Prepared by the India HIV/AIDS Alliance (hereafter, Alliance India), this 40-page report provides an assessment of the capacity, impact, and sustainability of support groups of women and children in 3 Indian states: Tamil Nadu, Andhra Pradesh, and Delhi. In evaluating this strategy for addressing HIV/AIDS among vulnerable populations through community-centred communication, Alliance India hopes to advance a participatory methodology for enabling support groups and external stakeholders to monitor and evaluate support group capacity development.

The evaluation focuses on Alliance India's Home and Community-Based Care Alliance and Support Programme (supported by the Abbott Fund) and the programme on Community-Driven Approaches to Address the Feminisation of HIV/AIDS (supported by Department for International Development (DFID) India Challenge Fund) - both of which reflect the Alliance's commitment to ensuring that communities are at the centre of any HIV/AIDS response. A key activity has been the formation and capacity building of community-driven and -led support groups as a mechanism for providing psychosocial and emotional support for those affected by and/or living with HIV/AIDS. As explained here, the idea is that members provide each other with various types of non-professional, non-material help: sharing relevant information, relating personal experiences, listening to others' experiences, offering sympathetic understanding, and/or establishing social networks. A support group may also provide ancillary support, such as serving as a voice for the public or engaging in advocacy.

Specifically, Alliance India and its lead partners (hereafter, LPs) and implementing NGO partners (hereafter, iNGOs) have been carrying out regular one-on-one and group community interactive sessions on HIV/AIDS, reproductive tract infections and sexually transmitted infections, anti-retroviral therapy, prevention of mother-to-child transmission, menstrual hygiene, contraception and pregnancy, gender, laws and policies, rights and entitlements, and government welfare schemes. Condom demonstrations were carried out in each group meeting. The iNGOs and the LPs regularly gathered community members together for capacity-building sessions on these topics. Information, education, and communication (IEC) material distribution for behaviour change communication (BCC) was another core component of this effort to actively engage community members - low-income women and children, in particular - in addressing the problem of HIV/AIDS in India.

The evaluation was carried out as a participatory exercise. The underlying principle for this methodology emphasised the use of evaluation as an "empowering" process - as a learning tool - and not as a means of simply extracting information. To that end, participatory tools were designed such that all players could contribute to the process of understanding of their achievements, strengths, weaknesses, and capacity-building needs. Namely, 22 support groups were selected to participate in the evaluation. Ten of them were children's groups, including 6 groups of those deemed "at risk", and 4 groups whose members included children affected by HIV/AIDS (CAA)/children living with HIV/AIDS (CIA). Among the 12 women's groups were 6 groups whose members are women living with HIV/AIDS (WLHA) and 6 groups defined as "vulnerable women's groups", selected based on the members' occupation or the occupation of the spouses, e.g., sex workers, wives of migrant spouses, women working in industries, women working as road construction workers, and women who work as side artists in the film industry). These groups took part in semi-structured focus group discussions (FGDs); this methodology was used to enable changes to be incorporated as and when required by the groups. The FGDs explored questions such as: How and why was the group formed, and what helped in the formation? What makes one want to be a member? Which strategies are have members found helpful in maintaining or strengthening their group?

An excerpt from the Executive Summary follows:

"Findings indicate that support group formation is a robust and time-tested strategy to involve the community in bringing about awareness and knowledge transfer. Support group formation can be seen to be an empowerment process of the individuals and the community within which they live as well as interact with. Lessons learnt can be summarised as follows:

• People not directly affected by HIV/AIDS can also take an active interest and help in promoting awareness, without necessarily getting or aspiring for material rewards.
• Support groups formed for different profiles of people help to address their individual needs, while also aiding the larger cause and impact sought by the project.
• Support groups find strength and confidence in the information that they get in these group meetings.
• Support groups cannot be promoted and advocated to function only for a project period. This will hamper the sustainability of the group.
• Smaller groups of 10-15 seem to function more cohesively. A larger group does not ensure participation and involvement of each member.
• Vulnerable groups use the information and knowledge they get as a source of power to increase one's status in community, to be heard, to bring about awareness, and also to promote prevention. They work towards acceptance and mainstreaming of positive people, giving them support and understanding. They take on the role of being socially responsible people.
• WLHA use the knowledge to empower oneself, to face oneself and know that this is not the end of the road for them. It gives them the confidence to face and challenge the stigma and discrimination that they face, and is a boost to their survival instinct. They work towards their own acceptance into the society and community.
• Programme approaches differ for these two groups. WLHA give more importance to meeting and sharing and interacting with group members. The group plays the role of family for them. For the at-risk groups it is a means to make friends, socialise and create an identity for themselves within their homes and community.

Dos and don'ts for establishing Support Groups:

• The existing presence of an iNGO in the community aids in group formations.
• Intensive interaction and participation of iNGO staff with the group members and the community is very important for establishing a functional group.
• People/persons with similar profiles should be part of one group.
• Fun times interspersed with training and information sessions helps ensure participation.
• Issues that concern the members and can make a visible change in their lives immediately should be addressed first.
• Simultaneous awareness creation of the larger community is important to ensure that they support the group formation and participation by its members.
• It is important to tell the beneficiaries that even if the project period is small, all the activities are oriented towards making them self-reliant and making the group sustainable.
• Members should be made to realise and recognise their abilities and limitations.
• The income generation activities should not be given clear preference over other
  activities.
• Do not treat PLHAs as special. This only helps in increasing stigma and discrimination.
• Do not plan activities and group functioning as per project period only.
• Do not take up any activities that compromise on the confidentiality of the members.

The following are the broad areas of the capacity building of groups:

• Leadership skills, confidence building and self-reliance
• Team building, team spirit and group solidarity
• Networking and communication skills
• Resource mobilisation
• The value of a rights-based approach in community-led interventions
• Aspects of self-reliance and self-help as opposed to dependence on iNGO guidance and presence.

Irrespective of the type of group, issues of sustainability and phasing out of the iNGO presence needs to be addressed. Some members were of the opinion that once the project period ended, the group would also stop functioning. Not because they feel that they cannot run the group themselves, they are simply unaware that the group can function without the presence of the iNGO. Participatory exercises will have to be conducted for groups to be able to comprehend their importance, the change it has brought into their lives and also the very fact that they themselves have been integral and instrumental in carrying out most of the activities..."