title: It takes a village: community-based organizations and the availability and utilization of HIV/AIDS-related services in Nigeria.
abstract: Community-based organizations (CBOs) have emerged as a vital part of the response to HIV/AIDs in Nigeria. The evaluation, on which this article is based, conducted in 28 communities in 6 states and the Federal capital Territory in Nigeria, assessed the effects of the CBO engagement on a set of outcomes related to HIV/AIDS knowledge, attitudes, beliefs, and practices, stigma, service availably and utilization and social capital. It consisted of three components: a household survey conducted in all 28 communities, qualitative data collected from CBO staff and key informants (KIs), and a funding allocation study (qualitative interviews and the funding allocation study were conducted in a subset of 14 communities). This article focuses on the association between CBO engagement and reported availability and utilization of HIV/AIDS-related services. It shows that CBO engagement has a potential to add value to the national response to HIV/AIDS by increasing the awareness, availability, and utilization of HIV/AIDS-related services, especially in the area of prevention, care and support. The CBOs in the evaluation communities focused on prevention activities as well as on providing support for people living with HIV/AIDS (PLWHA) and prevention and care and support were the highest expenditure categories reported by CBOs. Respondents in communities with a stronger CBO engagement were more likely to: (1) be aware of any HIV/AIDs-related services, (2) report that prevention and care services were available in their communities, and (3) have used any HIV/AIDS related services, prevention-related and care-related services than respondents in communities where CBO engagement was weaker. The association between service awareness and service use and CBO engagement was stronger in rural than in urban areas.
authors.affiliation: ICF International, Atlanta, GA, USA. jKakietek@icfi.com
authors.forename: Jakub
authors.initials: J
authors.lastname: Kakietek
authors.forename: Tesfayi
authors.initials: T
authors.lastname: Geberselassie
authors.forename: Brigitte
authors.initials: B
authors.lastname: Manteuffel
authors.forename: Kayode
authors.initials: K
authors.lastname: Ogungbemi
authors.forename: Anya
authors.initials: A
authors.lastname: Krivelyova
authors.forename: Sarah
authors.initials: S
authors.lastname: Bausch
authors.forename: Rosalía
authors.initials: R
authors.lastname: Rodriguez-García
authors.forename: Rene
authors.initials: R
authors.lastname: Bonnel
authors.forename: N'Della
authors.initials: N
authors.lastname: N'Jie
authors.forename: Joseph
authors.initials: J
authors.lastname: Fruh
authors.forename: Sani
authors.initials: S
authors.lastname: Gar
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000706:statistics & numerical data*; D019058:Community Networks / Q000458:organization & administration*; D055812:Community-Based Participatory Research; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D036301:Qualitative Research; D012111:Residence Characteristics; D012424:Rural Population / Q000706:statistics & numerical data; D012932:Social Facilitation; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult