The multisectoral approach to HIV/AIDS program in Haiti: a critical review of the actors involved in its governance

Summary Aim: The multisectoral approach is often adopted in national policies of fight against AIDS. This article analyzes the characteristics of the actors’ network and their influence on the governance of the HIV program in Haiti. Methods: The qualitative data comes from interviews, observations and documentation. For their analysis, two techniques are used: namely thematic and structural analysis. The interpretation of results is based on the theory of the strategic actor (Crozier M, et al. L’acteur et le système : les contraintes de l’action collective. Paris : Ed. du Seuil ; 1977 [1]) and the theory of network governance. These concepts allow to study and have an insight on the participants’ potential power, their strategies and interactions within the network. Results: These actors, with their diversity, the resources they control, and the nature of their interactions, determine the challenges regarding governance. There is a gap between the leadership role attributed to the national coordinating body and the true and actual nature of its influence within the network. This discrepancy is mainly attributable to the fact that its potential power, defined by available resources, places it in a weak position, which as a result translates into its incapacity to effectively impact the situations at hand. The study reveals the links between the actors’ characteristics and their ability to influence the process of governance through the web of relationships and the structure of power game. Conclusion: In Haiti, many actors are involved in the fight against HIV. The analysis of the complex network they operate within has shown that their potential to influence the program were uneven. This constitutes an important challenge for the national coordinating body. Prat Organ Soins. 2012;43(2):131-141