SUBSTANTIALLY CHANGED FROM LAST YEAR

The HHS/CDC cooperative agreement with Potentia Namibia Recruitment is a continuing mechanism from COP09. The mechanism supports Potentia to perform a limited number of human resource-related

services on behalf of the Ministry of Health and Social Services (MOHSS). These include, administering payroll with a local bank to ensure that electronic funds transfers are completed to MOHSS contract staff on time, and, when requested by the MOHSS, support for recruitment.

This mechanism will expire during the first half of COP10. Because of this, only a portion of COP10 funding will be routed through this existing mechanism. A new, competitive, cooperative agreement will be announced in 2009. A TBD partner will be identified in early 2010 and awarded a five year cooperative agreement to provide these limited human resource services. A TBD IM has been created for this new mechanism.

Objectives: This mechanism has one primary objective: (1) to provide limited human resource services to the MOHSS and other PEPFAR-supported partners. These services, which have been provided since COP05, fill a substantial human resource capacity gap within the MOHSS and the broader GRN civil service. During the first four years of the award, Potentia provided substantial management oversight for staff hired on its contracts. Indeed, during this period, these contractors were employees of Potentia. In COP09, however, a new Namibian Labour Law forced a significant shift in the management of these contract positions. Under the revised law, clients of contract firms were required to establish formal "employee-employer" relationships with contract staff. For the MOHSS, this requirement led to an expansion of human resource (HR) capacity within the Directorate for Special Programmes (DSP). Four HR positions were established under the direction of the Deputy Director of the DSP. These HR specialists now manage the day-to-day relationship between the MOHSS and several dozen contract staff. As noted above, in COP10, Potentia's duties will be restricted to overseeing the electronic payroll transfers from a local bank to the employees' personal bank accounts. Potentia may also provide limited recruiting services to the MOHSS, but this activity, too, has been substantially absorbed by the MOHSS.

Partnership Framework: This mechanism encompasses a broad range of activities and commitments described in the Partnership Framework (PF). Specifically, key objectives are supported under the Coordination and Management thematic area (human resources/human capacity development, and monitoring and evaluation). By linking professionals to MOHSS positions, private HR contract agencies also indirectly support other technical areas (e.g., prevention, care and treatment). However, as the management responsibilities of private contracting firms are increasingly transferred to clients, including the MOHSS, this indirect impact will be minimized.

Coverage: The activities under this mechanism are national in scope. The target clientele includes the MOHSS and other PEPFAR-supported partners (e.g., I-TECH). In COP10, the USG will work with GRN ministries to strengthen the capacity of the civil service to, either, absorb contract staff within the civil service, or manage an outsourcing program for short-term contractors. In COP10, the following

personnel categories will receive limited HR support from Potentia: Physicians, nurses, pharmacists and pharmacy assistants, case managers, training staff, data management staff and supervisors.

Health systems strengthening: As noted above, this mechanism played an essential role in the successful scale-up of ART services in Namibia. Short-term HR services provided through this mechanism were highlighted as a best-practice for rapidly scaling up ART service delivery (Capacity Project report, 2006). Without the recruitment and HR management services provided by Potentia, weaknesses in the MOHSS HR system would have delayed scale-up and negatively impacted patient care. In the last year, the success of Potentia's support for rapid scale-up has been complemented by the transition to MOHSS ownership driven by the new Labour Law. As the role of private HR service companies evolves, the USG will support the development of HR systems within the GRN civil service. While the USG will continue to support the GRN civil service as the primary public sector employment mechanism, technical assistance will encourage the development of flexible and diverse HR mechanisms within the civil service, including outsourcing.

Cross-cutting/Key issues: This mechanism will contribute to Human Resources for Health objectives through support the development of transparent and flexible HR systems within the MOHSS and GRN civil service.

Cost efficiency: Activities supported under this mechanism are integrated with CDC's technical assistance to the MOHSS, both at the national level and in the field. As Potentia's responsibilities for contract staff have been reduced so, too, have the management fees. M&E: All CDC cooperative agreement grantees must submit a detailed work plan with their annual continuation application. This work plan must be based on PEPFAR indicators and aligned with targets set for each country. Grantees must also submit bi-annual status reports to program managers in Namibia. Data in these reports may be used inform any year-on-year changes to the work plan.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuing activity from COP09 which supports activities with one main component: 1) Contract human resource (HR) services for physicians, nurses, pharmacists, pharmacy assistants, case managers (CM), and training staff. These services will include: recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This shift was required to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change. In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff and is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions: 1) Physicians. Medical officers fill gaps in the MOHSS clinical staffing structure and provide a full range of medical services to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 2) Registered Nurses. RN will provide advanced clinical nursing services, including palliative and curative care to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 3) Licensed Practical Nurses. LPN will support RN staff on clinical wards in MOHSS facilities. They provide services for HBHC, HTXS, PDCS, and PDTX. 4) Pharmacists. These staff will manage facility-based pharmacies and dispensaries in MOHSS facilities.

Responsibilities include: Stock management, filling prescriptions, patient counseling, and supervision of pharmacy staff. Pharmacists provide services for HBHC, HTXS, and PDCS. 5) Pharmacist Assistants. Fulfill a task-shifting function by absorbing some stock management, pill counting, filing, data entry tasks from pharmacists. 6) Pharmacist "Hands." Serve a task-shifting function. These positions are also a career entry point for young or inexperienced staff across HBHC, PDCS, HTXS and PDTX. For accounting purposes across the five technical areas, HBHC funds will support: • 12 of 65 physicians • 17 of 76 RN • 10 of 51 LPN • 6 of 41 pharmacists • 9 of 44 pharm. assistants • 3 of 14 pharm. "hands" 7) Case Managers (CM). COP10 will continue support for 21 CM across HVAB, HVOP, HVCT, HTXS, PDTX, PDCS, HVTB, and HBHC. CM will devote approximately 10% of their time to HBHC. CM have direct contact with newly diagnosed HIV patients, and patients already enrolled in services. A client assessment tool will allow for early recognition of issues that could impact compliance with care and treatment or HIV risk. CM address these issues through an intervention plan. CM also: a. Coordinate links to community resources, facilitate social support groups, and psycho-social support for PLWHA. b. Assist with treatment defaulter tracing. c. Counseling patients on adherence, prevention with positives, Family Planning (FP), STI services and disclosure/partner referral. d. Refer patients to other health and social services (e.g., FP, STI services, drug/alcohol treatment and domestic violence). e. Encourage men to seek services and to support their partners and children to do the same. CM work directly with other clinical and lay staff. An assessment will determine the roles and responsibilities of expert patients (e.g., possible default tracing) in support of CM activities. 8) Trainers. One curriculum development officer, one STI trainer, one nurse trainer, and one training manager: These four positions will be based at the National Health Training Center and supervised and managed by the MOHSS. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Labour Law have driven an expansion of MOHSS capacity to manage and administer contract staff. USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as

contractors funded and managed by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's chronic shortage of healthcare workers.

In line with the Partnership Framework (PF), CDC will support the MOHSS and Potentia to assess sustainability options and develop transition plans for these positions. CM also contribute to cost containment by identifying clients' issues early and avoiding potentially expensive clinical costs (e.g., drug resistance related to treatment default). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE WITH SUBSTAINTIAL CHANGES

This is a continuing activity from COP09. Activities will support one component: Contract human resource (HR) services for physicians, nurses, pharmacy staff, district supervisors, and case managers (CM). These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change. In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1) Physicians. Medical officers fill gaps in the MOHSS clinical staffing structure and provide a full range of medical services to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 2) Registered Nurses. RN will provide advanced clinical nursing services, including palliative and curative

care to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 3) Licensed Practical Nurses. LPN will support RN staff on clinical wards in MOHSS facilities. They provide services for HBHC, HTXS, PDCS, and PDTX. 4) Pharmacists. These staff will manage facility-based pharmacies and dispensaries in MOHSS facilities. Responsibilities include: Stock management, filling prescriptions, patient counseling, and supervision of pharmacy staff. Pharmacists provide services for HBHC, HTXS, and PDCS. 5) Pharm. Assistants. Fulfill a task-shifting function by absorbing some stock management, pill counting, filing, data entry tasks from pharmacists. 6) Pharm. "Hands." Serve a task-shifting function. These positions are also a career entry point for young or inexperienced staff across HBHC, PDCS, HTXS and PDTX. For accounting purposes across the five technical areas, HTXS funds will support: - 41 of 65 physicians - 43 of 76 RN - 31 of 51 LPN - 33 of 41 pharmacists - 18 of 44 pharm. assistants - 7 of 14 pharm. "hands" 7) Case Managers (CM). COP10 will continue support for 21 CM across HVAB, HVOP, HVCT, HTXS, PDTX, PDCS, HVTB, and HBHC. CM will devote approximately 10% of their time to HTXS. CM have direct contact with newly diagnosed HIV patients, and patients enrolled in services. A client assessment tool allows early recognition of issues that could impact compliance with care and treatment or HIV risk. CM address these issues through an intervention plan. CM also: a. Coordinate links to community resources, facilitate social support groups, and psycho-social support for PLWHA. b. Assist with treatment defaulter tracing. c. Counsel patients on adherence, prevention with positives, Family Planning (FP), STI services and disclosure/partner referral. d. Refer patients to other health and social services (e.g., FP, STI services, alcohol treatment and domestic violence). e. Encourage men to seek services and to support their partners and children to do the same. CM work directly with other clinical and lay staff. An assessment will determine the roles and responsibilities of expert patients (e.g., possible default tracing) in support of CM activities. 8) District Health Supervisors (DHS). HTXS will support salaries for TK of 34 DHS nurses. DHS provide supportive supervision and mentoring. They also monitor post-training skill utilization. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers. CM also contribute to cost containment by identifying issues early and avoiding potentially expensive costs (e.g., drug resistance). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuing activity from COP09. Activities will support one component: Contract human resource (HR) services for trainers and training support staff, quality assurance coordinators, and case managers (CM). These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change. In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1. Trainers. HR contract services will support the following training and training support staff: Eight HCT trainers, one driver, one community counselor training coordinator, one specialized counseling trainer, one rapid test training coordinator, and two rapid test trainers. All of these staff will be managed and

supervised by the MOHSS, with input from I-TECH. 2. HCT Quality Assurance Coordinators (HCTQA). Thirteen (13) HCTQA coordinators will be managed and supervised by the MOHSS. One coordinator will be based in each of Namibia's 13 regions. These coordinators support the rollout of HIV rapid testing in Namibia. Specific activities will include: a. Support the Namibia Institute of Pathology (NIP) in the certification of regional rapid-test sites and staff. b. Conduct supportive site visits to ensure the confidentiality, accuracy, and safety of rapid testing carried out in MOHSS facilities. c. Review data accuracy and completeness, and relay findings to appropriate monitoring and evaluation bodies (e.g., Response M&E). d. Advise and mentor district Case Management Officers to strengthen the referral mechanisms and ensure continuum of care for tested clients. 3. Case Managers (CM). COP10 will continue support for 21 CM across HVAB, HVOP, HVCT, HTXS, PDTX, PDCS, HVTB, and HBHC. CM will devote approximately 10% of their time to HVCT. CM have direct contact with newly diagnosed HIV patients, and patients enrolled in services. A client assessment tool allows early recognition of issues that could impact compliance with care and treatment or HIV risk. CM address these issues through an intervention plan. CM also: a. Coordinate links to community resources, facilitate social support groups, and psycho-social support for PLWHA. b. Assist with treatment defaulter tracing. c. Counsel patients on adherence, prevention with positives, Family Planning (FP), STI services and disclosure/partner referral. d. Refer patients to other health and social services (e.g., FP, STI services, alcohol treatment and domestic violence). e. Encourage men to seek services and to support their partners and children to do the same. CM work directly with other clinical and lay staff. An assessment will determine the roles and responsibilities of expert patients (e.g., possible default tracing) in support of CM activities. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers. CM also contribute to cost containment by identifying issues early and avoiding potentially expensive

costs (e.g., drug resistance). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES This is a continuing activity from COP09. Activities will support one component: Contract human resource (HR) services for physicians, nurses, pharmacy staff, case managers (CM), and training staff. These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change. In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1) Physicians. Medical officers fill gaps in the MOHSS clinical staffing structure and provide a full range of medical services to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 2) Registered Nurses. RN will provide advanced clinical nursing services, including palliative and curative care to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 3) Licensed Practical Nurses. LPN will support RN staff on clinical wards in MOHSS facilities. They provide services for HBHC, HTXS, PDCS, and PDTX. 4) Pharmacists. These staff will manage facility-based pharmacies and dispensaries in MOHSS facilities. Responsibilities include: Stock management, filling prescriptions, patient counseling, and supervision of pharmacy staff. Pharmacists provide services for HBHC, HTXS, and PDCS. 5) Pharm. Assistants. Fulfill a task-shifting function by absorbing some stock management, pill counting,

filing, data entry tasks from pharmacists. 6) Pharm. "Hands." Serve a task-shifting function. These positions are also a career entry point for young or inexperienced staff across HBHC, PDCS, HTXS and PDTX. For accounting purposes across the five technical areas, PDCS funds will support: - 5 of 65 physicians - 6 of 76 RN - 3 of 51 LPN - 2 of 41 pharmacists - 2 of 44 pharm. assistants - 1 of 14 pharm. "hands" 7) Case Managers (CM). COP10 will continue support for 21 CM across HVAB, HVOP, HVCT, HTXS, PDTX, PDCS, HVTB, and HBHC. CM will devote approximately 15% of their time to PDCS. CM have direct contact with newly diagnosed HIV patients, and patients enrolled in services. A client assessment tool allows early recognition of issues that could impact compliance with care and treatment or HIV risk. CM address these issues through an intervention plan. CM also: a. Coordinate links to community resources, facilitate social support groups, and psycho-social support for PLWHA. b. Assist with treatment defaulter tracing. c. Counsel patients on adherence, prevention with positives, Family Planning (FP), STI services and disclosure/partner referral. d. Refer patients to other health and social services (e.g., FP, STI services, alcohol treatment and domestic violence). e. Encourage men to seek services and to support their partners and children to do the same. CM work directly with other clinical and lay staff. An assessment will determine the roles and responsibilities of expert patients (e.g., possible default tracing) in support of CM activities. 8) District Health Supervisors (DHS). PDCS will support salaries for a percentage of 34 DHS nurses. DHS provide supportive supervision and mentoring. They also monitor post-training skill utilization. 9) Trainers. One curriculum development officer, one STI trainer, one nurse trainer, and one training manager: These four positions will be based at the National Health Training Center. They will be supervised and managed by the MOHSS. PDCS will support a percentage of these positions. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based

HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers. CM also contribute to cost containment by identifying issues early and avoiding potentially expensive costs (e.g., drug resistance). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuing activity from COP09. Activities will support one component: Contract human resource (HR) services for physicians, nurses, pharmacy staff, district supervisors, and case managers (CM). These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change. In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1) Physicians. Medical officers fill gaps in the MOHSS clinical staffing structure and provide a full range of medical services to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 2) Registered Nurses. RN will provide advanced clinical nursing services, including palliative and curative care to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. 3) Licensed Practical Nurses. LPN will support RN staff on clinical wards in MOHSS facilities. They provide services for HBHC, HTXS, PDCS, and PDTX.

4) Pharm. Assistants. Fulfill a task-shifting function by absorbing some stock management, pill counting, filing, data entry tasks from pharmacists. 5) Pharm. "Hands." Serve a task-shifting function. These positions are also a career entry point for young or inexperienced staff across HBHC, PDCS, HTXS and PDTX. For accounting purposes across the five technical areas, PDTX funds will support: - 5 of 65 physicians - 9 of 76 RN - 7 of 51 LPN - 16 of 44 pharm. assistants - 3 of 14 pharm. "hands" 6) Case Managers (CM). COP10 will continue support for 21 CM across HVAB, HVOP, HVCT, HTXS, PDTX, PDCS, HVTB, and HBHC. CM will devote approximately 15% of their time to PDTX. CM have direct contact with newly diagnosed HIV patients, and patients enrolled in services. A client assessment tool allows early recognition of issues that could impact compliance with care and treatment or HIV risk. CM address these issues through an intervention plan. CM also: a. Coordinate links to community resources, facilitate social support groups, and psycho-social support for PLWHA, especially for care-givers of HIV-positive children. b. Assist with treatment defaulter tracing. c. Counsel patients on adherence, prevention with positives, Family Planning (FP), STI services and disclosure/partner referral. d. Refer patients to other health and social services (e.g., FP, STI services, alcohol treatment and domestic violence). e. Encourage men to seek services and to support their partners and children to do the same. CM work directly with other clinical and lay staff. An assessment will determine the roles and responsibilities of expert patients (e.g., possible default tracing) in support of CM activities. 7) District Health Supervisors (DHS). PDTX will support salaries for TK of 34 DHS nurses. DHS provide supportive supervision and mentoring. They also monitor post-training skill utilization. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers. CM also contribute to cost containment by identifying issues early and avoiding potentially expensive

costs (e.g., drug resistance). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuation of COP09 activities. Activities in this area will support one main component: 1) Contract human resource services for 50 members of the MOHSS Strategic Information (SI) staff. These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management.

In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change.

In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1. Facility-based Data Clerks: Twenty-nine facility-based data clerks (including three senior clerks) will focus on ART exclusively to include facilitating data collection, entry and report dissemination for PMTCT, VCT, and TB programs. 2. Regional Data Clerks: These positions are based in each of Namibia's 13 regions. The 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 coordinates 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: Data analysts will 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 COP07. 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 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. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES: This is a continuing activity from COP09 which includes one component: 1) the provision of contract human resource (HR) services for educators and training support staff at the University of Namibia (UNAM), the National Health Training Center (NHTC), I-TECH and selected regional sites. These services include: recruitment and hiring (using MOHSS contracts) and payroll management. A 2009 new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this. In response, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of

Special Programmes (DSP) to assume direct management of these contract staff (Potentia was previously responsible). This transition represents a significant shift in the day-to-day management of contract staff and is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or contractors. UNAM and ITECH have taken similar steps to align their HR practices with the new Labour Law. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions: 1. University of Namibia (UNAM) Technical Advisor (TA). The TA will be seconded to the UNAM Nursing School to support the implementation of the integrated nursing curriculum that emphasize the integration of HIV/AIDS modules in the broader curriculum. "Mainstreaming" HIV/AIDS into the broader healthcare system is a key priority for the Partnership Framework. 2. Nursing Lecturers and four part-time Clinical Instructors at UNAM. COP10 funds will support 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 UNAM re-service training. 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. Ten NHTC and Regional Health Training Center (RHTC) pre-service tutors. COP10 funds will support two pre-service tutors stationed at the NHTC and eight at the five RHTC. These tutors follow up the nursing students in their clinical sites where they learn how to take care for people living with HIV/AIDS (PLWHA). Training for these tutors will be provided by I-TECH. 4. Two HR development staff. COP10 funds will support one HR Development Advisor and one Data Clerk assigned to the MOHSS Directorate of Policy, Planning and HR Development to assist with the management of contract staff, policy development, HR forecasting, management of the staffing database, training strategies and strategic planning, including defining of the expanded roles of nurses and community counselors (CC) in HIV/AIDS care. 5. Fourteen digital video conferencing (DVC) staff. COP10 funds will support one DVC Program Coordinator, one DVC Technologist, and 12 DVC Assistants to ensure the DVC program is coordinated and operational throughout Namibia. 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 national to local level, such as technical updates, and provides technical and managerial support to sites as they expand. 6. Two specialized training staff. COP10 funds will support one Training Coordinator and one Clerk assigned to the NTHC to coordinate training activities in PMTCT, VCT, and couples counseling. 7. Fourteen I-TECH/Namibia field office staff. COP10 funds will support the following personnel for I- TECH Central Operations:

• Deputy Director • Office Manager • Financial Officer • Receptionist • Driver • Administrative Assistant for the Oshakati RHTC office • Development Manager to coordinate all major curricula and media products • Two Training Assistants • Materials Production Clerk to support training coordination • Facilities Manager • Housemother • Two Cleaners Supportive supervision: The MOHSS now provides additional contract staff management oversight and supervision.

Sustainability: As noted above, the MOHSS has expanded the duties of the DSP Deputy Director to include direct management and administration of six contract staff and the CC cadre. This transition represents an important step toward the eventual full MOHSS absorption and financing of these staff - either as civil servants or contractors. Long-term cost savings are being achieved through the focus on recruiting and deploying staff within their own communities. CC retention rates are also high, suggesting a high level of morale among this cadre. Also of note, several CC have recently "graduated" to enroll in nursing school and similar transitions will be encouraged throughout the task-shifting initiative.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES This is a continuing activity from COP09. Activities will support one component: Contract human resource (HR) services for a National Male Circumcision (MC) Coordinator, and eight specialist physicians (to perform MC). These services will include: Recruitment and hiring (as needed, using Ministry of Health and Social Services (MOHSS) contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change.

In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions: 1. National MC Coordinator. In COP10, PEPFAR funds will continue to support a National Male Circumcision Coordinator based in the MOHSS Directorate of Special Programmes for HIV, TB, and Malaria (DSP). This position is responsible for the development of standard operating procedures for MC and coordinating the implementation of MC in the public sector. Some of the job responsibilities for the MC Coordinator include: (a) Coordinating the Male Circumcision task force. (b) Collaborating with the MOHSS Division of Primary Health Care (PHC) to explore the expansion of neonatal MC services in maternity wards throughout Namibia. (c) Collaborating with PHC to identify traditional circumcisers to be trained and possibly certified to perform MC services. (d) Working closely with I-TECH and overseeing the training of health care providers in the public and faith-based sectors. (e) Guiding and coordinating MC services in faith-based facilities. (f) Liaising with the health facilities and MOHSS Central Medical Stores to ensure that appropriate supplies, commodities, and equipment are available for MC services. (g) Working with Nawa Life Trust, the MC Task Force, and other partners in designing and implementing a communications and advocacy campaign. (h) Working with the Nursing board to develop a task-shifting strategy for MC. The MC coordinator may also work with Namibian Medical Aid 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. Specialist physicians to perform MC. Eight physicians with expertise and experience in MC will be supported in COP10. This represents an increase of three MC specialist physicians since COP09. The additional providers will be trained by I-TECH and will work closely with the National Male Circumcision Coordinator. As in COP09, all MC physician specialists 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. These eight specialist physicians will contribute to an ongoing assessment of task-shifting opportunities for nurses in the CIRC technical area. MC specialist

physicians, nurses and midwives will participate in any eventual planning for task-shifting in MC. The draft national policy includes recommendations on task shifting, including the identification of potential cadres to take up new responsibilities, tasks that could be shifted and training needs. Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff. Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuing activity from COP09. Activities in this area will support one main component: 1) Contract human resource services for case managers and a National Prevention Coordinator. These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management.

Because Case Managers do not exclusively provide HVAB services, a portion of the funding to support these positions is reflected in MTCT, HVOP, HTXS, PDTX, HBHC, PDCS, and HVTB. Half of the funding for the National Prevention Coordinator is reflected in HVOP.

In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change.

In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to

manage the eventual full absorption and financing of these staff - either as civil servants or as contractors.

These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1) Case Managers (CM). COP10 will continue support for 21 CM in eight program areas (HVOP, HVCT, HTXS, PDTX, HBHC, PDCS, and HVTB), including HVAB. These CM will commit approximately 10% of their time to HVAB activities. CM will have immediate contact with newly diagnosed HIV patients, as well as patients already enrolled in care and treatment services. A client assessment tool will allow for early recognition of client issues that could impact compliance with care and treatment. Through an intervention/service plan CM will address issues that place clients at risk of defaulting on HIV care or becoming HIV-infected. CM will: • Coordinate resources for clients, including links to and facilitation of social support groups, and psycho- social support for PLWHA. • Assist with treatment defaulter tracing. • Counsel patients on adherence, prevention with positives, ABC, Family Planning (FP), STI services and disclosure/partner referral • Refer patients to other health and social services (e.g., FP, STI services, drug/alcohol treatment and domestic violence) • Encourage men to seek services and to support their partners and children in doing the same. CM will work directly with other clinical and lay staff. As part of the development of the overall CM program, an assessment will determine the optimal roles and responsibilities of expert patients (e.g., possible default tracing, education, etc) in support of CM activities.

2) Prevention Coordinator. This position coordinates prevention efforts across line ministries and with other stakeholders in the national response. The prevention coordinator leads the National Prevention Technical Advisory Committee, and is leading the development of the National Prevention Strategy.

Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Namibian Labour Law have resulted in cost savings and an expansion of MOHSS's role in the management and administration of contract staff (see above). USG will continue to advocate for expanded management capacity within the MOHSS, and to assist with the development of plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to

address Namibia's chronic shortage of healthcare workers.

In line with the objectives described in the Partnership Framework Implementation Plan (PFIP), CDC will support the MOHSS and Potentia to assess sustainability options for these positions. This assessment will inform the development of transition plans for both partners.

CM also contribute to cost containment by identifying and addressing clients' issues early and avoiding potentially expensive clinical costs (e.g., drug resistance related to treatment default). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuing activity from COP09. Activities in this area will support one main component: 1) Contract human resource services for 20 Condoms Logistics Officers, 34 Case Managers, and a National Prevention Coordinator seconded to the MOHSS.

Because Case Managers do not exclusively provide HVOP services, a portion of the funding to support these positions is reflected in MTCT, HVOP, HTXS, PDTX, HBHC, PDCS, and HVTB. Half of the funding for the National Prevention Coordinator is reflected in HVAB.

In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change.

In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors.

These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1) Condom Logistics Officers. In COP10, 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 nongovernmental organizations (NGO) and faith-based organizations (FBO) who distribute condoms to high-risk people.

2) Case Managers (CM). COP10 will continue support for 21 CM in eight program areas (MTCT, HVOP, HTXS, PDTX, HBHC, PDCS, and HVTB), including HVAB. These CM will commit approximately 10% of their time to HVAB activities. CM will have immediate contact with newly diagnosed HIV patients, as well as patients already enrolled in care and treatment services. A client assessment tool will allow for early recognition of client issues that could impact compliance with care and treatment. Through an intervention/service plan CM will address issues that place clients at risk of defaulting on HIV care or becoming HIV-infected. CM will: • Coordinate resources for clients, including links to and facilitation of social support groups, and psycho- social support for PLWHA. • Assist with treatment defaulter tracing. • Counsel patients on adherence, prevention with positives, ABC, Family Planning (FP), STI services and disclosure/partner referral • Refer patients to other health and social services (e.g., FP, STI services, drug/alcohol treatment and domestic violence) • Encourage men to seek services and to support their partners and children in doing the same. CM will work directly with other clinical and lay staff. As part of the development of the overall CM program, an assessment will determine the optimal roles and responsibilities of expert patients (e.g., possible default tracing, education, etc) in support of CM activities.

3) Prevention Coordinator. This position coordinates prevention efforts across line ministries and with other stakeholders in the national response. The prevention coordinator leads the National Prevention Technical Advisory Committee, and is leading the development of the National Prevention Strategy.

Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Namibian Labour Law have resulted in cost savings and an expansion of MOHSS's role in the management and administration of contract staff (see above). USG will continue to

advocate for expanded management capacity within the MOHSS, and to assist with the development of plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's chronic shortage of healthcare workers.

In line with the objectives described in the Partnership Framework Implementation Plan (PFIP), CDC will support the MOHSS and Potentia to assess sustainability options for these positions. This assessment will inform the development of transition plans for both partners.

CM also contribute to cost containment by identifying and addressing clients' issues early and avoiding potentially expensive clinical costs (e.g., drug resistance related to treatment default). Task-shifting from doctors and nurses to CM reduces workloads for medical staff and maximizes their ability to deliver services.

NEW/REPLACEMENT NARRATIVE

This is a continuing activity from COP09. Activities in this area will support one main component: 1) The provision of contract human resource services for six members of the MOHSS PMTCT training team based at the National Health Training Center (NHTC). These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In early 2009, the passage of a new Labour Law required all human resource contractors to revise contractual mechanisms to shift legal responsibility for contract staff from the private contractor to the client. This shift was required to establish a clear employee-employer relationship between the client and contract staff. With this change, private human resource contractors may continue to provide HR services (e.g., recruitment, payroll management), but may no longer be the formal "employer." In this program area, six contract staff were affected by this change. These positions are described below. In response to this change, the MOHSS expanded the duties of the Deputy Director of the Directorate of Special Programmes (DSP) to include direct management and administration of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step toward the eventual full absorption and financing of these staff - either as civil servants or as contractors - by the MOHSS. These changes have also resulted in cost savings for the USG. As the MOHSS has taken on greater responsibility for managing these positions, Potentia has reduced the monthly management fees

associated with these contracts. The following staff are deployed at the MOHSS' National Health Training Center and at Regional Health Training Centers:

(1) Five in-service tutors placed throughout the NHTC network. These tutors provide decentralized training and supportive supervision in PMTCT and dried blood spot (DBS) for DNA-PCR testing for infants. These tutors will conduct at least 50 post-training site visits to reinforce training content and measure utilization of newly acquired skills.

(2) One driver to transport the tutors to training and clinical sites.

Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff. Additional supportive supervision is provided through I-TECH activities.

Sustainability: Changes in the Labour Law have strengthened MOHSS capacity to manage and administer contract staff. In line with the Partnership Framework, the USG will continue to advocate for expanded HR management capacity within the MOHSS, and to assist with plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's shortage of healthcare workers.

USG support for PMTCT training is also leveraged and harmonized with similar support from the Global Fund.

NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES

This is a continuing activity from COP09. Activities will support one component: Contract human resource (HR) services for physicians, nurses and a tuberculosis (TB) infection control specialist. These services will include: Recruitment and hiring (as needed, using MOHSS contracts) and payroll management. In 2009, a new Labour Law required HR contractors to shift legal responsibility for contract staff from the contractor to the client. This was done to establish a clear employee-employer relationship between the client and contract staff. With this change, private HR contractors may continue to provide HR services

(e.g., recruitment, payroll management), but may no longer be the formal "employer." All of the contract staff in this program area were affected by this change. In response to this change, the MOHSS expanded the duties and staff of the Deputy Director of the Directorate of Special Programmes (DSP) to assume direct management of these contract staff. Potentia was previously responsible for this work. This transition represents a significant shift in the day- to-day management of contract staff. It is an important step in the development of GRN systems to manage the eventual full absorption and financing of these staff - either as civil servants or as contractors. These changes have also resulted in cost savings. As the MOHSS has taken on greater responsibility for these positions, Potentia has reduced the management fees associated with these contracts. Position descriptions 1) Physicians. Medical officers fill gaps in the MOHSS clinical staffing structure and provide a full range of medical services to patients in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. PEPFAR is working closely with MOHSS and the USAID Tuberculosis Control Assistance Program (TBCAP) to ensure that these physicians are posted where the need is greatest. To this end, one HIV/TB physician will be based at Katatura Hospital. The other will work at Walvis Bay Hospital. 2) Registered Nurses. RN will provide advanced clinical nursing services, including Directly Observe Treatment Short course (DOTS) for patients with TB and TB/HIV co-infection. Nurses will also support surveillance for drug-resistant cases of TB in MOHSS facilities. Services cut across HBHC, HTXS, PDCS, PDTX, and HVTB. Other tasks will include: 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. 3) TB Infection Control Specialist. This expert will support MOHSS efforts to develop and implement infection control policies and guidelines. These materials will draw on technical assistance from CDC, WHO and other development partners (Netherlands TB control program) The IC specialist will also serve as a focal point for coordination between national TB and HIV programs, especially to support the implementation of the WHO "3 I's": Intensified case finding, Isoniazid preventive therapy, and Infection control. 4) Curriculum Development Manager. HVTB funds will support 100% of this position 5) TB/HIV Curriculum Developer. This individual will work with the National Health Training Center and I- TECH to revise national training curricula on the identification, prevention and management of HIV/TB co-infection. HVTB funds will support 100% of this position. 6) In-service IMAI/TB Trainer. The trainer will provide on-site instruction and supportive supervision to nurses involved with HIV/TB patients. HVTB funds will support 100% of this position.

For accounting purposes across the five technical areas, HVTB funds will support: - 2 of 65 physicians - 1 of 76 RN Supportive supervision: As noted above, the MOHSS now provides additional management oversight and supervision for contract staff.

Sustainability: Changes in the Namibian Labour Law have resulted in cost savings and an expansion of MOHSS's role in the management and administration of contract staff (see above). USG will continue to advocate for expanded management capacity within the MOHSS, and to assist with the development of plans for the full absorption of these staff, either as civil servants or as contractors funded by the MOHSS. The use of a locally-based HR contractor further builds public and private sector capacity to address Namibia's chronic shortage of healthcare workers.

In line with the objectives described in the Partnership Framework (PF), CDC will support the MOHSS and Potentia to assess sustainability options for these positions. This assessment will inform the development of transition plans for both partners.