Author: 
Jill Gay
Melanie Croce-Galis
Karen Hardee
Amelia Peltz
Publication Date
December 1, 2017
Affiliation: 

What Works Association (Gay, Croce-Galis); Population Council (Hardee); United States Agency for International Development, or USAID (Peltz)

"Interviews with [36] key individuals and a review of 55 national policies and programming documents have found that What Works has had a substantial impact in promoting the use of evidence to effect positive change in HIV interventions for women and girls across donors and in a number of countries."

This paper reviews the evidence for how the What Works for Women and Girls: Evidence for HIV/AIDS Interventions (hereafter What Works) knowledge translation platform has made a difference in the global AIDS response. With an aim to increase use of evidence in policies and programmes to reach women and girls, the paper asks: What difference has What Works made? Has evidence from it informed the policies and programmes of donors? Has it informed national policies and plans? Has it contributed to the information used by civil society organisations (CSOs)? Has access to the What Works website been sufficient, or were other activities needed to enhance the use of the evidence from the website? This paper documents how the key components of the platform resulted in demonstrable change in HIV programming for women and girls, with the hope that lessons learned from this effort may assist others who are working to create cultures of evidence.

The paper examines the development of the What Works platform, more information about which may be found at Related Summaries, below. In brief, it can be described as a publically accessible, web-based one stop shop that is owned and maintained by the What Works Association and that features a range of evidence on HIV/AIDS interventions for women and girls. (Its reference section includes more than 6,000 citations as of this writing.) Its expert-reviewed evidence is designed to be useful for policymakers, programmers, advocates, and researchers. Because the focus is on gender-responsive programming, it does not ignore men and boys. What Works puts the science in programmatic context and programmatic language and presents the evidence for interventions, rather than promoting favoured interventions. Inclusion criteria reflect programming and geographic spread of the evidence. The evidence covers all aspects of programming (prevention, care, and treatment, in addition to the enabling environment and health systems). Finally, the utility of the website and evidence is augmented with training and technical assistance. Trained consultants use the resource in multiple countries.

The What Works team employed a multitude of strategies to promote the knowledge platform to inform evidence-based, gender-responsive programming and policymaking, including: electronic and physical dissemination; meetings with individuals; group presentations; conference posters, presentations, and trainings; publishing of peer-reviewed papers, tying the platform to complementary organisations' efforts; and providing direct in-country training and technical assistance. Each of these is briefly discussed in the paper. These dissemination and outreach efforts "have all aimed to enhance a culture of evidence use through several of the components noted by Hardee and Wright (2015). In addition to making research directly available through the knowledge platform itself, outreach efforts strengthened the capacity of those seeking to use evidence in their work, used intermediaries between researchers and decision-makers, and created better packaging and communication of findings."

The evaluation of What Works found that the knowledge platform has been used in Gender Assessment (GAs) in 16 countries, in National Strategic Plans (NSPs), in 7 countries, and Global Fund for AIDS, TB and Malaria (GFATM) Concept Notes (CNs) in 11 countries. Specifically, it served as a key resource for donor and aid organisations, including the GFATM, the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the President's Emergency Plan for AIDS Relief (PEPFAR). For example, in providing support to countries and civil society, the GFATM gender team has referred people to the What Works website as a useful resource in building evidence-based cases for women and girls in Concept Notes (CN). In fact, interviews and reviews of plan documents found that evidence from the What Works platform was found in NSPs and/or CNs for 14 countries that were developed between 2013 and 2016. The evaluation attributes this effect in large part to the in-country technical assistance that What Works team members provided to country groups. Five of the countries are highlighted in the paper as examples of how What Works prompted greater attention to and inclusion of evidence-informed HIV interventions for women and girls.

CSOs have also used the website to advocate for attention to gender issues in the HIV response, or to use as a basis for their work plans or funding proposals. Examples from three CSOs (Silver Rose, KELIN, and UGANET) are given here. "[H]aving the evidence base allowed CSOs to advocate for evidence-based programming and donors to request revised plans that adequately addressed gender and human rights."

In reflecting on the evaluation, the authors point out that users of this resource have noted the utility of having a range of up-to-date and vetted evidence in one place that is easily accessed on the web. They have also noted that the evidence is packaged in a way that speaks to programmes - that research is made accessible to a range of stakeholders for their purposes. However, no one resource or tool can be solely responsible for changing policies and programmes. Furthermore, there are limitations to this type of resource. The main challenge is that the platform loses its timeliness if it isn't kept up to date, which is a labour-intensive activity. In addition, one of the main benefits of the platform - that it is not attached to one donor - is also a drawback in that it has been difficult to attract donors beyond piecemeal updates.

Noting that access to and use of the evidence is an important first step, the authors stress that, particularly in HIV, there are many gender-related issues that still do not have a solid evidence base on which to programme (see gaps in each section of the What Works website). In addition, the experience with What Works illustrates the challenges of getting evidence into policies and programmes at global and national levels. While access to evidence is necessary, it is not sufficient to transform the epidemic. "The next step globally is to assess how and if evidence-informed gender transformative policies and programs have been effectively implemented, and if so, what difference has this made in the HIV epidemic?"

Source: 

Posting from the Evidence Project to the IBP Consortium Knowledge Gateway, December 1 2017; and Evidence Project website, December 4 2017.