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Does Capacity Development Increase Demand for Health Services and Rights Among Key Populations Affected by HIV? A Systematic Review of Evidence from Low and Middle-Income Countries

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Abstract

Capacity development is a process by which individuals, organizations and societies develop abilities to perform functions, solve problems and achieve objectives. This systematic review sought to document capacity development interventions, the associated outcomes and its effectiveness in increasing demand for rights and health services among key populations (KP) in low and middle-income countries. Twenty papers met our review’s selection criteria. Significant improvements in health service utilization were achieved in most community mobilization and peer-led interventions. Whilst we found ample evidence linking capacity development to uptake of services, there was a striking dearth of research examining the impact of capacity development on demand for rights among KP. There was inadequate contextual data to explain variations in intervention effectiveness across different projects. More evidence is needed on the impact of capacity development on demand for health services and rights among KP. Consensus on parameters of capacity development and priority outcomes is required.

Resumen

El desarrollo de capacidades es un proceso para que personas, organizaciones y sociedades desarrollen sus habilidades a la hora de desempeñar su trabajo, resolver problemas y alcanzar objetivos. Esta revisión sistemática documenta intervenciones en el ámbito de desarrollo de capacidades, los resultados asociados con estas intervenciones y su efectividad para incrementar la exigencia de derechos y servicios de salud por parte de las poblaciones clave en países de renta media y baja. Veinte artículos cumplieron los criterios de selección de nuestra revisión. Estos artículos muestran mejoras significativas en la utilización de servicios de salud propiciadas por la mayoría de las intervenciones de movilización comunitaria e intervenciones con pares. Sin embargo, hay una escasez sorprendente de estudios que examinen el impacto del desarrollo de capacidades en la exigencia por parte de las poblaciones clave del cumplimiento de sus derechos. Asimismo, los datos de contexto encontrados no permiten explicar las diferencias en la efectividad de las intervenciones de desarrollo de capacidades según proyecto o región. Se necesita generar más evidencia sobre el impacto del desarrollo de capacidades sobre la exigencia de servicios y derechos de salud por parte de las poblaciones clave y se requiere un consenso sobre los parámetros para medir el desarrollo de capacidades y los resultados asociados a estas intervenciones.

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Acknowledgements

This research was funded by the PITCH programme (Partnership to Inspire, Transform and Connect the HIV Response), which is a strategic partnership between Aidsfonds, Frontline AIDS and the Dutch Ministry of Foreign Affairs. The purpose of this systematic evidence review was to test the PITCH programme Theory of Change. We thank Afya Research Africa for their support with primary article screening. We also thank all participants, including people living with HIV, who generously participated in the research studies and projects we reviewed.

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Authors and Affiliations

  1. African Institute for Children Studies, Repen complex, Suite B202, Syokimau-Katani Road, Off Mombasa Road, Nairobi, Kenya

    Michael Kiragu, Samuel Munyuwiny & Preston Izulla

  2. The Medical University of South Carolina, Charleston, USA

    Virginia A. Fonner & Kevin R. O’Reilly

  3. Frontline AIDS, Brighton, UK

    Marija Pantelic & Enrique Restoy

  4. Department of Social Policy and Intervention, Oxford University, Oxford, UK

    Marija Pantelic

  5. Aidsfonds, Amsterdam, The Netherlands

    Ellen Eiling

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Kiragu, M., Fonner, V.A., Munyuwiny, S. et al. Does Capacity Development Increase Demand for Health Services and Rights Among Key Populations Affected by HIV? A Systematic Review of Evidence from Low and Middle-Income Countries. AIDS Behav 24, 2268–2281 (2020). https://doi.org/10.1007/s10461-020-02936-9

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