PHMI is a non-profit organization established in 2006, with a mission to improve quality of life through organizational capacity building and enhancing individual capacities of public health (PH) professionals. The goal of PHMI is to build human and organizational capacities improving systems for SI management, evidence based decision making, data based planning and program implementation by introducing scientific systems of needs identifications, assessments, trainings, building human capacities and addressing organizational challenges. The current focus of PHMI is on HIV/AIDS programs and related activities in Andhra Pradesh through PH trainings, providing consultants (India, AP and District), adopting scientific approaches for program planning, designing and implementation that emphasize the quality and standardization of healthcare delivery.

Objectives of PHMI:

1. To develop competency of PH workforce with special focus on HIV through:

i. The Public Health Field Leader Fellowship (PHFLF) program at State level, through the District AIDS and Prevention Control Unit's (DAPCU) capacity building initiatives at district level and the Data for Decision Making (DDM) training program for both the public and private. sector

ii. Short term trainings on Management, Communication, Advocacy, DDM, etc for district and state level managers

iii. Conducting continuing medical education and workshops encouraging the sharing of experiences and mainstreaming HIV interventions

iv. Creation of a virtual platform for information and knowledge-sharing among faculty, fellows and trainees

v. South to South collaboration: Provide assistance to state and national level PH workforce to gain knowledge from international field experience

2. Systems and policy strengthening by providing consultancy, manpower and TA to:

i. Local institutions such as Andhra Pradesh State AIDS Control Society (APSACS) and National Rural Health Mission (NRHM)

a. by placing technical experts as consultants for specific components under NACP III

b. by directly giving TA on various program components, activities or campaigns, data management, and analyses and dissemination in the context of program priorities

c. by assisting with quality documentation and reporting work

ii. NGOs (both USG and non-USG Partners) in AP and other areas in India

Key Ongoing Activities:

System strengthening through TA by providing domain experts as consultants for strategic and evidence-based planning and implementation, as a support to APSACS and other developmental partners in AP, specifically:

Consultants for (i) Surveillance, Monitoring and Evaluation (ii) Integrated Counseling and Testing Centre and (iii) DAPCU and NRHM Convergence programs

Developmental partners and Local NGOs are trained for implementing HIV programmes as per NACP guidelines through direct human capacity development. Domain Experts from developmental partners were also called for these trainings

Building human capacities of individuals and organizations for quality and standardized implementation of the NACP III program adapting scientific tools and instructional design-based approaches with National and State priorities. Activities under this include:

Capacity building of DAPCU staff: On the basis of scientific training needs assessment by PHMI, APSACS developed a strategy for capacity building of DAPCU staff in five different phases

A DDM Program based on international experience to provide both State and District level PH professionals with ongoing "in-service" technical training and mentoring assistance to use information and data for effective planning and program implementation

Short term trainings for various PH personnel and NGO stakeholders for effective program planning, management and implementation e.g. Epi-Info, Excel, Data management, TI program management, Program Management (PM) and DDM

Provide TA and trainings to support APSACS program managers in developing evidence-based decentralized action plans at the district level for implementation of HIV/AIDS services

South to South collaboration to facilitate various stakeholders' sharing of programmatic experiences in larger national and international forums and also towards providing opportunities for capacity building of said stakeholders

Develop a virtual and open source Learning Management System and web portal to share and disseminate various resources developed as well as a Public Health Human Resource Directory for AP to set up Human Resource Information systems within the State, as a model for larger replication.

Project Achievements and Innovations:

Continue to assist 3 consultants at APSACS providing technical support in program planning and implementation in areas of Surveillance/M and E, ICTC and DAPCU/ NRHM convergence.

Facilitated and provided TA to APSACS in decentralized evidence-based District Action Planning exercize with participation from approximately 1,400 HIV program staff representing 600 organizations, who are developing an evidence based State annual action plan for 2009-10.

Built capacity of all 23 districts' Additional District Medical and Health Officers (ADMHOs) in AP, and another 50 participants (Field Expert Group) for developing an evidence-based decentralized action plan.

Assisted APSACS in recruiting 69 DAPCU staff (1 per district), including District Programme Managers, M and E assistant and Accounts assistant.

Undertook orientation and induction training of all 69 DAPCU staff.

As a part of APSACS capacity building strategy, trained 22 DPM on NACO- Targeted Interventions (TI), STI components and 23 M and E assistants on NACO- Basic Services Division (BSD), Blood Safety (BS), Computerised Management Information System (CMIS) and Monitoring and Evaluation

Trained 89 participants from 64 TI NGOs on PM and 48 participants from various organisations on Epi-Info and Excel.

Initiated and completed one year PHFLF program with a batch of 25 PH professionals; Internal and Mid-term Reviews have also been carried out.

Provided TA for an integrated approach services mapping; training given to 65 outreach workers in one district of AP

Organized a media sensitization workshop for journalists focused on interpretation of essential HIV/AIDS information in India and AP.

SUMMARY

The National Program in India, under NACP-III, is increasingly prioritizing the use of data and information for program planning and designing. It is generating quality, reliable and complete programmatic data and feeding it back into the program to influence field level decisions. By doing so, effective evidence-based program planning, design, implementation, review and monitoring is seen as a key thrust area by Government of India (GOI) at the national and state levels.

SI support is continually a component of PHMI's efforts to strengthen National HIV program management at the national level and in USG priority states e.g. Andhra Pradesh (AP), Tamil Nadu (TN), Orissa, North-East (NE), among others. The activities are aimed at strengthening National Data and information management systems through various mechanisms; placing technical consultants for SI, conducting a review of existing HMIS, planning for redistribution of human resources and logistics, disseminating scientific information and latest updates on HIV/AIDS, building the capacity of the state and district-level staff from government and non-government sectors on data and information management. The following activities describe specifically the FY10 plan of PHMI:

Activity 1: TA/Consultancy to NACO, NERO & SACS (in AP, TN, Karnataka, NE states) and collaborative support with non-HIV stakeholders within the Government or NGOs

PHMI has a rich experience of providing direct TA at different levels, for different program priorities that include assistance for NRL and SRL assessment, scale-up of Link ART Center in AP; support to FEG in AP; preparation of District and Annual Action Plan (DAP & AAP); ongoing TA for data triangulation and epidemiological profiling at district level; assistance in scale-up of the private sector ICTC; piloting of lab certification in public sector; assistance for SHUBHAM in AP documentation, etc. In addition to those above, PHMI will continue to provide TA to various aspects of system strengthening like convergence of the National HIV program with NRHM; smooth functioning of supply chain system; data triangulation from surveillance, NFHS, routine program data and other sources, standardized scale up of ICTCs in private hospitals; quality assurance in Link ART Centers (LAC); private sector scale-up of care and treatment services; system for quality assurance for HIV testing; quality data management system particularly for surveillance; scientific and programmatic documentation / publication; HCD systems within the National program; building interest and providing support in evidence-based program planning and implementation for SACS and DAPCU staff etc.

Share India PHMI will explore areas of convergence and integration with existing non-HIV public health programs by collaborating with Government and developmental partners including WHO, ICMR, NIE, PHFI. Specific TA would be provided such as development of an effective mentorship program to guide and direct professional working in the field; Collaborating with organization like ICMR and facilitating the application of research knowledge and theories in to practical real life settings; Providing managerial skills training to public health professionals in order to strengthen their team building leadership, interpersonal, effective communication skills and program management competencies.

By collaborating with the leading institutions and agencies listed above, it would be practical to then draw on the expertise and valuable inputs of these institutions and staff, which will help in empowering the professionals working in the program technically, managerially and programmatically.

Activity 2: Consultants & Experts as staff for TA to and at NACO, NERO & SACS (in AP, TN, Orissa, NE States)

SHARE India PHMI, in consultations with CDC and NACO, will utilize additional staff as consultants and technical experts to provide programmatic and technical assistance, which will focus on convergence of core areas of national HIV/AIDS program such as: RTI/STI management; Condom Promotion; VCT; PPTCT; BCC; Blood Safety; Training; and HIV data/Information Management Systems in to NRHM, HCD trainings, strategic information, supply chain management to forecast for HIV drugs, laboratory reagents, equipments and commodities ensuring overall compliance with corporate assets management, HIV testing quality assurance in ICTCs, ART program quality assurance, Centers of Excellence and others.

The role of these consultants will be to provide TA to programs and their staff, in terms of strengthening program design, planning, implementation, review, monitoring and supervision. The broader goal will be to establish sustainable systems with adherence to national guidelines and build in-house capacities of the host government and program staff through mentoring, on-the-job training assistance and supportive supervision.

Activity 3: Public Health Fellowship on HIV/Public Health Management

Public Health Field Leaders Fellowship (PHFLF) deals with the science, skills and practices of public health for mid-career professionals working in the field of HIV program planning, monitoring and implementation. The program will be conducted in collaboration with PHFI. It is a one year on-the-job training program with six contact weeks (following a particular theme such as project management, communication and advocacy, prevention and behavior change, Continuum of Care, community assessments, science-based interventions design, and evidence-based planning) with distance learning assignments and background reading material. To maximize synergy of the contact courses, Fellows will be assigned an advisor who will serve as a mentor throughout the entire course of study.

This program adopts its training culture from CDC-FETP and DDM program. During the course of this funding, alternate ways of conducting FETP program for non-government sector with exchange of technical resources and innovative costing mechanisms will be identified. The objective is to expand the reach of this high quality training beyond public sector because Public Health programs as well as health care seeking practices in India are now occurring largely in non-public health sector.

Activity 4: Training on DDM for District and State level staff

Competent staff is important for NACP III's strategic thrust on evidence-based program planning in a decentralized setting. Using data for making decisions is important for program managers in meticulous planning and decision making for current programs based on available data. SHARE India will conduct training programs on Data for Decision Making (DDM) for district and state level staff from the government and non-government sector. The curriculum will be developed after scientifically assessing participant's needs. Major curriculum areas include development of skills on project management, community assessment, science-based interventions design, and evidence-based planning.

This primary focus of the DDM on-the-job trainings rests on five core areas: advanced concepts of planning/formulation of District Action Plan (DAP), implementation of DAP, supportive supervision, communication, advocacy and program management. Faculty, trainers and trainees will be supported by web-based distance learning modules and an online repository of documents.

Activity 5: Technical assistance to Districts for District Level Program Management

Based on the success of Field Experts Group (FEG), a concept during development of state and district level action plans for 2009-2010, with APSACS, PHMI envisages giving continuity to the FEGs with a redefined role of providing TA to the Districts and new district- level staff to implement, manage, review, monitor and supervise the programs. Accordingly, PHMI will undertake the following specific activities:

a) Strengthening of FEGs- to focus on implementation of NACP III at district-level who will play an important role in mentorship and supportive supervision of DAPCU staff. The group of experts will be brought in on a voluntary basis to support DAPCU.

b) Mentors training and Periodic workshops- Training of Trainers (ToT) and refresher trainings will be conducted for FEGs to refine their approach towards field mentoring exercise. PHMI will sponsor FEGs for various trainings, workshops or seminars for new ideas and capacity building, based on their performance and rapport with district staff.

Activity 6: Technical Workshops for disseminating and sharing information on HIV, Health and Public Health science:

The main objective of technical workshops is to disseminate data, evaluation reports and best practices on HIV/AIDS-related information to understand public health status in AP, TN, NE states and Orissa.

The target group includes state health department officers, NRHM and APSACS officials, DAPCU team, public health experts, field level coordinators, district level program officers, health and management institutional heads, training officers of government, non- governmental institutions working in Health sector and the state and district level positive network representatives.

PHMI will organize two such workshops in the year 2010-2011. These workshops will be conducted in collaboration with various public health academic, training and research institutions like IIPH, ASCI, HIS and leading universities such as Osmania and Pune. PHMI will undertake two dissemination workshops to share the findings of processes, output, outcome evaluation reports and best practice learning documents.

SUMMARY

Share India under this grant has the mandate and a major goal of building organizational strengths through capacity building of program staff, managers, and to provide technical support and information sharing. Developing robust, sustainable systems and sound manpower to manage them is essential and PHMI will focus on activities to address the two. Creating platforms for mutual sharing of information and ideas is an important task in this sector. PHMI through the activities listed below, aims to achieve the above stated broader goal of building organizational, as well as human capacity for strengthening systems for HIV programming in AP and beyond.

Activity 1: TA/Consultancy to NACO, NERO & SACS (in AP, Tamil Nadu, Karnataka, North East states) and collaborative support with non-HIV stakeholders within the Host Government or NGOs

PHMI has a rich experience of providing direct TA at different levels, for different program priorities: Assistance for NRL and SRL assessment; Scale up of Link ART Center in AP; support to FEG in AP; preparation of District and Annual Action Plan (DAP and AAP); ongoing TA for data triangulation and epidemiological profiling at district level; assistance in scale-up of private sector ICTC; Piloting of Lab certification in public sector; and assistance for SHUBHAM in AP documentation. In addition to above, PHMI will continue to provide TA to various aspects of system strengthening: convergence of the national HIV program with NRHM (by collaborating with the host government and developmental partners including WHO, ICMR, NIE, PHFI); smooth functioning of supply chain system; data triangulation from surveillance, NFHS, routine program data and other sources, standardized scale up of ICTCs in private hospitals; quality assurance in Link ART Centers (LAC) ; private-sector scale up of care and treatment services; system for quality assurance for HIV testing; quality data management system particularly for surveillance; scientific and programmatic documentation/publication; HCD systems within the national program; building interest and providing support in evidence-based program planning and implementation for SACS and DAPCU staff etc.

Specific TA would be provided in arenas such as, development of an effective mentorship program; collaboration with organizations like ICMR, and facilitation of the application of research knowledge and theories in to practical real life settings; providing managerial skills training to public health professionals in order to strengthen their team building leadership, interpersonal, effective communication skills and program management competencies.

Activity 2: Consultants & Experts as staff for Technical Assistance to and at NACO, NERO & SACS (in AP, Tamil Nadu, Orissa, North eastern States)

SHARE India PHMI, through consultations with CDC and NACO, will place additional staff as consultants and technical experts to provide programmatic and technical assistance, which will focus on convergence of core areas of National HIV/AIDS program like RTI/STI management, Condom Promotion, VCT, PPTCT, BCC, Blood Safety, Training, and HIV data/Information Management Systems in to NRHM, HCD trainings, SI, Supply chain management to forecast for HIV drugs, laboratory reagents, equipments and commodities ensuring overall compliance with corporate assets management, HIV testing quality assurance in ICTCs, ART program quality assurance, and Centers of Excellence.

The role of these consultants will be to provide TA to the program and its staff in terms of strengthening program design, planning, implementation, review, monitoring and supervision. The broader goal will be to establish sustainable systems with adherence to national guidelines and build in-house capacities of the host government and program staff through mentoring, on-the-job training assistance and supportive supervision.

Activity 3: Public Health Fellowship on HIV Management

Public Health Field Leaders Fellowship (PHFLF) deals with the science, skills and practices of public health for mid-career professionals working in the field of HIV program planning, monitoring and implementation. The program will be conducted in collaboration with PHFI. It is a one year on-the-job training program with six contact weeks (following a particular theme such as project management, communication and advocacy, prevention and behavior change, Continuum of Care, community assessments, science-based interventions design, and evidence-based planning) with distance learning assignments and background reading material. To maximize synergy of the contact courses, fellows will be assigned an advisor who will serve as a mentor throughout the entire course of study.

During the course of this funding, alternate ways of conducting FETP program for the non-government sector with exchange of technical resources and innovative costing mechanisms will be identified. The objective is to expand the reach of this high quality training to beyond public sector because public health programs, as well as health care seeking practices, in India are now occurring largely in non-public health sector.

Activity 4: Training on DDM for District and State level staff

Competent staff is needed for NACP III's strategic thrust on evidence-based program planning in a decentralized setting. Using data for making decisions is important for program managers in meticulous planning and making decisions for current programs based on available data. SHARE India will conduct training programs on Data for Decision Making (DDM) for district and state level staff from government and non-government sector. The curriculum will be developed after scientifically assessing participant's needs. Major curriculum areas include development of skills on project management, community assessment, science-based interventions design, and evidence-based planning.

This primary focus of the DDM on the job trainings is on five core areas: advanced concepts of planning/formulation of District Action Plan (DAP), implementation of DAP, supportive supervision, communication, advocacy and program management. Faculty, trainers and trainees will be supported by web based distance learning modules and an online repository of documents.

Activity 5: Human Resource Information Systems (HRIS)

PHMI had identified the need for a strong human resources information directory and management system to allow program leaders and managers to quickly assess key training requirements, gaps and redundancies within program and staff needs. This directory will enable decision makers to create informed, effective strategic plans to ensure a steady supply of trained health professionals and deploy human resources in the correct positions and locations to meet health care needs,

The HRIS strengthening process is designed to foster better understanding of the current health workforce picture in AP. This will prepare decision makers to effectively plan for recruitment, training, retention and replacement of health professionals.

The HRIS system will enable decision-makers to obtain data about domain-wise expertise available in the state.

Activity 6: South to South Collaboration

South-to-South partnerships create an effective platform for building sustainable institutional and human-resource capacity through open exchange of knowledge, information, and professional experience. A regional collaboration will add an important dimension into training program; an international problem-oriented perspective, to enable training of specialists in a multi-disciplinary fashion with a broader target-oriented framework.

PHMI will continue to assist the state and national-level public health workforce to share experiences at the international level preferably with other USG partners in the South focusing on areas of HIV prevention, care, strategic information and systems strengthening. PHMI is promoting south to south faculty and student exchange programs between India and other countries and will encourage public health experts to go for study tours, meetings, conferences, and other related short-term trainings.

Activity 7: Instructional Design Trainings

The training on instructional design will be conducted for staff working with NACO, NERO and SACS in priority states. The primary objective is to introduce scientific and pedagogical practices and applications into planning, designing, implementing and evaluating training programs for any cadre of staff, irrespective of the topic, theme or content of the training. The training will be conducted in collaboration with TSU, NIE, GHTM, PHFI and NIHFW. The participants of these training programs will be deputed as master trainers in their field to design and impart training to staff working in their area to strengthen the HIV program at national or state level.

Activity 8: Technical assistance to Districts for District Level Program Management

Based on the success of Field Experts Group (FEG) a concept during development of state and district level action plans for 2009-2010 with APSACS, PHMI envisages giving continuity to the FEGs with a redefined role of providing TA to the Districts and new district level staff to implement, manage, review, monitor and supervise the programs. Activities for this include:

a) Strengthening of FEGs- to focus on implementation of NACP III at district level who will play an important role in mentorship and supportive supervision of DAPCU staff. The group of experts will be brought in on a voluntary basis to support DAPCU.

b) Mentors training and Periodic workshops- ToT and refresher trainings will be conducted for FEGs to refine their approach towards field mentoring exercise. PHMI will sponsor FEGs for various trainings or workshop or seminar for new ideas and capacity building based on their performance and rapport with district staff.

Activity 9: Web based LMS and Video Conferencing

With increasing need for evidence-based planning and building human resource capacities, sharing knowledge, information and data in an objective, demand driven, and easily accessible manner is a priority in India. The Learning Management System (LMS) is one such web based technology within organization, to collate and provide training courses, knowledge and information online, free of cost to all. Through video conferencing, PHMI plans to provide trainees an opportunity to participate in 2-way communications with resource persons and co-participants. Through this initiative, participants from diverse communities, regions and backgrounds can come together on a single platform ensuring hassle-free learning.

Activity 10: Conference on HIV

As a part of its mandate to provide TA at different levels, PHMI will conduct conferences on HIV- related aspects, which will involve stakeholders, in addition to national and international experts contributing experiences and evidence-based knowledge. The conference would be designed to identify and prioritize various HIV programmatic needs and assist people working in HIV/AIDS programs to develop, manage, and sustain effective and efficient programs guided by validated evidence and findings.

This conference will be unique in providing an opportunity for Public health leaders and decision makers to collaborate face to face. The conference will offer exhibiting opportunities for national, state and district level agencies, public and private corporations and foundations, AIDS service organizations, and pharmaceutical companies.

Activity 11: Technical Workshops for disseminating and sharing information on HIV, Health and Public Health science:

The main objective of technical workshops is to disseminate data, evaluation reports and best practices on HIV and AIDS related information to understand public health status in AP, TN, NE states and Orissa.

The target group include state health department officers, NRHM and APSACS officials, DAPCU team, public health experts, field level coordinators, district level program officers, health and management institutional heads, training officers of government, non- governmental institutions working in the health sector and the state and district level positive network representatives.

These workshops will be conducted in collaboration with various public health academic, training and research institutions like IIPH, ASCI, HIS and leading universities like Osmania and Pune. PHMI will undertake two dissemination workshops to share the findings of process, output/outcome evaluation reports and best practice learning documents.

Activity 12: Short term thematic in-service trainings for HIV Program managers

As mentioned, NACP-III and NRHM thrust upon strategic decentralization of program plans. PHMI plans to act as a means of enhancing the capacity in terms of management of programs, different components within NACP III, data management, finance management, communication and advocacy and human-resources through STT. The trainings will deliver stand-alone packages on HIV program management development programs with a variety of topics. Some examples include: training on project management, data management, hard skills like Excel, Epi-Info, Power-point, SPSS etc; communication and advocacy; and scientific writing skills and documentation.