United Nations Development Programme

1 EVALUATION OF UNDP S ROLE AND CONTRIBUTIONS IN THE HIV/AIDS RESPONSE IN SOUTHERN AFRICA AND ETHIOPIAU nited Nations Development ProgrammeCOUNTRY STUDIES Evaluation Office, September 2006 United Nations Development ProgrammeHIV/AIDSEVALUATION OF UNDP S ROLE AND CONTRIBUTIONS IN THE HIV/AIDS RESPONSE IN SOUTHERN AFRICA AND ETHIOPIACOUNTRY STUDIES Copyright UNDP 2006, all rights reserved. Manufactured in the United States of analysis and recommendations of this report do not necessarily reflect the views of the United Nations Development Programme , its Executive Board or the United Nations Member is an independent publication by UNDP and reflects the views of its :Suazion Inc.,Bloomingburg, NY SuppliesTeam LeaderDr. Sulley GaribaInternational Ikwo Arit EkpoConsultantsA.

2 E. ElmendorfAnthony KinghornNational Yema Ferreira (Angola)ConsultantsSimon Muchiru (Botswana)Yayehirad Kitaw (Ethiopia)Keiso Matashane-Marite (Lesotho)Steven Chizimbi (Malawi)Scholastika Ndatinda Ipinge (Namibia)Shaun Samuel (South Africa)Dumisile Shabangu (Swaziland)Mukosha Bona Chitah (Zambia)Anna Cletter Mupawaenda (Zimbabwe)EO Task ManagerRuth AbrahamResearch AssistantsAnselme SadikiAfiya McLaughlin-WhyteExternal ReviewersDr. Sigrun Mogedal, HIV/AIDS Ambassador,Government of NorwayProfessor Lincoln Chen, Harvard University EVALUATION TEAMEVALUATION OF UNDP S ROLE AND CONTRIBUTIONS IN THE HIV/AIDS RESPONSE IN SOUTHERN AFRICA AND ETHIOPIA: COUNTRY STUDIESE valuation of UNDP s Role and Contributions in the HIV/AIDS Reponse in Southern Africa andEthiopia,Main Report,New York: UNDP, 2006 ALSO IN THIS SERIESCONTENTSI ntroduction1 Angola Country background and HIV/AIDS of UNDP contributions and and recommendations14 Annex 1.

3 Acronyms and abbreviations16 Annex 2. References17 Annex 3. People interviewed19 Botswana Country on the Millennium Development of UNDP contributions and and recommendations43 Annex and abbreviations47 Annex 2. References48 Annex 3. People interviewed50 Ethiopia Country background and HIV/AIDS of UNDP contributions and and recommendations58 Annex 1. Acronyms and abbreviations75 Annex 2. References76 Annex 3. People interviewed78 Annex major outcomes and issues ofrelevance to UNDP s HIV/AIDS plans79 Annex 5. Breakthrough initiative groups, firstround of LDP,civil service reform and UNDP status of activities81 Lesotho Country Development of UNDP contributions and and recommendations107 Annex 1. Acronyms and abbreviations111 Annex interviewed113 Annex 4.

4 Participants of stakeholder workshop114iEVALUATION OF UNDP S ROLE AND CONTRIBUTIONS IN THE HIV/AIDS RESPONSE IN SOUTHERN AFRICA AND ETHIOPIACOUNTRY STUDIESN amibia Country of UNDP contributions and and recommendations128 Annex 1. Acronyms and abbreviations130 Annex 2. References131 Annex 3. People interviewed132 Annex 4. Financial resources for HIV/AIDS response133 South Africa Country of UNDP contributions and and recommendations152 Annex 1. Acronyms and abbreviations156 Annex 2. References157 Annex 3. People interviewed158 Swaziland Country of UNDP contributions and and recommendations181 Annex and abbreviations184 Annex 2.

5 References185 Annex 3. People interviewed187 Annex 4. Case study188 Zambia Country of UNDP contributions and and recommendations210 Annex 1. Acronyms and abbreviations213 Annex 2. References214 Annex interviewed216 Annex 4. Financial resources for the HIV/AIDS response218 Zimbabwe Country of UNDP contributions and 1. Acronyms and abbreviations242 Annex 2. References243 Annex 3. People interviewed245 Annex 4. Budget for Mashonaland East Province247 Annex 5. Technical note on HIV prevalence estimation methodology in Zimbabwe248iiEVALUATION OF UNDP S ROLE AND CONTRIBUTIONS IN THE HIV/AIDS RESPONSE IN SOUTHERN AFRICA AND ETHIOPIACOUNTRY STUDIES nCONTENTSINTRODUCTIONThis report is a companion volume to the main report on the evaluationof UNDP s role and contributions in the HIV/AIDS response inSouthern Africa and Ethiopia, prepared by the Evaluation Office of theUnited Nations Development is the leading cause of death in Southern Africa.

6 Almost one-third of the world s population infected with HIV/AIDS lives in theregion. In some countries, the HIV/AIDS prevalence rate is as high as 40 percent, and the disease continues to spread. The socio-economicimpact of the epidemic is so severe that it is reversing developmentalgains that have been made in the the adoption of the UN Millennium Declaration in September2000, eight Millennium Development Goals (MDGs) were drawn fromthe actions and targets contained in the Declaration. One of the goals ishalting and turning back the spread of HIV/AIDS. The United Nationshas recognized that failing to reach this MDG will compromise allothers. Unless there is a large and effective multisectoral response toHIV/AIDS, the virus will continue to spread and cause devastation.

7 Inlight of this, UNDP has incorporated HIV/AIDS into its corporatestrategy, making it one of its core UNDP Evaluation Office in New York commissioned an independentevaluation of UNDP s role and contributions to the HIV/AIDS responsein Southern Africa and Ethiopia. The main purpose of the evaluation wasto assess,within the context of the MDGs and the Declaration ofCommitment,UNDP s role in achieving key AIDS-related outcomes atthe country level in order to learn from experience and improve theeffectiveness of UNDP evaluation was to be strategic incharacter and forward evaluation was conducted in 10 countries in Africa: 9 countries inSouthern Africa Angola, Botswana, Lesotho, Malawi, Namibia, SouthAfrica, Swaziland, Zambia, and Zimbabwe--and Ethiopia, in the Hornof Africa.

8 Most of the countries were chosen due to their extremely highHIV/AIDS prevalence. The focus of the evaluation was the periodbeginning in 1999 and ending in 2004,with emphasis on outcomes thatcould be plausibly associated with UNDP s role and evaluation was undertaken by a team of four international consultantsand by one national consultant in each country. The national consultantsundertook country studies and drafted country reports, which are containedin this volume. The country studies and visits by the internationalconsultants to 6 of the 10 countries were conducted between November2004 and February OF UNDP S ROLE AND CONTRIBUTIONS IN THE HIV/AIDS RESPONSE IN SOUTHERN AFRICA AND ETHIOPIACOUNTRY STUDIES1 The main report, titled Evaluation of UNDP s Role and Contributions in the HIV/AIDS Responsein Southern Africa and Ethiopia was finalized May 2006 and presented to the UNDPE xecutive Board June 2006.

9 The report and the management response are available onUNDP/EO s website EVALUATION PROCESSD uring the first phase of the evaluation, the internationaland national consultants participated in a two-dayworkshop in Johannesburg, South Africa. The aim ofthe workshop was to get a shared understanding ofthe purpose, methods and outcomes of the evaluationand develop an approach for how the evaluation wouldbe conducted. National consultants were also briefedon their expected tasks. These included:nconducting an inventory of UNDP programmesat country levelnoutlining the evaluation methodology to befollowedndeveloping the research instruments to be used inconsultations with stakeholdersndeveloping the main evaluation report formatncreating individual work plans, including thejoint scheduling of international consultant visitsto six countriesThe next phase of the evaluation involved country-level assessments in which national consultants wereengaged in consultations with the identified the pre-designed evaluation instruments,different categories of people to be consulted wereidentified.

10 Consultations took different forms for thedifferent stakeholders. For senior policy levelofficials, donors and representatives of UN agencies,consultations took the form of interviews on a one-to-one basis. For UNDP staff, meetings were held withconcerned staff group discussionswere held with people at the community level, suchas chiefs, youth, women, members of non-governmentalorganizations, and people living with HIV/AIDS. In6 of the 10 countries, international consultants joinedthe national consultants in the assessment. Theseincluded Angola, Ethiopia, Lesotho, Malawi, SouthAfrica and focus was on outcomes and changes achieved,rather than on activities and processes of individualprojects supported by UNDP.