Development of coordination and localownership for large international HIV  programmes in the framework of        Northern...
Use of the Extended Logical Framework Approach in the planning of a multinational HIV Programme strategy within the NDPHS ...
The 10th Nordic Public Health Conference 24.08.20111. NDPHS and the EG HIV/AIDS & AI2. Logical Framework Approach3. Extens...
The 10th Nordic Public Health Conference 24.08.20111. NDPHS and the EG HIV/AIDS & AI NDPHS is a multilateral collaboration...
The 10th Nordic Public Health Conference 24.08.20112. Logical Framework Approach Logical Framework Approach (LFA) is a hol...
The 10th Nordic Public Health Conference 24.08.20113. Extension of the Logical Framework ApproachComprehensive planning of...
The 10th Nordic Public Health Conference 24.08.20114. Barents HIV Programme IThe Programme was planned in 2003-2004 The si...
The 10th Nordic Public Health Conference 24.08.20114. Barents HIV Programme IIExtension and modifications of the usual LFA...
The 10th Nordic Public Health Conference 24.08.20115. Steps in the development of theBarents HIV Programme IThree phases o...
The 10th Nordic Public Health Conference 24.08.20115. Steps in the development of theBarents HIV Programme II Subsequently...
The 10th Nordic Public Health Conference 24.08.20115. Steps in the development of theBarents HIV Programme III It is essen...
The 10th Nordic Public Health Conference 24.08.2011Problem Tree reveals and clarifies the core problem and theexpected con...
The HIV/AIDS Epidemic is spreading  Barents HIV                                in Barents region, 10th Nordic Public Healt...
Barents HIV Programme                        The HIV/AIDS Epidemic is spreading in Barents region, leading to treat of Nat...
The 10th Nordic Public Health Conference 24.08.2011Objective Tree defines the PURPOSE for the development activities shows...
Barents HIV                                                                                        Barents HIV  Programme ...
Barents HIV Programme                                                                                                     ...
The 10th Nordic Public Health Conference 24.08.20116. Implications of the Extended LFAfor the ownership and coordination I...
The 10th Nordic Public Health Conference 24.08.20116. Implications of the Extended LFAfor the ownership and coordination I...
The 10th Nordic Public Health Conference 24.08.20117. Planning Process of the NDPHS HIVExpert Group activities for the fut...
The 10th Nordic Public Health Conference 24.08.20118. Conclusions I Extended LFA can be used for any multilateral programm...
The 10th Nordic Public Health Conference 24.08.20118. Conclusions II Structuring of the Programme to understandable purpos...
The 10th Nordic Public Health Conference 24.08.2011Effective projects! Steps for tomorrow’s development impacts           ...
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Development of coordination and local ownership for large international HIV programmes in the framework of Northern Dimension. Ali Arsalo.

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Nfhk2011 ali arsalo_parallel5

  1. 1. Development of coordination and localownership for large international HIV programmes in the framework of Northern DimensionThe 10th Nordic Public Health Conference Ali Arsalo, MD, 24.08.2011
  2. 2. Use of the Extended Logical Framework Approach in the planning of a multinational HIV Programme strategy within the NDPHS Application of the experiences from the planning process of theBarents HIV Programme to the work of the HIV & AIDS Expert Groupof the Northern Dimension Partnership for Health and Social Wellbeing
  3. 3. The 10th Nordic Public Health Conference 24.08.20111. NDPHS and the EG HIV/AIDS & AI2. Logical Framework Approach3. Extension of the Logical Framework Approach4. Barents HIV Programme5. Steps in the development of the Barents HIV Programme6. Implications for the ownership and coordination7. Planning process of the Expert Group activities for future8. Conclusions Ali Arsalo, MD, Kevi Consulting
  4. 4. The 10th Nordic Public Health Conference 24.08.20111. NDPHS and the EG HIV/AIDS & AI NDPHS is a multilateral collaboration mechanism aiming at containing the spread of infectious diseases and developing healthy life styles EGs (Expert Groups) are practical, international working groups of the NDPHS EG HIV/AIDS & AI provision of support to identification of project needs and project planning Ali Arsalo, MD, Kevi Consulting
  5. 5. The 10th Nordic Public Health Conference 24.08.20112. Logical Framework Approach Logical Framework Approach (LFA) is a holistic way of thinking and acting with essential key words: Stakeholders, Beneficiaries, Participatory approach, Problem identification, Problem analysis, Orientation towards objectives and impacts LFA is based on participatory analysis of the needs of beneficiaries, making complex phenomena more simple to manage LFA aims at sustainable development impacts Ali Arsalo, MD, Kevi Consulting
  6. 6. The 10th Nordic Public Health Conference 24.08.20113. Extension of the Logical Framework ApproachComprehensive planning of complex and multilateralapproaches Usually, the basic information about development needs is produced in planning seminars where selected representatives of different stakeholders are invited However, when this is not relevant or possible, the identification of development needs can be carried out through extended LFA Extension means different and extended approaches to collect the maximum of relevant information, to analyze, test, reformulate and visualize it Ali Arsalo, MD, Kevi Consulting
  7. 7. The 10th Nordic Public Health Conference 24.08.20114. Barents HIV Programme IThe Programme was planned in 2003-2004 The situation was critical because HIV was rapidly spreading and it was indispensable to find new ways of collaboration and coordination The challenge was complex and necessitated wide multilateral approach involving many regions and countries, different types of organisations, authorities and institutions The planning was materialised so that essential principles of the LFA were made use of and applied through extensions beyond traditional arrangements Ali Arsalo, MD, Kevi Consulting
  8. 8. The 10th Nordic Public Health Conference 24.08.20114. Barents HIV Programme IIExtension and modifications of the usual LFA Traditional, relatively limited planning seminars were not organised but, instead, the LFA was seen as a tool for comprehensive analysis of the context and for creating a strategy for combating the spread of HIV and its harmful consequences In fact, along the planning process, a new way of making use of the LFA principles in planning of a wide development strategy was developed and tested The process produced also tools for improving the coordination during the implementation Ali Arsalo, MD, Kevi Consulting
  9. 9. The 10th Nordic Public Health Conference 24.08.20115. Steps in the development of theBarents HIV Programme IThree phases of consultations Relevant information was collected by a very wide series of consultations with different stakeholders. The information was analysed by using Logical Framework tools, like Problem and Objective Trees Then, as the second step, a meeting for almost 100 participants was organised where the conclusions from the first round of consultations were tested and more information was collected. Ali Arsalo, MD, Kevi Consulting
  10. 10. The 10th Nordic Public Health Conference 24.08.20115. Steps in the development of theBarents HIV Programme II Subsequently, the second versions of Problem and Objective Trees were formed. In the third phase, the new versions were presented to stakeholders during another round of consultations, after which the final proposals were prepared and presented to decision makers. Ali Arsalo, MD, Kevi Consulting
  11. 11. The 10th Nordic Public Health Conference 24.08.20115. Steps in the development of theBarents HIV Programme III It is essential that no ready-made, outside or blueprinted solutions were imposed but all the information on which the Programme was developed was collected from a wide range of different stakeholders Ali Arsalo, MD, Kevi Consulting
  12. 12. The 10th Nordic Public Health Conference 24.08.2011Problem Tree reveals and clarifies the core problem and theexpected consequences of the problems based on information from the wide range ofpartners and different stakeholders shows different problem areas to be tackled describes various needs for projects andactivities to improve the prevailing situation Ali Arsalo, MD, Kevi Consulting
  13. 13. The HIV/AIDS Epidemic is spreading Barents HIV in Barents region, 10th Nordic Public Health Conference 24.08.2011 HIV The Barents Programme leading to threat of National Security. ProgrammePROBLEM TREE 2005-> There is lack of expanded and Interventions to influence individual comprehensive response towards and societal norms, improve the health HIV/AIDS situation. Several infrastructure and alleviate structural socioeconomic, cultural, legal and and economical constraints to HIV health factors contribute to prevention and care still are not vulnerability to HIV infection effective and efficient Current HIV/AIDS National program coverage levels are insufficient1. Existing 2. Technical, 3. Prevention and 4. ARV treatment 5. Programs 6. Integration andLegislation for partner and Surveillance affordability and ensuring coordinationeffective response activities needs accessibility within respect towards between Primarynational capacity for to be widened, the Public Health human rights, Health care andpolicies to program or deepened and Care system need to including HIV/AIDS services,control the project supported be improved persons living Social andHIV epidemic planning and with HIV/AIDS Educationalneeds implementation (PLWHAs) are Services andstrengthening needs to be insufficient Sectors are improved insufficient Ali Arsalo, MD, Kevi Consulting
  14. 14. Barents HIV Programme The HIV/AIDS Epidemic is spreading in Barents region, leading to treat of National Security. Barents HIV Programme PROBLEM TREE 2005-> There is lack of Expanded and Comprehensive Interventions to influence individual and societal norms, response towards HIV/AIDS situation. Several improve the10th Nordic Public Health Conference 24.08.2011 The health infrastructure and alleviate structural socioeconomic, cultural, legal and health factors and economical constraints to HIV prevention and care contribute to vulnerability to HIV infection still are not effective and efficient Current HIV/AIDS National program coverage levels are insufficient 1. Existing 2. Technical, partner and 5. Programs ensuring 6. Integration and 3. Prevention and Surveillance 4. ARV treatment affordability and Legislation for response capacity for respect towards human coordination between Primary activities needs to be widened, accessibility within the Public effective national program or project rights, including persons Health care and HIV/AIDS deepened and supported Health Care system need to be policies to control the planning and living with HIV/AIDS services, Social and improved HIV epidemic needs implementation needs to (PLWHAs) are insufficient Educational Services and strengthening be improved Sectors are insufficient Networks of low-threshold centres for hard-to-reach target groups are week ARV treatment is not available for all General awareness Services at primary care level The laws and regulations Training strategies that are Links between drug treatment, HIV counselling and about the impact of to assure broadest access to in Federal and Regional responsive to the needs of testing programs and primary health care services Insufficient counselling about the the emerging threat, effective care and prevention of level are not in the target audience are not are not established. need to continue protective action economical impact HIV/AIDS are weak compliance well established and information on the effects of and measures to Current programs towards increasing knowledge, ARV for clients and their sexual control is weak Knowledge among providers to Policies and regulations to In-service/field supervision encouraging healthy attitudes, developing skills or partners manage counselling and testing ensure universal, non- for continued skills transfer changing behaviour among youth are insufficient Insufficient and prophylaxis against discriminating access to is absent Information and education for participation of opportunistic infections at the anti-retroviral drug Young peoples access to user-friendly STI services, communities and society on the mass-media in primary care level is insufficient. treatment to all infected Poor cooperation between voluntary counselling and testing (VCT), condoms possibilities of ARV use are not in information people are not in place different institutions: STI, and other resources for sexual health are limited place dissemination for Communication and referral Penitentiary and TB in protection of systems to link closely primary Legal status of Harm dealing with HIV/AIDS Lack of counselling attitude among health care Training health teams (doctor, PLWHAs providers to more specialised reduction programs is workers nurse, counsellor, laboratory staff) HIV services are inadequate. unclear Political acknowledgement in both the public and private Shortage of and support for HIV/AIDS Information on methods of Second generation HIV sectors, with regular updates on vulnerability and School curriculums are lacking The lack of legislative acts activities are week surveillance system among health care workers is treatment and care options are stigma reduction information on HIV/AIDS ensuring implementation insufficient insufficient strategies prevention prevention strategies Inadequate collaboration among vulnerable groups among key stakeholders in Monitoring of changes in the risk behavior patterns Lack of universal and no Support services Programmes and courses to all sectors (cooperation that are associated with HIV, and monitoring of discriminative access to treatment and support groups respond to new needs arising Inappropriate legislation between NGO’s, civil sexual behavior, especially among the vulnerable for PLWHAs are from an AIDS-affected society to protect orphans and societies, private business groups is week Poor development of systems to week and insufficient within Colleges and universities other vulnerable children and governmental integrate HIV care in outpatient are abscent and their families agencies) Lack of general awareness on current trends of departments and at health centres Societal factors are LLack of advocacy activities care, prevention and infection safety, among health not sufficiently Lack of teaching capacity to Lack of legislation to towards policy and decision care workers indirectly involved with HIV/AIDS Insufficient development of system considered in deliver HIV/AIDS education promote partnership makers of medical care for TB/HIV patients HIV/AIDS preventive among key stakeholders Communication strategies to promote services, interventions Absence of strategic planning NGOs in small cities and improve symptom awareness and STI treatment TB education and training for HIV/AIDS in the education The laws and regulations rural areas are not seeking behaviour are insufficient wherever HIV services are Psychological, sector which define roles and developed delivered is insufficient socioeconomic and responsibilities of different Insufficient participation of mass-media in legal needs for Weak social safety supporting institutions in the context Budgeting system is unclear information dissemination on HIV/AIDS Laboratory facilities needs PLWHA are met orphans and vulnerable of HIV/AIDS preventions and does not promote strengthening and upgrading inadequately children are not clear effectiveness Insufficient MTCT prevention activities for pregnant Absent of special system of ARV women with drug dependence or in prison treatment for IDUs Ali Arsalo, MD, Keviprevention programs in HIV Consulting Prisons are insufficient
  15. 15. The 10th Nordic Public Health Conference 24.08.2011Objective Tree defines the PURPOSE for the development activities shows why it is important to implement active measures based on the information given by the Problem Tree shows different working areas to tackle describes various topics for projects and activities for detailed planning and implementation Ali Arsalo, MD, Kevi Consulting
  16. 16. Barents HIV Barents HIV Programme ProgrammeOBJECTIVE TREE The spread of HIV/AIDS epidemic 2005-> The 10th Nordic Public Health Conference 24.08.2011 in Barents region and its impact is under control Expanded and Comprehensive Relevance, efficiency and effectiveness of actions against HIV/AIDS the interventions, influencing individual implemented. Socioeconomic, and societal norms are improved. Health cultural, legal and health infrastructure strengthened and structural factors are respected in the and environmental constraints for HIV prevention of HIV infection prevention and care alleviated. Current HIV/AIDS National program coverage levels are sufficient for responding to prevailing realities1. Existing 2. Technical, 3. 4. ARV treatment 5. Programs 6. CoordinationLegislation for partner and Comprehensive Affordability and ensuring respect between HIV/AIDSeffective response and realistic accessibility towards human services andnational policies capacity for Prevention and within the Public human rights, Primary Healthto control the program or Surveillance Health system including persons care, Educational,HIV epidemic project activities are correlate to living with Penitentiary andupdated planning and implemented individual needs HIV/AIDS Social Services implementation (PLWHAs) are and Sectors is improved implemented established Ali Arsalo, MD, Kevi Consulting
  17. 17. Barents HIV Programme Barents HIV Programme OBJECTIVE TREE The spread of HIV/AIDS epidemic in Barents region and its impact is under control 2005-> Expanded and Comprehensive actions against Relevance, efficiency and effectiveness of the interventions, HIV/AIDS implemented. Socioeconomic, influencing individual Nordic Public Health Conference 24.08.2011 The 10th and societal norms are improved. Health cultural, legal and health factors are respected infrastructure strengthened and structural and environmental in the prevention of HIV infection constraints for HIV prevention and care alleviated. Current HIV/AIDS National program coverage levels are sufficient for responding to prevailing realities1. Existing Legislation 2. Technical, partner 3. Comprehensive and 4. ARV treatment 5.Programs ensuring 6. Coordination betweenfor effective national and response realistic Prevention Affordability and respect towards human HIV/AIDS services andpolicies to control the capacity for program and Surveillance accessibility within the human rights, including Primary Health care,HIV epidemic updated or project planning activities are Public Health system persons living with Educational, Penitentiary and implementation implemented correlate to individual HIV/AIDS (PLWHAs) are and Social Services and improved needs implemented Sectors is established• The laws and regulationsin Federal and Regional • Networks of low-threshold centres for hard-to- • Training strategies that reach target groups strengthened.level are in compliance are responsive to the needs • ARV treatment is available for all • General awareness • Broadest access to effective of the target audience are in need about the impact of care and prevention of HIV/AID• Policies and regulations • Links between drug treatment, HIV the emerging threat, at primary care level is assured developed and counselling and testing programs and primaryensuring universal, non- implemented • Ongoing counselling about the economical impactdiscriminating access to health care services established. need to continue protective action and measures to • Training programs to manage • In-service/field supervisionanti-retroviral drug for continued skills transfer and information on the effects of control increased counselling , testing andtreatment to all infected • Programs, towards increased knowledge, ARV for clients and their sexual prophylaxis against opportunistic established encouraging healthy attitudes, developing skillspeople are founded • Cooperation and partners is established and • Sufficient infections among providers at or changing behaviour among youth, instituted. operational. participation of mass- the primary care level are coordination between• Legal status of Harm different institutions: STI, media in information createdreduction programs • Accessibility for young peoples to user-friendly • Programs for information and dissemination for • Communication and referral Penitentiary and TB in STI services, voluntary counselling and testingestablished dealing with HIV/AIDS education of communities and protection of PLWHAs systems to link closely primary (VCT), condoms and other resources for sexual society on the possibilities of ARV ensured providers to more specialised created health improved• Legislative acts providing use are created and implemented HIV services are established.information on • Health care workers counselling skills • Vulnerability and Information on HIV/AIDS • Needs for support of development programs established.implementation of HIV/AIDS Politically • Training programs for health stigma reduction prevention is included in Schoolprevention strategies • Information on methods of Second generation workers in both the public and strategies created and curriculums. acknowledged. HIV surveillance system among health careamong vulnerable groups • Coordination structured private sectors, with regular implemented • Programmes and courses tocreated workers is easily accessible. updates on treatment and care respond to new needs arising among key stakeholders in • Monitoring of changes in the risk behaviour all sectors (cooperation options instituted • Support services and from an AIDS-affected society• Appropriate legislation to patterns that are associated with HIV, and support groups for within Colleges and universities between NGO’s, civil monitoring of sexual behaviour, especiallyprotect orphans and other societies, private business • Systems to integrate HIV care in PLWHAs are are established and operational.vulnerable children and among the vulnerable groups is established outpatient departments and at established and • Teachers capacity to deliver and governmental • General awareness on current trends of care,their families developed agencies) established health centres developed operational relevant HIV/AIDS education prevention and infection safety, among health increased . • Advocacy activities care workers indirectly involved with HIV/AIDS• Partnership among key towards policy and decision • Systems of medical care for • Societal factors are • Strategic planning forstakeholders is supported increased TB/HIV patients are updated and elaborated and HIV/AIDS is included in the makers are set up. • Communication strategies to promoteby legislation operational integrated in HIV/AIDS education sector. services, improve symptom awareness and STI • Programs for TB education and preventive • Social support • NGOs in small cities and treatment seeking behaviour are established• The lows and regulations rural areas established and training whithin HIV services are interventions program/projects of orphansdefining roles and and operational. established and vulnerable children are developed • Mass-media participation in informationresponsibilities of different • Laboratory facilities are • Institutions to meet developed and implementedinstitutions in the context of dissemination on HIV/AIDS ensured psychological, • HIV/AIDS prevention programs • Increased use of upgraded, equipped, staffedHIV/AIDS preventions • MTCT prevention activities for pregnant socioeconomic and within Penitentiary system Budgeting system for and operationalestablished promotion of program and women with drug dependence or placed in • Special system of ARV treatment legal needsAli Arsalo, for MD,createdConsulting Kevi and implemented prisons are established and operational. PLWHA are set up. project effectiveness for IDUs are established
  18. 18. The 10th Nordic Public Health Conference 24.08.20116. Implications of the Extended LFAfor the ownership and coordination IIn-built basic factors to influence sustainability High relevance, connected to realistic and comprehensive contents through wide consultations of various stakeholders, those who are the best experts and who are directly concerned Different actors will find their voice in the Programme plan which supports feeling of realism and the development of ownership Ali Arsalo, MD, Kevi Consulting
  19. 19. The 10th Nordic Public Health Conference 24.08.20116. Implications of the Extended LFAfor the ownership and coordination IIImproving strategic orientation and coordination Comprehensive strategy can be developed through the extended LFA process All the main elements become visible and transparent, allowing and improving long-term planning and concentration to priority issues Provision of tools and mechanisms for local authorities to coordinated actions instead of short term fragments Ali Arsalo, MD, Kevi Consulting
  20. 20. The 10th Nordic Public Health Conference 24.08.20117. Planning Process of the NDPHS HIVExpert Group activities for the future The wide range of Barents experiences, conclusions and suggestions can be used in developing strategies and coordination for new international approaches The NDPHS EG on HIV, AIDS & AI is currently developing an action plan and mechanisms for supporting project planning internationally and for partner countries In this task, the experiences, conclusions and suggestions from the Barents HIV Programme planning and implementation are made use of Ali Arsalo, MD, Kevi Consulting
  21. 21. The 10th Nordic Public Health Conference 24.08.20118. Conclusions I Extended LFA can be used for any multilateral programme planning process internationally or regionally The use of extended LFA planning needs resources, effective management, transparency, long term visions and willingness for collaboration The process produces and provides easy and effective tools for coordination and management if sustainable results are to be achieved Improvement of effectiveness of projects can be achieved Ali Arsalo, MD, Kevi Consulting
  22. 22. The 10th Nordic Public Health Conference 24.08.20118. Conclusions II Structuring of the Programme to understandable purpose, realistic components and relevant assumptions Extension of LFA based planning provides simple tools for programme managers Simple coordination tools will also be available for implementing and financing agencies Through extended planning and long-term commitment to the implementation directing towards improvement of effectiveness of projects Ali Arsalo, MD, Kevi Consulting
  23. 23. The 10th Nordic Public Health Conference 24.08.2011Effective projects! Steps for tomorrow’s development impacts Ali Arsalo, M.D. Managing Director Kevi Consulting Pvt.Ltd gsm 050 537 6265 ali.arsalo@kevicon.fi www.kevicon.fi Ali Arsalo, MD, Kevi Consulting

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