Download - John Stephen - EGPAF, Tanzania
1
Transitioning an internationally managed HIV program to local ownership:
the experience of EGPAF -Tanzania
John Stephen, BVM, MSc & MBAAssociate Director, Field Programs –
EGPAF
HIV Capacity Summit, Birchwood Hotel
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.
• AGPAHI awarded a sub award from EGPAF.
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 health and skills laboratory”.
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
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.