DOI: 10.5061/dryad.z08kprrkz
title: Qualitative raw data and behavioral analysis for understanding VMMC policy decision-making

description: 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.
description: 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.
description: # VMMC Decision Mapping - Phase 1
 ## Description of the data
 and file structure 1. 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. 2. 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 3. 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