Implementing Mechanism Details
Mechanism ID: 17028
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Mechanism Name: HIV Innovations for Improved Patient Outcomes for Priority Populations (Adolescent Friendly Services for Prenatally & Behaviorally HIV Infected Adolescents )
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Funding Agency: U.S. Agency for International Development
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Procurement Type: Cooperative Agreement
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Prime Partner Name: Wits Reproductive Health& HIV Institute
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Agreement Start Date: Redacted
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Agreement End Date: Redacted
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TBD: No
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New Mechanism: Yes
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Global Fund / Multilateral Engagement: No
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G2G: No
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Managing Agency:
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Total Funding: 2,283,595
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Funding Source
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Funding Amount
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GHP-State
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2,283,595
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Sub Partner Name(s)
(No data provided.)
Overview Narrative
This programme targets adolescents living with HIV (ALHIV) between 10-19 years of age within region F of the City of Johannesburg and the Matlosana sub-district of the North West Province. The goal is to in collaboration with the Departments of Health, Basic Education and other partners to develop, pilot, evaluate and support the scale-up of a replicable model of targeted and linked interventions across clinics, schools and communities (the 3 streams of the PHC re-engineering programme) to improve the screening, diagnosis, treatment, adherence, retention in care, and psychosocial and mental health of ALHIV. The programme is highly aligned with the HIV & AIDS and TB National Strategic Plan 2012-2016, the National Youth Policy 2009-2014, the Draft Adolescent Youth Health Policy and the Integrated Schools Health Policy. The programme is implemented in close collaboration and partnership with the WRHI health systems strengthening programme and operational research projects include cost, coverage and yield analyses to obtain cost efficiencies. The project includes strong foci on alignment with national and district priorities, institutionalizing best practices and capacity building in collaboration with Regional Training Centers to ensure sustainability and transition. There are no data on adolescents within the DHIS. WRHI is exploring tier 2 and 3 systems, and is advocating for inclusion of adolescent data points in the National Indicator Data Set. WRHI will develop a mobile data platform to monitor the programme, and also to support referrals and retention in care across services. In the interim, operational research mechanisms will be utilised. Primary outcomes of interest are viral load suppression and retention rates using a snapshot approach.
Cross-Cutting Budget Attribution(s)
Education
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1,400,000
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Gender: Gender Equality
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880,500
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Human Resources for Health
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1,320,000
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Motor Vehicles: Purchased
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93,950
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TBD Details
(No data provided.)
Key Issues
Implement activities to change harmful gender norms & promote positive gender norms
Increase gender equity in HIV prevention, care, treatment and support
Increasing women's legal rights and protection
Child Survival Activities
TB
Family Planning
Budget Code Information
Mechanism ID:
Mechanism Name:
Prime Partner Name:
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17028
HIV Innovations for Improved Patient Outcomes for Priority Populations (Adolescent Friendly Services for Prenatally & Behaviorally HIV Infected Adolescents )
Wits Reproductive Health& HIV Institute
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Strategic Area
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Budget Code
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Planned Amount
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On Hold Amount
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Treatment
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HTXS
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1,283,595
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0
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Narrative:
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Note: WRHI’s adolescent programme targets adolescents living with HIV (ALHIV) between 10 to 19 years of age. WRHI will utilise age appropriate programming to address ALHIV needs. Activities are not easily separated into distinct adult and pediatric categories. This section should be read in conjunction with the PDTX section.
In order to avoid duplication of effort and ensure alignment, WRHI will identify and consult stakeholders and partners relevant to adolescents living with HIV (ALHIV). WRHI will develop and pilot an evidence-based toolkit to address identified gaps regarding the diagnosis, care, treatment, sexual and reproductive health, nutritional, psychosocial and mental health of ALHIV. In FY2013 WRHI will capacitate one adolescent expert clinic within each of region F of the City of Johannesburg and Matlosana sub-district of the North West Province to provide expert level clinical, psychosocial and mental health care for ALHIV. Utilising the toolkit, WRHI Quality Improvement Advisors (QIAs), in conjunction with DCTS and RTCs, will train and mentor DoH staff within the expert clinics and 5 PHC clinics within each supported region/sub-district. In conjunction with district department of health and relevant stakeholders, WRHI will revise or develop new pre- service training material for management of ALHIV. WRHI will also provide direct onsite supervision to the two expert adolescent clinics, which will include clinical, psychosocial as well as monitoring and evaluation support. The 5 PHC clinics in each district will receive on-site clinical, psychosocial and data management support from QIAs. The level of on-site supervision is anticipated to decrease in future years. There are currently no routinely reported indicators related to adolescents within the DHIS. Discussions with NDoH to modify the national indicator data set to analyse adolescent HIV service utilisation and outcomes will continue. Alternatively, once available tier 2 and 3 data systems could be analysed to identify adolescents using dates of birth. WRHI will develop specifications for an open-source mobile data platform to monitor the programme, and also support referrals and retention in care. The mobile data platform will be aligned with NDoH policies and systems. In the interim operational research mechanisms including file reviews will be utilised to collect baseline data and monitor the programme. Primary outcomes of interest are viral load suppression and retention rates using a snapshot approach. Available data will be reviewed on a quarterly basis with clinical staff, and will be used to identify clinics with low retention and/or suppression rates allowing for targeted support by WRHI QIAs. Action plans utilising CQIM will be developed and implemented with clinic staff to address quality of care issues identified. Robust referral mechanisms between the three streams of PHC re-engineering will be developed, implemented and monitored. WRHI will consult with I ACT and other stakeholders and will implement and evaluate clinic-, school- and community-based psychosocial support groups for ALHIV. The programme is aligned with priorities of district and national structures, to ensure local ownership and sustainability, and is implemented in close collaboration and partnership with the WRHI health systems strengthening programme teams to obtain cost efficiencies.
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Strategic Area
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Budget Code
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Planned Amount
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On Hold Amount
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Treatment
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PDTX
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1,000,000
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0
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Narrative:
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In order to avoid duplication and ensure alignment WRHI will identify and consult with stakeholders and partners working with adolescents living with HIV (ALHIV). Through participating in national guideline committees, SANAC task teams, the NDoH’s adolescent steering committee, supporting District Management Teams (DMTs) and District Clinical Special Teams (DCSTs) and disseminating outcomes of operational research activities WRHI staff members will inform policy and build capacity at national, regional, and district levels to address the needs of ALHIV. Building on the Harriet Shezi adolescent clinic, WRHI will develop and pilot an evidence-based toolkit to support clinics to address identified gaps in the provision of diagnosis, care, treatment, sexual and reproductive health, nutritional, psychosocial and mental health, disclosure and step-up adherence services for ALHIV. In FY2013 WRHI will capacitate one clinic within region F of the City of Johannesburg and Matlosana sub-district of the North West Province to provide expert level clinical, psychosocial and mental health care for ALHIV. Utilising the toolkit, WRHI Quality improvement advisors in conjunction with DCTS and Regional Training Centers, will train and mentor DoH staff within the expert clinic and 5 PHC clinics within each supported region/sub-district to provide adolescent friendly HIV-related services which address the specific needs of ALHIV. WRHI will implement and monitor robust referral mechanisms between the PHCs and the sub-district level expert adolescent clinics to ensure adolescents receive high quality care including management of drug complications, treatment failure, and complex psychosocial and mental health conditions. In partnership with other stakeholders, WRHI will support the implementation and evaluation of school-based and community-based support groups. Through supporting the implementation of the Integrated Schools Health Policy (ISHP) WRHI will strengthen the screening, diagnosis and referral of ALHIV. WRHI will strengthen coordination and linkages between school health services, ward based PHC re-engineering teams and clinics to strengthen continuity of care for ALHIV across the 3 streams of PHC re-engineering. Utilising existing community fora, community radio, and social media, WRHI will support community social mobilization on specific issues related to ALHIV, including late presentation of MTCT and HCT. Strategies to support and monitor the transition of adolescents to adult services will be developed and evaluated. WRHI will incorporate management of ALHIV specific needs into pre-service curricula. There are currently no routinely reported indicators related to adolescents within the DHIS. During FY2013 WRHI will develop specifications for an open-source mobile data platform to monitor the programme, and also to support referrals and retention in care. The mobile data platform will be aligned with NDoH policies and systems. In the interim, operational research mechanisms including file reviews will be utilised to collect baseline data and monitor the programme. Harriet Shezi adolescent clinic data were used to set interim targets for FY2013 and FY2014. There are currently 399 adolescents <15 years of age on ART attending the Harriet Shezi adolescent clinic. In FY2013 and FY2014, 150 and 250 adolescents <15 years of age will be commenced on ART, with a total ever on ART in FY2013 and 2014 of 550 and 800 respectively.
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Implementing Mechanism Details
Mechanism ID: 17029
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Mechanism Name: HIV Innovations for Improved Patient Outcomes in South Africa (Innovation Clinic)
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Funding Agency: U.S. Agency for International Development
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Procurement Type: Cooperative Agreement
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Prime Partner Name: Witkoppen Health & Welfare Centre (WHWC)
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Agreement Start Date: Redacted
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Agreement End Date: Redacted
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TBD: No
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New Mechanism: Yes
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Global Fund / Multilateral Engagement: No
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G2G: No
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Managing Agency:
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Total Funding: 4,390,092
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Funding Source
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Funding Amount
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GHP-State
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4,390,092
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