Technical Assistance for Health Systems Development: Benefits for HIV/AIDS Programs <br />Nicole Barcikowski, MA<br />Heal...
Outline<br />National Policy Impacts<br />Financial: Mali, Kenya, India<br />Human Resources: Côte d’Ivoire<br />Organizat...
National PolicyImpacts: Mali CBHI<br />Strengthen community-based health insurance (CBHI)<br />Develop policy, operational...
National Policy Impacts: Kenya HAPSAT<br />HIV/AIDS Sustainability Analysis Tool (HAPSAT) assessment in 2010 found HIV/AID...
National Policy Impacts: India PLWHA Insurance Coverage<br />Develop road map to cover people living with HIV/AIDS in broa...
National Policy Impacts: Côte d’Ivoire HRH<br />Assess human resources for health (HRH) to inform strategy<br />Health Sys...
Organizational-levelImpacts: Mozambique Global Fund Grants<br />Improve access to Global Fund grants<br />MOH requests Hea...
Organizational-level Impacts: Liberia NAC<br />Establish permanent National AIDS Council (NAC) Secretariat to provide coor...
Organizational-level Impacts: Kenya HIS<br />Strengthen HIV/AIDS data collection and reporting system to streamline servic...
Organizational-level Impacts: Côte d’Ivoire HRH  (1)<br />Use performance-based incentives (PBI) to improve HRH capacity a...
Organizational-level Impacts: Côte d’Ivoire HRH (2)<br />Results<br />PBI<br />Return of HRH to areas affected by socio-po...
Organizational-level Impacts: Guyana HAPSAT<br />HIV/AIDS Sustainability Program Analysis (HAPSAT) of public sector HIV/AI...
Thank you<br />www.HealthSystems2020.org<br />
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Technical Assistance for Health System Development: Benefits for HIV/AIDS Program

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Technical Assistance for Health System Development: Benefits for HIV/AIDS Program

  1. 1. Technical Assistance for Health Systems Development: Benefits for HIV/AIDS Programs <br />Nicole Barcikowski, MA<br />Health Systems 20/20 <br />Abt Associates Inc.<br />Global Health Council<br />June 17, 2011<br />
  2. 2. Outline<br />National Policy Impacts<br />Financial: Mali, Kenya, India<br />Human Resources: Côte d’Ivoire<br />Organizational-level Impacts<br />Financial: Mozambique, Liberia<br />Information Systems: Kenya<br />Human Resources: Côte d’Ivoire, Guyana<br />
  3. 3. National PolicyImpacts: Mali CBHI<br />Strengthen community-based health insurance (CBHI)<br />Develop policy, operational plan, budget for Mali’s first government-subsidized CBHI policy<br />Partners: MOH, World Bank, Ministerial Leadership Initiative (Gates Foundation)<br />Steering and technical committees met with MOH in Rwanda, where 85% of population is covered by CBHI schemes<br />Results<br />CBHI policy adopted by President and Board of Ministries in Feb 2011<br />Government will subsidize 50% of CBHI plan ($83 million over five years)<br />Complements 2009 law requiring formal sector employers to provide and subsidize health insurance for employees<br />
  4. 4. National Policy Impacts: Kenya HAPSAT<br />HIV/AIDS Sustainability Analysis Tool (HAPSAT) assessment in 2010 found HIV/AIDS funding unstable, 75% from donors, and recommended: <br />Use air traffic levy as short-term source of income for HIV/AIDS programming<br />Increase government contributions to health to 15% as per Abuja Declaration<br />Partners: MOH, National AIDS Control Council, National AIDS and STI Control Programme<br />Results<br />Cabinet memorandum to implement levy drafted in March 2011 <br />
  5. 5. National Policy Impacts: India PLWHA Insurance Coverage<br />Develop road map to cover people living with HIV/AIDS in broader risk pools and mainstream HIV/AIDS coverage in insurance packages<br />Partner: Indian government<br />Result: Expect policy decision on HIV/AIDS insurance coverage by fall 2011<br />
  6. 6. National Policy Impacts: Côte d’Ivoire HRH<br />Assess human resources for health (HRH) to inform strategy<br />Health Systems 20/20 (and PHRplus) assessments (public sector 2005, private sector 2007) estimated HRH at 11,749 staff: nurses (58%), midwives (18%), doctors (14%)<br />Partners: MSHP, local stakeholders<br />Results<br />Developed costed5-year strategy for HRH focused on both demand and supply <br />Activity success attributable to consistent consultation with local stakeholders and strong government leadership through MSHP<br />
  7. 7. Organizational-levelImpacts: Mozambique Global Fund Grants<br />Improve access to Global Fund grants<br />MOH requests Health Systems 20/20 assistance to clear system roadblocks to accessing Global Fund grants and create a more effective financial management system<br />Establish Global Fund unit within MOH Planning Department<br />Work with the Department of Finance and Administration to customize financial management system to receive, track, and report on various donor grants and activities<br />Results<br />Clear backlog of Global Fund disbursements (Rounds 2, 6, 7)<br />Use grant funding to serve 1.5 million living with HIV/AIDS and 110,000 with TB, and help prevent over 19,000 malaria deaths per year (WHO)<br />
  8. 8. Organizational-level Impacts: Liberia NAC<br />Establish permanent National AIDS Council (NAC) Secretariat to provide coordination, strategy development, M&E, advocacy<br />Define functions, develop staffing plan and position descriptions, determine operating budget <br />Clarify relationship of Secretariat to NAC Executive Committee<br />Do team building, management capacity building, executive coaching<br />Results<br />Legislation formally establishing NAC approved by Congress, awaits president’s signature<br />Revised National Strategic Framework for HIV/AIDS<br />Fully staffed Secretariat with office space and operating funds<br />Task forces being formed for M&E, partner coordination, etc.<br />
  9. 9. Organizational-level Impacts: Kenya HIS<br />Strengthen HIV/AIDS data collection and reporting system to streamline service delivery and access<br />Standardize national HIV/AIDS data collection and reporting (number people screened, HIV positive, needing/receiving ART, etc.)<br />Build capacity to collect higher-quality, standardized data<br />Create HIV/AIDS framework within broader HIS, eliminating parallel systems<br />Results<br />Better M&E and data collection system at 6,000 facilities in 250 districts<br />Improved information available for decision makers <br />
  10. 10. Organizational-level Impacts: Côte d’Ivoire HRH (1)<br />Use performance-based incentives (PBI) to improve HRH capacity and HIV service delivery<br />Health Systems 20/20 (and PHRplus) HRH assessments showed severe maldistributionof HRH (60% in Southern region) and high worker turnover in hard-to-fill posts<br />Health Systems 20/20 support to:<br />Pilot MSHP PBI scheme in Ferkessedougoudistrict<br />Build regional and district capacity in management and leadership in decentralized health system<br />
  11. 11. Organizational-level Impacts: Côte d’Ivoire HRH (2)<br />Results<br />PBI<br />Return of HRH to areas affected by socio-political crisis (94% HRH presence)<br />Increased funds for facility premises and equipment, higher-quality service delivery<br />Improved availability and access to HIV and other priority services at peripheral level<br />Strengthened local capacity in management and leadership, including HIS management and reporting, planning <br />
  12. 12. Organizational-level Impacts: Guyana HAPSAT<br />HIV/AIDS Sustainability Program Analysis (HAPSAT) of public sector HIV/AIDS services<br />Results<br />Review distribution of HIV counselors<br />Ensure clinics are open 8 hours to maximize limited HRH<br />Rethink use of mass media for HIV awareness<br />Establish electronic formats of paper data collection forms in anticipation of construction of strategic information database <br />Provide input into UNAIDS’ country ownership consultation and next national HIV strategy, to help in better utilizing GF HIV/AIDS funding<br />
  13. 13. Thank you<br />www.HealthSystems2020.org<br />

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