AIDS Prevention Initiative in Nigeria (APIN): Development and Status

AIDS Prevention Initiative Nigeria

AIDS Prevention Initiative in Nigeria (APIN):

Development and Status

Prosper Okonkwo. MDAPIN, Nigeria

8th Annual Track 1.0 ART Program MeetingMaputo, Mozambique

August 11, 2010

Friday, April 21, 2023


Outline

Development Introduction Governance Phases of Transition Management Systems

Status Lessons learned Questions from the field



Introduction

History

APIN was established as a program of HSPH in 2000 with a grant from the Gates Foundation

The Harvard PEPFAR(APIN Plus) Program

APIN LLC was incorporated as a local NGO in 2007 to gradually assume HSPH’s work in Nigeria.

Triggers of NGO formation



Governance

Two tiered structure

HRSA’s recommendations on governance

New board Composition More diversified board Meeting transition guidelines (85 % Nigerians) Broadened scope of activities

E.g. Resource mobilization for sustainability



Phases of Transition

APIN as sub contractor managing all HSPH sites.

APIN as sub contractor for all HSPH sites and an independent IP ( RFA PS07- 730).

APIN as sub contractor for some sites and IP with more sites transferred from HSPH each year.

APIN to soon absorb all “available” HSPH sites.



APIN Ltd and Harvard PEPFAR Sites

Nigerian states that currently include sites under APIN Ltd & Harvard PEPFAR

11



APIN/Harvard PEPFAR Sites: as of 2007

APIN Program OfficeSites Under Harvard PEPFAR

Sites Under Harvard PEPFAR

Sites Under APIN LtdSites Under APIN Ltd

68 Nigerian Army Reference Hospital Nigerian Institute for Medical Research

National Military Hospital, ‘Creek’ Lagos University Teaching Hospital

University of Lagos, College of Medicine Mushin General Hospital

PHC-Iru Victoria Island Onikan Women’s Hospital

68 Nigerian Army Reference Hospital Nigerian Institute for Medical Research

National Military Hospital, ‘Creek’ Lagos University Teaching Hospital

University of Lagos, College of Medicine Mushin General Hospital

PHC-Iru Victoria Island Onikan Women’s Hospital

Sacred Heart Catholic Hospital Lantoro


Federal Medical Centre Makurdi

Federal Medical Centre Makurdi

Jos University Teaching Hospital

Our Lady of Apostles Hospital Jos

8 Satellite Hospitals, 44 PHCs




University of Maiduguri Teaching Hospital

State Specialist Hospital MaiduguriNursing Home Maiduguri



University of Nigeria Teaching Hospital


Ahmadu Bello University Teaching Hospital

Ahmadu Bello University Teaching Hospital

Widowcare Abakiliki Ebonyi


Federal Medical Centre Nguru


University of Ibadan College of Medicine

3 Satellites under UCHAdeoyo Maternity Hospital

University of Ibadan College of Medicine




Site Allocation: 2007-2008Harvard PEPFAR APIN Ltd

+ Oyo 43 Oyo State DOTS Centres

Benue: Federal Medical Centre Makurdi Borno

University of Maiduguri Teaching Hospital State Specialist Hospital Maiduguri Nursing Home Maiduguri

Ebonyi: Widowcare Abakiliki Enugu: University of Nigeria Teaching Hospital Ituku-Ozalla Kaduna: Ahmadu Bello University Teaching Hospital Lagos

68 Nigerian Army Reference Hospital Nigerian Institute for Medical Research National Military Hospital, ‘Creek’ Lagos University Teaching Hospital University of Lagos, College of Medicine

Mushin General Hospital PHC-Iru Victoria Island Onikan Women’s Hospital

Ogun: Sacred Heart Catholic Hospital Lantoro Oyo

University of Ibadan College of Medicine 3 Satellites under UCH

Adeoyo Maternity Hospital Plateau


8 Satellite Hospitals, 44 PHCs Our Lady of Apostles Hospital Jos

Yobe: Federal Medical Centre Nguru



APIN/PEPFAR Sites: August 2010

Nigerian Institute for Medical Research Lagos University Teaching Hospital

Mushin General Hospital PHC-Iru Victoria Island Onikan Women’s

Hospital

Nigerian Institute for Medical Research Lagos University Teaching Hospital

Mushin General Hospital PHC-Iru Victoria Island Onikan Women’s

Hospital



University of Ibadan College of University of Ibadan College of MedicineMedicine


43 Oyo DOTS Centres

University of Ibadan College of University of Ibadan College of MedicineMedicine


43 Oyo DOTS Centres

APIN Program Office

Federal Medical Centre Federal Medical Centre MakurdiMakurdi

Federal Medical Centre Federal Medical Centre MakurdiMakurdi

Jos University Teaching Jos University Teaching HospitalHospital



Jos University Teaching Jos University Teaching HospitalHospital









Ahmadu Bello University Teaching Ahmadu Bello University Teaching HospitalHospital

Ahmadu Bello University Teaching Ahmadu Bello University Teaching HospitalHospital







Indicator Year 1 Year 2 Year 3

Cumulative On Care

Adult 1500 21,350 33,341

Pediatric 200 1,050 2.270

Current On ART

Adult 550 13100 16,854

Pediatrics 200 1050 1,561

No of Sites 1 5 11

PMTCT Services

Pregnant women tested for HIV and received their results

5,000 14,200 50,000

HIV positive pregnant women receiving prophylaxis to reduce mother to child transmission

852 1,702

No of Sites 2 6 11

Annual Budget $1.705m $12.325m $14.864m*



Management Systems

Improvement imperative to: Receive and manage US funding directly Provide direct oversight to many big sites

Objectively verifiable systems improvement

Responses to HRSA’s recommendations, especially HR related.

Systems adjudged adequate by other assessments



Status

Management Systems (HR, finance, procurement etc.).

Plans are on to recruit for key positions.

Programs SI

Data Management M&E QI/QA

Supply Chain Management APIN 5 Yr. Strategic Plan. Moving from HIV/AIDS

focus to the broader public Health domain.



Lessons learned

Effective Communication and early buy-in among key stakeholders is crucial.

Building on already existing structures makes for smoother transition.

Building the capacity of the site personnel reduces the potential challenges of future TA.

Willingness to modify implementation models to suit the transition plan



Questions

How does the transition to local NGOs fit into program ownership by National Governments?

What effects (if any) would regionalization, finalization of the partnership framework ,etc.have on the implementation models of independent NGOs?

What are the expected outcomes of transition ? How do we know if we have been successful or not?



THANK YOU THANK YOU

AIDS Prevention Initiative in Nigeria (APIN): Development and Status

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