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INTRODUCTION This Report Describes a Feasibility Study Conducted Between October 2012 and September 2013, Its Findings, and Reco ELI Feasibility Study Final Report November 2013 Page 1 INTRODUCTION This report describes a feasibility study conducted between October 2012 and September 2013, its findings, and recommendations for a leadership development curriculum. The purpose of the study was to clarify the priority action and scope of capacity building needed to “develop the capacity for FBOs to advocate for improved healthcare for all citizens and hold governments accountable.” The mandate for this endeavor came from a PEPFAR consultation held in Kenya in May 2012 on The Role of Faith-based Organizations in Sustaining Community and Country Leadership in the Response to HIV/AIDS. This study and its leadership development goals are one of several commitments generated by participants at this consultation aimed at leveraging and strengthening the role of FBOs in HIV/AIDS prevention, treatment, and community care. The Interfaith Health Program Public Private Partnership (IHP PPP) at Emory University collaborated on this project with the firm, Okaalet and Associates, led by Dr. Peter Okaalet. Dr. Okaalet was chosen by IHP PPP in consultation with the Division of Global HIV/AIDS at the US Centers for Disease Control and Prevention because of his long- standing leadership working with religious leaders to address HIV/AIDS, not only in Kenya but across many of part of sub-Saharan Africa. Dr. Okaalet directed the work in Kenya, both the design and implementation, taking a key role in conducting the key informant interviews. Emory IHP PPP staff worked closely with Dr. Okaalet in the development of the interview questions and jointly on the analysis of the interview data. For a 2-month period, Emory IHP PP provided on-the-ground support with a graduate student from Emory University enrolled in the Masters in Development Practices Program who supported the benchmark survey activities. The report concludes with a set of recommendations to advance the planning for leadership capacity to achieve strong country leadership responses to HIV/AIDS in Kenya. METHODOLOGY In this study we employed a two-pronged approach to learn from key leaders in the field and to map the field of leadership development related to the goals of this initiative. One approach was in-depth key informant interviews and the other was a search for related models. The final list of key informants and interview questions are provided as attachments. The interview questions aim to understand views on pressing HIV issues, religious leadership roles in meeting those, knowledge and capacities necessary to address them, and the features of an optimum learning environment. An initial list of 53 leaders was developed with the potential key informants organized in the following groups: 1. policy decision makers (government, civil society, and religious organizations) 2. religious leaders (faith-based program implementers) 3. health (medical and health professionals with faith-based health responsibilities) 4. development (program implementers – NGO, CSO, CBO, FBO, and private sector) ELI Feasibility Study Final Report November 2013 Page 2 5. education (university and theological training institutions). We set an initial goal of 12 to 20 interviews and identified priority leaders from each of the five categories. Over a 2-month time period, efforts were made to contact these leaders and conduct in-person interviews, keeping in mind a representative distribution across the five groups. A set of interview questions was sent ahead via email in most cases and some of the responses were obtained in writing when an interview was not feasible. Twelve leaders participated as key informants, the majority in interviews conducted by Okaalet and Associates. Extensive notes were taken by a second person during the interviews and compiled into one document for analysis. Parallel analyses were conducted by Okaalet & Associates and by Emory IHP PPP staff to identify common themes across the interviews. Agreement between the two analyses was achieved by document reviews and exchange followed by conference call deliberation. A document that contains the final list of consensus common themes is attached to this report and key highlights are described in the next section. Okaalet and Associates by virtue of their standing and reputation across the network of key informants provided a very valuable opening to the time and perspectives shared by those interviewed. It is important to note that there is likely some bias given the history and visibility within these relationships. Access to these relationships is a priority given the need for high-level engagement in this project. We expect that collaboration with Emory IHP PPP staff in the analysis reduced some of the bias. Twelve key informants should provide a range of perspectives. However, their extent to which their positions represent the full field of voices and views should be considered in a final interpretation of the interviews and vetting of a recommended curriculum. The identification of relevant models was accomplished through online searches, a review by Okaalet, and referrals made during key informant interviews. The purpose of this component of the study was to identify existing educational resources, potential partners, and expert faculty in the field. Criteria used to select the models are as follows: 1. leadership development focus 2. African context (preferably East Africa) 3. existence of a policy or advocacy learning component 4. presence of a religious or faith-based orientation and/or a health/HIV/AIDS focus. SUMMARY OF KEY FINDINGS This section contains key findings from the analysis of the interview notes. The lines of inquiry and overarching topics are noted in bold. The themes most commonly cited corresponding to these overarching topics are presented in italics and described in more detail when there is congruence across the three lines of inquiry most pertinent to the goal of the study – perceptions of religious leader roles, needed knowledge and skills, and recommendations for learning or capacity building experiences. ELI Feasibility Study Final Report November 2013 Page 3 The first part of the key informant interviews set the tone and context for later questions about religious leaders’ roles and capacities by asking interviewees the most pressing needs in Kenya and their community associated with HIV/AIDS. The three most frequently cited pressing issues are financing of prevention and treatment services, stigma, and the need for a national forum and framework. Less frequently mentioned but of significance is the socioeconomic factors that drive the disease and issues related to children – treatment and support of OVCs. In the development of the curriculum, these additional issues should also be included as feasible when selecting content as well as formulating the intended impact that is important to these leaders. There are three themes or characteristics most frequently cited by respondents of religious leadership roles. To address the most pressing needs and challenges associated with HIV/AIDS, leaders need to -- assure that relevant and accurate information is provided to their constituents; be advocates and policy influencers; and facilitate congregational involvement and responses to community needs. Dissemination of accurate information about HIV/AIDS is thought to be important for reducing stigma, prevention of further spread, demystifying HIV, preventing harmful “moralizing,” and assuring compassionate care. Further along in the interviews when asked about the knowledge and capacities leaders need to have an impact, the two themes that capture the most commonly reported capacities are knowledge on HIV and communication or messaging. The knowledge deemed necessary includes HIV transmission, prevention, treatment literacy, and the “broader social/political/economic environments within which it exists and spreads.” Communication and messaging are also important knowledge and skills that are necessary to have an impact. This is congruent as well with the role of religious leader to provide relevant and accurate information. Further in the interview, key informants were asked to provide advice on learning experiences that would be most useful and feasible for religious leaders. The common themes found in these responses align with what emerged when asked about roles, knowledge and skills. Many of the key informants said that factual information on HIV/AIDS should be included. Additionally several responded that this should be accompanied with religious and theological content. Related to this as well is the theme of contextualizing the content to their realities – that it be culturally and religiously appropriate and draw from real experiences from the field. Religious Leader Role Knowledge & Skills Optimum Learning (Theme 1) Experiences Assure relevant and Knowledge on HIV Factual information on accurate information is Communication, HIV provided to constituents messaging that Accompanied by religious creates change & theological content Contextualized to their realities ELI Feasibility Study Final Report November 2013 Page 4 When asked about exemplars in the field, participants cited a number of relevant common characteristics regarding the role of religious leaders. Two in particular stood out. The first was “those who are personally affected” become “agents of change through testimonies and positive living.” The second was “those active at the local, “grassroots, and middle levels” are thought to have the greatest impact. The
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