Abstract
BACKGROUND: Civil society organizations (CSOs) are often assumed to be institutions that facilitate communication between citizens and policymakers. However, CSO advocacy is only as effective as the space allowed by government, the resources available from funders, and their own internal capacity. This article presents findings from a study in Nigeria that explores the advocacy and service delivery roles of CSOs working in Human Immunodeficiency Virus (HIV) prevention and mitigation. We will argue that donor and government treatment of civil society as service delivery organizations, rather than as organizations that participate in democratic norms, have shaped how civil society organizations work to mitigate and prevent HIV. METHODS: From February to April 2012, a team of Health Systems 20/20 staff and one consultant conducted 48 in-depth interviews with civil society organizations, State AIDS Control Agencies (SACAs), donors, international organizations, and networks of people living with HIV to examine a wide range of advocacy efforts by CSOs. For quantitative data collection, sampling frames were assembled from lists of HIV-oriented or involved CSOs. This sampling frame consisted of 2548 CSOs from all 36 states and the Federal Capital Territory. A random sample was then taken from the sampling frame, and we contacted 665 CSOs to arrange interviews. With a response rate of 80.2 %, the project conducted 533 surveys in February 2012. RESULTS: These surveys showed that CSOs advocacy efforts focused on community mobilization related to behavior change, such as peer education (54.9 % of CSOs) and rallies (58.2 % of CSOs), and not on changing government policies. In-depth interviews highlighted the role of donors and government in shaping a purely apolitical role for most CSOs through funding constraints, regulations, and capacity development choices. CONCLUSIONS: In light of these findings, we present key points for considering the influence of donors and government on civil society advocacy for HIV services and rights. We present evidence that donors, and international organizations, conceive of civil society as apolitical, and not as independent actors that compete for political space. More democratic and rights-based views of civil society's role, such as holding government accountable for providing services or promoting policy change, are not emphasized.