- Whose Agency: The Politics and Practice of Kenya's HIV-Prevention NGOs by Megan Hershey
In Whose Agency, political scientist Megan Hershey uses a mixed-methods research approach to argue that local nongovernmental organizations (NGOs) in Kenya are highly adaptable and thus able "to thrive within the interplay of donor, state, and religious demands" (20). She balances discussion of academic works on NGOs with examples from participant-observation, interviews, focus groups, and surveys in nuanced and engaging ways.
The first chapter summarizes the literature on NGOs and program evaluations of HIV-prevention programs as well as key terms and methodologies for the remainder of the book. Hershey focuses on local NGOs, as opposed to international NGOs or community-based organizations. She measures NGO success through its direct reach ("the number of individuals who attended a training program"), indirect reach ("the number of individuals with whom trainees shared HIV-prevention information"), the number of individuals obtaining HIV tests as a proxy for individual behavioral change, and the use of participatory approaches (15–17). She uses four case studies of local NGOs in Nairobi, Kenya: two each that operate in universities or informal settlements and two each that are faith based or secular. She conducted participant-observation and staff interviews at each site over a period of six weeks or more, surveyed youth in the NGOs' target areas, and interviewed youth who participated in the NGOs' programs. In chapter 2, she provides background information for future chapters, with a brief history of the NGO sector and HIV/AIDS contexts in Kenya. She discusses the settings of the four case studies: the Kibera and Mathare informal settlements, the University of Nairobi, and Daystar University.
Chapter 3 details the four local NGOs Hershey studied, including their locations, work cultures, and programs. It includes survey results relating to the organizations' direct reach, indirect reach, and effects on behavior (as reflected in HIV testing rates) in their target areas. Hershey finds "NGOs are effecting real behavior change in addition to reaching people directly and indirectly" (70). The next chapter describes how the NGOs conduct their training and how they adapt "to attract and meet the needs of their target audiences," as by providing a small financial incentive in informal settlements or making the training entertaining to compete with other activities available to university students (90). Interestingly, Hershey finds that a lower percentage of survey respondents in informal settlements attended HIV training sessions, but those who did so shared the information more widely, reaching as many as twenty-six people per trainee.
In chapter 5, Hershey focuses on participation, including "whether local NGOs were responding to community members' needs and whether these community members were meaningfully incorporated into the decision-making [End Page 97] process as participants" (91). She finds that the NGOs in informal settlements incorporated more participation into their processes, such as involving local youth groups, although neither they nor their university-based peers incorporated ideal amounts of participation. She attributes this to poor internal communication within the NGOs and donor restrictions, which may lead NGOs to prioritize the donor's desired outcomes over the community's participation or preferences. The following chapter examines the role of religion. Hershey reports that "faith is not a key element of NGO programs" for either the religious or secular NGOs, since religious NGOs downplay faith to align with donor restrictions and attract participants, while secular NGOs include some religious practices, like prayer, to boost their legitimacy in local contexts (123). There is thus no difference in programs, but there are nonetheless some differences in the NGOs' cultures, their approaches to networking, and their employees' perceptions of their own and their organizations' work.
In chapter 7, Hershey discusses the relationship between HIV/AIDS NGOs and the Kenyan state. After providing a brief history of the state's response to HIV/AIDS, she argues that NGOs have "carefully cultivat[ed] positive relationships with the state in order to access more resources with which to better serve their communities...