Title - Leveraging an HIV Care and Treatment Program to Strengthen Local Health Care Networks

1. Leveraging an HIV Care and Treatment
Program to Strengthen Local Health
Care Networks
Ruth Stark, PhD
Senior Technical Advisor, CRS South Africa

2. • Nine years
• Ten countries
• USD 740 million,
funded by PEPFAR
• Designed for transition
to local ownership

3. 19 local partners working Over nine years, the CRS-led
directly through 276 facilities AIDSRelief consortium delivered
high-quality HIV care and
treatment in ten countries with
more than $700M in PEPFAR
700,000+ clients, including support.
395,000+ who initiated ART •
Viral suppression = 88.2%
Retention = 83%
Mortality = 7.8%

4. The AIDSRelief Approach
Capacity Strengthening =
Capacity Building
+
Institutional Strengthening
+
Accompaniment

5. Key Interventions
and Approaches
Comprehensive, interdisciplinary approach
based on a framework:
 Organizational capacity
 Technical capacity
 Funding capacity
 Policy and advocacy capacity

6. Key Interventions
and Approaches
• Baseline assessment of organizational
strengths and gaps
• Clear milestones based on assessment results
• Dynamic capacity building plans

7. Key Interventions
and Approaches
Ongoing assessment using:
•Site Capacity Assessment (SCA)
•Clinical Assessment for System Strengthening
(ClASS)

8. Key Interventions
and Approaches
• Joint site visits
• Long-term
accompaniment/mentoring
• Proven practices of adult
learning (didactic work, practical
application, on-site training)
• Exchange visits

9. Key Interventions
and Approaches
• Continuous quality improvement teams
• Clinical task shifting
• Continuing, locally-owned education
• Incremental transfer of responsibilities

10. Results
• Partners sustained quality patient services
• Managed USG sub-grants
• From 2008-2012, more than 30,000
participants trained
• Transition: 14 local partners in 8 countries
secured direct PEPFAR funding to manage the
programs.

11. Conclusion
Disease-specific resources can improve
organizational capacity to better manage
operations and service delivery, thereby
strengthening the overall health system.

12. Lessons learned
• Begin early
• Dedicate resources
• Leverage local resources
• Work with host government
• Disengage gradually

13. www.crsprogramquality.org