Contracting non-governmental organizations to combat HIV/AIDS

In many developing countries, non-governmental organisations (NGOs) have taken the lead in responding to the HIV/AIDS crisis. As international funding to combat HIV/AIDS has increased, donors and government officials are looking for effective ways to distribute new funding to maximise impact. This report, by the Partners for Health Reform (PHR), examines the use of contracting NGOs as a mechanism to deliver HIV/AIDS services and programs in developing counties.

Contracting was found to give the purchaser more influence over defining the results of NGO activities and make the purchaser and NGO more accountable. Contracting was also found to be more conducive to introducing performance-based systems into HIV/AIDS programs. Challenges include the need for resources to plan and implement a contracting program, political resistance, and lack of capacity among NGOs, the public sector, and international agencies in relation to NGO contracting. The key operational elements for NGO contracting include: assessing the operating environment of the country; determining the institutional arrangements and objectives of the contracting program; and designing the solicitation and selection process, the contract terms, and the monitoring and evaluation systems. Best practices are recommended based on two case studies of large scale NGO contracting programs in Brazil and Guatemala. [adapted from authors]