Paper short abstract:

The specificity of NGO delivery systems funded by Global Fund, is discussed, as they were juxtaposed to the state-owned HIV healthcare in Ukraine.

Paper long abstract:

Ethnographic enquiry is increasingly used in Global Health studies to better understand the complex transnational processes of combating the HIV epidemic, in which individuals, organisations, policies, and values constantly interact. In line with the critique of 'top-down' development model implying that international development initiatives often import value systems and principles into local contexts, the PhD study, recently completed by the author, analysed how the service delivery model by NGOs promoted by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF), manifested itself on the ground in Ukraine. A critical ethnographic enquiry including 50 participant interviews in three oblasts in Ukraine, and in capital Kyiv, investigated the conduct and practice of international and national nongovernmental organizations (NGOs) as Principal Recipients of GF grants in Ukraine from 2003-2012. The study aimed to understand how NGO-based HIV prevention services were implemented within a post-Soviet 'Semashko' health care context. The paper presents some of the findings that emerged from the analysis and discusses the specificity of NGO delivery systems, juxtaposed to the state-owned HIV healthcare system in Ukraine. Instead of an anticipated outcome of robust and effective delivery of HIV services by NGOs, deeply embedded in GF rhetoric and promoted in its delivery models, the NGO-run programmes were reported as not to have been integrated with the state health care system, and were run in a 'standalone', isolationist manner, which compromised referral into the HIV continuum of treatment and care.