11 partnership between bmgf and goi to scale and sustain programs- a comprehensive sustainability...
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11Partnership between BMGF and GOI to scale and sustain programs- a comprehensive sustainability approach
1. Aligned policies: NACO continues focus on scaled prevention with MARPs as key prevention strategy
2. Aligned approaches, scaled programs and strengthened organizational systems within government: NACO scales up coverage and quality of its own prevention programs with MARPs
3. Transferring fiduciary and management responsibility of Avahan interventions to government in a phased manner
Focus of today’s
discussion
22Sharing of Avahan lessons with GOI to enable rapid scale up of MARPs program
Approach to MARPs programming • Microplanning tools• Community strengthening• Intensive peer led outreach• Robust MIS and feedback loop
Supervision and capacity building approach• ‘Mother NGOs’ with role to strengthen
programs through on-site mentoring• Intensive field presence of project officers
to mentor NGOs• Ratio of 1:6 project officers: NGOs
© 2009 Bill & Melinda Gates Foundation |
2
Approach to MARPs programming incorporated into drafting NACO operational guidelines and training modules
Supervision and capacity building approach similar – through robust Technical Support Units, many with experience in donor programming
Ratio of 1:10 project officers: NGOs
Avahan lessons …incorporated by NACO
33GOI lessons incorporated by Avahan
Approach to MARPs programming • Focus on HIV testing
Cost savings• ‘programs’ can be managed at slightly
lower costs
© 2009 Bill & Melinda Gates Foundation |
3
Avahan incorporated HIV testing 2009 onwards
Avahan reduced program costs by 20% to be aligned with government costing structures
NACO lessons …incorporated by Avahan
44Program management: Strategic in-sourcing for quality assurance
NACP III recognised that it would benefit from taking advantage of technical capacity available with institutions with appropriate skills, flexibility & capacity.
Usually, the government tries to do it all!
Inputs into guideline development
Issuing guidelines, policy and planning
Funds release, administration, implementation
Developing appropriate
monitoring tools
Managing in-sourced units
Supportive supervision and
‘feel on the street’ quality
assurance
Inputs into guideline development
Issuing guidelines, policy and planning
Funds release, administration, implementation
Developing appropriate
monitoring tools
Managing in-sourced units
Supportive supervision and
‘feel on the street’ quality assurance
In-sourced supportGovernment Programme delivered
55Technical Support Units: Alignment with government structures
© 2009 Bill & Melinda Gates Foundation | 5
BMGF NACONTSU, TSGs
SLPs SACS TSUs
NGOs CBOs
Level 1: Policy setting, management and funding
Level 2: Management and implementationTechno-managerial implementation support, rigorous and regular reviews and financial
oversight
Level 3: ImplementationService delivery
Transfer
Avahan
State level
District level
Government
National level
NGOs CBOs
66The role of quality assurance and supportive supervision units/mechanisms
© 2009 Bill & Melinda Gates Foundation | 6
Role of government division
Issuing guidelines/policies
Administration
Reviews and ensuring support structures deliver
against mandate
Funds flows
Handling public inquiries
Role of support structure
Technical inputs into guideline and module
development
Developing appropriate tools and MIS to monitor program
Feet on the street supportive supervision
Oversight of implementing partners (NGOs/CBOs)
Strategic planning and ‘problem solving’ of
emerging issues
Imp
lem
enta
tio
n
Qu
ality assuran
ce
77Technical and management support in NACP III
© 2009 Bill & Melinda Gates Foundation | 7
National
State
District
National TSU Truckers TSG Condom TSG
State TSU State Training and
Resource Center
District AIDS Units
BMGF and USG BMGF BMGF and USAID
All donors Government/World
Bank, USAID, DfID
Government/World Bank
CDC
Support structure Source of support
TSU = technical support unit, TSG = technical support group
88Partnership between BMGF and GOI to scale and sustain programs- a comprehensive sustainability approach
1. Aligned policies: NACO continues focus on scaled prevention with MARPsas key prevention strategy
2. Aligned approaches, scaled programs and strengthened organizational systems within government: NACO scales up coverage and quality of its own prevention programs with MARPs
3. Transferring fiduciary and management responsibility of Avahan interventions to government in a phased manner
99Planned and phased handover through a Memorandum of Understanding between donor and government
© 2009 Bill & Melinda Gates Foundation | 9
20%10%
80%
2009 2010 2011 2012 2013
Avahan Phase II
20%
25%75%Condom social marketing interventions
Truckers interventions
High-risk group interventions 70%
1010Tight coordination with government at all levels to add pos role
Project Director Team Leader
Joint Director, Targeted Interventions
Team Leader, Targeted Interventions
Additional project director + Joint
Directors
Team Leader, Capacity Building
Project Director and Additional project
Director
Team Leader, Strategic planning
SACS (public) TSU (private)
NGOs/CBOs
State Level Private Pubic Partnership National Level
NACO, State Nodal Officer
NTSU, Team Leader and Program
Officers
Field level Program Officer
1111
Technical support group for condoms resulted in disruptive growth in socially marketed condoms
11Condom Technical Unit initiated under NACP III
Millions of condoms
Growth – inflationary at 7-10%
Growth – 17-20%
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
339 384 439 635 722
886
545 639 639
835 844
825
884 1,023 1,078
1,470 1,566
1,711
Commercial Social Total
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