Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 13761
Country/Region: South Africa
Year: 2013
Main Partner: Aurum Institute
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $14,388,001

This program aims to identify need, recruit, hire and manage various levels of clinical, technical, and administrative health care staff to support the SAGs implementation of HIV and TB prevention, care and treatment services in South Africa. The following are NDOH and CDC agreed identified priority districts/areas for this project: Free-State: Xhariep, Motheo, Lejweleputsa, Fezile Dabe, Eastern Cape: Nelson Mandela Bay Metro, Buffalo City, OR Tambo, Northern Cape: Pixley ka Sema, Francis Baard, KwaZulu Natal: Zululand, Umzinthathi, Uthukela, Umgungundlovo, Limpopo: Waterberg, North West: Bojanala, Ngaka Modiri Moleme, R Moila, Tswaing. Measurable outcomes will be in alignment with: To rapidly assess and prioritise the human resource needs in the areas identified as well as conduct a baseline assessment of existing PEPFAR supported human resource provision to those areas, especially partners with current CDC funding which is about to expire, To conclude and implement memoranda of understanding with the relevant NDOH structures at the various levels to ensure the support for this project. To recruit, hire and place suitable staff to meet the identified needs in the areas based upon the priorities determined, To manage the consistent remuneration and administration of the placed staff based on equitable standards acceptable to the NDOH and in accordance with all relevant laws and regulations, To conduct adequate performance management of all staff throughout the grant period, To progressively and systematically arrange for the transfer to and absorption of staff into the NDOH by the end of the grant, according to agreed schedules, and To monitor and evaluate the performance of all role players in this project to ensure project performance.

Funding for Care: Adult Care and Support (HBHC): $591,408

This program provides Human Resource (HR) staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and the Department of Health (DOH). The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

In HBHC, activities and inputs support mainly the roll-out of the Public Health Care (PHC) re-engineering strategy of SAG, which should build connection to the community and strengthen the linkages to care. At the community level, it is likely that the needs identification process will point towards the strengthening of the community outreach team as defined in the PHC re-engineering strategy. These outreach teams are likely to have a number of vacancies without initial mechanisms to fill them which is where this grant will be appropriate.

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the HBHC needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting HBHC staffing targets.

Funding for Care: TB/HIV (HVTB): $1,655,942

This program provides HR staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and DOH. The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

In HVTB, activities and inputs support the following:

Alignment of annual planning activities to strategic level policies and plans for TB and HIV;

Specialist data analysis to reviewing and report trends in TB epidemiology and diagnosis;

Guide the NDOH on interpretation of reports on PEPFAR TB/HIV ;

Researching innovative approaches to improved efficiencies in TB/HIV;

Reviewing District level TB/HIV linkage issues with a view to finding efficiencies and more effective approaches.

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the HVTB needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting HVTB staffing targets.

Funding for Care: Pediatric Care and Support (PDCS): $413,986

This program provides HR staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and DOH. The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

In PDCS, the staffing to be provided will be targeted mainly at very high priority key facility and community workers undertaking PDCS activities for HIV-exposed children and their families aimed at extending and optimizing the quality of life of such children. Included in the activities undertaken are: diagnosis, clinical, family and psychosocial support.

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the PDCS needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting PDCS staffing targets.

Funding for Health Systems Strengthening (OHSS): $0

This program provides HR staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and DOH. The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

A) In the first instance (budget $600 000), staffing will be targeted mainly at roles which are cross-cutting the pillars of sound health systems, including human resource planning, financial planning, management and leadership, and interdisciplinary health professional capacity. The work of the seconded staff will target health systems support work such as:

Identifying and developing proposed system solutions to district level systems barriers impeding overall programme efforts;

Identifying and describing cross-cutting issues which could improve systems performance;

Activities supporting the forward planning capacities of District Management Teams.

Support for an NHLS project manager to coordinate a pilot project to evaluate cryptococcal antigen testing in NHLS facilities.

B) In the second instance (budget $300 000), this work will support the development of a Human Resources Transition Plan together with the NDOH for all USG Care and Treatment personnel to the NDOH over an as yet to be defined transition period. This activity is likely to be a joint exercise between Aurum and sub-partner SEAD engaging with the NDOH and USG agencies.

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the PDTX needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting PDTX staffing targets.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $2,559,845

Aurum will maintain its established high volume MMC site in Ekurhuleni District, Gauteng, accomplishing 5,000 MMCs in 2012 and 5,000 MMCs in 2013 ($100/MMC). Unit costs per MMC reflect use of efficient staffing and site management and are the standard rate for MMC in South Africa. Aurum will operate against a sustainability plan to transfer their skill set to facility staff for impact past the completion of the project. Project will support SAG monitoring efforts by using reporting mechanisms that fold into district, provincial and national systems, avoiding creating parallel reporting structures. Their program will continue to build on best practices in MMC, including use of forceps-guided surgery, employing models to optimize volume and efficiencies (MOVE), incorporating gender messaging on male norms and proper treatment of females, and delivering these as part of a minimum package of HIV prevention services, including HCT, age-appropriate risk reduction counseling, condom demonstration, provision and promotion, and linkages to family planning, STI, HIV, TB, and other treatment services. Aurum will make efforts to retain patients in care through the duration of their healing to minimize complications and reinforce risk reduction messages. Demand creation will be essential and entail community dialogues, mass media, local media, engagement of female partners and caregivers, engagement of key influencers, employers, and community stakeholders, peer referral networks, word of mouth campaigns, and strong linkages from HCT, PMTCT and other touch points within the health system. The MMC activities are intended not only as a single biomedical intervention to reduce HIV acquisition risk, but also an opportunity to engage men in health services and maximize linkages to other key resources for males improved long-term engagement in the health sector, increasing their likelihood to seek support for sexual and reproductive health and chronic disease management.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $1,715,083

This program provides HR staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and DOH. The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

In MTCT, activities and inputs support the following:

Building the capacity of health care providers and facilities to provide PMTCT services at facility level in the priority sub-districts;

Building capacity at national, provincial, district and clinical site level to oversee the program, routinely collect data and monitor the quality of services;

Improving/coordinating practices that promote paired mother-infant care and linkage to other appropriate treatment, and care and support services;

Supporting integration of PMTCT into routine maternal/child health services and other prevention programs.

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the MTCT needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting MTCT staffing targets.

Funding for Treatment: Adult Treatment (HTXS): $6,032,358

This program provides HR staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and DOH. The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

In HTXS, activities and inputs support the following:

Training activities, including pre- and in-service training and mentorship focusing on improved treatment quality and coverage;

On-site HSS activities;

Efforts to track and evaluate clinical outcomes and other performance data and current clinical outcomes to measure performance for quality improvement at the sub-district and site level;

Efforts to improve retention of patients initiated on ART and outcomes of these activities;

Adherence activities and outcomes of these adherence activities;

Target population(s) and coverage with a comprehensive care and treatment package, including ART provision, cotrimoxazole prophylaxis, and TB screening;

Efforts to improved efficiencies to allow for continued expansion of services

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the HTXS needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting HTXS staffing targets.

Funding for Treatment: Pediatric Treatment (PDTX): $1,419,379

This program provides HR staffing support in public sector clinics and health departments, generally focused in 12 districts nationally, to fill critical gap staffing needs as determined jointly with PEPFAR partners and DOH. The partners work is coordinated with another PEPFAR partner (HST) providing programmatic capacity support and TA in the same districts. The two partners coordinate their work together, and with DOH, for comprehensive program impact.

In PDTX, activities and inputs support the following:

Training activities, including pre- and in-service training and mentorship focusing on improved treatment quality and coverage;

On-site HSS activities with paediatric outcome objectives;

Efforts to track and evaluate clinical outcomes and other performance data and current clinical outcomes to measure performance for quality improvement at the sub-district and site level;

Efforts to improve retention of patients initiated on ART and outcomes of these activities;

Adherence activities and outcomes of these adherence activities;

Target population(s) and coverage with a comprehensive care and treatment package, including ART provision, cotrimoxazole prophylaxis, and TB screening;

Efforts to improved efficiencies to allow for continued expansion of services; and

The M&E approach is a fundamental component of the grant execution. For this budget code, the sub-partner (SEAD) executing a baseline HR survey of the target districts will include the PDTX needs analysis and the meeting of that need over the course of the grant. Annual re-surveys will inform HR planning for this category of health worker. The M&E plan also addresses internal performance of the consortium in meeting PDTX staffing targets.

Cross Cutting Budget Categories and Known Amounts Total: $588,954
Motor Vehicles: Purchased $588,954
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
Tuberculosis