Qualitative raw data and behavioral analysis for understanding VMMC policy decision-making
Data files
Jan 31, 2024 version files 9.04 MB
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README.md
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S2_file_upd.xlsx
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S3_file_upd.xlsx
4.61 MB
Abstract
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.
https://doi.org/10.5061/dryad.z08kprrkz
Description of the data and file structure
- Supplementary File S1 contains the raw data from all the stakeholder interviews that were conducted. It contains the questions and the responses that were provided by the participants.
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Supplementary File S2 is an elaborate analysis document. The document consists of different sheets where analysed content has been put in. The immersion analysis contains analysis of the data collected across three stages - funding strategy, policy development, and implementation. The columns in each of these sheets present the different sub-stages involved in each of these stages. Data from primary data is then analysed and placed as it fits to the different sub-stages. The rows represent the stakeholder dimension where the learning/data originates. Other sheets in this document brings in in-depth understanding of different decisions and functions involved within Ministry of Health, Zambia.
- Sheet - Immersion Analysis 1: Data organised for the EI/EAMC policy development phase as per the different decisions embodying the phase.
- Sheet - Immersion Analysis 2: Data organised for the EI/EAMC policy development phase as per the different decisions embodying the phase.
- Sheet - Immersion Analysis 3: Data organised for policy implementation phase as per the different decisions embodying the phase.
- Sheet - Stakeholder Mapping: Developing an understanding of the relevant stakeholders for the project immersion with the health ministry as well as the VMMC program
- Sheet - Activity Mapping: Contains information on the different functions with the organisation
- Sheet - Decision Dynamics: Definition/Explaination of some of the organisational decision dynamics clustered under different headers akin to organisational decision-making
- Sheet - Scenario Planning for Interview: Laying out the conceptual note on the future state related projection technique
- Sheet - Decision Mapping Immersion: This contains the note taking tool and illustrations of some of the decision contexts that would be part of the probing structure
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Supplementary File S3 where the contextual information is presented to help on understand the functions within ministry of health, the data on drop out rates for VMMC that helped us select the sample geographies and also secondary data on organisational sustainability that helped draft the discussion guides.
- Sheet - Partners+Targets+Dropouts: provides district wise targets given to partners and performance agains these targets. It also consists of the district wise drop out rates. Note - some %achievement numbers might be missing as there might be instances where the targets might have been just introduced for the district and hence there are no priors.
- Sheet - Zambia health Context: Provides information on Zambia’s health care relevant for the project
- Sheet - Provides brainstorming notes on the possible array of functions within the health system
The data was collected using a semi-structured style discussion guide. Participants were interviewed and the data was audio recorded with participants consent. The data was then captured in excel sheets and analyzed using qualitative thematic techniques.