Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014

Details for Mechanism ID: 13183
Country/Region: Democratic Republic of the Congo
Year: 2013
Main Partner: Programme National de Lutte contre le VIH/SIDA et IST/ National AIDS Control Program - DRC
Main Partner Program: NA
Organizational Type: Host Country Government Agency
Funding Agency: HHS/CDC
Total Funding: $499,000

IM 14824: OVERVIEW NARRATIVE

The first component of PNLS activity is aimed at providing reliable and accurate HIV data for planning and evaluating the impact of the HIV/AIDS interventions in DRC by conducting consecutive annually rounds of ANC sentinel surveillance targeting pregnant women. Reports including HIV prevalence trends will be produced and disseminated among the MOH and all the stakeholders for planning and program evaluation purposes.

The second component focuses on the setting up and the management of an unique countrywide reporting system using standardized forms starting at service delivery points, at the intermediate level to the central M&E level at the PNLS. This information will be made available through a web-based reporting system. The system will be led by the PNLS, as the National Control Program and will therefore be used throughout the country in order to have reports on-time, avoid reporting delays and make DRC's relevant data available for PEPFARs partners and all stakeholders.

The third component is to develop and manage a quality assurance system at the national referral lab (the lab branch of the PNLS) which will provide QA/QC services through 3 of its provincial labs and subsequently to some labs involved in HIV testing and HIV /AIDS disease monitoring.

PNLS will work closely with CDC/DRC and key partners to achieve the goals of this project. For this purpose, a focus will be maintained on the strengthening capacity of the PNLS in PEPFAR program management.

Finally, in the framework of the PMTCT Acceleration plan, the PNLS will ensure QA/QC services to PEPFAR-supported sites, through its lab branch, the national referral lab (NRL) and will monitor the efficacy of interventions by conducting pediatric HIV surveillance activities in

Funding for Laboratory Infrastructure (HLAB): $250,000

The third component is to develop and manage a quality assurance system at the national referral lab (the lab branch of the PNLS) which will provide QA/QC services through 3 of its provincial labs and subsequently to some labs involved in HIV testing and HIV /AIDS disease monitoring.

To accelerate the setup of national laboratory network with an efficient quality control system.

This activity will strengthen the capacity of the National referral laboratory of PNLS (NRL) to better play its role of ensuring quality assurance of lab activities. Thus, It will support the QC of lab analysis performed by 09 health facilities located in 3 PEPFAR supported-provinces (Kinshasa, Katanga and Orientale). The main activities will consist (1) in preparing and sending each month the DTS panels (a set of 6 samples) to the lab of the selected health facilities. They wil perform analysis on the DTS; they will re-send DTS results and additional DBS samples to the NRL for control and feedback.

(2) support the 09 health facilities in providing lab reagents and other materials for avoiding stock-outs.

(3) in conducting regular sites formative supervision (on-site mentoring each quarter). Findings from QC will determine the kind of training needed for improving on-site lab analysis.

(4) in purchasing a laboratory software for lab data management system. It will permit a better lab data record keeping, analysis and using for decision-making.

and (5) in strengthening lab staff capacity in data management.

Funding for Strategic Information (HVSI): $249,000

The first component for the program is related to the conduct of ANC sentinel surveillance activities. The overall aim of establishing routine sentinel surveillance among ANC attendees in DRC is to collect data for the estimation of HIV prevalence rates. In addition, it is in line with the 2011-2015 national strategic plan. It relies on a cross-sectional, biological survey using the UAT approach. Due to ethics issues, in 2012, PNLS will start in 9 pilot sites offering quality PMTCT services and enrolled in QA/QC program, equally to collect data in order to assess the feasibility of using PMTCT program data for surveillance purpose by comparing them with data yield by routine UAT methodology. In addition, the number of sentinel site will increase from 47 to 54 throughout the country among them 70% will be located in rural areas. This is to be consistent with the geographical split of the population in DRC. To strengthen the capacity of the PNLSs Surveillance team, they will attend regional trainings such as the 2013 Regional Meeting on updating of HIV prevalence estimates and projections (EPP Spectrum).

The second component focus on the setting up and the management of an unique countrywide reporting system using standardized forms starting at service delivery points, at the intermediate level to the central M&E level at the PNLS to improve the accuracy, reliability, timeliness, completeness and the precision of the data produced for decision-making.

The reporting system is a critical HIV M&E tool linked to the National Health Information System comprised of in the 2011-2015 National Health Development Plan. It aims to facilitate the collection, transmission, analysis and the dissemination of routine HIV program data and the results of relevant surveillance surveys.

For COP 12, activities will be focusing on updating and standardizing data collection and reporting tools and building capacity of MOH staff at all level (Health District, Province and Central).

In addition, the PNLS will also support the organization of monthly meeting organized for validation of data at all level prior to their posting at the web.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $0

In DRC, there is little capacity to follow HIV exposed babies at maternities and as such they are referred to specialized centers based on a family care model. Due to several factors, including the low coverage rates of PMTCT, rates of EID are low as are the number of infants on ART.

However, as a key component of PMTCT for diagnosis and treatment, laboratory capacity for providing an HIV test within 12 months of birth to infants born to HIV positive women must be enhanced.

Currently all the specimens are tested at the national referral lab (NRL) that is the single unit running the EID in the country. This lab was appropriately equipped with CDC support and thanks to PEPFAR, lab reagents and other consumables are somehow provided. However, it faces the daily challenges of a shortage of test kits, an inconsistent supply of reagents, and frequent electricity supply interruption.

There is also a provincial referral lab in Lubumbashi, not fully functional but equally equipped and staffs trained that can be leveraged for long term scale up of EID services.

Furthermore, with PEPFAR support, a QA/QC process targeting 9 sites started in FY 12, but the national referral lab (NRL) did not have the capacity to scale-up.

With the PMTCT acceleration plan opportunity, in FY 2012, the national referral lab (NRL) in Kinshasa and the provincial lab in Lubumbashi (Katanga) will be technically and financially supported in order to expand EID services (create a system of referral documentation and follow up for all mothers and infants who need ART in place and utilized by PEPFAR-supported sites, develop and adopt a national HTC curriculum including QA at point of care for HIV rapid testing, etc.) and scale up QA/QC activities for HIV testing, EID and CD4 testing capacities to PEPFAR supported sites in Kinshasa and in Lubumbashi.

The second main activity for evaluating efficacy of the PMCT acceleration interventions will be the rolling out of routine pediatric HIV surveillance activities in some selected MCH facilities in Kinshasa. The overall methodology will consist in estimating HIV prevalence trends in using for testing purpose the leftover blood drawn from babies for routine testing.