Coordination and Implementation of the National AIDS Response Iris Semini, MENA RST Yvonne Nkrumah, ASAP Oussama Tawil
THE 3 ONES Comprehensive Response to HIV Prevention, Treatment, Care and Support toward Universal Access One agreed AIDS action framework One national AIDS authority One agreed M&E system Political Commitment, Multi sector response, reaching vulnerable groups, involvement of civil society and PLHIV
Coordination and Governance of the Response National AIDS Coordinating Mechanisms established in all countries in MENA Diverse commitment, role and leadership in the formulation of the NSPs and Implementation of the response Different modus operandis, composition and limited funding
What are the key elements to ensure effective coordination and management of the implementation of the AIDS Response?
Coordination of: Participatory national AIDS strategy, targets set and operational plan elaboration
Functioning NACs, plans and programmes reflect the input of all partners: Government, civil society, people living with HIV, key populations
Accountability, Transparency of resource allocations and resource utilization
Challenges of Coordination and Governance of the response - What are the costs? Not reaching with services those most in need services mostly centralized in capital cities Distortions in human capacity, policy dialogue, focus, Resources utilization, partnership Limited capacities of non-health sectors, civil society, including at decentralized level Credibility of the national response is compromised Undermine quality of governance and capacity of public sector, civil society Stakeholder confidence levels fall
Key Observations Participatory involvement of various actors on planning, implementation and reviews Clear roles and responsibilities between coordination and implementation Equitable coverage (e.g. urban vs. rural, rich vs poor) Harmonize donors and UN agencies support to National Strategic Plans development and implementation
Review of National AIDS Coordination Mechanisms Assess existing national coordination mechanisms & produce operational guidelines for National AIDS Coordination bodies (to complement CCM guidelines): roles & responsibilities, composition, functions and relationships among each body and with other stakeholders at country Ensure that line ministries programming include their responsibilities in the national AIDS response
Key Observations Ensure transparency and information sharing to allow data use for decision-making under the government leadership Include as components in NSP and OP and budget resources to: Strengthen coordination at central and decentralized level Reinforce capacities across sectors, civil society, key populations, people living with HIV Accountability and transparency oversight structures in place Undertake reviews and measure progress toward targets
Thank you!
Main Steps and Roadmap for NSP and Operational Planning on AIDS Iris Semini Regional Support Team for MENA Oussama Tawil
Technical Working Group on NSF - Reporting to the National AIDS Committee Situation & Response Analysis Priorities Key Strategies Objectives, Outputs M&E Framework National Strategic Framework Consensus Workshop at national and decentralized level Operational Plan Costed Implementation Partners (themes, sectors) Resource Mobilization, Implementation
Applying the Logic of the Results Chain to HIV Impact Reduced HIV Incidence and Prevalence: HIV prevalence, monitoring, and evaluation (longer-term goal) Strategy Outcome Increased Coverage: access and use of services and behavior changes (strategy objectives and results) Programming Output Input Products and Services: First level results needed to achieve the outcomes (program outputs) Critical resources: money, people, equipment, supplies and know how (program inputs) Ref: World Bank, 2007. Planning and Managing for HIV Results, a Handbook
Steps to develop an NSF Establish the Working Group on AIDS - multi-disciplinary working group; Compositions: members representing key stakeholders (sectors, epidemiologist, social sciences, civil society, people living with HIV), committed to work on developing the NSF; Function: responsible for developing the NSF and coordinating input of different stakeholders; effective communication, need for clear Terms of Reference Management: is coordinated by a designated focal point and will report to the National AIDS Committee
Define Guiding Principles Adopting the Three Ones as framework for the AIDS Response Multi-partners engagement Reduce stigma and discrimination Empower people living with HIV Proactive involvement of communities, concerned populations, people living with HIV, NGOs Human right based approach and respect of confidentiality, equity
Key steps: Roadmap for NSP or OP Elaboration National consensus meeting on the roadmap for the elaboration of NSP or OP The roadmap includes: Main steps to be undertaken (epidemiological and behavioural review, response analyses, priority setting, planning, budgeting costing) Roles and responsibilities of different partners Costs of each step, including data collection and meetings Technical support needed: national, international, scope and costs Timeline, follow up and feedback mechanisms to various partners
Situation and Response Assessment Gather Information and Analyse Synthesis of epidemiological data, review of published and grey literature Main risk behaviors that are likely driving the epidemic Socio Economic environment and factors that increase vulnerability Response Analysis Legislation, policies, health factors, social values etc. Compile an inventory of existing programmes, the coverage and gaps: Prevention, Service utilization, treatment, care Civil society, PLHIV, Institutional Capacity assessment Identify opportunities and areas for expanding HIV interventions Consensus meetings (national and decentralized) Technical support, budget resources in the roadmap
Priority Setting and Strategy Elaboration Priorities set National and decentralized workshops on results of situation and response analysis Goals, objectives, results Strategic Areas of the response Programmes and services Populations Geographical areas
Development of Operational Plan
Key elements Goals, objectives, are defined through consultative workshops, interviews and the Working Group Based on priorities, the strategies/programmes, activities, and geographical coverage, M&E, data collection, targets, indicators, budget resources for generating and ensuring flow of information Identify the implementing partners Budgeting and identifying financial gaps Elaborate and cost operational plans
Technical support plan as integral part The analysis of the response need to yield results of the capacities of institutions and civil society to implement the response Implementation of innovative programmes and approaches necessitates technical support (national and international) Need to identify technical support needs along the main programmes, include it in the plan and budget it Scope of the ToRs will help to develop clear ToRs and expected outputs
Resource Mobilization Include plan for resource mobilisation Mapping of potential donors, round table and proactive approaches Budget resources to implement resource mobilization strategy Budget technical support to facilitate efforts
IMPLEMENTATION!!
Joint reviews using data to inform planning
Technical Support for NSP, Operational Plans on AIDS ASAP & MENA RST seminii@unaids.org jleno@worldbank.org