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ICAP Lesotho Transition Strategy for Sustainability

ICAP Lesotho Transition Strategy for Sustainability. M&E Technical Meeting. Introduction. ICAP’s supports the Lesotho MOHSW to reduce the impact of TB/HIV Provide technical assistance within the framework of Lesotho TB/HIV Strategic Plan Provide nationwide support all 10 districts

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ICAP Lesotho Transition Strategy for Sustainability

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  1. ICAP Lesotho Transition Strategy for Sustainability M&E Technical Meeting

  2. Introduction • ICAP’s supports the Lesotho MOHSW to reduce the impact of TB/HIV • Provide technical assistance within the framework of Lesotho TB/HIV Strategic Plan • Provide nationwide support • all 10 districts • all health facilities(21 hospitals + 184 HCs & FCs) • All facilities are owned by the MOHSW, CHAL or are Private • no ICAP facilities

  3. LS TB and HIV/AIDS landscape • STI, HIV and AIDS Directorate (SHAD) • HIV/AIDS programs (HTC, PMTCT, Care, Treatment, BCC, etc) • Nascent M&E system • EGPAF main partner • Department of PHC • Dept. of Disease Control • National TB Program (NTP) • Strictly TB activities only • Fairly well developed TB surveillance system • ICAP main partner HIV/AIDS patient TB/HIV patient TB patient

  4. Current (inherited) TB/HIV Surveillance System WHO GF Funder National TB Program (data cleaning, analysis, dissemination) Partner support Partner parallel System (electronic patient level db) DHMT/District hospital (maintenance of district TB Rx reg, ETR, dispatches, reports, backups) Partner support Hospital B HC3 HC4 HC5 HC1 HC2

  5. Why the parallel M&E system? • No data collection tools at the beginning of support • No dedicated MOHSW data personnel • Meet reporting requirements • internal ICAP, URS, PEPFAR • Tight deadlines • Indicators not harmonized • ‘Pre-transition era’

  6. Effects of the parallel M&E system • Undermined the national M&E system • Threatened relationships with MOHSW • Not sustainable • One positive - Lesotho has embraced data personnel • Plan to have at least 1 data clerk in each health center • 65 recruited for the northern districts to date

  7. Major shift in new program • MOHSW is (rightly!) insisting on ownership: • partners must support the ONE M&E system • no ICAP sites, so no parallel systems • PEPFAR/CDC promoting transition • “If not a local indigenous organization, the applicant must articulate a clear exit strategy which will maximize the legacy and sustainability of this project…..”

  8. Strategy for sustainability Remove the parallel M&E system and support the NTP’s TB/HIV surveillance system What comes out of the NTP goes to partners and funders • Surveillance System Strengthening • Data Quality • Data feedback • Data appreciation and use • Monitoring of community activities

  9. Strengthening the TB/HIV Surveillance System WHO National TB Program (data cleaning, analysis, dissemination) ICAP LS URS CDC ICAP support GFCU DHMT/District hospital (maintenance of district TB Rx reg, ETR, dispatches, reports, backups) ICAP support Hospital B ICAP support HC3 HC4 HC5 HC1 HC2 Maintenance of site tools (TB cards, suspects, Rx)

  10. Surveillance System Strengthening • Human resources (2 SO) • Regular supervision & follow-up • Data collection & reporting tools • Advocate for incorporation of TB variables in HIV tools • Enhance Electronic TB Register • Eradicate errors, improve report generation • Train HCW • Ensure regular updating • Ensure regular data dispatches to NTP

  11. Data Quality • Routine supervision of paper tools at sites and ETR at district level • Improved validation criteria in the ETR • Quarterly data verification exercises • NTP, DHMT, partners • Annual structured QDA • NTP, DHMT, partners

  12. Data Appreciation and Use • PERFORMANCE FEEDBACK • Quarterly district progress review meetings • Annual Joint Review (national) • Identify “star” HCW or sites and use them as “peer-educators”

  13. Rea Leboha (Thank You)

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