ArticleBMC health services research2015
Management practices to support donor transition: lessons from Avahan, the India AIDS Initiative.
Article in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed.
- Article
- The impact of shifts in PEPFAR funding policy on HIV services in Eastern Uganda (2015-21).Health policy and planning · 2024Article
- Drivers of retention of the HIV workforce transitioned from PEPFAR support to the Uganda government payroll.Human resources for health · 2023Article
- From External to Local: Opportunities and Lessons Learned from Transitioning COMSA-Mozambique.The American journal of tropical medicine and hygiene · 2023Article
- Geographic prioritisation in Kenya and Uganda: a power analysis of donor transition.BMJ global health · 2023Article
- Designing for Impact and Institutionalization: Applying Systems Thinking to Sustainable Postpartum Family Planning Approaches for First-Time Mothers in Bangladesh.Global health, science and practice · 2022Article
- The impacts of donor transitions on health systems in middle-income countries: a scoping review.Health policy and planning · 2022Article
- Working toward sustainability: Transitioning HIV programs from a USA-based organization to a local partner in Zimbabwe.PloS one · 2022Article
- Transitioning health workers from PEPFAR contracts to the Uganda government payroll.Health policy and planning · 2021Article
- The effects of polio eradication efforts on health systems: a cross-country analysis using the Develop-Distort Dilemma.Health policy and planning · 2021Article
- Effects of transition on HIV and non-HIV services and health systems in Kenya: a mixed methods evaluation of donor transition.BMC health services research · 2021Article
- The impact of loss of PEPFAR support on HIV services at health facilities in low-burden districts in Uganda.BMC health services research · 2021Article
- Middle-income countries graduating from health aid: Transforming daunting challenges into smooth transitions.PLoS medicine · 2019Article
- Feasibility, acceptability and potential sustainability of a 'diagonal' approach to health services for female sex workers in Mozambique.BMC health services research · 2018Article
- The Avahan Transition: Effects of Transition Readiness on Program Institutionalization and Sustained Outcomes.PloS one · 2016Article
- Monitoring and Evaluating the Transition of Large-Scale Programs in Global Health.Global health, science and practice · 2015Article
- Article
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7 authors.
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Abstract
backgroundDuring 2009-2012, Avahan, a large donor funded HIV/AIDS prevention program in India was transferred from donor support and operation to government. This transition of approximately 200 targeted interventions (TIs), occurred in three tranches in 2009, 2011 and 2012. This paper reports on the management practices pursued in support of a smooth transition of the program, and addresses the extent to which standard change management practices were employed, and were useful in supporting transition.
resultsWe conducted structured surveys of a sample of 80 TIs from the 2011 and 2012 rounds of transition. One survey was administered directly before transition and the second survey 12 month after transition. These surveys assessed readiness for transition and practices post-transition. We also conducted 15 case studies of transitioning TIs from all three rounds, and re-visited 4 of these 1-3 years later.
resultsConsiderable evolution in the nature of relationships between key actors was observed between transition rounds, moving from considerable mistrust and lack of collaboration in 2009 toward a shared vision of transition and mutually respectful relationships between Avahan and government in later transition rounds. Management practices also evolved with the gradual development of clear implementation plans, establishment of the post of "transition manager" at state and national levels, identified budgets to support transition, and a common minimum programme for transition. Staff engagement was important, and was carried out relatively effectively in later rounds. While the change management literature suggests short-term wins are important, this did not appear to be the case for Avahan, instead a difficult first round of transition seemed to signal the seriousness of intentions regarding transition.
conclusionsIn the Avahan case a number of management practices supported a smooth transition these included: an extended and sequenced time frame for transition; co-ownership and planning of transition by both donor and government; detailed transition planning and close attention to program alignment, capacity development and communication; engagement of staff in the transition process; engagement of multiple stakeholders post transition to promote program accountability and provide financial support; signaling by actors in charge of transition that they were committed to specified time frames.
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