Health Information System Country Ownership & Leadership Continuum Mr Mark Landry
ENHANCING COUNTRY OWNERSHIP: AN ANALYTICAL REVIEW OF COUNTRY HIV PROGRAMMES
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Transcript of ENHANCING COUNTRY OWNERSHIP: AN ANALYTICAL REVIEW OF COUNTRY HIV PROGRAMMES
ENHANCING COUNTRY OWNERSHIP:
AN ANALYTICAL REVIEW OF COUNTRY HIV PROGRAMMES
Dr. Morris Edwards: Head, Strategy and Resourcing Division, PCU
Dr. Ingrid Cox Pierre: Strategy and Resourcing Officer, Care, Treatment and Support
Focus of Presentation Role of the PANCAP Coordinating unit in
achievement of the goals of Caribbean
Regional Strategic Framework (CRSF) 2008
– 2012
Analysis of country needs for achieving
these goals.
Challenges encountered in the process
BackgroundVision of the Caribbean Regional Strategic
Framework (CRSF) 2008 - 2012
“Substantially reduce the spread and
impact of HIV in the Caribbean through
sustainable systems of universal access
to HIV prevention, treatment, care, and
support”.
Assigned roles PANCAP Coordinating Unit (PCU)
Coordination of regional response
Resource mobilization
Advocacy
PANCAP 10th AGM identified critical areas
for emphasis to achieve the goals of the
CRSF.
Reduction of new HIV infections by 50%.
Elimination of mother to child transmission of HIV.
Increased access to treatment by 80%.
Accelerate the agenda to achieve human rights for
PLHIV including the elimination of travel restrictions for
PLHIV.
Elimination of travel restrictions for PLHIV.
For the PCU to effectively perform
its role, it must be able to collect
information at country level and
from partners on: Ongoing initiatives
Available resources
Gaps in implementation of national
strategies
Activities conducted by PCU to support its functions
Development of the PANCAP Biennial
Operational Plan (PBOP)
Country assessments to ascertain implementation
gaps in their NSP
Convening a Partners meeting and development
of an implementation matrix of ongoing activities
in countries by partners
Activities conducted by PCU to support its functions……..
Establishment of a lab partners working
group
Review of financial resources available
at country level for implementation of
NSP and their contribution to the
achievement of the Tenth AGM targets.
Resource mobilization by PCU Estimated (under estimate) US$58 M required
for implementation of the CRSF.
The PCU has mobilized approximately US$47
M
of this estimate
However priority areas of prevention and
treatment and care have secured resources
in
excess of that budgeted for by the CRSF
PRIORITY AREACRSF ESTIMATED NEEDS (US$)
FUNDING SECURED (CRSF)
FUNDING GAP (CRSF)
PA1 6,337,300 2,951,189 3,386,111
PA2 9,156,900 912,208 8,244,692
PA3 11,287,600 25,573,778 -14,286,178
PA4 2,000,000 3,467,415 -1,467,415
PA5 9,208,050 4,126,858 5,081,192
PA6 7,730,000 4,250,203 3,479,797
Coordinating & Monitoring Bodies 8,027,360 6,343,344 1,684,016
IEC Strategy supporting CRSF 2,000,000 2,000,000
Contingency (5%) 2,787,360 2,787,360
Total 58,534,570 47,624,995 10,909,575
Source: Progress Report and Financial Analysis of Implementation of the CRSF for 17th Executive Board Meeting
COMPARATIVE ANALYSIS OF FINANCIAL SUPPORT TO THE CRSF 2008-2012
Inadequacy of resource mobilization effortsAlthough secured funds are in excess of that budgeted for in these two areas, regional reports have identified that: Some areas in prevention, especially interventions
with MARPS (other than MSM and CSWs) and
PMTCT are critical areas or gaps in the
response. The area of treatment and care is inadequately supplied as
many countries are below the required coverage for
persons who require ARVs
Inadequacy of resource
mobilization…….
This emphasizes the importance of
information to guide the resource
mobilization process and focus
efforts where needed
Country Analysis Methodology
1. Available country NSPs were evaluated for alignment with the CRSF
2. Country assessments were conducted from 2010 to 2011 looking at gaps in implementation of country NSPs or implementation plans
The reports were presented at prior meetings and to the PACC
Country Analysis Methodology…..
3. A financial review of allocated resources at country level in relation to the tenth AGM targets
Template designed to collect information on areas of focus under the individual 10th AGM targets noting:
Area of strategic focus Source of funding (whether govt. or donor) Specific area funded e.g prevention programmes for MARPS Budget allocated Timeframe of support Identified gaps in the response and associated funding
Results9 countries responded:
Antigua and Barbuda Dominica Jamaica Suriname Belize St. Kitts and Nevis Montserrat Tortola Trinidad and Tobago
Results….. Countries are at different stages in reaching
the 2015 targets.
Main issue is sustainable funding, especially of commodities such as ARVs.
Funding in most of the reporting countries is still largely supported by donor agencies.
Results….. The areas highlighted as deficient in the
funding of the CRSF correspond closely to
those that are being reported in countries.
There is the need to include stigma and
discrimination in the area of human rights
There is a need for targeted prevention
interventions especially for groups such as
youth, with critical focus on minors
because of early sexual debut.
Prevention Targets
Prevention Target Gaps AB Bze Dom Jam Mon Sur Tor SKN TT
Strategic information related to prevention efforts especially MARPs
X X X X X X X
Models for development of prevention strategies especially in MARPs
X X X X X
Support to HFLE programme for sustainability and technical assistance (TA) for expansion of education sector response
X X X X
Expansion of STI services and integration into existing services e.g PHC
X X X X
Prevention Target Gaps AB Bze Dom Jam Mon Sur Tor SKN TT
BCC especially with reference to a communication strategy for the target groups and programme planning
X X
Support for expansion of testing sites including test kits and training of providers
X X X
Programmes for drug users and interventions for incarcerated youth and inmates.
X X X X
Prevention Target Gaps AB Bze Dom Jam Mon Sur Tor SKN TT
Prevention interventions in youth such as SRH interventions for parents, support for adolescent PLHIV, comprehensive programmes to respond to sexually active minors in the school setting
X X
Development of gender based interventions
X X X
Prevention in positives
X X X
Prevention Target Gaps
AB Bze
Dom
Jam
Mon
Sur
Tor SKN TT
Strengthening the NGO,CBO and CSO contribution to the prevention response
X
Strengthening universal access to social support services for PLHIVs
X
Legislation and policies related to testing of minors.
X
Elimination Target
Elimination target
Many countries did not outline deficiency in funding in this area however regional data available shows that the coverage is not optimal
Elimination Target Gaps AB Bze
Dom
Jam Mon
Sur
Tor SKN
TT
Drugs for PMTCT X X X X
Financial resources for procurement of testing supplies, testing at least twice during pregnancy and partner testing
X X
Programmes to improve adherence to PMTCT drugs by Positive mothers
X
Follow up of exposed infants
X
Integration into MCH programmes
X
Surveillance X X
Elimination Target Gaps
AB Bze
Dom
Jam
Mon
Sur
Tor SKN TT
Drugs for PMTCT X X X X
Financial resources for procurement of testing supplies, testing at least twice during pregnancy and partner testing
X X
Programmes to improve adherence to PMTCT drugs by Positive mothers
X
Follow up of exposed infants
X
Integration into MCH programmes
X
Surveillance X X
Treatment and Care Target
Treatment & Care Target Gaps AB Bze Dom Jam Mon Sur Tor SKN TT
Diagnosis and treatment of Opportunistic infections (OI).
X X X
Strategies including policies for integration of HIV/STI care into existing services
X
Sustainability of treatment
X X X X X X X X
Laboratory tests for monitoring ARV treatment
X X X X X
Research on drug resistance
X X
Treatment & Care Target Gaps AB Bze Dom Jam Mon Sur Tor SKN TT
Social support programmes for adolescent, orphans and children living with HIV
X X
Capacity building in forecasting for procurement of ARV drugs to prevent stock outs
X
Capacity building in laboratory surveillance, internal quality control documentation and implementation, external quality assurance
X X X
Human Rights Target
Human Rights Target Gaps
AB Bze Dom
Jam Mon Sur Tor SKN TT
Funding for expansion of initiatives: development of polices and legislation as well as advocacy
X X X X X X X
Development of a framework and policies to encourage support and empowerment of PLHIVs
X
Capacity building for monitoring and advocacy of the policy and legislative arena
X
Training of CSOs, NGOs etc and other partners within the multi-sectoral response in advocacy
X X
Human Rights Target Gaps AB Bze Dom Jam Mon Sur Tor SKN TT
Capacity building for redress mechanisms
X X
Sensitization of health care workers
X
Development of sector wide change agents
X
Gender agenda with focus on gender violence related to women and sexual orientation
X X
Human Rights Target Gaps
AB Bze Dom
Jam Mon Sur Tor
SKN TT
Removal of punitive laws related to same sex relationships
X
Research related to S&D X
Advocacy to include developed policies in the legislative agenda
X
Capacity building of administrative and financial abilities is essential to improve the effectiveness of their advocacy agenda.
X
M&E reporting and management capacity of CSOs
X
Challenges
ChallengesMain challenges encountered in gathering the
data were: Regional level:
Difficulty in getting the required data from regional partners and donor agencies.
National level Poor response from member countries possibly due to:
– Competing interests: Harmonization of donor efforts at country level is needed
– Unavailability of data or information needed at country level
THE MEETING is invited to: (i)Advise on mechanisms to overcome the
challenges with information sharing; and (ii) Agree on the strategic objectives, regional
public goods and services and activities to be included in the Biennial Operational Plan, 2012-2013