Article Text

Download PDFPDF

Learning about scale, measurement and community mobilisation: reflections on the implementation of the Avahan HIV/AIDS initiative in India
  1. Tisha Wheeler1,
  2. Usha Kiran2,
  3. Gina Dallabetta3,
  4. Matangi Jayaram2,
  5. Padma Chandrasekaran4,
  6. Annie Tangri2,
  7. Hari Menon2,
  8. Sameer Kumta2,
  9. Sema Sgaier2,
  10. Aparajita Ramakrishnan2,
  11. James Moore2,
  12. Alkesh Wadhwani2,
  13. Ashok Alexander2
  1. 1Formerly with the Bill & Melinda Gates Foundation, Washington DC, USA
  2. 2Global Health Program, Bill & Melinda Gates Foundation, New Delhi, India
  3. 3Global Health Program, Bill & Melinda Gates Foundation, Washington DC, USA
  4. 4Independent consultant, Chennai, India
  1. Correspondence to Dr Tisha Wheeler, Futures Group, One Thomas Circle, NW Suite 200, Washington DC 20005, USA; twheeler{at}


Debates have raged in development for decades about the appropriateness of participatory approaches and the degree to which they can be managed, scaled and measured. The Avahan programme confronted these issues over the last 7 years and concludes that it is advantageous to manage scaled community mobilisation processes so that participation evolves and programming on the ground is shaped by what is learnt through implementation. The donor (Bill & Melinda Gates Foundation) and its partners determined a standard set of programme activities that were implemented programme-wide but evolved with input from communities on the ground. Difficulties faced in monitoring and measurement in Avahan may be characteristic of similar efforts to measure community mobilisation in a scaled programme, and ultimately these challenges informed methods that were useful. The approach the programme undertook for learning and changing, the activities it built into the HIV prevention programme, and its logic model and measurement tools, may be relevant in other public health settings seeking to integrate community mobilisation.

  • Community participation
  • community mobilisation
  • HIV prevention
  • female sex workers
  • evaluation methodology
  • organisational development
  • socio-economic
  • social inequalities
  • social science
  • social capital
  • sexually trans dis

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Linked articles 200562, 200487, 200465, 200475, 200514, 200511, 200832, 201065, 200478, 200508, 200590.

  • Funding This work was supported by the Bill & Melinda Gates Foundation under the HIV/AIDS Division through a range of grants in the Avahan portfolio, including grants of the following identification numbers: 29868, 29928, 30080, 30111, 30121, 30138, 30148, 30177, 30183, 30553, 31280 39418, and 5189.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement An open access data policy is in place for all data associated with the project.

Linked Articles