Presentation to the ACSM Subgroup at Country Level Session 8

2nd Meeting of the Subgroup on Advocacy, Communications and Social

Mobilizationat Country Level

Advocacy, Communication and Social Mobilization Sub Group at Country Level: Building a Technical Assistance Network

Presentation to the ACSM Subgroup at Country Level

Session 8



Outline

1. ACSM 10-year Strategic Framework for Action

2. Utilization of ACSM

3. Discussion and decisions



Utilization: Rapid growth in ACSM

19

9

0

2

4

6

8

10

12

14

16

18

20

2002 2005 2007

HBC's withNational ACSMPlans

2002 data as gathered from ACSM Needs Assessment Survey of HBC's

2006-2007 data gathered from HBC DOTS Expansion survey

*Planned



Funding: HBCs with GFATM funding via rounds 1-5 for ACSM activities

2

12

18

0

2

4

6

8

10

12

14

16

18

20

2002 2004 2006*

Countries

2002 data as gathered from ACSM Needs Assessment Survey of HBC's 2006-2007 data gathered from HBC DOTS Expansion survey *Approved grants from 5th round GFATM



Funds at Country Level via GFATM

Successful 5th round for ACSM: $35 million over two years $63 million over five years

(Some TA budgeted for in some 5th grants)

Challenge #1: How to access resources to maximise the impact of available GFATM funding and to achieve the targets as detailed in the GP2 and ACSM Strategic Framework for technical cooperation among partners and countries.

Country ACSM 2 year budgets

(in millions)

Bangladesh 1.8

DRC 1.7

Indonesia 9.1

Nigeria 7.3

Zimbabwe 3.5

Gambia .8

Brazil 1.02



6th round GFATM supported by partners and using ACSM framework

Afghanistan Congo Rep Eritrea

Ethiopia Togo Zambia Egypt

Iraq Morocco Pakistan PNG Vietnam Botswana



Improving funding for ACSM Technical Assistance Lagging (as of Sept 2006)

00.5

1

1.5

2

2.5

3

3.5

44.5

5

Capacitybuilding

Monitoringand eval

Operationalresearch

KnownCommitment

Global PlanEstimate

Gap

US$9 million gap in ASCM projected TA needs at country level

Note: USAID is the largest single donor for ACSM technical support

In millions



Previous discussions on TA

2004—CB meeting Beijing: Endorsement of ISAC to respond to shortage funding for TA TB/HIV: Requested funds for operational research and policy

monitoring 2005—CB meeting Addis Ababa: Agreement to support

countries with technical assistance to prepare 5th GFATM Proposals

Jan. 2006—Partners TA meeting Geneva: discussed the growing need for TA for all of technical issues

Feb. 2006—Coordinating Board presentation. TBCTA, ISAC and other channels provide needed TA

but ACSM access to those funds is limited



Session 8: Status Report on ACSM

at Country Level Presentation to the 2nd Meeting of

the Sub-group on ACSM at Country Level

Tanya Siraa/Stop TB



What was the survey about?

Annual survey sent to 22 HBC's to assess needs and progress of NTP's which feeds into Global TB Control Report.

2006 was the 2nd edition to include questions on ACSM: Type of messages communicated Media types used Activities of patient-centred organizations Availability of ACSM monitoring and evaluation data Barriers to ACSM implementation



ACSM activities are focused primarily on public education; less on advocacy.(Average, in order of importance):

1. Educating on signs and symptoms of TB2. Educating on where to go for TB testing and

treatment3. Encouraging care seeking behaviour4. Increasing knowledge of risk factors for TB5. Combating stigma6. Calling for increased political and financial support7. Encouraging community action8. Providing a channel for the afflicted to voice their

concerns

Public education

Advocacy

Source: 2006 Stop TB strategy questionnaire (Q.N3a) from Afghanistan, Bangladesh, Brazil, China, India, Indonesia, Kenya, Myanmar, Nigeria, Pakistan, Philippines, Russia, Tanzania, Uganda, Vietnam, Zimbabwe. No data from Cambodia, Congo, Ethiopia, Mozambique, South Africa or Thailand.



Electronic and print media Interpersonal communication Community mobilization Point of service promotion Folk media

Countries use a wide variety of media for their ACSM activities:(Average, in order of importance):




Activities of patient-centred organisations:

1. Community mobilization (100%)2. Active case detection (89%)3. Treatment support (78%)4. Consultation with NTP regarding

policy/programme implementation (67%)5. Activism for national policy change or national

resource mobilization (56%)



We must enable countries to gather data for monitoring and evaluation. Only five out of 17 countries claim to have country-level

data to evaluate the efficacy of ACSM strategic plan which will allow programme improvement and dissemination of information: Brazil, China, India, Indonesia, Philippines

The remaining 12 countries claim to have no M&E system in place for ACSM: Afghanistan, Bangladesh, Kenya, Myanmar, Nigeria,

Pakistan, Russia, Tanzania, Thailand, Uganda, Vietnam, Zimbabwe.




Countries face multiple barriers to implementing ACSM programmes.

Top six reasons across countries:

1. Limited staff capacity

2. Limited resource availability

3. Geographic/linguistic/cultural diversity

4. Administrative or managerial constraints

5. Identifying and reaching priority target groups

6. Stigma




Countries face multiple barriers to implementing ACSM programmes.

Other top reasons (average across countries):

7. Lack of health sector coordination

8. Poor understanding of TB risk factors

9. Lack of commitment from health care providers

10. Lack of commitment from civil society

11. No action plan

12. Lack of political commitment from central government




Questions?



Unique opportunity

Technical assistance program



Unique Opportunity

USAID and Stop TB developed a TA proposal and secured $507K in funding from OGAC to support countries with rounds 1-6 ACSM implementation.

Funding is designed to remove obstacles and accelerate implementation.

Funding conditional on: Type of TA need Country needs



Examples of TA requeststhat could be funded

Formative behavioral/demographic/market research

Data interpretation Project management strengthening Monitoring and evaluation planning Micro-planning



Program outline

Only countries with GFATM rounds 1-6 funding are eligible for catalytic TA

Component 1: Technical Assistance Mechanism

Component 2: Country-specific Program Evaluation

Component 3: Program Management



Monitoring and evaluation of TA

Two tier systemTier one: Standardized matrix of ACSM

elements as suggested in 10-Year Strategic Framework with respect to county TA needs

Progress towards implementation as detailed in GFATM Grant.

Increased NTP capacity

Tier two: Partner progress reports



Next Steps

Survey of country needs TA applications from country Subgroup to discuss/agree on basic standards

for rendering TA. Priority countries, utilization of the Framework,

compliance with terms of the grant.

TA to be country/TA partner and coordinated by Stop TB



Recap

Challenge #1: How to coordinate effectively among partners to maximise gains, measure outcomes and advance the GFATM Grants in assisted countries?

Challenge #2: What should be the guiding principles governing the USAID-funded Technical Assistance program?



Proposed Guiding Principles

1) TA for ACSM will be focused on assisting counties in the initial phases of their GFATM ACSM grants.

2) TA for ACSM must accelerate the absorptive capacity and improve the performance of the ACSM component in those projects approved by the GFATM.

3) TA for ACSM must be catalytic in nature and will be targeted to remove obstacles to successful ACSM implementation and build local capacity.

4) TA for ACSM must be in alignment with the standards, methodologies, objectives as articulated in the component 5 of the Stop TB Strategy.



Recommendations

Presentation to the ACSM Subgroup at Country Level Session 8

Documents

Transcript of Presentation to the ACSM Subgroup at Country Level Session 8