The BPS Theory of Change & Prevention Cascade
Most HIV prevention programs/projects target increasing delivery and uptake of specific prevention interventions or supporting specific populations – often at a very small scale or in multiple locations across a country. What if instead one built the capabilities and capacities of a district to detect and target risk, generate demand for HIV prevention services and products, effectively deliver prevention products and interventions, and enable effective and sustained use of prevention products by the end user while simultaneously building the technical leadership and governance needed to plan, implement, coordinate, and evaluate HIV programs; ability to utilize data systems for decision making; and develop the ability to engage and partner with non-governmental entities, e.g. civil society, communities, and the private sector? That is the hypothesis underlying BPS and its change strategy. BPS posits that it will establish a district-based system optimized with these prevention cascade capabilities and health systems capacities, capable of deploying existing and new prevention products, institutionalized within local structures, and attractive to investment. The larger goal is to bring down new infections and support Malawi in sustaining control of its HIV epidemic.
This theory of change is at the heart of BPS’s approach and implementation. BPS work streams are organized around the prevention cascade under the leadership of Blantyre District and City with expert partners supporting and building capacity. This approach (as illustrated in the graphic below) is intended to build a replicable, unified, and highly effective system of HIV prevention.