Transitioning an internationally managed HIV program to localownership: the experience of EGPAF -Tanzania John Stephen, BVM, MSc & MBA Associate Director, Field Programs – EGPAF HIV Capacity Summit, Birchwood Hotel1 19 Mar 2013
Presentation outline• Introduction• Why transition to local affiliate• Phases of transition process• Establishment of a local affiliate• Criteria for selection of the region• Program implementation• Capacity building initiatives• Evidence for achievements• Challenges and counter strategies• Lessons learnt• Conclusions
1.0 Introduction• Local ownership of HIV service delivery and HSS programs in sub-Saharan Africa is critical to ensure long-term sustainability.• In 2004, EGPAF received Track One funding from CDC to implement Project HEART.• Transition was mandated as part of the Track 1.0 re-authorization by the US Congress in 2008.• EGPAF believes in country ownership.• Transition is the EGPAF’s process of transferring existing programs and services to local partners.
2.0 Why transition to local affiliates ?• Promote local capacity and sustainability of programs.• Accountability through affiliation agreement.• Monitoring of quality through regular accreditation system.• Capacity building and transfer of EGPAF systems.• Guided by principles and standards for affiliation.• Shared elements (logo, mission) facilitate the development of a strongly linked global network and synergy.• Promotes common purpose and shared strategy to achieve mission.
4.0 Ariel Glaser Pediatric AIDS Healthcare Initiative (AGPAHI)• Non profit and autonomous organisation organized locally at both the grassroots and national levels.• Registered on 21 Feb 2011 as local NGO under NGO Act No 24 of 2002 of Tanzania and launched on 18 May 2011.• Vision: envisions a world where children and families have access to quality health services and live free from HIV/AIDS to realize their full potential.
5.0 Establishment of AGPAHI• A founding committee of six members formed.• Stakeholders involvement.• Drafted paperwork for registration of the new NGO.• Ten BoD candidates screened through the developed criteria, eight members selected.• Procedures and policies developed.• AGPAHI official inauguration on 18 May 2011.• Affiliation agreement btn EGPAF & AGPAHI signed.•
6.0 Criteria for selection of Shinyanga• High HIV prevalence - high 7.4%.• Underserviced HIV program – potential for programmatic expansion.• Strong leadership and local government support.• Potential for donor to support expansion of the program.• Less number of NGOs/CSOs working on HIV programs.
7.0 Program implementation• EGPAF transitioned one of six regions; 41 HIV C&T clinics with 20,272 patients.• AGPAHI adopted EGPAF’s implementation model.• AGPAHI received a C&T sub award from EGPAF• AGPAHI received direct funding from CDC.• Annual accreditation review.• In January 2012 AGPAHI received a sub award from EGPAF on PMTCT/ RCH.• July 2012, AGPAHI received a USAID funding on “Innovations in family planning, reproductive
8.0 Capacity building initiatives for AGPAHI• Secondment of EGPAF staff to AGPAHI.• Policies and procedures (fin, M&E,CGIS, HR).• Board members orientation workshop.• AGPAHI staff trained and administered tools; OCVAT, SCP & CCA in Shinyanga.• Accreditation review in Sept 2011, Jun & Sept 2012• Technical / operations support from EGPAF.• Bilateral management training – Aug 2011.• Effective Leadership and Gov training in Oct 2011.• AGPAHI participated in NBD workshop in 2012.• Quarterly DAW and sub grantee monitoring
9.0 Conceptual Framework for AGPAHI Capacity Building Plan
10.0 Evidence for achievements• A full fledged independent local NGO.• Four funding sources within two years.• HIV Care and Treatment clinics expanded from 41 to 68 with over 61,546 patients.• Program expanded to new regions of Geita & Simiyu within two years.• Good support and collaboration with Government.• Integration of HIV and family planning programs.
11.0 Challenges and counter strategies• Narrow funding base for AGPAHI, mostly USG and lack of unrestricted funds. Strategy – prospecting for non USG donors.• Supply chain management challenges - test kits. Strategy – sourcing for local suppliers.• Higher services demands with limited resources. Strategy – integration for HIV services.• Stigmatization of local NGOs in Tanzania. Strategy – evidence good work by results.• Transition lacked clarity, appropriate guidance and donors keep changing their focus. Strategy – EGPAF and AGPAHI worked on best practices.
12.0 Lessons learnt• Establishing an organization as an affiliate shortens the turn round processes for the organization to take off smoothly.• Affiliation enables local NGOs access funds within short time.• Choice of board members is critical to success.13.0 Conclusions• Establishment of AGPAHI as a local partner is step toward ensuring sustain of HIV programs in Tz.• Affiliation helps to leverage financial, programmatic and technical resources.