PWAs have organised and taken over service delivery roles but still using state structures – hence they have become de facto government health workers.
Discussion: HIV/AIDS SD organisations can ably work on both sides of the equation – building state capacity as well as empower citizens to hold the state accountable. PWAs have the capacity to manage SD challenges arising out of a weak and retreating state.
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