Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 13619
Country/Region: South Africa
Year: 2012
Main Partner: Johns Hopkins University
Main Partner Program: JHPIEGO
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $3,320,000

JHPIEGO MMC program goal is to build sustainable capacity within Nkangala District to promote primary prevention of HIV by scaling up safe, comprehensive MMC services with: provision of high quality, high-volume, integrated adult MMC services; collaborate with circumcising communities and leaders to offer MMC as a component of traditional initiation rites; work in partnership with local workplaces and unions generate demand for MMC services; and collaborate with other HIV partners in the district to ensure the continuum of care and promote and refer clients to MMC. JHPIEGO will enter year 2 of an intensive MMC program in 3-4 hospitals and roving services. This program directly supports the prevention goal of the PF, including addressing female vulnerability to HIV and other STI infection. It is also supportive of the NSP goal to reduce new HIV infections by 50%. Providers of HCT and other health services will be oriented to MMC and provided with tools to refer HIV-negative men. This and regular follow up from JHPIEGO will strengthen bidirectional referrals and linkages between MMC and other services. Clients recruited for MMC will be encouraged to bring their partners. Training and knowledge development of staff from area clinics will increase cost efficiencies by reducing JHPIEGOs follow up burden. Bulk procurement of MMC consumables will ultimately reduce costs as well. The project will build sustainable local capacity with a cadre of trained professionals and equipped facilities for transition to SAG management at the end of project period. JHPIEGO will work with SAG and other partners to implement a quality assurance training program per national guidelines. JHPIEGO plans to purchase one vehicle with COP 2011 funds; and three with COP 2012 funds.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $3,320,000

JHPIEGO will contribute towards provincial and national MMC targets by circumcising 32,000 males in FY 2013. Four percent of HIV-negative males aged 15-49.This will be achieved with fixed services at district hospitals and mobile services in hard-to-reach populations in Nkangala District, Mpumalanga. JHPIEGO proposes to conduct MMC in high volume settings. The unit cost for MMC in the second project year in a high volume setting is estimated at $100/procedure, inclusive of the full package of services and supportive activities such as social mobilization and program monitoring. JHPIEGO will conduct MC in District hospital, they will place Doctors and Nurses to support DOH staff in the MC Procedures. JHPIEGO will operate against a sustainability plan to capacitate health facilities and their staff for MMC impact beyond the completion of the project. JHPIEGO will build on best practices in MMC, including use of forceps-guided surgery, employing models to optimize volume and efficiencies, incorporating messaging on gender norms and proper treatment of females, and delivering these as part of a package of prevention services, including HCT, age-appropriate risk reduction counseling, condom demonstration, provision and promotion,linkages to family planning, supportive supervision and QA, STI, HIV, TB, and other treatment services.Demand creation will include formative assessments of clients, their partners and communities to understand facilitators, barriers and preferences in MMC service delivery; resulting demand creation activities will utilize a mix of media and grassroots approaches to attract adequate client flow.The program will use reporting mechanisms that fold into SAG district, provincial and national systems.This will integrate the project within the larger MMC effort in South Africa and avoid creating parallel structures.The MMC activities are intended not only as a single biomedical intervention to reduce HIV acquisition risk, but also an opportunity to engage men in health services and maximize linkages to other key resources for males improved long-term engagement in the health sector, increasing their likelihood to seek support for sexual and reproductive health and chronic disease management.

Cross Cutting Budget Categories and Known Amounts Total: $100,000
Human Resources for Health $100,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Mobile Populations