Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014

Details for Mechanism ID: 10725
Country/Region: Zambia
Year: 2012
Main Partner: Catholic Relief Services
Main Partner Program: NA
Organizational Type: FBO
Funding Agency: HHS/CDC
Total Funding: $530,000

The Catholic Relief Services, through the Integrated Support for ART & PMTCT (ISAP) program aims to support local partner treatment facilities (LPTFs) and their communities to use a family centered approach to respond to HIV/AIDS related needs. ISAP supports 11 sites in six provinces to focus on PMTCT, HSS, PDCS, HTC, within PMTCT, and SI.Using the base funds, ISAP will support the MOH to deliver sustainable high quality comprehensive PMTCT services in the 11 LPTFs in collaboration with AIDS Relief, a PEPFAR project that currently supports ART programs at the same LPTFs. ISAP has the following objectives:a. Ensure pregnant women access to high quality PMTCT activities.b. Ensure HIV exposed infants receive high quality follow-up and support services until their second birthday.ISAP will integrate PMTCT services into existing services such as MNCH units, FP units and community based services by targeting:women and men of child bearing age, especially couples; HIV infected pregnant women and their partners; HIV exposed and infected children; MARPs in particular prisoners and migrant populations.ISAP will continue to upgrade and refurbish MNCH departments, waiting shelters, and lab facilities. ISAP will support the sustainable transition of its services through increased on-site mentoring and technical support. CRS-ISAP will focus on implementing activities designed to specifically: continue to expand integration models for ANC and ART for increased coverage of more efficacious ARV regimens for PMTCT including HAART; Support development and deployment of integration models for PMTCT, pediatric HIV care, and routine MNCH services such as EPI, growth monitoring, nutritional support, and post natal services in order to optimize service delivery, reduce LTFU rates.

Funding for Care: Adult Care and Support (HBHC): $0

ISAP will link HIV infected pregnant women to the ART services provided by AIDS Relief to ensure that these women and their families receive appropriate care so that they remain in care especially for subsequent pregnancies. MNCH nurses and midwives and ART providers at these ISAP will mentor LPTFs staff to provide safe pregnancy counseling/FP counseling to women and their partners and to link them to available FP services.

Funding for Care: Pediatric Care and Support (PDCS): $125,000

ISAP will support exposed babies of HIV infected women by ensuring that they are managed in line with the latest MOH guidelines to ensure they are given appropriate Septrin prophylaxis, appropriate treatment with Pre-exposure prophylaxis (PrEP) in the form of Nevirapine syrup and that early infant diagnosis (EID) guidelines are followed and implemented.

ISAP will work to support facilities as well as district health teams to improve EID by reducing DBS turnaround time to an acceptable level by supporting the Ministry in the Scale up of the SMS technology as well as by integrating DBS transport systems into existing systems. ISAP will also build capacity of the management teams to co-ordinate DBS logistics management.

ISAP will continue to mentor LPTF staff and train CHWs to track all patients to ensure appropriate feeding as well as ensuring results get back to the caregivers.

ISAP will continue to mentor staff to ensure that all HIV infected children and their families are enrolled in care.

ISAP will train CHWs to follow-up HIV exposed infants up to at least 24months.

ISAP will provide comprehensive MNCH services to exposed children including NACS and appropriate linkages to other organizations which supply supplementary food to exposed HIV infants, prevention of diarrhoea diseases and prevention of TB using IPT.COP 12 PMTCT PLUS-UP FUNDS IN THE AMOUNT OF $25k

Funding for Laboratory Infrastructure (HLAB): $0

ISAP will support LPTFs to maintain or upgrade their laboratory infrastructure in order to support the provision of DBS collection services, CD4 count services and other laboratory services necessary to provide ART care and support.

ISAP will support the decentralization of lab services to improve efficiencies but ensure quality is maintained through internal and external quality assurance. One way in which ISAP intends to achieve this is to ensure all MNCH clinics are able to provide point of care services for Heamoglobin (Hb) calculation using the MoH approved Haemocue machines. Also ISAP will support the drive to eliminate Congenital Syphilis by supporting the implementation of rapid RPR testing in all antenatal sites. Furthermore, ISAP will support the Ministry of Health to implement point of care CD4 testing in all MNCH departments. Lastly, ISAP will support the introduction of cost effective, sustainable new technologies which are MoH approved such as point of care early infant diagnostic services. All these measures will help to decongest lab services, improve efficiencies and lead to better patient outcomes.

Funding for Strategic Information (HVSI): $0

ISAP will work with Futures Group Global to provide strategic information and monitoring and evaluation for the PMTCT ISAP project in Zambia. ISAP will integrate paper based SmartCare ANC/PMTCT modules to electronic records and work to produce valid accurate reports. ISAP will work with MOH and CDC at national, provincial and district levels to enhance deeper appreciation of SmartCare. ISAP will embrace EDU (epidemiological Data Use) approach to enhance data use for better patient outcomes, targeted technical assistance and cost effective evidence based programming. ISAP will conduct SmartCare refresher training to 22 Health Workers and ensure that all 11 sites have certified SmartCare trained M&E staff.

ISAP will produce monthly, quarterly, annual and semi-annual progress reports and adhoc reports as requested by the MOH, in-country CDC and local partners.

ISAP will ensure that all 11 sites are on the latest/updated version of the national electronic medical records system (EMR) SmartCare. ISAP will work with MOH in ensuring correct usage of ANC/PMTCT modules in SmartCare for accurate data entry, report production and data utilization for improved patient care management and efficient utilization of resources.

ISAP will use indicators from PEPFAR, other United States Government (USG) agencies, and the MOH to track the provision of high quality PMTCT services within broader public Health care and, specifically, HIV/AIDS care and treatment.

ISAP will conduct PMTCT-related M&E trainings and other capacity building activities to LPTFs.

Future Group Global, LLC will support CRS and other Consortium Members to participate in promoting and sustaining best practice M&E activities and systems.

ISAP will work with the donor, CDC, and the Zambian Ministry of Health as required on technical working groups and adhoc initiatives related to M&E. ISAP will be involved in the national technical working group for PMTCT

ISAP will share program experiences and lessons learned with other stakeholders, as requested.ISAP will contribute setting up of targets, monitoring progress made and also participate in data reviews meetings with MOH.

Funding for Health Systems Strengthening (OHSS): $0

PMTCT one time plus-up funds will be used to renovate mothers waiting shelters in an attempt to increase institutional deliveries for HIV infected pregnant women.ISAP will continue to upgrade, remodel or refurbish antenatal clinics, maternity units, MCH and laboratory facilities within the mission network to improve efficiency in PMTCT services.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $0

ISAP will promote male circumcision by training health workers and community health workers to include appropriate information on medical MC in all community and health facility based health talk. ISAP will link clients to other partners who manage implementing mechanisms focused on male circumcision (e.g. Jhpiego, Society for Family Health).

Funding for Testing: HIV Testing and Counseling (HVCT): $0

ISAP will increase HIV testing and counseling (HTC) of communities and families surrounding LPTFs by training Community Health Workers (CHWs) in HTC while maintaining quality. CHWs will also be mentored to provide the necessary support and to provide appropriate linkages and follow-up to the clients they test. LPTFs will use standard guidelines and keep records of the services received by the clients in SmartCare regardless of the point of care that the service was accessed.

ISAP will mentor facility and community staff to ensure Provider Initiated Testing and Counselling (PITC) is provided in the LPTFs with emphasis on MNCH departments, FP units and pediatric wards.

ISAP will continue to provide same day results and support the LPTFs in appropriate management of HTC logistics

ISAP will provide focused prevention messaging based on HIV test results as well as training in couples counseling, focusing on quality assurance in both counseling and testing procedures.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $305,000

ISAP will implement an integrated PMTCT and ART care and delivery service by establishing comprehensive ART care for pregnant women and their families. ISAP will support communities surrounding LPTFs participate in all four prongs of PMTCT services focusing on sensitizing the community members on primary prevention of HIV among women and men of child bearing age, benefits of HIV testing and knowing their status, the importance of HIV testing and re-testing in pregnancy, the importance of preventing Gender Based Violence, sensitization on gender equity and appropriate messages and information related to medical male circumcision. ISAP will train CHWs in MOH approved PMTCT packages to enable them sensitize the community and to be able to track HIV infected pregnant women in their communities as well as tracking of exposed infants.ISAP will ensure that pregnant women, HIV exposed children and their families are engaged in comprehensive HIV/AIDS care and treatment by focusing on strengthening linkages and integration between ART and MNCH clinics, training MNCH nurses and midwives to provide comprehensive HIV care and treatment in addition to comprehensive ANC, and growth monitoring services including timely DBS/EID services, Septrin prophylaxis, Isoniazid Preventive Therapy (IPT), infant feeding counseling, child counseling, syphilis screening at baseline and at 32 weeks, Nutrition Assessment, Counseling and Support (NACS), linking to programs offering supplementary/replacement feeding programs. ISAP will support the MOH to incorporate the changes in the new guidelines into a new ANC card as well as the requisite registers, IEC materials and training packages.ISAP will ensure that pregnant women receive an evidence-based effective combination of ART and prophylaxis focusing on prioritizing CD4 counts for pregnant women and supporting the MOH in acquiring Point of Care CD4 machines, training 22 MNCH nurses and midwives in basic ART management in order to provide ART services in line with standard ART care within the MNCH department including screening for TB. ISAP will provide onsite mentoring to MNCH nurses and midwives on the latest Zambian guidelines. ISAP will encourage self evaluation and local data use by encouraging sites to develop PMTCT Continuous Quality Improvement (CQI) teams and to link these teams to already established AIDS Relief ART CQI teams in order to encourage program ownership and effectiveness in the use of resources. The COP12 PMTCT PLUS UP funds $ 50,000 will contribute towards the acceleration of the Ministry of Health (MOH) PMTCT program specifically in health facilities operated by Faith Based Organizations across the country. These funds will be used to implement one-off activities intended to contribute towards the strengthening of the base of the national PMTCT program for a more effective MTCT elimination drive. Further using these additional funds, CRS-ISAP will focus on implementing activities designed to specifically: continue to expand integration models for ANC and ART for increased coverage of more efficacious ARV regimens for PMTCT including HAART; Support development and deployment of integration models for PMTCT, pediatric HIV care, and routine MNCH services such as EPI, growth monitoring, nutritional support, and post natal services in order to optimize service delivery, reduce loss-to-followup rates, and maximize leveraging of efforts across programs for increased overall impact.

Funding for Treatment: ARV Drugs (HTXD): $0

ISAP will put some funds aside for emergency procurement of nevirapine pediatric formulation as buffer stock in case of stock out which have been experienced in some of our sites in the previous year. The buffer stock will support exposed babies for a period of three months.

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

ISAP will ensure all HIV infected children are initiated on treatment by referring them to Paediatric ART services which are provided by AIDS Relief in all ISAP sites.Narrative (2250 characters)

Subpartners Total: $0
Chikuni Mission Hospital: NA
Children's AIDS Fund International: NA
Chreso Ministries: NA
Chreso Ministries: NA
Chreso Ministries: NA
Circle of Hope: NA
Palladium Group (formerly Futures Group): NA
Katondwe Mission Hospital: NA
Macha Mission Hospital: NA
Malcolm Watson Mine Hospital: NA
Mukinge Mission Hospital: NA
Sichili Mission Hospital: NA
University of Maryland: NA
Wusakile Mine Hospital: NA
Key Issues Identified in Mechanism
Addressing male norms and behaviors
Increasing gender equity in HIV/AIDS activities and services
Child Survival Activities
Safe Motherhood