Detailed Mechanism Funding and Narrative

Years of mechanism: 2013 2014 2015 2016 2017

Details for Mechanism ID: 16678
Country/Region: Malawi
Year: 2013
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $4,968,543

IMPACT: This mechanism is designed to directly scale up high quality HIV treatment and PMTCT services at the facility level, through filling service delivery gaps to remove bottlenecks to effective service delivery. This mechanism will be critical to the effective delivery of services, especially focusing on the new Option B+ at the operational level. The expected reduction in new HIV infections and general morbidity and mortality will be realized through increasing the effectiveness, sustainability, equity and efficiency of district-based planning, budgeting and implementation processes in selected districts in Malawi, and supporting evidence-based prevention, care and treatment interventions at the facility level. This program will be fully aligned with district health service and budget planning processes to ensure full harmonization and district level ownership. Elements of this program include increasing alignment with government, and mutual accountability through directly funding zones or districts through sub-grants, while carefully monitoring performance, providing direct financial and technical support to strengthen planning, budgeting, financial and expenditure processes, and integrating strategic information more effectively and directly in district planning. This mechanism will directly deliver needed HIV services, develop or adapt performance-based financing at district and facility levels, promoting the provision of improved health services by strengthening leadership and governance, the health workforce, information systems, laboratory and other health system components at district level by supporting specific critical health services across multiple disease areas consistent with priorities identified in Malawis Health Sector and HIV Strategic Plans.

Funding for Care: Adult Care and Support (HBHC): $200,000

This implementing mechanism will support HIV programs in strengthening their approaches to linking communities and facilities, ensuring that each facility and provider has a community support services directory, and working with Community Health Committees to maximize bidirectional referrals and retention in HIV care.

Funding for Care: TB/HIV (HVTB): $200,000

For Treatment Scale-Up.

Strengthen laboratory capacity in TB/HIV. USD 200,000 in CDC COP 12 money will be allocated to:

Improve quality and access to fundamental laboratory services necessary for diagnosis, staging and treatment in children and adults, including viral load, POC CD4 and improved TB diagnosis, including scaling up access to LED microscopy and GeneXpert. Additional funding will also be used to support the national scale up of specimen transportation networks for VL, EID and CD4.

Funding for Strategic Information (HVSI): $300,000

This implementing mechanism will work with districts to ensure that data collected is utilized to support decision-making. Referrals and linkages between community and facility will be strengthened to ensure adherence and retention in PMTCT and other HIV services.

Funding for Health Systems Strengthening (OHSS): $101,000

This partner will strengthen the district health planning, financial management, implementation and monitoring processes to achieve a robust and effective district level health sector response; Districts will have a comprehensive annual health plan; Zonal Health Offices will annually review DIPs for completeness and quality as per central MOH guidance; Districts will effectively implement and monitor the activities in the annual health plan with quarterly reviews. Additionally, data use for program planning and monitoring will be improved to ensure that district implementation plans clearly cite rationale for approach and source credible data

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $200,000

MSH will provide support to Malawi's newest HIV prevention strategy: Voluntary Medical Male Circumcision (VMMC). MSH will provide direct service delivery support to scale up MC in targeted districts. This effort will utilize multiple service delivery models including high volume outreach sites, low volume static sites, and high volume static sites. These efforts will be in collaboration with other CDC partners including MOH and CHAM.

Funding for Testing: HIV Testing and Counseling (HVCT): $200,000

This partner will strengthen HTC at facility and district level through improving QA: ensuring national HTC protocols are implemented; increasing the number of providers available to provide PITC, and ensuring all high risk patients have access to HTC, including those in ANC, Maternity, TB, NRUs and STI clinics. This partner will also support quarterly supervision visits to facilities from district level.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $2,800,000

This partner will support and provide comprehensive PMTCT services in districts, including integration of FP into ART settings; identification of HIV-infected pregnant women and their partners, improved male participation in HTC at the first ANC visit; early initiation on ART as per the MOH guidelines, strengthened linkages into community and clinical care programs, improved maternal and neonatal clinical service provision in maternity, and improved follow-up of mother-infant pairs. This partner will support improved electronic and paper health information systems to ensure better identification, referral, and retainment of HIV-infected pregnant women and their exposed infants throughout the PMTCT continuum of care.

Funding for Treatment: Adult Treatment (HTXS): $867,543

This partner will support the national ART program through multiple approaches including: Referral of HIV-positive patients to ART clinic; integration of ART into ANC clinics; quarterly supportive supervision, and direct provsion of treatment services at the facility level.

Funding for Treatment: Pediatric Treatment (PDTX): $100,000

Through strengthened PITC and Health Information Systems, this partner will ensure that HIV-infected infants are identified early, referred appropriately and inifiated and maintained on treatment. This mechanism will also directly support the provision of treatment services to chlidren.

Cross Cutting Budget Categories and Known Amounts Total: $500,000
Human Resources for Health $100,000
Motor Vehicles: Purchased $400,000
Key Issues Identified in Mechanism
Implement activities to change harmful gender norms & promote positive gender norms
Increase gender equity in HIV prevention, care, treatment and support
Child Survival Activities
Safe Motherhood