Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012

Details for Mechanism ID: 7306
Country/Region: South Africa
Year: 2012
Main Partner: University Research Corporation, LLC
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $2,029,617

FY2012 funds will support adult & pediatric basic health care, adult ART treatment, HIV counseling and testing, and health system strengthening activities at national, provincial and district levels. URC-HCI will provide technical assistance and work closely with provincial and district managers to support implementation and scale-up of HIV services at all DOH sites in 31 districts in Limpopo, Mpumalanga, North West, Eastern Cape, and KwaZulu Natal. URC-HCI will assist districts to facilitate further scale-up of HCT, adult & pediatric HIV care and treatment services, improving retention, and the quality of services provided to PLHIV and their families. Working within the district framework, URC-HCI will focus on supporting development of integrated referral systems between different levels of care and health programs. In line with the NSDA and PEPFAR priorities, URC-HCI will play an integral role in the implementation of the PHC re-engineering initiative, while also strengthening the capacity of District Management teams to develop accurate district health plans and district health expenditure reviews in all 31 districts. URC-HCI staff will also assist the SAG with preparations for implementation of the NHI, through ongoing work with the National Core Standards. URC-HCI will capacitate DOH staff to use DHIS data to track and evaluate clinical outcomes. Support will also be provided to improve the DHIS especially the HIV care data management, analysis and data quality assessments at all levels. URC-HCI will also strengthen and support the implementation of the ART Tier.Net in supported areas. Target populations include: PLHIV, Healthcare providers, Program Managers, PEPFAR partners, NGO/CBO/volunteers. Two vehicles have been purchased during the life of this activity.

Funding for Care: Adult Care and Support (HBHC): $600,967

In FY2012 URC-HCI will support five provinces (Limpopo, Mpumalanga, North West, Eastern Cape and Kwa-Zulu Natal) to ensure high quality facility and home/community-based services are provided to all HIV-infected adults and their families.Working closely with provincial and district managers, URC-HCI will provide technical assistance to support implementation and scale-up of HIV care and support services at all DOH sites in 31 districts in the 5 provinces. In line with the NSDA and PEPFAR priorities URC-HCI will play an integral role in the implementation of the PHC re-engineering initiative, through training and capacitation of DOH health workers, specifically community health workers, lay counselors and medical staff; provision of supportive supervision; development of educational materials and SOPs; monitoring compliance with HIV guidelines, norms and standards; and ongoing clinical mentoring and coaching. URC-HCI staff will also assist with implementation of various quality initiatives, especially as these pertain to improvement in HBHC services, including infection prevention and control, patient safety and the National Core Standards for Health Establishments in all provinces.Working within the district framework, URC-HCI will focus on supporting development of integrated networks/referral systems between different levels of care and different health programs to aid retention of patients in care. The project will also strengthen and support any existing systems (e.g. outreach, HBC, etc.) to maximize retention rates in HIV care. In line with overall capacity development, URC-HCI will train all stakeholders on QA/QI methodology and use of programmatic data for QI.Support will also be provided to improve the DHIS especially the HIV care data management, analysis and data quality assessment at all levels. Provision of TA and capacity building at district and provincial level fits with SAG and PEPFAR priorities, as these are in line with development of overall sustainability of the program.The population targeted for these interventions include PLHIV, Healthcare providers, Program Managers, PEPFAR partners, and NGOs/CBOs/volunteers.

Funding for Care: Pediatric Care and Support (PDCS): $131,309

In FY2012 URC-HCI will support five provinces (Limpopo, Mpumalanga, North West, Eastern Cape and Kwa-Zulu Natal) to ensure high quality facility and home/community-based services are provided to all HIV-infected children and their families.Working closely with provincial and district managers, URC-HCI will provide technical assistance to support implementation and scale-up of HIV care and support services at all DOH sites in 31 districts in the 5 provinces. In line with the NSDA and PEPFAR priorities URC-HCI will play an integral role in the implementation of the PHC re-engineering initiative, through training and capacitation of DOH health workers, provision of supportive supervision; monitoring compliance with HIV guidelines, norms and standards; and ongoing mentoring and coaching. URC-HCI staff will also assist with implementation of various quality initiatives, especially as these pertain to improvement in PDCS services, including infection prevention and control, patient safety, and integration of PDCS with routine pediatric care, nutrition services and maternal health services.Working within the district framework, URC-HCI will focus on supporting development of integrated networks/referral systems between different levels of care and different health programs to aid retention of children in care. The project will also strengthen and support existing systems (e.g. outreach, home-based care, etc.) to maximize retention rates in HIV care. Issues such as disclosure, adherence, and psychosocial counseling for HIV-infected children and adolescents will also be addressed. In line with overall capacity development, URC-HCI will support the DOH to train all stakeholders to improve early identification of HIV exposed/infected babies at 6 weeks and advocate for regular IMCI training.Support will also be provided to improve the DHIS especially the HIV care data management, analysis and data quality assessment at all levels.The population targeted for these interventions includes HIV exposed children, healthcare providers, program managers, PEPFAR partners, and NGOs/CBOs/volunteers.

Funding for Health Systems Strengthening (OHSS): $630,000

In FY2012 URC-HCI will support health system strengthening activities at a national, provincial and district levels. Working closely with provincial and district managers in five provinces (Limpopo, Mpumalanga, North West, Eastern Cape and Kwa-Zulu Natal) URC-HCI will provide technical assistance to support implementation and scale-up of health services at all DOH sites in 31 districts in the 5 provinces.

In line with the NSDA and PEPFAR priorities URC-HCI will play an integral role in the implementation of the PHC re-engineering initiative, through provision of in-service training, including NIMART, and development of preceptor programs specifically for community health workers, lay counselors and medical staff; provision of supportive supervision; development of educational materials and SOPs; monitoring implementation of work by PHC teams, compliance with HIV guidelines, norms and standards; and ongoing mentoring and coaching. URC-HCI will also start to develop competency based assessments for all cadres of PHC team members.

URC-HCI will also strengthen and support the capacity of District Management teams through provision of assistance with development of district health plans (DHPs) and district health expenditure reviews (DHERs) in all 31 districts.

Building on previous experience, URC-HCI will capacitate DOH staff to utilize data to track and evaluate clinical outcomes, utilizing ART cohort data where available. In addition, URC-HCI will also strengthen and support the implementation of the ART Tier.Net data management system to support M&E. Support will also be provided on ART data management, analysis and data quality assessment during the implementation of the 3 tiered system.

In preparation for the rollout of NHI, URC-HCI staff are already assisting all 5 provinces with implementation of various quality initiatives, especially the 6 Ministerial priorities and the National Core Standards for Health Establishments. This work will be scaled up.

The population targeted for these interventions include DOH (National, Provincial, District, Facility), health workers, PEPFAR partners, other stakeholders, and NGOs / CBOs.

Funding for Testing: HIV Testing and Counseling (HVCT): $139,553

In FY2012 URC-HCI will support five provinces (Limpopo, Mpumalanga, North West, Eastern Cape and Kwa-Zulu Natal) to expand both provider-initiated and client-initiated HCT services within health facilities and the community to avoid missed opportunities.Working closely with provincial and district managers, URC-HCI will provide technical assistance to support implementation and scale-up of provider initiated HCT (PICT) services at all DOH sites in 31 districts in the 5 provinces. The high HIV prevalence figures (2008) amongst the 15-49 year age group in these provinces indicate the need to scale up high quality HCT services. HIV prevalence rates range from 13.7% in Limpopo to 25.8% in KwaZuluNatal. As provincial support partner, URC-HCI will work closely with DOH managers, stakeholders and partners at all levels to achieve universal HIV testing through enhanced provision of PICT. URC-HCI will support the expansion to access to and uptake of HCT while monitoring the quality of services provided through supportive supervision with emphasis on networking/linkages/referral to other care systems. URC-HCI will also support the use of the collaborative approach to integrating HIV testing with programs such as ANC, STI, TB, FP and others towards expanding HCT services.In line with the NSDA and PEPFAR priorities URC-HCI will play an integral role in the implementation of the PHC re-engineering initiative, through provision of in-service training; provision of supportive supervision; monitoring compliance with HIV guidelines, norms and standards; and ongoing mentoring and coaching. URC-HCI will also strengthen and support any existing systems to maximize retention rates of those not enrolling into HIV care and treatment programs.URC-HCI will capacitate DOH staff to utilize data to track and evaluate clinical outcomes, utilizing HCT register and DHIS data, for quality improvement at the facility level. Support will also be provided to improve DHIS especially HCT data management, analysis and quality assessment at all levels.The population targeted for these interventions include adults and children, pregnant women, Healthcare providers, Program Managers, PEPFAR partners, and NGOs / CBOs.

Funding for Treatment: Adult Treatment (HTXS): $527,788

In FY2012 URC-HCI will support five provinces (Limpopo, Mpumalanga, North West, Eastern Cape and Kwa-Zulu Natal) to expand the SA Comprehensive HIV and AIDS Care, Management and Treatment plan, which seeks to increase access to and improve retention in ART care and treatment.Working closely with provincial and district managers, URC-HCI will provide technical assistance to support implementation and scale-up of ART services at all DOH sites in 31 districts in the 5 provinces. In line with the NSDA and PEPFAR priorities, URC-HCI will play an integral role in the implementation of the PHC re-engineering initiative, through provision of in-service training, including NIMART, development of preceptor programs specifically for community health workers, lay counselors and medical staff; provision of supportive supervision; development of educational materials and standard operating procedures (SOPs); monitoring compliance with HIV guidelines, norms and standards; and ongoing mentoring and coaching. URC-HCI will also strengthen and support any existing systems to maximize retention rates in HIV treatment.Building on previous experience, URC-HCI will capacitate DOH staff to utilize data to track and evaluate clinical outcomes, utilizing ART cohort data where available. Other performance data and current clinical outcomes will also be utilized for quality improvement at the facility level.In addition, URC-HCI will also strengthen and support the implementation of the ART Tier.Net data management system to support M&E. Support will also be provided on ART data management, analysis and data quality assessment during the implementation of the 3tiered system.In addition, URC-HCI staff will assist with implementation of various quality initiatives, especially as these pertain to improvement in ART services, including infection prevention and control, patient safety, waiting times, access to medicines and the National Core Standards for Health Establishments in all provinces.The population targeted for these interventions include adult HIV patients, healthcare providers, Program Managers, PEPFAR partners, and organizations/volunteers.

Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services