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Sharing Knowledge Globally to Fight HIV/AIDS Locally


Regional Support Office

The TA-NPI and NuPITA teams are co-located in Kampala, Uganda as it represents common time-zone to the grantees, good air links for site visits, and three of the 11 African Round 2 implementers were in Uganda. Awards made in Round 3 increased the number of implementers in Uganda and Kenya.

Forms of Support Available to Grantee Organisations

The support adopts several channels of delivery ranging from collective meetings with grantees from several or all the implementing countries, to one-on-one site visits at the implementation location, spanning a few days of involving multi-month personnel on the ground.

Flexibility of support has been necessary as TA-NPI and NuPITA together serve 27 ‘lead’ implementers but often working also with their contracted sub-recipients and lower level service delivery partners, together numbering more than 150 entities. As the implementers are established community- and faith-based organizations, TA support is planned with consideration of the ongoing service delivery to the community and the preferred or expected approaches to learning for the staff at each level of the organization.

Broad Categories of Potential Support

The overall goal of NPI is to provide support to established organisations, having limited prior U.S. government funding, to
"increase the total number of partner organizations and their capacity to provide prevention and care services."

Support therefore addressed overarching management of the NGO that had been awarded the funds. Specific systems for compliance with contractual obligations of U.S. government funding were developed as well as ‘whole organisation’ systems for staff management, reporting and feedback structures, financial accountability, and community involvement, governance, volunteer retention, and performance monitoring.

The second category is programme-related and more ‘HIV technical’ in nature. Bridging the existing capacity of staff and resources, the national priorities and guidelines, the local community reality, and access to relevant international best practice has been an ongoing area of support.

The third category has been a key feature of NPI; to promote ongoing NGO capacity, retaining collaboration networks with the community and other service providers, working with government on quality standards, and reporting of achievements, publicising successful approaches, and sharing challenges and how to mitigate them.

Unique Features of Technical Assistance (TA) to NPI Grantees

In contrast to the project management unit/short-term project method of development spending, the New Partners Initiative awardees already had premises, staff, management systems, and methods of service delivery. The organisations also had their own motivations for existence and ethos of internal controls and collaboration with government and the beneficiary community.

Support within the three broad categories requires simultaneous discovery of the organisation’s needs while continuing service delivery to their clients and funding-related compliance. Support began with a multi-grantee ‘launch,’ which gave an overview of the context of the support, immediate or short-term mandated changes for compliance, and examples of rapid adjustments to existing technical approaches to update or improve service delivery. The real-time nature of support to established service providers with minimal delay for start-up was challenging, but a unique feature of the TA.

The existing strength of the organisations to deliver services that the community needed and to work as part of a comprehensive programme of health and HIV support was a distinction from the short-term project model of implementation. The technical assistance does not solely focus on set-up/delivery/close-out, nor a single aspect of a prevention campaign or counselling programme. The NGO’s are very keen to ensure broad service coverage, integrating health behavioural change with faith or maternal care with HIV prevention.

The breadth of the available support was seen as a pleasant surprise by the implementing organisations. Their whole entity is supported rather than just the posts or departments managing the current funding. Staff management systems are developed to the level necessary for U.S. government regulations and further, where beneficial to the current structures of the NGO. Systems have been developed from their pre-award state without losing their familiarity or the compliance already built-in for European bilateral, foundation, or grant-funded activities.

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Examples of Support

Organisational management capacity

  • Financial management,
  • Record keeping,
  • Analysis and reporting,
  • Staff and organisational administration systems, including stock and materials for service delivery,
  • Systems for performance monitoring,
  • Quantitative and qualitative data collection, analysis and use in decision-making,
  • Working with sub-partners and peer organisations,
  • Collaboration with government and other large, funded programmes,
  • Strategic planning facilitation,
  • Development of staff job descriptions and appraisal systems,
  • Workshops for supportive supervision,
  • Field training in sub-recipient management for accounting and impact reporting,
  • Finance and human resource manual writing,
  • Training management and simplified implementation with lower level organisations.

Technical programme support & performance reporting

The funded organisations were working in HIV awareness/prevention, mobilising and/or delivering counselling and testing services including PMTCT, or care and support including home-based care and OVC care. As established implementers, there was a need for rapid understanding of local realities and inherent skills and gaps for the implementing organisation. A common situation was that the NGO had found past materials that they were now using, but they had not been involved in training of how to use them, lacked the printed or audio-visual IEC content, or knew that the materials were not fully-appropriate for a target audience, resulting in an identifiable gap in the population they worked with.

Being regionally-based and also therefore able to quickly link the experiences of one NGO in a certain population with another NGO in a similar but distant population, we could offer empathy for their frustration, but more importantly, rapid adjustments to help the implementers. Our links to the national AIDS authority and to other in-country donors could help remove bottlenecks related to IEC printing runs, test kits, complete care and support kits, or joining a centrally-coordinated list for ARV treatment.

The setting of service delivery standards and the subsequent monitoring, analysis, and use of the information has been a major part of TA-NPI technical support. Working with the field implementing staff, ‘problem tree analysis’ has tried to reveal cultural and local drivers of HIV; and the social ecology model and profiling of audiences has considered personal, household, and wider pressures that can affect uptake and consistent use/adherence.

Both of these strategies have guided revisions or adaption of materials and addressed fundamental challenges such as men attending HIV testing, youth afraid of group exclusion, and women gaining information on HIV and prevention (by integrating it with child health and reproductive health clinics).

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Partnership support & coordination with government

An urgent request from the grantees was that the activities they outlined in the request for NPI funds was only part of their services to communities. They had mostly tried to form partnerships and share the burden of health services delivery to their communities, but had been ‘below-the-radar,’ as they lacked the track record of being previous recipients of donor funds. Locally, even at the local government level, the NGOs were recognised as part of the national health response, but the liaison of donors and government was at the capital city level, not at the field implementation level.

Support therefore raised their profile, the organisation’s ability to describe and prove its work and internal skills, and to express the needs of the community and what a network off comprehensive services should look like. The NPI recipients, especially where the awards were to in-country, community level organisations, demonstrated that relatively low levels of funding could deliver high and rapidly-increased numbers of people reached for prevention, testing, or care and support. Host governments have generally welcomed statistical reporting and emerging-issues briefings from the NPI implementers.

Capacity building: community-based organisations

At the OGAC and CDC Global AIDS Program briefings, specific results and methods for working with the partners were showcased.

  • A community-founded NGO in western Kenya, which manages the functions of a Ministry of Health hospital, doubled the number of people attending counseling and testing services (4,800 to 9,797) in one year, developed materials targeting youth and men, and set up a network of community mobilisers in collaboration with government structures. 16 government facilities now utilize the built laboratory capacity at the NGO.
  • A network of organizations representing the needs of people with disability in Rwanda strengthened its ability to deliver services through the network and manage financial awards and reporting systems through these partners. The sub-partners have formed links to government staff and facilities, and became trainers to the government staff on inclusive materials, minimizing physical barriers to accessing services, training in signing for the hearing-impaired, and Braille counseling materials for visually impaired counselors.

Capacity building: faith-based organisations

  • A broad network of 26 Christian denominations in four regions of Kenya has worked together to deliver consistent prevention materials through more than 250 congregations, focusing on the new infection risks of multiple concurrent partnerships and discordant couples – in line with the UNAIDS Transmission Report for Kenya 2010. Materials have been adapted for the unique drivers in the four regions that span major trading routes in the west and beach tourism in the east.
  • An interfaith consortium of Christian, Ethiopian Orthodox, Islamic, and other religions in Ethiopia, which has used a network model to share capacity to deliver services without the previously experienced direct competition.

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