PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
NEW/REPLACEMENT NARRATIVE
This area includes only one activity: the provision of salary and other benefits for PMTCT in-service tutors
and support staff that are seconded to the National Health Training Center by I-TECH.
The lack of training institutions and the lure of the more lucrative private sector, combined with the growing
population of Namibians needing to access public HIV/AIDS services contribute to a chronic shortage of
qualified health professionals. Without outsourcing of health professionals and in-service trainers, the
MOHSS simply would not be able to provide comprehensive services on the scale and at the level of quality
that is required.
In 2007, the most recent year for which data were available, the vacancy rate in the Ministry of Health and
Social Services (MOHSS) was 35% for doctors, 22% for registered nurses, 26% for enrolled nurses, and
41% for pharmacists. Since FY04, the USG has assisted the MOHSS to address this human capacity gap
by providing supplemental personnel to the MOHSS through Potentia, which administers salary and
benefits equivalent to those of the MOHSS.
Beginning in FY06, Potentia also began supporting technical and administrative staff previously funded
through I-TECH in order to streamline administration and reduce costs. This human resources strategy has
been central to Namibia's success to date with meeting its prevention, care and treatment targets.
For trainers outsourced through Potentia, I-TECH, the MOHSS, and CDC agree on scopes of work and
participate in the selection of trainers. USG support for PMTCT training is leveraged and harmonized with
similar support being provided through the Global Fund.
FY 2009 COP funding for PMTCT will cover salaries and support for the following positions:
(1) Five in-service tutors placed throughout the National Health Training Center (NHTC) network. These
tutors will provide decentralized trainings in PMTCT and in dried blood spot (DBS) for DNA-PCR testing for
infants, and conduct at least 50 post-training PMTCT site visits to reinforce training content.
(2) One driver to continue to transport the tutors to training and clinical sites. Supplemental support for the
work carried out by these staff is funded through I-TECH.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16190
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16190 3898.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $428,337
Disease Control & Recruitment Agreement
Prevention Consultancy U62/CCU02515
4
7344 3898.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $312,303
3898 3898.06 HHS/Centers for Potentia Namibia 3139 1064.06 $137,517
Disease Control & Recruitment
Prevention Consultancy
Emphasis Areas
Health-related Wraparound Programs
* Child Survival Activities
* Safe Motherhood
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $323,337
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
This activity includes two primary components: partial salary and personnel costs for (1) 34 clinical case
mangers and (2) a National Prevention Coordinator seconded to the Ministry of Health and Social Services
(MOHSS).
Because the Case Managers are not exclusively providing HVAB services, a portion of the funding to
support their positions are also reflected in MTCT, HTXS, PDTX, HBHC, PDCS, HVTB, and HVOP.
Funding for the Prevention Coordinator is also reflected in HVOP.
There is a critical human resources gap at facility levels to deliver HIV/AIDS services in Namibia. The lack
of pre-service training institutions for doctors and pharmacists and limited capacity to train allied health
professionals in Namibia contributes to a chronic shortage of health care workers who could provide
comprehensive HIV/AIDS prevention, care and treatment services on the scale and quality that is required
for continued rollout of services. The lack of community of health professionals creates challenges not only
in offering suitable incentives to attract newly trained Namibians to return to Namibia and practice in the
public sector but also in offering incentives to retain Namibian and third-country nationals currently serving
in the country.
Since 2004, the USG has assisted the MOHSS to address this gap by providing supplemental personnel
though Potentia, a Namibian private sector company that administers salary and benefits equivalent to the
MOHSS. These personnel will be gradually absorbed into the MOHSS workforce. Absorption of USG-
supported clinical staff is a cornerstone of the sustainability efforts to be outlined in the Partnership
Compact between the US and Namibian governments. By the end of 2007, 18 Potentia staff members had
transitioned into permanent MOHSS positions, both at the clinical and administrative level.
This human resource strategy has been central to Namibia's success with meeting its prevention, care and
treatment targets. Potentia has a rapid personnel recruitment, deployment and management system. Both
the MOHSS and CDC will continue to collaborate in refining scopes of work and selecting health personnel
who are supervised by the MOHSS, and receive training and on-the-job support from TECH, CDC, and the
MOHSS. As noted above, these personnel are managed and compensated commensurate with MOHSS
staff, and are to be gradually absorbed into the MOHSS workforce as funding allows.
1. Case Managers. COP09 will continue to support 34 case managers who commit 10% of their time to
abstinence/be faithful activities. Potentia was first funded to recruit and hire 34 clinical case managers with
COP08. Case managers fall in the chain of command of the MOHSS Directorate of Special Programmes'
Case Management Unit. Some, but not all, of the duties of the case managers include:
a. Counseling patients on adherence, prevention with positives, and disclosure/partner referral;
b. Tracing patients who "slip through the cracks";
c. Facilitating support groups;
d. Referring patients to other health and social services, including counseling for drug/alcohol treatment
and domestic violence; and
e. Encouraging men to seek services and to support their partners and children in doing the same.
Some delays have occurred in the start-up of this activity in 2008 and thus the case managers are funded at
0.83 FTE in 2009; carryover funds will be used to make up the remaining 0.17 FTE. These delays resulted
from discussions regarding merging this case management program with the work being done by voluntary
"expert patients" who provide supportive services to others with HIV/AIDS, including accessing facility- and
community-based services, adherence, and disclosure. The newly envisioned case management program
will have these expert patients working alongside case managers with backgrounds in psychology or social
work. Case managers and expert patients will be trained by I-TECH.
2. Prevention Coordinator. In 2007, the MOHSS requested assistance to hire a Prevention Coordinator
who would be based within MOHSS, but could coordinate prevention efforts across line ministries and with
various stakeholders in the country. In the absence of such a position, a variety of MOHSS managers and
supervisors with other responsibilities were taking on prevention work as their schedules allowed. With
reprogrammed COP08 funds, PEPFAR was able to support a prevention coordinator through Potentia to
work at the national level who will also be a counterpart to USG prevention technical advisors.
The sustainability of these positions relies heavily on the ability of the MOHSS to absorb them in to their
human resource organizational structure; these posts will be closely monitored in order to ensure their
effectiveness is optimized and ascertain their value added. As in past years, the USG will continue to work
with the MOHSS to enhance the capacity of the human resources department as well as support a Human
Resources strategic plan in order to better absorb the Potentia supported positions over time.
Continuing Activity: 16538
16538 16538.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $68,000
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Estimated amount of funding that is planned for Human Capacity Development $106,440
Table 3.3.02:
This activity includes partial funding for salaries and related personnel costs for the following positions to
support the Ministry of Health and Social Services (MOHSS): (1) 20 Condoms Logistics Officers, (2) 34
Case Managers, and (3) a National Prevention Coordinator seconded to the Ministry of Health and Social
Services (MoHSS).
Because the Case Managers are not exclusively providing HVOP services, a portion of the funding to
support their positions are also reflected in MTCT, HTXS, PDTX, HBHC, PDCS, HVTB, and OHSS.
Funding for the Prevention Coordinator is also reflected in HVAB.
professionals in Namibia contributes to a chronic shortage of health care workers who can provide
for continued rollout of services. The lack of a community of health professionals creates challenges not
only in offering suitable incentives to attract newly trained Namibians to return to Namibia and practice in
the public sector but also in offering incentives to retain Namibian and third-country nationals currently
serving in the country.
staff, and are to be gradually be absorbed into the MOHSS workforce as funding allows.
1. Condom Logistics Officers. In COP09, funding will continue to support 20 Condom Logistics Officers at
district hospitals to facilitate local supply and distribution from hospital pharmacies to health facilities and
PEPFAR-funded NGOs and FBOs who distribute condoms to high-risk people.
2. Case Managers. COP09 will also continue to support 34 case managers who commit 10% of their time
to other prevention activities. Potentia was first funded to recruit and hire 34 clinical case managers with
a. Counseling patients on adherence, prevention with positives, and disclosure/partner referral,
b. Tracing patients who "slip through the cracks,"
c. Facilitating support groups,
d. Referring patients to other health and social services, including counseling for drug/alcohol treatment and
domestic violence, and
Some delays occurred in start-up of this activity in 2008, and thus the case managers are funded at 0.83
FTE in 2009; carryover funds will be used to make up the remaining 0.17 FTE. These delays resulted from
discussions regarding merging this case management program with the work being done by voluntary
3) Prevention Coordinator. In 2007, the MOHSS requested assistance to hire a prevention coordinator who
would be based within MOHSS, but could coordinate prevention efforts across line ministries and with
Continuing Activity: 16191
16191 7994.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $283,080
7994 7994.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $204,923
Estimated amount of funding that is planned for Human Capacity Development $234,956
Table 3.3.03:
This activity includes 2 primary components: (1) the hiring of a National Male Circumcision Coordinator and
(2) the hiring of additional medical providers to perform male circumcision (MC).
1. In 2008, Namibia completed a comprehensive situation assessment for MC that culminated in a national
MC stakeholders meeting. Based on the situation assessment and the stakeholders meeting, Namibia is in
the process of finalizing a MC policy and action plan to be approved by the Ministry of Health and Social
Services (MOHSS) and parliament. In Namibia, there is an established MC task force that includes
representatives from MOHSS, USG agencies, UNAIDS, and many other non-governmental organizations.
The MC taskforce has been very successful in guiding MC activities in Namibia to date. However, upon
approval of the MC policy and action plan, it is anticipated that there will be many new implementation
activities in the upcoming years. As such, a key recommendation from the MC stakeholders meeting,
supported by the MC task force, was that the MOHSS should identify a dedicated focal person responsible
for coordinating roll-out of MC activities in Namibia.
The National Male Circumcision Coordinator would operate out of the MOHSS Directorate of Special
Programmes for HIV, TB, and Malaria (DSP). This person would be responsible for overall implementation
of MC in the public sector, by working closely with DSP colleagues and medical staff at government facilities
to develop and implement standard operating procedures for MC.
Some of the job responsibilities for the MC coordinator will include:
(a) collaborating with the MOHSS Division of Primary Health Care (PHC) to explore the further
implementation of neonatal MC services in maternity wards throughout Namibia,
(b) collaborating with PHC to identify traditional circumcisers to be trained and possibly certified to perform
MC services,
(c) working closely with I-TECH and overseeing the training of health care providers in the public and faith-
based sectors,
(d) guiding and coordinating efforts of the faith-based health sector for MC services,
(e) liaising with the health facilities and MOHSS Central Medical Store to ensure that the appropriate
supplies, commodities, and equipment are available for MC services throughout Namibia, and
(f) working with Nawa Life Trust in designing and implementing a communications and advocacy campaign.
The MC coordinator may also have to work with Namibian Medical Aids to include adult MC within its
insurance package. Adult MC is currently only covered by national insurance when indicated for medical
reasons, and the cost of private MC services is prohibitive for most Namibians.
2. Based on anticipated demand for MC services, Potentia will hire at least five new health care providers
for the public sector to conduct MC. The additional providers will be trained by I-TECH and will work closely
with and likely report to the National Male Circumcision Coordinator. The five new MC health care providers
will be strategically assigned to facilities throughout Namibia to cover the areas with the highest HIV
prevalence, lowest MC rates, and anticipated highest demand for MC services. The MC initiative may
eventually require task shifting to senior nurses and midwives to alleviate the burden on medical doctors.
The draft national policy includes recommendations on cadre numbers, task shifting, and training. The
hiring of additional health care providers will be based on the recommendations of the MOHSS.
New/Continuing Activity: New Activity
Continuing Activity:
Estimated amount of funding that is planned for Human Capacity Development $300,000
Program Budget Code: 08 - HBHC Care: Adult Care and Support
Total Planned Funding for Program Budget Code: $7,982,340
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Total number of people on ART as of 30 September 2008:
Adults: 48,977 (at least 15 years old)
Children: 7,077 (less than 15 years old)
Total: 56,054
Since March 2006, ART services and facility-based palliative care have been offered in 35 public hospitals. According to the
Ministry of Health and Social Services (MOHSS) electronic Patient Monitoring System (ePMS), as of September 30, 2008, an
estimated 56,054 patients were reported to be on treatment; 48,977 (87%) of these were adults over the age of 15. MOHSS
projections anticipate 71,900 people on treatment by the end of March 2010; 80% of these patients will be seen by the public
sector.
Strong commitment and leadership from MOHSS, with substantial support from the US Government (USG), has been key to
exceeding ARV treatment targets. USG technical advisors support MOHSS in development of guidelines, protocols and enhanced
management structures to deliver high-quality, cost-effective ART services. Leadership is being supported by pre- and in-service
training, attendance at relevant international meetings, study tours, and other knowledge-building activities. Sustainability is
boosted by the continued development of Human Resource Information system (HRIS) which allows rational planning,
deployment and tracking of health care providers. In COP 09, the following components will be supported:
Human Resources for Health: There is a critical human resources gap to deliver HIV/AIDS services in Namibia. The lack of pre-
service training institutions for doctors and pharmacists in Namibia contributes to a chronic shortage of health professionals who
can provide comprehensive HIV/AIDS care and treatment services on the scale required for continued rollout of ARV and
palliative care services. The lack of a community of health professionals creates challenges not only in offering suitable incentives
to attract newly-trained Namibians to return and practice in the public sector but also enticing Namibians and third-country
nationals currently serving in the country to remain in service.
In 2007, the MOHSS engaged in a costing exercise supported by the European Commission and the USG that projected a need
for 76 physicians, 191 nurses, 44 pharmacists, and 40 pharmacy assistants to manage 71,900 patients projected to be receiving
treatment services in the public sector by 2010. Even with continued expansion of IMAI and task-shifting, the MOHSS will not
have the capacity to fully support the costs for the projected number of staff persons required. Since 2004, the USG has assisted
the MOHSS to address this gap by providing supplemental personnel though Potentia, a Namibian private sector company that
administers salary and benefits equivalent to the MOHSS. These personnel will be gradually absorbed into the MOHSS
workforce. Absorption of USG-supported clinical staff is a cornerstone of the sustainability efforts to be outlined in the Partnership
Compact between the US and Namibian governments. This human resource strategy has been central to Namibia's success with
meeting its prevention, care and treatment targets.
Bio-clinical monitoring tests: The USG will continue to support MOHSS and mission facilities to carry out routine bio-clinical
monitoring tests performed by the Namibia Institute of Pathology (NIP) for the anticipated 71,900 patients on ART in 2010 and for
CD4 monitoring of non-ART patients enrolled in palliative care at communicable disease clinics (CDCs) and IMAI sites.
More than 12,000 viral load tests will likely be performed in FY09 and PEPFAR will continue to fund an NIP lab technologist in
order to have sufficient capacity to meet demand. Linked to this, the MOHSS Technical Advisory Committee (TAC) recently
recommended limited resistance testing for up to 100 patients failing on their ART regimens in which HIV drug resistance is
suspected.
The high prevalence of human papillomavirus (HPV) infection and cervical cancer among HIV positive women prompted the TAC
to propose piloted cervical cancer screening for HIV positive women seen in treatment settings. The MOHSS and I-TECH, will
collaborate in developing a practical training course for HCWs to enhance their skills in doing PAP smears for cervical cancer
screening. Clinical Mentors and Nurses Tutors in the regions will pilot the training in three sites, training six HCWs per site.
Increased lab costs will be funded through leveraging of MOHSS, GF and PEPFAR funds.
Community Counselor (CC) Initiative: Facility-based HIV programs depend on the assistance of CCs. PEPFAR will continue to
support the CCs program to link patients between prevention, care and treatment services. More details on CCs can be found in
the HVCT Program Area Narrative. In COP 09, priority sites for deployment of CCs include TB clinics, ART clinics, and outpatient
departments (where nearly all STI cases are seen). CCs will receive refresher training in prevention with persons living with
HIV/AIDS (PwP), preventive care counseling for children, and Provider Initiated Testing and Counseling (PITC).
Provision of Outreach Services: This is one of the new priority areas in COP09. The current outreach program in which health
care workers offer services in peripheral facilities will be taken to scale to ensure patients can receive ART close to their homes to
better serve rural populations of Namibia.
To ensure quality, outreach services will be implemented in stages. Each of the three outreach teams will consist of a camper
van; four community counselors (two to provide counseling and testing and two to coordinate logistics and supplies); a nurse; and
a driver. CT services and prevention education will be implemented first. A regimented evaluation program will be put in place to
determine cost per client, success in reaching first-time testers, coordination between the outreach team and community
mobilizers, and community receptiveness. Once CT services are successfully implemented, ART will be added. If the teams can
effectively deliver additional services, other components may be added, including TB screening and DOTs, PMTCT, case
management, and alcohol counseling and referrals.
An anticipated uptake in testing as a result of the annual National HIV Testing Day (NTD) and expansion of PITC will likely lead to
an increase in demand for ART. Many MOHSS facilities will need additional space to accommodate the large influx of ART
patients. With COP09, CDC will seek to secure an infection control technical advisor who will have, among other duties, the
responsibility of ensuring that all future renovations maximize structural interventions that can prevent transmission of TB. The
USG will continue to collaborate with the MOHSS, the Ministry of Works, the GF, and other donors to leverage resources and
determine priority renovation sites.
Procurement of basic equipment: Many of the existing and future ART facilities are ill-equipped in terms of basic equipment such
as examination beds, ENT sets, glucometers, Hb meters, stadiometers, weighing scales and filing cabinets. COP09 will fund the
MOHSS to procure equipment to support decentralizing care and treatment services.
Care and Support: With COP09, SCMS will continue to support the MOHSS Home Based Care (HBC) Kit logistics system, and
supplement GF procurement and replenishment of HBC kits to ensure that funded faith based organizations (FBOs), NGOs and
CBOs have access to essential supplies. SCMS will monitor this system's performance and develop a Logistics Management
Information System (LMIS) to report data and an Inventory Control System to ensure appropriate quantities of HBC kits at all
levels of the system. SCMS will coordinate with the US Department of Defense (DOD) to procure HBC kits for military patients
receiving care and support and distribute HBC kits for the public sector care and support programs.
Linkages between facility and community-based care and support services will be strengthened by educating communities on the
bidirectional referral systems for health and psychosocial support. Partners such as Catholic AIDS Action (CAA) and Pact will
continue to integrate palliative care into home-based care settings. CAA will expand their nurse-supervised HBC program from 7
to 10 regional offices with continued technical assistance from the African Palliative Care Association (APCA). Volunteers
supervised by trained nurses will support pain management. Pact will work closely with its subgrantees and the MOHSS to further
develop and test the national HBC standards, seek accreditation of training materials, and define and scale up a new cadre of
community care workers. Pact will support the MOHSS to develop and test an action-based field manual for use by community
HBC providers with low literacy levels, and engage subgrantees in using national materials to measure outcomes. Treatment
adherence remains a challenge and COP09 efforts with community care partners will focus on symptom screening, bi-directional
referrals with health facilities, and CTX use. Structured supervision of caregivers and quality services will remain priorities for all
USG partners. Nawa Life Trust will also continue to support treatment literacy efforts.
Prevention efforts for adult care and treatment will include HIV negative preventive counseling, PwP, STI and TB screening and
treatment, family planning counseling, and home care referral. HIV-positive women will be referred to access other reproductive
services including cervical cancer screening. FANTA-2 will also support implementing partners to integrate food and nutrition into
HIV services through technical assistance to the MOHSS Food By Prescription program, continued support for the HIV short
course for regional HCWs, coordination with I-TECH/UNAM on the MPH certificate program in nutrition, and roll-out of food
supplementation operational guidelines. Much of this support will be guided by a FY07 assessment of the food and nutrition
needs of PLWHA.
Reinforced linkages between care and treatment partners will address issues that affect ART adherence such as alcohol abuse,
food insecurity, or simply inefficiencies in provision of care and support. APCA will continue to work with I-TECH to support pre
and in-service training of HCWs. Continued partnership to review the Namibian adaptation of the IMAI palliative care module and
to support the UNAM school of nursing to integrate palliative care into pre-service curricula will be priorities. APCA will also
support selected HCWs and Namibian leaders to attend palliative care training, and support service delivery and policy
development through continued strengthening of a National Task Force for Palliative Care.
The involvement of PLWHA in palliative care and adherence support programs will be continued; PLWHA will be speakers in
community forums, work as community counselors, and be supported through a network of PLWHA (Positive Vibes) that
advocates for improvements in community- and facility-based care.
The HIVQUAL project will continue to support capacity building for quality improvement for health facilities managed and
supported by the MOHSS and Catholic, Lutheran and Anglican Health Services. Planned activities will strengthen data collection
and systems of care and treatment. Intrahealth will support provision of clinical and spiritual care at faith-based sites to further
enhance the quality of services.
Prevention with Positives: Namibia is one of three countries participating in the centrally-funded PWP initiative in care and
treatment settings. The curriculum and job aids used in this initiative will be modified and adapted for Namibia for national scale
up of PWP activities. I-TECH and the MOHSS will collaborate to develop a curriculum for a comprehensive prevention training
which will integrate PwP, STI, post-exposure prophylaxis, isoniazid preventive therapy, and other prevention topics into one
course. Likewise, community counselor training will include training on PWP. PWP training materials for CCs will complement
the materials that developed by I-TECH for HCWs. As part of the roll out of PWP activities, PEPFAR will support procurement of
related equipment, furniture, and supplies. Namibia is also participating in a centrally-funded PWP initiative in community-based
settings. These activities will start in 2009, and will complement PWP activities in care and treatment settings.
The Case Management Program initiated in COP08 will be continued to enhance facility-based care and support and bidirectional
linkages between facility- and community-based services. These case managers work closely with "expert patients" to assist
PLWHAs and their families. Some of the duties of the case managers include:
• Counseling patients on adherence, PWP, and disclosure/partner referral;
• Tracing patients who "slip through the cracks;"
• Facilitating support groups;
• Referring patients to other services, including counseling for drug/alcohol treatment, domestic violence, and community income-
generating programs; and,
• Encouraging men to seek services and to support their partners and children in doing the same.
Overall, the USG program will continue to leverage its resources for care and treatment services with those of the GF, MOHSS,
Clinton Foundation, and the private sector.
Table 3.3.08:
This activity includes provision of a portion of the salaries and other benefits for the following cadres
outsourced through Potentia and seconded to the MOHSS: (1) 243 health care workers, including
physicians, nurses, pharmacists, and pharmacy assistants, (2) 34 district health supervisors, (3) 34 case
managers, and (4) 3 trainers who work collaboratively with MOHSS' National Health Training Center and I-
TECH.
Because these Health Care Workers and Health Supervisors are not exclusively providing HBHC services,
a portion of the funding to support their positions are also reflected in MTCT, HVTX, PDTX, PDCS, HVTB,
and OHSS. Funding for Case Managers is also reflected in HVAB, HVOP, PDCS, HVCT, and HTXS.
Funding for training staff is also reflected in PDCS.
1. Health Care Workers. There is a critical human resources gap at facility levels to deliver HIV/AIDS
services in Namibia. The lack of pre-service training institutions for doctors and pharmacists in Namibia
contributes to a chronic shortage of health professionals who can provide comprehensive HIV/AIDS care
and treatment services on the scale and quality that is required for continued rollout of ARV and palliative
care services. The lack of a community of health professionals creates challenges not only in offering
suitable incentives to attract newly trained Namibians to return to Namibia and practice in the public sector
but also in offering incentives to retain Namibian and third-country nationals currently serving in the country.
In 2007, the vacancy rate in the MOHSS was 35% for doctors, 22% for registered nurses, 26% for enrolled
nurses, and 41% for pharmacists.
treatment targets. Potentia has a rapid personnel recruitment, deployment and management system. In
2007, the MOHSS engaged in a costing exercise supported by the European Commission and the USG that
projected a need for 76 physicians, 191 nurses, 44 pharmacists, and 40 pharmacy assistants to ensure full
rollout of Integrated Management of Adult Illness (IMAI) by the end of 2009.
The MOHSS is gradually shifting tasks from physicians to nurses, with nurses beginning to provide palliative
care, managing clients not yet eligible for ART, and clients who have received their first six months of ART
at hospital communicable disease clinics. Key priorities in palliative care service delivery by Potentia-
supported health care workers will include:
• Provision of the preventive care package for adults and children
• Management of opportunistic infections
• Adherence counseling for HIV/TB
• Routine clinical monitoring
• Symptom and pain management.
Closer partnerships with districts and communities will allow increased opportunities to expand safe water,
hygiene strategies and access to malaria prevention for persons living with HIV/AIDS (PLWHA) and their
families.
Even with expansion of IMAI and task-shifting, the MOHSS will not have the capacity to fully support the
costs for the projected number of staff persons needed in 2009/2010. FY 2009 COP levels supported by
PEPFAR represented approximately 69% of the human resource needs, with the remainder of staff
supported by the MOHSS, the Global Fund, and other development partners. Together, these colleagues
work together under the supervision of the MOHSS to manage 85% of the patients receiving care and
treatment services in Namibia.
Because of the reduced FY 2009 COP budget and the need to identify new resources for rollout of outreach
-based services and expansion of the bursary system, the FY 2009 COP funding for this effort is level.
Therefore, the request is to continue to support the following positions:
• 65 physicians
• 79 registered nurses
• 46 enrolled nurses
• 28 pharmacists
• 25 pharmacy assistants.
Both the MOHSS and CDC will continue to collaborate in refining scopes of work and selecting health
personnel who are supervised by the MOHSS, and receive training and on-the-job support from TECH,
CDC, and the MOHSS. As noted above, these personnel are managed and compensated commensurate
with MOHSS staff, and are to be gradually be absorbed into the MOHSS workforce as funding allows.
2. District Health Supervisors. In an ongoing activity, USG funds will provide salary and benefits for 34
nurses who report to the national-level supervisory public health nurse. These district supervisors are
placed in high-burden districts and assist with coordination and supportive supervision of ART, TB and
palliative care activities. These positions were added in response to priority needs identified in 2006 during
the MOHSS' annual supervisory support assessment.
3. Case Managers. FY 2009 COP will also continue to support 34 case managers who commit 30% of
their time to adult and pediatric palliative care activities. Potentia was first funded to recruit and hire 34
Activity Narrative: clinical case managers with FY 2008 COP. Case managers fall in the chain of command of the MOHSS
Directorate of Special Programmes' Director of Case Management. Some, but not all, of the duties of the
case managers include:
• Counseling patients on adherence, prevention with positives, and disclosure/partner referral
• Tracing patients who "slip through the cracks"
• Facilitating support groups
• Referring patients to other health and social services, including counseling for drug/alcohol treatment and
domestic violence
Some delays have occurred in start-up of this activity in 2008 and thus the case managers are funded at
4. Trainers. In FY 2006, Potentia also began supporting technical and administrative staff involved in this
activity previously funded through I-TECH to streamline administration and reduce indirect costs. This
activity will continue to support the provision of training personnel to the MOHSS' National Health Training
Center, the Regional Health Training Centers, and I-TECH. The training centers do not have sufficient
human capacity to provide IMAI training due to competing priorities. This activity will cover:
• 0.5 FTE of an I-TECH curriculum development expert to develop Namibian capacity in this area
• STI trainer
• Nurse trainer
• Training manager
• Transportation costs for tutors to travel to clinical sites for follow-up after IMAI training.
Continuing Activity: 16192
16192 3894.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $2,750,000
7340 3894.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $2,387,182
3894 3894.06 HHS/Centers for Potentia Namibia 3139 1064.06 $1,008,283
* Reducing violence and coercion
* TB
Estimated amount of funding that is planned for Human Capacity Development $2,028,075
physicians, nurses, pharmacists, and pharmacy assistants, (2) 34 district health supervisors, and (3) 34
case managers
Because these Health Care Workers and District Health Supervisors are not exclusively providing HVTX
services, a portion of the funding to support their positions are also reflected in MTCT, PDTX, HBHC,
PDCS, HVTB, and OHSS. Funding for Case Managers is also reflected in HVAB, HVOP, HBHC, PDCS,
PDTX, and HVCT.
In 2007, the vacancy rate in the MOHSS was 35% for doctors, 22% for
registered nurses, 26% for enrolled nurses, and 41% for pharmacists
projected a need for 76 physicians, 191 nurses, 44 pharmacists, and 40 pharmacy assistants to manage
66,854 patients projected to be receiving treatment services in the public sector by 2010.
Even with continued expansion of IMAI and task-shifting, the MOHSS will not have the capacity to fully
support the costs for the projected number of staff persons needed in 2009/2010. FY 2008 COP levels
supported by PEPFAR represented approximately 69% of the human resource needs, with the remainder of
staff supported by the MOHSS, the Global Fund, and other development partners.
the MOHSS' annual supervisory support assessment. A chief benefit of these new positions will be more
hands-on and frequent personnel management and quality assurance in the outlying areas. Currently,
supportive supervision visits are infrequent because of the logistics and expense of traveling from Windhoek
to distant facilities throughout the country.
3. Case Managers. FY 2009 COP will also continue to support 34 case managers who commit 40% of
their time to adult and pediatric treatment activities. Potentia was first funded to recruit and hire 34 clinical
case managers with FY 2008 COP. Case managers fall in the chain of command of the MOHSS
Activity Narrative: community-based services, adherence, and disclosure. The newly envisioned case management program
Continuing Activity: 16195
16195 3893.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $6,627,810
7339 3893.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $4,734,262
3893 3893.06 HHS/Centers for Potentia Namibia 3139 1064.06 $2,294,324
Estimated amount of funding that is planned for Human Capacity Development $5,497,439
Table 3.3.09:
This area includes provision of a portion of the salaries and other benefits for the following cadres
managers, and (4) 3 trainers and 1 training support staff who work collaboratively with MOHSS' National
Health Training Center and I-TECH.
Because these Health Care Workers and Health Supervisors are not exclusively providing PDCS services,
a portion of the funding to support their positions are also reflected in MTCT, HVTX, PDTX, HBHC, HVTB,
and OHSS. Funding for Case Managers is also reflected in HVAB, HVOP, HBHC, HVCT, and HTXS.
Funding for training staff is also reflected in HBHC.
1. Health Care Workers. There is a critical human resources gap at facility levels to deliver adult and
pediatric HIV/AIDS services in Namibia. The lack of pre-service training institutions for doctors and
pharmacists in Namibia contributes to a chronic shortage of health professionals who can provide
comprehensive HIV/AIDS care and treatment services on the scale and quality that is required for continued
rollout of ARV and palliative care services. Currently 10% (10,414/90,632) of all patients receiving care and
treatment services in health facilities are pediatric patients. The lack of a community of health professionals
creates challenges not only in offering suitable incentives to attract newly trained Namibians to return to
Namibia and practice in the public sector but also in offering incentives to retain Namibian and third-country
nationals currently serving in the country. In 2007, the vacancy rate in the MOHSS was 35% for doctors,
22% for registered nurses, 26% for enrolled nurses, and 41% for pharmacists.
rollout of Integrated Management of Adult Illness (IMAI) and Integrated Management of Childhood Illness
(IMCI) by the end of 2009.
care, managing clients not yet eligible for ART, and patients who have received their first six months of ART
Even with expansion of IMAI, IMCI and task-shifting, the MOHSS will not have the capacity to fully support
the costs for the projected number of staff persons needed in 2009/2010. FY 2008 COP levels supported
by PEPFAR represented approximately 69% of the human resource needs, with the remainder of staff
work together under the supervision of the MOHSS to manage 85% of the adult and pediatric patients
receiving care and treatment services in Namibia.
Therefore, the 2009 request is to continue to support the following positions:
• 46 enrolled (licensed practical) nurses
personnel who are supervised by the MOHSS, and receive training and on-the-job support from I-TECH,
palliative care activities for both adults and children. These positions were added in response to priority
needs identified in 2006 during the MOHSS' annual supervisory support assessment.
Activity Narrative: 3. Case Managers. FY 2009 COP will also continue to support 34 case managers who commit 30% of
their time to adult and pediatric palliative care activities. Potentia was first funded to recruit and hire clinical
Directorate of Special Programmes' Director of Case Management. The responsibility of the case
managers include, but are not limited to:
• Providing adherence, prevention with positives and disclosure counseling with families
• Following up on patients who "slip through the cracks"
• Referring patients to other health and social services, including OVC services
• Providing information to caregivers on caring for HIV-infected and affected children
Center, the Regional Health Training Centers, and I-TECH. These personnel will support continued training
on IMCI, IMAI and pediatric ART, among other trainings. Funds will support:
• Transportation costs to travel tutors to clinical sites for follow-up after IMAI and IMCI training.
Estimated amount of funding that is planned for Human Capacity Development $676,025
Table 3.3.10:
Because these Health Care Workers and District Health Supervisors are not exclusively providing PDTX
services, a portion of the funding to support their positions are also reflected in MTCT, HVTX, HBHC,
HVTX, and HVCT.
and treatment services on the scale and quality that is required for continued rollout of adult and pediatric
ARV services. The lack of a community of health professionals creates challenges not only in offering
66,854 adult and pediatric patients projected to be receiving treatment services in the public sector by 2010.
placed in high-burden districts and assist with coordination and supportive supervision of adult and pediatric
ART, TB and palliative care activities. These positions were added in response to priority needs identified in
2006 during the MOHSS' annual supervisory support assessment. A chief benefit of these new positions
will be more hands-on and frequent personnel management and quality assurance in the outlying areas.
Currently, supportive supervision visits are infrequent because of the logistics and expense of traveling from
Windhoek to distant facilities throughout the country.
their time to adult and pediatric treatment activities. Potentia was first funded to recruit and hire clinical
case managers with FY 2009 COP. Case managers fall in the chain of command of the MOHSS
• Following up on adult and pediatric patients who "slip through the cracks"
Activity Narrative: will have these expert patients working alongside case managers with backgrounds in psychology or social
Estimated amount of funding that is planned for Human Capacity Development $994,172
Table 3.3.11:
This activity includes provision of a portion of the salaries and other benefits for the following staff that will
be outsourced through Potentia and seconded to the Ministry of Health and Social Services (MoHSS): (1)
two TB/HIV physicians, (2) 40 Integrated Management of Adult Illnesses (IMAI) nurses, and (3) one
physician training manager and curriculum developer as well as one IMAI/TB in-service trainer.
Because the IMAI nurses are not providing HVTB services exclusively, a portion of the funding to support
their positions is also reflected in HBHC and PDCS. Partial funding for the physician training manager and
curriculum developer is reflected in HVTX and PDTX. Funding for the IMAI/TB in-service trainer is also
reflected in HBHC and PDCS.
There is a critical human resources gap at facility levels for delivery of HIV/TB services in Namibia. The lack
of pre-service training institutions for doctors and pharmacists, coupled with a limited ability to train other
allied health professionals, contributes to a chronic shortage of health professionals who can provide
comprehensive HIV/TB care and treatment services on the scale and at the level of quality that is required
for ART roll out and palliative care expansion, including early detection and treatment of TB.
The lack of a community of health professionals creates challenges not only in offering suitable incentives to
attract newly trained Namibians to return to Namibia and practice in the public sector but also in offering
incentives to retain Namibian and third-country nationals currently serving in the country. In 2007, the
vacancy rate in the MoHSS was 35% for doctors, 22% for registered nurses, 26% for enrolled nurses, and
41% for pharmacists.
Since COP04, the USG has assisted the MoHSS to address this gap by providing supplemental personnel
to the MoHSS through Potentia, which administers salary and benefits packages equivalent to those of the
MoHSS. Both CDC and the MoHSS participate in developing scopes of work and the selection of health
personnel who are then trained and deployed with field support from the MoHSS, CDC, and I-TECH clinical
mentors.
1. In response to increasing cases of drug resistant TB, including XDR-TB, 2008 COP funding supported
two physicians with TB expertise. This activity continues in 2009 COP. These physicians will not only care
for clients, but will also be responsible for improving TB/HIV integration in MoHSS facilities and bidirectional
linkages with community-based TB/HIV services. PEPFAR is working closely with MOHSS and
Tuberculosis Control Assistance Program (TBCAP) to ensure that these staff are positioned in settings with
the highest needs. One physician will be located in Katutura Hospital, and the other is to be determined.
2. Continuing from FY 2008 COP , funding through Potentia will support 40 additional nurses to support
ongoing rollout of the IMAI program, which is expected to have a significant impact on improving early
detection and treatment of TB, as well as the provision of TB preventive therapy for People Living with HIV
and AIDS (PLWHA).
3. Trainers. Potentia will also continue to support technical and administrative staff previously funded
through I-TECH to streamline administration and reduce costs. This human resources strategy has been
central to Namibia's success to date with meeting its prevention, care and treatment targets. In this activity,
Potentia will contract professionals to serve as TB/HIV trainers with I-TECH and the MoHSS' National
Health Training Center (NHTC). I-TECH and NHTC collaborate to provide the majority of training for health
workers in Namibia. Requested funds include half of the cost of a physician training manager and
curriculum developer (shared with treatment services) and a full-time IMAI/TB in-service trainer to be based
at the NHTC. The training content corresponds to Namibia's national guidelines and emphasizes:
a. Routine counseling and testing for consenting TB patients
b. Isoniazid preventive therapy for eligible TB/HIV patients
c. Cotrimoxazole prophylaxis
d. Linkages of TB with HIV/AIDS services
e. Provision of ART for eligible TB/HIV patients, including children.
Greater expansion of the "Three Is" strategy will be central to TB efforts in COP09.
Continuing Activity: 16193
16193 3896.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $263,218
7342 3896.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $87,721
3896 3896.06 HHS/Centers for Potentia Namibia 3139 1064.06 $30,036
Estimated amount of funding that is planned for Human Capacity Development $263,216
Table 3.3.12:
This area includes provision of salaries and other benefits for trainers and support staff who ensure the
quality of counseling and testing (CT) services in public facilities. Positions outsourced through Potentia
and seconded to the Ministry of Health and Social Services (MOHSS) include: (1) 14 CT training staff,
including eight CT trainers, one driver, one community counselor training coordinator, one specialized
counseling trainer, one rapid test training coordinator, and two rapid test trainers, (2) 11 rapid testing quality
assurance technicians, and (3) 34 case managers
Because the 34 case managers are not providing HVCT services exclusively, a portion of the funding to
support their positions is also reflected in HVAB, HVOP, HBHC, PDCS, HTXS, PDTX, and HVTB.
There is a critical human resources gap at facility levels to delivery quality HIV prevention, care and
treatment services in Namibia. The lack of pre-service training institutions for doctors and pharmacists in
Namibia, coupled with limited ability to train other allied health professionals, contributes to a chronic
shortage of health professionals who can provide comprehensive CT services on the scale and at the level
of quality that is required.
1. CT Training Staff. Beginning in FY06, Potentia began supporting technical and administrative staff,
previously funded through I-TECH, in order to streamline administration and reduce costs. This human
resources strategy has been central to Namibia's success to date with meeting its prevention, care and
treatment targets. The CT will be deployed to the MOHSS' VCT Unit, National Health Training Center, and
Regional Health Training Centers.
To increase capacity for decentralized training, eight trainers and one driver will train health workers in
counseling and testing, rapid testing, and couples counseling. An additional position, the Community
Counselor Training Coordinator, is placed at the MOHSS VCT program to develop curricula, train trainers,
provide mentoring and evaluation support, and plan and implement supervision strategies for this cadre of
health workers. A specialized counseling trainer will take the lead on Prevention with Positives and
alcohol/substance abuse training. One Rapid Test (RT) training coordinator will be supported as the lead
person at the national level to identify trainees from health facilities and organize trainings. This activity also
includes the cost of two RT trainers. Gradually, these personnel will be absorbed into the MOHSS
workforce as funding allows.
2. Rapid Testing Quality Assurance Technicians. FY 2009 COP funds will be used to support 11 laboratory
technicians to carry out HIV rapid testing quality assurance. These technicians will relieve major bottlenecks
in the ongoing rollout of HIV rapid testing in Namibia, specifically with regard to certifying rapid testing sites
and the staff persons who carry out rapid testing. The technicians will:
• Certify sites and individual staff based on guidelines established by the Namibia Institute of Pathology
(NIP) and the MOHSS
• Ensure the confidentiality, accuracy, and safety of rapid testing carried out in MOHSS facilities
• Conduct site visits to ensure the integrity of testing sites and the performance levels of the staff
• Review data collection for accuracy and completeness
• Relay findings to appropriate persons within the VCT program to inform programmatic decision-making.
This activity will eventually be scaled back as test sites are certified and coverage is maximized.
3. Case Managers. FY 2009 COP will also continue to support 34 case managers who commit 10% of their
time to HVCT activities. Potentia was first funded to recruit and hire 34 clinical case managers with COP08.
Case managers fall in the chain of command of the MOHSS Directorate of Special Programmes' Director of
Case Management. Some, but not all, of the duties of the case managers include:
Continuing Activity: 16194
16194 3897.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $764,540
7343 3897.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $682,419
3897 3897.06 HHS/Centers for Potentia Namibia 3139 1064.06 $153,651
Estimated amount of funding that is planned for Human Capacity Development $832,467
Table 3.3.14:
This activity is a continuation of FY 2008 COP activities. The activity provides salary support for various
cadres of Strategic Information (SI) staff.
Potentia is a private-sector Namibian human resources agency used to contract personnel that are
necessary to support positions for program implementation that are not yet established as formal
Government of Namibia (GRN) staff and thus must be hired by a third party.
Each year, Namibian public health services provide PMTCT to more than 40,000 women, VCT to >75,000
additional people, ARV treatment to >55,000, and TB treatment to approximately 20,000 (many of whom
have HIV co-infection). Monitoring and evaluation (M& E) of these programs is critical to optimize their
delivery and secure their continued support. Personnel with data collection, analysis, and dissemination
skills are thus essential to these services.
Since FY 2004 COP, data clerks and analysts hired through Potentia have successfully analyzed and
summarized ART and care data to service providers and policy makers at the local and national levels to
help track and improve services. National level staff report to the Namibian Government and partners
including PEPFAR, the UN, WHO, and the Global Fund. In FY2006COP and FY2007COP the
responsibilities of this cadre were expanded beyond routine data collection and reporting to assist, with
analytic guidance from USG technical advisors, with national surveys that enable more in-depth program
evaluation.
SI personnel included here are those supporting collection, analysis, and reporting of ART, PMTCT, VCT,
and TB activities: data clerks, data analysts, graduate student analysts, M& E program administrators and
evaluation officers. Representatives from both the USG and the Ministry of Health and Social Services
(MOHSS) participate in the selection of personnel who are then trained and advised in the field by the
MOHSS and the USG.
Training for SI personnel will also be expanded in FY2009COP. Training efforts, combined with a more
efficient computer-based management information system, will increase the quantity and quality of program
design evaluation (including targeted evaluation) so that successful intervention strategies can be identified
and disseminated.
Personnel:
1. Facility-based Data Clerks: The number of facility-based data clerks will remain at 29 in FY 2009 COP,
which includes an additional three at a senior level. In FY2007COP the data clerk role was expanded from
a focus on ART exclusively to include facilitating data collection, entry and report dissemination for PMTCT,
VCT, and TB programs. There is periodic turnover among the data clerk cadre, but a number of clerks have
been with the program since June of 2004. When possible, experienced data clerks are promoted to a
senior data clerk level.
2. Regional Data Clerks: These positions were created in FY2007COP with one per region. These clerks
partner with the regional HIV/TB program administrators to ensure coordinated collation and dissemination
of ART/PMTCT/VCT/TB data at the regional level.
3. PCR Data Clerk: This position has been in place since FY 2007 COP and is placed at the national level
to coordinate data collection for the growing volume of PCR testing for early infant diagnosis. This clerk
receives PCR testing results linked to post-natal PMTCT information. Entry and management of this data
enable effective monitoring of the early infant diagnosis program.
4. Data Analysts: Since FY 2005 COP, data analysts have been funded through this mechanism to provide
training and technical support to the data clerks and to coordinate national-level data processing and
dissemination. This activity began with one senior and one junior data analyst and expanded to include an
additional junior and senior data analyst in FY2007COP. The data analysts are assigned to the head office
of the MOHSS National Health Information System in Windhoek.
5. Program Administrators for M&E Unit: These three positions will continue from FY 2007/08 COP. They
assist with surveillance, evaluation, database management and compiling and disseminating M&E data
from around the country. One will coordinate surveillance efforts called for by the National M&E Plan; the
second is in charge of technical evaluations; and the third will assist with database management, data
quality assurance, and collecting and disseminating HIV-related M&E data from government sectors outside
of health and from NGO partners.
6. UNAM Information for Action Fellowship Programme: To support the National AIDS Program with
analysis and dissemination of a survey that can be used to improve care and prevention services, the USG,
in collaboration with the MOHSS Response Monitoring and Evaluation sub-Division, will offer five
scholarships for Namibians who present the best proposals for analysis of recent survey data from Namibia.
These human resources will support the collection and processing of quality data for all HIV services in the
country and thus play a central role in the overall SI program area as all SI activities rely on high-quality
data. Potentia personnel will target the general population with emphasis areas in strategic information,
capacity building, and public health evaluation.
Continuing Activity: 16196
16196 3892.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $1,069,229
7338 3892.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $1,177,833
3892 3892.06 HHS/Centers for Potentia Namibia 3139 1064.06 $531,229
Estimated amount of funding that is planned for Human Capacity Development $1,069,229
Table 3.3.17:
This continuing activity includes support for salaries and benefits for the following personnel who support
pre- and in-service training carried out in collaboration with I-TECH and the Ministry of Health and Social
Services (MOHSS) National Health Training Center (NHTC): (1) one University of Namibia (UNAM)
Technical Advisor, (2) three Nursing Lecturers and four part-time Clinical Instructors at UNAM, (3) ten
NHTC and Regional Health Training Center (RHTC) pre-service tutors, (4) two human resources
development staff, (5) 14 digital video conferencing (DVC) staff, (6) two specialized training staff, and (7) 14
I-TECH/Namibia field office staff.
This activity addresses the critical human resources gap at facility levels to deliver HIV/AIDS services in
Namibia. The lack of pre-service and in-service training institutions for clinical and allied health
professionals in Namibia contributes to a chronic shortage of professionals who can provide comprehensive
HIV/AIDS prevention, care and treatment services. The lack of a community of health professionals creates
challenges not only in offering suitable incentives to attract newly trained Namibians to return to Namibia
and practice in the public sector but also in offering incentives to retain Namibian and third-country nationals
currently serving in the country. In 2007, the vacancy rate in the MOHSS was 35% for doctors, 22% for
registered nurses, 26% for enrolled nurses, and 41% for pharmacists.
Since COP04, the USG has assisted the MOHSS to address this gap by providing supplemental personnel
to the MOHSS through Potentia Human Resources Consultancy, a Namibian firm which administers salary
and benefits packages equivalent to those of the MOHSS. The Potentia mechanism is efficient, flexible,
and low-cost and is used for supporting personnel for MOHSS not only for OHSS efforts, but also for nearly
all programmatic areas. Personnel supported in programmatic areas outside of OHSS include physicians,
nurses, pharmacists, data clerks/analysts, condom logistics officers, case managers, and district health
supervisors.
I-TECH is supported by PEPFAR to collaborate with MOHSS' National Health Training Center to build
capacity and provide training. In collaboration with the NHTC, I-TECH provides a variety of trainings in-
person and via digital video conferencing on a variety of clinical and programmatic topics. Beginning in
COP06, Potentia began to support technical and administrative staff previously funded through I-TECH in
order to streamline administration and reduce costs. This human resources strategy has been central to
Namibia's success to date with meeting its prevention, care and treatment targets. Potentia funding within
OHSS covers support for a total of 50 personnel that either focus on pre-service rather than in-service
training, or that cut across all of the other program areas that Potentia supports. These personnel are:
1. UNAM Technical Advisor. This funding supports one Technical Advisor placed at the University of
Namibia (UNAM) to assist the nursing program with delivery of HIV-integrated curriculum for the four-year
nursing diploma program.
2. UNAM Lecturers and Clinical Instructors. This funding supports three Nursing Lecturers and four part-
time Clinical Instructors at UNAM campuses in Windhoek and Oshakati to support students following their
placement in clinical sites to continue to strengthen HIV/AIDS integration into pre-service training at UNAM.
UNAM has increased its intake of nursing students in response to the severe shortage and needs continued
support in the classroom and clinical training setting.
3. NHTC and RHTC pre-service tutors. This funding supports two pre-service tutors stationed at the NHTC
and eight at the five RHTCs. These tutors follow up the nursing students in their clinical sites where they
learn about how to take care of people living with HIV/AIDS (PLWHA). I-TECH staff trains them on
HIV/AIDS and related topics and provides ongoing professional development opportunities.
4. Human Resources Development staff. This funding supports one Human Resources Development
Advisor and one Data Clerk assigned to the MOHSS Directorate of Policy, Planning and Human Resources
Development to assist with policy development, human resource forecasting, management of the staffing
database, training strategies and strategic planning, including defining of the expanded roles of nurses and
community counselors in HIV/AIDS care. These efforts are critical for sustainability.
5. Digital Video Conferencing (DVC) staff. This funding supports one Digital Video Conferencing (DVC)
Program Coordinator, one DVC Technologist, and 12 DVC Assistants to ensure that the DVC program is
coordinated and operational throughout the country. The DVC program provides training opportunities such
as HIV case conferences, lectures on opportunistic infections and HIV co-morbidities, and video
demonstrations of HIV counseling sessions. The DVC program also provides an efficient and cost-effective
means of communicating programmatic HIV/AIDS-related information from the national to the local level,
such as technical updates, and to provide technical and managerial support to the sites as they expand.
6. Specialized Training Staff. This funding supports one Training Coordinator and one Clerk assigned to the
NTHC to coordinate training activities in PMTCT, VCT, and Couples Counseling.
7. I-TECH Field Office Staff. This funding supports the following personnel for I-TECH Central Operations:
a. Deputy Director
b. Office Manager
c. Financial Officer
d. Receptionist
e. Driver
f. Administrative Assistant for the Oshakati RHTC office
g. Development Manager to coordinate all major curricula and media products
h. Two Training Assistants
i. Materials Production Clerk to support training coordination
j. Facilities Manager
k. Housemother
Activity Narrative: l. Two Cleaners
Continuing Activity: 16197
16197 3895.08 HHS/Centers for Potentia Namibia 7374 1064.08 Cooperative $1,361,821
7341 3895.07 HHS/Centers for Potentia Namibia 4385 1064.07 Cooperative $1,435,545
3895 3895.06 HHS/Centers for Potentia Namibia 3139 1064.06 $1,361,988
Estimated amount of funding that is planned for Human Capacity Development $1,341,677
Table 3.3.18:
