leveraging an hiv care and treatment program to strengthen local health care networks_mwayab...
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Leveraging an HIV Care and Treatment Program to Strengthen Local Health
Care NetworksMwayabo J. C Kazadi, MD, MPH, MBA
Senior Technical Advisor, Catholic Relief Services
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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%Loss to follow up = 10.6%
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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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Thank You
www.crsprogramquality.org