Transcript Models of Support to FBO providers to scale up HIV services

Models of Support to FBO providers to
scale up HIV services
Members
• Martin Sirengo-Kenya
• Bruno Miteyo-DRC
• Samuel Mwenda-Kenya
• Jean Claude Kazadi-USA
• Robert J. Vitillo –Caritas Int
• Carla Smith-USA
• Abubakar Sebwela-RSA
• Lebo Mothae-Lesotho
• Gift Werekhwe-Malawi
• Mona Bormet-USA
• Nyambura NjorogeSwitzerland
• Mafase Sesani-Malawi
• Bzorg Sandkjaer-Norway
• Sue Parry-Zimbabwe
• Theresa Maseka-Zambia
Introduction
• Arrangements date back to colonial period
• Many countries have national secretariats
coordinating discussions and service delivery
• Some have one umbrella secretariat like
Malawi (CHAM) and Zambia (CHAZ) whereas
others are separate like Uganda and Kenya
• Gentleman's agreement used initially until no
funding was forthcoming. This has led to govts
entering into MOUs with FBOs
Current models (MOUs)
General
1. MOUs-general
2. PPP agreements
Specific
• Financial support agreements
– Between Govt-FBO secretariat
 MOH-FBOs
 MOF-FBOs
• Service agreements -for compensation for certain services
provided
– May differ from one area to another
Areas of collaboration
• Human resource support
– Hire/secondment of HCWs
– Training of HCWs
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Payment of utility bills e.g. Electricity and water
Supply of commodities and essential drugs
Policy formulation and IEC role
M&E: Reporting and accountability
Service delivery
Challenges
• Respect and operationalization of MOUs?-Sometimes
Misinterpretation of MOUs
• Changes in the Political landscape affects existing MOUs
• Govts may have reservations about capacity of FBOs to
provide services. NB: FBOs services are complementary
• Government support not matching the workload of FBOs
• Staff turn-over (back and forth movement depending on
funding esp among seconded HCWs)
• Nationalization of church services by governments causing
suspicion and mistrust
• Compensation may not be commensurate to the workload,
cost of services and may not be timely
Recommendations
1. Have and operationalize MOUs and its specifics i.e
 Funding
 HR support
 Supply chain support
 Service delivery
 M&E
Additionally:
 Monitoring and accountability mechanism for the MOU
implementation
 Harmonization of terms of service, salaries and benefits
for HCWs