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‘Keeping mothers a nd children a live and healthy in South Africa‘ Dr Sanjana Bhardwaj , MD, MPH

‘Keeping mothers a nd children a live and healthy in South Africa‘ Dr Sanjana Bhardwaj , MD, MPH UNICEF, South Africa Precious Robinson, DD, NDoH Lerato Lesole , CDC South Africa Maryet Mogashoa , CDC South Africa. Action Framework Monitoring + Coordination +. Partner coordination.

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‘Keeping mothers a nd children a live and healthy in South Africa‘ Dr Sanjana Bhardwaj , MD, MPH

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  1. ‘Keeping mothers and children alive and healthy in South Africa‘ DrSanjanaBhardwaj, MD, MPH UNICEF, South Africa Precious Robinson, DD, NDoH LeratoLesole, CDC South Africa MaryetMogashoa, CDC South Africa

  2. Action Framework • Monitoring + • Coordination +

  3. Partner coordination PMTCT Steering committee NDOH: MCH Directorate PMTCT unit PMTCT TWG CCMT meeting MCH coordination meetings Joint UN EMTCT working group HIV/AIDS Pediatric HIV TWG Civil society consultations Provincial DOH: PMTCT coordinator Provincial PMTCT Steering committee meeting SANAC TTT MCH LEADERSHIP VISION GOAL TORs PLANS PRIORITY SETTING IMPLEMENTATION DRILL AREAS MONITORING FEEDBACK LOOP LINKAGES ENGAGEMENT District PHC managers MCH manager, HIV manager District MCH meetings Sub district coordinators, MCH coordinators, HIV coordinators Sub district MCH meetings Facility meetings Facility manager Community outreach, workers Community engagement

  4. Action Framework: ‘No child born with HIV by 2015 and improving the health and well being of mothers, partners and babies in South Africa’, 2012-2016 National Guidelines + Policy + Resources + 9 Provincial Action Frameworks 52 district Action Frameworks Business work plans IMPLEMENTATION MONITORING EMTCT Tracker 4 PRONGS 5 Strategic objectives Priority actions based on bottleneck analysis Shared accountability Robot Dashboard (7indicators) Data for Action reports (all 9 provinces and 52 districts each quarter Cascade indicators National Health Insurance CARMMA campaign MCH strategy Primary Health Care reengineering National Strategic Plan for HIV/AIDS, STI, TB 2012-2016 Keeping children alive and healthy in South Africa: Blue Print for action for pediatric and adolescent (0-15 years) HIV integrating prevention, early identification of HIV and link to treatment, care and support 2012-2016

  5. Partnership Framework Tool Eg – district from Eastern Cape province

  6. EMTCT Tracker • Robot Dashboard • Cascade indicators • NHLS data • SAPMTCT Impact study • ANC HIV prevalence survey • Saving Mothers report 2008-2010

  7. Quarterly from national (monthly at provincial and district and sub district levels Highlights progress in key indicators Analyzes DHIS data and Lab data Prioritizes actions Data for Action reports: PMTCT/MCH District Facility National Province Subdistrict Key 7 indicators PMTCT MCH Tracks progress over time ROBOT DASHBOARD Has given programme managers and implementers an easy to use and understand tool to track progress and prioritize actions Has also helped in linking data from different sources (DHIS and Lab) Linked to activities and targets in the EMTCT action framework 2012-2016 Stock Taking exercise

  8. Data for Action – reports national/provincial/district Cascade Indicators + interlinked indicators Robot Dashboard Discussion/review at district/provincial/national level meetings (quarterly/ monthly) Response to robot dashboard (within a month) Quarterly Review partnership framework ACTION Discussions/review with all partners /shared accountability + Community linkages + civil society + traditional leaders + academic partners + innovation (MOMCONNECT) Review expenditure rates Review progress against work plan Management framework

  9. NATIONAL

  10. PHASE 1 (July 2011 to June 2012) PHASED APPROACH Bottleneck analysis + + PHASE 2 (July 2012 to June 2013)

  11. Strong evidence base + + • Review data from different sources • Identify best practices • Identify lessons learned • Improve coordination amongst all stakeholders

  12. EXAMPLE

  13. SAPMTCT Study National: • 2010: 3.5 (2.9 – 4.1) • 2011: 2.7 (2.1-3.2)

  14. KEY PRIORITIES • ANC early registration + + • ANC CD4 testing • ANC HAART initiation and on treatment • Quality ANC care • Postnatal care and follow up • EID (PCR positive) • PCR + linked to treatment • Family planning + • TB • Impact on maternal health outcomes (deaths) • Impact on child health outcomes

  15. Action Framework : strategic direction Key priority areas+ Data for action reports (quarterly) Dashboards + Lab data (monthly) Special surveys + (Beyond percentages to numbers) Use data at all levels Ensure feedback loop Quality Improvement Health care worker for change QI workshops – tools + SOPs + • Communication plan + • Community awareness • Social mobilization • Materials Partnerships + Coordination (programs and partners, civil society)

  16. Variability + Provinces and districts

  17. WE ALWAYS HAVE TIME ENOUGH, IF WE WILL BUT USE IT ARIGHTJohann Wolfgang Von Goethe

  18. COUNTDOWN TO ZERO Believe It Do It

  19. Thank you

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