Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 12406
Country/Region: India
Year: 2010
Main Partner: Save the Children
Main Partner Program: Global Health Technical Assistance
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $989,272

The Global Health Technical Assistance (GH Tech) project which was announced in February 2005 provided the Global Bureau for Health (GH) at the U.S. Agency for International Development (USAID), with high-quality independent technical support for design, monitoring, and evaluation of health, population, and HIV/AIDS activities. Under this contract, the awardees included a consortium of partners led by the QED Group, which comprises LLC, CAMRIS International, and Social and Scientific Systems, Inc. (SSS). The project facilitated support to USAID's health programs through technical assistance (TA), global health program and research management secretariat, mission support and logistical support. The project provided the USAID GH, regional bureaus and missions with flexible access to a range of technical and managerial expertise to design, monitor, and evaluate program activities.

Some of the successful activities undertaken by GH-TECH in various countries include the evaluation of the private sector program, mid-term evaluation of the PEPFAR integrated Management of Adolescent and Adult Illness Project and evaluation of the High-Risk Corridors Initiative in Ethiopia and the midterm evaluation of Forte Saude Project in Mozambique. The project consortium also completed several assignments for GH including the strategic appraisal of the ACQUIRE Project and operational plans for data quality assessments in Malawi. In India, the GH-TECH project assisted in the evaluation of the Innovations in Family Planning Services (IFPS-II) Project that helped develop a detailed performance management plan that allowed IFPS II management to oversee TA effectively, plan future activities, and communicate results to a broad and varied audience.

The GH-TECH project has worked with private-sector clients, US agencies and overseas governments, international donors, and private voluntary organizations and nongovernmental organizations (NGOs) in the United States, Europe, the former Soviet Union, Africa, Asia, the Middle East and Latin America and will end in October 2010.

The follow-on to this project is expected to be announced by September 30, 2009. The focus of the follow-on mechanism is expected to propose continued high-quality independent technical support for design, monitoring, and evaluation of health, population, and HIV/AIDS activities. The USG India intends to use this proposed new mechanism to undertake specific activities related to redesigning the USAID India HIV/AIDS portfolio to reflect emerging priorities and address them within the national and sub-national context.

Funding for Health Systems Strengthening (OHSS): $989,272

SUMMARY

The third phase of the $2.5 billion National AIDS Control Plan-III (NACP III; 2006-2011) is implemented by the National AIDS Control Organization (NACO). The NACP III outlines an ambitious timeline to deliver large-scale outcomes, e.g., prevention interventions at over 2,000 sites for most-at-risk populations (MARPs) across the country; free antiretroviral (ARV) treatment through more than 200 centers; and counseling and testing(CT) services at more than 4,500 sites across India. The newly established District AIDS Control Units (DAPCUs) aim at decentralizing HIV/AIDS management and control to the district level. The USG team contributed to the design and implementation plan of NACP III and is currently actively involved in its roll out. The USG participates in several national technical working groups (TWG) on Prevention, Care and Treatment, Laboratory Strengthening, behavior change and communication (BCC) and orphans and vulnerable children (OVC). The USG provides technical assistance (TA) to strengthen health systems in India through a spectrum of activities that intersect virtually all technical areas. As NACP III is scaled up rapidly, NACO has determined that institutional capacity building at state and regional levels is the long-term mechanism for ensuring sustainable resources for an expandable response to the currently concentrated epidemic.

The USAID response to the HIV/AIDS epidemic in India has been spearheaded through the HIV/AIDS Division of the Population, Health and Nutrition office, which conceptualized and facilitated the implementation of the first comprehensive HIV/AIDS project, the AIDS Prevention and Control (APAC) Project in 1992. The reversal of the HIV epidemic in the state of Tamil Nadu can be attributed to over fifteen years of significant USAID support for direct interventions through the APAC project. Subsequently, USAID made substantial investments in other high prevalence states such as Maharashtra. Its geographic areas of coverage expanded in 2006 to Karnataka and Andhra Pradesh in response to the state government's request for similar support for demonstrating quality programming and provision of high quality TA.

Over the years, the wealth of experience in community-based programming, the leadership role in private sector programming and a very strong partner network of diverse skills have helped to build the technical excellence in the HIV/AIDS portfolio of USAID. Since the roll-out of NACP III, the USAID HIV/AIDS portfolio has expanded to included technical expertise in prevention programming among MARPs, care, support and treatment programs with comparative advantages in private-sector partnerships, strategic information, BCC and strengthening health systems at national, state and district levels.

USAID is also experiencing an internal transition that refocuses its developmental lens towards sustainable and scalable systems. To provide leadership that harnesses the extensive health and developmental expertise, the mission intends to maximize state-of-the-art HIV/AIDS programming through strategic leadership, technical excellence, cutting edge research and an expanded partnership for development. In response to NACP-III's emphasis on repositioning donor support for systems strengthening and targeted TA, USG investments are also increasingly transitioning from direct support for field-level implementation to providing more technical and management assistance at higher levels to NACO and the State AIDS Control Societies (SACS). At the India PEPFAR Program Review debrief, the Government of India articulated the need for a USG role in areas of comparative advantage such as program management, communication, strategic information, private-sector partnerships and health systems strengthening including human capacity development. New emerging areas of priority are institutional capacity building, human resources for health, supply chain management and convergence.

Additionally, most of the HIV/AIDS projects under the current USAID India portfolio will close out in the next couple of years. There is a need to develop a redefined portfolio to effectively respond to the context of the Indian epidemic, while aligning with NACP III and PEPFAR-2 priorities. In this context, TA in FY10 is sought through the GH-TECH follow-on mechanism to facilitate the realigning of the USAID India HIV/AIDS portfolio to reflect these emerging priorities and address them within the national and sub-national context. This will lead to a clear articulation of the proposed technical and geographical priorities, strategic objectives and implementation mechanisms designed to address them.

The primary audience for outcomes provided through this mechanism will be USAID in addition to other stakeholders such as NACO and the state AIDS control societies (SACS) of USG priority states.

ACTIVITY 1: Assist USAID in the preparatory phase of designing the USAID HIV/AIDS strategy to align with emerging priorities

As part of realigning the USAID India HIV/AIDS portfolio to the global mission of technical excellence and expanded partnership for development, the mechanism will provide TA for assisting USAID in a preparatory phase that involves gaps analysis and other exercises to inform the structure and design of the USAID India HIV/AIDS portfolio. Specifically, the project will: 1. Support gaps analysis assessments and other required reviews, which will input into a specific roadmap for designing the overall portfolio 2. Facilitate internal and external environmental analysis to identify national and regional priorities and gaps in strategic HIV/AIDS programming 3. Determine the viability of restructuring of the HIV/AIDS portfolio through state or regional level programming versus cross-cutting thematic approach

ACTIVITY 2: Support the design of a strategic framework and determine scope of work for the restructured USAID India HIV/AIDS portfolio

The mechanism will support the USAID India HIV/AIDS team in analyzing the recommendations of the various exercises undertaken under Activity 1 (stated above) that will inform the development of a strategic framework for the revised HIV/AIDS portfolio. The project will work in close collaboration with the USAID India HIV/AIDS team for implementing a series of activities related to the strategic framework. Specifically, the mechanism will: 1. Determine design of potential USAID HIV/AIDS programming with specific recommendations towards a road map for a national level strategy that aligns the global, national and PEPFAR priorities; 2. Facilitate the development of regional or state-level strategies and activities as determined under the framework of the national strategy; 3. Support the redesign of the existing projects including, but not limited to, the bilateral Avert project in Maharashtra; 4. Develop the request for proposals and request for applications for new awards that is informed from the realigned HIV/AIDS portfolio; and 5. Support the supplemental activities for the award of the new grants.