Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015 2016 2017

Details for Mechanism ID: 12307
Country/Region: Ethiopia
Year: 2010
Main Partner: Pathfinder International
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $452,300

Mechanism Narrative:

Pathfinder has developed an efficient, cost-effective and sustainable strategy to increase access to and use of cervical cancer prevention services among HIV positive women in Ethiopia. Pathfinder will build upon its extensive and strongly-rooted USAID-funded reproductive health and HIV/AIDS activities in Ethiopia and close working relationships with the MOH at national, regional, and community levels. Pathfinder will continue to pilot and document whether an integrated, single-visit approach to cervical cancer screening and treatment is safe, acceptable, and feasible in 14 health facilities providing HIV care and treatment. These facility-based activities will be complemented by community-based sensitization and mobilization as well as system-level leadership and facilitation aimed at integrating cervical cancer prevention into the national HIV care and treatment plan. Pathfinder will partner with the SPIRES program at Stanford University's School of Medicine to bring technical knowledge, evidence-based training materials, and established base of experience in introduction of VIA and cryotherapy to low-resource settings.

Geographic scope: The regions of Addis Ababa, Amhara, Oromia, Tigray, and SNNPR have been targeted for the pilot project based on: 1) higher HIV prevalence and burden (collectively they account for >90% of the HIV epidemic); 2) greater availability and uptake of HIV care and treatment services; and 3) existing human resources and infrastructure. Final selection will be made in close collaboration with national and regional stakeholders, including the MOH, Regional Health Bureaus (RHBs), the cervical cancer TWG, HIV care and treatment implementing partners, and other key stakeholders. Pathfinder is currently working in these regions and has close working relationships with the RHBs, Woreda health offices, and at the community level.

Pathfinder will build on its existing strategic alliances to collaborate with the MOH, RHBs, hospital managers, USG implementing partners, and professional organizations (such as the Ethiopian Society of Obstetricians and Gynecologists and Ethiopian Nurses Association) to: 1) identify national, regional and local champions and empower them with credible evidence on cervical cancer; 2) foster discussions around the scientific evidence of the single-visit approach and its potential impact on improving HIV care in Ethiopia; and 3) organize attention-generating events to create national, regional, and local visibility on the issue. Pathfinder will take the lead in convening a National Cervical Cancer Technical Working Group, which will develop standard operating procedures and clinical protocols for integrating the single-visit approach, as well as partnering with the MOH and other relevant stakeholders to revise the existing reproductive health strategy and palliative care training materials to include prevention and treatment of cervical cancer for women living with HIV.

Pathfinder's M&E system is three-pronged to: 1) monitor performance, 2) support stakeholder use and mid-course corrections, and 3) evaluate impact, to allow M&E results to guide project management and program improvement, as well as meet reporting requirements to CDC and satisfy information needs of stakeholders. The project's M&E system will measure, analyze, interpret, and report on program results in a way that provides accurate and useful information at all levels. Data obtained will be used to assess and report on the extent to which the program achieves its desired results, providing CDC, GOE, and partners with a record of evidence-based progress, outcomes, and lessons learned. Partners and stakeholders will be involved during all phases of M&E activities to instill ownership of the process, avoid duplication of effort, and ensure better use of the resultant data. In addition, monitoring data will be used to ensure transparency of operations toward project beneficiaries as well as other stakeholders.

Funding for Care: Adult Care and Support (HBHC): $452,300

In FY 2009, Pathfinder and SPIRES partnered with facility-based, government, and community partners to build the system and technical foundation needed for introducing the single-visit approach, including establishing five Regional Cervical Cancer Prevention Centers of Excellence (COEs). Selection of sites for COEs is participatory, involving the MOH, RHBs, the cervical cancer TWG, and regional HIV care and treatment implementers. The Regional COEs serves three important roles as: 1) service delivery models for integration of cervical cancer screening and treatment into HIV care; 2) training centers for cervical cancer screening and treatment; and 3) referral facilities for women with advanced cervical cancer or complicated cases.

In COP 2010, Pathfinder will expand to nine additional health outlets, implementing the procedures, training, referral mechanisms, and lessons learned from the COEs, and adapting them as needed to the new sites. The selection of these sites will be made collaboratively with key government, technical, and community stakeholders.

Pathfinder will focus on institutionalization and refinement of the single-visit approach and its associated procedures via on-going supportive supervision and feedback from monitoring data. Pathfinder applies international best practices and "safe, acceptable, effective, and pragmatic public health approaches." These include: supporting comprehensive facility services for quality and impact; building community education, support, and linkages; and establishing strategic alliances and partnerships.

Pathfinder will continue to support comprehensive facility services for quality and impact.

In COP 2010, master trainers will train provider teams from the nine new pilot facilities. Pathfinder and the regional stakeholders will support trained staff at each facility to integrate and introduce the single-visit approach and to provide referrals for advanced cases. Thorough analysis of monitoring data collected during site development, training and implementation will take place and results and lessons learned will be used to strengthen implementation of cervical cancer screening and treatment across all 14 sites. The partner being within PEPFAR will play its part in Global Health Initiative.

Subpartners Total: $0
Stanford University: NA
Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services
Safe Motherhood
Family Planning