CITY AIDS AMERICAS
Americas Leadership Initiative for AIDS Competence in Cities

1st Annual Workshop and Conference

A Program of CIFAL Atlanta
Hosted by Emory Rollins School of Public Health
Atlanta, GA, June 19-23, 2005
• Workshop Home

Self-Assessment of AIDS Competence

Topic: A Human Capacity Development Framework

This document includes:

• Some answers to Frequently Asked Questions
• A diagram of the Process
• A Self-Assessment Excersize
• Some tips for Facilitators

Frequently Asked Questions

What is AIDS Competence?

AIDS Competence means that we as people in families, communities, in organizations and in policy making:
• acknowledge the reality of HIV and AIDS,
• act from strength to build our capacity to respond,
• reduce vulnerability and risks,
• learn and share with others and
• Live out our full potential.

Who is this for?

Any group (whether a nation, district, municipality, organisation or community) that wants to assess their competence in responding to HIV/AIDS: National AIDS council, districts, local neighborhoods, young people, a business, health workers, church leaders…

What are the basic premises of the framework?

• Effective responses are grounded in the strengths of communities and in their collaboration with service providers and policy makers.
• Communities, organizations and people influencing policy can continuously develop human capacity to achieve AIDS Competence.
• We can use our own knowledge and experience, and adapt that of others, so that everyone becomes more competent in dealing with HIV and AIDS.
• Everyone has something to share. Everyone has something to learn.

How is the tool to be used?

    The assessment measures the key practices that lead to AIDS competent nations, communities and organizations. There are 10 key practices each with 5 levels from BASIC to HIGH. Groups are invited to assess themselves using the criteria for each of those practices as a guide. They compare present with past performance and set targets for the future. They can also compare their performance with that of other groups.  The key output is a “river diagram” which gives a quick summary overview of actual and target scores for each group. The range of scores is shown for comparison in the form of a river.

For more detail on a particular practice a “stairs diagram” shows group scores and their desire for improvement, presenting those with something to learn and something to share. As groups progress through the levels, they build their capacity to deal with HIV and AIDS. The stairs diagram can be used between comparative groups such as districts, or organizations; and in addition it can be used by 'partners' working together and transparently, yet from different perspectives in order to match groups that have something to learn or share from each other.

Why would we choose to use is the tool?

• For strategic planning to optimise the use of limited resources
• To assess our degree of AIDS Competence and measure the improvement over time
• To set specific targets for improving practices for AIDS Competence
• To identify what knowledge we have to share, and what we want to learn from others.

The Self-Assessment process

Self-Assessment Excercise

1 (BASIC)
2
3
4
5 (HIGH)
Acknowledgement and Recognition We know that HIV and AIDS exist We know enough about HIV/AIDS in order to respond We publicly recognize that HIV/AIDS is affecting us as a group/ community We regularly discuss AIDS, and have a common program of action to respond Our response to AIDS is part of our daily life. We know our own status and act from strength
Inclusion We know that some of our families are particularly infected and/or affected We understand the necessity to include in our response persons and families that are particularly affected We occasionally include in our response people particularly affected by HIV/AIDS Affected persons are systematically involved in all stages of our response Affected persons and families actively take part in all aspects of society
Linking Care with Prevention We have the basic knowledge for prevention and care We understand the link between care and prevention Some of our actions link care with prevention As a community we systematically link care and prevention activities Care strengthens our relations and helps us change
Access to Treatment We are aware of the existence of ARVs We know where and how to access ARVs ARVs are available for some of us who need them Some of us are using ARVs All those in need of ARV drugs are using them effectively
Identify and Address Vulnerability We understand the concept and are aware of general factors of vulnerability We have identified our own factors of vulnerability to HIV Our response includes some specific actions to address our own vulnerability to HIV We systematically address our own factors of vulnerability Our actions to address vulnerability to HIV strengthens us in addressing other challenges
Learning and Transfer We appreciate the need to learn We adopt good practice from outside We sometimes exchange our view points to draw lessons from our actions We learn, share and apply what we learn regularly, and seek people with relevant experience to help us We continuously learn how we can respond better to HIV/AIDS and share our experiences with others
Measuring Change We recognize the need to measure change We know how to measure change We occasionally measure our own group’s change We measure our change continuously and can demonstrate measurable improvement We invite others to share our experience of change
Adapting our Response

We adapt our response following external interventions

 We recognize that we need to adapt our response to our results, to lessons learned from others and to scientific progress We can provide examples of adaptation of our response We regularly take stock to adapt our response We see implications for the future and adapt to meet them
Ways of Working We are aware that AIDS challenges our ways of working We seek to mobilize our own strengths We work as teams to mobilize our own strengths, assess our progress and resolve problems as we recognize them We find our own solutions and access advice from others We systematically seek to improve our ways of working and share our experience with others
Mobilizing Resources We realize the importance of mobilizing our resources We wait what others avail to us to realize the actions they determine We take some initiatives based on our own resources We identify possible sources of support to complement our own strengths We use our own resources, access other resources to achieve more and have planned for the future

Facilitation tips

For facilitating a self-assessment session for a common entity

1. Involve a good cross section of people (of the nation, city, organization, or community) representing a diverse set of views. 15 to 25 people is a good number to deal with. Members of a regularly constituted group are likely to reach consensus more quickly, though including different people will introduce new perspectives.

2. Allow half a day to a day for this process. Give some thought to the setup of the room. A circle with everyone with an equal voice is to be encouraged. If the group is large consider breaking into smaller groups to allow the quiet ones a voice.

3. Manage the pace of the discussion so they spend approximately equal time on each practice. The first will take the longest time as people get used to the process.

4. It is useful if the group leader sets the context and gives an overview relevant to the group. This may involve explaining all practices and the river diagram. The role of the facilitator is to support them through the process. Encourage an open discussion and encourage different viewpoints.

5. Facilitation skills required for this exercise include good oratory skills, knowledgeable about the self assessment framework, a wide vocabulary (in the local language preferably), flexible, open minded, able to use stories to illustrate a point.

6. One lead facilitator, but real time coaching of that facilitator by others works well. If the group is to split several facilitators will be needed.

7. Explain that the benefit of using a common assessment tool is that it provides a strategic framework for action and a common language to make effective sharing possible. That sharing can only be effective for the practices that are common.

8. At this stage if the group wants to add additional practices, or indeed sub practices let them do so.

9. Emphasize that this process is not a competition between people, but shared learning about issues and approaches, by people who have a shared vision that AIDS competence is possible.

10. The self-assessment approach is different from evaluation by others. It is less threatening, more subjective and more engaging.

11. The discussion of what level the group is at for each practice is a key benefit of the process. Aim for the group to reach a common view, or at least recognize why there are differences.

12. Use a single practice to demonstrate the process, let people appreciate there are steps from one level to another. Walk them up the steps, and then get them to choose the level they are currently at. Encourage discussion about why people in the group chose different levels, giving concrete examples, and how they obtain an agreed level.

13. After working through all practices, get the group to select three practices they wish to improve in the next 12 months. Also get them to share experience and discuss ideas for the steps or actions they will take to do this. (Three will ensure a degree of focus; they can later move on to improve other practices.)

14. For those three practices, get people to plot themselves on the stairs diagram vertically, and then mark how many steps they want to improve horizontally. Get those at level 5 and 4 to offer to share with those who want to learn. Agree a time to share and learn, either immediately or in the future. Even people at level 5 usually have something to learn from the experiences of others.

15. The approach should be very flexible - not only is it possible for people to work with flipcharts or blackboards, indicating levels in written form, but there are other ways - such as groups placing themselves at a position between one and five, which are  pre-assigned spaces within a workshop room, or an open-air space. Make it fun.

16. Recording – Assign someone to record the process and the outcome. Often a lot of good ideas come out of the discussions that are not part of the self-assessment. Record these too. Likewise, if groups wish to record evidence to support their conclusions, encourage them to do so.