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Transitioning an internationally managed HIV program to local ownership: the experience of EGPAF -Tanzania. John Stephen, BVM, MSc & MBA Associate Director, Field Programs – EGPAF HIV Capacity Summit, Birchwood Hotel 19 Mar 2013. 1.0 Introduction.
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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
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 AIDSHealthcare 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%. • High fertility rate – 3.3%. • 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.
EGPAF AGPAHI
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.