SUMMARY:

The Foundation for Professional Development (FPD) supports the expansion of access to comprehensive

HIV and AIDS palliative care by focusing on human capacity development with a view to increasing the

detection and treatment of patients with TB and HIV co-infection. The emphasis areas for these activities

are local organization capacity building and HCD. Target populations for these activities include people

living with HIV and AIDS (PLHIV) and most at risk populations.

BACKGROUND:

FPD is a South African Private Institution of Higher Education working exclusively in the health sector in

Southern Africa. With PEPFAR funding, FPD supports the public sector expansion of access to

comprehensive HIV and AIDS care by focusing on provision of antiretroviral therapy (ART) and increasingly

basic health care (wellness programs) for people living with HIV (PLHIV) who do not yet require ART. Due

to the acknowledged drop-off of patients who test positive for HIV between testing and actually entering

ART the basic care program attempts to provide a continuum of basic care at places of testing to ensure

retention of patients.

This approach allows patients to be enrolled in a care support program that allows regular contact with

health care providers, monitoring of CD4 counts and early referral of patients into ART programs. Activities

include supporting the establishment of such programs in public sector, NGO and FBO CT sites, through

the provision of staff, training, equipment purchase, technical assistance, mentoring, and refurbishment of

facilities. Care programs offer psychosocial support through support groups and individual counseling and

treatment of opportunistic infections. The program also includes dedicated staff (tracers) who follow-up on

any patients who drop out of the program to determine the reason and where possible attempt to convince

such patients to return to the program. The emphasis areas for this activity are human capacity

development, gender, local organization capacity development and construction and renovation.

Coordination with provincial Departments of Health (DOH) takes place through Memorandums of

Understanding (MOUs). FPD provides substantial assistance initially to public sector facilities and works

towards a diminished role over time, working towards sustainability at the sites. Sub-agreements are used

to partner with NGOs and FBOs to provide care support services where public sector facilities are either

overcrowded or not accessible. Gender issues are embedded in all aspects of the project and include

collecting gender-specific data in treatment programs, linkages with NGOs working in the gender field, CT

services that specifically focus on couple counseling, domestic violence and abuse detection. Other issues

addressed by this project are: 1) Male norms and behaviors that are addressed in the counseling provided

at basic care sites. All staff actively work towards reducing violence and coercion by identifying victims of

violence.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Support to Government ART, CT and PHC clinics

PEPFAR funds are used to respond to requests from provincial DOH to support South African Government

(SAG) ART, CT and Primary Health Care Clinics (PHC) through temporarily seconding clinical and

administrative staff, providing equipment, refurbishment and technical assistance. The FPD-supported staff

will play a critical role in introducing the provision of basic care programs at these sites as they will

supplement to government staff. Patients enrolled in such programs will be linked into the electronic patient

record system currently supporting patients on ARVs to allow patient tracking, mentoring by FPD specialists

and early referral to treatment facilities.

ACTIVITY 2: Support to NGOs and FBOs

Numerous NGOs and FBOs in the areas where FPD supports ART services are involved with CT activities

but seldom provide basic care, FPD will partner with these organizations to expand their services to include

a basic care component, including regular monitoring of CD4 counts at six month intervals, diagnosis and

treatment of opportunistic infections and psychosocial support. Patients enrolled in such programs will be

linked into the electronic patient record system currently supporting patients on ARVs to allow patient

tracking, mentoring by FPD specialists and early referral to government treatment facilities. It is anticipated

that this activity will also leverage existing resources in these organizations in support of basic care

programs and to expand the services provided to patients enrolled in the basic care program especially for

psychosocial support and income generation. FPD will also provide additional support through its Compass

Project, an organizational development project funded by the Dutch Government. This project provides

technical assistance to help develop and strengthen these local organizations in the areas of governance,

management, and M&E.

ACTIVITY 3: Referral and linkages

FPD will continue to strengthen and expand the referral networks and linkages of its partner NGOs and

CBOs with care and treatment services for clients identified to be HIV-infected. Linkages with community

mobilization and outreach activities will be initiated to promote the uptake of both HIV CT and basic care

services, including the regular monitoring of CD4 counts, treatment of opportunistic infections including the

provision of cotrimoxazole, and psychosocial support.

FY 2008 COP Activities: Although FPD has not in past years been funded for basic care activities such

activities were conducted at the ART sites that FPD supports. New activities will include expanding care

support activities to where CT takes place in both public and civil society facilities. This will help to ensure

that those who are HIV-infected but not yet eligible for treatment are enrolled in a care program. Where

feasible such programs will also be introduced at Primary Care facilities. A critical component will be

integrating patient data from basic care programs into the electronic record system that currently supports

patients on ART; this will allow better patient tracking and referral and allow the FPD clinical mentoring team

to also support patients on basic care.

FPD will contribute to the PEPFAR goals of 2-7-10 by developing the capacity of organizations to expand

access to ART services for adults and children, building capacity for monitoring ART service delivery and

Activity Narrative: reaching thousands of individuals with care and ART.

SUMMARY:

The program supports the expansion of access to comprehensive HIV and AIDS care by focusing on

service delivery and Human Capacity Development with a view to increasing the detection and treatment of

patients with TB and HIV coinfection. The emphasis areas for these activities are construction/renovation

and HCD. The target populations for these activities include people living with HIV and AIDS (PLHIV), and

most at risk populations.

BACKGROUND:

The Foundation for Professional Development (FPD) is a South African Private Institution of Higher

Education working exclusively in the health sector in Southern Africa. PEPFAR funding has allowed large

scale training and antiretroviral treatment to take place over the past year. FPD supports ART sites that are

in high TB prevalence areas with case rates ranging from 300-1500:100,000 and as such there is a need to

integrate TB and HIV services, improve the diagnosis and treatment of TB and provide training to health

care professionals on TB/HIV in FY 2008. FPD provided training to over 800 clinicians and nurses on the

management of TB/HIV during FY 06 and introduced programs in all the ARV clinics it supports to increase

the identification of TB/HIV co-infected individuals while in FY 2007 the emphasis is on strengthening TB

treatment sites with regard to identification of HIV co-infected individuals an initiation of ART at such sites.

Treatment related activities are closely coordinated with provincial Departments of Health (DOH) through

memorandums of understanding (MOUs) with provincial DOH and through close coordination with district

TB programs. National Department of Health (NDOH) guidelines are also incorporated in all activities and

training programs. A gender focus is built into all aspects of the project ranging from ensuring gender parity

in uptake of testing and treatment, including gender in data collection, all counselors will be trained on

aspects relating to male norms and behavior and equal access to training activities will be ensured. It is

envisaged that FPD will be the main project implementer; however, sub-agreements with CBOs and FBOs

may be used to increase community participation and to increase CT for TB and HIV. This project will place

specific emphasis on gender issues in the context of the CT activities. All CT staff will be trained and

provided with counseling tools in order to equip them to undertake couple counseling, identify, counsel and

refer victims of sexual abuse and violence, and reduction of stigma and discrimination. Most of these

activities will be aimed at strengthening the public healthcare system, promoting closer cooperation

between the public sector and civil society institutions, and developing human capacity. Activities will offer

sustainable and long-term benefits for the South African healthcare system.

ACTIVITIES AND EXPECTED RESULTS:

FPD will continue to work with the national and provincial departments of health and specifically with the

HAST (HIV, AIDS STI, and TB) managers to prioritize interventions designed to address weaknesses

(identified by the departments of health) in the DOTS and TB/HIV programs. FPD will focus on improving

policy adherence and patient follow-up. Individuals will be hired for each site as tracers to track patients and

ensure that referrals are completed. FPD is setting aside funding to develop (with other relevant partners or

agreement counterparts) standardized tools to ensure that policies and guidelines recommended by NDOH

are followed, including guidelines for infection control. FPD will continue to integrate TB/HIV interventions

with existing agreement programs as they work seamlessly and side by side with government employees at

government facilities.

ACTIVITY 1: Support to South African Government

PEPFAR funds will be used for human resources at public sector ART sites and surrounding TB clinics.

Funds will be utilized predominantly and in the form of salary support for FPD staff seconded to these sites.

Sustainability will be ensured through strengthening systems and developing and supplementing capacity of

existing government staff to increase identification of TB/HIV co-infected individuals, through promoting

routine HIV CT for TB patients and routine TB screening of HIV patients at ART treatment sites. This will

allow in time withdrawal of FPD seconded staff. Emphasis will also be placed on strengthening systems and

developing and supplementing capacity to increase identification of TB/HIV co-infected individuals, through

promoting routine HIV counseling and testing (CT) for TB patients and routine TB screening of HIV patients

at TB treatment sites. Dedicated and cross-trained TB/HIV counselors will be placed at all TB sites who will

actively promote CT among TB patients. TB Nurses will be deployed to all ARV sites and tasked with

increasing the diagnosis of TB, especially sputum-infected TB in patients receiving ART. TB screening will

be done by nurses following a protocol of history taking, routine sputum specimens, and x-rays as needed,

and suspected smear-negative TB will be referred to an infectious disease clinician. These dedicated

nurses will also ensure a fast track for patients requiring TB therapy and will maintain contact with patients

to ensure they are not lost to ART. Co-infected patients who are on ARV treatment and TB treatment

simultaneously will receive additional clinical monitoring due to the increased risk of Immune Reconstitution

Syndrome, and challenges in the profiling of side effects. Emphasis is placed on adherence support to

address the heightened risk of non-compliance due to high pill burden, and to cope with higher incidence of

side effects due to drug interaction and overlapping hepatotoxicity. This activity plays an institutional

strengthening role at TB sites with a view to such sites becoming ART down referral sites. PEPFAR funds

will also be used to address minor infrastructure needs e.g. sputum rooms, nebulization apparatus and

mobile x-ray facilities to improve the diagnosis and infection control of TB transmission. Funds will be

utilized for culture and sensitivity tests where MDR-TB is suspected if government protocols or facility

budgets do not make provision for such testing.

ACTIVITY 2: Outreach

Active TB case finding will be utilized at selected sites to increase uptake of TB and HIV testing among

contacts of patients with TB and HIV coinfection. Dedicated staff (mentioned in Activity 1) will actively trace

all contacts of TB patients on treatment to encourage the participation of these contacts in CT for both TB

and HIV. ACTIVITY 3: Human Capacity Development. This activity ensures a cadre of skilled healthcare

practitioners, in predominantly government service, who are able to provide care to PLHIV who are co-

infected with TB. Healthcare workers will be trained on various subjects such as: clinical management of

AIDS and TB, Management of CT, Palliative care, and Adherence and Workplace, using a proven short

course training methodology that provides training close to participants work. PLHIV form part of the faculty

to help with stigma reduction among participants and to articulate the needs of PLHIV. To maintain

Activity Narrative: knowledge, an alumni program of newsletters and regular refresher sessions has been developed. Given

the high risk that MDR-TB poses for immune compromised individuals, particular emphasis will be placed

on training facility managers, facility designers and clinical managers on infection control. Training takes

place in all provinces for both public and civil society organizations, for public sector training such training is

coordinated with relevant HR Departments. ACTIVITY 4: Referral and linkages. The strengthening and

expansion of referral networks and linkages with care and treatment services for clients identified TB/HIV co

-infected will be a central focus of the project. Linkages with community mobilization and outreach activities

will be initiated to promote the uptake of both TB and HIV CT services PEPFAR funds may be utilized in the

form of sub-awards for NGOs working in the field of DOT support and community outreach.

FY 2008 COP activities will expand on the activities successfully started in previous years. FPD will

contribute to the PEPFAR goals of 2-7-10 by developing the capacity of organizations to expand access to

ART services for adults and children, building capacity for monitoring ART service delivery and reaching

thousands of individuals with care and ART.

SUMMARY:

This Foundation for Professional Development (FPD) project focuses on promoting early diagnosis of HIV

as an entry point to wellness programs and access to prophylactic treatment. FPD will expand counseling

and testing (CT) activities through various models ranging from institutional based CT at antiretroviral

treatment (ART) sites to introduce new easily accessible CT at sites based in civil society e.g. pharmacies,

faith-based organizations (FBOs), tertiary academic institutions and private medical practices. FPD will

focus on offering routine CT (RCT) to all patients admitted to public sector hospitals where FPD supports

ART services. All patients who test positive will be referred to wellness programs to reduce loss to treatment

initiation. The emphasis areas are gender, human capacity development and local organization capacity

development. The activities will directly and indirectly target people living with HIV (PLHIV) and most-at-risk

populations.

BACKGROUND:

FPD is a South African private institution of higher education working exclusively in the health sector in

southern Africa. PEPFAR funding has enabled large-scale training and substantially increased access to

ART. FPD has not received PEPFAR funding for CT activities in the past, even though CT services are an

integral part of the comprehensive care package offered at a number of FPD-supported clinics since FY

2004. To date, FPD has provided training for approximately 800 clinicians and nurses on CT. Coordination

with provincial Departments of Health (DOH) takes place through Memorandums of Understanding (MOUs).

The project will focus on various gender-related activities. It is envisaged that FPD will be the main project

implementer, but given that this is a new project activity, sub-agreements with local non-governmental

organizations (NGOs) and FBOs may be used to increase community participation and to increase CT

services.

ACTIVITIES AND EXPECTED RESULTS:

FPD's activities will be aimed at strengthening the existing healthcare system, promoting closer cooperation

between the public sector and civil society institutions, and developing human capacity. It is expected that

all activities will offer sustainable and long-term benefits for the South African healthcare system.

ACTIVITY 1: Support to the South African Government at the sites where FPD is supporting treatment

activities

FPD will increase dedicated staff who will focus on expanding CT services for couples, infants and children

and adults, as well as cross-testing (testing STI and TB patients for HIV and vice versa). Dedicated CT

nurses and counselors will offer RCT for all patients moving through these healthcare facilities. Standard

registers and negotiated performance targets will be used to drive this activity and monitor its

implementation. PEPFAR funds will largely be used for human resources (e.g. nurses and lay counselors).

PEPFAR funds will also be utilized for training and to address minor infrastructure needs where necessary

for the delivery of CT services at government, NGO, and FBO sites. PEPFAR funds will be utilized for the

procurement and distribution of HIV test kits if necessary and may be utilized for CD4 count testing where

such tests are required to increase access to care.

ACTIVITY 2: Establishment of New CT Sites

FPD will introduce new civil society based CT services at easily accessible sites such as private medical

practices, private pharmacies, tertiary educational facilities, mobile testing sites and NGOs and FBOs. In

addition, FPD will expand of CT services in the existing treatment services sites. Outreach activities will be

introduced to create awareness of these services in the larger community with specific emphasis on at risk

groups and vulnerable populations. The introduction of new testing sites at NGOs, FBOs, student

healthcare services, private practices, and private pharmacies will ensure the widespread and sustainable

availability of CT services. Emphasis will be placed on promoting client-friendly rapid testing facilities. The

introduction of CT services in venues that are not perceived as having an HIV or AIDS connotation (private

pharmacies or private medical practices) will contribute to overcoming stigma induced barriers to accessing

CT due to fears of being seen at an "AIDS facility". Staff will be trained on proper recording and data

management.

ACTIVITY 3: Human Capacity Development

FPD will provide training in CT services for medical practitioners, lay counselors, and nurses to ensure strict

adherence to CT protocols and high quality counseling. This activity emphasize gender issues as all

participants and CT staff will be trained on couple counseling, identifying and referring of victims of sexual

abuse and violence, and stigma reduction. The program will address gender by creating an ARV-related set

of services that will increase gender equity through mitigating the burden of care on women. At the time of

CT and other ARV related services women will be identified and -- if they fit the profile -- will be referred to a

number of faith-based programs that also support the clinics and CT sites. These faith-based programs

provide women with resources ranging from accommodation, to nutritional support and job creation

programs. Male norms and behaviors are addressed in the counseling provided at these facilities and all

staff actively work towards reducing violence and coercion by identifying victims of violence. The FBO

partners provide a shelter for female victims of violence. Training takes place in all provinces for both public

and civil society organizations. For public sector training such training is coordinated with relevant human

resources departments

ACTIVITY 4: Linkages and Referrals

The strengthening and expansion of referral networks and linkages with care and treatment services for

clients identified as HIV-infected will be a central focus of the project. FPD will link with local CBOs, NGOs,

and FBOs to increase demand for CT services and to help with referral and follow up. All CT staff will be

trained on referrals and linkages. Each CT site will have a list of local service providers that patients can be

referred to. All referrals will be bi-directional and followed up to make sure that clients are accessing the

services and providers are providing the services. PEPFAR funds will largely be used for human resources

(e.g. nurses and lay counselors) in support of CT services.

Activity Narrative:

PEPFAR funds will largely be used for human resources (e.g. nurses and lay counselors) in support of CT

services. PEPFAR funds will also be utilized for training and to address minor infrastructure needs where

necessary for the delivery of CT services at government sites. The government will provide test kits at

government sites and kits will be purchased for use at non government sites. Funds may be utilized for CD4

count testing where such tests are required to increase access to care. FPD will also expand new civil

society based CT services at easily accessible sites such as tertiary educational facilities, NGOs and FBOs.

Outreach activities will be introduced to create awareness of these services in the larger community with

specific emphasis on at risk groups and vulnerable populations. The introduction of new testing sites at

NGOs, FBOs, student healthcare services will ensure the widespread and sustainable availability of CT

services. Emphasis will be placed on promoting client-friendly, provider-initiated, rapid testing.

The above activities will be continued in FY 2008. Activities will be expanded to at least 20 new sites in FY

2008.

SUMMARY:

The Foundation for Professional Development's (FPD) treatment activities focus on building public and

private sector capacity to deliver safe, effective and affordable antiretroviral therapy (ART). PEPFAR funds

will be used to procure ARVs and other drugs to support the expansion of faith-based organization (FBO)

treatment services in Pretoria (Gauteng province), one facility in the inner city and one in a nearby township.

Services will be expanded at the Pretoria Inner-City Clinic (PICC) in collaboration with a faith-based

coalition, the Tshwane Leadership Foundation and at Leratong Hospice. Both sites have been developed by

the not-for-profit private sector, and antiretroviral drugs will only be provided to residents who cannot access

public sector treatment for specific reasons. The Leratong Hospice will begin providing ART through

PEPFAR funding in 2007. For all of the Gauteng Department of Health (GDOH) facilities assisted by FPD

other than the PICC and Leratong Hospice, drugs are provided through the South African Government's

(SAG) ART roll-out program. The emphasis areas are construction/renovation, gender, human capacity

development (HCD) and local organization capacity building. Target populations for the activities include

the general population and people living with HIV (PLHIV). FPD will consider using the Partnership for

Supply Chain Management to assist with the procurement of drugs.

BACKGROUND:

FPD is a South African private institution of higher education working exclusively in the health sector in

Southern Africa. Previous PEPFAR funding has allowed the training of thousands of healthcare

professionals and supported the provision of ART to thousands of PLHIV in South Africa. It provides

assistance to over 25 large public sector ART roll-out facilities. Although the SAG has a robust ARV roll-out

program, it is not universally accessible. This project provides ART and related services to vulnerable

groups living in the inner-city of Pretoria and in one of the surrounding townships who cannot afford private

care and do not have access to public sector care due to factors such as long waiting lists, inability to pay

minimum public sector user fees, fear of discrimination, and stigma.

Started with FY 2006 funding, this project partners FPD in a strategic alliance with the Tshwane Leadership

Foundation and the Leratong Hospice who operate clinics that do not provide ARVs. Both partners are

FBOs that currently provide social welfare services to PLHIV in the city, including hospice care. FY 2006

funds were used at one of these facilities to serve as a rapid initiation and stabilization site for patients

whose lives are at risk due to long waiting lists. Negotiations are currently underway with the GDOH to have

these clinics accredited as down referral sites for the major ART clinics at Tshwane District Hospital and

Kalafong Hospital (both already supported by FPD). Every effort is made at all facilities to reduce stigma

through staff training, one-to-one counseling, and counseling for families and support groups. Sustainability

is partially addressed through the public-private partnership (PPP) with the Tshwane Leadership

Foundation. This organization brings together a large number of churches in the city and has access to

additional funding sources to support the project. In addition, the government supports all drugs and labs. It

is only at one clinic where FPD provides drugs. FPD is working on getting this clinic accredited so that the

provincial government will supply the drugs. FPD is also working with government to transfer responsibility

for salaries when positions are filled.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Procurement and Distribution of Drugs

These sites provide an integrated ART service including treatment, palliative care, wellness programs and

psychosocial support for adults and children, and income generation schemes for women. The sites have a

minimum target of 10% of patients who will be children. PEPFAR funds will be used for the procurement

and distribution of ARV drugs for the PICC and the Leratong Hospice, supporting the salaries of necessary

doctors, nurses, pharmacists, social workers, counselors, and administrative staff. This project has a close

working relationship with an FBO consortium that supports the community of the inner-city and it is

envisaged that they will provide palliative care services and psychosocial support. Subject to needs

assessments, PEPFAR funds may be used to address minor infrastructure needs. Technical assistance and

systems strengthening will be provided for forecasting drug needs, procurement, storage, and related data

systems.

ACTIVITY 2: Human Capacity Development

Human capacity development is promoted by requiring all clinical staff at the three sites to attend mandatory

training. Training for staff at these sites will include training on supply chain management to ensure proper

procurement and related systems. The pharmacist that will supervise dispensing at all sites will also receive

refresher training. As part of the overall FPD program, FPD training ensures a cadre of skilled healthcare

practitioners able to provide care to PLHIV. Healthcare workers are trained in various courses, including

clinical management of AIDS and TB, counseling and testing, palliative care, adherence and workplace

AIDS programs using a proven short-course training methodology. PLHIV form part of the faculty to help

with stigma reduction among participants and to articulate the needs of PLHIV. To maintain knowledge, an

alumni program including regular continuing medical education (CME) opportunities, meetings, journals,

newsletters and mentorship has been developed. This program provides alumni with membership in a

relevant professional association (Southern African HIV Clinicians Society). FPD's public-private partnership

(PPP) with Eskom (large power and utility company) and Discovery Health (private health insurance

company) also financially support this training. All staff at the three PEPFAR-funded facilities will access all

of the training opportunities.

ACTIVITY 3: Quality Assurance/Supportive Supervision

Quality assurance mechanisms developed through a strategic alliance with JHPIEGO will be expanded to

these sites. These quality assurance mechanisms allow clinic staff to rate all aspects of service delivery

from drug procurement to patient care. This process will lead to continuous improvement of quality and will

be rated once a year by an external consultant. In addition, monitoring of CD4 counts, viral loads, and

resistance testing are part of the monitoring system.

This project will contribute to PEPFAR's 2-7-10 goals by expanding access to ART services for adults and

Activity Narrative: children, by building capacity for ART service delivery including the provision of ARVs, and increasing the

demand for and acceptance of ARV treatment.

SUMMARY:

The Foundation for Professional Development (FPD) program supports the public sector expansion of

access to comprehensive HIV and AIDS care by focusing on provision of care, and through human capacity

development (HCD). Activities supporting improved and expanded service delivery in public sector ART

clinics include the provision of staff, clinical and management training, equipment, technical assistance,

mentoring, and refurbishment of facilities. Additional HCD activities include an international volunteer and

an intern program. The emphasis areas for these activities are Human Capacity Development, Local

Organization Capacity Building and Workplace Programs. Target populations for the activities include

people living with HIV (PLHIV) and the Business Community. The activities also target most at risk

populations.

BACKGROUND:

FPD is a South African private institution of higher education working exclusively in the health sector in

Southern Africa. Since FY 2005, FPD has supported treatment for thousands of PLHIV and training for

thousands of healthcare providers and managers delivering ART and related services. Coordination with

provincial Departments of Health (DOH) takes place through Memorandums of Understanding (MOUs).

FPD provides substantial assistance initially to public sector facilities and works towards a diminished role

over time, working towards sustainability at the sites. Sub-agreements are used for supporting a national

HIV consumer line (HIV 911). Gender issues are embedded in all aspects of the project and include

collecting gender specific data in treatment programs, linkages with NGOs working in the gender field,

counseling and testing (CT) services that specifically focus on couple counseling, domestic violence and

abuse detection.

Other issues addressed by this project are: 1) Male norms and behaviors that are addressed in the

counseling provided at ART sites. All staff actively work towards reducing violence and coercion by

identifying victims of violence; 2) stigma and discrimination is addressed in counseling and training

programs; and 3) volunteers, including Peace Corps volunteers, will be involved at treatment sites.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Support to Government ARV Clinics

PEPFAR funds are used to respond to requests from provincial DOH to support South African Government

(SAG) ART sites through temporarily seconding clinical and administrative staff, providing equipment,

refurbishment and technical assistance. The FPD-supported staff play a critical role in service delivery and

have been able to reduce waiting times to less than a week at most facilities. FPD works with each public

sector site to determine the number of staff needed, and the timeframe for transferring them into SAG

employment. Most sites provide an integrated system of treatment and prevention, including CT and

wellness services. These services emphasize adherence and promote ART services among referral clinics

(TB, STI & Family Planning). All sites are also linked to a system of dedicated tracers who follow-up on any

patients who drop out of treatment to determine reasons and where possible try to encourage patients to

return to treatment. All sites are pediatric treatment sites and a minimum target is set at 10% of patients.

FPD's support to SAG ARV clinics will expand substantially to include increased numbers of patients.

ACTIVITY 2: Human Capacity Development (HCD)/Clinical Training

This activity ensures a cadre of skilled healthcare practitioners able to provide care to PLHIV. Healthcare

workers will be trained in various courses (clinical management of AIDS and TB, CT, palliative care,

adherence and workplace AIDS programs) using a proven short-course training methodology that provides

training close to where participants work. PLHIV form part of the faculty to help with stigma reduction among

participants and to articulate the needs of PLHIV. To update knowledge, an alumni program including

regular continuing medical education (CME) opportunities, meetings, journals, newsletters and mentorship

has been developed. This program provides alumni with membership in a relevant professional association,

the Southern African HIV Clinicians Society. Eskom (large power and utility company) and Discovery Health

(large health insurance company) are in a PPP with FPD to financially support this training.

Training takes place in all provinces for both public and civil society organizations. For public sector training

such training is coordinated with relevant human resources departments.

ACTIVITY 3: HCD/Management Training

This activity addresses the severe shortage of skilled managers within the public, NGO and FBO sector to

manage rapid scale-up of AIDS care through a one year management training program, offered in

association with Yale University, designed to develop local organizational capacity. Students are recruited

through a competitive scholarship program and graduates are enrolled with the SA Institute of Healthcare

Managers to provide them access to alumni services. Quality assurance mechanisms for Activities 2 and 3

are those currently prescribed by the Council for Higher Education for SA Universities. Impact studies and

participant surveys and external impact assessments are also conducted on a regular basis to assess

relevance quality and impact. Results of these surveys are used to make revisions to the management

training program. The management training program will be expanded in FY 2008 to introduce a lower level

operational management course geared at clinic rather than program managers. A need for such training

has been identified during the past two years of management training that has shown that the skills needed

at the clinic manager level is much more operational rather than strategic, the current management training

program does not meet the specific need of this more junior level managers.

ACTIVITY 4: HCD/Internship Program

There is a growing need for rapid expansion of the development of human capacity to support ARV

treatment programs. Based on the success of the current internship program that improves the skills of

graduate students by partnering them with implementing PEPFAR partners or public sector institutions, FPD

will continue to support a formalized HCD Program. FPD is well placed for this activity as training and HCD

activities are FPD's core business. The USG PEPFAR Task Force is developing a more robust HCD

Activity Narrative: strategy, and this activity will contribute to that strategy. FPD will coordinate with universities and other

institutions to recruit interns and will mentor both the intern and the recipient organization to ensure that

interns are optimally utilized to promote treatment initiatives.

ACTIVITY 5: HCD/Placement Project

This activity further expands FPD's role in HCD in the public sector by providing a user-friendly recruitment

mechanism that attempts to meet severe shortages of healthcare workers in the public sector by recruiting

local and internationally qualified professionals against public sector funded vacancies, on both a

remunerated and voluntary basis. Support provided includes matching applicants with vacancies, fast-

tracking the registration of international participants and mentoring international recruits. Atlantic

Philanthropies, a charitable organization, funded the startup of this activity in 2006 through a public-private

partnership (PPP) with FPD.

ACTIVITY 6: HCD/Call Center/Clinical mentoring support

The call center will provide access for healthcare workers to infectious disease specialists, pediatricians and

clinical pharmacologists through a toll-free line for queries related to treatment and post-exposure

prophylaxis. This call centre closely cooperates with the HIV 911 Call Centre that handles consumer queries

for referral to AIDS service organizations in both the public and the civil society sectors.

FPD will contribute to the PEPFAR 2-7-10 goals by expanding access to ART services for adults and

children, building capacity for ART service delivery, and increasing the demand for and acceptance of ARV

treatment.

SUMMARY:

The Foundation for Professional Development (FPD) program supports the expansion of access to

comprehensive HIV and AIDS care by focusing on human capacity development (HCD). The project aims to

develop human capacity in strategic information (SI) at AIDS service organizations by having master's

degree fellows work for a six-month period on the monitoring and evaluation (M&E) systems of South

African PEPFAR partners. The emphasis areas for this activity are strategic information and local

organization capacity building. In FY 2008, this fellowship program has been offered to other PEPFAR

countries whereby they can provide funds to support fellows who are recent graduates of South African

universities but must return to their country of origin after they complete their coursework. This practicum

experience with a South African PEPFAR partner will provide them with skills for future work in M&E when

they return to their countries. FPD has also offered to teach other PEPFAR countries how to start a similar

program in their country. This new activity aims to improve south-to-south capacity development.

BACKGROUND:

FPD is a South African private institution of higher education working exclusively in the health sector in

Southern Africa. With PEPFAR funding, FPD supported treatment to thousands of people living with HIV

(PLHIV) and training for thousands of healthcare providers and managers. This activity, started in FY 2006,

supports the more formalized approach to human capacity development (HCD) needs in South Africa. It will

be scaled up through the FPD given their ability to expand to all universities. FPD, as a nation-wide training

institution, is well placed for implementation of this activity as training and other HCD activities are their core

business and FPD has well-developed relationships with other academic institutions in the country. These

relationships will create a conduit to recruit master's degree fellows from a variety of these institutions. FPD

also provides training to various PEPFAR partners and other health service institutions. FPD will facilitate

the placement of fellows with PEPFAR partners who need to strengthen their M&E capacity. With FY 2008

funding, FPD will support the expansion of access to comprehensive HIV and AIDS care by focusing on

HCD. In addition to training and mentoring, this activity will close the gaps in capacity in a number of South

African institutions implementing PEPFAR-funded activities. M&E expertise is lacking for many partners,

who must develop systems and overall capacity to document progress toward implementation of the South

African PEPFAR program. Emphasis will be placed on ensuring gender representation in the recruitment of

fellows.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Human Capacity Development

The project is aimed at improving the skills of graduate students at masters degree level who have a

specialization or interest in SI by partnering them with implementing PEPFAR partners or other related

AIDS service organizations. The fellows who will provide M&E and SI assistance and support to these

organizations will be recruited from South African universities that specialize in SI-related qualifications.

Both the fellows and the organizations will be technically supported by FPD, university and USG M&E staff.

In addition, an effort will be made to design projects that are of interest to the fellow, so both the

organization and the fellow will benefit.

ACTIVITY 2: Local Organization Capacity Development

The project further supports the ability of such organizations to engage in SI activities by providing them

with a fellow with specialized knowledge in SI related disciplines. The aim of the fellowship is not just to do

reports for the organization, but also to provide technical assistance in the development and maintenance of

M&E systems. It is required that the organization accepting the fellow has a full-time M&E Officer, so the

systems built during the fellowship are sustainable. Funding will be utilized to appoint a dedicated project

manager, pay stipends and transport costs for fellows and to allow FPD to coordinate with various

universities and recipient organizations with regard to recruitment, placement and evaluation of the

program. The sustainability component of this project revolves around the premise that some of the

recipient organizations will recruit the fellows at the end of their placement period. It is also expected that

fellows will have effected a substantial improvement in the strategic information capacity of the recipient

organization during their placement and that this improvement will be maintained after their departure.

FPD will contribute to the PEPFAR 2-7-10 goals by developing the capacity of organizations to expand

access to antiretroviral therapy services for adults and children, building capacity for monitoring ART service

delivery.