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Planning for Sustainability of MMC

ProgramsPanel discussion

Dr. Alex OpioArusha, Tanzania (June 2010)

Background

• MMC will only have long-term impact on HIV prevention if the services are developed in a sustainable manner

• Thus, the planning process for MMC programs should take into consideration the factors that facilitate sustainability

• Some thoughts on the above

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Key Facilitating Factors for Sustainability of MMC Programs

• Advocacy

• Appropriate leadership

• Strategic planning based on evidence of needs

• Integrated implementation approach

• Working in partnership

• Innovative implementing approaches

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Advocacy

• Advocacy needed at international, national and community levels to build consensus on developing sustainable MC programs

• Advocacy for MC services is vital right from the beginning of establishment of MC programs and during the implementation– Builds support for key decisions on policies– Encourages involvement of high level

leadership

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Appropriate Leadership• Leadership can champion development and

implementation of sustainable MMC programs• High political support is conducive for sustainability

of MC interest and keep MC high on the national health agenda

• Leaders who are on board of MMC programs will advocate for support and provide or mobilization resources

• Supportive leaders can set enabling policy and regulatory environment. Leadership is expected to provide the required direction and guiding principles and set national goals

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Strategic Planning Based on Evidence of Needs

• Clear MC strategies facilitate advocacy and resource mobilization; hence sustainability

• Ensuring that national MC strategies complement or are part of the existing HIV prevention strategy can promote sustainability

• Implementing situational analysis is an important method for creating stakeholder support, engaging leaders and ensuring informed policies and programs

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Integrated Implementation Approach

• Leveraging all MC service delivery sectors (public and private) is vital for the sustainability of MC programs– Integration across sectors

• Many levels of the existing health systems may be able to provide MC services with little additional investment

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Working in Partnership• The scale-up of MC services requires

actions at many levels and across different sector

• Partnership facilitates advocacy, resource mobilization and bringing knowledge and experiences from different program areas

• Partners can contribute to MC services based on their comparative advances

PEPAR budget allocationIP Agency Geog

coverageNo. sites

Activities Targets

Model of service delivery

Budget

Walter Reed

DOD Kayunga & Mukono districts

2 sites -Establish training satellite-provide MMC

10,000 Static, outreach

$1,150,000

UPDF DOD Countrywide 6 sites -Site preparation-provide MMC

6,000 Static $372,000

HIPS USAID Country wide 10 sites Site preparation-provide MMC

4,000 Static $354,580

HCP USAID National level Policy, Communica-tion strategy, job aides, IEC

516,587

MOH CDC National level Policy development

$100,000

PEPAR budget (1)IP Agenc

yGeog coverage No.

sitesActivities Target

sModel of service delivery

Budget

STAR E USAID Kapchorwa, Sironko, Bududa, Pallisa, Busia, Bukwo, Budaka, Butaleja, Mbale

TBD SitepreparationProvide MMC

TBD Static $50,000

STAR SW

USAID Kisoro, Kabale, Ibanda, Isingiro, Rukungiri, Ntungamo, Kiruhura, Kanungu

TBD SitepreparationProvide MMC

TBD Static $50000

STAR EC

USAID Iganga, Bugiri, Mayuge,Kaliro,Kamuli, Jinja

8 sites

SitepreparationProvide MMC

16,000 Static, outreach

$850,000

PEPAR budget (2)IP Age-

ncyGeog coverage

No. sites

Activities Targets Model of service delivery

Budget

MUSPH CDC Rakai, Lyantonde, Masaka

14 sites -TOT-trainingservice providers-MMC

8,000 Static, outreach

1,900,000

TBD Comprehen-sive prevention

CDC 8 districts 40 sites -Site preparationProvide MMC

10,000 Static,Outreach

$500,000

TBD Prevention

USAID

TBD TBD -Site preparation-Surgery

TBD Static, Outreach

$500,00

TBD-KCC CDC Kampala district

7 sites -Site preparation-Surgery

6,000 Static, Outreach

$300,000

TBD-Mbarara CDC Mbarara Reg hosp,

8 sites -Training Satellite -provide MMC

8,000 Static, Outreach

$423,420

Total 39 Districts 96 Sites

68,000 $7,066,587

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Innovative Implementing Approaches

• Implementing a mix of both vertical and integrated approaches

Vertical approach at the beginning to attain high MC volumes

• Task-shifting approach to sort out human resource problems; especially at peripheral health facilities

• Ensuring the incorporation of the MMC commodities into lists of national essential medicines and equipment and in the procurement and distribution systems used by service delivery sites

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I thank you