Management practices in community-based HIV prevention organizations in Nigeria

Abstract

Background: Nigeria has one of the largest Human Immunodeficiency Virus (HIV) epidemics in the world. Addressing the epidemic of HIV in such a high-burden country has necessitated responses of a multidimensional nature. Historically, community-based organizations (CBOs) have played an essential role in targeting key populations (eg. men who have sex with men, sex workers) that are particularly burdened by HIV. CBOs are an essential part of the provision of health services in sub-Saharan Africa, but very little is known about the management practices of CBOs that provide HIV prevention interventions. Methods: We interviewed 31 CBO staff members and other key stakeholders in January 2017 about management practices in CBOs. Management was conceptualized under the classical management process perspective; these four management phases—planning, organizing, leading, and evaluating—guided the interview process and code development. Data analysis was conducted thematically using Atlas.ti software. The protocol was approved by the ethics committees of the National Institute of Public Health of Mexico (INSP), the National Agency for the Control of AIDS in Nigeria (NACA), and the Nigerian Institute for Medical Research (NIMR). Results: We found that CBOs implement variable management practices that can either hinder or facilitate the efficient provision of HIV prevention services. Long-standing CBOs had relatively strong organizational infrastructure and capacity that positively influenced service planning. In contrast, fledgling CBOs were deficient of organizational infrastructure and lacked program planning capacity. The delivery of HIV services can become more efficient if management practices are taken into account. Conclusions: The delivery of HIV services by CBOs in Nigeria was largely influenced by inherent issues related to skills, organizational structure, talent retention, and sanction application. These, in turn, affected management practices such as planning, organizing, leading, and evaluating. This study shows that KP-led CBOs are evolving and have strong potentials and capacity for growth, and can become more efficient and effective if attention is paid to issues such as hierarchy, staff recruitment, and talent retention.

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Item Type:	Article
Authors/Creators:	Akeju, David Nance, Nerissa Salas-Ortiz, Andrea https://orcid.org/0000-0003-1839-096X Fakunmoju, Ayoola Ezirim, Idoteyin Oluwayinka, Adejumoke G. Godpower, Omoregie Bautista-Arredondo, Sergio
Copyright, Publisher and Additional Information:	Funding Information: This study focused on managers working in CBOs that have received sub-award grants from an implementing partner. The implementing partner was a large non-profit organization was funded through the SHiPS for MARPs (Strengthening HIV Prevention Services for Most-at-Risk Populations) and the Global Fund Programs. Both funding programs focused on the provision of HIV testing and counselling (HTC), sexually transmitted infections treatment (STIT) and HIV education (HIVE) services to FSWs and other KPs. The goal of the intervention was to expand access to more high-risk populations to ultimately lower the HIV prevalence rates in these groups. The sampling frame was 31 CBOs spread across the north and south geopolitical zones, from which 7 were purposively selected based on their involvement in the implementation of HIV prevention projects for FSWs. Given the scale of insecurity in Nigeria which made some states in the south and the north inaccessible, sampling of CBOs was limited to Abuja and Nasarawa (in the north) and Lagos (in the south). For the purposes of this study, we focused on services offered by CBOs to FSWs only. Funding Information: We are very grateful for the support of staff from Society for Family Health (SFH) and the National Agency for the Control of AIDS in Nigeria (NACA). Special thanks to: James Anenih, Emem Effiong, Ogbonna Amanze, and Sani H Aliyu for their support and contributions throughout the entire duration of the project. Most of all, we are profoundly grateful to all our colleagues working for the non-governmental organizations (NGOs) included in this study. Their passion and commitment have been an inspiration for us. We would like to thank Gabriela Le?n for creating the figure used in this article and the administrative support of the project; we also thank Abigail Gutmann-Gonzalez for her help proofreading. The views expressed in this publication do not necessarily reflect the views of Society for Family Health (SFH) or the National Agency for the Control of AIDS in Nigeria (NACA). Publisher Copyright: © 2021, The Author(s).
Keywords:	Female sex workers; community-based organizations,HIV prevention interventions,Management practices,Nigeria
Dates:	Published: 22 May 2021 Accepted: 6 May 2021
Institution:	The University of York
Academic Units:	The University of York > Faculty of Social Sciences (York) > Economics and Related Studies (York)
Depositing User:	Pure (York)
Date Deposited:	09 Feb 2024 11:00
Last Modified:	16 Dec 2024 00:19
Published Version:	https://doi.org/10.1186/s12913-021-06494-1
Status:	Published
Refereed:	Yes
Identification Number:	10.1186/s12913-021-06494-1
Related URLs:	http://www.scopus.com/inward/record.url?...
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:209005

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