Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 7410
Country/Region: Ethiopia
Year: 2007
Main Partner: Johns Hopkins University
Main Partner Program: JHPIEGO
Organizational Type: University
Funding Agency: USAID
Total Funding: $500,000

Funding for Health Systems Strengthening (OHSS): $500,000


Table 3.3.15: Program Planning Overview Program Area: Management and Staffing Budget Code: HVMS Program Area Code: 15 Total Planned Funding for Program Area: $ 13,563,095.00

Program Area Context:

MANAGEMENT AND STAFFING: Current Program Context

The Emergency Plan budget experienced an unexpected increase from $120M in FY06 to $210 for FY07.

The USG Team is fortunate to have a very close and productive working relationship with the Ethiopian Federal Ministry of Health.

Within the US Mission, the PEPFAR team, as representative of the Office of Global AIDS Coordinator, leverages the strengths, expertise and traditional relationships of the USG partners to build host nation capacity in both private and public sectors. Of our two leading USG team members, CDC is almost exclusively focused on PEPFAR implementation whereas USAID, with many years in Ethiopia, manages PEPFAR activities as one of several programs in its health portfolio. At DoD, PEPFAR is managed by the security office. With the return of Peace Corps, 40 volunteers will join the team and provide critical support to bridging the literal and figurative distance between hospitals and health centers.

The current Charge d 'Affaires, has delegated PEPFAR oversight to the Deputy Chief of Mission. A country coordinator joined the PEPFAR country team in January 2006.

Construction of a new embassy compound, to house the entire USG mission, will begin in 2007. In preparation, the State Department required the mission to undertake a "rightsizing" exercise". Proposed PEPFAR positions, as all new ones at the mission, must fit within the plan adopted in April 2006. The team will aim to fill existing vacancies before new positions, some of which will be limited appointments.

To improve program management, the PEPFAR Team (1) holds quarterly meetings with all partners to identify shared concerns, improve monitoring, and deepen its commitment to a shared vision; (2) works on transparent management processes, (3) holds monthly meetings of the PEPFAR executive council and quarterly joint meetings of the executive council with the collaborative team; (4) uses as a management and communications tool; (5) applies consensus decision-making to improve interagency synergy and nurture team unity; and (6) holds an annual retreat in which challenges are addressed and the team structure is reviewed and updated to reflect changing circumstances and OGAC guidance.

There are excellent coordination mechanisms at technical and policy levels for government and donor relations. The USG team has an excellent relationship with MOH and members sit on various government bodies. The Deputy Director for Programs at CDC is the team representative to the Global Fund's Country Coordinating Mechanism. In FY07, further efforts will be taken to expand on these and donor relationships. Creation of a Government Relations Working Group is under consideration.

A comparative advantage is PEPFAR Ethiopia's operational structure (Executive Council, Coordination Office, Collaborative Team, Technical, Public Diplomacy and Management Working Groups). It consists of the Deputy Chief of Mission who is the Chief of Mission's designee, Country Directors of CDC and USAID, a DOD representative. The Peace Corps director will join the team. The country coordinator serves as its ex-officio secretary.

The executive council serves to (1) provide strategic direction and policy guidance (2) recommend to the COM, the proposed annual Country Operational Plan and Semi-annual and Annual Program Results Reports (SAPR / APR); (3) review recommendations endorsed by the collaborative team; (4) provide review and feedback; (5) arbitrate disagreements from working groups or the collaborative team; and (6) identify and submit appropriate issues for resolution to the COM.

Four technical working groups - Prevention, Care & Support, Treatment, and Strategic Information --

provide the technical leadership and program coordination in their respective areas. Two additional working groups assist in areas of public diplomacy and management. The working group chairs have a clear set of duties: to facilitate COP planning within their technical areas, coordinate with other TWG to address cross-cutting issues; ensure partners' representation through sub-working groups; disseminate information; identify technical assistance needs; represent the TWG on the Collaborative Team; participate in national and regional forums and working groups; ensure their TWG has access to information regarding OGAC and PEPFAR Ethiopia guidance, and provide briefing notes and other TWG documents to the Collaborative Team. All USG agencies are represented on the six working groups.

The Collaborative Team is comprised of the chairs of all working groups, the USAID HIV/AIDS team leader, CDC Deputy Director of Programs, and a representative of the Population, Refugees and Migration Office. The chair is the Country Coordinator. The Team is at the core of PEPFAR in country because the chairs, and by extension, the working group members, are responsible for planning, overseeing implementation, evaluating and confronting challenges, and monitoring the program to maximize its synergy with the government's strategic plan. It meets weekly.

CDC has strong ties to the Ministry of Health and is focused on strengthening Ethiopia's health sector response to the epidemic through science-based technical guidance. CDC has comparative technical advantage in the areas of blood safety, ARV services, laboratory infrastructure, and strategic information. Its care and treatment efforts concentrate on strengthening comprehensive hospital-based services. It also coordinates closely with USAID in many other HIV areas.

USAID's role in the implementation of the network model is focused at the health center and community levels. Its experience working with communities has definite short- and long-term advantages for PEPFAR. USAID has a comparative advantage in the multi-sector approach to HIV/AIDS program development. It provides critical administrative functions including procurement, financial management, donor coordination, monitoring and evaluation, and contracting needed for rapid program scale-up. The USAID PEPFAR team spans a wide range of expertise including child survival, nutrition, training and education, malaria, health economics, and food security.

The proposed Management and Staffing budget is below 7% of the total FY07 budget.

Table 3.3.15: