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






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

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