End-term review HIV Law SIDA Project (Africa)

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Title End-term review HIV Law SIDA Project (Africa)
Atlas Project Number: 00063928
Evaluation Plan: 2018-2021, Bureau for Policy and Programme Support
Evaluation Type: Final Project
Status: Completed
Completion Date: 12/2019
Planned End Date: 12/2019
Management Response: No
Focus Area:
  • 1. Others
Corporate Outcome and Output (UNDP Strategic Plan 2018-2021)
  • 1. Output 1.2.1 Capacities at national and sub-national levels strengthened to promote inclusive local economic development and deliver basic services including HIV and related services
SDG Goal
  • Goal 1. End poverty in all its forms everywhere
  • Goal 10. Reduce inequality within and among countries
  • Goal 12. Ensure sustainable consumption and production patterns
  • Goal 16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels
  • Goal 3. Ensure healthy lives and promote well-being for all at all ages
  • Goal 7. Ensure access to affordable, reliable, sustainable and modern energy for all
  • Goal 9. Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation
SDG Target
  • 1.2 By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions
  • 10.2 By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
  • 10.3 Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard
  • 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
  • 16.b Promote and enforce non-discriminatory laws and policies for sustainable development
  • 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
  • 3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
  • 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
  • 3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
  • 3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
  • 9.4 By 2030, upgrade infrastructure and retrofit industries to make them sustainable, with increased resource-use efficiency and greater adoption of clean and environmentally sound technologies and industrial processes, with all countries taking action in accordance with their respective capabilities
Evaluation Budget(US $): 80,000
Source of Funding: SIDA
Evaluation Expenditure(US $): 53,594
Joint Programme: No
Joint Evaluation: No
Evaluation Team members:
Name Title Nationality
Sofia Gruskin and Laura Ferguson Lead Evaluator
GEF Evaluation: No
Key Stakeholders: Government, CSOs and UN partners
Countries: GLOBAL

III. Findings

There are six sub-sections within this findings section. Section (A) describes key elements of project design that affected implementation; Section (B) focuses on institutional roles and relationships; Section (C) presents key successes and challenges in project implementation; Section (D) explores implementation of different components of the project in more detail; Section (E) discusses the utility of EOPE findings in relation to the project’s results framework and indicators; and Section (F) analyses funding for this work, including how countries leveraged additional funding from other sources to move forward the work. General themes are expounded in each sub-section with illustrative country and regional level examples provided.

Tag: Relevance Multi Donor Trust Funds Human rights HIV / AIDS Reproductive Health Programme/Project Design Education Capacity Building


B. Institutional Roles and Relationships

The primary stakeholders for Phase II of this work are the same as those for Phase I. This section explores the roles of the primary project stakeholders engaged in the project. Specific information regarding each of the key stakeholders involved is presented in turn, starting with Sweden as the funder at the most macro level.

Sida Sida is the funder for this work. Through regular contact with the UNDP Regional Service Centre (RSC), Sweden has kept abreast of progress and remained committed to the project. Once the scope of the project had been agreed with UNDP, Sida took a relatively hands-off approach to this work to allow countries to set their own priorities and identify the most appropriate processes for working towards these. Furthermore, they were amenable to the geographical scope of the project changing in response to other funds becoming available and additional requests for participation in activities.  

UNDP The UNDP RSC has also consciously created space for countries to determine their own objectives, workplans and activities. They have managed the project funding, responded to requests from countries and provided reports to Sweden as required. The RSC provided technical support and advice to regional level activities and to country offices when required. For example, in some instances, when new countries entered into this project, the RSC talked to them about the recommendations made by the Global Commission on HIV and the Law to see how these might be used to good effect at the national level. They also provided information on human rights to help country offices support operationalization of human rights in national HIV responses. The UNDP RSC also provided international consultants to work hand in hand with local consultants throughout relevant project processes such as LEAs and national action planning; these international consultants brought a wealth of technical expertise as well as a sensitivity to close collaboration with and building the capacity of the local consultants. The UNDP RSC has also played an important role in providing technical and political support to regional processes, including, for example, giving a ‘solidarity speech’ at the SADC Parliamentary Forum at the final endorsement of the Model Child Marriage Prevention Act. UNDP has become a widely recognized and highly respected authority on HIV, law and human rights in the region so public appearances and demonstrations of support such as this can be very meaningful. At the national level, UNDP focal points were the contact points and coordinators for this work. Their primary roles included convening, coordinating and providing technical support to the government and civil society partners for project activities, with the ultimate aim of strengthening human rights, laws and policies for HIV and SRHR. The often-longstanding relationships that UNDP Country Offices have with keys parts of government including Ministries of Health and Justice, national AIDS councils and local government bodies have been important for securing and sustaining multi-sectoral participation in this project. In addition, UNDP is recognized for its ability to bring together and bridge government and civil society actors to work together, which is also seen to be key in this project. In many places, UNDP focal points also assumed responsibility for resource mobilization where additional funds were needed to advance the work (e.g. Burkina Faso, Cameroon, Namibia).

Regional Economic Communities (RECs) The RECs in the African region have continued to be involved in this project. During Phase II, the project provided strategic policy support to the East African Community (EAC) and the Southern African Development Community (SADC) and its Parliamentary Forum (SADC-PF), as well as the African Union Commission. The RECs have, to differing degrees, continued to push for progressive regional frameworks to help countries improve national legislative environments for HIV and SRHR.

Tag: Civic Engagement Health Sector HIV / AIDS Reproductive Health Donor relations Ownership Partnership Country Government South-South Cooperation


C. Project Implementation

Before exploring the detail of implementation of different components of this work, it seems useful to extract some of the overarching lessons from this evaluation. Key successes and challenges are presented in this sub-section.

Key successes

Stakeholders who were interviewed for this evaluation were all asked what they thought were the biggest successes of the work. Although these perspectives do not cover all project countries, a few themes emerged that seem useful to note. No respondents said that legal change (even where it had occurred) was the greatest success of the project. Most pointed to factors associated with the processes of how this work has been approached as critical facilitators not only to achieving project goals but to revolutionizing how work around HIV, human rights and the law is carried out locally. Some people highlighted the fact that key populations are now part of the conversation and national HIV responses, and active contributors to this response, as a primary project success. Although SRHR was not mentioned in the same way, in many places it is the same multi-stakeholder working groups working on SRHR as HIV suggesting that, even if maybe not yet as embedded or recognised, the ways of working on SRHR nationally may also be changing. People spoke about the satisfaction of finding the appropriate way to work in a challenging environment, focusing on the importance of bringing together the range of stakeholders involved in this project: “Human rights is difficult but we’ve found the appropriate way to do it here, with the right mix of people – government, civil society, key populations – so we could all work together”. A UNDP focal point noted that previously all partners worked in silos but now there is a technical team involving everyone, which could be a platform for work in other sectors and on other issues. He spoke of “mobilizing partners around the key issue – bringing all hands on deck, bringing to life collective intelligence in moving towards what we are achieving now”. Many described how having everyone involved throughout the process as critical for ownership.

Opening up safe spaces for government and civil society to interact and mobilizing communities to be visible in these spaces was another frequently mentioned success. The increase in trust between stakeholders engendered through these spaces has led to increased collaboration between communities, police, Ministries of Health and national human rights commissions, and access to justice is seen to have improved because communities can now report violations to the police or human rights commission. These  benefits have much broader reach than the project objectives, and they extend beyond HIV and SRHR. The breadth of activities involved in this project increased its acceptability to the wide range of stakeholders who are involved. Recommendations that emerged from the LEAs were not exclusively in the domain of legal and policy reform, but also encompassed capacity building and building collaborations at national and regional levels. This allowed all stakeholders to find a piece of the work that they were comfortable with. In addition, there were obvious benefits to adopting multi-pronged approaches to trying to effect change: multiple avenues could be simultaneously followed, all to an agreed-upon similar end.

Tag: Global Fund Human rights Justice system HIV / AIDS Reproductive Health Human and Financial resources Ownership Programme Synergy Project and Programme management Country Government


C. Project Implementation (Continuation)


Capacity to address HIV, human rights, law and issues relating to key populations can be limited among government and civil society stakeholders alike. In some places, governments have never had to understand or address issues relating to key populations so understandably they need support to do this. Civil society representatives, including key populations, may never before have engaged in dialogue with government or legal advocacy work; this too requires capacity building. Government representatives outside the fields of HIV and SRHR may have no prior training in these areas nor how law and human rights might apply, meaning that they too require substantial capacity building to effectively engage in this work. None of this can be achieved through a single training; the capacity building required for duty bearers and rights holders alike is a long-term process that requires substantial and sustained investment, training and support. National ownership of the work under this project – including both government and civil society – is critical to success and supporting ongoing efforts to ensure sufficient capacity to understand and lead the work is a precursor for any of this to work.

Tag: Effectiveness Sustainability Global Fund Resource mobilization Civic Engagement Human rights Justice system HIV / AIDS Reproductive Health Ownership Country Government UN Agencies Capacity Building


D. Project Implementation Processes

As has been mentioned, there is substantial flexibility in this project, which means that different activities have been carried out in different countries. A few of the main project components are highlighted within this sub-section but not all have been implemented in every country. Furthermore, the order in which activities are carried out can also vary e.g. where both an LEA and an engagement scan have been carried out the order of these is not always the same. In most countries, the LEA has been a core component of this work. This is usually followed by a multi-stakeholder validation and/or planning meeting, which leads to the implementation of follow-on activities including advocacy and capacity building, often with a view to informing changes in laws, policies, strategies or practices. An engagement scan may be carried out somewhere in this process to help identify strategic opportunities for trying to effect change. On top of this, regional-level activities complement work at the country level. Each of these components is further explored below, and a final sub-section examines how different countries have leveraged additional funding to expand the scope or promote the sustainability of this work.

1. Engagement Scans

Engagement scans were introduced into the project in Phase II as a way of identifying opportunities for action around HIV, the law and human rights in a specific country. A guidance document to conduct national engagement scans was drafted, tested and finalised in 2016.

Engagement scan purpose and process

Engagement scans are intended to be complementary to the LEAs. Building on the information on the legal and policy environment that the LEA provides, the engagement scans help stakeholders working on HIV and SRHR to plan for and strategically engage and advocate for legal and policy reform. It includes a calendar of specific key opportunities for effecting legal and policy change. The engagement scan maps out the structure and roles of the main branches of the government and outlines relevant processes for engagement with each branch of government e.g. the executive branch is responsible for policy promulgation/reform, and CSOs can engage in these processes through various entry points such as writing a letter to the relevant Minister. The same information is provided for international and regional processes such as the Universal Periodic Review, Treaty Monitoring Bodies and the African Commission. Where an LEA has already been completed, its recommendations are grouped and potential actions identified as ways to help effect change. While the initial work was always done by an international consultant, a local consultant also contributed additional information, and a national consultation and validation meeting were always held to fill in data gaps and help engender ownership of the final document. This appears to be a longer process than originally envisioned but the aim has been to create a sense of ownership of the process and product without it taking as long as the LEA. Challenges around ensuring ownership of the engagement scan remain, with particular relevance to ensuring that the calendar of opportunities for influencing laws and policies remains updated.

Tag: Gender Mainstreaming Civic Engagement Human rights Public administration reform Rule of law HIV / AIDS Reproductive Health Ownership


D. Project Implementation Processes (Continuation)

2. Legal Environment Assessments (LEAs)

A number of LEAs were completed during Phase I of this project and more were completed during Phase II. This sub-section covers the latter. Any follow-up to the LEAs is covered in sub-section 3 below.

The LEA purpose and process

As noted in the MTE report: “The Legal Environment Assessment (LEA) process has been a cornerstone of most countries’ involvement with the project. As described by UNDP’s Practical Manual for conducting an LEA: ‘An LEA is an assessment of a country’s national legal and policy framework. In the human rights context, an LEA can aim to identify and examine all important legal and human rights issues affecting all people in a country. In the context of HIV, it is an important step in understanding how the legislative environment can play a role in influencing HIV prevention, treatment and impact mitigation efforts. LEAs can be critical to strengthening a country’s response to HIV.’” For Phase II, this has explicitly also included attention to SRHR alongside HIV, which has expanded the scope of the LEAs.

Tag: Effectiveness Human rights Justice system Rule of law Health Sector HIV / AIDS Reproductive Health Education


D. Project Implementation Processes (Continuation)

3. Implementation of LEA recommendations

At the time of the mid-term evaluation, given the limited time for which the project had been implemented, it was difficult to say very much about follow-up to the LEAs and multisectoral action planning. At this stage, there is much more evidence of action that has arisen from these processes and the tangible impact across a range of countries. This sub-section explores some of the activities and impacts arising from the LEAs. First, there is some documentation of the multi-stakeholder action planning processes that took place in different countries and some overarching lessons that can be drawn from these experiences. Then, documented changes in laws and policies are explored followed by changes in national policies, strategies and plans. Finally, some of the ongoing advocacy for change in the national legislative environment are highlighted to show the ongoing commitment to this work.

Tag: Civic Engagement Human rights Justice system Parliament Rule of law Health Sector HIV / AIDS Reproductive Health Communication Policies & Procedures


D. Project Implementation Processes (Continuation)

4. Capacity Building of Key Stakeholders

One of the primary activities to have emerged in Phase II has been capacity building of a wide range of relevant stakeholders. This includes capacity building of duty bearers to understand  their HIV-related human rights obligations and, albeit to a lesser extent, of civil society actors to help them advocate for their rights. In some countries this has now been sustained over multiple years while in other places it appears to be more ad hoc. An overview of the sorts of capacity building efforts undertaken with different types of stakeholders under this project is provided below.

Government officials The approach to training of government officials, including parliamentarians, law-makers, policy-makers and other government officials, has varied by country, tailored to national priorities and entry points for action. In many countries, capacity building efforts were focused around supporting the passage of a revised law or policy. For example, in Chad capacity building of parliamentarians on HIV and human rights was carried out at an opportune time, which may have helped facilitate adoption of the Revised HIV Act. In many countries, capacity building efforts were focused around supporting the passage of a revised law or policy. For example, in Chad capacity building of parliamentarians on HIV and human rights was carried out at an opportune time, which may have helped facilitate adoption of the Revised HIV Act. In other places (e.g. eSwatini, Cameroon), capacity building was designed to decrease stigma and discrimination, and improve access to services for key populations either through improved strategies or direct service delivery more generally. These trainings covered a range of duty bearers including parliamentarians, magistrates/judges, ministry of health officials and health service providers. In eSwatini, UNDP collaborated with the Swaziland Business Coalition on HIV/AIDS and the ‘Public Sector HIV/AIDS Coordinating Committee’ to conduct a baseline assessment on sexual harassment in the workplace with the aim of understanding the extent of the problem as well as how it impacts the national HIV response. Capacity building on workplace sexual harassment and the importance of data to inform a national policy was carried out with senior public sector officers, including HIV coordinators, and UNDP supported the establishment of a website for reporting workplace sexual harassment to enable real time data collection and policy reform in an effort towards helping reduce new HIV infections.

Tag: Effectiveness Sustainability Civic Engagement Human rights Justice system Health Sector HIV / AIDS Reproductive Health Country Government Capacity Building


D. Project Implementation Processes (Continuation)

5. Regional Level Activities/Cross-country Learning

Regional Economic Communities and African Union

Most work has been carried out directly with the Regional Economic Communities (RECs). UNDP has worked with the EAC and SADC throughout this project on the development of regional strategies for HIV and SRHR. Similar to the LEA process, this strategy development has been very participatory with active involvement of the REC Secretariats, national governments, key population groups and development partners. The longstanding nature of these collaborations appears to facilitate these bodies’ ability to collaborate and constructively move forward relevant regional frameworks. During Phase I, the project supported a SADC position paper on child marriage, which has since been used by the SADC Parliamentary Forum as the basis for drafting a Model Law on Eradicating Child Marriage. The Model Law has already been used by some countries in the region, either to review/reform existing laws (e.g. in Zimbabwe where the marriage law was overturned to ensure a minimum legal age of marriage of 18) or to inform other in-country work such as discussions with local and traditional leaders around child marriage. This has fed into work at the level of the African Union, which was also supported by UNDP, to strengthen their framework around child marriage. All project LEAs now also include reference to child marriage, which can also open discussions around the issue at the national level. 

Tag: Gender Equality Human rights Justice system Rule of law Health Sector HIV / AIDS Pandemic Reproductive Health UN Agencies Education Capacity Building South-South Cooperation


E. Project Monitoring and Evaluation

A tension always exists in project monitoring between seeking sufficient information to truly understand project activities and impact, and not overburdening project staff with reporting requirements. None of the key informants reported feeling overburdened by the monitoring requirements of the project, and there is substantial information available to help understand project activities and impact. The results framework for this project comprises very few, quantitative indicators. The indicators are, in many way, key markers that work is being carried out, and most of them have been exceeded over the project period, which is of course a positive sign. However, some of the indicators could be improved as they are slightly vague: it is, for example, unclear what constitutes “Number of Countries engaged in LEA follow-up for relevant law, policy and/or strategy reform, or capacity strengthening of key stakeholders to strengthen the legal and policy environment for LGBT”.


Tag: Human rights Rule of law HIV / AIDS Reproductive Health Monitoring and Evaluation Results-Based Management Data and Statistics


F. Leveraging additional funds

Given the geographic scope of this project, the amount of funding received by each country is relatively modest. However, in most places, the funding has been sufficient to generate interest to leverage additional funding from other sources to expand the work and its impact. In many places, Sida funding has been used to leverage additional funding through the UBRAF country envelope (Cameroon, Ghana, Lesotho, Namibia). In other places, “Sexual Orientation and Gender Identity Rights” (SOGIR) funding has also been available and Country Offices have combined resources from these two projects to maximise efficiency (Cameroon).

Tag: Resource mobilization Human rights Rule of law HIV / AIDS Pandemic Reproductive Health Human and Financial resources Bilateral partners UN Agencies


FINDING 1(continuation)

A. Key Elements of Project Design that Affected Implementation

Flexibility of the Project Design

The overarching flexibility of the project design allowed the countries being supported to change, with some that were initially considered part of this work ‘moving out’ as other donor funds became available to support the work there, and Sierra Leone being added on the basis of the government’s request for a LEA. One UNDP representative noted the flexibility of this project to be interesting because, particularly in relation to other donors, “countries could pick up the pieces that were interesting or feasible for them”. At the national level, stakeholders expressed true appreciation for the ability to use the funding for the work within the project scope that seemed most relevant to their national context. One focal point noted that the lack of pressure to show quick results was critical, allowing them to really focus on problem solving, tackling the deep-rooted issues affecting the situation, and bringing everyone on board at the right pace. Each country is in a different stage of the ‘process’ of understanding and trying to improve their legal environment as well as a different political moment. Capacity to address these issues also varies by country. National focal points valued the ability to use this funding to  be responsive to their own reality and try to catalyse appropriate actions to advance the agenda.

The lack of pressure to achieve particular timebound commitments around legal or policy change was also appreciated with many noting the non-linear nature of these processes and the importance of ensuring an appropriate approach to the work. Allowing countries to focus on process rather than immediately achieve targets has strengthened capacity and trusting relationships between different stakeholders. This strengthening of capacity and deepening of relationships, while time-consuming, can provide an invaluable foundation for the sustainability of activities beyond the project period. This can be seen in Malawi, for example, which was not part of Phase II of this project (although it did receive occasional ad hoc support) but where structures created in Phase I have remained active. Prior to the project, it was difficult for civil society, particularly LGBT organisations, to engage with the government but the project helped open up safe spaces and build trust between these different stakeholders. There are now key population representatives in a range of national working groups. In addition, capacity strengthening enabled local civil society organisations to take the lead generating evidence around HIV, key populations and the law as well as advocating for the use of such evidence for informing policies, programmes and services.

Tag: Effectiveness Relevance National Local Governance Rule of law HIV / AIDS Reproductive Health Policies & Procedures Programme/Project Design Health Sector


FINDING 3 (continuation)

C. Project Implementation

Political/cultural environment

Perhaps the biggest challenge faced across many of the project countries remains prevailing negative attitudes towards people living with HIV, key populations and SRHR generally, which seems to be reduced to abortion, adolescent SRH and key populations in some people’s minds. Politicians and other duty-bearers may be unwilling to take on these issues for fear of political reprisals (from other parts of government and/or constituents). This is an area where the complex structures of government play a role: people working in the field of HIV (or even public health) have a relatively good understanding of issues around stigma, discrimination and human rights but in other sectors the level of understanding is much lower, creating barriers to willingness to engage in this work. Where change has occurred it has been centred around HIV; challenges persist in many places with regard to changing key population-specific laws (e.g. Burkina Faso, Cameroon, eSwatini, Namibia, Sierra Leone) or policies around, for examples, access to comprehensive sexuality education (e.g. Sierra Leone). In one country, a key informant noted that they were struggling to get the LEA report validated and to translate it into action. Admitting that the reasons for these impediments were not fully understood, the UNDP Country Office suggested carrying out an engagement scan to identify appropriate entry points for action. In some settings, creating a space where key populations feel sufficiently supported to participate and speak up remains a challenge. In some countries, such as Gabon, access to key population representatives for inclusion in the LEA and follow-up processes was a challenge as there were no pre-existing relationships with the communities.

Despite broad government involvement in LEA processes, sometimes only specific parts of government have been willing to advance work with key populations, and they may not always be willing to stand up to other parts of government. This comes into particularly sharp focus with respect to multi-sectoral action planning and the ensuing implementation of these plans. It is, of course, critical that this planning be multi-sectoral but it is equally important that there is a single entity tasked with ensuring follow-up and that they have the mandate to hold others accountable for their commitments. Political cycles (such as elections) and instability can also be disruptive to project activities (Burkina Faso, eSwatini, Gabon, Lesotho). While the engagement scans can help foresee  some of this disruption, it is impossible to mitigate it entirely. Changes in government can mean having to ‘start again’ with advocacy for legal change, building the capacity of allies within government, and re-building a sense of ownership of ongoing activities. All of this should be factored into workplans and targets; and strong leadership from UNDP Country Offices can help in these situations. Friction among different civil society groups as well as between civil society and government can hamper project progress. The relationships between government and civil society can be complicated as their interests are not always aligned. While collaboration is critical much of the time, civil society’s watchdog role can also be very important, and it is not always easy to balance potentially competing interests and perspectives. 

Tag: Effectiveness Efficiency Human rights Rule of law HIV / AIDS Reproductive Health Human and Financial resources Policies & Procedures


FINDING 6 (continuation)

2. Legal Environment Assessments (LEAs)

Overarching lessons

Across all countries where LEAs took place during Phase II, there was broad collaboration between government (encompassing different parts of government) and civil society organisations, with support from UNDP and, sometimes, other development partners. Key informants noted that the LEA process was important for bringing together a wide range of stakeholders, for forcing discussions around difficult issues and for identifying synergies for advocacy and other work moving forward. For example, the LEA process was the first time in Gabon that religious and traditional practitioners and leaders were involved as key partners in the HIV response, which is considered a significant advance. In Sierra Leone, there were discussions around comprehensive sexuality education in schools and although no follow-up actions on this were prioritized, even opening up this discussion felt like a step forward.  In Cameroon, UNDP consciously sought to create synergies between legal advocacy work around HIV and SRHR, which has helped to deepen both of these areas of work. The importance of the participatory approach of the LEA has been well-documented but has emerged very strongly again in Phase II. One key informant noted that the LEA process was one of the most useful things in the project because it constitutes a process of getting people on board, getting them used to the idea that they are going to assess laws and policies that they might not want to talk about, and that they are going to own it. Setting up the structures required for the LEA process and involving the range of stakeholders recommended also allowed for opportunities to identify and cultivate “champions” who could help create opportunities for action and progress.

Tag: Effectiveness Impact Sustainability Civic Engagement HIV / AIDS Reproductive Health Partnership Programme Synergy Country Government Education Capacity Building


FINDING 7 (continuation)

Legal and policy change


Pathways towards legal change are long, complicated and non-linear. Despite this, several countries report that laws have been changed or are in the process of reform at least in part as a result of this project. Unsurprisingly, given that the focus of Phase I was HIV, most of the laws that have been changed to date are laws governing national HIV responses. All of these changes have resulted not only from the LEA itself but also ongoing advocacy, technicalsupport and mobilization. Other efforts outside this project likely also contributed to the changes in these laws. Laws that include strong anti-stigma provisions were introduced in Ghana and Sierra Leone. In Ghana, consolidating work done during Phase I, UNDP provided technical support and advocacy with lawmakers/parliamentarians to keep them engaged with provisions in the proposed Ghana AIDS Commission Bill and to help ensure its passage. As part of the Joint UN Team on HIV and AIDS, the project helped to support the development of the legislative instrument for the Ghana AIDS Commission Act, which will support operationalisation of its anti-stigma provisions. In Sierra Leone, where work only began in Phase II, the National AIDS Commission Act 2011 was reviewed and protections against stigma improved. As part of this, and with other potentially positive impacts, a series of community dialogues were held on stigma and discrimination in each of the country’s 14 districts. The law now needs to be reviewed by the Judiciary and Parliament before it can be enacted. Ongoing work includes UNDP, along with UNAIDS and the UN Country Team supporting the National AIDS Secretariat to develop a new HIV policy. The policy has been agreed to in principle by the Ministry of Health but will also have to be reviewed by the Judiciary to assess consonance with the proposed law.

In the DRC, the provision in the HIV Law that criminalized HIV transmission was successfully repealed in 2018, and work is ongoing in Burkina Faso to the same end. In the DRC, the LEA report recommended repealing the criminalization of HIV transmission, and this was an area to which the project paid particular attention including organizing a parliamentarian forum to discuss the repeal of this provision. In Burkina Faso, one of the recommendations in the LEA was that the law criminalizing HIV transmission be brought in line with international standards, which included decriminalizing HIV transmission. This led to the national working group on HIV and human rights (coordinated by the Permanent Secretariat of the National Council to fight against HIV and STIs) initiating a very participatory process of law reform using LEA findings that included the preparation of advocacy documents, anadvocacy meeting with the national network of parliamentarians on health and development as well as a national consultation with key stakeholders (including the parliamentarians), both of which allowed for views, inputs and comments to be shared to form the basis of redrafting the law and its accompanying implementation decree. Turnover of senior leadership within the Permanent Secretariat of the National Council to fight against HIV and STIs and the Ministry of Health have slowed the process slightly, but these documents are ready for presentation by the Ministry of Health to the national assembly for validation.

Tag: Effectiveness Gender Equality Gender-Based Violence Human rights Justice system Parliament Rule of law HIV / AIDS Reproductive Health Policies & Procedures Institutional Strengthening


FINDING 7 (continuation)

Policies, strategies and plans

National policies, strategies and plans can be easier to influence than laws: usually designed to cover a five-year period, there are regular opportunities to influence their content as understanding of the health situation, including the epidemiology relating to HIV and SRH, evolves. Project activities appear to have positively influenced a range of national policies and strategies and plans in different countries. In some instances, countries report generally that recommendations emerging from the LEA helped to inform national strategies and policies. For example, in Gabon, the LEA recommendations provided guidance that supported drafting a national policy on gender and sexual violence, HIV and sexual and reproductive health and the 2018-2022 National HIV Strategic Plan includes promotion of the integration of key populations and strategies to promote their access to care and services.

In other cases, technical support was provided specifically to support a particular policy or plan. In eSwatini, UNDP provided technical and financial support for the review and development of the public sector policy and strategic plan for HIV, which constitute a progressive and expanded national response to HIV and wellness within the public sector that the project helped to inform. The strategic plan is already approved, and the policy is to be presented at Cabinet for final adoption. Work is also ongoing in eSwatini to revise the gender policy.

Tag: Gender-Based Violence Human rights Rule of law HIV / AIDS Reproductive Health Policies & Procedures Vulnerable Women and gilrs Youth


FINDING 7 (continuation)

Community mobilization and advocacy

Even where laws and policies have not yet changed, ongoing community mobilization and advocacy efforts constitute important efforts towards implementing the priority actions arising from the LEA process, and may ultimately effect legal and policy change. The LEA recommendations are used to inform legal advocacy including for the rights of key populations, decriminalization of HIV transmission, eradication of forced sterilisation of women living with HIV, for increased access to HIV and SRHR services for LGBT people and  clarity and uniformity on the age of consent for young people’s access to SRHR.

In some countries, community mobilization has been an important follow-up activity from the LEA process. For example, in eSwatini, meetings have been organized in an attempt to establish a key populations consortium under the Coordinating Assembly of NonGovernmental Organisations. Additional funding provided by OSISA supported a consultation with Parliamentarians on key populations’ rights, which provided a platform for engagement and awareness raising.In Namibia, meetings were held with civil society organisations to assess capacity building needs for advocacy where legal reform was a priority. While the final LEA report is yet to be validated, the findings have been used by civil society to advocate for the decriminalisation of sex work and repeal of the ‘sodomy law’. The project has provided support to the government in eSwatini to align existing laws with protections in the Constitution, particularly focusing on women. Four laws were identified for review in order to ensure legal protections around gender equality and human rights, and this work is ongoing. UNDP in Sierra Leone has also provided technical assistance to the National AIDS Secretariat to draft a communications strategy, which led to the establishment of communication platforms (social media) and resulted in a MOU with the inter-faith network to deliver stigma/discrimination-free messages to their respective congregations. A social media platform for key populations to communicate on issues relating to HIV and sexual health was also established in Gabon.  

Tag: Effectiveness Gender-Based Violence Civic Engagement Human rights Rule of law Policies & Procedures Advocacy Vulnerable Women and gilrs


FINDING 8 (continuation)

D. Project Implementation Processes - 4. Capacity Building of Key Stakeholders (Continuation)

Law enforcement agents

In many countries, the LEAs highlighted the problem of bad policing practices having a negative impact on access to HIV and legal services, as well as quality of life for people living with HIV, LGBT people and women and girls. As a result, there has been substantial training of law enforcement agents – police and prison officers – in a range of countries under the project. This capacity building work is wide-ranging, encompassing training of trainers workshops, on HIV, human rights, key populations and sexual and gender-based violence (e.g. eSwatini, Sierra Leone), development of a training manual/module for police on HIV and human rights (e.g. eSwatini, Lesotho), and awareness-raising campaigns on GBV and the protection of women from abuse (e.g. eSwatini). In the DRC, a training module on laws, human rights and HIV was incorporated into the formal training curriculum of magistrates and police officers from 2017. While all of this seems useful for changing the practices of law enforcement agents, no documentation yet exists of the impact of these capacity building efforts. Assessment of the extent to which practices have changed will be important moving forward.

Health care practitioners

In Cameroon, thirty health care practitioners and officials from the Ministry of Public Health were trained on issues relating to sexuality, gender identity and the provision of stigma-free health services. It is too recent to know the impact of this training but ‘champions’ have been identified among the participants whom the project hopes will take a lead in promoting human rights-based health care.

Tag: Effectiveness Civic Engagement Human rights Rule of law HIV / AIDS Reproductive Health Institutional Strengthening National Institutions


FINDING 9 (continuation)

Regional judges’ forum During Phase II of the project, UNDP convened three regional judges’ fora, with consistently high-level participation from across the region. These fora constitute an important and much-appreciated space for cross-country learning. Judges from across project countries participate in these fora, and many countries have reported that the trainings change judges’ perceptions, particularly in relation to key populations, and that this has led to several landmark judgments across the region. For example, following participation in the forum, a member of the Africa Judges Forum wrote the judgement that overturned a conviction for wilful transmission of HIV in Malawi; and a judge in Kenya who had participated in the regional fora recently ruled that it was illegal to imprison people with TB to force them to adhere to treatment. Countries report regular participation of judges in these regional fora, with the result that an ever-expanding group of judges exists across the continent who can help appropriately interpret and apply the law in the context of HIV and key populations. The judges appear to value their participation in these fora very highly, including the opportunities to learn about the latest legal, scientific and medical information that can help them make evidenceinformed rulings and hearing directly from key populations to better understand their lived experiences. The judges who have participated are developing a training curriculum on ‘Integrating human rights and HIV/TB’. The sub-committee responsible for this work presented their workplan at the most recent forum, which laid out plans to initiate curriculum development for incorporation into judicial training at national level throughout the region.

The Forum adopted the workplan. This is a key and important development, but financial support will be needed to be able to carry this throughMany key informants pointed to the regional Judges’ Forum as one of the project’s greatest continued successes. The Judges Forum began in 2014 during Phase I of the project. During Phase II, the forum has been largely funded by the Global Fund supported regional ‘Removing Legal Barriers’ project that is also being implemented by UNDP. The Sida project has continued to provide technical support for the Judges Forum through Phase II most notably during the Fourth Regional Judges’ Forum on HIV, Human Rights and the Law in 2018. Its critical success factors are not entirely clear but the fact that it was a regularly convened group who received relevant training every year appears important: one-off trainings are simply not sufficient to instil the level of commitment seen in this group. That they started with a small group of 11 judges from 8 countries in Africa and kept the same participants, expanding membership slowly to currently 30 judges may also have been important. And the chosen approach of allowing the group to shape the content of the fora, with the project playing the role of supporting and facilitating has been highlighted as key. Additional factors to consider in relation to this forum are the small number of cases on HIV and SRHR that ever reach the courts and the reasons underlying this (e.g. barriers to accessing justice such as costs and low legal literacy) and how this might be addressed. As with the work with the RECs, the regional judges’ forum expands the project reach beyond its ten countries, with judges from a wider range of countries participating. One challenge is how to sustain this sort of regional level work beyond the project period.

Tag: Effectiveness Efficiency Gender Equality Gender Mainstreaming Women's Empowerment Regional Human rights Justice system HIV / AIDS Reproductive Health Institutional Strengthening National Institutions



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