SUM II (TRG) Implementing Mechanism Narrative

The SUM II Program, was specifically designed to address the need to build capacity of local government and civil society organizations (CSOs) to deliver services sustainably. The main objectives of the SUM II Project are to: 1) Provide targeted assistance in organizational performance required to scale up effective, integrated HIV interventions that lead to substantial and measurable behavior change among MARPs; and 2) Provide and monitor small grants to qualified CSOs to support the scale-up of integrated interventions in hotspots, where there is a high concentration of one or more MARP and where high-risk behavior is prevalent, including DKI Jakarta, East Java, Papua, Riau islands and North Sumatra.SUM II will strengthen the capacity of CSOs in the HIV response by providing targeted TA to indigenous CSOs that will eventually become leaders and mentors for other CSOs in their communities. While Year 1 of the project was spent conducting baseline assessments for the selection of promising NGOs, the primary function of FY12-14 will be to build the capacity of these CSOs to manage their services and programs more effectively, increase their ability to leverage funding other than USG funds, and graduate these organizations into technical assistance providers for other community organizations. At the same time, capacity building on organization performance for district governments will also be provided by SUM II. As a result, efficiency gains, along with proper and sustainable transition of CSOs from SUM II to partner governments or other organizations can then be achieved. Monitoring and Evaluation plans for included activities are reviewed and revised on an annual basis.

Similar to HVOP, SUM II will support CSOs to improve organizational performance of MARPs-based care, support and treatment for FSWs, MSM, Waria and PWIDs. HBHC will include TA and support for management of post-counseling, adherence, psycho-social support, and positive prevention aimed at reducing morbidity and mortality among PLHIV. During 2012, SUM II will encourage the establishment of up to 15 MARP-based support groups.

SUM II will support Spiritias provincial catalyst and local peer support groups for PLHIV that are ensconced in SUMs provinces and districts, including Papua, offering an opportunity for collaboration with SUM in our targeted intervention sites. In addition, SUM II organizational and program TA and grant support to Spiritia will build its capacity to manage its network.

Our activities are implemented to supplement national program efforts in/for underserved areas and groups, and are thus fully linked with national program efforts. However, this is an under-developed program area in the national program, and thus coverage with services that approximate global good practices is low.

SUM II will provide TA that will legalize un-registered CSOs by securing legal entity status according to Indonesian laws and regulations; strengthen organizational governance by re-visiting and developing organizational vision and mission statements, organizational constitutions, organizational management and operational structures and standard operating procedures; promote strategic organizational thinking and longer term planning by developing 3-year strategic plans and annual work plans through one-to-one mentoring and facilitation; develop sound financial management practices and establish organization-wide standard operating procedures; and build CSO capacity in community mobilization through advocacy and community empowerment by applying best practices and evidence based decision making approach. The TA will be provided by local institutions specializing in these technical areas using SUMs Manuals for supporting CSOs to promote consistency and sustainability.

SUM II provides TA in monitoring and evaluation to GFATM Principal Recipients, to CSOs in 6 of 8 priority provinces collecting routine monitoring data. SUM II also conducts district expanded readiness assessments (ERAs) in selected communities and hotspots.

The SUM Team prepared OP/TC assessment tools consisting of an Organizational Profile, Budgeting and Financial Management, and Program Management. The SUM Team requests CSOs to fill out the profile and return before the implementation date of the OP/TC assessment. The Profile identifies the CSOs legal status, characteristics, availability of resources, and current programs.

In FY 2012, SUM selected a university to conduct a stigma and discrimination survey in the 3 provinces. The main objectives of the stigma and discrimination survey are to 1) provide baseline data for the measurement of stigma and discrimination across multiple population levels; and 2) provide information that can be used for strategic intervention planning and advocacy. In addition, SUM also selected a university to conduct a FSW baseline survey in two SUM intervention sites in Jakarta and Surabaya. This survey will supplement the IBBS 2011.

To achieve fundamental improvement in organizational performance at targeted intervention sites, SUM II will focus most of its resources on health systems strengthening in the 6 of 8 priority provinces in collaboration with SUM I during FY 2012. SUM II will develop a package of services and support that will be based on the identified needs of organizational performance and technical capacity development for local government, other stakeholders, and, in particular, for CSOs to design, plan, and effectively implement HIV comprehensive intervention models for MARPs.

SUM II and local institutions selected to receive grants will provide training and coaching to about 29 CSOs in 11 districts in DKI Jakarta, East Java and Papua during the second year. SUM II will also continue to provide training and coaching to CSOs for advocacy and resource mobilization using the Resource Estimation Tool for Advocacy (RETA). In 2011, RETA was introduced and further adapted to the Indonesian context. RETA is an easy-to-use tool that helps calculate the resources needed to deliver a comprehensive package of HIV prevention services for the four MARPs (originally for MSM only). Users enter local population size estimates and set program scale-up coverage targets and targets for specific services to sub-populations of MARPs. Using those targets and local information on costs to deliver services, RETA calculates how much the HIV prevention program will cost per year for 5 years. By comparing those costs with expected resources, RETA estimates the resource gaps.

RETA produces information that is easy to read and use. RETA automatically generates reports and creates graphs and charts that are specially designed to answer key questions from donors and program planners, in a format that makes them simple to copy into reports and funding proposals. SUM II will continue to provide RETA training and coaching to CSOs in FY 2012 and TA that leads to the CSOs using RETA to advocate for more resources and mobilize communities and leaders.

TA to CSOs in particular but also to local government institutions and other partners will include:

Strategic planningHIV program designAnnual costing for planning and implementationResource allocation mobilization planningResource needs modeling and estimation for advocacyPolicy development for HIVProgram managementFinancial and administrative management, including accountingPublic-private partneringLeveraging funds from non-USG sources, including Corporate Social Responsibility fundsLocal monitoring and evaluation.

SUM II supports CSOs engaged in increasing demand for testing and counseling among MARPs. CSOs are funded to work with MARP indigenous leaders to develop drop-in centers in communities. The MARP-based centers will be socially and geographically acceptable to MARPs and provide education and information related to HIV prevention and care. They will also provide pre-counseling services to MARPs if MARP members are already trained as co-counselors or lay-counselors.

Support to CSOs includes training to be counselors at the drop-in centers conducting pre- and post-counseling. Wherever workable, CSOs will second the MARP lay-counselors to be local health providers of VCT services. Following review of existing VCT centers at Puskesmas or local hospitals, SUM II will provide small grants to CSOs for consumable supplies, incentives for additional staff, and staff training and coaching to build technical capacity.

SUM II will support PKVHI (Indonesia VCT HIV Counselor Association) to strengthen their management so that they can expand HCT coverage effectively and improve the quality of counseling and testing services and supplement HCT at Puskesmas.

SUM II will provide TA and small grants to CSOs for services to MARPs, mobilization and community self-reliance activities aimed at prevention of HIV infection from sexual transmission. CSOs provide services to brothel- and street-based FSWs, MSM, Waria, and PWIDs. MARP participation at all levels of program planning, implementation, and evaluation is believed to improve their sexual and health-seeking behaviors. USG will expand SUM II further to Riau Islands and North Sumatra in FY12, as well as Papua.SUM-supported CSOs provide all MARP groups with a standard package of community-based services, including outreach, peer education/promotion, risk reduction counseling, access to prevention commodities (condoms, lubricants, clean needles and syringes), targeted media/internet-based behavior change communications, and referral for clinic-based services (HC&T, STI management, CST for HIV-positives, and management of opportunistic infections, including TB). District-level intervention packages also include provincial/district level structural interventions and health system strengthening initiatives. Intervention packages chosen based upon global good practices, Expanded Readiness Assessments in Districts, and findings from case studies with CSOs at intervention sites.

The TA package consists of (1) an Implementation Manual based upon global and Indonesian good practices, (2) training workshops on intervention design and implementation, (3) field mentoring, (4) TA for QA/QI and (5) support to district-level planning, monitoring and evaluation to facilitate integration. Intervention package chosen based upon global good practices, including good practices in Indonesia.

SUM II will engage in local structural interventions aimed at advocacy for policy reform, planning and budgeting for the HIV program, community mobilization, raising the prominence of MARP leaders and champions, and reducing stigma and discrimination. SUM IIs focus on PWIDs will be on preventing sexual transmission as requested by the NAC. Implementation Manuals and 8 modules were developed by SUM in the first year to address the four MARPs, provide guidance to local institutional grantees that will provide training and coaching to CSOs, and improve CSO performance and expand their participation in the response.

SUM II will provide management support to CSOs providing Community-Based Drug Dependency Treatment as requested by the NAC. Eleven CSOs were funded by GFATM in 2011 and may be supported by the Indonesia Partnership Fund (IPF) and national budget in 2012. SUM II will provide small grants and TA to 3 of the 11 CSOs.