Abt HFG mechanism will focus on HICD, targeting key government ministries and NGOs to strengthen organizational systems and structures that promote their sustainability. The national strategies for HRH and SW in line with the PFIP Pillar 5 objectives will be prioritized. The emphasis is supporting the scaling up the HIV response and enhancing the sustainability of priority HR interventions. Synergy with the four pillars is critical to complement the efforts of other USG projects and other donors in line with national priorities. The HRH and SW Technical Working Groups will be the primary forums to coordinate these efforts in which development partners and in-country stakeholders will develop and contribute towards long term HRH and SW objectives. HFG will systematically seek to strengthen existing in-county systems and networks and focus on building the capacity of local institutions and individuals, thus minimizing the costs associated with supporting international systems and TA. Technical advisors will be placed at MOH and DSW to drive the support. Priority for the project is advocating for the transition of donor-funded positions to the government. Local stakeholders have been involved in the development of the HRH and SW Strategic Plans to ensure a long-term vision in implanting the plans by the local staff, strengthening coordination systems and capacity building of local entities to manage the systems. This will lead to country-owned interventions and M&E systems to evaluate progress. Supporting the HRIS in ensuring that reliable workforce planning data is critical and leverages PEPFAR TA support with defining staffing levels in facilities and the review of the Health Information Systems.

The objectives of the projects OVC component in Swaziland will be to 1) strengthen the delivery of social welfare services to vulnerable children and families 2) develop a national framework for social protection for vulnerable children. These objectives fit into PEPFARs OVC priorities for strengthening systems as per the CARE TAN, namely 1) strengthening and decentralization of the Department of Social Welfare, 2) strengthening the child protection system and 3) enhanced M&E for impact mitigation. Target populations will be vulnerable children and families which will benefit from improved social services and child and social protection. The strategies to achieve these objectives are in line with global evidence-based OVC guidance, namely strengthening the social welfare workforce and its systems and policies that address the unique needs of children in Swazilands epidemic.

Abt HFG mechanism will provide technical assistance to the Directorate of Social Welfare (DSW) to upgrade the skills of its social workers many of whom lack adequate training, and will review key practices and systems in the Directorate to enable improved case management and child protection, with emphasis on decentralization of DSW. The mechanism will also support the University of Swaziland to set up a degree course for social work, including the development of a curriculum. Pending government approval of a proposed new DSW structure including a cadre of auxiliary social workers, a pre-service training program for parasocial workers will be developed.

Another area of support through Abt will be a review of the various social assistance programs that benefit OVC's i.e: free primary education which currently extend to Grade 5;school-feeding for primary schools and for community facilities called Neighbourhood Care Points; a bursary scheme for eligible secondary school students; and grants to the elderly, many of whom take care of OVC's. A cash transfer program to OVC will be piloted by the World Bank. However, the system is fragmented and sustainability as well as functionality of these and other social protection components is weak. Activities will include a series of consultations and tailored training to develop consensus on national social protection priorities.

The five-year PFIP 2009-2013 seeks to address the spread of HIV not only by supporting the scaling up behavioral and biomedical interventions, but also by strengthening public health and community systems to foster a sustained response. As such, cross-cutting efforts to strengthen local capacity focus on building a human and institutional base to allow for expanded and extended service delivery. Over the length of the PFIP, the partnership expects to shift further toward capacity building and financial sustainability as USG gradually takes on a supportive role more focused on technical rather than financial assistance.

The HICD pillar in the PFIP addresses workforce imbalances and barriers that impact programs supported by PEPFAR across the 5 pillars, ensuring effective and efficient healthcare and social welfare service delivery systems. As highlighted in the HRH Strategic Plan (SP), HR functions overlap across various ministries and fragmentation in workforce planning, development, and management present a challenge that impacts the function of this pillar. Several assessments have highlighted a glaring lack of capacity in the MOH/HR that challenges the ability of the MOH to manage HRH and to effectively implement the HRH SP. Swaziland is also undergoing a number of strategic changes in the Social Welfare sector. The delivery of social welfare services is being reassessed, including a restructuring of the DSW and the adoption of strategies to foster a greater impact of Social Welfare services.

In light of the above challenges, the Abt-led Health Finance and Governance project (HFG) was selected by the USG team in Swaziland to strategically address gaps evident in USG-supported health and social welfare programs in Swaziland. Abt was the lead implementer of the HS 20/20 award, is a vendor under the ECSA-led HRAA program, and has worked in Swaziland conducting costing work including the HRH Strategic Plan and the MOH restructuring. The USG program can leverage this global expertise to strengthen support to all the PFIP pillars, consistently weak with SAHCD and HRAA. Further, health financing is garnering increased attention in Swaziland and the need for a strong partner in this area is essential. To achieve this Abt will need a presence in Swaziland.

PEPFAR has supported the development of several critical national-level documents i.e.: HRH Strategic Plan approved by cabinet, Development of the Staffing Norms to implement the Essential Health Care Package in line with decentralization of health services, Restructuring of the SWD. HFG support will follow and complement this work, and impact our support decentralization of ART and social welfare services and PMTCT Plus scale-up.

There is a growing interest to support HICD with the new World Bank/ EU HSS project, GF HSS grant and PEPFAR partners being encouraged to address HSS more holistically. Through PEPFAR, Pact Swaziland is building CANGOs capacity to be a UGM for smaller civil society organizations that do not receive GF and PEPFAR funding. PEPFAR is funding WHO directly and leveraging the relationship they have with the MOH to improve coordination of HR at a national level. This presents a prime opportunity for HFG to support WHO in strengthening the governance mechanisms of the multi-ministerial forums responsible for HR and SW to address key technical and policy implementation issues.