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  1. 1
    Peer Reviewed

    Effective Collaboration for Scaling Up Health Technologies: A Case Study of the Chlorhexidine for Umbilical Cord Care Experience.

    Coffey PS; Hodgins S; Bishop A

    Global Health, Science and Practice. 2018 Mar 21; 6(1):178-191.

    The global health field is replete with examples of cross-organizational collaborative partnerships, such as networks, alliances, coalitions, task forces, and working groups, often established to tackle a shared global health concern, condition, or threat affecting low-income countries or communities. The purpose of this article is to review factors influencing the effectiveness of a multi-agency global health collaborative effort using the Chlorhexidine Working Group (CWG) as our case study. The CWG was established to accelerate the introduction and global scale-up of chlorhexidine for umbilical cord care to reduce infection-related neonatal morbidity and mortality in low-income countries. Questions included: how current and past CWG members characterized the effectiveness, productivity, collaboration, and leadership of the CWG; what factors facilitated or hindered group function; institutional or individual reasons for participating and length of participation in the CWG; and lessons that might be relevant for future global collaborative partnerships. Data were collected through in-depth, semistructured individual interviews with 19 group members and a review of key guiding documents. Six domains of internal coalition functioning (leadership, interpersonal relationships, task focus, participant benefits and costs, sustainability planning, and community support) were used to frame and describe the functioning of the CWG. Collaboration effectiveness was found to depend on: (1) leadership that maintained a careful balance between discipline and flexibility, (2) a strong secretariat structure that supported the evolution of trust and transparent communication in interpersonal relationships, (3) shared goals that allowed for task focus, (4) diverse membership and active involvement from country-level participants, which created a positive benefit-cost ratio for participants, (5) sufficient resources to support the partnership and build sustainable capacity for members to accelerate the transfer of knowledge, and (6) support from the global health community across multiple organizations. Successful introduction and scale-up of new health interventions require effective collaboration across multiple organizations and disciplines, at both global and country levels. The participatory collaborative partnership approach utilized by the Chlorhexidine Working Group offers an instructive learning case.
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  2. 2

    The Reproductive, Maternal, and Neonatal Health Innovation Fund Project: Lessons learned from technical assistance.

    Habte M; Hiruy A; Kifle R; Minwyelet M; Monaghan J; Osakwe C; Rifkin R; Tekalign W; Tomasulo A; Unninayar S

    Addis Ababa, Ethiopia, Reproductive, Maternal, and Neonatal Health Innovation Fund Project, 2018. 24 p.

    In 2015, the Federal Ministry of Health and UK’s Department for International Development established a Reproductive, Maternal, and Neonatal Health Innovation Fund, and committed £19 million (amount after the closure decision) over four project years (2014 to 2018). Pathfinder International, as the Technical Assistance Supplier, embedded its team members to provide technical support to the different directorates within the Federal Ministry of Health. As the project is approaching its end after three years of implementation, Pathfinder International Ethiopia has documented feedback, reflections, and analysis of what worked well over the course of the project and identified areas of improvement under four major themes: achieving program outputs and management; coordination and learning platforms; capacity building; and promoting reproductive, maternal, and neonatal health innovations by involving the different stakeholders in the project--including Federal Ministry of Health Officials, regional health bureau representatives, Department for International Development, Pathfinder, and grant subrecipients.
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  3. 3
    Peer Reviewed

    Low sustainability, poor governance, and other challenges encountered by grassroots non-governmental organizations targeting HIV prevention for men who have sex with men in China - a nation-wide study.

    Lau JTF; Wang Z; Kim Y; Li J; Gu J; Mo PKH; Wang X

    AIDS Care. 2017 Dec; 29(12):1480-1490.

    Grassroots non-governmental organizations (NGOs) played pivotal roles in HIV prevention among men who have sex with men (MSM) in China. Their governance and sustainability issues were under-studied. This nation-wide study surveyed leaders of 202 of the HIV related NGOs in China.58.4% of the leaders believed that their NGO would last for /=3 non-sustainability issues; associated factors included perceived inadequacies in prevention skills, management skills, policy support, technical support, operational support, and CDC's support; a reverse association was found for frequent collaboration with organizations in China. 30.6% of the leaders mentioned >/=7 governance issues; a stepwise model found a positive association with having no office and negative associations with number of full-time staff and core volunteers. These problems would severely limit the effectiveness of HIV prevention among MSM. Related improvements and support are warranted.
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  4. 4
    Peer Reviewed

    A reporting system to protect the human rights of people living with HIV and key populations.

    Williamson R; Fiscian V; Olson RU; Poku FN; Whittal J

    Health and Human Rights. 2017 Dec; 19(2):211-222.

    People living with HIV and key populations face human rights violations that affect their access to health services, relationships in their communities, housing options, and employment. To address these violations, government and civil society organizations in Ghana developed a discrimination reporting system managed by the Commission on Human Rights and Administrative Justice that links people living with HIV and key populations to legal services. This article presents findings on how Ghanaian stakeholders built this reporting system and discusses preliminary data on its impact. To organize our analysis, we used a conceptual framework that outlines the legal frameworks that protect human rights, the institutions that promote access to justice, and the mechanisms that link people living with HIV and key populations to legal services. Using in-depth interviews, we show that targeted technical assistance increased stakeholders’ knowledge of issues that affect people living with HIV and key populations, strengthened these stakeholders’ commitment to address discrimination, streamlined case management systems, and improved relationships between civil society and the government. Through case review, we find that most discrimination happens when accessing government services, inside communities and families, and in the workplace. Finally, we describe implications for other human rights commissions that are considering using a reporting system to protect human rights, including using legal frameworks, developing case management systems, and working with civil society.
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  5. 5

    Strengthening Namibia's pharmacy sector and workforce.

    Fults E; Sagwa E; Mazibuko G; Kagoya H

    Arlington, Virginia, Management Sciences for Health [MSH], Systems for Improved Access to Pharmaceuticals and Services Program [SIAPS], 2016 Oct. 8 p. (SIAPS Technical Brief)

    Namibia faces a dual public health burden of HIV and AIDS and tuberculosis (TB). Critical to the treatment and management of these diseases is an effective workforce that can provide quality pharmaceutical services throughout the country. Pharmacists and pharmacist assistants (PAs) play critical roles in dispensing life-saving medications, monitoring patient health and progress, and educating both patients and other health professionals about proper medication use, storage, and dispensing practices. To meet the high demand for quality pharmaceutical services and to ensure that pharmacy personnel needs are being met, the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program supported the Government of the Republic of Namibia in the long-term planning of pharmaceutical human resources and building the capacity of two local institutions to provide pre-service and in-service pharmaceutical management training.
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  6. 6

    New institutional formation in the intersection of Tanzanian decentralization and HIV/AIDS interventions.

    Long CA

    Journal of Eastern African Studies. 2017 Oct 2; 11(4):692-713.

    Assessments of sub-Saharan African decentralization processes often overlook change experienced and facilitated by technical institutions operating in recipient countries on behalf of major donor interventions. This change affects public service delivery at different government levels and the decentralization-oriented exchanges between those levels. This article examines these institutions as well as the change they experience and facilitate. It does so from the perspective of program implementing units (PIUs) contracted by donors to support technical public service delivery. The selected PIU cases are those contracted by the Tanzanian operations of the American President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR Tanzania played an instrumental role in the national health sector’s HIV/AIDS policy shift from a focus on prevention of and care for those with the virus to the adoption and implementation of a national treatment policy. Complicating treatment in Tanzania were expectations for homogenous national distribution of HIV/AIDS requiring extensive, consistent service support at every point of care. The government’s decentralization strategy introduced the PIUs as core HIV/AIDS service institutions. The PIUs’ resulting position in decentralization structures facilitated their own institutional change as well as change in relevant decentralization stakeholders’ exchanges that altered the government’s decentralization-by-devolution strategy.
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  7. 7
    Peer Reviewed

    Aligning Funding and Need for Family Planning: A Diagnostic Methodology.

    Fan VY; Kim S; Choi S; Grepin KA

    Studies In Family Planning. 2017 Dec; 48(4):309-322.

    With limited international resources for family planning, donors must decide how to allocate their funds to different countries. How can a donor for family planning decide whether countries are adequately prioritized for funding? This article proposes an ordinal ranking framework to identify under-prioritized countries by rank-ordering countries by their need for family planning and separately rank-ordering them by their development assistance for family planning. Countries for which the rank of the need for family planning is lower than the rank of its funding are deemed under-prioritized. We implement this diagnostic methodology to identify under-prioritized countries that have a higher need but lower development assistance for family planning. This approach indicates whether a country is receiving less compared to other countries with similar levels of need.
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  8. 8

    Opening the black box of maternal and newborn deaths in Kenya. A report on technical support for implementation of maternal and perinatal death surveillance and response.

    University of North Carolina at Chapel Hill. Carolina Population Center. MEASURE Evaluation PIMA

    Chapel Hill, North Carolina, MEASURE Evaluation PIMA, University of North Carolina at Chapel Hill, 2017 Sep. 18 p. (TR-17-213)

    Kenya aims to reduce its high maternal mortality rate from 362 deaths per 100,000 live births to 200 deaths per 100,000 live births by 2030. Maternal and perinatal death surveillance and response (MPDSR) is an essential, high-impact element of obstetric and newborn care and a game-changing approach to attaining this goal. In 2008, the Kenya Ministry of Health (MOH) adopted the World Health Organization’s technical guidelines on maternal death reviews and incorporated a perinatal component. A 2014 audit of the implementation of maternal death reviews showed weaknesses, such as a lack of knowledge of classification of causes of death in accord with the International Classification of Diseases, low levels of reporting of maternal deaths, and a lack of reporting forms. These issues show that health workers in maternal and neonatal health programs face challenges in providing specific services to eliminate the deaths of women and newborns. WHO has described these kinds of data gaps -- in Kenya and elsewhere -- as the “black box of maternal mortality.” The missing data are necessary for Kenya to track preventable maternal and newborn deaths precisely and in real time and to respond effectively. MEASURE Evaluation PIMA, funded by the United States Agency for International Development, helped with the audit, the development of maternal and perinatal death surveillance and response guidelines, tools for implementing the guidelines, and efforts to strengthen maternal and perinatal death surveillance and response. This report outlines those efforts and lessons. In Kenya, knowledge of MPDSR as a high-impact intervention has increased, especially among health workers, despite varying degrees of implementation by county MPDSR committees. With global and national commitments to eliminate preventable maternal, child, and newborn deaths, and Kenya’s efforts toward these goals, there is promise that the vision for a functional MPDSR system will be achieved. Experience from efforts to institutionalize MPDSR in the five focus counties shows that although reporting is still low, information on the extent and characteristics of maternal and perinatal deaths is becoming more available and accessible. Specific maternal and perinatal mortality data from the “black box” are increasingly accessed, analyzed, and used for policy and service delivery.
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  9. 9

    Best practices in strengthening community health information systems.

    University of North Carolina at Chapel Hill. Carolina Population Center. MEASURE Evaluation PIMA

    Chapel Hill, North Carolina, MEASURE Evaluation, University of North Carolina at Chapel Hill, 2016 Mar. 56 p. (TR-16-126)

    This report describes the lessons learned and best practices towards strengthening the capacity of the community health information systems (CHIS) in Kenya to generate complete and quality data and promote data use for decision making. The focus is on partners’ collaboration in leveraging resources, empowering disadvantaged groups, involving the community in decision making, and on the MOH commitment to help achieve M&E capacity building. The report also documents challenges, best practices, and lessons learned during program implementation that could be useful for Kenya in the future and for other organizations interested in increasing M&E capacity.
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  10. 10
    Peer Reviewed

    Succeeding in New Vaccine Introduction: Lessons Learned From the Introduction of Inactivated Poliovirus Vaccine in Cameroon, Kenya, and Nigeria.

    Scotney S; Snidal S; Saidu Y; Ojumu A; Ngatia A; Bagana M; Mutuku F; Sobngwi J; Efe-Aluta O; Roper J; LeTallec Y; Kang'ethe A

    Journal of Infectious Diseases. 2017 Jul 01; 216(suppl_1):S130-S136.

    Introducing a new vaccine is a large-scale endeavor that can face many challenges, resulting in introduction delays and inefficiencies. The development of national task teams and tools, such as prelaunch trackers, for the introduction of new vaccines (hereafter, "new vaccine introductions" [NVIs]) can help countries implement robust project management systems, front-load critical preparatory activities, and ensure continuous communication around vaccine supply and financing. In addition, implementing postlaunch assessments to take rapid corrective action accelerates the uptake of the new vaccines. NVIs can provide an opportunity to strengthen routine immunization, through strengthening program management systems or by reinforcing local immunization managers' abilities, among others. This article highlights key lessons learned during the introduction of inactivated poliovirus vaccine in 3 countries that would make future NVIs more successful. The article concludes by considering how the Immunization Systems Management Group of the Global Polio Eradication Initiative has been useful to the NVI process and how such global structures could be further enhanced. (c) The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.
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  11. 11

    Training to improve quality and access to contraceptive implants in Burundi’s Kayanza and Muyinga Provinces.

    Pathfinder International. Evidence to Action for Strengthened Reproductive Health [E2A]

    Washington, D.C., E2A, 2014 Jul. 12 p. (USAID Contract No. AID-OAA-A-11-00024)

    E2A worked with the Pathfinder International-led, USAID-funded Maternal and Child Health (MCH) Project in Burundi to broaden the contraceptive method mix, and in particular increase the provision of Jadelle implants in Burundi’s Kayanza and Muyinga provinces. This technical brief describes the technical assistance provided by E2A, which built upon the MCH Project’s close partnership with the Government of Burundi’s National Program for Reproductive Health and included the following: developing a Facilitators’ Guide on insertion and removal of implants; training master trainers (senior health facility providers and supervisors) to use the Facilitators’ Guide for training health facility providers; developing job aids on implants for use by community-based distributors and health facility providers; assisting with ensuring the continued provision of high-quality family planning services; assisting with documenting the process and outcomes of the increased provision of Jadelle to inform scale-up.
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  12. 12

    Multisectoral nutrition programming: FANTA achievements and lessons learned.

    FHI 360. Food and Nutrition Technical Assistance Project [FANTA]

    Washington, D.C., FANTA, 2017. 20 p. (USAID Cooperative Agreement No. AID-OAA-A-12-00005)

    In line with USAID’s Multi-Sectoral Nutrition Strategy, FANTA has been working on multiple levels toward achieving USAID’s objective of scaling up effective, integrated nutrition-specific and nutrition-sensitive interventions, programs, and systems in humanitarian and development contexts through a multisectoral approach. On a global level, FANTA has provided technical assistance and developed tools and methods to promote country-led, evidence-based, scalable multisectoral approaches that have improved nutrition and built sustainable capacity. Multisectoral Nutrition Programming outlines FANTA’s activities in the multisectoral arena in areas including: Nutrition advocacy; Development of multisectoral policies, action plans, and guidelines; Nutrition costing and resource mobilization; Analysis and use of nutrition gap data to strengthen agricultural linkages; Multisectoral capacity building; Multisectoral nutrition research; M&E for integrated programming; Knowledge sharing.
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  13. 13
    Peer Reviewed

    The Arc of Human Immunodeficiency Virus Capacity Development: Insights from a Decade of Partnership for Medical Education in Zambia.

    Claassen CW; Hachaambwa L; Phiri D; Watson DC; Patel D; Bositis CM; Bositis A; Mubangizi D; Redfield R; Mwaba P; Sheneberger R

    American Journal of Tropical Medicine and Hygiene. 2017 May; 96(5):1011-1013.

    AbstractZambia and other sub-Saharan nations suffer from a critical shortage of trained health-care professionals to combat the human immunodeficiency virus/acquired immunodeficiency syndrome crisis. The University of Maryland and the Zambian Ministry of Health have partnered over the past decade to develop health-care capacity among physicians, nurses, and community health workers. We describe novel interventions to train health-care workers at all levels and argue that our collaboration represents a successful model for such partnerships between western medical institutions and African governmental health agencies.
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  14. 14

    Focus on community-based family planning: Partnership with Uganda Ministry of Health.

    Research Triangle Park, North Carolina, FHI 360, 2013 Mar. 4 p. (USAID Cooperative Agreement GPO-A-00-08-00001-00)

    The Ugandan Government has an ambitious goal to reduce unmet need for family planning (FP) from its current 34% to 10% over the next 10 years. To help achieve this goal, FHI 360 has been working with the Ugandan Ministry of Health (MOH) to improve its capacity to expand community-based family planning (CBFP) services and systems. With FHI 360’s support, the MOH has gradually developed national systems to support a CBFP program, including community-based access to injectables (CBA2I), for which Uganda has served as a model for other countries developing their own CBA2I programs. FHI 360’s goal is to help develop and leave behind CBFP systems that the MOH can sustain in the future. This brief shares experiences and lessons from capacity building for FP at the national and district levels in Uganda. The U.S. Agency for International Development supports this work, through the PROGRESS and STRIDES for Family Health projects. (excerpt)
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  15. 15
    Peer Reviewed

    Analysis of stakeholders networks of infant and young child nutrition programmes in Sri Lanka, India, Nepal, Bangladesh and Pakistan.

    Uddin S; Mahmood H; Senarath U; Zahiruddin Q; Karn S; Rasheed S; Dibley M

    BMC Public Health. 2017 Jun 13; 17(Suppl 2):405.

    BACKGROUND: Effective public policies are needed to support appropriate infant and young child feeding (IYCF) to ensure adequate child growth and development, especially in low and middle income countries. The aim of this study was to: (i) capture stakeholder networks in relation to funding and technical support for IYCF policy across five countries in South Asia (i.e. Sri Lanka, India, Nepal, Bangladesh and Pakistan); and (ii) understand how stakeholder networks differed between countries, and identify common actors and their patterns in network engagement across the region. METHODS: The Net-Map method, which is an interview-based mapping technique to visualise and capture connections among different stakeholders that collaborate towards achieving a focused goal, has been used to map funding and technical support networks in all study sites. Our study was conducted at the national level in Bangladesh, India, Nepal, and Sri Lanka, as well as in selected states or provinces in India and Pakistan during 2013-2014. We analysed the network data using a social network analysis software (NodeXL). RESULTS: The number of stakeholders identified as providing technical support was higher than the number of stakeholders providing funding support, across all study sites. India (New Delhi site - national level) site had the highest number of influential stakeholders for both funding (43) and technical support (86) activities. Among all nine study sites, India (New Delhi - national level) and Sri Lanka had the highest number of participating government stakeholders (22) in their respective funding networks. Sri Lanka also had the highest number of participating government stakeholders for technical support (34) among all the study sites. Government stakeholders are more engaged in technical support activities compared with their involvement in funding activities. The United Nations Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) were highly engaged stakeholders for both funding and technical support activities across all study sites. CONCLUSION: International stakeholders were highly involved in both the funding and technical support activities related to IYCF practices across these nine study sites. Government stakeholders received more support for funding and technical support activities from other stakeholders compared with the support that they offered. Stakeholders were, in general, more engaged for technical support activities compared with the funding activities.
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  16. 16

    Integrating quality improvement in HIV / AIDS care and treatment in the Lualaba Province of the Democratic Republic of Congo to retain PLHIV on antiretroviral therapy. Case study.

    Boucar M; Saley Z; Manday T; Kanyanga F; el Khazen M

    Chevy Chase, Maryland, Applying Science to Strengthen and Improve Systems (ASSIST) Project, 2017 Jun. 6 p.

    In fiscal years 2015-2016, the USAID ASSIST Project funded by PEPFAR provided technical assistance to improve the retention of PLHIV on ART in 10 health facilities in the province of Lualaba. The work was executed in collaboration with two implementing partners: PATH’s PROVIC Project and MSH’s PROSANI Project. This intervention was guided by the results of a baseline assessment carried out by ASSIST in the care services of PLHIV from July-August 2015. This baseline assessment highlighted quality gaps in PLHIV care, especially retention and adherence to ART. Based on the baseline results, ASSIST's goal is to help improve the retention of PLHIV on ART to ensure that all patients who start antiretroviral therapy adhere to and continue to receive ART. To achieve its objectives, ASSIST has used the collaborative approach to performance improvement, a process of mutual learning among the 10 sites in the province of Lualaba. The results show that in November 2015 at the start of the HIV / AIDS collaborative, with a total of 2,358 PLHIV expected in the 10 collaborative sites in the province of Lualaba, only 853 PLHIV were supplied with ARVs: a gap of 1,500 people. With the progressive implementation of change ideas during the intensive phase of the collaborative, in June 2016 with 2,536 PLHIV expected to be on ARVs, 1,566 PLHIV were supplied with ARVs: a gap of 970 cases. Hence, despite the increasing number of PLHIV supported by the sites, the gap of those lost decreased. This case study allowed us to describe the experience of improving the retention of PLHIVs in ART in one province in DRC. However, like many technical assistance projects in developing countries, main challenges remain to sustainability, scaling up of good practices, and institutionalizing quality improvement.
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  17. 17
    Peer Reviewed

    Lessons Learned From Transitioning PEPFAR Track 1.0 Care and Treatment Programs: Case Studies in Financial Management Capacity Building in Zambia and Botswana.

    Kuehn C; Tidwell G; Vhugen J; Sharma A

    Journal of Public Health Management and Practice. 2015 Nov-Dec; 21(6):564-72.

    In 2008, the United States government mandated transition of internationally managed HIV care and treatment programs to local country ownership. Three case studies illustrate the US Health Resources Services Administration's fiscal assessment and technical assistance (TA) processes to strengthen local organizations' capabilities to absorb and manage United States government funding. Review of initial, TA and follow-up reports reveal that the 1 Botswanan and 2 Zambian organizations closed 10 of 17 financial capacity gaps, with Health Resources Services Administration assisting on 2. Zambian organizations requested and absorbed targeted TA on the basis of the consultant's desk review, their finance staff revised fiscal policies and procedures, and accordingly trained other staff. In Botswana, delays in integrating recommendations necessitated on-site TA for knowledge building and role modeling. Organizational maturity may explain differences in responsiveness, ownership, and required TA approaches. Clarifying expectations of capacity building, funding agreement, and nonmonetary donor involvement can help new organizations determine and act on intervening actions.
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  18. 18
    Peer Reviewed

    [Impact of a targeted technical assistance to improve vaccine coverage in Cameroon, Cote d'Ivoire, and Mauritania in 2014] Effets d'une assistance technique ciblee pour l'amelioration de la couverture vaccinale au Cameroun, en Cote d'Ivoire et en Mauritanie en 2014.

    Ahanhanzo YG; Palenfo D; Saussier C; Gbedonou P; Tonda A; Da Silva A; Aplogan A

    Bulletin de la Societe de Pathologie Exotique. 2016 Aug; 109(3):185-91.

    Within the framework of its strategic goal of vaccine coverage (VC) improvement, GAVI, The Vaccine Alliance has entrusted the Agence de medecine preventive (agency for preventive medicine, AMP) with technical assistance services to Cameroon, Cote d'Ivoire (Ivory Coast), and Mauritania. This support was provided to selected priority districts (PDs) with the worst Penta3 coverage performances. In 2014, PDs benefited from technical and management capacities in vaccinology strengthening for district medical officers, supportive supervisions and technical assistance in health logistics, data management and quality. We analyzed the effects of the AMP technical assistance on the improvement of the cumulative Penta3 coverage, which is the key performance indicator of the expanded programme on immunization (EPI) performance. We compared Penta3 coverage between PDs and other non-priority districts (NPDs), Penta3 coverage evolution within each PD, and the distribution of PDs and NPDs according to Penta3 coverage category between January and December 2014. Technical assistance had a positive effect on the EPI performance. Indeed Penta3 coverage progression was higher in PDs than in NPDs throughout the period. Besides, between January and December 2014, the Penta3 VC increased in 70%, 100% and 86% of DPs in Cameroon, Cote d'Ivoire and Mauritania, respectively. Furthermore, the increase in the number of PDs with a Penta3 coverage over 80% was higher in DPs than in NPDs: 20% versus 8% for Cameroon, 58% versus 29% for Cote d'Ivoire and 17% versus 8% for Mauritania. Despite positive and encouraging results, this technical assistance service can be improved and efforts are needed to ensure that all health districts have a VC above 80% for all EPI vaccines. The current challenge is for African countries to mobilize resources for maintaining the knowledge and benefits and scaling such interventions in the public health area.
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  19. 19

    Stakeholder review and update of materials to Support PMTCT services in Angola.

    Peacock K; Simione TB

    Arlington, Virginia, JSI Research and Training Institute, Strengthening High Impact Interventions for an AIDS-free Generation [AIDSFree], 2017 Mar. 36 p. (September 2016 Technical Assistance Report; USAID Cooperative Agreement No. AID-OAA-A-14-00046)

    Since 2013, HIV interventions in Angola to address MTCT and HIV in children have centered on expanding integrated services for antenatal care (ANC) and prevention of mother-to-child transmission (PMTCT), and on improving the quality of HIV health services. The Government of Angola has sought to align with international norms for PMTCT, including the Millennium Development Goals, and in 2013 began expansion of Option B+, as recommended by the World Health Organization (WHO). The USAID Angola Mission asked AIDSFree to support PMTCT efforts by meeting two objectives: (1) documenting USAID's experiences and compiling the PMTCT materials produced from 2011 through 2015 in Angola and (2) completing the transfer of USAID-produced PMTCT materials to the Government of Angola. This report details AIDSFree's progress in the second objective. It describes the process of developing the PMTCT Toolkit and the accomplishments and challenges encountered during the development and presentation of the toolkit.
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  20. 20

    Evaluation of the USAID / Cambodia PEPFAR HIV / AIDS flagship project, 2012-2017.

    Lowe D; Hales D; Burns K; Pick B; Cassell M; Bunsoth M; Bunnary C

    Washington, D.C., Global Health Performance Cycle Improvement Project, 2016 Nov. 125 p. (USAID Contract No. AID-OAA-C-14-00067)

    Evaluation questions: Questions related to the effectiveness of project innovations in detecting new cases of HIV among key populations (KPs); effectiveness of technical assistance in improving case management, antiretroviral therapy (ART) initiation, adherence, and retention in HIV treatment; and the capacity of implementers to use data in monitoring and planning services. Methods: Collection of qualitative data from interviews and focus groups with project implementers, KP clients and stakeholders; analysis of project indicator data; secondary data analysis; and document review. Key findings and conclusions: Community HIV testing of KPs by outreach workers (OW) was successfully scaled up (58,285 tests to June 2016). The very low HIV case detection yield of 0.44% was associated with a lack of data on KP sub-groups with high-risk behaviors and limited reach by OWs to high-risk KP segments, and a poorly functioning OW system. Innovations to increase KP reach and yield were either delayed, over-engineered, or not scaled up. There was no evidence of development of a culture of innovation at the field level. Active case management for People Living with HIV (PLHIV) was successfully scaled up, resulting in 100% of newly diagnosed HIV cases among KPs (227) being enrolled in ART. Loss to follow-up declined from 38% in Year 1 to 4% in Year 4. Ninety-six percent of those on ART achieved viral load suppression. Cost efficiencies could be achieved by differentiated care for stable and non-stable PLHIV. The capacity of most NGO implementing partners to analyze data, draw lessons learned, and apply those lessons was limited.
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  21. 21

    Improving dietary diversity to enhance women’s and children’s nutritional status in Guatemala’s Western Highlands: Recommendations for the Guatemalan agriculture sector.

    FHI 360. Food and Nutrition Technical Assistance Project [FANTA]

    Washington, D.C., FANTA, 2016. 4 p. (Technical Brief; USAID Cooperative Agreement No. AID-OAA-A-12-00005)

    The agriculture sector has a significant role to play in improving the nutritional status of women and children. Strengthening the link between agriculture and nutrition is critical to improve availability of, and access to, nutrient-dense local foods to improve dietary diversity and reduce nutrient gaps among pregnant and lactating women and children 6–23 months of age. This brief provides recommendations for the agriculture sector based on a recent study on the feasibility of using local foods to meet nutrient needs in the Western Highlands of Guatemala.
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  22. 22

    The Cervical Cancer Prevention Initiative: Investing in Cervical Cancer Prevention 2015–2020. Year One update, November 2016.

    Wittet S

    [Seattle, Washington], PATH, 2016 Nov. 7 p.

    It has been a year since the groundbreaking meeting in London where the Cervical Cancer Prevention Initiative was launched. This short report documents progress building the Initiative over the past 12 months, and lists key global milestones in cervical cancer during that time.
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  23. 23

    DNCC initiative: Process of defining DNCC functionality.

    FHI 360. Food and Nutrition Technical Assistance Project [FANTA]

    Washington, D.C., FANTA, 2016 Dec. 4 p. (FANTA Brief; USAID Cooperative Agreement No. AID-OAA-A-12-00005)

    The brief describes support provided to Uganda District Nutrition Coordination Committees (DNCC) and their stakeholders to define DNCC functionality, which includes specific roles, responsibilities, and benchmarks against which DNCC capacity and performance can be measured. These efforts were part of FANTA’s DNCC Initiative, which has strengthened national and district nutrition leadership and governance in Uganda.
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  24. 24

    USAID Botswana performance evaluation -- Tsela Kgopo Gender and OVC Project final report (RFTOP number SOL-674-15-000007).

    Southern Hemisphere

    [Washington, D.C.], United States Agency for International Development [USAID], 2015 Nov 24. 98 p.

    The Tsela Kgopo Orphans and Vulnerable Children and Gender Project is funded by USAID and managed by PCI, who provides technical support to ten Implementing Partners and the Government of Botswana. This is meant to contribute to creating an enabling policy environment and improved services for OVC, youth and women and ultimately is meant to improve the quality of life of OVCs. The uniqueness of this project lies in its use of a comprehensive family care (CFC) approach. A performance evaluation of this project was conducted by Southern Hemisphere between March and October 2015. The evaluation sought to determine whether the project had been implemented as planned; what the strengths and challenges were in implementation; whether there were signs of the intended results (outcomes); and how programme effectiveness could be enhanced. A qualitative research design, comprising semi-structured interviews (SSIs) and focus group discussions (FGD) was used for this performance evaluation. Interviews were conducted with key informants at USIAD and PCI, national and district government, five implementing partners and beneficiaries. The TK Project has been well designed to meet the needs of OVCs and their families and has taken services to hard to reach areas. However the demand for services has not been met as there are vulnerable areas, and particular sub-groups of OVCs (e.g. children on farms and streets) that are still not being reached. (Excerpts)
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  25. 25

    January 2016 technical assistance report: Compiling and systematizing USAID-supported PMTCT experiences and materials in Angola.

    Peacock K; Esiru G; Simione TB

    Arlington, Virginia, JSI Research and Training Institute, Strengthening High Impact Interventions for an AIDS-free Generation [AIDSFree], 2016 Dec. 50 p. (USAID Cooperative Agreement No. AID-OAA-A-14-00046)

    Angola has a generalized, heterosexually-driven HIV epidemic with an adult prevalence of 2.42 percent, according to 2014 estimates from the Joint United Nations Programme on HIV / AIDS (UNAIDS). The proportion of women receiving ART to prevent mother-to-child transmission (MTCT) of HIV has increased from 23 percent in 2009 to 39 percent in 2013. Despite this increase, the proportion of women tested remains low. This means that it is critical to identify these women and start them on treatment for their own health and to prevent MTCT. The USAID Angola Mission asked AIDSFree to 1) document USAID's experiences and compile the PMTCT materials produced during four years in Angola; and 2) complete the transfer of USAID-produced PMTCT materials to the Government of Angola. This report details AIDSFree's progress in the first objective. It describes Angola's health care and PMTCT management; outlines the Project and its PMTCT interventions; and details the process, progress, and findings of AIDSFree's work in compiling PMTCT materials produced by USAID and gathering information on the systematization of PMTCT tools and materials.
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