Evaluating transition readiness towards sustainable HIV/AIDS response: Evidence from four Eastern European countries
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1 Evaluating transition readiness towards sustainable HIV/AIDS response: Evidence from four Eastern European countries Ivdity Chikovani, Tamar Gotsadze, Ana Amaia, George Gotsadze IAEN preconference, July 15,
2 About the study Commissioned by The Global Fund (2015) Aiming at: developing and testing the Framework for Transition Readiness Assessment guiding countries transition process & informing the Global Fund s sustainability and transition policy development 2
3 Countries Studied Belarus Georgia Bulgaria Ukraine
4 Transition Preparedness Assessment (TPA) Framework External Environment Internal Environment Governance Inputs Outcome Programme Source: Amaya, A.B., Gotsadze, G. and Chikovani, I. (2015). The road to sustainability: Assessing transition preparedness for a post- Global Fund context. Tbilisi, Georgia: Curatio International Foundation.
5 TPA Framework Domains & Components Source: Amaya, A.B., Gotsadze, G. and Chikovani, I.
6 About the TPA Framework Assesses HIV/AIDS, TB and Malaria Uses Health Systems lens Identifies bottlenecks to be addressed for successful transition 59 Indicators specific to the HIV/AIDS 12 Indicators general for TB, HIV/AIDS, Malaria Data sources Public databases (the WB, UNAIDS, etc.) Country specific literature and databases Qualitative Supported by the Excel tool (Eng, Rus) and User s Manual (Eng, Rus) To be applied by national stakeholders
7 TPA Component scoring example
8 TPA results visualization 4 countries 8
9 External Environment Strong political will to invest in health (Bel, Bul), favourable economic indicators (Bel, Bul, Geo) to facilitate transition process Enabling environment for CSO participation in the national response and available contracting mechanisms reduce sustainability risks (Bul, Geo, Ukr) The persistence of stigma and punitive legal environment limit access to services for KP, leading to reduced coverage (Bel, Geo, Ukr) 9
10 Financing, HR, HIS Increasing trend in expenditure for HIV/AIDS, however significant financial dependence on external support, low spending on prevention activities TGF investments in human resource trainings, mostly not institutionalized and create risks after transition Information production (second generation surveillance) completey donor dependent Data transparency, easy access is challenging 10
11 Governance Political commitment demonstrated by legally empowered NSP (exp Geo). Externally funded coordination function (CCM) not well placed within national governance structure Institutional and individual leadership effectiveness with varying degree Conducive environement for CSO Bul, followed by Ukr, Geo 11
12 Service Delivery, Transition Coverage and treatment adherence improving, coverage with KP preventive services increasing Sub-optimal integration of HIV & TB services, HIV & Primary care SCO contracting is lacking Lack of adequate planning and/or preparedness for transition 12
13 TPA application Transitioning Countries Assess Transition Preparedness Transition plans development and monitoring LIC & L-MIC Assess transition risk of the Program Grant components Planning of steps ahead towards sustainability
14 Thank You
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