Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014

Details for Mechanism ID: 13453
Country/Region: India
Year: 2012
Main Partner: FHI 360
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $450,000

SNEH is a continuing project that contributes to PEPFAR Indias goals 2 and 4 (data for decision-making and HSS). The goal of SNEH is to increase capabilities of nurses to provide HIV clinical services in India as part of sector-wide efforts to strengthen human resources for health (HRH) systems. Project objectives are to 1) demonstrate an effective model to enhance HIV clinical capacities of nurses working on HIV ; 2) provide TA to nursing councils and Ministry of Health and Family Welfare (MoHFW) to strengthen human resource planning/management; and 3) provide need-based TA (models) in capacitating nursing councils and institutions.

The project targets nursing decision-makers at national level, and all nurses working in the area of HIV in India. SNEH will work with associations of nurses, nursing institutions, and academic institutions and build their overall institutional capacity in areas including information systems, continuing education, curriculum development, accreditation and policy review and development. Increasing gender equity in HIV services is addressed in all components of these in-service trainings.

To support cost-efficiency, SNEHs activities are limited to TA at the national and state level, with all implementation done by GOI. SNEH will ensure through regular partner meetings that efforts of USG funded agencies are complementary rather than duplicative. The project strategy is to build capacity of local government staff, so that effects will be sustainable beyond the project life.

M&E will be through project-specific process monitoring of activities and through Management Information Systems developed by FHI 360 and its sub partners. FHI will hold quarterly review meetings with donors and project partners.

Funding for Health Systems Strengthening (OHSS): $177,690

SNEH will work with nursing councils, associations and academic institutions and build their overall institutional capacity in areas including information systems, continuing education, curriculum development, accreditation, policy review and development in close collaboration with the Ministry of Health and Family welfare.

Health workforce planning supports efficient recruitment, training and deployment of health workers. Managers and health planners need information about the size, composition, skill sets, training needs, and performance of the public health workforce in order to make informed, well-timed decisions. However, in India, human resources for health data are limited, inconsistent, out-dated, or unavailable. At present most use paper-based systems for health workforce information. Computerized human resources for health management information systems (HRHMIS) enable countries to collect, maintain, and analyze health workforce data. The development and use of HRHMIS is an attainable and cost-effective strategy to address workforce shortages and improve public health in India.

In FY10, SNEH facilitated formation of and mentored a core group for Human Resource for Health Management Information System (HRHMIS), which developed a project management Plan for designing, developing and implementing HRHMIS in India. SNEH is supporting this core group to pilot HRHMIS in Andhra Pradesh in FY11. In FY12, SNEH will revise and replicate the HRHMIS in new states. SNEH will work closely with the HRHMIS core group which includes Andhra Pradesh State Project Management Unit (SPMU), Directorate of Medical Education (Government of Andhra Pradesh), National Health System Resource Centre (NHSRC), National Informatics Center, and Public Health Foundation of India (PHFI). Project sub-partners (CHAI and SHARE India) will continue to be involved in the project for HRHMIS and nursing council capacity building.

1: Strengthening human resource for health management within nursing councilsBased on the FY11 pilot HRHMIS (one state) and feedback from State Nursing Councils (SNCs), in FY12 SNEH will continue to work closely with the HRHMIS core group and provide technical assistance (TA) to replicate the HRHMIS in three states (to be decided). SNEH will also ensure registration and tracking through HRHMIS of all nurses undergoing the training program. USG and partners will provide TA to SNCs and state health departments to utilize HRHMIS data for strategic planning to optimally utilize available health care human resources in the state.

2: Capacity building for nursing councils and nursing institutionsIn FY12, SNEH will continue to provide TA to three SNCs to implement their five-year strategic plans and budgeted annual action plans which were developed in FY11. In FY12 USG and partners will revisit the SNCs and review progress on implementing the annual action plan. USG and partners will provide TA to SNCs to address specific challenges to implementation. SNEH will also build on these experiences to provide TA to three additional states to develop similar strategic plans and annual action plans. SNEH will also provide need- based TA (develop models) to nursing associations and nursing institutions.

Funding for Treatment: Adult Treatment (HTXS): $272,310

A 2007 CDC/I-TECH review of the technical capacities of nurses in ART centers and Community Care Centers showed that most nurses lacked satisfactory HIV knowledge, skills and formal training. It also found that the roles of these nurses were unclear. NACO ART operational guidelines recommend clinical triaging for nurses working in ART centers for better clinical care of patients. SNEH will introduce clinical triaging in HIV service centers through training and defining the task sharing roles of nurses.1: Task-sharing for nurses working in HIV: Based on the FY11 review of workload of nurses in sample HIV service centers, in FY12 SNEH will provide TAto i) State AIDS Control Societies (SACS) to redefine and expand roles for nurses (task sharing) in HIV clinical care in collaboration with NACO and MOHFW, ii) develop action plans in consultation with NACO and SACS to raise the capacities of selected HIV service centers to function as demonstration sites for HIV nursing.

2: Specialized training for nurses working in HIV: SNEH facilitated development of 10-day in-service ART nurses training curriculum and framework with continuous mentoring in FY10 and trainings rolled out in FY11. This specialized training bridges the current NACO/Indian Nursing Council 5-day basic course for all nurses and the Yale University/Clinton Health Access Initiative advanced training (3-months) planned through the Indian Institute of Advanced Nursing (IIAN). In FY12 SNEH will continue roll-out of this 10-day training/mentoring support for the nurses; develop a 3-day refresher hands-on curriculum for nurses trained in FY10-11; develop need-based curriculum for the nurses to improve HIV clinical skills and develop print and audio-visual material. SNEH will review the capabilities of trained nurses 9 months post training. Increasing gender equity in HIV services is addressed in all components of these in-service trainings.3: Continuing Nursing Education (CNE) on HIV clinical care via distance self-learning: In FY12 SNEH will continue to provide TA to Indira Gandhi National Open University (IGNOU) to strengthen Indias first certified distance learning courses on HIV for nurses (begun in FY11). In FY12, SNEH/IGNOU will revise the pilot web-based and distance learning CNE based on FY11 assessments. SNEH will advocate with public (NACO, SACS, ART, LAC, CCC, CHCs, district hospitals and Medical Officers of ART centers and LACs) and private sector institutions (profit and not for profit, faith based organizations) to facilitate the use of self-learning modules in all clinical care services in India.

4: Quality Assurance (QA) program for monitoring nurse training: Through site visits, SNEH will develop and implement a QA system for monitoring quality of training provided to nurses. Quality standards including standard operating procedures and quality checklists will be administered to trainees and key elements of process, content and facilitation skills of the trainers will be assessed. SNEH will regularly monitor the quality of the mentorship program and the self-learning module through use of quality checklists and feedback from nurses/mentors on the use of knowledge and skills gained through the training. Results of QA assessments will be fed back into training modules, the mentorship program and self-learning modules.

Implementing Mechanism Indicator InformationRedacted

Subpartners Total: $0
Catholic Health Association of India: NA
Science Health Allied Research Education Foundation: NA
Cross Cutting Budget Categories and Known Amounts Total: $450,000
Human Resources for Health $450,000
Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services