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A Report on Addressing HIV/AIDS issue within the Purview of Good Governance

Preamble

The state of HIV/AIDS is deteriorating in Nepal without any respite. Realising the gravity of the crisis of the epidemic, the central government, health sector, some of the local governments including municipal governments and other non-health related projects, have started their own initiation to address the HIV/AIDS problem. Rural Urban Partnership Programme (RUPP), a UNDP assisted project is working with 12 municipalities and 33 Rural Market Centres (RMC), with the several important objectives including poverty alleviation through good governance and mainstreaming HIV/AIDS in municipal planning and activities. RUPP, while assisting partner municipalities in mainstreaming HIV/AIDS, also persuades the partner municipalities to address the HIV/AIDS issue with a holistic approach and within the purview of good governance. This has many fold advantages as this would ensure the involvement of all three partners i.e. municipal government, civil society and private sector which is deemed as a necessary in the war against HIV/AIDS, which also demands always multi-sectoral response. Other advantage of addressing HIV/AIDS within purview of good governance is that it enhances outcomes in their qualities by addressing the nine core characteristics of good governance.

Butwal Municipality, one of the RUPP's partner municipalities, has been conducting HIV/AIDS program and its commitment for good governance is well established as it has already administered the TUGI Report Card in the context of participation of civil societies for the urban good governance. RUPP /UNDP, in its part of providing technical backstopping in the process of mainstreaming HIV/AIDS in municipal activities and planning, envisaged the TUGI Good Governance Issues Report Card, as an appropriate tool, which can help guide the municipalities in their response to HIV/AIDS.

Objective

With the goal of supporting Butwal Municipality in managing the HIV/AIDS issue within the purview of good governance, RUPP along with Butwal Municipality evaluated the Municipal response to the HIV/AIDS with the application of Good Governance Issue Report Cards on HIV/AIDS developed by TUGI/UNDP. It is also perceived that the results of the Report Card would also serve as a baseline report and hence, similar application of the Report Card on the same municipality will reveal the progress, if any, made in the direction of addressing the HIV/AIDS within the scope of good governance.

Process

A two-day workshop was organised for the purpose of application of TUGI Good Governance Issue Report Cards on HIV/AIDS. The workshop was organised with the technical and financial support from RUPP. A total of fifty fours participants from different walk of lives, including outgoing mayor and outgoing deputy mayor and other ex elected representatives, civil societies, government officials, municipal staffs, INGO and NGO, health workers, private sector, journalists and artistes attended the workshop.

The workshop was divided in the following sessions:

In order to enhance the effectiveness of the workshop, the nine groups - each with six persons in an average, were formed especially for the sessions 4 and 5. In session 4, each group was asked to develop /refine or select 4 indicators from the given 5 (in TUGI Report Cards) indicators of 9 core characteristics of good governance. The same groups evaluated the Municipal response to HIV/AIDS with the indicators they developed/ refined during the session 4. Except for the sessions 4 & 5, all other sessions were conducted in plenary.

Scoring on Report Card

The scoring was done in exactly the manner prescribed in the TUGI Report Card. Each group evaluated all the indicators of nine core characteristics. Each person initially gave a score in each indicator and discussed within the group members and developed consensus on a figure. Justifications were given on why they gave respective figures. The average score for nine groups on each element came out as follows:

Observations on the scoring

• The scores given indicated that everyone is familiar with HIV/AIDS and related issues.
• Participation, one of the nine core characteristics of good governance, has secured the highest marks. It seems quite reasonable also, as the current response to HIV/AIDS not only involves municipal governments but also civil societies. Admittedly private sector, so far, has very limited role, but the most of the participants were also aware of the fact that Rural Urban Partnership Section of Butwal Municipality has adopted the policy of promoting private -public partnership in order to address the problem of HIV/AIDS.
• Another characteristics of good governance, Consensus, also with 65% secured good grade. This can be explained partly, on the ground that civil societies and partners involved in the response to HIV/AIDS has agreed to the Butwal municipality's HIV/AIDS program. And partly on the ground, the civil societies also have some saying while designing and implementing the municipal response to HIV/AIDS. The participants of the workshop also admitted that consensus with People Living with HIV/AIDS have not been materialized so far, because of the absence of Person / People Living with HIV/AIDS in Butwal Municipality.
• Similarly, the reason behind Transparency securing the third highest mark can be explained on the fact that participants agreed to the fact that access to information on overall municipal activities for an ordinary citizen is there. As the Municipality has established an Urban Information Centre with RUPP's support with the objective of ensuring increased access to information for an ordinary citizen. Similarly the Municipality has a mandatory obligation of declaring annually its expenditures and Butwal Municipality has been doing this without any failure. Moreover, after the adoption of Participatory Municipal Development Planning (PMDP) by the Municipality has also enhanced some degree of transparency on the selection of program/s.
• Accountability scored 62% with a fair grade. The reason behind the accountability securing the fair grade is that the Municipal staffs and civil societies are not only aware of the devastating impacts of HIV/AIDS but also have realized some sense of responsibility in this respect. The workshop perceived HIV/AIDS awareness program spearheaded by the Municipality with the active participation of civil societies and NGO - targeting not only each households but also vulnerable groups, of the Butwal Municipality as an evidence of accountability of the Municipal staffs and civil society. It was also realized that the important role of private sector is yet to be materialized.
• Effectiveness and Efficiency secured only fair grade with 62%, indicating despite the extensive awareness program, number of persons with high-risk behavior is increasing. The most of the participants expressed the view that the Municipal responses to HIV/AIDS are effective only to creating awareness but not effective to behavior change which is very crucial to the management of the HIV/AIDS problem. Effectiveness and Efficiency, when judged in the perspective of providing support to drug addicts and Person / People Living with HIV/AIDS, it was realized that a lot needs to be done specially for these two groups.
• The municipality has shown its commitment to address HIV/AIDS issue with long term and short term planning even ensuring the active participation of other stakeholders including private sector, it is this fact that Strategic Vision helped to scored 58%. However, It was also realized that a concrete vision to address the HIV/AIDS issue including addressing the problem of drug abuse is yet to emerge. At same time, the workshop also realized that a plan envisioned with strong and effective participation of private sector is still lacking.
• Equity and Responsiveness, both characters, scored the same mark, i.e. 52%, indicating the these aspects needs to be addressed with a emphasis if the HIV/AIDS issue is to be addressed within the purview of good governance. Similarly, the Rule of Law scored the least mark implying legal provision for the supports for People Living with HIV/AIDS and other vulnerable groups such as sex workers are almost non-existence.

Lesson learned

• The scores given were not markedly different from group to group and they are around 3 to 4 out of 5 in each indicator. All elements acquired over 50% scores except Rule of law (48.3 %) and Equity (45.5%) and average score of under 60 % indicates that much improvement is needed in improving the situation. Overall scores in participation, consensus and transparency fared well, perhaps due to the result of Tole Lane Organization (TLO) — formed by Municipality/RUPP for the implementation of all the programme activities, who are familiar with the program on HIV/AIDS.
• It should be admitted that the scores might be indicative but perhaps do not fully reflect the situation of the present condition as the participants did have some kind of difficulty in understanding the issues and concept of Good Governance. It was realized that developing and/ refining the indicators for Report Card especially for HIV/AIDS is a difficult task, as it needs good understanding of issue, good governance and HIV/AIDS. Since the participants of the workshop were selected from a wide spectrum (even in terms of intellectual capacity), a significant portion of the participants did have some difficulty while refining the indicators. And this led them to use available indicators with some minor changes, which may not be completely relevant to Butwal Municipality. A lesson learnt from this workshop is that an ample time of the workshop should be devoted to clarifying issues like what is a good indicator and issues of good governance, before evaluating with indicators.