Forming Networks of Community-Based Organizations: Early Experiences from the Avahan India AIDS Initiative

"It has long been recognized that vulnerability to HIV infection is not simply an issue of individual behavior but involves complex webs of individuals, communities, and social structures. Can groups and networks also make people less vulnerable to this disease?"

This case study illustrates how community-based organisations (CBOs) formed under the Avahan India AIDS Initiative began to form networks. The networks were created to strengthen the CBOs' ability to work for HIV prevention and wider social empowerment by representing their interests to government and other authorities at district and state levels. The case study describes: (i) the initial process of consultation and capacity building that helped the networks develop, (ii) the inputs made by programme partners, (iii) early challenges faced, and (iv) possibilities for the networks' future.

As noted here, since 2003, communities from 6 states in India have participated in Avahan, funded by the Bill & Melinda Gates Foundation. Community mobilisation has been central to Avahan's strategy of encouraging up to 320,000 community members to work for HIV prevention and undertake other harm reduction activities on a sustained basis. The context for this work is the fact that, in India, those most at risk of HIV infection are among the most marginalised social groups - female sex workers (FSWs), high-risk men who have sex with men (HR-MSM), transgender people (TGs), and injecting drug users (IDUs) - with little control over many of the factors that make them vulnerable to HIV (e.g., being denied access to healthcare because of their sex, case, or sexual orientation).

From early on, the Avahan programme encouraged and facilitated the development of informal groups of community members as part of its HIV prevention strategy. Groups often gathered at sites set up by Avahan partners for the delivery of services. Over time, attendees at these service sites and peer educators (PEs) began to organise more formally to address structural issues such as violence and access to government health services and other social services. As community mobilisation gained momentum and leaders emerged, some informal groups matured into legally registered community-based organisations (CBOs). The CBOs engaged members in promoting HIV prevention and other issues of concern, including reducing social stigma and discrimination, and education for members' children.

This case study is based on a qualitative review of the early stages of CBO network formation in the Avahan programme to identify elements that strengthened the effectiveness of the networks. Interviews were conducted in early 2011 in two of the states where the Avahan programme operates, Andhra Pradesh and Maharashtra, with several groups of subjects. What emerged is this description of the processes, programme inputs, and capacity development that strengthened CBOs and began to create networks. It reflects the initial thinking and direction of those involved, as well as some of the early lessons learned and challenges that arose. The experiences of community mobilisation networks in other countries are also briefly considered.

Concrete suggestions for CBOs engaging in communication for advocacy in the HIV prevention context are presented. For example:

• "Even taking into account cultural differences, short, concise, action-oriented messages are often the best way to gain the initial attention of busy decisionmakers with necessarily limited attention spans.
• If a person needs more information than is given in the basic message, they (or their staff) will usually ask for it. At that point, the overall message can be expanded."

One section of the document presents lessons from other CBO networks to provide a context for comparison with Avahan's experiences and point to ways in which networks may help to further HIV prevention."

Broader communication strategies outlined for CBOs include:

• Serving members (e.g., by helping members feel that they are part of a movement with district, state, or national reach)
• Sharing experiences (e.g., through write-ups in network newsletters or reports, exchanges between CBOs, or informally during conversations at meetings)
• Linking with other organisations ("While forming alliances between networks is common, clarity about the purpose, organization, and processes is needed so that each partner understands its role and responsibilities.")
• Expanding influence ("Influence through advocacy comes from being well organised and well prepared. A common weakness in networks is the absence of a solid analytical base to support the issues they address; another is not knowing how best to reach decisionmakers with key points and action items.")

An excerpt from the report follows:
"The mobilization of community members to practice safe sex and seek medical services led to the formation of CBOs whose mandate extends further to address inequity and make community engagement sustainable. Their work in promoting HIV prevention and addressing structural factors that contribute to HIV risk was an important achievement in itself. Given the interest of the CBOs in improving the lives of their members, district federations and state-level networks were seen as the logical means to expand opportunities for addressing CBOs' concerns at structural levels (i.e., to work for institutional and policy change).

The remit of CBO networks may also extend beyond HIV prevention: for example, in Andhra Pradesh, CBO members involved in structuring the new networks expressed a desire to become involved in the planning of non-health-related social and economic programs. A member of the working group in Maharashtra expressed a related sentiment: 'We are the network, we make it work, and it will assist us as we work on local issues.'

The initial experience of network formation within the Avahan program suggests that several foundational elements are required:

• Enthusiasm and commitment among CBO members in support of the networks
• Implementing partners with creative ideas, sound technical skills, and a willingness to broker important political relationships on behalf of communities, if necessary
• Innovation and flexibility that permit ideas to be tested and adapted to suit the circumstances of each state network
• Skills in analysis, communication, and problem solving, as well as capacity building in organizational management
• Agreement on the mission among the members of a network to ensure that differences do not divide constituencies within it

...Networks of CBOs emerging within the Avahan program context may collaborate with other organizations and networks on specific issues or work to build a wider constituency for their own issues."

Editor's note, September 28 2017: Our apologies, but this document is no longer available online.