Here we are an overview of the Continuum of care for HIV/AIDS services and the areas in which there has been some private sector role. As you can see, the private sector has played a role in prevention, VCT and treatment; less so in palliative care. In the area of prevention, the private sector has pioneered some of the most innovative methods to reach out the general population to inform them of the risks associated with HIV/AIDS and to provide them with condoms for protection. Some of the most commonly known methods include social marketing of healthy behavior messages and wide spread distribution of condoms through a variety of outlets. Second area is work-based programs that provide IEC and condoms to their employees and often the communities they work in. Lastly, Harm reduction and needle exchange programs offered by a wide variety of small NGOs. Under VCT, we see private providers and private laboratories offering VCT for a fee. Once again, work-based programs are an important source of VCT, particularly in Africa. A new and interesting model is franchising of VCT services as a stand alone services. A more recently, may countries are experimenting with mobile VCT units. Lastly, under treatment we see that increasingly, MOHs are turning to private sector and NGO partners to help increase access to life saving treatment through a variety of methods. Private providers Including other health cadres such as nurses and Pharmacists are delivering ARVs. Work-based program also deliver ARVs. We are now seeing the emergence of private provider networks and clinic/pharmacy networks participating in ARVs. Many govts are experimenting with national social insurance, and/or private health insurance plans to cover a full range of HIV/AIDS interventions.
Slide shows Percent of respondents who received HIV test from private sector source Analysis conducted by PSP-One project using most recent Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) Overall, the proportion of respondents reporting they had ever received an HIV test was low, ranging from 2% to 30% [ 2% (women in Chad) to 29% (women in UG)] Among this group, seeking this service from the private sector varied from 6% to 24% (Ethiopian women and Chadian men) Gender differences: Men more frequently reported a private sector source for HIV testing than did women [With the exception of the countries of Benin, Ethiopia]. Men also were more likely than women to report receiving an HIV test from a nongovernmental organization (NGO) clinic, although overall use of NGO services was low.
HS2020/SHOPS and the World Bank Group held a regional workshop in Mombasa with 7 African countries and learned:
Based on the Bophelo! model, new MoU in place between MoHSS and PharmAccess for the provision of mobile primary health services; SHOPS provided TA in structuring the MoU Bophelo!: mobile testing vans owned and operated by Namibia Business Coalition on HIV/AIDS and Pharmaccess Namibia screen the population for HIV and other diseases. Patients are referred to private or public providers for follow-up, depending on their medical scheme coverage. >> Based on the Bophelo! model, new MoU in place between MoHSS and PharmAccess for the provision of mobile primary health services; SHOPS provided TA in structuring the MoU Interesting PPP launch of a primary health care mobile clinic in Otjizondjupa region. It is financed by Heineken, employers and other company CSRs—with all commodities etc being provided by the MoHSS (MOHSS will also coordinate its outreach with the van). Namibia Inst. Of Pathology is also contributing to do lab, pathology and QA related activities. The clinic will visit each point along its route once a month. It will provide basic PHC services that a registered nurse can provide and will help with follow-up, referrals, and even picking up chronic medication for patients so they don’t have to travel long distances. Two other regions will also roll out similar models soon (Omaheke and Khomas). The launch focused heavily on sustainability and the need to be self-reliant. It will be interesting to see how this pilot turns out.
Network for Africa - RATN Launch
Understanding the Role of Public-Private Partnerships in Respondingto HIV/AIDSIlana RonAfrica Regional Manager, SHOPS19 March 2013 SHOPS is funded by the U.S. Agency for International Development. Abt Associates leads the project in collaboration with Banyan Global Jhpiego Marie Stopes International Monitor Group O’Hanlon Health Consulting
Presentation Overview• Importance of private sector to health systems strengthening in Africa• Diverse examples of private sector delivering different aspects of HIV/AIDS services• Moving forward with the private sector through the Network for Africa
PPP Examples from Africa• Wide variety of private sector actors are active in all the health systems building blocks but are often overlooked• There is an “explosion” of different PPPs – including in HIV/AIDS - in the region • Requiring documentation and sharing of experience• A wider definition of private sector engagement is needed to clarify misunderstandings on the term “PPP”Based on 7 Countries that Participated in Network for Africa Mombasa Workshop 2012
Prevention: Male Circumcision through theUgandan Private Sector Health Initiatives for the Private Sector• Funded by USAID/Uganda and implemented by Cardno• Work with Uganda business community to find cost- effective ways to improve access and utilization• Use a PPP model• Conducted readiness assessment• Rolled-out Safe Male Circumcision (SMC) services at 10 sites• Private company leveraging nearly 2:1 The UGACOF clinic recently opened to an Ugandan community• Participating partners and clinics have become main referral points for MC Impact 3,000 Peer 26 private clinics 78 health 130,000 people 2,310 MC educators providing SMC providers reached with procedures trained on SMC services trained message on SMC conducted
Counseling and Testing: Mister Sister Reaching Remote Populations in NamibiaNamibia on mobile testing vans - a true PPP in HIV/AIDS• Vans purchased by Heineken Africa Foundation, Namibia Breweries and Ohlthaver & List• Financed by • Corporate sponsorship by Namibia Medical Care • Fee for insurance (NAU-NLU) • Rural employer’s payment for subscribed employees• Vans operated by PharmAccess Foundation/Namibia, SHOPS and the Namibian Institute of Pathology • Screen rural population for HIV and other diseases • MOH provides staff and inputs (e.g. test kits, vaccines) • Employers/Unions pay part of cost
Treatment: Local Manufacturing of ARTsSupplying the MOHSW in Tanzania Collaboration between Tanzania Pharmaceutical Industry (TPI) and GoT Manufacturing plant originally 100% state- owned, currently 60% privately owned TPI receives exemptions from VAT, import and excise taxes GoT ensures steady purchase (80% to 100%) of TPI’s total ART production Plans to expand production to serve the local private market Ensures steady supply of: Generic antiretroviral Generic medicines Offers preferential pricing to Medical Stores Department compared to foreign suppliers (15%)
Treatment: Gold Star Network Harnessing Kenyan Private Providers to Deliver ART• Network • Funded through PEPFAR and USAID/Kenya and implemented by Family Health International • 511 participating providers in 4 geographic areas • Serving 11,187 clients • ever started on ART -- 6,356 • currently managing -- 3,482• Benefits to private providers: • Increased workload; Brand (quality); Networking (comprehensive range of services) • Access to public sector program subsidy (government training, experts, commodities, and facilities)• Benefits to public sector • Leverages existing human resources and latent expertise in private sector • Provides mechanisms to mobilize and coordinate private providers • Helps ensure quality of private services
Network for Africa and its Role in PromotingPrivate Sector Involvement in HIV/AIDS Network for Africa: • Is a community of practice that strengthens the capacity of African public and private health sector leaders to partner in health • Comprises Ministries of Health staff and private sector leaders from over 24 African countries • Over 550 individuals are members of N4A
Network for Africa Purpose • Exchange experiences and best practices in partnering with the private health sector • Share tools and materials used to engage with the private health sector • Build capacity within the public and private sectors to effectively dialogue and partner together to meet shared public health objectives • Share ideas on how to go about private sector health financing
Network for Africa Offers: • Monthly E-Letters • Resource center • N4A interviews • On-line chats • Virtual meeting place for members only • Annual technical exchanges
Network for Africa under RATN Leadership• Since late 2012, the USAID- funded SHOPS project has partnered with the RATN• SHOPS-RATN partnership is for two years as a transition period• RATN is assuming full technical leadership and management of the N4A• We need you – RATN members – to let us know how to make N4A more responsive to HIV/AIDS issues by harnessing the private sector
Ilana Ron Leveyilana_ron@abtassoc.comwww.shopsproject.org SHOPS is funded by the U.S. Agency for International Development. Abt Associates leads the project in collaboration with Banyan Global Jhpiego Marie Stopes International Monitor Group O’Hanlon Health Consulting