Costing community mobilisation within the Investment Framework
With technical and financial support from UNAIDS, the Alliance engaged in a pilot study across three countries, Cambodia, Zambia, and Kenya, to generate more information about the costs of community mobilisation within national responses to HIV.
The study looked at different types of interventions defined by the six programme activities described in the Investment Framework. The study looked at pricing (unit costs per person reached + sample activity costs) of community mobilisation for focused prevention activities in Cambodia, for prevention to mother to child transmission (PMTCT) in Zambia and for Behaviour Change Communication in Kenya.
Some of the top-line results of the study included:
- The development of a comparatively low cost methodology for costing community mobilisation that civil society organizations and planners will be able to test and apply in other settings
- The development of a structure for pricing community mobilisation as it relates to three types of HIV programme activities. The study covered 3 of the 6 basic programme activities described in the Investment Framework.
While costs are not meant to be comparable across countries or types of programme, generally the programme activities that required the highest number of community mobilisation activities and were the most expensive were those for focused prevention with key populations. This is compared to the relatively low cost of community mobilisation for PMTCT. This difference in cost is not meant to imply that one type of community mobilisation effort is more or less effective than another. Rather, the results demonstrate that more community mobilisation effort is required to prevent HIV among key populations than improve referral rates for PMTCT services, information consistent with the Alliance’s experience of community mobilisation.
Lessons learnt and recommendations
This is an important first step, and the tool is sufficiently flexible to allow for costs associated with community mobilisation to be captured, that extend beyond a standard package of activities. However, the study has only scratched the surface, and significant gaps and questions remain. It should be considered as one contribution towards the longer term goal of getting broad agreement around the definitions and the costs of community mobilisation.
This study demonstrated that the community contribute at least 10% to the cost of a programme. This study looked at community costs primarily in terms of the earning potential of community volunteers, but more research into a broader range of costs borne by communities in the context of community mobilisation is needed. Remaining challenges for civil society include the non-alignment of finance and monitoring data and the need to standardise costs to the community.