2015 Eastern Cna
2015 Eastern Cna
2015 Eastern Cna
FOREWORD ..........................................................................................................................................................3
GLOSSARY .............................................................................................................................................................6
INTRODUCTION ..............................................................................................................................................11
METHODOLOGY ..............................................................................................................................................12
FINDINGS .............................................................................................................................................................16
DISCUSSIONS ....................................................................................................................................................38
CONCLUSIONS .................................................................................................................................................44
REFERENCES ......................................................................................................................................................44
APPENDICES ......................................................................................................................................................45
Eastern Region Capacity Assessment Report
Foreword
Eastern province is vast and unique in that it almost contains three provinces in one; Upper Eastern, the
Mountain region and the lower Eastern region. It is the second largest province in Kenya, with an area of
159,891 km². The terrain is richly varied, spanning diverse climates of the desert, mountain, lake, and savannah.
This province comprises of 36 constituencies, with a population of 5,668,123 inhabitants- according to the 2009
population census. Its provincial administrative capital is Embu.
The HIV prevalence rate in Eastern province is 4.7 % (KAIS 2008). Though substantially lower than the national
average of 7.1%, this rate masks the scale of the epidemic in densely populated urban areas where infections are
well over10%. About two thirds of the adult population of this province, as it is country wide, are yet to test for
HIV. Research indicates a worsening scenario in sexual behaviour among the sexually active, (most of whom do
not know their HIV status), citing less than half had ever used a condom and less than 20 % used a condom the
last time they had sex.
The drivers of the HIV epidemic contrast sharply by region within the Province. In the upper part of the
Province, for instance, it is largely driven by cultural practices associated with nomadic lifestyles while in the
mountain region, the epidemic is fanned by migratory activities linked to agriculture based trades; Miraa, flowers
and bananas, horticultural produce, tea and coffee. Farm workers oscillate between farms in search of casual
work, while the middle-link traders- both men and women- shuttle between towns both within and without the
province. The lower region of eastern province- largely inhabited by the Kamba community- is chiefly a savannah
climatic zone, characterized by drought. Famine overshadows otherwise important intervention activities and the
ensuing struggle for survival seems to subtly enhance the ‘food for sex’ practice. Challenges of ARV adherence
are as real as they can get.
In the backdrop of this situation, the Kenya Government’s national response to HIV infection is enshrined in the
Kenya National Aids Strategic Plan III (KNASP 2005/6-2009/10) and implemented through the National Aids
Control Council (NACC). It is guided by the “Three Ones”i principle.
This principle envisages a situation where there are joint and participatory efforts in building an effective national
response, with all stakeholders (including the community) working together within the framework of key priority
areas of: ‘Prevention of new Infections’, the ‘Improvement of quality of life of people infected and
affected by HIV and AIDS’, and the ‘Mitigation of socio-economic impact’, thus ultimately, an AIDS free
society.
Eastern Region Capacity Assessment Report
Funds for the execution of this strategy are sourced from the World Bank and channelled to grassroots Civil
Society Organizations (CSOs) through the National AIDS Control Council’s “Total War against AIDS” project
(TOWA). The request for applications for these funds is made through the media and the web network.
In the strategy, one of the key pillars outlined in tackling the AIDS epidemic is the community.
Fighting the HIV and AIDS epidemic requires involvement of many key sectors of society- including civil society
organizations; private and public sector organizations.
Civil Society organizations are significant actors in prevention, care and support in the area of HIV and AIDS
program implementation in this province.
Findings of an assessment study of Organizational development levels and technical gaps of 155 CSOs working in
AIDS control projects under the TOWA funding stream revealed a universal challenge in administration, project
management and leadership.
Strategies to track treatment drop out; to manage stigma, or address TB/HIV co-infection are deficient. National
guidelines are yet to reach the grassroots. Far too few networks of People Living with AIDS and Most at Risk
Populations (MARPs) come forward for funding or skills to support Income Generating Activities.
These and other gaps including the limited knowledge of the relationships between HIV infection and Cultural
practices or the gender dimensions to HIV infection, defeat the very precious advantage that CSOs have; “…
home grown solutions, which provides a tremendous platform to challenge societal norms and practices.
The first thing that must be done is to sharpen the CSOs focus in their appreciation of technical issues, then train
and mentor them in practices that will ensure and safeguard the achievement of the KNASP III objectives,
specifically, to reduce: the number of new HIV infections; AIDS-related (mortality) deaths; HIV related illnesses and
negative socio economic impact of HIV at household level, ultimately edging towards an AIDS competent society.
As the Chinese philosopher Wu Ch’I (430-381 BC) observed, “To lead people, walk beside them and remember
there are five matters to which a general must pay strict heed. The first of these is administration; the second,
preparedness (work planning); the third, determination; the fourth, prudence; and the fifth, economy."
Thank you,
Glossary
AIDS Competent Society:
In an AIDS competent society, people are dealing effectively with AIDS where they live and work when they accept the
reality of HIV, they assess how HIV and AIDS are affecting their lives and work, and they are adapting to live positively with
HIV.
The strategic use of communication to promote positive health outcomes, based on proven theories and models. It employs
a systematic process beginning with formative research and behavior analysis followed by communication planning,
implementation and monitoring and evaluation.
Refers to, all organizations and groups that are Not-for-profit, Non-Governmental, Non-Political, which are formed
voluntarily to respond to a felt need within the community.
Not for profit groups and organizations that are formed by community members primarily in the village and local levels.
Many are not registered. Others register with the Ministry of Social services and Development. A few well established CBOs
reach regional and national status and later convert to NGO status. The CBOs are the single biggest group of CSOs in
Kenya numbering to more than 340,000.
These are CSOs that are operating under the auspices of a faith based community, church, religious institution. The many
register as CSO but work towards delivering on the goals of their religious order.
Legal definition of an NGO in Kenya is a CSO that is registered by the NGO Coordination Board under the 1990 NGO
Coordination Act. There were nearly 7,000 Kenyan registered NGOs by July 2009. Charity status is conferred by Ministry of
Finance. Trust Funds are conferred by Ministry of Lands. The term broadly used includes a not-for-profit companies, large
well established local CBOs and CSO networks, Trusts, Foundations, Faith Based Organizations, International charities and
voluntary groups operating local branches. In this respect the estimated number by Government is 14,000.
MARPS:
It stands for most at risk populations. These are population groups whose behavior puts them at greatest risk of being
infected with HIV. In Kenya, female and male sex works, injecting /intravenous drug users (IDU), and men who have sex with
men (MSM) are considered primary MARPS.
A tested community based approach to enhance the capacity of local organizations addressing HIV and AIDS to design,
implement, monitor and evaluate the impact of their interventions. It is a dynamic and outcome based participatory process
that emphasizes the organizational ownership.
Eastern Region Capacity Assessment Report
The ODSS Framework for organizational development. This is the bedrock upon which this training needs
assessment was conducted and is the roadmap for charting the path forward.
Table 1.The ODSS steps to organizational development: source Amref Maanisha project
4.Mature stage
Organizations pass through these stages at different rates but tend to remain at the initial stage until they have developed a clear mission,
good management structures and systems, management skills, volunteers, and staff who use these.
Eastern Region Capacity Assessment Report
EXECUTIVE SUMMARY
The main objective of the study was to profile the capacity of grass root CSOs and PSOs in 36 constituencies in
the Eastern province of Kenya.The methodology applied in conducting the assessment consisted of face to
face administration of a quantitative questionnaire by the RFA consultants and trained research
assistants. The Amref- Maanisha OCAT tool was used and, later the Amref Maanisha MIS system was
utilized for on-line data entry.
The data was then exported and analyzed in SPSS version 17, results from which went to advise this report.
The CSO population was the listing of close to 1,000 government registered CSOs implementing HIV and AIDS
activities and submitting the COPBAR tool to the CACCS in 36 constituencies in Eastern province. The required
number of CSOs (155) was proportionate to the total population size in Eastern province.
Key findings
Administrative Issues: For lack of offices, most CSOs (130; 83.9%) often meet in churches, primary schools
and members’ houses. Records are generally kept by the groups’ secretaries in their own houses. The level of
literacy for some of the groups is quite low.
All of the 155 CSOs assessed were found to be legally registered though most of them (134; 86.5%) did not
demonstrate satisfactory development of organizational systems.
Organizations generally have members’ responsibilities defined before hand and this is discussed during meetings.
Virtually all the organizations (136; 87.7%) have no documented HIV & AIDS work place policy to guide their
members.
This is one of the areas that need redress.
The area of HIV & Aids activities at community level: Most CSOs (132; 85.2%) who had received funding
got it from NACC (TOWA), some from Maanisha, APHIA Plus and a few other donors. Through the CSOs the
community at large had benefited from outreaches; Behavior change communication and distribution of materials
like condoms (106; 68.4%). Notably, all 16 CSOs with VCT-related activities were located within hospital
premises.
On Leadership Governance Strategy: Most of the CSOs do not fully involve PLWHAs or other vulnerable
groups in decision making- at the planning, implementing and monitoring stages- except for the groups that were
purely PLWHAs support groups.
Many organizations (72; 46.5%) had ‘rules’ and ‘constitutions’ on paper only- as a requirement for legal
registration.
Most organizations (124; 80%) had committees that meet regularly
Aspects of vision (47.7% had none), mission (55.5% had none) and strategic plans were a common gap found
amongst the CSOs.
Eastern Region Capacity Assessment Report
Monitoring and Evaluation (M&E): All the (NACC funded) organizations filled in the COPBAR tool
quarterly. Only two of the CSOs were found to have carried out an impact evaluation.
Financial management: All except three of the 155 CSOs have a bank account.
Very few organizations (6; 3.9%) had audited accounts while 52 (33.6%) CSOs currently use donor-based
procedures for their financial management.
HR procedures: Most of the groups (72.9%) are run by volunteers who only work on a need-basis; they do not
have any employed staff. Their work is basically guided by the by-laws outlined in their constitutions.
On Networking and Advocacy: Most institutions (110; 71%) are only a member of CACC but not involved in
formal networks within the constituency or district level; half (49.0%) did not understand what networking
entails.
Technical capacity: A few members have attended training workshops on HIV and AIDS and have basic facts
of HIV & AIDS. A majority of the CSOs (63.2%) understand that women are more vulnerable to HIV and AIDS
but minimally address it. The CSOs dealing with PLWAS (63.9%) would like to conduct TB Education and
advocacy but do not have the knowledge to articulate the same. Some of these CSOs (56; 36.1%) were however
minimally addressing this during their awareness program. Most CSOs (70; 45.16%) understand the issues of
stigma reduction and relations between people’s rights and HIV & AIDS but do not have the knowledge to
articulate the same. None of the groups assessed collaborated with or engaged in multi-sectoral partnerships.
Most CSOs (115; 74.19%) visited had knowledge that some cultural norms and practices contribute to the high
risk of HIV and AIDS infection. However they lacked strategies to challenge these practices. Use of IEC materials
was low. A greater number of CSOs (128; 82.59%) knew that people infected and affected by HIV and AIDS have
rights that should be protected but did not know how this should be addressed.
Support from government structures: All the CSOs visited revealed that they received great support from
their CACCs in form of technical support. Some had received materials and had consultations on several issues.
The support of DTCs was not common among the (50; 32.25%) CSOs visited. Most CSOS (45; 29.03%) use
national guidelines in implementing HIV and AIDS related interventions. Few CSOs (29; 18.70%) knew about
KNASP II and III.
Knowledge and management: The CSOs (124; 80%) have generally not embraced ICT and are therefore not
able to gain from its benefits. They however have minimal knowledge of documenting or disseminating best
practices. Few CSOs (38; 24.51%) attested to using cyber for computer and internet related services though all
of them use the mobile for communication. Most CSOs (88; 56.77%) mentioned that they access new HIV
information from the CACC/ Ministry of Health which they in turn shared with their group members. The
Eastern Region Capacity Assessment Report
assessment also revealed that (62; 40%) of the CSOs can identify some good and bad experiences as well as best
practices (34; 12.93%), yet most CSOs (114; 73.54%) have minimal knowledge of documenting or disseminating
the same.
Sustainability: Many organizations have some income generating activity for the continuity of their work
without external funding. This means that end of funding would not lead to a full scale discontinuation of the
services. Most of the CSOs (132; 85.16%) play an important role in the community but do not envision
sustenance support from the community. Financially, 135 (87.09%) CSOs were found to be dependent on donor
funds and 61 (35.34%) of them had funds for ongoing activities only.
Eastern Region Capacity Assessment Report
1.0 Introduction
This report outlines the process and results of a capacity needs assessment of 155 groups collectively referred to
as Civil Society Organizations (CSOs). These comprise of Community Based Organizations (CBOs), Self Help
Groups (SHGs), networks of People Living with HIV and AIDS (PLWHAs), Non Governmental Organizations
(NGOs), Faith Based Organizations (FBOs) and youth groups- all dealing with HIV and AIDS, prevention care and
support within Eastern Province.
The assessment was carried out in Eastern Province in the Month of June 2011. The CSOs were sampled by the
Regional Facilitating Agency (RFA), the National Aids Control Council (NACC) field officers, and the
Constituency Aids Co-ordinators (CACCs) using an agreed number of four CSO’s per constituency for the 36
constituencies in the Province. These four CSOs were selected taking into consideration variables inclusive of
funding status, target population, rural urban status, and type of activity and technical area of focus. The CACCS
then contacted and mobilized the CSOs, while the RFA assessed them using the Amref Maanisha Organizational
Capacity Assessment Tool (OCAT).
2.0 Methodology
The methodology applied in carrying out the assessment consisted of administration of quantitative questionnaire
through face to face interviews administered by the RFA and trained research assistants. The Amref Maanisha
OCAT tool was used and, later the Amref Maanisha MIS system was utilized for on-line data entry.
The data was then exported and analyzed in SPSS version 17 for report generation.
2.1 Population
The CSO population used as a universe from which the sample size was drawn were the over 3,000 government
registered CSOs implementing HIV and AIDS activities and submitting the COPBAR tool to the CACCS in 36
constituencies in Eastern province. It mainly included those who had applied for TOWA funds irrespective of
whether they qualified or not.
2.2 Sampling frame and sample size
The provincial sample size calculated by NACC and AMREF and given to the RFA was based on number of CSOs
(funded and non-funded) per region. The required number of CSOs (144) was proportionate to the total
population size in Eastern province. An over sample of 19 CSOs was prescribed on the basis of Most at Risk
Populations (MARPs). These were purposively sampled from the flower farming expanse of Timau, the traditional
miraa producing ranges of Nyambene and the transport corridor along Mombasa road.
AFH then took an approach of multi-stage purposive sampling for the next level of sample selection. Rationale
for the choice of CSOs included:
Of the four CBOs in each of the 36 constituencies, three were funded under TOWA (because of the
aspect of mentorship and exchange visits) while one potential non funded CSO was identified.
A stratified purposive approach for the individual selection of four CSOs per constituency so as to
capture a broad range of target groups; prevention, care and support activities, most at risk populations,
rural urban locations, self help groups, faith based organizations, youth groups and networks of PLWHAs
and OVC centered groups.
Consideration of the terrain and navigability of the clusters; distance from one CBO to another was
required to be reasonable to enable teams to cover the assignment within time and budget.
Ease in accessibility of the CSOs by road and good coverage by cell phone communication network for
ease in feedback and spot checking.
Due consideration of security issues to ensure safety of the team.
Overcoming language barrier by ensuring that at least one member of the CSO could communicate in a
national language- English or Kiswahili.
Eastern Region Capacity Assessment Report
2.3 Planning
Prior to fieldwork, mapping and routing was done in close consultation with the respective CACCs at a meeting
in Embu on the 14th of June 2011. Due to its vast expanse, the Eastern region was necessarily split into four
zones. The preparation employed planning tools including a shared power-point Presentation on zones and
clusters of constituencies, guidelines for developing the CSO Listing and a training Kit for Research Assistants.
The zoning of the Province ensured logistical ease. The zones are presented in table one below.
Zone 1 :ISIOLO 6 6 x 4 = 24
Zone 3 :KITUI 10 10 x 4 = 40
The road winds uphill to the very top. Upon Mt. Kenya: locking horns with the BIG one
Eastern Region Capacity Assessment Report
There was clarity in the definition of roles and responsibilities amongst different players as outlined in table 2
below.
Table 2: Roles and responsibilities of partners in the CSO Capacity Assessment study.
CACC Provide listings of CSOs. Avail listing. Host the teams in - Ensure research teams
Link between research team constituencies ( sites, suggest Reach the CSOs
Co-
and CSOs accommodation, inform on security)PR
ordinators
The Organizational Capacity Assessment tool (OCAT) developed by AMREF was used for data collection.
The interviews covered the following capacity areas:
Project Design and Management Technical Capacity
Leadership, Governance and Strategy HIV and AIDS Knowledge and Management
Financial Management Sustainability
Administration and Human Resources Monitoring and Evaluation.
Networking and Advocacy
The AFH/NACC team met all the 36 CACC’s in the Province and sensitized them to the ODSS and its roll-out.
It was an opportunity to introduce the Regional Facilitating Agency to the teams in the province. AFH fashioned
the Province into four zones along geographical lines for logistical ease. Each zone was managed by one team. The
teams visited a constituency a day and evaluated four CSOs per day. NACC provided the logistical support of
vehicles and the network of CACCs on the ground to help in creating the much needed rapport, to support in
identifying the sampled groups and the acting a guide to get to meeting venues which were in many cases
members homes, churches and mosques, primary schools and social halls, a few had offices and orphanages had
homes.
Notably, all the coordinators (CACCs) were well organized and in good command of their areas of
administration thus enabling the teams to achieve their daily targets easily. The task was demanding, though, with
working hours often spanning 12 hours; from 8.00am- 8.00 pm. The groups were generally welcoming and eager
to participate since they had been earlier mobilized by the CACCs.
Data was collected over a period spanning 7 days in Eastern province. The consultants provided technical
backstopping and guidance in the field. On average, interviews took 1 - 2 hours. In some areas translation into
Kiswahili or local language had to be done.
Data collection was done in an articulate and systematic manner. Each team handled four CSO’s per day. There
was mutual sharing and exchange of phone numbers between RFA, FO, R.A, CACCs, and CBOs to enhance team
communication. Each team edited questionnaires in the field before leaving the respondents (CSO’S). Half day
pre-testing was done in one constituency by the entire Eastern team (8 member team). Data was collected in the
week of 20 to 29th of June 2011.The research assistants worked under guidance from the AFH core consultants.
NACC officials and the AMREF Maanisha teams provide quality control through spot checks and sit in during
interviews. Data quality control was ensured through daily review of completed questionnaires by the district
supervisors and on-site checks by the consultants in the field.
2.9 Data entry and analysis
Quantitative data was coded, cleaned, entered in the GM and E system and then validated and analysed using
SPSS version 17. This was done over a period of two weeks by a team of 5 data clerks under the supervision of a
data analyst. MS Excel was used for data presentation.
Eastern Region Capacity Assessment Report
3.0 Findings
This section contains the findings of the capacity assessment of the 155 CSO’s in Eastern Province. It dwells on
several organizational HIV and AIDS competences of CSOs that are necessary for their effective contribution to
the national HIV efforts -as implementers of community based action against HIV and AIDS.
Figure 1:
CSOs by
type of
registration
Though generally registered either as CBOs, FBOs, NGOs or SHGs, 10 (6.5%) of the groups specifically
categorized themselves as PLWHA Support Groups; 3 (1.9%) as Network groups.
Majority of the CSOs operate at the location level as noted by a proportion of (34.2%), division level (33.0%), and
district level (23.0%), while (8.0%) operate at the sub-location level. Some fledgling attempts at achieving
provincial networks were noted (2%) and only one organization posted National coverage (see charts below).
Eastern Region Capacity Assessment Report
60 53 51
Proportion (%) of
assesed CSOs
50
40 35
30
20 12
10 3 1
0
Sub-Location Location Division District Province National
Geographic Area of coverage
The table above portrays the CSOs as the main operative in Eastern Province with a count of
138 (89%) as compared to Private Sector organizations 15 (9.7%) and government at 2 (1.3%).
Frequency Percent
Government 2 1.3
Areas of collaboration/partnership between CSOs and other partners include funding and technical support. 75 %
of the CBOs/PSOs are funded mostly by NACC, USAID APHIA Plus, and Child Fund and Food for the Hungry
International (FHI). The CSOs that participated in the assessment have received funding ranging from KShs.
175,000 to 3 million. Three of the CSOs have exceptional funding, with two running on a budget of up to Kshs.
24 Million.
International NGOs
1. Hope Worldwide
2. Child Fund
Table 6:
4.3 Matrix of Technical Assistance Partnerships in Eastern Province by the areas they support
Services Commodities
i. Training: vi. Medicine:
APHIA Ministry of Health
Bar Hostess Association of Kenya LVCT
Catholic Church PSI – FP commodities
Christian Children Fund vii. Water Food and Clothes:
Compassion International Food for the Hungry International
Food for the Hungry International GOK/Chief/ DC’S office
Grace Africa Groots
Groots Ripples International
KEMU _ Kenya Methodist University Njaa Marufuku
Kenya Forestry Services Redeemed gospel Church
Faulu Kenya Nithi Water Company
LVCT World Vision
Ministry of Agriculture viii. Printing and stationery: World Vision/ Ministry of Health
Ministry of Livestock /APHIA
Key: PWD – people with disabilities; OVC Orphans and Vulnerable Children; SW sex Workers; IDU- Injecting
Drug Users; PLWHA – People Living with HIV and AIDS; MSM- men having sex with men.
Eastern Region Capacity Assessment Report
Only 15 (9.7%) of CSOs are doing community outreach-training of CHWs for PMTCT
Similarly, only 15 (9.7%) of CSOs are doing Door to door (home) C & T
Even less CSOs are doing Community outreach- Moonlight VCT at 12 (7.7%)
Prevention with positives is another low performance area with 19 out of 155 CSOs.
Community outreach-School based programs are also quite weak; at 41 (26.5%).
80
70
70
63
59
60
50
45
38
40
32 32
30
30
20
10
0
Training for HCBC Nutritional provision of food other support e.g. Training on the Training on Provision of Training on
education and and nutritional (skills rights of PLWHIV adherence support adherence support legal/human right
counseling support improvement, to people advocacy
material, receiving ART
psychosocial,
IGAs support)
Key: PWD – people with disabilities; OVC Orphans and Vulnerable Children; SW sex Workers; IDU- Injecting Drug Users;
PLWHA – People Living with HIV and AIDS;MSM- men having sex with men.
Total
Activities Target Audience number of
Improvement of quality of CSOs
life PWD WIDOWS OVC SW YOUTH GENERAL PLWHA MSM MIGRANTS PRISONER IDU
Training for HCBC 0 1 8 2 2 37 20 0 0 0 0 70
provision of food and
nutritional support 0 3 22 1 4 4 25 0 0 0 0 59
Nutritional education and
counseling 0 3 7 1 3 18 30 0 1 0 0 63
other support e.g. (skills
improvement, material,
psychosocial, IGAs support) 0 7 13 1 5 1 17 0 1 0 0 45
Training on legal/human
right advocacy 1 2 5 1 3 9 9 0 0 0 0 30
Training on the rights of
PLWHIV 0 4 2 3 2 6 21 0 0 0 0 38
Training on adherence
support to people receiving
ART 0 1 4 0 1 3 23 0 0 0 0 32
Provision of adherence
support 0 0 2 1 1 4 24 0 0 0 0 32
1 21 63 10 21 82 169 0 1 0 0
The CSOs need support in training on ‘ART adherence’ and ‘provision of adherence support’. Training on human
rights needs to be addressed as does the crucial issue of income generation-IGAs. activities and legal rights
programming.
Eastern Region Capacity Assessment Report
Key: PWD – people with disabilities; OVC Orphans and Vulnerable Children; SW sex Workers; IDU- Injecting
Drug Users; PLWHA – People Living with HIV and AIDS; MSM- men having sex with men.
120
97
100
80
60
41
37
40
24
22
20
0
OVC support e.g. (shelter OVC support -income Skills training for skills training for Support to
food education clothing generating activities IGAs guardians/care givers and widows/widowers and OVC/Widows/widowers on
health psychosocial support) provision of inputs for IGAs provision of inputs for IGAs legal rights eg
e.g. seeds rabbits goats etc land/inheritance rights
Eastern Region Capacity Assessment Report
SW, PWD, PLWHA- at ‘Moi Girls’, Chuka A PWD group leader A PLWA group working at their IGA, Chuka
Eastern Region Capacity Assessment Report
This table gives a snap-shot of the number of times a target group in mentioned by CSOs in the province. It is a
multiple response question which gives an idea on the most popular target audiences and those that are getting
little or no attention.
An adolescent OVC, ‘Moi girls’, Standing to be counted- a Preparing lunch- Caregiver, Chuka township.
Chuka. young OVC, ‘Moi girls’, Chuka.
Eastern Region Capacity Assessment Report
100
79
80
No. of CSOs
58
60
40
13
20
5
0
over 75% 50-74.9% 25-49.9% 0-24.9%
quartile
5.2 The provincial scores for the ODSS indicators are presented in the chart below:
60
56
54.48
50.97
50 48.44 48.55
45.75
40.65
40 38.84
33.5
Score (%)
30
20
10
0
Leadership Fin. Mgmnt Admin & HR Project Design M & E Tech. Capacity Netwkng & Sustainability HIV & AIDS KM
& Mgmnt Advocacy
Capacity area
At 46.61%, the average collective Provincial score places CSOs in Eastern Province in the second stage of
maturity- the emerging stage. They need to be moved to the third stage (consolidation) and ultimately to the
mature stage. Great effort is required to effect this shift- if only for the initially assessed (155)- and more for all
those other CSOs upon whom the nearly six million inhabitants of Eastern province must rely on for effective
prevention, care and support needs.
Eastern Region Capacity Assessment Report
6.0 Specific Organizational capacity assessment results as per the OCAT tool
Vision, Mission, Strategic Direction and Work Plan are markedly the weakest elements in the area of Leadership,
Governance and Strategy.
Medium
High level of
level of
Low level capacity
capacity
of capacity
0 1 2 3 4
Budgets and Cash Flow Does the organization prepare, monitor and review 16 52 43 30 7
planning budgets?
‘Financial Procedures’ and ‘Budgets and Cash Flow planning’ are the weakest elements in the Financial
Management Area of assessment.
How does the organization manage its operations, staff and volunteer?
Question Medium
High level of
level of
Low level capacity
capacity
of capacity
0 1 2 3 4
Office and equipment Does the organization have its own office with office 46 29 38 17 18
equipment?
Managing Staff/ How does the organization ensure that staff and 16 107 8 12 5
volunteers volunteers are well managed?
HIV & AIDS Workplace Does the organization have a formal and documented 48 30 58 12 0
Policy HIV & AIDS workplace policy to guide its officials,
member’s volunteers or staff as they carry out work
for the organization?
Eastern Region Capacity Assessment Report
Knowledge management is a vital component of effective HIV & AIDS prevention, care and support interventions and in impact mitigation. How does the
organization record, store, maintain and share relevant HIV & AIDS data and information?
Medium
High level of
level of
Low level of capacity
capacity
capacity
0 1 2 3 4
Managing data and To what extent is the organization using information and 80 36 8 19 3
information communication technologies ICT like the internet, email and
cell phones to connect with key stakeholders, facilitate
transfer and sharing of information?
Access to HIV & AIDS In what ways does your organization seek to access new HIV 14 46 24 58 6
information & AIDS information?
Identification of lessons How does the organization identify and use lessons learned? 22 30 77 9 10
learnt
Identification of best How does the organization identify best practices in any of its 26 44 62 13 3
practices HIV & AIDS work?
Documenting lessons How does the organization document its lesions learned and 22 54 38 19 15
learnt and best practices best practices?
Disseminating lesions learnt How does the organization disseminate lessons learned and 22 54 38 19 15
and best practices best practices?
Eastern Region Capacity Assessment Report
Eastern Region Capacity Assessment Report
6.5 Sustainability: How does the organization ensure sustainability in order to be effective in its HIV & AIDS programme
implementation?
0 1 2 3 4
6.6 Networking and Advocacy: How does the organization relate with other local, national and international organizations? How
does the organization carry out advocacy work?
Medium
High level of
level of
Low level capacity
capacity
of capacity
0 1 2 3 4
What knowledge and experience does the organization have in HIV & AIDS work?
Medium
High level of
level of
Low level capacity
capacity
of capacity
0 1 2 3 4
HIV and AIDS Do officials, staff, volunteers and members have the 3 36 58 27 24
knowledge necessary HIV and AIDS skills to do their duties well
Gender and HIV and What do officials, staff, volunteers and members 16 24 74 31 3
AIDS understand about the relationship between gender
and HIV and AIDS?
Culture and HIV & AIDS What do officials, staff volunteers and members 11 22 80 30 5
understand about the relationship between cultural
norms and practices related to sexuality and HIV &
AIDS?
TB and HIV and AIDS What do officials, staff, volunteers and members 13 30 56 43 6
understand about the relationship between TB and
HIV and AIDS?
Human rights and HIV What do officials, volunteers, staff and members 18 60 50 13 7
and AIDS understand about the relationship between peoples’
rights, legal protection, and HIV and AIDS?
6.8 Project Design and Management: How does the organization develop and manage its projects?
Eastern Region Capacity Assessment Report
Medium High
Low level level of level of
of capacity capacity
capacity
0 1 2 3 4
How does the organization monitor, evaluate and track the implementation of its programmes?
Medium
High level
level of
Low level of capacity
capacity
of capacity
0 1 2 3 4
Inputs: Inputs are the resources Are input indicators incorporated in the 33 58 36 17 4
available to carry out an activity. implementation and reporting
methods/approaches?
Outputs: Out puts are measurable, After implementing its activities, does the 33 10 47 50 8
direct results of activities, such as organization look back to check what actually
products or services provided took place?
(example:# of OVCs reached
7.0 Discussions
Eastern is vast, the terrain is challenging and distances to cover are very long.
Security is a major issue in this region and not guaranteed in upper Eastern.
During the assessment study, there was severe drought in the upper and lower sections of the province.
For lack of offices, most CSOs often meet in churches, primary schools and members’ houses.
Records are generally kept by the groups’ secretaries in their own houses.
The level of literacy for some of the groups is quite low.
All of the 155 CSOs assessed were found to be legally registered though most of them did not
demonstrate satisfactory development of organizational systems.
Institutions have members’ responsibilities defined before hand and this is discussed during meetings.
Virtually all the organizations have no documented HIV & AIDS work place policy to guide their
members. This is one of the areas that need redress.
Majority of the CSOs work with other partners in implementing HIV and AIDs activities.
Most CSOs who had received funding got it from NACC (TOWA), some from Maanisha, APHIA Plus
and a few other donors.
Majority of CSOs had been trained at some point, either by a donor or through workshops held in their
localities.
Some Institutions had received food and clothing
Through the CSOs, the community at large had benefited from outreaches; Behavior change
communication and distribution of materials like condoms.
There are few CSOS undertaking School Based activities.
Notably, CSOs with VCT-related activities were located within hospital premises.
The CSOs in HCBC provided nutritional and psychosocial support especially to the PLWAS.
That most of the CSOs targeting the vulnerable groups like OVCs and PLWAS had no trained guardians
is of great concern.
Many Organizations targeted the vulnerable group like OVCs and PLWAS
The CSOs generally responded to their own objectives and did not work with National guidelines.
CSOs made no attempts to mainstream gender. The aspect of gender mainstreaming was also found to
be quite a challenge as most of the groups were women groups
Organizations had no coping mechanisms of dealing with Humanitarian crisis; very few could actually
conceptualize ‘Humanitarian crises.
Virtually all the organizations need to understand what a phasing-out strategy is.
CSOs worked with specific target groups while a few worked with the general public.
Eastern Region Capacity Assessment Report
Most of the CSOs do not fully involve PLWHAs or other vulnerable groups in decision making- both at
the planning, implementing and monitoring stages- except for the groups that were purely PLWHAs
support groups.
Leaders who were also founder members of the organizations were rarely challenged to elections by
other members- except for PLWHAs whose leaders were members or volunteers in the organization.
Many organizations had ‘rules’ and ‘constitutions’ on paper only- as a requirement for registration by the
Ministry of Gender and other bodies.
Most organizations had committees that meet regularly
Aspects of vision, mission and strategic plans were a common gap found amongst the CSOs.
Majority of the CSOs maintained visibility at public gatherings where they spoke about HIV and AIDS.
Lack of a strategic plan was a rather universal finding.
Most CSOs currently use donor-based procedures for their financial management.
7.7 HR procedures
Use of IEC materials was low although 80 CBOs said they are involved in this activity. The major
channels include ‘Word of mouth” or community dialogue as the most common medium used to raise
awareness of HIV/Aids. This was mostly in meetings as well as in barazas.
A small percentage of the CSOs used other communication channels such as use of T-shirts, pamphlets
and posters. Most of these were developed by other stakeholders.
7.10 Human rights and HIV/Aids:
A greater number of CSOs knew that people infected and affected by HIV/Aids have rights that should be
protected but did not know how this should be addressed.
7.11 Support from government structures
All the CSOs visited revealed that they received great support from their CACCs in form of technical
support. Some had received materials and had consultations on several issues.
The support of DTCs was not common among the CSOs visited.
The use of national guidelines in implementing HIV/Aids activities was minimal, with most CSOs not
comprehending what ‘guidelines’ were. A few CSOs knew about KNASP II and III.
7.12 Knowledge and management:
The CSOs have not embraced ICT fully and are therefore not able to gain from its benefits.
o Among the 155 CSOs visited, only 4 had computers and 2 had access to internet via modems.
o A few of them attested to using cybers for computer and internet related services.
o All of them were however found to use the mobile phone for communication.
All the CSOs assessed were found to access new HIV information through community dialogues.
Some also mentioned that they access this information from the CACC as well as from the Ministry of
Health. They in turn share the same with their group members.
The assessment also revealed that some of the CSOs can identify some good and bad experiences, as
well as best practices. They however have minimal knowledge of documenting or disseminating the
same.
7.13 Sustainability
o Most organizations have do not have any income generating activity for the continuity of its work without
external funding.
o They also regard themselves as playing an important role in the community but do not envision support for
sustenance from the community.
o This means that end of funding would not lead to a full scale discontinuation of the services.
Eastern Region Capacity Assessment Report
o Some of the “other” programs identified as those that would sustain the CSOs are table banking, savings and
mobilization, Income Generating Activities such as goat keeping, poultry and small scale farming, “merry go
rounds”.
o Financially, the CSOs were found to be dependent on the donor funds and most of them had funds for the
ongoing activity only.
Eastern Region Capacity Assessment Report
Sustainability 45.75%
M&E (48.44%)
Technical Capacity (48.55%)
Overall people with disabilities - are a hidden population for all three intervention activities.
In activities that are very specific to OVC, PLWHA, Widows -
o Strengthen CSOs in Income generating activities
o Legal rights programming.
o Training on ART adherence
o Provision of adherence support;
o Training on human rights
Technical Issues
There is need for more training and improved funding On Voluntary Counseling and Testing
Community outreach-training of CHWs for PMTCT only 15 CSOs are doing it.
Community outreach-Door to door (home) C & T only 15 CSOs are doing it as well
Community outreach- Moonlight VCT only 12 CSOs are doing in Eastern province
Community outreach-School based programs are weak at 41/155 CSOs.
Prevention with positives is another low performance area with 19 out of 155
Conclusions
Based on lessons learned, it is evident that majority of the CSOs have a long way to go in attaining the
target goals. There is need for capacity building right from the technical aspect, interventions bordering
on HIV/AIDS interventions, and across the 9 key areas of interest. Given the high illiteracy levels,
awareness creation needs to be done in ensuring that all the groups are at par through such forums as
workshops, seminars, visual audio, and exchange programs. There is also need for proper governance
and in particular, in the area of documentation and reporting.
9.0 References
1. AMREF Annual report, 2007
Eastern Region Capacity Assessment Report
6. AMREF (2010) Report on the Evaluation of the AMREF Maanisha HIV and AIDS
12. PATHFINDER International Strengthen your Organization. A series of modules and materials for
Appendices
Appendix 1: Challenges during field work
Eastern Region Capacity Assessment Report
1. Security: The region is awash with insecurity right from Isiolo as one gets out of town. The risky points
along the Great North Highway are around Merille and Log Logo towns. Another trouble spot is the
Isiolo – Kina road where motorists have to get security detail for them to proceed to Kina. The other
dangerous stretch is between Sololo and just 10 kms before Moyale town. Sololo is the training ground
for the OLF (Oromo Liberation Front) from Ethiopia. Despite the need for security escort, the team
devised ways of evading trouble by ensuring safer choice of routes to use by day to their destinations.
Long distances
The entire exercise covered a total of 1747 Kms… quite a bit of back breaking travel with only 450 Kms
being tarmacked. The greater 1297 Kms is rough, Stony or treacherous graveled roads interposed by
scorching ‘camel tracks’ as is the Marsabit- Maikona – Turbi- Chalbi desert sections, The vehicle was
good, though, and the driver well up to the task. The team progressed as scheduled.
2. Mobilization: Time was of essence with regard to booking appointments as well as keeping them. Some
officials were out of station, necessitating the team to do with a few officials …mainly the secretaries,
treasurers and one or two committee members. This was deemed sufficient as time could not allow
waiting for chairpersons who despite prior briefing and appointments, chose to delegate to their
secretaries. The pro side of this, as emerged, was that those delegated to were in most cases the contact
persons in the day –to- day running of their organizations.
4. Fatigue: To cover this distance and there being no rest day is quite a task. The team had to stick to the
schedule and by sheer focus and objectivity managed to accomplish the exercise successfully. In this vast
and treacherous terrain more time should be allocated to avoid burn out.
Literacy levels
The levels of literacy of some of the groups were quite low. Teams would spend much more time with such
groups while ensuring appropriate translations and back-translations; ascertaining proper understanding of the
questions by the respondents and translating back the responses into English for coding.
Appendix 2
Acknowledgements:
Eastern Region Capacity Assessment Report
We acknowledge and recognize the contribution, time and efforts of Civil Society organizations with whom African Family
Health worked with during this needs assessment exercise. The exercise was a collaborative effort of the National Aids
Control Council, AMREF HIV and AIDS Maanisha project and the Regional facilitating agency.
This project was made possible by generous financial support from the World Bank.
Set for the field: Part of the Eastern team outside NACC offices at Embu
Eastern Region Capacity Assessment Report
Evaluation system.