January 2007

SYNERGIZING KNOWLEDGE AND ACTION – AIDS Community of Solution Exchange

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‘And this gray spirit yearning in desire To follow knowledge like a sinking star, Beyond the utmost bound of human thought.’ -Lord Tennyson (from ULYSSES)

The above lines aptly describe the concept of Solution Exchange.  Solution Exchange is an Internet based ‘Knowledge Management Partnership’ of the UN Country Team in India. It begun in early 2005 and has had good success in the Indian context. Cutting across semantics, Solution Exchange is a new initiative of the United Nations Country Team in India that offers communities of development practitioners a UN-sponsored space where they can provide and benefit from each other’s solutions to the day-to-day challenges they face. It is an endeavour in connecting people who share similar concerns and interests, bringing them together virtually and face-to-face towards the common objective of problem-solving. The UN Country Team is playing a convening role, providing an impartial space for professionals from government, NGOs, policy and research institutions, donor partners and the private sector to constructively interact and take forward their common development agenda.  This initiative is branded as ‘Solution Exchange’.

Through Solution Exchange, community members interact on an ongoing basis, building familiarity and trust, thereby gaining in knowledge that helps them contribute more effectively to development challenges. There are ten communities of practice established by December 2006, with more than 7,000 participants; growing at over 100 members a week. Among other results are more than 200 synthesized responses to members’ issues, six face-to-face priority-setting workshops, nine ongoing examples of collective small-group work, and nine consultations on government policy documents.

Each community has a dedicated team of professionals to moderate the discussions. Solution Exchange foresaw support for development practitioners, concerned with HIV in India. The service would be hosted by UNAIDS as the secretariat to the ‘UN Theme Group on HIV’. Taking advantage of this opportunity to reach out through an UN-sponsored platform, the National AIDS Control Organization (NACO) requested UNAIDS to support civil society consultation through an e-consultation on the National AIDS Control Program Phase-III (NACP III). UNAIDS offered Solution Exchange as a platform to seek the views of the public; to contribute their insights into the working groups.

Solution Exchange has overcome the challenge of sharing undocumented experiential knowledge in a community, thereby solving the various issues caused by the epidemic that is spread across a large country like India.

Echoing the excitement and interest generated in this pioneering effort, this e-consultation received substantial press coverage, with headlines reading ‘You can help make AIDS policy’ (Asian Age, New Delhi), ‘e-Consultation to help the Government of India design its national AIDS policy’ (i4donline.com), and the likes. Through this e-consultation, the Indian Government has set an example for other countries, by seeking direct participation of the people at large in its efforts to design a National AIDS Control Programme. Responses received totaled over 300 in the three months of the consultation. A booklet  named ‘Summary of the NACP III e-Consultation’ was also printed, as a product of this endeavour. The final NACP III policy document is likely to roll out in March 2007. By capturing as wide a range of perspectives as possible, including those of People Living with HIV (PLHIV), the resulting programme will have a much better chance of meeting its goals and mitigating the spread of HIV in India.

The Solution Exchange for the AIDS Community in India then moved on to knowledge-sharing activities and other efforts intended to help ensure that members work more effectively, both individually and as a group. Solution Exchange has overcome the challenge of sharing undocumented experiential knowledge in a community, thereby solving the various issues caused by the epidemic that is spread across a large country like India.

The Solution Exchange service primarily functions in the following manner. When members of the AIDS community come across a challenge and would like to have ideas from their peers, they put their query through an e-mail, and the moderator posts it to all community members.  Members offer advice, experiences, contacts or other suggestions.  In about ten days, the moderator posts a consolidated reply, which is a synopsis of responses to the mail group, including the original contributions as well as additional helpful resources and links. The result of this Query-Response-Consolidated Reply service is a comprehensive range of solutions, tailored to adapt to the local context. Compelling examples that influenced policy formulation include discussion on themes like stigma and discrimination, mandatory testing for HIV, training of trainers, section 377 and MSM, as well as registration for sex workers.

Since the launch of the Solution Exchange Service on 19 October 2005, forty-five queries have been posted. At present, this list has around 2500 members with largest membership from the NGOs (40.3 percent), followed by the UN and other inter-governmental organizations, which account for 24.1 percent. While the government agencies comprise 15.8 percent, the academicians are 12.9 percent and the private sector is the smallest group with 6.9 percent representation. Apart from the Query-Reply-Consolidated Reply services, Solution Exchange provides e-discussion, e-consultation, action groups and visioning workshop formats. Through Solution Exchange, community members interact on an ongoing basis, building acquaintance and trust, gaining in knowledge that helps them contribute more effectively to the challenges of this epidemic.

Solution Exchange uses only six types of e-mail messages.  Each type represents a different purpose for sending a message to the community through the mail list, so that the community members will know what to expect when opening it. The six standardized prefixes shown here in capitals help to distinguish the message types included in the subject heading:

When members of the AIDS community come across a challenge and would like to have ideas from their peers, they put their query through an e-mail, and the moderator posts it to all community members.  Members offer advice, experiences, contacts or other suggestions.

1. QUERY: Indicates a request for solutions or information by a community member.

2. DISCUSSION: An open e-discussion on a particular topic with a structured format. The mail with this heading would: (i) introduce the topic for discussion, (ii) introduce the guest moderator(s) or conveners, if any, and (iii) provide details on the modalities for the discussion.

3. FOR COMMENTS: Draft documents that network members or the public are asked to review and comment on within a specific period.  Might be used, for example, by a member for a peer review, or for wide consultation on a draft policy document, program or project proposal. Depending on the item, a consolidated reply could be prepared at the end of the period.

4. CONSOLIDATED REPLY: Provides a brief synthesis and analysis of the contributions received, as well as the list of contributors with their individual contributions. It also provides additional information regarding relevant resources and contacts. Consolidated replies have a standardized structure and format to make them easy to index and search for in the knowledge repository.

5. DISCUSSION/FOR COMMENTS INTERIM SUMMARY; DISCUSSION/FOR COMMENTS CONCLUSIONS :  Works on the same principle as the consolidated reply. It provides the summary and analysis of the e-discussion or consultation, and may be prepared in collaboration with the guest moderator, where relevant.  Summaries are issued over the course of the discussion, and conclusions are issued at the close of the discussion.

6. FOR INFO: Announcements from the moderator about updates and newsletters issued, and from members sharing news or announcements.  The latter are supply-driven messages, and as a rule should not be encouraged.  The preferred option is to include them on the community’s website in the appropriate category.

Translating knowledge to action

The Visioning Workshop uses a two-day format. The first day is devoted to three community ‘champions’ or members who commit to sponsoring ‘action groups.’ The champions present their cases and identify their respective action plans for taking a strategic priority forward. Examples of this from the AIDS Community Visioning Workshop were universal access, stigma and discrimination, and community response to HIV. The second half-day session is devoted to networking and to introducing a new knowledge-sharing technique that participants can use in their own environments. Now, participants do a ‘peer assist’; that is sharing their experiences in a face-to-face demonstration of the Solution Exchange Query-Response-Consolidated Reply format.

An e-discussion or consultation is a virtual brainstorming by members of a community of practice to address a broad topic of interest and provide a range of insights, conclusions or recommendations for the benefit of policy makers or for community members to take forward their work. It results in an ‘e-discussion summary’ paper that reflects the highlights of the discussions and the conclusions reached. E-discussions are posted on the community’s mail group and are moderated in the same manner as the Query-Consolidated Reply process. In an e-consultation, as we have seen in the singular example of the NACP-III consultation, the difference is that non-member participation and anonymous postings are allowed. An example of e-discussion was the one on Universal Access, the summary of which was used in various National Stakeholder Consultation Workshops in various Asian countries.

Action Groups prepare high-value, strategic interventions that will take the community’s agenda forward.  The intervention can be a program or project proposal, a study to fill a knowledge gap, a training package, policy recommendations, or anything that can be prepared within a 20-week period by a small team, including consultants.  Action group topics are based on community priorities, identified in a visioning workshop, or because of a particularly compelling query that received a substantial number of responses.

The action group on stigma and discrimination completed a national work plan in the following way: An overwhelming response to a query on stigma and discrimination reiterated that it was the biggest problem faced by PLHIV. These contributions provided a convincing case on what can be accomplished through active, determined efforts.  One member even suggested preparing a comprehensive programme of action at a national level. So, an action group meeting was held, which led to the creation of AAROHII, an acronym for Action Advocacy Research on HIV in India. This coalition enabled the members to maximize their impact, both individually and collectively. AAROHII has now drawn up its constitution, objectives, a vision for India as the least stigmatizing country, and a project document that translates these objectives into activities, addressing stigma and discrimination.

An e-discussion or consultation is a virtual brainstorming by members of a community of practice to address a broad topic of interest and provide a range of insights, conclusions or recommendations for the benefit of policy  makers or for community members to take forward their work.

Community updates provide community members with periodic news, information on the queries, and information on other community activities. Information could be on ‘open’ queries and e-discussions for which replies and contributions are still expected, on closed queries or e-discussions that took place over the period, on announcements of events and new resources received from members during the period, and on lists of new members that have joined the community.  Updates are serially numbered and are particularly useful for managers and others, for reviewing queries and consolidated replies without having to review all the individual messages. The AIDS community has seen its eighth community update recently.

Among the main benefits of Solution Exchange are the following:

 Enhanced knowledge on development issues.  The learning gained by CoP members draws from both documented knowledge and undocumented experiences.

 Branding for the UN as a source of ideas.  UN Agencies are the ‘convenors’ of the communities of practice, and play a highly visible role as knowledge brokers, both in the country and through the global linkages that UN agencies are in the best position to access.

 Team building within the UN.  The close involvement and collaboration of the UN Heads of Agencies in this UNCT initiative have facilitated other team-based exercises such as the recent UNDAF preparation exercise.

The first annual compendium of the AIDS Community, Solution Exchange was released by Dr. Peter Piot,  the utive Director of UNAIDS, on 18 December 2006. This compendium contains the first thirty-six consolidated replies, issued during its maiden year from 19 October 2005 up to 18 October 2006.

The benefits of a knowledge management partnership and Solution Exchange have also been seen as replicable in other countries.  In June, at the invitation of the India Country Team, representatives of 13 UN Country Teams across the world, along with agency headquarter and regional unit staff, participated in a consultation on how to adapt the Solution Exchange model for other Country Teams.  Currently the India project team is pursuing several invitations to help set up similar initiatives.

The customer has the last word in confirming our role in policy formulation. Jaffer Inamdar of Positive Lives Foundation, Goa wrote in: “After our discussions on ‘Pre-marital Mandatory Testing for HIV’ and the public debate that was held, the Goa State Government has declared that pre-marital testing for HIV would be by ‘opt-in’ which is akin to voluntary. Therefore, for a long time we in Goa will remember this discussion more for its influential power than for its engrossing controversy.”

Creating Space for e-Health
Space Hospitals, the Chennai-based telemedicine services provider, has some ambitious plans on the anvil. By the end of 2007, the healthcare chain, which works through an alliance of 14 major super- speciality hospitals in India, has endeavoured to enhance its existing telemedicine network across Tamil Nadu by adding 126 new telemedicine centers to its network. Besides this, the organisation also aims to establish 38 satellite medical centres and nine regional association hospitals, which will improve its presence in the rural areas. Space Hospitals is engaged in talks with some major hospitals to join as its regional associate partners. All total, Space Hospitals has aims of setting up 500 satellite medical centres, 40 regional associate hospitals and 800 telemedicine centres throughout the country during 2007.

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