Twinning Partnership to improve quality of VCT Services

This is a new activity for COP 07 and linked to COP ID # 5678 (treatment: ARV services).

AIHA Twinning Center partnerships focus on institution to institution peer relationships. Unlike traditional consultancy approaches, the AIHA partnerships are voluntary, peer-based technical assistance programs, with an emphasis on professional exchanges, voluntary contributions, and leveraging private sector funds.

In order to strengthen service provision of voluntary counseling and testing, AIHA proposes a South-South twinning partnership between the Liverpool VCT Program (an indigenous Kenyan organization) and institutions responsible for VCT at the national level. The partnership will provide assistance in the area of quality assurance, policy development, material development to increase the capacity of the Federal Ministry of Health and Regional Health Offices to develop and support VCT sites. This south to south partnership will work at the national and regional levels to ensure coordination and quality assurance of VCT activities throughout Ethiopia. Ethiopian VCT Partner -National and Regional Institutions responsible for VCT training and support.. Since it was first established as a Kenyan NGO in 1998, Liverpool VCT, Care & Treatment (LVCT) has partnered with the Government of Kenya, through the Ministry of Health's National AIDS and Sexually Transmitted Infections Control Program (NASCOP) in scaling up quality assured counseling and testing services in resource-poor settings throughout Kenya, including Nyanza. LVCT also serves as the secretariat for NASCOP's National Quality Assurance Team for counseling and testing and has been central to the development of standards and guidelines for VCT as well as the legal bases for registration, licensure and accreditation of VCT sites. Of the nearly 800 VCT sites in Kenya, LVCT has helped to establish over 400; of these, 150 of these have been "graduated" to be managed by the Kenyan government, CBO and/or FBO. For the remaining 250 on their way to being graduated, LVCT provides staff, basic training, refresher training, supervision and quality assurance guidance. LVCT has also trained over 70% of all the VCT counselors in Kenya. Through its strong targeted evaluation program, LVCT contributes to evidence-based policy formulation and programming in Kenya by sitting on many of the task forces of NASCOP as well as the Interagency Coordinating Committee of the National AIDS Coordinating Council (NACC). LVCT has also spearheaded gender equitable provision of HIV/AIDS prevention, care and treatment services with particular emphasis on improving access to services for groups with special needs, including victims of sexual violence, the deaf, and men who have sex with men. LVCT supports to MOH and RHB includes: (1) Assessments of selected sites and define status quality assurance (2) Review lesson learned from the implementation of national and regional demonstration sites (3) Develop strategies to improve quality of VCT service (3) Develop national QA tools and provide TOT

A Twinning Center Program Officer will be assigned to work with a partnership coordinator designated by the partnership to monitor the partnership's progress and to help identify areas where technical assistance might be required. A Twinning Center Program Associate will be responsible for day-to-day project administration, including budget monitoring and logistical support.

Twinning Center staff will work with the partners to develop and implement a monitoring and evaluation system. In collaboration with the US evaluation team, appropriate PEPFAR indicators will be selected and reported upon twice yearly. The Twinning Center M&E team will evaluate the partnership's effectiveness in meeting its goals and objectives, as stated in the partnership work plan.

This activity relates to Technical Support for ART Scale-up (5658; 5661; 5664; 5666)

The Twinning Center's Volunteer Initiative and the identification, facilitation and management of twinning partnerships are continuing activities from FY06. As of August 2006 the partner is on track according to the targets outlined in their work plan.

The HIV/AIDS Twinning Center is supported by American International Health Alliance's (AIHA) with 13 years of experience designing and implementing health interventions in low-resource settings. Through twinning partnerships, volunteers, and supportive assistance programs, the Twinning Center will contribute significantly to building human and organizational capacity by: (a) directly training and mentoring caregivers, (b) strengthening existing and new training and educational institutions and (c) developing models of care for improved organization and delivery of services for rapid scale-up of interventions to help meet the goals of PEPFAR in Ethiopia to prevent, treat and care for HIV+ individuals and AIDS orphans. AIHA has managed 116 health projects in 22 countries. An evaluation conducted by RTI International of AIHA's health partnerships in Central and Eastern Europe found the overall development impact to be extensive. The impact of the partnerships were found at four levels; as a mechanism for reforming individual institutions, as a vehicle for catalyzing systemic change, as a tool of foreign assistance, and as a tool of foreign policy.

Activities to date: (1) Mobilized and engaged the Ethiopian Diaspora in the US, a Memorandum of Understanding has been signed by Visions for Development Inc., People to People Inc. and Ethiopian Health Professionals in North America to work together to recruit qualified professionals from the diasporas. (2) A website for the Network of Ethiopian Professionals in the Diaspora (NEPID) has been developed to provide information about the project, post volunteer scopes of work and provide an opportunity for interested candidates to apply for volunteer positions. (3) Received the support from the four US University partners to coordinate the placement of volunteers (4) Identified 15 potential volunteer assignments after conducting site assessments at four ARV clinics and one association (5) Created scopes of work jointly with local placement sites and the Twinning Center outlining specific and measurable objectives for 5 volunteer assignments, including; Information Technology Advisor, Database Development Advisor, Patient Health Educator, Mental Health Advisor, and ARV physician (6) A Pediatrician/Mental Health Expert and an Information Technology advisor have been identified and will begin their service in early September

The partner is requesting additional funding for the following expansion activities in 2007: (1) Placement of up to an additional 40 volunteers (ARV treatment sites, academic institutions, ARC central and regional offices, EPHA, and additional sites as determined) (2) Placement of information technology (IT) volunteers at the ARC regional sites to assist at centralized trainings and provide ongoing support to satellite sites. (3) Development of monitoring and evaluation tools to ensure effectiveness of the volunteer program. This will include exit interviews of volunteers and placement sites, documentation of lessons learned and success stories.

Accomplishments to date: (1) Initiated the AIDS Resource Center (ARC) (Ethiopia)/AIDS Treatment Information Center (ATIC) (Uganda) Partnership. The first exchange visit took place in August 2006, The partners will meet in September to develop specific partnership objectives and a workplan. This south-south twinning relationship facilitates knowledge and skills transfer between two organizations that share the similar experience of working in a resource constrained environment. The goal of this partnership is to increase the capacity of the ARC to establish a clinical providers' warmline through a twinning relationship with ATIC. (2) The partner is coordinating with Johns Hopkins University on two potential partnerships. Concept papers have been developed to increase training for pharmacists in ART, increase the capacity of nursing schools and improve infection prevention at the hospital level. (3) The partner is coordinating with I-TECH to establish an institutional partnership between Gondar University and Hadassa University in Israel, an initial assessment visit between Gondar, Hadassa and the Twinning Center is scheduled for September.

The partner is requesting additional funding for the following expansion activities in 2007: (1) Expansion of the ARC/ATIC partnership to include the implementation of a clinical

provider's warmline, exchanges between partner sites, and communication to provide ongoing support.(2) Expansion of the partnerships established in coordination with the US treatment partners (Johns Hopkins University and I-TECH).(3) Initiation, facilitation and management of an additional partnership to be determined based on needs and availability of partners. Potential for additional partnerships exists in coordination with the US treatment partners and with the Ethiopian Public Health Association and the American Public Health Association (APHA). EPHA has expressed a specific interest in partnering with APHA in the area of membership strengthening.

This activity relates to Technical Support for ART Scale-up (5658, 5661, 5664, 5666) The Twinning Center's Volunteer Initiative, and identification, facilitation and management of twinning partnerships continuing from FY06. The HIV/AIDS Twinning Center is supported by American International Health Alliance (AIHA), with 13 years' experience designing and implementing health interventions in low-resource settings. Through twinning partnerships, volunteers, and supportive assistance programs, the Twinning Center will contribute to building human and organizational capacity by: • directly training and mentoring caregivers • strengthening existing and new training, and relevant educational institutions • developing care models for improved organization and service delivery for rapid scale-up of interventions to help meet PEPFAR Ethiopia goals to prevent, treat and care for HIV+ individuals and AIDS orphans. AIHA has managed 116 health projects in 22 countries; evaluation of AIHA's health partnerships in Central and Eastern Europe found the overall development impact to be extensive. The impact of the partnerships was fourfold: • a mechanism for reforming individual institutions • a vehicle for catalyzing systemic change • a tool of foreign assistance • a tool of foreign policy

The partner's second objective is to increase human and organizational capacity to prevent and treat HIV/AIDS through initiation and management of institutional twinning partnerships. Accomplishments to date: • Initiated the AIDS Resource Center Ethiopia and AIDS Treatment Information Center (ATIC) (Uganda) Partnership. The first exchange occurred in August 2006. The partners met in September to develop specific objectives and a work plan. This south-south twinning relationship facilitates knowledge and skills transfer between two organizations with similar experiences working in a resource constrained environment. The goal is to increase capacity of the ARC to establish a clinical providers' warmline through a twinning relationship with ATIC. • The partner is coordinating with Johns Hopkins University on two potential partnerships. Concept papers have been developed to increase ART training for pharmacists, increase capacity of nursing schools and improve infection prevention at hospital level. • The partner is coordinating with I-TECH to establish an institutional partnership between Gondar University and Hadassa University in Israel; initial assessment visit between Gondar, Hadassa and the Twinning Center is scheduled for September.