Globally, HIV/AIDS programs face pressure to document accountability and achievement via “evidence-based” criteria or “monitoring and evaluation” (“M&E”). Donors have increasingly made M&E a funding stipulation funding. They want numeric data that speak to universal indicators of efficacy, a newly hegemonic means of assessment in the field of governance based in business management. Advanced by major global institutions like the United States President’s Emergency Plan for AID Relief (PEPFAR), M&E systems—structures of metrics, procedures, people, and technology—are variously set up around the globe. M&E plays an increasingly deeper role through a program’s entire lifespan and in the daily activities of program workers. Yet surprisingly, little is known about how M&E occurs on the ground and the social and political effects: What kinds of actions and social relations does M&E instigate? How does its practice maintain or challenge the status quo? Furthermore, “developing” countries, incredibly dependent on foreign program funding, encounter M&E through uneven postcolonial relations. How does M&E reflect and possibly influence postcolonial relationships, and country sovereignty? My dissertation explores these questions through an ethnographic study of the M&E of an HIV/AIDS prevention program in Ghana called BRIDGES, funded by the United States Agency for International Development (USAID). For 20 months I followed the M&E of BRIDGES through a focus on one non-governmental organization (NGO). I argue that M&E is a key site through which HIV/AIDS intervention is trans/formed. It not only reflects but also produces (unexpected) social relations and habits, which shape how HIV/AIDS intervention operates. In Ghana, M&E unintentionally deepened unequal relations between donor-recipient, organizations, and personnel. I demonstrate that this effect occurred on and through the practices and agency of those governed by M&E. M&E is not an agent in its own right, but is deployed in particular ways by actors in fields of power.
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Thesis advisor: Pigg, Stacy Leigh
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