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Partnering to Strengthen Local Efforts Can Help Us Get to Six Million on ART. Anja Giphart, MD MPH Vice President, Program Implementation Elizabeth Glaser Pediatric AIDS Foundation July 25, 2012. Project HEART Countries and Number of Sites.
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Partnering to Strengthen Local Efforts Can Help Us Get to Six Million on ART Anja Giphart, MD MPH Vice President, Program Implementation Elizabeth Glaser Pediatric AIDS Foundation July 25, 2012
Project HEART PMTCT Results 2005-2011 62,000 pediatric infections averted
Local Capacity Building Approach #1: District Approach to Expansion of Services
District Approach • An effective approach to rapidly scaling-up HIV services while building local financial, technical and management capacity • Working “through” the districts: • Districts are responsible and accountable for implementation, quality and scale-up of HIV services in their location • EGPAF provided technical assistance and direct funding via subgrants • EGPAF worked with a total of 159 districts across 5 countries • In the final project year 96% of subaward funds were awarded to local partners, the majority being districts and community organizations
Tanzania Care and Treatment Scale-up District Approach Expanded in 2007
Directly and Indirectly Supported Care and Treatment Sites, Tanzania N=260 N=6,016 N=56,486 ART results for 5 Regions as of March, 2012
Local Capacity Building Approach #2: Decentralizing Training
Traditional In-Service Training Over 25,000 Healthcare Workers Trained in the provision of comprehensive HIV care and treatment
Pre-Service Training in Cote d’Ivoire 245 health professionals trained, 2007-2011
Pre-Service Training in Mozambique • By June 2011, Project HEART supported a total of 9 courses for 259 medical officers, nurses, pharmacy agents, and assistant health officers.
Targeted Mentoring for Pediatric Treatment “Systematic analysis of EID cascade and implementation of specific interventions: Lessons from Tanzania.” Schimana, W et al. IAS, 2011
Targeted mentoring to improve pediatric ART initiation - Tanzania* * Data are from three referral hospitals in Tanzania
Local Capacity Building Approach #3: Transition Services to Local Partners
Two Phases of Project HEART Two Program Phases
Project HEART Transition Approach Enabling Environment Policies, political stability, human rights, gender equality, etc.
Country Transition Approaches • Health Systems Strengthening, capacity building and transition to local authorities -2 Provinces Directly Funded by CDC in Mozambique • Transition to Existing NGO • Zambia: CIDRZ • South Africa: McCord Hospital and Health Systems Trust, Aurum Institute • Enhanced health systems strengthening and transition to a new independent NGO (EGPAF Affiliate) in • Cote d’Ivoire • Mozambique • Tanzania
Acknowledgements • PEPFAR and the US Government • Ministries of Health and the National, Regional and Local Governments in Cote d’Ivoire, Mozambique, South Africa, Tanzania and Zambia • International and local partners • CDC/Atlanta (from GH, PGO, Budget Office and ADS) • CDC in Cote d’Ivoire, Mozambique, South Africa, Tanzania and Zambia • EGPAF staff in LA, DC and Cote d’Ivoire, Mozambique, South Africa, Tanzania and Zambia • Other Track 1.0 partners for their collaboration • The patients, providers and communities for their participation, engagement and courage