Post on 18-Jan-2018
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Investing in Different Models of Local Ownership to Ensure
Sustainable Patient CareTrack 1 Implementers Meeting
Maputo, MozambiqueAugust 2010
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Presentation Overview
Sustainability and building Local Ownership to support TransitionLessons Learned
GlobalKenyaZambiaSouth Africa
Questions2
Faith-Based Health Care in Africa
History of Faith-Based Health Care in AfricaCurrent Infrastructure – 30-70%Global Trends
PEPFAR provided opportunityLoss of resources
Seamless Relationship3
Sustainability: Sustained access to quality care with durable patient outcomesContinuing support to and scale-up of National programs Facilitating a seamless relationship between Faith-Based Health Networks and Government Health Systems
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Approach to Sustainability Fostering partnerships and developing sustainable capacities of Treatment Facilities and Local Partners
so that:
• Treatment facilities provide high quality treatment
• Local partners provide long-term support to sustain treatment facilities’ care delivery
• Local partners engage in productive dialogue with National Governments around the their role in provision of health services and Health Policy
Capacity Building Cycle
Support($, TA)
What is thisamount?
time
PartnerCapacity
Status of Partner Capacity
Plan Implement Scale Up Sustain
Vision for Transition
Faith Based Health Networks are an integral part of their countries Health Care Systems
Local Partners are leaders in the Anti-Retroviral Therapy programs with decreasing support from AIDSRelief across timeFaith Based Health Services are resourced adequately to serve the needs in the country and continue across time
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Local PartnersMeet PEPFAR Criteria:
Local organization or government entity
Have the capacity to: Be a competitive prime for USG fundingManage all functions of Track 1.0 projectReach a sustainable level of operations
Slide 8
Principal Approach to Technical TransitionBuilding capacity of MOH institutions at all levels to provide oversight for treatment programs and for outcomes evaluation
Building advanced clinical education capacity
Entering into partnership with medical institutions in host country through which TA to LPTFs will be sustained
Working with host MOH to develop evidence driven HIV policies
Strategic Approach to Technical Transition
Building partnerships with institutions that can take on different technical roles over the long term:Local Partners, Treatment Facilities:
For care and treatment delivery – site activation, evaluation/improvement, treatment planning
Ministries of Health:For technical oversight including continuous quality improvement and outcomes evaluation
Medical Education Institutions:For pre-service, in-service education and technical support to sites through on-going mentoring
National Labs Institutions:For laboratory systems strengthening
Where are we now: Year 7 Priorities for Transition
Transitioning – Not business as usualAligning – with Ministry of Health on Transition strategiesStrengthening – action plans rolled-out Transferring – site management to Local PartnersCompeting – preparing for FOAs
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Models for Local Partners Model 1: MOH or other government entity as local partner
Rwanda: Six Sites Transitioned as of March 2010
Model 2: Local partners (local umbrella org) in collaboration with national technical partner/s for clinical and SI (MOH/university/other)
Kenya: Faith Based Network MEDS with CHAK, KEC & University of NairobiHaiti: Faith Based Network St Boniface NGO with University of Notre Dame de Haiti
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Models for Local Partners Model 3: Local partners (local umbrella org) with sub-grantees providing technical assistance
Zambia: Faith Based Networks CHAZ & CHRESO South Africa: SACBC AIDS Commission & IYDSA NGO network
Model 4: Sites as direct primes to CDC South Africa: St. Mary’s Hospital in DurbanGuyana: St Joseph Mercy Hospital and Davis Memorial Hospital
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Lessons Learned for Transition
1. We are all learning as we go (AIDSRelief, Donors, Local Partners). In-country and global transition committees are critical to address practicalities of the process.
2. Communicate clearly and frequently on transition.
3. Strive for a shared long-term vision for the role of faith-based partners.
4. Technical transition requires a unique design per country, as there is not one model for medical or strategic information transition.
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Lessons Learned5. Flat-lined budgets mean reduced funding for transition
due to increasing numbers of patients on treatment.6. Switching treatment sites between different models is
difficult. Example: AIDSRelief to Global Fund7. The capacity strengthening of local health system for
long-term sustainability will take longer than 3-4 years. 8. Staff retention within Local Partners, Treatment
Facilities and with INGOs is essential for transition success.
9. Work to ensure future funding opportunities for local partners by Sept. 2011. Prepare to respond quickly.
Slide 15
Timeline for Transition (Expected)