INTEGRATED ACTIVITY FLAG:

This activity is one of several funded through a cooperative agreement between the South Africa NDOH AIDS program and the CDC. This cooperative agreement provides financial and technical assistance in the areas of PMTCT (#3042), Basic Health Care and Support (#3037), TB/HIV (#3040), Strategic Information (#3810 and #3039), ARV Services (#3035), and Laboratory Infrastructure (#3038).

SUMMARY:

PEPFAR funds will support Abstinence/Be faithful (AB) prevention activities targeted to young people in South Africa. These activities will be implemented through a cooperative agreement with the NDOH. The major emphasis area of this program will be information, education and communication with minor emphasis placed on community mobilization/participation, development of network/linkages/referral systems, and training. The target population will include children and youth (non-OVC), community leaders, religious organization, South African based volunteers and implementing non-governmental organizations (NGOs).

BACKGROUND:

The cooperative agreement has been in place since 2003. Specific support for AB prevention activities began in FY 2005, when PEPFAR funding was provided to the NDOH to support the three faith-based organizations (FBOs) with which NDOH had an existing relationship (Muslim AIDS Project, Youth for Christ, and Scripture Union). These three FBOs will no longer receive PEPFAR funds through the cooperative agreement, but will receive direct funding from PEPFAR in FY 2007. In FY 2006 an addional four new NGOs were added, Educational Support Services Trust (ESST); Theatre for Life Developing Resilient Youth (AREPP); AIDS Sexuality and Health Youth Organization (ASHYO); and South African San Restitution (SASI). The activities that will be conducted include life skills HIV education, the promotion of healthy norms and behaviors, and reinforcing the role of parents in young people's discussions about HIV and sexuality. FY 2007 funds will be used to build infrastructure within the NDOH for HIV prevention activities and continue to support the four NGOs for AB activities focused on youth.

ACTIVITIES AND EXPECTED RESULTS:

These funds will assist in expanding the department's current AB activities. The four NGOs are experienced in providing AB prevention activities and will work with churches in rural areas to develop radio messages and train peer educators to reinforce the radio messages. In addition AREPP will carry out AB messages through drama in both primary and secondary schools. After presenting the drama, they will lead a discussion about the issues that were raised and focus on HIV risk reduction. Technical assistance and coordination of the activities will be facilitated by the CDC Youth Specialist. The NGOs will carry out peer education in schools and these will be implemented in conjunction with the Harvard School of Public Health peer education efforts in order to streamline the peer education strategy.

The abstinence-focused messages are geared towards children ages 10-14 in primary schools; messages to high school students ages 14-19, out-of-school youth and young adults focus on abstinence, delayed sexual debut and faithfulness. They also discuss correct and consistent condom use to this group, but the focus is more geared towards AB messages. This is consistent with the PEPFAR ABC guidance.

By educating children and young people with AB prevention messages, these activities are designed to contribute to a reduction in the number of new HIV infections in this population. Channeling these activities through NGOs will also allow the messages to spread beyond the target population, to parents and others involved with the organization. These accomplishments will support the PEPFAR's goal of preventing seven million new infections worldwide. These activities also support the HIV prevention goals outlined in the USG Five-Year Strategy for South Africa.

INTEGRATED ACTIVITY FLAG:

This activity relates to Eastern Cape Regional Training Center activities in TB/HIV (#7962), ARV Services (#7963) and Laboratory Support (#7965). This partner may benefit from the Partnership for Supply Chain Management ARV Drugs activity (#7935), which will explore current pain and symptom management practices, drug availability and cost, and provide recommendations.

SUMMARY:

The Eastern Cape Regional Training Center (RTC) will use FY 2007 funds in the Eastern Cape for sustainable human capacity development for all health workers in the Eastern Cape. RTC staff will also continue to improve their knowledge and skills by having weekly academic discussions, internal workshops, attending relevant conferences and ongoing mentoring from its key partner, ITECH. This will facilitate health workers to deliver quality HIV and AIDS palliative care. Three teams from RTC will each support a facility and its feeder clinics for a period of four months to initially evaluate the HIV and AIDS palliative care training needs and provide targeted didactic training, ongoing mentoring and coaching using standardized procedures manuals and tools. Two workshops will be conducted; one for health advocates in leadership and another for CBOs on governance. Non-governmental organization (NGO) facilitators will be trained to implement a level four comprehensive community health worker curriculum. The primary emphasis will be given to training, and minor emphasis to quality assurance and supportive supervision, and information, education and communication (IEC). The primary target groups are public and private health care workers.

BACKGROUND:

RTC was established through a service agreement between the prime partner Eastern Cape Department of Health (ECDOH) and the Walter Sisulu University to provide ongoing training for quality improvement in HIV care and treatment programs.

The function of RTC has been to develop accredited training modules and care protocols for different categories of health workers based on National Department of Health (NDOH) guidelines. RTC has demonstrated and evaluated the HIV, TB and STI best practices continuum of prevention, care and treatment model in selected facilities, providing direct patient care and the opportunity for HCWs to receive practical training. RTC provides technical assistance to the ECDOH regarding the expansion of its HIV intervention programs, supporting Eastern Cape hospital/clinic site readiness for accreditation to provide comprehensive HIV care and treatment. A key gap to address is inpatient support and follow-up at clinic and community level. Patients present late for antiretroviral treatment (ART), already with severe complications. There is limited awareness and skill among the communities to enable early entry into the care system.

Since 2004 RTC has developed two wellness centers in two hospitals and nine clinics and generated a model and protocols which will be introduced at new sites in FY 2007. A system of improvement cycles have been introduced in one sub-district.

RTC has been working with ECDOH managers in developing and disseminating care protocols and will be providing support and working closely with the district and facility managers to increase skills capacity to improve the quality of HIV treatment and support services at facilities and community level.

ACTIVITIES AND EXPECTED RESULTS:

In FY 2007 RTC activities will continue to address activities related to training; local organization capacity development; quality assurance; and supportive supervision. Funding will be used to train workers at new sites for accreditation as provincial ART sites and providing clinical mentoring to selected sites. RTC will employ comprehensive care training teams consisting of a community care mobilization manager and administrative assistant to work with the clinical mentoring teams at each of the three satellite sites in the Eastern Cape -- Mthatha, Port Elizabeth and East London. Each team will provide dedicated support to a district hospital site with five feeder clinics for a period of four

months, and then will move to the next site for the next four months completing three cycles a year.

During this period, the team will work with and support the facility managers to initially evaluate the HIV care and ARV services training needs, adapt standardized protocols and procedures to local facilities, and provide targeted didactic training, ongoing mentoring and coaching using standardized protocols and operating procedures manuals. The activity will address the priority areas of human capacity development, improving skills of a care team including managers, social workers, health promoters, CHW, doctors and nurses at a facility and its feeder clinics through targeted didactic, case discussions, mentoring and community follow-up of patients with facility staff, while considering and reviewing relevant local system issues. CHW will continue to be supported by ongoing telephone consultations after the 4 months. RTC will train and mentor facilitators from NGOs who will cascade the training of an accredited comprehensive curriculum for community health workers.

RTC will hold three-monthly sessions with three local community-based organizations (CBOs) at each facility to articulate their role and function in HIV treatment services programs and to enhance their knowledge and skills required to function in that role. This will include one workshop on governance and administration, a workshop with the partner Masihlanganeni for leadership training for people living with HIV (PLHIV) advocates.

RTC training, coaching and mentoring will address establishment of wellness programs at each facility to encourage support group activities, ongoing counseling, nutrition advice, and referrals for social support at clinic and community level. Training will emphasize and enhance community awareness for prevention, stigma reduction, early detection of symptoms through simple algorithms, and referral of sick individuals into care programs.

Improving the skills of a care team at a facility and its feeder clinics as one unit will help build capacity at clinic level and strengthen the system of referring patients between the hospital, clinics and NGOs for community follow-up, using standardized protocols and operational procedures adapted to local facilities. RTC training and mentoring will address data collection, maintaining accurate records, feedback and usage through quality improvement cycles, quality of counseling, follow-up of patients on ART and pharmacovigilance reporting.

The RTC is an ECDOH initiative based at the Walter Sisulu University and conducts training at public sector facilities. RTC has, and will continue to provide technical assistance to the province through regular meetings and assignments from province managers as well as training for managers.

PEPFAR funding will help to establish the program on a firm footing, and at this point, the program will continue with ECDOH funding. RTC is currently operating in very rural area of South Africa where the shortage of skills has taken greater effort to enhance care systems to be able to mentor health workers to provide quality care.

This activity contributes to the PEPFAR objective of 2-7-10 by increasing the people in care as well as preventing new HIV infections through increased uptake of services.

INTEGRATED ACTIVITY FLAG:

The activities of the Eastern Cape Regional Training Center are integrated, and include activities in the following program areas: Basic Health Care and Support (#7961), TB/HIV (#7962), ARV Services (#7963) and Laboratory Support (#7965).

SUMMARY:

The Eastern Cape Regional Training Center (RTC) will use FY 2007 funds in the Eastern Cape to strengthen the capacity of health care workers (HCW), facility managers, social workers, doctors, nurses, lay counselors and community health workers (CHW), including DOT supporters, to deliver quality TB/HIV services. Three teams from RTC will each support a facility and its feeder clinics for a period of four months to initially evaluate the TB/HIV training needs and provide targeted didactic training, ongoing mentoring and coaching using standardized procedure manuals and tools. NGO facilitators will be trained to implement a level four comprehensive community health worker curriculum incorporating HIV and TB. The primary emphasis will be given to training, and minor emphasis to quality assurance and supportive supervision, and information, education and communication (IEC).

BACKGROUND:

RTC was established through a service agreement between the prime partner Eastern Cape Department of Health (ECDOH) and the Walter Sisulu University (WSU) to provide ongoing training for quality improvement in HIV and TB care programs.

The function of RTC has been to develop accredited training modules and care protocols for different categories of health workers based on National Department of Health guidelines. RTC has demonstrated and evaluated the HIV, TB and STI best practices continuum of prevention, care and treatment model in selected facilities, providing direct patient care and the opportunity for HCW to receive practical training. RTC provides technical assistance to the ECDOH regarding the expansion of its HIV intervention programs supporting Eastern Cape hospital/clinic site readiness for accreditation to provide comprehensive HIV care and treatment.

During the past three years ECDOH has introduced a comprehensive program for HIV care. From observations during RTC activities in clinics and communities, more than 70 percent of TB patients are HIV-infected and there seems to be a gap in screening all TB patients for HIV and early identification of TB in HIV patients who are presenting in facilities. Patients present late for care, already with severe complications. No clinical prophylaxis of TB is currently provided. There is limited awareness and skill among the communities to enable early entry into the care system. There are known drug-drug interactions in patients with co-treatment of ARV and TB drugs. There is an opportunity to combine follow-up of TB patients with patients on ARVs at community level.

RTC has been working with ECDOH managers in developing and disseminating care protocols and will be providing support and working closely with the district and facility managers to increase skills capacity to improve the quality of TB/HIV treatment and support services at facilities and community level.

ACTIVITIES AND EXPECTED RESULTS:

In FY 2007 RTC will continue to address the following areas: training; local organization capacity development; quality assurance; and supportive Supervision. Funding will be used to enhance the RTC strategy of training preparation of new provincial sites for accreditation as ARV sites and providing clinical mentoring to selected sites. RTC will continue supporting training administration and logistics of a comprehensive care training team allocated to provide dedicated support to three district hospital sites and at least five feeder clinics, for a period of four months, which will then move to the next three sites for the next four months, completing three cycles a year.

During this period the team will work with and support the facility managers to initially evaluate the TB/HIV palliative care services training needs, adapt standardized protocols

and procedures for local facilities, and provide targeted didactic training, ongoing mentoring and coaching using standardized protocols and operating procedure manuals. The activity will address the priority areas of human capacity development, improving skills of a care team including managers, doctors, social workers, health promoters, CHW, DOT supporters and nurses at a facility and its feeder clinics through targeted didactic, case discussions, mentoring and community follow-up of patients with facility staff while considering and reviewing relevant local system issues. Ongoing support will continue through telephone consultations after the 4 months. RTC will train and mentor 35 facilitators from 7 NGOs who will cascade the training of a comprehensive level four curriculum for community health workers who will be providing community awareness for TB/HIV symptoms and follow-up of both patients for HIV and TB treatment adherence.

RTC will hold three-monthly sessions with three local CBOs at each facility to articulate their role and function in TB treatment services and enhance their knowledge and skills required to function in that role.

The RTC team will develop simplified TB screening algorithms for HIV patients at clinics and support the improved provision of INH prophylaxis, early detection and better management of TB/HIV in clinics. RTC training and mentoring will address the establishment of wellness programs at each facility to encourage community follow-up, nutrition advice, referrals to clinics and social support at community level.

RTC training and mentoring will address data collection, maintaining accurate records, feedback and usage through quality improvement cycles to address early presentation, and follow-up of patients on TB treatment.

RTC is an ECDOH initiative based at the Walter Sisulu University and conducts training at public facilities. RTC has and will continue to provide technical assistance to the province through regular meetings and assignments from province managers as well as training for managers.

The PEPFAR funding is helping to establish the program on a firm footing where it can continue with ECDOH funding.

The primary objective of the project is sustainable targeted human capacity development for all health workers. RTC staff will also continue to improve their knowledge and skills by having weekly academic discussions, two internal workshops, attending relevant conferences and ongoing mentoring from another PEPFAR partner, I-TECH.

This activity contributes to the PEPFAR objective of 2-7-10 by increasing the number of people in care and strengthening the linkages between HIV and TB programs.

INTEGRATED ACTIVITY FLAG:

The activities of the Eastern Cape Regional Training Center are integrated, and include activities in the following program areas: Palliative Care (#7961), TB/HIV (#7962), ARV Services (#7963) and Laboratory Support (#7965).

SUMMARY:

The Eastern Cape Regional Training Center (RTC) will use FY 2007 funds in the Eastern Cape to strengthen the capacity of healthcare workers (HCW), facility managers, social workers, doctors, nurses, lay counselors and community health workers (CHW); prepare new sites for accreditation; and provide mentoring to strengthen the provision of quality antiretroviral (ARV) treatment. Three teams from RTC will each support a facility and its feeder clinics for a period of four months to initially evaluate the treatment services training needs and provide targeted didactic training, ongoing mentoring and coaching using standardized procedures manual and tools. NGO facilitators will be trained to implement a level four comprehensive community health worker curriculum incorporating ARV treatment. The primary emphasis will be given to training, and minor emphasis to quality assurance and supportive supervision, and information, education and communication (IEC).

BACKGROUND:

The RTC was established through a service agreement between the prime partner Eastern Cape Department of Health (ECDOH) and Walter Sisulu University (WSU) to provide ongoing training for quality improvement in HIV care and treatment programs.

The function of RTC has been to develop accredited training modules and care protocols for different categories of health workers based on National Department of Health guidelines. RTC has demonstrated and evaluated the HIV, TB and STI best practices continuum of prevention, care and treatment model in selected facilities, providing direct patient care and the opportunity for HCW to receive practical training. RTC provides technical assistance to the ECDOH regarding the expansion of its HIV intervention programs, and supports hospital/clinic site readiness for accreditation to provide comprehensive HIV care and treatment.

The primary target populations are the facility managers, doctors, nurses, social workers, lay counselors, CBO staff and community health workers.

During the past three years ECDOH has introduced a comprehensive HIV care program. After workshops alone HCW were unable to implement programs. A number of patients have been started on ARVs at hospital level, but there is a gap in preparing primary clinics to continue supporting patients (down-referral). Many eligible patients are started late on ARVs which results in poor outcomes. There is limited awareness and skill among clinics to enable early diagnosis and entry into the care system. There are known drug-drug interactions in patients with co-treatment of ARVs and other drugs and a number of side-effects and complications are beginning to emerge. There is a need to provide facility-level mentoring support from more experienced clinicians.

RTC has been working with provincial ARV treatment managers in developing and disseminating care protocols and will be providing support and working closely with the district and facility managers in introducing the process to increase skills capacity to improve the quality of HIV treatment.

In FY 2004 and FY 2005 RTC has been involved in clinical care in two hospitals and nine feeder clinics in order to develop systems, inform curriculum content and develop experience for providing mentoring support.

ACTIVITIES AND EXPECTED RESULTS:

In FY 2007 RTC activities will continue to address the following activities: training; local organization capacity development; quality assurance; and supportive supervision. Funding will be used to enhance the RTC strategy of training preparation of new facilities

for accreditation as ARV sites, and providing clinical mentoring to selected sites. RTC will use funds to employ and support administration and logistics of a comprehensive care training team consisting of a clinical director, three doctors, three nurse clinicians and three administrative assistants for three teams, one each placed at the three satellite sites (Mthatha, Port Elizabeth, and East London). Each team will provide dedicated support to three district hospital sites and at least five feeder clinics for a period of four months, and then move to the next three sites for the next four months, completing three cycles a year.

The activity will address the priority areas of human capacity development, improving skills of a care team at facilities (doctors, nurses, managers, social workers, health promoters and CHW) through targeted didactic training, case discussions and mentoring in assessing, initiation, follow-up and monitoring of patients on ARVs while considering and reviewing relevant local system issues. Ongoing support will continue with telephone consultations after the four months. RTC will train and mentor 35 facilitators from 7 NGOs who will cascade the training of a comprehensive level four curriculum for community health workers to include ARV treatment.

RTC training and mentoring will address data collection, maintaining accurate records, feedback and usage through quality improvement cycles to address early presentation, follow-up of patients for adherence, complications and pharmacovigilance.

Training of facility staff, a CBO and community health workers will emphasize follow-up and tracking mothers from the PMTCT program to enable PCR screening, early detection and referral of children into the care and treatment programs.

RTC is an Eastern Cape Department of Health (ECDOH) initiative based at Walter Sisulu University and conducts training at public facilities. RTC provides technical assistance through regular meetings and assignments from province managers as well as training for managers.

The PEPFAR funding compliments ECDOH funding to establish the program on a firm footing to continue with ECDOH funding when the PEPFAR program ends.

The primary objective of the project is sustainable targeted human capacity development for the HCWs. RTC staff will also continue to develop and improve their knowledge and skills by having weekly academic discussions, attending relevant conferences and ongoing mentoring from local experts and visiting experts through collaboration with partners I-TECH and the Owen Clinic.

In the past twelve months with USG funds, RTC has developed protocols and models which have been introduced in the province as new sites are supported for accreditation. More than 27 treatment sites have been supported for accreditation and the RTC will continue to support accreditation of at least 25 new sites in FY 2006 and FY 2007. A system of improvement cycles has been introduced. A pharmacovigilance program has piloted in two hospitals and nine clinics, which highlighted a number of complications as well as drug-related problems, which will be addressed through the training and mentoring program.

This activity contributes to the PEPFAR objective 2-7-10 by increasing the capacity of the public sector to effectively provide HIV care and treatment services.

INTEGRATED ACTIVITY FLAG:

This activity is part of the integrated program that includes Basic Health Care and Support (#7961), TB/HIV (#7962) and ARV Services (#7963).

SUMMARY:

The Eastern Cape Regional Training Center (RTC) will use FY 2007 funds in the Eastern Cape to strengthen the capacity of healthcare providers; prepare new sites for accreditation; and deliver quality HIV care and treatment services. RTC will employ a laboratory technologist who will support the RTC training team at new or established facilities and feeder clinics for a period of four months per cycle to initially evaluate the clinical laboratory investigations training needs and provide targeted didactic training, ongoing mentoring and coaching using standardized procedure manuals and tools. Primary target populations are facility managers, doctors and nurses.

BACKGROUND:

RTC was established through a service agreement between the prime partner Eastern Cape Department of Health (ECDOH) and Walter Sisulu University (WSU) to provide ongoing training for quality improvement in HIV care programs.

The function of RTC has been to develop accredited training modules and care protocols for different categories of health workers based on National Department of Health (NDOH) guidelines. RTC has demonstrated and evaluated the HIV, AIDS, tuberculosis (TB) and sexually transmitted infection (STI) best practices continuum of prevention, care and treatment model in selected facilities, providing direct patient care and the opportunity for healthcare workers (HCW) to receive hands-on practical training. RTC provides technical assistance to the ECDOH regarding the expansion of its HIV intervention programs supporting hospital/clinic site readiness for accreditation to provide comprehensive HIV care and treatment.

A number of clinical follow-up investigations are not adequately done. The quality of specimen collection needs improvement. There is a need to improve turnaround time and record-keeping. New tests such as polymerase chain reaction (PCR) from dried blood spots (DBS) and onsite rapid tests now performed by nurses need quality assurance and ongoing training. With antiretroviral (ARV) and other drug-drug interactions and a number of side-effects and complications beginning to emerge, there is a need for early laboratory detection. This requires facility level mentoring support from more experienced laboratory personnel who are themselves having ongoing support and mentoring.

RTC has been working with the National Health Laboratory Services and will be providing support and working closely with the facility managers in introducing the process to increase skills capacity to improve the quality of laboratory support services at the facilities.

In FY 2004 and FY 2005 RTC was involved in clinical care in two hospitals and nine feeder clinics to develop systems, inform curriculum content and develop experience for providing mentoring support.

ACTIVITIES AND EXPECTED RESULTS:

In FY 2007 RTC activities will continue to address PEPFAR areas of legislative interest: training; local organization capacity development; quality assurance; and supportive supervision. Funding will be used to enhance the RTC strategy of training preparation of new facilities for accreditation as ARV sites, and providing clinical mentoring to selected sites. RTC will use funds to employ and support training administration and logistics of a comprehensive care training team consisting of a Clinical Director, three doctors, three nurse clinicians and three administrative assistants, thus comprising three teams, one placed at each of the three satellite sites (Mthatha, Port Elizabeth, East London). A laboratory technologist will join these teams. Each team is allocated to provide dedicated support to a district hospital site (including at least five feeder clinics) for a period of four months, and then moves to the next site for the next four months, completing three cycles

a year.

During this period the team will work with and support the facility managers to initially evaluate the laboratory training needs and adapt available protocols to the local conditions and provide targeted didactic training, ongoing mentoring and coaching using standardized protocols and procedure manuals. The activity will address the following priority areas:

Human Capacity Development: To improve skills of a care team including managers, doctors, and nurses at a facility and its feeder clinics through targeted didactic, case discussions, mentoring the facility staff in laboratory diagnostic investigations and systems improvement. After four months supported the team will leave an established process that will sustained by the facility managers and staff with the opportunity for further ongoing telephone consultations.

Experience on the ground will be incorporated into the adaptation of the current provincial training program.

Quality Improvement and Assurance: RTC training, coaching and mentoring will be addressing data collection, maintaining accurate records, feedback and usage through quality improvement cycles to address increased reliable laboratory investigations, turnaround time, quality of rapid tests, introduction of PCR specimen collection and communication with laboratory services.

Support to the South African Government (SAG): RTC is an ECDOH initiative based at Walter Sisulu University and conducts training at public facilities. RTC has provided, and will continue to provide technical assistance to the province through regular meetings and assignments from province managers as well as training for managers.

The PEPFAR funding is complimenting ECDOH funding to establish the program on a firm footing. The RTC operates in a very rural area of South Africa where the significant shortage of skills has taken greater effort to enhance care systems to be able to mentor healthcare workers to provide quality care.

The primary objective of the project is sustainable targeted human capacity development for the managers, laboratory staff, doctors and nurses. RTC staff will also continue to develop and improve their knowledge and skills by having academic discussions, attending relevant conferences and ongoing mentoring from local experts and visiting experts through collaboration with I-TECH and the Owen Clinic.

In the past 12 months with PEPFAR funds, RTC has continued to developed protocols and models which have been introduced in the province as new sites are supported for accreditation. More than 27 treatment sites have been supported for accreditation and the RTC will continue to support accreditation of at least 25 new sites in FY 2007. A system of improvement cycles have been introduced in one local service area. A pharmacovigilance program has been piloted in two hospitals and nine clinics, which has highlighted a number of complications as well as drug-related problems. A comprehensive care training team consisting of a doctor, nurse clinician and administrative assistant has been placed and begun training at each of the three satellite sites.

This activity contributes to the PEPFAR objective 2-7-10 by increasing the people in care and treatment.

SUMMARY:

At the request of the National Department of Health (NDOH), CDC will use PEPFAR funds through a Cooperative Agreement to support activities of the 11 Monitoring and Evaluation (M&E) Officers whose placement is currently in process. They will be placed in Information Management Offices at the national and provincial levels. Specifically, two officers will be placed at the NDOH, and the remaining nine will be placed in provincial department of health (DOH) offices. These officers will support information gathering and reporting efforts and contribute to improving the flow of critical data within the department and among its external partners. The major emphasis area for this program will be the placement and training of proposed staff for strategic information (SI) with minor emphasis given to developing health management information systems and monitoring, evaluation and reporting. The activity targets policy makers, National AIDS Control Program staff and other NDOH staff.

BACKGROUND:

The NDOH has identified a need to have M&E Officers working in each province to coordinate and facilitate district-level data reporting to the provincial level and then to the national department. A lack of high-quality data has a negative impact on the NDOH's ability to analyze disease trends and plan new policies and interventions. The capacity gap at the provincial level was identified by the NDOH some time ago; however, due to a lack of resources and other constraints, local capacity building exercises have not been conducted. The move to assign new staff to provincial offices began in mid-2004. Since then, questions about roles and responsibilities, reporting lines between the provincial and national departments, and supervision have been addressed and new guidelines have been formulated. With this policy foundation in place, the NDOH is now in the process of assigning M&E officers to the nine provinces and two officers at the national level. These officers will assist in improving the collection, flow and analysis of data for planning purposes.

ACTIVITIES AND EXPECTED RESULTS:

Eleven M&E officers will be recruited and trained in South African information management policies and practices. Upon completion of the training, the officers assigned to the nine provinces will take up their positions, as will the two officers assigned to the NDOH.

The M&E officers will provide technical expertise in strategic information, with a special emphasis on improving data flow within the provincial DOH (e.g., between districts and the provincial capital) and between the provinces and the national level. The officers based at the NDOH will also contribute to improving the department's ability to share information with external partners. In addition to facilitating information flow, the officers will work to build local capacity in data management and the use of public health/epidemiological data for planning.

By improving the quality of data collected in the field (i.e., at the district and provincial level) and facilitating the flow of information from the provincial to the national level in an efficient and timely manner, the M&E Officers will contribute to the NDOH's ability to produce high quality policy and scientific reports, and to provide appropriate reporting data to its partners in the donor community. The development of a reliable data system from the district level to the national level will also improve the NDOH's ability to respond to changing disease trends and plan future program interventions. The ultimate objective for these activities is to generate a positive impact on the way HIV and AIDS prevention, care and treatment services are delivered nationwide.

Improving data quality and analysis will directly contribute to improvements in HIV and AIDS service delivery. These improvements, in turn, will have a positive impact on South Africa's ability to prevent new infections, care for patients living with HIV, and provide treatment for those with AIDS - all goals outlined in PEPFAR's 2-7-10 strategy.