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Enhancing HIV/AIDS Resource Tracking Institutionalization

Learn about capacity building and regional networks to institutionalize HIV/AIDS resource tracking in-country. Key elements include stakeholder buy-in, capacity building, and regional network challenges.

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Enhancing HIV/AIDS Resource Tracking Institutionalization

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  1. Tracking HIV/AIDS resources in-country: Institutionalization through capacity building and regional networks T. Dmytraczenko and S. De, Abt Associates Inc.and PHRplus In collaboration with José Antonio Izazola, SIDALAC and Teresa Guthrie, Idasa

  2. Points of clarification • What do I mean by institutionalization? • Housed in a national institution • Periodic • PHRplus experience • NHA, HIV/AIDS subanalysis • SIDALAC experience • NAA

  3. Overview of process • Principal goal is to produce data that can and will be used by policymakers • Stakeholder buy-in of NHA process is critical • Heavy emphasis on institutionalization • Building capacity within the government so that data can be collected regularly • Closely follows NHA framework • Adapts to the state of the epidemic and country context

  4. Key elements in the the institutionalization process • Determine when to conduct subanalysis • Concurrent with implementation of a general NHA • Set up the subanalysis core team • Members of the general NHA • Ministry of Health (MoH) • Representatives from MoH HIV/AIDS program and/or multi-sectoral HIV/AIDS committee • Lead the process

  5. Key elements in the the institutionalization process (cont.) • Consultation with a broader group of stakeholders • Steering Committee • CCM, major donors (such as CDC, UNAIDS), NGOs involved in HIV/AIDS, civil society organizations • Communicate policy concerns to NHA team • Give feedback to NHA team on results and findings • Facilitate any difficulties NHA team might encounter • Assist in interpreting the NHA results and drawing policy implications

  6. Steering Committee and core team General country stakeholders Steering Committee NHA & HIV/AIDS subanalysis Core Team

  7. Building capacity • Orientation to methodological approach • OECD System of Health Accounts • A Guide for Producing NHA in Low- and Middle Income Countries – WHO, World Bank, USAID • Identification of data sources • Review of secondary data • Primary data collection as a last resort • PLWHA survey • Donor survey, NGO survey, employer survey etc. • Adapted to state of the epidemic

  8. Capacity building (cont.) • Technical support • Survey instrument development by core team, approval by steering committee • Training local data collectors • Data analysis by core team in consultation with steering committee • Report writing by core team, vetting by steering committee • Formulation of a dissemination strategy • Discussion of how to incorporate data collection within ongoing government information systems

  9. Stakeholder involvement “-” “+” Dissemination strategy Policy linkages “Controllable” Factors Credibility of report Timeliness Ownership Policy advocate Political opportunity “-” “+” Government stability Factors that affect policy use of NHA HIV/AIDS Minimal Use In Policy Maximum Use In Policy “Chance” Factors

  10. Regional Networks

  11. Regional networks • SIDALAC • National AIDS accounts network • 20 countries in Latin America and the Caribbean • Aim to start a network in West Africa • PHRplus and partners • National Health Accounts networks • Idasa • Civil society advocacy networks throughout Africa that can support resource tracking networks

  12. Regional networks • Creation and maintenance of a forum for exchange by geographical region / sub-region • Electronic, study visits or periodic meeting • Bring together teams conducting HIV/AIDS tracking in different countries • Provide south-south and horizontal technical assistance • Exchange of lessons learnt • Process and technical • On-going technical cooperation and harmonization of methods • Mechanism for capacity building

  13. Challenges in creating and sustaining regional networks • Dependence on external support • Launch and sustain networks • Possible to leverage existing efforts • May not get desired participants nor optimal skill set • Sufficient financing of new estimates, and secure financial support for medium/long term initiatives (not a once exercise) • Avoid dominance by one country

  14. Challenges (continued) • Mechanism for formal peer-review • Willingness to submit estimates for revision by expert sources • Empowering civil society organizations to undertake HIV/AIDS budget monitoring and participate in networks for resource tracking • Political will to use and validate the information • National authorities, international agencies / programs • Support the use of the information for advocacy purposes, but keep objectives separate

  15. Challenges (continued) • Capacity-building should occur through the process of resource tracking • Expenditure tracking: government entity • Budget analysis: civil society organizations • Building national systems to track performance • Weak commitment in HIV/AIDS community • Purview of broader health system • Is it really?

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