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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.

3.0 Phases of transition process

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.

AGPAHI

EGPAF

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

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.

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