Developing a framework for understanding policy decision-making behaviors in the transition of a HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision program Article Swipe
Nishan Gantayat
,
James A. Baer
,
Alok Gangaramany
,
Steve Kretschmer
,
Rasi Surana
,
Alick Samona
,
Njekwa Mukamba
,
Bright Jere
,
Tina Chinsenga
,
Ram Komal Prasad
,
Stephen Goetschius
,
Saransh Sharma
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.12688/gatesopenres.15189.1
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.12688/gatesopenres.15189.1
Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia’s VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0-2 months) and early-adolescent (15-17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.12688/gatesopenres.15189.1
- OA Status
- gold
- References
- 29
- Related Works
- 10
- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4392359509Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.12688/gatesopenres.15189.1Digital Object Identifier
- Title
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Developing a framework for understanding policy decision-making behaviors in the transition of a HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision programWork title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
-
2024-03-01Full publication date if available
- Authors
-
Nishan Gantayat, James A. Baer, Alok Gangaramany, Steve Kretschmer, Rasi Surana, Alick Samona, Njekwa Mukamba, Bright Jere, Tina Chinsenga, Ram Komal Prasad, Stephen Goetschius, Saransh SharmaList of authors in order
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https://doi.org/10.12688/gatesopenres.15189.1Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.12688/gatesopenres.15189.1Direct OA link when available
- Concepts
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Sustainability, Government (linguistics), Developing country, Program evaluation, Public relations, Business, Political science, Economic growth, Public administration, Economics, Linguistics, Biology, Ecology, PhilosophyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
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29Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| publication_date | 2024-03-01 |
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| corresponding_author_ids | https://openalex.org/A5094044553, https://openalex.org/A5046948779, https://openalex.org/A5058948908, https://openalex.org/A5108221571, https://openalex.org/A5094044555, https://openalex.org/A5081684813, https://openalex.org/A5094044557, https://openalex.org/A5086436383, https://openalex.org/A5094044554, https://openalex.org/A5038571077, https://openalex.org/A5094044558, https://openalex.org/A5034149644 |
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