Through this project TB Care Association (THCA) will provide mobile and client-centered HCT, STI screening, and referral services for the entire sub-population of CSW in the target areas. Aside from preventing missed opportunities for diagnosing HIV at health facilities through provider-initiated HCT (PITC), community-based HIV counseling and testing (HBCT) services will be provided to reach people who don’t access health facilities. HCT, TB, and STI screening will be delivered using one mobile HCT team in each of sub-districts. Each team will consist of 1 professional nurse (PN), 3 lay counselors, and 4 CSW Peer Educators (CPEs). All mobile teams will be equipped with a Pima CD4 machine ($8.00/cartridge), providing point of care CD4 counts to HIV positive clients. HCT will be provided according to national guidelines and counseling will focus on personalized risk assessment and risk reduction that take into consideration issues around CSW sexual risk behaviors. Community-based HCT and TB and STI screening will identify HIV-positive clients, TB suspects, and STI suspects who will be appropriately referred for diagnosis and treatment. CPEs will coordinate with community care workers to trace these patients ensuring continuum of care. Clinicians at identified sites will be trained, mentored, and supported on CSW sensitivity and CSW-specific risk reduction counseling and health needs. Patients started on ART or TB treatment at health facilities will be linked with CCWs to ensure retention in care and adequate treatment adherence support. Indicators will be monitored and reported on a quarterly basis to the project team, the District, and PEPFAR. Processes will be set in place to evaluate the effectiveness of prevention services and will be evaluated using the continuous quality improvement methods. Managers of the mobile HCT teams will be trained using the CQI approach and will work with nurses at health facilities to implement these interventions, review regular performance quality, improve quality and systematically close the gaps through the development and testing of innovative solutions to effectively deliver services. In FY 2012 THCA aims to provide HCT to 1,600 CSW (800 in Cape Town and 800 in eThekweni).
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
HVOP
1,260,000
0
Narrative:
The project is focused on interventions that address the immediate health and safety needs of sex workers as well as targeting sex workers collectively with in-depth workshops around safer sex, general health, and life skills. In FY 2012, THCA will promote behavior change interventions and structural prevention strategies in consultation with the district and provincial department of health, community leaders, and important stakeholders, including NGOs with expertise in issues around HIV, sex work, gender, mental health, and substance abuse. THCA will collaborate with Sex Workers Education and Advocacy Taskforce (SWEAT) to engage all levels of society in addressing dominant concepts of masculinity, reducing stigma, discrimination, and gender-based violence towards sex workers; increase knowledge about HIV prevention; reduce CSWs’ risk behaviors; and improve rates of HIV testing for CSWs. To build the capacity of the public health system to address the health needs of CSWs, THCA will support the DOH to improve and integrate clinical care of CSWs into existing health services through clinical mentorship and supportive supervision of nurses and other health providers in the target areas, including sensitivity training and inclusion of risk behavior assessments specific to CSWs. Current and former sex workers will be empowered with skills to enhance their capacity to negotiate safer sex and make informed choices about their health, occupation, and human rights. To promote sustainability and government ownership, THCA will place focused emphasis on improving and developing a functioning tracking system for CSW client identification, treatment, care, and support follow through, using a community consultative approach in the development, integration, and implementation of the CSW HIV prevention project. Over the lifetime of the project, THCA aims to reach 80% of CSWs in the target areas with HCT and behavior change interventions. In FY 2012 THCA aims to reach to 1,600 CSW (800 in Cape Town and 800 in eThekweni) with individual or group level evidence-based prevention interventions and reach 400 HIV positive CSW (200 in Cape Town and 200 in eThekweni) with prevention with positives services.
Funding Agency: U.S. Department of Health and Human Services/Health Resources and Services Administration
Procurement Type: Cooperative Agreement
Prime Partner Name: International Center for AIDS Care and Treatment Programs, Columbia University
Agreement Start Date: Redacted
Agreement End Date: Redacted
TBD: No
New Mechanism: No
Global Fund / Multilateral Engagement: No
G2G: No
Managing Agency:
Total Funding: 1,162,707
Funding Source
Funding Amount
GHP-State
1,162,707
Sub Partner Name(s)
(No data provided.)
Overview Narrative
The shortage of health professionals especially nurses, along with increased demand for health care as a result of TB/HIV, places severe limitations on South Africa’s ability to deliver effective services. Nursing Tutors lack appropriate knowledge and skills. The Nursing Capacity Building Program (NCBP), a multi country program, consists of two types of sub-projects: (a) general pre-service and/or in-service nursing training and capacity building has a special focus on HIV/AIDS, addresses a range of nursing issues, and has flexibility in addressing multi-sectoral, national, and local nursing issues and (b) the Nursing Education Partnership Initiative (NEPI) - focuses on improving the quality and quantity of nurse and midwifery graduates through the strengthening of nursing/midwifery educational institutions. The NCBP helps build individual country level programs and collaborates with Nurses Councils and Associations to provide enhanced technical expertise and networking support for governments to develop expanded scopes of practice and increased nursing leadership. The goals of the program are identifying the needs of nursing education institutions, so that they can adequately train graduating nurses for clinical work, and improving the pre-service training. NCBP will work closely with the DOH in identified provinces in the country as well as with nurse educational institutions (NEI) to build on the Campus to Clinic Mentorship Program (CTCM) developed by the ICAP Nurse Capacity Initiative (INCI) and to improve the production, quality, and relevance of nurses and midwives to address essential population-based health care needs, including HIV and other life threatening conditions.
Cross-Cutting Budget Attribution(s)
Human Resources for Health
1,162,000
TBD Details
(No data provided.)
Key Issues
(No data provided.)
Budget Code Information
Mechanism ID:
Mechanism Name:
Prime Partner Name:
13923
NEPI
International Center for AIDS Care and Treatment Programs, Columbia University
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Governance and Systems
OHSS
1,162,707
0
Narrative:
The continuing shortage of health professionals especially nurses, along with increased demand for health care as a result of TB/HIV, places severe limitations on South Africa’s ability to deliver effective services. Nursing Tutors who teach TB/HIV interventions in the nursing schools, lack appropriate knowledge and skills, and continues to contribute little to the training of nursing students in the area of TB/HIV.
The goals of the NCBP program in South Africa is identifying the needs of nursing education institutions, so that they can adequately train graduating nurses for clinical work and improving the pre-service and in-service training. The NCBP in South Africa helps build programs aimed at:
• Equipping nursing faculty with comprehensive HIV and TB training and confidence to teach these skills to nursing students; and
•Provide nursing students with a comprehensive pre-service teaching before entering practice.
NCBP/SA will also collaborate with the South African Nursing Council and Associations to provide enhanced technical expertise and networking support for the South Africa government to develop expanded scopes of practice and increased nursing leadership in the country. NCBP/SA will work closely with identified provincial Departments of Health as well as nurse educational institutions (NEI) in the provinces to expand on the Campus to Clinic Mentorship Program (CTCM) that was developed by INCI during 2009 and 2010, and to improve the production, quality, and relevance of nurses and midwives to address essential population-based health care needs, including HIV and other life threatening conditions, in low resource settings. Advisory Committees will be formed with heads of the relevant departments of health and senior representatives from each NEI. The program will employ full time staff that will be supervised by a senior nursing advisor. The program uses a case study approach covering knowledge, skills and systems thinking.
The goal of this program is to integrate safe medical male circumcision (MMC) into hospitals and clinics in Sisonke District, KwaZulu-Natal (KZN) Province as part of a package of HIV prevention services for 90% of males 15-49. This program directly supports Goals of the Partnership Framework including: preventing new HIV and TB infections and addressing female vulnerability to HIV and other STI infection by reducing incidence in male sexual partners. It is similarly supportive of the National Strategic Plan to reduce new HIV infections by 50%, as well as the KZN HIV strategy that lists MMC as one of three top priority interventions. The program will train healthcare professionals in safe MMC and build the capacity of 4 district hospitals and approximately 20 district clinics to provide routine facility-based and mobile MMC; the program will also establish linkages between MMC and STI, HIV, and TB management. MMC commodities will be purchased to support safe clinical procedures. Institutional skills and knowledge and bulk procurement will create cost efficiencies beyond the initial sunk costs of program setup and training. The project will create a cadre of trained professionals and equipped facilities for seamless transition to SAG management at the end of the project period. CMMB will ensure all program activities, outputs, outcomes and impact are tracked effectively and generate monthly, quarterly, semi-annual, and annual reports. CMMB will integrate data systems to avoid duplication with SAG systems. Data systems will be electronic and automated and in real-time in order to permit timely reporting of all MMC activities and outcomes. CMMB will purchase two vehicles to support expanded coverage to 3 new hospitals and surrounding clinics in its 2nd year of operation.
Cross-Cutting Budget Attribution(s)
Gender: Gender Equality
100,000
Motor Vehicles: Purchased
36,492
TBD Details
(No data provided.)
Key Issues
(No data provided.)
Budget Code Information
Mechanism ID:
Mechanism Name:
Prime Partner Name:
13938
Catholic Medical Mission Board
Catholic Medical Mission Board
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
CIRC
500,000
0
Narrative:
CMMB will contribute towards provincial and national MMC targets by circumcising 14,200 males in FY FY2012 (at $140/MMC) and 17,000 males in FY2013 (at $100/MMC). This will be achieved with fixed services at district hospitals and clinics and mobile services in hard-to-reach populations. As staff’s technical skills and site management capacity increase, more efficiencies and cost savings are anticipated. CMMB will operate against a sustainability plan to capacitate facilities and their staff for MMC impact beyond the completion of the project. The program will use reporting mechanisms that fold into SAG district, provincial and national systems, avoiding creating parallel structures. CMMB will build on best practices in MMC, including use of forceps-guided surgery, employing models to optimize volume and efficiencies, incorporating messaging on gender norms and proper treatment of females, and delivering these as part of a package of prevention services, including HCT, age-appropriate risk reduction counseling, condom demonstration, provision and promotion, and linkages to family planning, STI, HIV, TB, and other treatment services. Demand creation will include coordination with local partners, and building upon its existing relationships with local community-based and faith-based organizations, and engaging local leaders to encourage men to accept and request MMC. Men will be reached in their homes, through the community centers, workplaces, athletic events, markets, churches, and also in the schools and provided with targeted prevention and MC uptake messages, as well as information on the availability of MC. The MMC activities are intended not only as a single biomedical intervention to reduce HIV acquisition risk, but also an opportunity to engage men in health services and maximize linkages to other key resources for males’ improved long-term engagement in the health sector, increasing their likelihood to seek support for sexual and reproductive health and chronic disease management.
Implementing Mechanism Details
Mechanism ID: 14126
Mechanism Name: GH11-1151 MARPs
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention
