pepfar’s approach to maximize efficiency, effectiveness and impact nalinee sangrujee, phd mph...

PEPFAR’s Approach to Maximize Efficiency, Effectiveness and Impact

Nalinee Sangrujee, PhD MPHPEPFAR20 April 2012

1. Strengthen use of economic and financial data to ensure efficient use of resources

2. Incorporate innovations that promote efficiency and allocate resources based on impact

3. Increase collaboration with governments, the Global Fund and others to align programs and target investments

4. Reduce costs by streamlining USG operations and supporting increased country ownership

5. Achieve best all-inclusive commodity pricing6. Leverage creative mechanisms for healthcare finance to

bring additional resources to bear7. Develop and evaluation research agenda that will show

how to improve efficiency and impactSource: http://www.pepfar.gov/smart/index.htm

PEPFAR Smart Investments to Increase Impact and Efficiency

PEPFAR Finance and Economics Work Group

PEPFAR is adapting to achieve more with finite resources

Need timely financial monitoring data

Identify efficient models of service delivery that maximize value

PEPFAR programs typically had limited program area-specific financial data/indicators at their disposal for decision-making

Using Cost Data to Increase Efficiency

“PEPFAR is …identifying and implementingefficiencies in its work”


Match achievements and actual expenditures to estimate USG expenditure per beneficiary Country USG –level: inform program

planning (COP, GF rounds, MOH budgeting cycle, identify efficiencies etc.)

PEPFAR HQ-level: inform global budgeting

National – level: contribute to national expenditure processes

PEPFAR Expenditure Analysis Initiative

PEPFAR Expenditure

s

Other External Partner

Expenditures

National Governmen

t Expenditure

s

Understanding the full cost to support National HIV/AIDS Programs

Provide timely cost data and build capacity of USG teams to use cost data for improved management and efficient operation of programs


Work with other stakeholders to ensure integration and use of PEPFAR data in broader national cost analysis efforts

Total PEPFAR Expenditures for Fiscal Year

Routine financial monitoring of PEPFAR programs Provides annual data on expenditures by program area

and cost category Not a panacea: Puts the “M” in financial M&E and

highlights the need for “E”

What is PEPFAR Expenditure Analysis?

……………VMMCPMTCTART

Investment

Recurrent

Program Management

Monitoring and Evaluation

Health System Strengthening

Site-level

Above Site-level


Use of Expenditure Analysis Results for Partner Management to Improve

Efficiency


Goal to ensure IPs that are providing similar services/support are adopting best practices and using PEPFAR resources optimally

Step 1: Identify outliers

Step 2: In–depth analysis to identify cost drivers

Step 3: Agreement to lower UE by $X in coming year by decreasing expenditures or increasing targets

Trend Analysis


PEPFAR is exploiting more of its data to more effectively allocate resources

PEPFAR continues to support studies to evaluate programs including multi- country randomized community trial on combination prevention

Evidence-Based Approach to Increase Effectiveness

Recent PEPFAR COP Guidance to focus on uptake of core interventions

“E” dependent on good outcomes/output measures


Use of Expenditure Analysis Data to Inform Effective Programming


Optimal use of PEPFAR resources to maximize the reach, quality and impact of global HIV programs Strategic coordination of donors Crowding-in of internal and other external resources Recognizes that HIV programs may achieve greater

scale and reach with contributions from other sources Partnership Frameworks is PEPFAR’s move towards a

dialogue of partnership including the development of strong financing frameworks Promote national ownership Feasible, affordable, transparent, and sustainable Efficient and smart Easily implemented and monitored

Leveraging PEPFAR’s Resources


Note: Per-patient budget allocation is estimated as treatment allocation divided by lagged end-of-reporting direct patients.

Scale-Up of ART Access and Declining PEPFAR Per-Patient

Costs, 2004-2009


PEPFAR Continues to Develop Measures of

Efficiency and EffectivenessOur ability to improve efficiency and effectiveness is correlated with our ability to define and link interventions to measurable outputs

Clear service delivery models

No standard intervention models

Treatment

PMTCT

Counseling and Testing

Health System Strengthening

Behavior Change and Communication

OVC

Num

ber

of

Eco

nom

ic

Stu

die

s


THANK YOU!

For additional information:www.PEPFAR.gov

Acknowledgements:PEPFAR country teams and Implementing Partners for participation in Expenditure Analysis PilotsPEPFAR Finance and Economics Work Group

http://www.pepfar.gov/

pepfar’s approach to maximize efficiency, effectiveness and impact nalinee sangrujee, phd mph...

Documents