Ruth Stark - Catholic Relief Service (CRS)
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Leveraging an HIV Care and Treatment Program to Strengthen Local Health
Care NetworksRuth Stark, PhD
Senior Technical Advisor, CRS South Africa
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• Nine years
• Ten countries
• USD 740 million,
funded by PEPFAR
• Designed for transition to local ownership
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Over nine years, the CRS-led AIDSRelief consortium delivered high-quality HIV care and treatment in ten countries with more than $700M in PEPFAR support.
•
19 local partners working directly through 276 facilities
700,000+ clients, including 395,000+ who initiated ART
Viral suppression = 88.2%
Retention = 83%
Mortality = 7.8%
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Capacity Strengthening =
Capacity Building
+
Institutional Strengthening
+
Accompaniment
The AIDSRelief Approach
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Comprehensive, interdisciplinary approach based on a framework:
Organizational capacity Technical capacity Funding capacity Policy and advocacy capacity
Key Interventionsand Approaches
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Key Interventionsand Approaches
• Baseline assessment of organizational strengths and gaps
• Clear milestones based on assessment results• Dynamic capacity building plans
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Ongoing assessment using:
•Site Capacity Assessment (SCA)
•Clinical Assessment for System Strengthening (ClASS)
Key Interventionsand Approaches
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• Joint site visits
• Long-term accompaniment/mentoring
• Proven practices of adult learning (didactic work, practical application, on-site training)
• Exchange visits
Key Interventionsand Approaches
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• Continuous quality improvement teams• Clinical task shifting• Continuing, locally-owned education• Incremental transfer of responsibilities
Key Interventionsand Approaches
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Results
• Partners sustained quality patient services• Managed USG sub-grants• From 2008-2012, more than 30,000
participants trained• Transition: 14 local partners in 8 countries
secured direct PEPFAR funding to manage the programs.
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Conclusion
Disease-specific resources can improve organizational capacity to better manage operations and service delivery, thereby strengthening the overall health system.
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Lessons learned
• Begin early• Dedicate resources • Leverage local resources• Work with host government• Disengage gradually
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www.crsprogramquality.org