HISP is the developer of the national, primary HIS for routine health data, the District Health Information System (DHIS), and as such they are a natural leader in health information systems (HIS) and SI in South Africa. The SI barriers for the planned HISP SI activities are primarily that there are multiple different HIS which operate in parallel and are non-compatible, only one of which is the DHIS. Facilities are expected to report on required indicators using multiple different HIS, separate HIS for HIV/AIDS, TB, drug-resistant TB, HRH, pharmacy supply management, and primary healthcare routine indicators. There is a lack of interoperability between HIS, even those that seek to collect identical datasets. The new HISP agreement seeks to address these barriers by developing an enterprise architecture for the eHealth strategy which will account for the role and technical functionality of every HIS. The development of the architecture will enlist all stakeholders including NDOH and software developers who created the current HIS, as well as architecture experts and frameworks. HISP will also work towards developing standards for interoperability between HIS, and work to facilitate a national electronic data standards committee. These activities will be done enlisting the approval and cooperation of the NDOH. HISP will also pilot methods of leading the development of governance structures for HIS at the provincial level. They will also works closely with the USAID partner John Snow, Inc/Enhance SI and the CDC partner WAMTech. These linkages pertain to SI activities such as routinely monitoring and improving data quality within the DHIS, and working towards interoperability between the DHIS and the TB and drug-resistant TB electronic registry HIS by revising the database structure and function. The opportunities for future linkages include working towards interoperability in the newly selected ART monitoring HIS, and PEPFAR South Africa will work to ensure that cooperation.
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Governance and Systems
OHSS
1,500,000
0
Narrative:
HISP will strengthen the National Health Information System (NHIS) through facilitating an independent HIS capacity assessment to identify gaps in the overall NHIS. This assessment should at least assess and analyze 1) the Enterprise Architecture of the NHIS, 2) health data standards, 3) health data governing structures, 4) institutional capacity to support NHIS, 5) inter-sectoral collaboration, 6) country ownership and leadership. The results will be used to develop plans to bridge gaps in collaboration with NDOH and Provincial DOH. HISP will provide technical assistance, guidance and support to implement these plans as determined by NDOH. HISP will give implementation support to Districts and PEPFAR District Partners for Tiers 1 and 2 of the 3-tiered ART monitoring system. This system was selected by the National Health Council of South Africa to be the single ART monitoring system in the country; all ART statistics are to be reported via this system. OHSS activities pertaining to this roll-out are change management and tool-specific training for the district management teams and each facility. HISP will draft a comprehensive capacity building strategy and activity plan and start implementing the initiatives during FY2012. The plan will be drafted in collaboration with NDOH and PEPFAR/SA to ensure alignment with SAG priorities and coordination within the Partnership Framework. HISP will embark on activities aimed at strengthening the HMIS and institutional capacity in South Africa through: 1) providing targeted technical assistance to NDOH, Provinces and Districts. The TA will focus on strengthening data management, data quality, use of data, and reporting at all levels but mainly at facilities; 2) supporting existing or establishing new HIS Coordinating or Data Committees for NDOH, Provinces and Districts. The role of these committees will be to deal with data quality, feedback to data sources, integration of data from parallel sources, security/confidentiality policies, and general data management issues. The idea is to replicate the existing National Health Information Systems Committee structure at Provincial and District levels.
Implementing Mechanism Details
Mechanism ID: 13688
Mechanism Name: GH1151
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention
The goal of this project is to prevent HIV infections in Gert Sibande, Mpumalanga by combine evidence based prevention programming targeting commercial sex workers (CSWs) and tavern patrons to reach 80% of CSWs in selected drinking places with comprehensive, evidence-based behavioral interventions to reduce high risk sexual behavior; ensure annual HIV testing of 90% of targeted CSWs; increase referral of CSWs to HIV care and support; implement Prevention with Positives; increase awareness of safer sex and alcohol use; and develop a project to be integrated into SAG services at provincial and district levels. When possible, indicators will be internationally recognized and derived from the PEPFAR Indicator Reference Guide. Standard data collection tools will be used to measure training and implementation outputs and outcomes, meetings will be conducted to discuss data and make data-driven decisions, information will be checked for accuracy and reliability, and audits will be conducted using established tools. HDA activities will be coordinated with Soul City’s ‘Phuza Wize’ campaign to ensure resource efficiency. The project aligns with South Africa’s strategic plan and partnership framework, and supports PEPFAR and SAG goals of supporting country-led initiatives aimed at primary prevention of HIV infections. HDA has a track record of building the capacity of local organizations, and the Departments of Social Development and Education regard HDA as a key partner in the delivery of capacity-building initiatives. PSASA staff will be trained as trainers and receive management and technical support to scale up interventions. As part of the community mobilization strategy, HDA will pass developed training resources and capacity building interventions to local organizations.
Reliable data exists neither of the HIV prevalence, current HCT coverage, nor the size of the sex worker population in this geographic area. Using a model that employs community mobilization through peer education and outreach, HDA will provide community-based HIV counseling and testing (HCT), STI screening, appropriate referrals to HIV, STI care treatment and support (including mental health and substance abuse support) to CSWs working at drinking establishments, and their male clients/tavern patrons. All HVCT funding provided through this cooperative agreement will support provision of HCT for CSWs, a most at-risk population. This project aims to reach 80% of identified sex workers in the target area with HCT. CSW peer advocates will be employed to facilitate referral to appropriate care and treatment services. HDA will work with PEPFAR partners and DoH to establish referral systems to ensure ease of access and track and follow up on the service provided. . In FY2012, HDA aims to provide HCT and STI screening to 1000 persons (800 CSWs and 200 of their male clients). In FY2012, HDA will conduct bio-behavioral surveillance as part of the situational assessment to obtain baseline prevalence and risk behavior information. In 2012, this surveillance activity will sample 500 CSWs in Gerte Sibande district at a unit cost of $40.57 per study participant.
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
HVOP
540,000
0
Narrative:
HDA has identified 5 target groups for this project: CSWs, male tavern patrons, tavern owners and managers, primary healthcare workers, and partnering CBOs. HDA's HCT activities will be complemented by sex worker peer advocates and male peer advocates trained through the “One Man Can” campaign, who will provide community mobilizations around HCT and STI screening services, distribute female and male condoms and risk reduction information to sex workers and male patrons at drinking establishments. CSWs identified through stakeholder engagement will participate in formal workshops and trainings (Stepping Stones Intervention) to examine attitudes towards gender and relationships, build on their knowledge of aspects of sexual health and HIV/AIDS, and develop skills to help them communicate their needs to others. The target for the Stepping Stones training in FY2012 is 600 CSWs. Of the CSWs participating in Stepping Stones, those who show leadership and an aptitude for peer education will be trained as peer advocates. The functions of peer advocates are to provide risk reduction education and condoms to their peers, support the practice of preventative behavior, and link CSWs to the primary health care system. HDA aims to train 80 CSW in FY2012 as peer advocates, who will in turn provide risk reduction information, support and materials to 6200 people in FY2012 . The ‘One Man Can’ tools and materials will be adapted to provide men-to-men peer outreach in taverns to discuss alcohol use, violence, and masculinity to ensure a combination of behavior change strategies in drinking locations. 20 peer educators for the One Man Can component of this project will be trained in FY2012. HDA will hold training sessions for tavern owners and managers on how to support the project and CSWs frequenting their establishments as well as ensuring the availability of condoms. The buy-in and support from local health workers is crucial for the creation of a conducive environment in which CSWs able to practice risk reduction behavior and seek appropriate health services. In partnership with Department of Health, DHA will obtain buy-in and provide clinic health staff with information and sensitizations trainings on providing cooperative and friendly places for CSWs (and their sex partners), to obtain appropriate health services, and collect condoms and lubricants. DHA will work with PEPFAR partners and DoH to establish referral systems based on the standard HBC system for their peer educators to ensure ease of access and track and follow up on the service provided.
Implementing Mechanism Details
Mechanism ID: 13695
Mechanism Name: Epicentre AIDS Risk Management
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention
Procurement Type: Cooperative Agreement
Prime Partner Name: Epicentre AIDS Risk Management
