technical assistance for health systems development: benefits for hiv/aids programs
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Technical Assistance for Health Systems Development: Benefits for HIV/AIDS Programs . Nicole Barcikowski, MA Health Systems 20/20 Abt Associates Inc. Global Health Council June 17, 2011. Outline. National Policy Impacts Financial : Mali, Kenya, India Human Resources: Côte d’Ivoire - PowerPoint PPT PresentationTRANSCRIPT
Abt Associates Inc. In collaboration with:I Aga Khan Foundation I Bitrán y Asociados I BRAC University I Broad Branch Associates I Deloitte Consulting, LLP I Forum One Communications I RTI International I Training Resources Group I Tulane University’s School of Public Health
Technical Assistance for Health Systems Development: Benefits for HIV/AIDS Programs
Nicole Barcikowski, MAHealth Systems 20/20 Abt Associates Inc.
Global Health CouncilJune 17, 2011
Outline
National Policy Impacts Financial: Mali, Kenya, India Human Resources: Côte d’Ivoire
Organizational-level Impacts Financial: Mozambique, Liberia Information Systems: Kenya Human Resources: Côte d’Ivoire,
Guyana
National Policy Impacts: Mali CBHI
Strengthen community-based health insurance (CBHI) Develop policy, operational plan, budget for Mali’s first government-
subsidized CBHI policy Partners: MOH, World Bank, Ministerial Leadership Initiative
(Gates Foundation) Steering and technical committees met with MOH in Rwanda,
where 85% of population is covered by CBHI schemes Results
CBHI policy adopted by President and Board of Ministries in Feb 2011
Government will subsidize 50% of CBHI plan ($83 million over five years)
Complements 2009 law requiring formal sector employers to provide and subsidize health insurance for employees
National Policy Impacts: Kenya HAPSAT
HIV/AIDS Sustainability Analysis Tool (HAPSAT) assessment in 2010 found HIV/AIDS funding unstable, 75% from donors, and recommended: Use air traffic levy as short-term source of income for HIV/AIDS
programming Increase government contributions to health to 15% as per Abuja
Declaration Partners: MOH, National AIDS Control Council, National
AIDS and STI Control Programme Results
Cabinet memorandum to implement levy drafted in March 2011
National Policy Impacts: India PLWHA Insurance Coverage
Develop road map to cover people living with HIV/AIDS in broader risk pools and mainstream HIV/AIDS coverage in insurance packages
Partner: Indian government Result: Expect policy decision
on HIV/AIDS insurance coverage by fall 2011
National Policy Impacts: Côte d’Ivoire HRH
Assess human resources for health (HRH) to inform strategy Health Systems 20/20 (and PHRplus) assessments (public sector 2005,
private sector 2007) estimated HRH at 11,749 staff: nurses (58%), midwives (18%), doctors (14%)
Partners: MSHP, local stakeholders
Results Developed costed 5-year strategy
for HRH focused on both demand and supply Activity success attributable to consistent consultation with local
stakeholders and strong government leadership through MSHP
Organizational-level Impacts: Mozambique Global Fund Grants
Improve access to Global Fund grants MOH requests Health Systems 20/20 assistance to clear system
roadblocks to accessing Global Fund grants and create a more effective financial management system
Establish Global Fund unit within MOH Planning Department Work with the Department of Finance and Administration to customize financial
management system to receive, track, and report on various donor grants and activities
Results Clear backlog of Global Fund disbursements (Rounds 2, 6, 7) Use grant funding to serve 1.5 million living with HIV/AIDS and 110,000
with TB, and help prevent over 19,000 malaria deaths per year (WHO)
Organizational-level Impacts: Liberia NAC
Establish permanent National AIDS Council (NAC) Secretariat to provide coordination, strategy development, M&E, advocacy Define functions, develop staffing plan and position descriptions,
determine operating budget Clarify relationship of Secretariat to NAC Executive Committee Do team building, management capacity building, executive coaching
Results Legislation formally establishing NAC approved by Congress, awaits
president’s signature Revised National Strategic Framework for HIV/AIDS Fully staffed Secretariat with office space and operating funds Task forces being formed for M&E, partner coordination, etc.
Organizational-level Impacts: Kenya HIS
Strengthen HIV/AIDS data collection and reporting system to streamline service delivery and access Standardize national HIV/AIDS data collection and reporting
(number people screened, HIV positive, needing/receiving ART, etc.) Build capacity to collect higher-quality, standardized data Create HIV/AIDS framework within broader HIS, eliminating parallel
systems Results
Better M&E and data collection system at 6,000 facilities in 250 districts Improved information available for decision makers
Organizational-level Impacts: Côte d’Ivoire HRH (1)
Use performance-based incentives (PBI) to improve HRH capacity and HIV service delivery Health Systems 20/20 (and PHRplus) HRH assessments showed
severe maldistribution of HRH (60% in Southern region) and high worker turnover in hard-to-fill posts
Health Systems 20/20 support to: Pilot MSHP PBI scheme in Ferkessedougou district Build regional and district capacity in management and leadership in
decentralized health system
Organizational-level Impacts: Côte d’Ivoire HRH (2)
Results PBI
Return of HRH to areas affected by socio-political crisis (94% HRH presence) Increased funds for facility premises and equipment, higher-quality service delivery Improved availability and access to HIV and other priority services at peripheral level
Strengthened local capacity in management and leadership, including HIS management and reporting, planning
Organizational-level Impacts: Guyana HAPSAT
HIV/AIDS Sustainability Program Analysis (HAPSAT) of public sector HIV/AIDS services
Results Review distribution of HIV counselors Ensure clinics are open 8 hours to maximize limited HRH Rethink use of mass media for HIV awareness Establish electronic formats of paper data collection forms in
anticipation of construction of strategic information database Provide input into UNAIDS’ country ownership consultation and next
national HIV strategy, to help in better utilizing GF HIV/AIDS funding
Abt Associates Inc. In collaboration with:I Aga Khan Foundation I Bitrán y Asociados I BRAC University I Broad Branch Associates I Deloitte Consulting, LLP I Forum One Communications I RTI International I Training Resources Group I Tulane University’s School of Public Health
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