Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4765
Country/Region: Mozambique
Year: 2007
Main Partner: Columbia University
Main Partner Program: NA
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $4,500,000

Funding for Treatment: Adult Treatment (HTXS): $4,500,000

This activity is linked to activities 8593 and 8545.

Columbia University's (CU) proposal for FY07 Track 1 funds and in-country supplemental funding in the amount of $5,411,250 builds on FY04-FY06 treatment activities. With this funding, CU will support the Ministry of Health (MoH) in the provision of ART treatment to 25,500 PLWHAs (23,000 with ongoing Track 1 Funding) and the expansion and improvement of service referral networks.

To achieve this target, CU will increase its current number of treatment sites from 18 currently to 24 in FY06 and 36 in FY07. CU's expansion is guided by the USG PEPFAR team's five-year strategic vision that ARV treatment services should reach beyond provincial capitals to include rural health facilities. The additional facilities supported in FY07 (primarily through the supplemental funding) will be outside major urban cities.

Beyond direct support of patients on ARV therapy, specific activities to be undertaken with Track 1 funds include:

1) Human Resources: CU will continue to supplement existing staff at 24 HIV care and treatment facilities by financing, training, and providing ongoing mentorship to 15-20 MoH clinic staff per facility in the provision of HIV care and treatment services for adults and children (400 staff total). These providers include doctors, medical technicians, nurses, counselors, pharmacists, data technicians and administrative staff. This relationship and support contributes to skills building and transfer at the point of service delivery.

Human Resource staffing is financed through sub agreements with Provincial Health Authorities in the six provinces supported by CU plus the Central Hospital in Maputo City.

Training: CU will continue to provide ongoing training by clinical-support teams to staff working at CU HIV care and treatment facilities in 6 provinces plus the Central Hospital in Maputo. Each team includes a Clinical Supervisor, 1-3 Clinical Officers, 1-2 Logistics Officer and a Data Officer. In particular, they provide refresher training for all health care providers to reinforce national guidelines and centrally-developed training programs. The teams also conduct on-site training and mentoring of clinicians in the management of HIV-exposed infants at CU-supported pMTCT facilities

All team members are hired directly by CU, based at Provincial Hospitals, and regularly travel to CU-supported facilities.

3) Infrastructure: CU will continue to provide supplies and additional equipment to maintain and expand services at 24 facilities through FY06. In addition CU will conduct renovations to existing health facilities as needed.

4) Policy and guidelines: CU will continue to provide technical support at the central level MOH to the Department of Medical Assistance (DAM). This support contributes to the development of policies and guidelines for managing the national ART effort. Specifically, CU technical staff will assist the HIV Management and ARV Committees to develop and revise clinical guidelines and an HIV service decentralization plan in addition to designing/updating training curricula and materials. CU will also work with the National Adherence Support group to develop adherence and psychosocial support materials. Internally, CU will work to strengthen their electronic patient-tracking system and paper-based systems for program monitoring purposes and will advise Emergency plan staff and other partners on the process for renovation of MOH facilities, including design, tendering and implementation.

4) Coordination: Columbia University will continue to participate in coordination meetings of the PEPFAR treatment partners as well as quarterly PEFAR partners meetings to ensure exchange of information, coordination of Emergency plan efforts and to provide regular updates of the program during the course of implementation.

Subpartners Total: $2,294,575
Abrantina Maputo: $91,011
Abrantina Jose Macamo: $469,755
Armindo and Gonsalves: $219,978
Arquiplan: $290,714
District Hospital, Ceta Milange: $431,065
University of Washington: $139,692
Nigico Mocuba: $379,359
Tavel Empreendimentos: $273,001