Tracking HIV/AIDS resources in-country: Institutionalization through capacity building and regional...
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Tracking HIV/AIDS resources in-country: Institutionalization through capacity building and regional networks
T. Dmytraczenko and S. De, Abt Associates Inc.and PHRplusIn collaboration with José Antonio Izazola, SIDALAC and Teresa Guthrie, Idasa
Points of clarification
What do I mean by institutionalization? Housed in a national institution Periodic
PHRplus experience NHA, HIV/AIDS subanalysis
SIDALAC experience NAA
Overview of process
Principal goal is to produce data that can and will be used by policymakers
Stakeholder buy-in of NHA process is critical
Heavy emphasis on institutionalization Building capacity within the government so that data can be
collected regularly
Closely follows NHA framework
Adapts to the state of the epidemic and country context
Key elements in the the institutionalization process
Determine when to conduct subanalysis Concurrent with implementation of a general NHA
Set up the subanalysis core team Members of the general NHA
Ministry of Health (MoH) Representatives from MoH HIV/AIDS program
and/or multi-sectoral HIV/AIDS committee Lead the process
Key elements in the the institutionalization process (cont.) Consultation with a broader group of
stakeholders Steering Committee
CCM, major donors (such as CDC, UNAIDS), NGOs involved in HIV/AIDS, civil society organizations
Communicate policy concerns to NHA team Give feedback to NHA team on results and findings Facilitate any difficulties NHA team might encounter Assist in interpreting the NHA results and drawing policy
implications
Steering Committee and core team
NHA & HIV/AIDS
subanalysis Core Team
Steering Committee
General country stakeholders
Building capacity
Orientation to methodological approach OECD System of Health Accounts A Guide for Producing NHA in Low- and Middle Income
Countries – WHO, World Bank, USAID Identification of data sources
Review of secondary data Primary data collection as a last resort
PLWHA survey Donor survey, NGO survey, employer survey etc.
Adapted to state of the epidemic
Capacity building (cont.)
Technical support Survey instrument development by core team, approval by
steering committee Training local data collectors Data analysis by core team in consultation with steering
committee Report writing by core team, vetting by steering committee
Formulation of a dissemination strategy Discussion of how to incorporate data collection within
ongoing government information systems
Factors that affect policy use of NHA HIV/AIDS
Maximum Maximum Use In Use In PolicyPolicy
MinimalUse In Policy
““ Con
trol
labl
e”C
ontr
olla
ble”
Fact
ors
Fact
ors
Stakeholder involvementStakeholder involvement
Policy linkagesPolicy linkages
Dissemination strategyDissemination strategy
OwnershipOwnership
TimelinessTimeliness
Credibility of reportCredibility of report
““ Cha
n ce”
Cha
n ce”
Fact
ors
Fact
ors
Government stabilityGovernment stability
Political opportunityPolitical opportunity
Policy advocatePolicy advocate
““--””
““--””
““+”+”
““+”+”
Regional Networks
Regional networks
SIDALAC National AIDS accounts network 20 countries in Latin America and the Caribbean Aim to start a network in West Africa
PHRplus and partners National Health Accounts networks
Idasa Civil society advocacy networks throughout Africa
that can support resource tracking networks
Regional networks
Creation and maintenance of a forum for exchange by geographical region / sub-region
Electronic, study visits or periodic meeting Bring together teams conducting HIV/AIDS tracking in different
countries Provide south-south and horizontal technical assistance Exchange of lessons learnt
Process and technical On-going technical cooperation and harmonization of
methods Mechanism for capacity building
Challenges in creating and sustaining regional networks
Dependence on external support Launch and sustain networks
Possible to leverage existing efforts May not get desired participants nor optimal skill set
Sufficient financing of new estimates, and secure financial support for medium/long term initiatives (not a once exercise)
Avoid dominance by one country
Challenges (continued)
Mechanism for formal peer-review Willingness to submit estimates for revision by expert sources
Empowering civil society organizations to undertake HIV/AIDS budget monitoring and participate in networks for resource tracking
Political will to use and validate the information National authorities, international agencies / programs
Support the use of the information for advocacy purposes, but keep objectives separate
Challenges (continued)
Capacity-building should occur through the process of resource tracking Expenditure tracking: government entity Budget analysis: civil society organizations
Building national systems to track performance Weak commitment in HIV/AIDS community Purview of broader health system
Is it really?