Leveraging an HIV Care and Treatment Program to Strengthen Local Health

Care NetworksRuth Stark, PhD

Senior Technical Advisor, CRS South Africa

• Nine years

• Ten countries

• USD 740 million,

funded by PEPFAR

• Designed for transition to local ownership

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%

Capacity Strengthening =

Capacity Building

+

Institutional Strengthening

+

Accompaniment

The AIDSRelief Approach

Comprehensive, interdisciplinary approach based on a framework:

Organizational capacity Technical capacity Funding capacity Policy and advocacy capacity

Key Interventionsand Approaches

Key Interventionsand Approaches

• Baseline assessment of organizational strengths and gaps

• Clear milestones based on assessment results• Dynamic capacity building plans

Ongoing assessment using:

•Site Capacity Assessment (SCA)

•Clinical Assessment for System Strengthening (ClASS)

Key Interventionsand Approaches

• Joint site visits

• Long-term accompaniment/mentoring

• Proven practices of adult learning (didactic work, practical application, on-site training)

• Exchange visits

Key Interventionsand Approaches

• Continuous quality improvement teams• Clinical task shifting• Continuing, locally-owned education• Incremental transfer of responsibilities

Key Interventionsand Approaches

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.

Conclusion

Disease-specific resources can improve organizational capacity to better manage operations and service delivery, thereby strengthening the overall health system.

Lessons learned

• Begin early• Dedicate resources • Leverage local resources• Work with host government• Disengage gradually

www.crsprogramquality.org