Trade-offs in Transition: Understanding Shared Responsibility for Sustainability through Transitions to Local Ownership
This study will explore how the process of transitioning the financing and management of global health prevention programs to local actors intersects multiple and sometimes competing policy priorities. Through a case study of the Avahan HIV prevention initiative's transition to government and community actors in India, this research aims to investigate the significance of transitions to local actors with respect to the concepts of sustainability, country ownership, and shared responsibility for sustainable improvements in population health. This study will highlight how the goals of transition are understood by different stakeholders in the transition process. In particular, this study will explore how different stakeholders understand and make tradeoffs between multiple objectives during the transition process. In addition, this project introduces a normative lens to the process of transition and situates the challenges of transitioning program to local actors within relevant bodies of ethical theory. Together, the empirical findings and normative inquiry will form the foundations of normative and policy guidelines for donors seeking to transition in a way that is consistent with the goals, values, and responsibilities of global health and development practice.