Developing governance models and funding mechanisms of state–civil society partnerships for HIV/AIDS treatment and prevention based on lessons from Ghana

Abstract

The contribution of civil society organisations (CSOs) to national HIV/AIDS responses in sub-Saharan African countries, with Global Health Initiatives’ (GHIs) funding channelled through National AIDS Commissions (NACs), is well researched. Less well understood are the governance models and funding mechanisms being used to successfully engage CSOs in the HIV/AIDS response. Using data from government, donor, CSO and documentary sources, this article characterises the organisational principles and practices and unique funding models adopted by the Ghana AIDS Commission (GAC) to effectively and efficiently engage CSOs in the HIV/AIDS response. It found four major governance principles and practices that target: 1) strategic planning for service delivery; 2) focussed expressions of interest; 3) competitive tendering and contracting for service delivery; and 4) adoption of results-based management. It also identified three predominant funding models that illustrate the application of these guiding principles to harness the inherent strengths of CSOs to more effectively respond to HIV/AIDS, namely: 1) direct funding of locally-based CSOs; 2) funding international and national NGOs to engage local CSOs in partnership; and 3) funding umbrella organisations. These findings are significant for Ghana but they may also have relevance for other low- or middle-income countries (LMICs) that have limited experience delivering HIV/AIDS services through state–civil society partnerships, as well as broader debates on the role of donors, governments and CSOs working in partnership to fight HIV/AIDS.

Keywords: state, civil society, partnerships, HIV/AIDS, Global Health Initiatives, donors, governance