Burden of Proof: Documentation of an HIV Prevention Program in Ghana
DOI:
https://doi.org/10.3138/anth.60.1.t23Keywords:
documents, data, monitoring and evaluation, HIV prevention, NGOs, GhanaAbstract
Globally, HIV programs face pressure to document their accountability and achievements using “evidence-based” criteria or “monitoring and evaluation” (“M&E”), yet little is known about how M&E occurs on the ground or its social and political effects. This paper explores how NGO actors in Ghana experienced routine documentation of a USAID-funded HIV program. Drawing upon 20 months of ethnographic fieldwork, I illustrate how M&E documentation reproduces hierarchical aid relations by engaging NGO actors to self-govern through unexpected strict adherence to documentation requirements. I explore institutional supervisors' frustration with their deference to documentation to further show how inequality is indirectly reproduced.
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References
Adams, Vincanne, ed. 2016. Metrics: What Counts in Global Health. Durham: Duke University Press. https://doi.org/10.1215/9780822374480
Adams, Vincanne, Michelle Murphy, and Adele E. Clarke. 2009. “Anticipation: Technoscience, Life, Affect, Temporality.” Subjectivity: International Journal of Critical Psychology 28(1): 246–265
Awuah-Werekoh, Kwasi. 2014. “Accountability Systems of Non-Governmental Organisations (NGOs): Case Study from Ghana.” PhD dissertation, Birmingham Business School, College of Social Sciences, University of Birmingham
Bell, Catherine. 2009. Ritual: Perspectives and Dimensions. New York: Oxford University Press
Biruk, Crystal. 2012. “Seeing Like a Prevention Project: Producing ‘High Quality' Data in AIDS Research in Malawi.” Medical Anthropology 31(4): 347–366. https://doi.org/10.1080/01459740.2011.631960
Biruk, Crystal. 2018. Cooking Data: Culture and Politics in an African Research World. Durham: Duke University Press
Contu, Alessia, and Emanuela Girei. 2014. “NGOs Management and the Value of ‘Partnerships' for Equality in International Development: What's in a Name?” Human Relations 67(2): 205–232. https://doi.org/10.1177/0018726713489999
Cooke, Edgar, Sarah Hague, and Andy McKay. 2016. The Ghana Poverty and Inequality Report. https://www.unicef.org/ghana/Ghana_Poverty_and_Inequality_Analysis_FINAL_Match_2016(1).pdf
Cornwall, Andrea, and Deborah Eade, eds. 2010. Deconstructing Development Discourse: Buzzwords and Fuzzwords. Bourton-on-Dunsmore: Practical Action Publishing. https://doi.org/10.3362/9781780440095
Coyle, Susan L., Robert F. Boruch, and Charles F. Turner, eds. 1991. Evaluating AIDS Prevention Programs. Washington: National Academy Press
De Lay, Paul, and Valerie Manda. 2004. “Politics of Monitoring and Evaluation: Lessons from the AIDS Epidemic.” New Directions for Evaluation 103: 13–31. https://doi.org/10.1002/ev.120
Ebrahim, Alnoor. 2003. “Accountability in Practice: Mechanisms for NGOs.” World Development 31(5): 813–829
Erikson, Susan L. 2012. “Global Health Business: The Production and Performativity of Statistics in Sierra Leone and Germany.” Medical Anthropology 31(4): 367–384. https://doi.org/10.1080/01459740.2011.621908
Esser, Daniel E. 2015. “Elusive Accountabilities in the HIV Scale-Up: ‘Ownership' as a Functional Tautology.” In HIV Scale-Up and the Politics of Global Health, ed. N.J. Kenworthy and R. Parker, 43–56. London: Routledge
Fisher, Celia B., Gala True, Leslie Alexander, and Adam L. Fried. 2013. “Moral Stress, Moral Practice, and Ethical Climate in Community-Based Drug-Use Research: Views from the Front Line.” AJOB Primary Research 4(3): 27–38. https://doi.org/10.1080/21507716.2013.806969
Ghana AIDS Commission. 2015. Country AIDS Response Program Report – Ghana. http://www.unaids.org/sites/default/files/country/documents/GHA_narrative_report_2015.pdf
Harper, Richard. 2000. “The Social Organization of the IMF's Mission Work: An Examination of International Auditing.” In Audit Cultures: Anthropological Studies in Accountability, Ethics, and the Academy, ed. Marilyn Strathern, 21–53. London: Routledge.
Harsh, Matthew, Paul Mbatia, and Wesley Shrum. 2010. “Accountability and Inaction: NGOs and Resource Lodging in Development.” Development and Change 41(2): 253–278. https://doi.org/10.1111/j.1467-7660.2010.01641.x
Hodžić, Saida. 2016. The Twilight of Cutting: African Activism and Life after NGOs. Oakland: University of California Press
Hull, Matthew. 2012. “Documents and Bureaucracy.” Annual Review of Anthropology 41(1): 251–267. https://doi.org/10.1146/annurev.anthro.012809.104953
Inglis, Kathleen. 2018. “The Social Life of Monitoring and Evaluation: An Ethnography of the Monitoring and Evaluation of an HIV/AIDS Prevention Program in Ghana.” PhD dissertation, Simon Fraser University, 2018
Justice, Judith. 1986. Policies, Plans, and People. Berkeley: University of California Press
Karimi, Faith. 2012. “Obama Hails Ghana as a ‘Model of Democracy' in Africa.” CNN, March 29. http://www.cnn.com/2012/03/08/world/africa/obama-ghana-president/index.html
Kingori, Patricia, and René Gerrets. 2016. “Morals, Morale and Motivations in Data Fabrication: Medical Research Fieldworkers' Views and Practices in Two Sub-Saharan African Contexts.” Social Science & Medicine 166: 150–159. https://doi.org/10.1016/j.socscimed.2016.08.019
Latour, Bruno. 1987. Science in Action: How to Follow Scientists and Engineers through Society. Cambridge: Harvard University Press
Lorway, Robert, and Shamshad Khan. 2014. “Reassembling Epidemiology: Mapping, Monitoring and Making-Up People in the context of HIV Prevention in India.” Social Science & Medicine 112: 51–62. https://doi.org/10.1016/j.socscimed.2014.04.034
Maes, Kenneth. 2017. The Lives of Community Health Workers. New York: Routledge
Mawuko-Yevugah, Lord. 2014. Reinventing Development: Aid Reform and Technologies of Governance in Ghana. Surrey: Ashgate Publishing
Merry, Sally Engle. 2011. “Measuring the World: Indicators, Human Rights, and Global Governance.” Current Anthropology 52(S3): S83–S95. https://doi.org/10.1086/657241
Merry, Sally Engle. 2016. The Seductions of Quantification: Measuring Human Rights, Gender Violence, and Sex Trafficking. Chicago: University of Chicago Press
Miller, Peter, and Nikolas Rose. 1990. “Governing Economic Life.” Economy and Society 19(1): 1–31. https://doi.org/10.1080/03085149000000001
Power, Michael. 1997. The Audit Society: Rituals of Verification. Oxford: Oxford University Press
Rose, Nicolas. 1989. Governing the Soul: The Shaping of the Private Self. London: Routledge
Rottenburg, Richard. 2009. Far-Fetched Facts: A Parable of Development Aid, translated by Allison Brown and Tom Lampert. Cambridge: MIT Press. https://doi.org/10.7551/mitpress/9780262182645.001.0001
Rottenburg, Richard, Sally Engle Merry, Sung-Joon Park, and Johanna Mugler, eds. 2015. The World of Indicators: The Making of Governmental Knowledge through Quantification. Cambridge and New York: Cambridge University Press. https://doi.org/10.1017/CBO9781316091265
Rugg, Deborah, Michel Carael, Jan Ties Boerma, and John Novak. 2004. “Global Advances in Monitoring and Evaluation of HIV/AIDS: From AIDS Case Reporting to Program Improvement.” New Directions for Evaluation 103: 33–48. https://doi.org/10.1002/ev.121
Sangaramoorthy, Thurka. 2012. “Treating the Numbers: HIV/AIDS Surveillance, Subjectivity, and Risk.” Medical Anthropology 31(4): 292–309. https://doi.org/10.1080/01459740.2011.622322
Schuller, Mark. 2012. Killing with Kindness: Haiti, International Aid and NGOs. New Jersey: Rutgers University Press
Shore, Cris, and Sharon Wright. 2015a. “Audit Cultures Revisited: Ratings, Rankings and the Reassembling of Society.” Cultural Anthropology 56(3): 421–444
Shore, Cris, and Susan Wright. 2015b. “Governing by Numbers: Audit Culture, Rankings and the New World Order.” Social Anthropology 23(1): 22–28. https://doi.org/10.1111/1469-8676.12098
Shukla, Anuprita, Paul Teedon, and Flora Cornish. 2016. “Empty Rituals? A Qualitative Study of Users' Experience of Monitoring and Evaluation Systems in HIV Interventions in Western India.” Social Science & Medicine 168: 7–15. https://doi.org/10.1016/j.socscimed.2016.08.041
Strathern, Marilyn, ed. 2000. Audit Cultures: Anthropological Studies in Accountability, Ethics, and the Academy. London: Routledge. https://doi.org/10.4324/9780203449721
Timmermans, Stefan, and Steven Epstein. 2010. “A World of Standards but Not a Standard World: Towards a Sociology of Standards and Standardization.” Annual Review of Sociology 36(1): 69–89. https://doi.org/10.1146/annurev.soc.012809.102629
True, Gala, Leslie B. Alexander, and Kenneth A. Richman. 2011. “Misbehaviors of Front-Line Research Personnel and the Integrity of Community-Based Research.” Journal of Empirical Research on Human Research Ethics 6(2): 3–12. https://doi.org/10.1525/jer.2011.6.2.3
United States Agency for International Development. 2017. “Budget: The Fiscal Year (FY) 2018 Budget Request for USAID Defends Our National Security Interests and Addresses the Challenges to American Leadership Abroad.” https://www.usaid.gov/results-and-data/budget-spending.
Watkins, Susan Cotts, Ann Swidler, and Thomas Hannan. 2012. “Outsourcing Social Transformation: Development NGOs as Organizations.” Annual Review of Sociology 38(1): 285–315. https://doi.org/10.1146/annurev-soc-071811-145516
World Bank Group. 2017. “Prevalence of HIV, Total (% of Population Ages 15–49).” https://data.worldbank.org/indicator/SH.DYN.AIDS.ZS
World Health Organization. 2017. “‘Three Ones' Agreed by Donors and Developing Countries.” http://www.who.int/3by5/newsitem9/en/.
Yarrow, Thomas. 2011. Development Beyond Politics: Aid, Activism and NGOs in Ghana. New York: Palgrave Macmillan.
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