Where and why Western lenses miss the mark in Africa: The case of HIV/AIDS prevention evaluations
“Given the norms that govern most patriarchal societies in Africa, should the Western epistemology, ethics and concepts be the main default lens for evaluation” “Despite their blindness to social cultural context, are these evaluations valid even though they are said to be based on scientific evidence”
A, B, and C—the ways of HIV/AIDS preventing transmission
Figure – Social Marketing to Prevent HIV/AIDS: Uganda, Adaptation of the Fleet of Hope, 1995. (Jhuccp.org)
|—“do not have sex” and “stick to your partner, or else, use a life jacket (condom) if you fall off the boat the chances of death are very high” Says Evaluation default lens.|
I conducted a metaevaluation on a number of evaluations from some of the most prominent bilateral agencies fighting HIV/AIDS in Sub Sahara Africa. Despite insufficient evidence to support evaluation claims, the majority of the evaluations assessed include recommendations which indicate either a need for continued funding, and/or increase of monitoring staff.
Here are some of the selected examples of my findings;
|Criticism||Evidence, Explanation, & Reasoning|
|Lack of Consideration of gender as an evaluative criterion||Despite the indisputable data on gender disparities, gender as an evaluative criterion is not considered (e.g., assessment of gender specific interventions which may indicate gaps in prevention).|
|Lack of Conceptualization of Cultural Values, Sexual Behavior as it relates to HIV/AIDS (as a poor health outcome)||There was lack of conceptualization of the meaning of “behavior,” in relation to HIV prevention, and yet, to a larger extent culture determines ones’ behavior.|
|Too much focus on Quantitative Measures
|Measures were mainly in terms of “behavioral practices and changes”. The behavioral indicators were not assessed to determine their relevence and effectiveness. While the HIV incidence as an outcome measure was never assessed, the efficacy and the validity of the link between changes in specific behaviors and the potential for reductions in HIV incidence—the ultimate goal of prevention interventions—are not very clear.|
|Seeking Attribution drives the Use of Log frames at the expense of more congruent causal inference approach.
|The Causal analysis mainly focused only on “behavioral changes” and failed to research different pathways of causality and their multiple relationships in HIV prevention. Entrenched gender norms and culture are common in social interactions, yet the causal mechanisms are hidden to an outside evaluator. Inadvertently, these planned and intended outcomes of the program abandon any unintended outcomes (either positive or negative) and the side effects.|
|Lack of Evaluation Capacity and Independence
|Too often evaluation methodologies and designs employed are largely supplied by donor agencies. Most donor agencies use the TORs to prescribe the “what and how” of evaluation methodology, which may affect the quality and robustness of the evaluation. This led to evaluation methodologies mostly prescribed around program goals, and only measure indicators spelled out in the program/project log frame, without assessment of other impacts, and or search for side effects including unintended consequences.|
|Poor Assessment of Institutional Processes to Assess “True Outcomes”
|The evidence indicates poor assessment of institutional process-oriented criteria, whose results are important as feedback mechanism for institutions to strengthen processes (such as gender specific interventions; advocacy, policy measures, knowledge and leadership cultivation, and evidence based M&E).|
The critical question of concern is where is the value judgment underlying recommendations found in some evaluation reports which fail to seek for side effects
Obvious the basis upon which HIV/AIDS prevention interventions maybe too narrow to shift the potential underlying social ecology (negative gender dynamics and socio-cultural norms) that gives rise to women’s HIV/AIDS vulnerability. The western lens may not be the main default lens in evaluation; social cultural and gender norms are an important part of the landscape for Sub-Saharan Africa. These dynamics and norms represent a Pandora box entrenched with hidden contents (i.e., side effects) which affect gender and HIV/AIDS prevention.
Watch for my next post, where I will be discussing the hidden contents of the Pandora’s box which are being ignored by evaluation.