Megan Hershey

Megan HersheyIntroduction:The HIV/AIDS pandemic claimed the lives of 2.4 million Africans in 2005. Last year’s 3.2 million new infections brought the number of people living with HIV in sub-Saharan Africa to an overwhelming 25.8 million (see: www.unaids.org). On a continent where most states are unable to provide sufficient social services, numerous non-governmental organizations (NGOs), both international and local, have aggressively launched education and treatment programs in response to the HIV/AIDS crisis. Despite being heavily hit by HIV/AIDS, one African country, Kenya, has actually seen its adult HIV prevalence rate drop dramatically from 13.5 percent in 2001 to 7.5 percent in 2004 (see: www.who.org).1 However, the precise reasons for this decline remain unclear. My project seeks to provide insights into this puzzle. I will study a sample of NGOs in Nairobi which conduct HIV/AIDS prevention education programs in an effort to answer the research question: what factors lead to NGO program success? My comparative research design and ethnographic methods will produce case studies of eight NGOs which conduct HIV/AIDS education programs. Using program reach as a measure of success, I will determine which factors contribute to NGO program success. I will consider the role of state and local government as well as other civil society actors in this process. But because program success can only be partially defined by people reached, it is important to understand what happens to HIV/AIDS messages after they leave the doors of the NGOs. Therefore, I will trace HIV/AIDS messages as they trickle down from the NGO, through formal and informal social networks, to ultimately affect behavioral change. Understanding how NGOs and communities disseminate HIV/AIDS message will demonstrate effective methods of fightingHIV/AIDS to scholars, policymakers and granting agencies. This project will reach beyond a 1 Recent numbers indicate that the 2005 HIV prevalence rate has dropped to 6.1 percent (see: www.avert.org).1 Megan Hershey general understanding of Nairobi’s NGOs to provide a nuanced analysis of the political and relational factors which lead to success. It also has implications for the long-term role of local networks in promoting sustainable, participatory development.Literature and Hypotheses: My project focuses on NGOs and local, participatory networks (informal groups such as church and community groups), which constitute a large part of Kenya’s civil society. I draw on Edwards’ writings to define civil society as the non-governmental, formal or informal, associational sector of a society (Edwards 2004). Scholars have linked a robust civil society with both increased democracy and development (Putnam 1994, Ritchey-Vance 2002, Howell and Pearce 2001, Therkildsen and Semboja 1995). In this study I further explore the developmental value of civil society, particularly its ability to distribute and sustain HIV/AIDS messages.NGOs, arguably the most central civil society actors, have been widely understudied by social scientists. NGOs have rapidly proliferated throughout East Africa over the past 25 years, constructing a politicized development space due to their ability to provide services the government cannot (Kanyinga 1995, Therkildsen and Semboja 1995). Their central position in civil society, and their essential role in fighting HIV/AIDS in Kenya, makes them worthy of study. Practitioners and scholars who do write about NGOs often fail to include important factors(such as the role of local, participatory networks) in their studies of NGO program success. It is common for scholars to focus too narrowly on the NGO itself, confusing service sustainability with sustainability of the organization (Lewis 2001, Edwards and Fowler 2002, Cannon 1999). In order to thoroughly analyze my case studies, I will explore seven factors which may explain NGO success. The first two factors I consider are especially important because they have not yet been rigorously tested by other scholars. The first factor I consider is an NGO’s 2 Megan Hershey utilization of local, participatory networks (such as informal church and community groups) to reach people and bring them to HIV/AIDS education sessions (Howell and Pearce 2001, Aubrey 1997, Therkildsen and Semboja 1995, Kanyinga 1995). The dynamic relationships between NGOs and local, participatory networks have not been thoroughly explored as a key to NGO program success, thus this project will hypothesize that local participatory networks are valuable in both advertising and facilitating NGO HIV/AIDS education programs.The second factor I will test for is the role of faith in an NGO. An increasing amount of rhetoric on the effectiveness of faith-based NGOs has emerged from both the United States and abroad, but no systematic study of NGOs has been conducted to compare the success of faith- based with non-faith-based NGOs. Sparse literature on faith-based NGOs has implied that the faith aspect of an NGO does matter and can affect its effectiveness (Kniss and Campbell 2004, Liebowitz 2002, Reinikka and Svensson 2002, Jeavons 1994). Therefore, I have chosen to include four faith-based NGO case studies in my project. Departing from the literature, I hypothesize that it is not necessarily faith itself that matters, but the position of faith-based NGOs in relation to the community that provides these NGOs with direct access to social networks through which they can widely distribute HIV/AIDS messages and attain success.In order to understand what the above factors contribute to NGO success, I will include five other explanatory factors which are more commonly thought to lead to success. The third factor I will observe is the source and amount of NGO funding (measured in dollars). The fourth factor is the expertise of the NGO staff (measured in years of formal education and informal trainings). My fifth factor is the level of non-financial support received from international ties (i.e. an NGO’s New York headquarters or connections with a Western church). Size and age of 3 Megan Hershey the NGO constitute my sixth factor. The final factor to be tested is the presence and type of non- financial support from local and national government actors. But there is more to NGO program success than training people about HIV/AIDS. These education messages only have value if they are passed on to others and actually affect behavioral change. The second part of my study will trace the HIV/AIDS education messages after they leave the doors of the NGOs to determine whether or not they ultimately change people’s lives. My hypotheses in this section address the spread of HIV/AIDS education messages through grassroots level relationships which sustain or reject these messages after they leave the NGO. Granovetter argues that personal relationships are strongly embedded within society and that they are vital generators of trust (Granovetter 1985). Drawing on Granovetter’s argument for the value of trust in relationships, I hypothesize that individuals receiving HIV/AIDS prevention messages second hand are more likely to accept the information and change their behavior if they have a close, personal relationship with the person from whom they received the message.In addition to evaluating the types of relationships which promote HIV/AIDS message transmission, I will evaluate whether or not local participatory networks adopt these messages and then sustain them. The concept of participatory development has been hailed as the next great development theory following the decline of modernization and dependency theories and has been praised for its ability to empower people, promote sustainable development and to lead to a more democratic culture (Davids, et al. 2005, Mulwa 2004, Cannon 2002, Ritchey-Vance 2002). Participatory development defines development as “what the people want” and emphasizes the importance of community “ownership” at all stages of development (Davids, et al. 2005). This project will explore how communities can participate in development at the stage of sustainability by disseminating HIV/AIDS prevention messages. In my final hypothesis, I 4 Megan Hershey posit that if local participatory networks adopt HIV/AIDS messages, the messages can be sustained in the community without the continued support of NGOs. Research Design and Methodology:My project will test a number of factors at the NGO level and then trace HIV/AIDS messages as they trickle down to the grassroots. Because I want to determine what factors lead toNGO program success, I will use a comparative research design with success, defined as reach, as the outcome. To measure reach, I will record the number of people who attend education sessions at each NGO. Therefore, I will select eight Nairobi-based NGOs as case studies: four NGOs which operate more successful programs (two faith-based and two non-faith-based) and four NGOs which have less successful programs (again, two faith-based and two non-faith- based). I will control my sample by choosing NGOs with similar HIV/AIDS program design and content. Also, because all of my NGO case studies will be located in Nairobi, I will be able to control for the local environment and the level of local NGO competition. I will use a combination of qualitative methods, including: participant observation, in- depth interviews and questionnaires. In order to closely observe the daily life of the NGOs, I will conduct participant observation at each NGO for four weeks. I will supplement my observations with in-depth interviews of NGO employees in order to determine which factors are relevant to success. I will conduct additional in-depth interviews with members of any local participatory groups which may work with the NGO in order to determine their role in program success. At this time I will also collect NGO financial and other reports to test my other factors.I will spend the next four months tracing the path of HIV/AIDS messages after they leave the doors of the NGOs. My goal in this part of the project will be to determine how and through whom, messages about HIV/AIDS prevention are spread from NGOs to individuals and to what 5 Megan Hershey extent they have been internalized and have affected individual choices. This part of the project will allow me to track the often ignored residual reach of NGOs.In order to gather this information, I will distribute questionnaires to a random sample of individuals who have attended NGO HIV/AIDS training sessions during the past year. Ten questionnaires will be administered per NGO, for a total of 80 questionnaires. Through these questionnaires I will determine if these attendees passed on HIV/AIDS messages to others and, if so, to whom. Then, I will conduct in-depth interviews with a sample of the individuals who received the information second hand. I will randomly choose three people who received HIV/AIDS messages from each person who filled out a questionnaire, for a total of 240 interviewees. The use of interviews will allow me to access individuals’ reactions to HIV/AIDS prevention messages. Also, these interviews will elaborate on the type of relationship the interviewee has with the person who passed information onto him or her. Capturing these nuances is vital if I am to analyze the relevance of relationship type in the dissemination of HIV/AIDS messages. Because of the sensitive nature of HIV/AIDS I will not ask in-depth questions about the sexual behavior of my interviewees. Instead, I will measure the success of the HIV/AIDS message by whether or not an interviewee is aware of his or her HIV status. I have been advised by medical professionals at the Moi University Medical School in Eldoret, Kenya that this indicator is commonly used to determine the effectiveness of HIV/AIDS education. Identifying how and through whom HIV/AIDS messages are disseminated, and whether they affect behavioral change, will demonstrate the sustainability of educational messages outside the confines of the NGO. 6 Megan HersheyPreparation and Preliminary Research: I have already taken a number of steps to ensure the success of my project, including pursuing academic coursework, language study and a preliminary research trip to Kenya. Two years of political science coursework at Indiana University have refined my proposed project and prepared me to conduct field research. My focus on comparative politics and public policy has exposed me to a wide range of theoretical literature in these fields. I wrote a review of the political science literature on NGOs and HIV/AIDS in Africa for my African politics course, and a separate course on NGOs exposed me to the range of environments NGOs operate in. My African studies minor has allowed me to take courses in a variety of disciplines; the bibliographyI created on the topic of HIV/AIDS in Kenya for my African Studies Bibliography course has proven quite useful for this project. My current work on a dissertation chapter will set up the research I plan to conduct in Kenya; it asks how and why the Kenyan government has addressed the issue of HIV/AIDS and what environment this has created for NGOs.My methodological skills are also well-suited for this research. I have practiced interviewing, participant observation and conducting focus groups in a qualitative methods course. I have also taken a statistics sequence which will allow me to read government and NGO data on HIV infection rates. This January, I will further my methodological skills by attending an intensive two-week course at the Arizona State University Institute for Qualitative Research Methods. After finishing my coursework, taking my qualifying exams and receiving approval for my dissertation proposal next semester, I will be ready to leave for Kenya in September 2007.In addition to my other coursework I have actively studied Swahili to prepare myself for work in Kenya. In only 13 months I have completed six semesters of Swahili. Two of these semesters were completed in summer 2006 at the intensive summer Fulbright Group Project 7 Megan HersheyAbroad in Tanzania. I will complete an additional three semesters worth of Swahili this year before embarking on field research. I plan to conduct my interviews in either Swahili or English, allowing the interviewees to choose the language they prefer to speak. Finally, I am in the process of creating Swahili interview guides with my Swahili professor for use in the field. I have laid additional groundwork for my project by taking a pre-dissertation research trip to Kenya this past summer. While there, I established contacts within the University of Nairobi, met with nearly twenty NGOs, collected government reports on HIV/AIDS and familiarized myself with the city. Through my preliminary interviews I gathered data on the types of NGOs operating in Nairobi and their activities. These preliminary interviews assisted me in refining my research question and defining measurements for my key factors.While in Kenya I assessed the resources available to support this project. First, the NGOs, and the people they train, are located in and around Nairobi; they will form the core of my research and access to them is vital to my project. Through my pre-dissertation work I found that accessing these NGOs is easier than accessing government offices and that their employees are usually willing and eager to talk. Additionally, once I have received my official research permit from the government of Kenya I will have access to the Ministry of Health’s statistics on HIV prevalence and infection rates. Finally, I will have full access to the University of Nairobi’s library and other university resources thanks to their generous extension of affiliation. Contacts in the Field:The contacts I have established with scholars and NGO managers in Kenya will be essential to my project’s success. While in Kenya, I received advice from Dr. Penninah A. Ogada, a political scientist at the University of Nairobi. I also discussed my research with the head of the political science department, Philip O. Nyinguro. The support of the accomplished 8 Megan Hershey scholars in the political science department will be essential to the success of my project. Additionally, I have secured a letter of support and affiliation with the University of Nairobi from Dr. Kenneth Muema Mavuti, director of the Centre of International Programmes and Links.I also met with nearly twenty NGOs while in Kenya in an effort to familiarize myself with the NGO sector and to identify case studies. I successfully identified several prospective cases based on NGO size, income, age and programming. Specifically, I spoke with Map International and Hope Worldwide about the possibility of studying their NGOs and received warm receptions from both. Before leaving to conduct my field research I will arrange formal agreements with these NGOs and identify the other six cases for my study via e-mail. I have made valuable contacts with individuals at several umbrella NGOs (i.e. KANCO) who will aid me in identifying and solidifying relationships with my final cases. Finally, while in Kenya I familiarized myself with the process of obtaining an official research permit. I will submit my application for a research permit to the Kenyan government at the same time I submit my research proposal for human subjects approval at Indiana University this spring. Research Dissemination:I am eager to share my research with my colleagues in both Kenya and the U.S. I will present my research, at various stages, to students and faculty at the University of Nairobi in order to solicit their feedback. Upon return I will convert this research into my dissertation. I will present my dissertation (during and after its completion) at political science and African studies seminars at Indiana University as well as at academic conferences. I will also send copies of my dissertation to my NGO case studies, the University of Nairobi library and to the Office of the President of Kenya. Finally, my dissertation research will form the basis of several scholarly articles for submission to academic journals, and will ultimately be published as a book. 9 Megan HersheyAdvisor Support:In order to achieve my dissertation and publication goals, I will need the support of faculty advisors. The advice and direction of my dissertation advisor, Lauren Morris MacLean, has already been integral to the conception of my project. Professor MacLean has spent hours with me grappling with all aspects of my research in order to develop a project that is both academically significant and valuable to the people of Kenya. Professor MacLean has also advised me on the cultural and practical issues of conducting research in sub-Saharan Africa. Professor Patrick O’Meara, one of my dissertation committee members, introduced me to a wealth of development literature. I will maintain close contact with Professor MacLean and my dissertation committee while I am conducting my research in Kenya. While abroad during my pre-dissertation research I e-mailed Professor MacLean weekly with progress updates and questions; I intend to continue this pattern next year. Additionally, I will maintain monthly contact with my dissertation committee members as I report progress and seek advisement. Conclusion:This project will critically analyze the factors which contribute to NGO HIV/AIDS program success in the context of Nairobi, Kenya. These programs are on the frontlines of the fight against HIV/AIDS in Africa. Therefore, it is essential for scholars and practitioners to understand how NGOs attain success and how they work with local participatory networks to disseminate messages that will be sustained beyond the reach of the NGOs. The coursework, methodological training and preliminary field research which I have completed have all served to prepare me to complete this project. I am eager to learn from, and contribute to, Kenyan society through my research. I am confident that my work on NGO success and information dissemination will be of use to scholars and policymakers as they continue to fight HIV/AIDS.10

Megan Hershey

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