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Planning for Sustainable HIV/AIDS Services using the HAPSAT

Planning for Sustainable HIV/AIDS Services using the HAPSAT. Elijah Sinyinza, MD,MPH Health Services and Systems Program (HSSP) May 27 2008

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Planning for Sustainable HIV/AIDS Services using the HAPSAT

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  1. Planning for Sustainable HIV/AIDS Services using the HAPSAT Elijah Sinyinza, MD,MPH Health Services and Systems Program (HSSP)May 27 2008 The USAID-funded HSSP Project is implemented by a consortium of partners. Abt Associates Inc. as prime contractor, JHPIEGO, ISTI and Save the Children as sub partners

  2. Outline of Today’s presentation • Policy Context • What is sustainability analysis? • Rationale for conducting a sustainability analysis • Planning tool : HIV/AIDS Program Sustainability Analysis Tool (HAPSAT)

  3. Policy Context • Policymakers are interested in the allocation of financial and human resources across public programs • Donors and policymakers interested in understanding the medium- and long-term impact of HIV/AIDS service provision on the health budget and human resources. • Concerns about ‘donor fatigue’ and the volatility of external funding streams. • Desire to find ways to deliver HIV/AIDS services to more of the people who need them.

  4. Definition of Sustainability analysis • Sustainability refers to ability of the country to provide HIV/AIDS services to those who need them as external resources are reduced. • Sustainability analysis seeks to identify points of vulnerability in a planned HIV/AIDS program • How much does the planned program for delivering HIV/AIDS services cost? • How many human resources will be needed to carry out the planned program? • What type of resource limitations are likely to constrain the scale-up of services? • Is the pipeline of human and financial resources adequate to meet future demand for services?

  5. Rationale for Conducting a Sustainability Analysis • Sustainability analysis is needed to guide policy decisions regarding resource mobilization • What share of the total cost will the government, donors, and patients contribute? • How many health workers are needed to sustain/scale-up the services? • Can scale-up occur in a sustainable way that ensures services can be maintained at a higher level over time without having perverse effects on the broader health care system?

  6. HAPSATHIV/AIDS Program Sustainability Analysis Tool • HAPSAT is a Microsoft Excel (version 2003) software tool for rational planning of HIV/AIDS services over a 3-10 year time horizon • To estimate the total cost of, and resources required to sustain/scale up a national HIV/AIDS program • To identify resource shortfalls (bottlenecks) that threaten the achievement of HIV/AIDS program goals • To support policy decisions, program planning, budgeting for HIV/AIDS provision, and resource mobilization

  7. Scope of HIV/AIDS Program in HAPSAT Model • Antiretroviral Therapy (ART) • Counseling and Testing (CT) • Prevention of Mother-to-Child Transmission (PMTCT) • Testing & Treatment for Tuberculosis (TB) • Prophylaxis and Treatment for other OIs • Prevention (ABC, IEC, Condoms, microbicides etc.) • Orphans and vulnerable children (OVC) • Program administration and management

  8. Data Inputs for HAPSAT • Demographic, epidemiological, and financial trends • Financing sources for HIV/AIDS program • Current volume of HIV/AIDS services delivered annually • Current stock of health workers by cadre • Clinical protocols (visits, lab tests, drug regimens, etc) • Current costs for labor, drugs, supplies, laboratory tests, equipment, and management

  9. Outputs from HAPSAT • How much does the current HIV/AIDS Program cost? • What are expected future resource gaps ( in financing, health workers, and physical infrastructure) for maintaining current volume of services? • What are expected resources required ( in financing, health workers, and physical infrastructure) to achieve target levels of services? • What are various options of financial resource mobilization and use (to address the gaps identified)?

  10. Example Output of HAPSAT(NOTE: not real data) Resource Shortfalls in Red

  11. Application to date • HAPSAT was applied to assess HIV/AIDS program sustainability in Zambia (MOH, HSSP, HS20/20, UNZA) • Upcoming assessments – Ethiopia, Coted’lvoire and Swaziland

  12. Thank you Reports related to this presentation are available at www.HS2020.org or email: info@healthsystems2020.org

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