Transcript Treatment, care and support

Programme Update
Overcoming HIV/AIDS Epidemic in Ukraine
National programme supported by GFATM
Presentation by I. Borushek, L. Shurpach, L. Hyde and P. Smyrnov at the
2nd Stakeholders’ Meeting on the GFATM Grant to Ukraine, Kyiv, June 3,
2004
Treatment, Care and
Support
Procurement of healthproducts
• ARVs
• Non-ARV medications and baby
formulas
• Diagnostic equipment and reagents
ARV supplies
• Emergency delivery (for 137 patients)
expected to start arriving on the 1st
week of June
• Main delivery (for 2000 adult patients) is
expected to arrive during the 3rd week of
June
• Main delivery of paediatric formulations
(for 100 children) is expected in the first
half of July
ARV supplies
• Specifications for ARV drugs for prevention
of mother-to-child HIV transmission
(PMTCT) and post-exposure prophylaxis
(PEP) are approved
• Permission of the Global Fund to procure
ARVs for PMTCT and PEP through IDA
obtained
Procurement: what’s done
• Local logistical companies recommended by
MoH assessed by an independent expert
• Agreements
– concluded with Ukrainian Centre for AIDS
Prevention on provision of humanitarian aid in the
form of ARVs;
– prepared with logistical company
“Ukrmedpostach” on handling ARV shipments
upon arrival
• Documents submitted to the Humanitarian
Aid Commission at the Cabinet of Ministers of
Ukraine (hearings are expected on June 3)
Procurement: what’s in progress
• Ongoing working contact with MoH, National
AIDS Centre, IDA, and PATH is maintained
• Agreement with IDA on procurement of ARVs
for PMTCT and PEP is being prepared
• Tender documentation for procurement of
medications for management of opportunistic
infections and equipment for CD4 testing
(with reagents) is being prepared
• Specifications for infant milk formula for
children born to HIV+ mothers and equipment
(with reagents) for viral load and CBC testing
are in progress
Clinical subcomponent
Grant Agreement with Ukrainian Centre for AIDS Prevention of the
MoH of Ukraine for implementation of the project «Organization
of medical care provision to people with HIV and AIDS»
budget USD 246,000
First steps of the project:
1. Treatment preparedness of the 6 priority regional AIDS
centres (by definition of the MoH) is assessed
2. Meeting of head physicians of the regional AIDS centers to be
the 1st stage treatment sites (Odesa, Donetsk, Dnipropetrovsk,
Mykolayiv, AR Crimea, Kyiv) held jointly with MoH and the
Alliance
3. Multidisciplinary treatment model adopted
4. Specifications for pharmaceuticals and medical equipment to
be procured under the project developed
5. Drugs distribution plan for the regions for the 1st stage of
ART implementation is prepared
Clinical subcomponent
Created Specification Review Committee for review and approval
of specifications for health products to be procured representing:
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International HIV/AIDS Alliance Secretariat (UK)
ICF „International HIV/AIDS Alliance in Ukraine”
Ministry of Health of Ukraine
Ukrainian Centre for AIDS Prevention
Clinic of the Institute of Epidemiology and Infectious Diseases of
AMS of Ukraine
World Health Organization (WHO)
All-Ukrainian Coalition of HIV-service NGO
All-Ukrainian Network of People Living with HIV
Program for Appropriate Technologies in Health (PATH).
Observers:
Local Fund Agent (PWC), USAID,Delegation of European
Commission to Ukraine (EU), DFID, MSF-Holland in Ukraine,
Embassy of Japan in Ukraine.
Clinical subcomponent
On May 26, 2004 the Specification Review
Committee has approved the following
specifications:
• Drugs for management of opportunistic infections;
• Drugs for prevention of mother-to-child
transmission;
• Drugs for post-exposure prophylaxis;
• Diagnostic equipment and test-systems for CD4
testing;
• Drugs for substitution therapy for HIV+ injecting
drug users.
Clinical subcomponent
• RFAs announced:
1)“Provision of technical assistance to the
clinical component implementers in planning,
implementation and monitoring of treatment
programmes" ,
2)“Provision of a comprehensive unified
professional training programme under the
project “Overcoming HIV/AIDS epidemic in
Ukraine"
• Applications Review Committee to assess the
received applications is being formed.
Care and support
Grant Agreement with the national charitable organization «AllUkrainian Network of PLHA» for implementation of the project
“Ensuring care and support for people living with HIV/AIDS”,
budget USD 801,000.
Components of the project:
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Non-medical home-based care
Self-help movement development
Psychosocial care and support (community cеntre)
Provision of comprehensive care to PLHA
Care and support for HIV+ children and women
Care and support in penitentiary institutions
Social entrepreneurship
Training and internships programme
Care and support
Grant Agreements with existing partners are being prepared for
signing:
А) Social and psychological ARV treatment support
• NGO «Time for Life +» (Clinic of the Institute of Epidemiology
and Infectious Diseases known as Lavra Clinic)
• NGO «Self-help club «Life+» (Odesa AIDS Centre)
Б) Rehabilitation of HIV+ injecting drug users
• NGO «Rehabilitation Centre «Steps»
В) National hot line on HIV/AIDS issues
• CF «Substance Abuse and AIDS Prevention Foundation»
(SAAPF)
Care and support
• RFA announced: „Social and
psychological ARV treatment support in
Kyiv, Dnipropetrovsk, Donetsk,
Mykolayiv oblasts and AR of Crimea” for
partner NGOs to work with AIDS
Centres
• Applications Review Committee to
assess the received applications is
being formed
Care and support
RFA announcements prepared for the following
projects:
• Care and support for HIV+ pregnant women,
young mothers and infants (up to 6 mnths.)
born to HIV+ mothers to prevent mother-tochild HIV transmission
• Introduction of substitution therapy
• Psychosocial rehabilitation of HIV+ drug
users
Prevention in Vulnerable
Communities
Achievements to date
• Expert meetings held on the following issues:
centralised/decentralised procurement of disposables, mutual
coordination of the Global Fund and World Bank
programmes, prevention in penitentiary institutions.
• Grant agreement with IRF has been signed.
• 9 grant agreements with local partners are signed.
• Expert Committee and Proposal Review Committee are
formed.
• Training on Project Monitoring and Evaluation for local
partners is developed.
• Coordination mechanisms for all prevention programs at the
oblast level are being developed.
Requests for Applications. Prevention
• RFAs on HIV prevention in Kyiv, Mykolaiv
and Odesa oblasts are about to be launched
(geographical expansion of prevention
activities – 5 new grants).
• RFAs on HIV prevention in penitentiary
institutions is being developed (2 new
grants).
• Tender on logistical support of the training
programme is being finalised.
Expected Results. Prevention
• 32000 people will receive HIV prevention services in 8
priority regions.
• At least 2500 people will get access to HIV prevention
services as a result of launching 5 new projects in Kyiv,
Mykolaiv and Odesa oblasts.
• At least 13500 people will receive HIV prevention services
in 13 “second line” regions.
• At least 2000 imprisoned people will receive access to
information, means of hygiene and protection, and services
of peer support groups.
• More than 300 local project staff will participate in 17
trainings.
• Inter-sectoral prevention programmes will be launched in
penitentiary institutions.
Creating an Enabling Environment
through Information, Education,
and Advocacy
• One-off grant to the Network of PLHA for
Memorial Day events.
• Participation in the 10th Kyiv International
Media Fair.
• Publications: 4th edition of HIV/AIDS and the
Media, new Policy and Advocacy Update,
programme update, PLHA booklet Recently
Diagnosed (with MSF).
National communication strategy
• A strategy coordinating all AIDS-related work
in Ukraine.
• Working group formed; collecting
assessments and research carried out in
Ukraine to serve as a basis of a strategy.
• Advocating for the strategy.
• UNAIDS ‘three ones’ principles of unified
strategy, unified M&E system and unified
country coordinating body.
HIV prevention through the education
system
• Series of RFAs for developing and piloting
educational programmes and materials,
running training courses for teachers and
peer educators.
• One grant to Ukrainian Scientific and
Methodological Centre of practical
psychology and social work of the MoES for
advocating for subcomponent activities.
• Seven regional resource centres (RFA for
NGO/government coalitions).
Advocacy
• Small grants to NGOs working on advocacy
issues around vulnerable groups.
• Grant to a national human rights organisation
working with PLHA Network alternative
information.
• Trainings, round tables for militia and prisons
administration on basis of regional resource
centres (involvement of trainers supported by
UNDP).
IEC work with vulnerable communities
• Grants for local NGOs to produce
materials tailored to local situations.
• Grants for national level publications.
• Working group assessing existing
materials for inclusion in a database.
Monitoring & Evaluation
Component activities
• Supporting
development of the
National M&E system
• Program monitoring and
evaluation of the Global
Fund project (all four
components)
– Monitoring and
Evaluation Plan
Program update
Routine and sentinel surveillance
Ukrainian AIDS Center was identified as a key partner
organization for conducting sentinel surveillance. Grant
agreement between the Alliance Ukraine and AIDS Center on
improving system of routine epidemiological surveillance and
on conducting sentinel surveillance was signed.
Program update
Working group on protocols and instructions
development
As a start-up activity of work within the component, previous PR work plan
has been reviewed and discussed. On its basis, a working plan for the M&E
component was developed. Consultations with international organizations
such as UNAIDS, UNDP, WB, AFEW, WHO etc., international
consultants, research institutions and Ministries as to the activities
suggested in the working plan were held in the beginning of April. As a
result of this process, several principal decisions have been made:
– to establish a working model of the M&E system by supporting its crucial
components, such as epidemiological and sentinel surveillance
– to conduct surveys and research in order to obtain information on National
indicators and report to UNGASS
– to establish an expert working group for development of standard methodology
and analysis of the results of social research
– to establish a working group which would facilitate official recognition of
methodology on National indicators
Program update
Special studies
Under the UNAIDS coordination 2 expert groups where established for
operationalizing and standardising M&E data collection protocols
The developing of the standardized protocols and methodical recommendations is
working on such process:
Expert sociological
group
Main research
organisation
representatives
Working group on
protocols and
instructions
developing
Representatives from
core ministries
Approving by
Technical
Working Group
on the Strategic
Planning
Process/UNGASS
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Officializing
Publishing
Program update
Special studies on national indicators
• Currently, the social research expert group is effectively
working on development of standard methodical
recommendations for behavioral research.
• As a result, standardized methodical recommendations and
questionnaires for sentinel surveillance among IDU and
FSW have been developed, approved by TWG
SPP/UNGASS and prepared for tender. Work on methodical
recommendations and questionnaires for BSS among youth
and MSM is in progress.
• Work of the expert group on surveys in structure of Second
Generation Surveillance is done in close cooperation with
AIDS Center.
Program update
Working group on protocols and instructions developing
The Alliance M&E team was actively participating in
preparation of the Cabinet of Ministries of Ukraine
Decree aimed to recognize national indicators and
designate responsible Ministries. In order to begin a
process of data collection and to be able to report to
UNGASS session on national indicators, a plan of
survey activities and actions on indicators, which will
be not covered by the research, was developed.
Monitoring and Evaluation of the GF
program
Monitoring and Evaluation Plan
• enable the collection of baseline data and the
subsequent monitoring of changes in the course of
the program/project
• develop common standards and guidelines
regarding the scope and quality of monitoring and
evaluating programs
• to establish causal relationships between the
activities of a particular program and results
Monitoring and Evaluation of the GF
program
Monitoring and Evaluation Plan Structure
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Introduction
Key Indicators
Collecting, Reporting and Managing
Using
Quality and Accuracy
M&E plan table
Key indicators
• Groups of indicators
– Process, coverage, impact
– National, international indicators, program
specific indicators
– Treatment, care and support, prevention, IEA,
capacity building
Collecting and Reporting
• Systematic data collection is the first and vital
element of well functioning M&E system.
• Software monitoring tool for programmatic activities
and reporting
• Reporting forms
• Reporting requirements – quarterly basis, step
approach
• Frequency – will depend on the indicator
• Responsibilities for data monitoring
• Regional focus
Process of the reporting and sharing
information
Global Fund
Alliance
R&R
Alliance
workplan
Collecting
information
NGO/IO
review
NGO/IO
workplan
NGO/IO
report
Alliance
report
Stakeholders
Quality, accuracy
• Assessment to assure minimum capacities
to successfully conduct monitoring and
evaluation activities within the project
• Monitoring visits to assure proper
monitoring and reporting practices
• M&E Technical Assistance
M&E plan
• Structure of the plan
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expected results
Indicators
timeframes for monitoring of each indicator
data source for verification of monitoring data
frequency of data collection for each indicators
person responsible for the data collection
• Connection with master work plan
• Main function of the plan
– to be a useful management tool
– To be a tool for evaluating results of the particular program