Health Program Descriptions

 

The approach taken by the Perinatal HIV Research Unit (PHRU) is one of comprehensive, high quality care and support for people living with HIV and AIDS (PLHIV). The PHRU will use PEPFAR funds to provide high quality coverage of prevention of mother-to-child transmission of HIV (PMTCT) in Soweto (Gauteng province) and Mpumalanga provinces. This will include support to pregnant women for pre- and post- test counseling and testing (CT), information on safe infant feeding choices, referral of women to appropriate HIV and AIDS treatment programs and support for early testing of infants exposed to HIV. The major emphasis area addressed is human resources; minor areas are information, education and communication, local organization capacity development and training. The target populations are adults, pregnant women, HIV-infected infants (0-5 years), PLHIV and their families.

 

 

BroadReach Healthcare (BRHC) supports integrated ARV services that include doctor consultations, lab testing, adherence support, patient counseling, prevention, remote decision support, quality assurance (QA), and data management. BRHC's emphasis areas are capacity building (major); with minor emphasis on strategic information and human capacity development (training). Primary target populations include adolescents, adults, and people living with HIV.

 

 

Capable Partners Program uses funds to continue building human capacity in the integration of maternal nutrition, infant and young child feeding and prevention of mother-to-child HIV transmission (PMTCT). The program is in line with the HIV & AIDS and STI Strategic Plan for South Africa, 2007-2011 and aims to broaden the involvement of agencies, including non-governmental organizations and communities to strengthen key programs such as health education and behavior change communication, voluntary counseling and testing, PMTCT, antiretroviral therapy, and screening for sexually transmitted infections and TB. All these activities will contribute to the reduction of new infections among pregnant and lactating women. The organization will continue trainings aiming at improving the quality of service delivery, focusing on the minimum packages during antenatal, labor and delivery and postnatal care based on the Batho Pele principles of respect for human rights and confidentiality.

 

 

Boston University, with its local partner Health Economics and Epidemiology Research Office (HE2RO) of the University of the Witwatersrand, generate accurate, current, program-relevant information about the outcomes, costs, cost-effectiveness, and benefits of HIV/AIDS and TB prevention, care, and treatment interventions. The project includes evaluations in five main areas:

1.    Estimating the costs and cost-effectiveness of adult and pediatric HIV treatment delivery

2.    National modeling of the costs of HIV care and treatment and PMTCT

3.    Reducing loss to pre-ART care and promoting earlier treatment initiation

4.    Improving treatment outcomes through epidemiological analysis of PEPFAR partner data

5.    Economic evaluation and modeling of TB and HIV/TB integration (case finding, diagnosis, treatment)

Each of these areas is a priority under Pillars 1 and 2 of the NSP and the Partnership Framework principles of sustainability, innovation, and responsiveness, as they focus on generating the knowledge base needed to identify efficient ways to deliver services, achieve health targets at the lowest cost, and ensure value for money. The project directly supports the SAG in improving budgeting and resource allocation. The project also strengthens decentralization and integration of health services by evaluating the outcomes and costs of different models of service delivery (e.g. nurse-managed HIV treatment and use of point-of-care TB diagnostics and CD4 tests).

 

 

FHI 360 is an Umbrella Grants Management (UGM) entity that supports institutional capacity building, technical assistance and grants administration for indigenous organizations that implement PEPFAR programs. The FHI 360 UGM aims to achieve: (i) increased capacity of South African organizations to implement USAID funded programs; (ii) increased sustainability of USAID’s HIV prevention, care and treatment efforts and enhanced country ownership of USAID funded projects; (iii) increased number of indigenous organizations moving from sub-funding under USG-based partners to direct USG funding with no intermediary; and (iv) improved networking among partners.  As a UGM partner, FHI 360 is a grants administrator, technical assistance provider, and mentor for eight sub-recipients, chosen by USAID, who in turn carry out the assistance programs. FHI 360 supports institutional and technical capacity building of local organizations. Local organizations supported under the FHI 360 UGM program include: Anglican AIDS and Healthcare Trust (AAHT), GRIP Intervention, Heartbeat, Humana People to People in South Africa, Nurturing Orphans of AIDS for Humanity South Africa, Project Concern International, Hands at Work, and Woz’obona Early Childhood Community Service Group.

 

 

The Foundation for Professional Development (FPD) supports the expansion of access to comprehensive HIV and AIDS palliative care by focusing on human capacity development with a view to increasing the detection and treatment of patients with TB and HIV co-infection. The emphasis areas for these activities are local organization capacity building and HCD. Target populations for these activities include people living with HIV and AIDS (PLHIV) and most at risk populations.

 

 

 

USAID has approved a three-year, $4.6 million public private partnership (PPP) with Atlantic Philanthropies, the Anglo American Chairman’s Fund, the De Beers Fund, and the Discovery Fund to support Africa Healthcare Placements (AHP). Africa Health Placements (AHP) supports and enhances healthcare systems in Africa by finding, placing, and retaining healthcare workers in rural and underserved areas. AHP has placed over 2,000 doctors in southern Africa, half of whom are foreign nationals.

 

 

GrassRoots Soccer’s work involves the development of a sports oriented peer

education intervention that uses both the appeal of playing sport and the use of sports analogies to promote prevention and behavior change. Sports NGOs are well placed in their linkages to schools as well as community-based sports initiatives to embark on a peer education intervention where the coaches are identified as supervisors in the program.

 

 

The Health Care Improvement Project (HCI) provides technical assistance and support in adult & pediatric basic health care, adult ART treatment, HIV counseling and testing, and health system strengthening activities to more than 80 facilities of the Department of Health (DOH), in 31 districts of all five provinces: Limpopo, Mpumalanga, North West, Eastern Cape, and KwaZulu Natal. Since 2007, HCI staff members worked closely with the national and provincial DOH to operationalize national protocols on HIV and AIDS and implement a continuum of care model to ensure that all HIV-infected patients receive optimal quality of care at any service delivery level (treatment or follow-up care site). A continuous quality improvement strategy is used, which emphasizes improving content and process of care. HCI assists districts to facilitate further scale-up of HCT, adult & pediatric HIV care and treatment services, improving retention, and the quality of services provided to PLHIV and their families. In line with the NSDA and PEPFAR priorities, HCI plays an integral role in the implementation of the PHC re-engineering initiative, while also strengthening the capacity of District Management teams to develop accurate district health plans and district health expenditure reviews in all 31 districts. HCI staff also assists the SAG with preparations for implementation of the NHI, through ongoing work with the National Core Standards. HCI capacitates DOH staff to use DHIS data to track and evaluate clinical outcomes. Support is also provided to improve the DHIS especially the HIV care data management, analysis and data quality assessments at all levels. Target populations include: PLHIV, Healthcare providers, Program Managers, PEPFAR partners, NGO/CBO/volunteers

 

 

The Hospice Palliative Care Association of South Africa (HPCA) currently has 75 member hospices throughout South Africa (SA), each an independent legal entity. The Mission of HPCA is to provide and enhance the provision of sustainable, accessible, quality palliative care. PEPFAR funds will strengthen the capacity of member hospices and other governmental and non-governmental organizations to provide quality services to HIV-infected persons.

 

 

The project aims to reduce new HIV infections, vulnerability and risk amongst migrants and mobile populations and the communities they interact with by facilitating, promoting, and providing access to HIV and TB services, strengthening capacity, and advocating for migration policies. IOM’s goals, objectives, and activities are fully aligned with the Partnership Framework and the NSP. The NSP includes migration issues as an HIV risk factor and migrants as a key population at risk. IOM implements evidence-based HIV prevention interventions targeting migrants and mobile population in Mpumalanga and Limpopo, and will extend support to Gauteng and KwaZulu-Natal, targeting migrants in hostels, migration centers, and high population density informal settlements.   Support to SAG on system strengthening will focus on increasing the understanding to effectively address migration and health to improve policy development and service delivery. Cost efficiency strategies include: implementation of evidence-informed interventions; partnerships; strengthening of local organizations; improving human capacity; and resource mobilization. Transition will include capacity building plans for phasing over of activities and shifting of roles and relationships during the four year period M&E will include target setting based on baseline data, indicators, and regular collection of key data to track progress. Data collected will be used to review project plans and develop evidence-based advocacy interventions. IOM's support to SAG will also facilitate country ownership and build capacity for provincial health departments to adhere to international human rights and guidelines on migrant health issues. Impact assessment will be conducted at the end of the project cycle.

 

 

USAID has approved a three-year, $2.2 million PPP with Chevron South Africa and AngloAmerican to support a gender-based microfinance program called Intervention with Microfinance for AIDS and Gender Equity (IMAGE). OGAC has approved two separate tranches of supplemental funding for this work, under the Public Private Partnership Challenge Fund and the Gender Challenge Fund. IMAGE is an HIV prevention program that addresses key structural drivers of HIV including poverty, gender-based inequalities, and vulnerability to HIV infection. The program combines microfinance with a gender and HIV training curriculum called Sisters For Life (SFL). It aims to improve women’s economic wellbeing and financial independence, reduce vulnerability to HIV and gender-based violence and fostering wider community mobilization. The proposal calls for scale-up of the IMAGE model in Gauteng and perhaps in KZN.

 

 

Johns Hopkins Health and Education in South Africa (JHHESA) and its 20 partners support USAID and the SAG at national, provincial, district and local level to implement evidence-based strategic advocacy, communication and social mobilization (ACSM) programs to address HIV issues. Initiatives are aligned to the NSP and USAID Prevention Guidance and Partnership Framework. JHHESA addresses HIV prevention and TB through comprehensive communication programming that address the social, structural, behavioral and biomedical drivers of the epidemic. Activities impact upon attitudes, norms, and risk perception. They also promote the uptake of services to reduce new HIV infections, increase HIV counseling and testing, drive demand for VMMC, and improve HIV/TB treatment adherence. Activities target key populations: youth, sex workers, people living with HIV, high risk women, and adult men. Activities are geographically targeted in high transmission areas including mining, farming, and informal settlements; they are tailored to each target group. Interventions combine community engagement, mass media, interpersonal, and communication approaches. Such approaches are enhanced through toolkits and social media, and link people to prevention, treatment, and social services. JHHESA also focuses on gender dynamics addressing male norms and women’s empowerment. JHHESA partners strengthen the social mobilization skills of community health care workers and NGOs. A post-graduate program focuses on health communication and workshops for provincial and district and local leaders to build capacity to design, implement, monitor, and evaluate ACSM strategies. As this is the final project year, JHHESA will document and disseminate challenges, successes and lessons learnt.

 

 

The Enhancing Strategic Information (ESI) project will provide a broad program of technical assistance and other targeted project support to improve the quality, availability and use of strategic information (SI) in South Africa. The SI activity will contribute to strengthening programs, improving accountability and reporting, and information sharing within PEPFAR partners. The proposed activities are new and focus on providing M&E technical support to PEPFAR implementing partners and USG/SA. The ESI project is managed by John Snow Inc. and aims to further strengthen M&E capacity of PEPFAR partners in the area of data management, data quality, data usage, and basic evaluation techniques through sustained technical support by Technical Task Leads. The project also intends to conduct a series of capacity building activities to strengthen M&E and program management at the implementation level.

 

 

 

In 2009, SAG restructured the Ministry of Education into the Department of Basic Education (DBE) and Department of Higher Education and Training. USAID currently provides direct support to DBE under a bilateral agreement and works with the higher education sector through targeted focus at university HIV/AIDS programs. USAID also provides technical assistance to develop policies, strategic framework, and relevant programs to respond to HIV/AIDS in schools. USAID and DBE contribute to the achievement of PF Goal 1: Prevent new HIV/TB Infections by working with DBE, Health, Social Development, and NGOs to strengthen SAG’s response to HIV prevention. Support for DBE is guided by the Draft Integrated Strategy on HIV/AIDS which focuses on the following outcomes: 1) Sexual and reproductive health (SRH) education, with HIV as a mandatory subject in all South African schools; 2) Age-adapted SRH and HIV-related life skills delivered through co-curricular means in schools; 3) Educators receive pre- and in-service training on SRH, including HIV; 4) Availability of a communication plan in all South African schools and Education Department to increase access to SRH and HIV services for learners, educators, and school support staff; 5) Service provision integrated within employee assistance programs; 6) Implementation and monitoring of a communicated safety plan that includes physical and psychological/emotional safety, including zero tolerance of discrimination, stigma, and sexual harassment/abuse; and 7) Mitigation of barriers to retention and achievement in schools for HIV affected/infected learners through policies implementation. USAID will support DBE achieve outcomes 1 to 4 and ensure harmonization with NDOH peer education programs, school health and other NGO initiatives in schools.

 

 

As an Umbrella Grants Management (UGM) partner, PACT supports institutional capacity building, technical assistance and grants administration for indigenous organizations that implement PEPFAR programs. PACT's primary goal is to build sustainable institutional capacity and increase the effectiveness of local partners to achieve expanded and high quality services. Primary target audiences include non-governmental, faith-based, and private voluntary organizations, PACT's major emphasis is the enhancement of local sub-partner capacity through the development and implementation of documented organizational systems and procedures and human capacity development at management and operational levels.

 

PACT's Rapid Response for HIV and AIDS in South Africa is an umbrella grant mechanism for USAID PEPFAR grants identified through a USG interagency competitive (APS) process. PACT's primary goal is to build sustainable institutional capacity and increase the effectiveness of local partners to achieve expanded and quality services. PACT conducts initial assessments (identifying key organizational strengths and weaknesses) and works with each partner to develop and implement a tailored, phased capacity building agenda.  

 

PACT provides funding and assistance to over 30 total PEPFAR partners and sub partners in South Africa.  Partners include: Africa Center for Health and Population Studies, CARE South Africa, Center for Positive Care, Child Welfare South Africa, Childline Mpumalanga, Childline South Africa, Children in Distress, CompreCare, Health and Development Africa, Kheth’Impilo, Living Hope, Mothers 2 Mothers Mpilonhle, National Association of Childcare Workers, Save the Children UK, Starfish, and World Vision South Africa. PACT has also provided and managed direct technical assistance in prevention, care and support strategies and has provided direct support for the Department of Health and Social Development.

 

 

In the FY12 period, SCMS will scope, plan and implement an effective pooled procurement and distribution mechanism for quality ARVs to be delivered to select PEPFAR Implementing Partners (IPs). Efficiency, availability, quality management and reduced stock obsolescence for ARVs will be the key program components. 

SCMS will assist the IPs in developing a pooled procurement model which enables ARVs to be efficiently procured and distributed while complying with the necessary regulations and governance requirements of both PEPFAR and the Government of South Africa. Appropriate tracking systems will be utilized to enable constructive monitoring and evaluation of the program, sharing relevant information with key stakeholders to guide enhancements in the supply chain to deliver ARVs to the IP patients aligned with national strategic goals. Streamlining and harmonization of the ARV supply will be an crucial outcome while still considering patient needs to ensure that the impact of essential health programs are achieved while mainstreaming patients into the public health sector.

The program will provide assistance in strengthening the IPs capacity and capability to develop efficient, sustainable long term healthcare supply chains which are locally sustainable. SCMS will leverage local partnerships and private sector capacity, driving supply chain efficiencies for the program by enabling centralized warehousing, executing appropriate commodity consolidation and/or rapid response to distribution of ARVs.

IP collaboration will be essential in developing this procurement and distribution approach, with clearly defined roles and responsibilities to establish the expected outcomes, timelines and deliverables for all the stakeholders.

 

 

FHI 360 will support the USG-SAG Partnership Framework and the NSP through care, support and MTCT interventions. FHI 360 will continue to provide the following services through its Mobile Service Units (MSU): Integrated Community Palliative Care and Integrated Access to Care and Treatment (I-ACT) programs, linkages from HIV testing to care & testing and pre-ART and retention in care and treatment. FHI 360 is the lead partner (coordinating with DOH) for the I-ACT project in the Northern Cape. I-ACT is aimed at retaining newly diagnosed HIV positive patients, not yet eligible for ART, screening of opportunistic infections, and support for preventive therapy. In its coordination efforts under I –ACT, FHI 360 will work the NCDOH as well as other partners to ensure that systems are put in place at facilities to allow for structured and functional pre-ART programs. FHI 360 will address the unmet family planning needs of HIV positive and most at risk women. Through the regional training centres (RTCs), FHI 360 will continue to participate in the NDoH led family planning (FP) and FP/HIV integration trainings/workshops for health care providers in selected provinces. FHI 360 in collaboration with NDOH and other partners will continue working on incorporating an FP/HIV integration module in the PMTCT, nurse-initiated management of ART (NIMART) and TB training manuals. FHI 360 will roll out the model of community based champions that is currently being piloted in an effort to improve FP uptake at district level. FHI 360 will focus on providing technical assistance in data collection, quality improvement, data management and reporting for NDOH.

 

 

Post-exposure prophylaxis (PEP) is an essential part of a comprehensive package of HIV prevention services and is a “foundational” part of combination prevention, critical to sustainable, long-term HIV prevention. The goal of this program is to enhance SAG capacity for sustainable nationwide access to post-rape, occupational, and voluntary post-PEP for HIV through support for policy development, building capacity for provision of PEP, and creating demand for PEP at the community level. This is a national project that will focus on women and girls, and will address other vulnerable populations such as migrants, men who have sex with men, and incarcerated populations. Focus districts for this program have been identified based on sexual assault rates and HIV prevalence.

Population Council South Africa (PCSA) will work closely with district and ward based teams identified as key pillars for the Primary Health Care re-engineering model for the adoption and implementation of policies and guidelines for PEP for sexual assault, occupational PEP, and PEP for voluntary exposures. Capacity building interventions for management in all departments and at all levels will include policy review, development and review of data collection tools, support for utilization of the tools to strengthen data quality and systematize data collection, and training on the available data to support policy development/alignment/implementation to improve the local capacity for monitoring and evaluating the HIV response. Overall training will utilize a master trainer model and the provinces will assume responsibility for all training over time. All PCSA interventions will be promoted for inclusion in subsequent district health plans.

 

 

Following the National Strategic Plan (NSP), Right to Care (RTC) will work to accelerate the scale up of family-centered approaches to adult and pediatric treatment, care and support. The specific aim is to increase the access to care support to 80% of individuals infected with HIV, in accordance with the NSP. Focus for the adult care and support program will be to scale up TB and antiretroviral (ARV) activity at all Department of Health, Comprehensive HIV and AIDS Care, Management and Treatment (CCMT) sites, supported by RTC. At the request of the provincial DOH and implemented according to the memorandums of understanding (MOUs) with each province, RTC will continue to support the activity and budget for family centered treatment, care and support.

RTC provides mentorship and technical assistance to over 18 sub-recipients. These are ongoing programs expanded with NDOH coordination and private sector support. By providing training and support to these sites, RTC leverages NDOH resources to reach an increasing number of patients. RTC supports these sites with infrastructure, staff, training, equipment and data management. In addition, the NDOH has recognized the successes of RTC supported NGO/FBO sites and has been accrediting these sites and taking over the provision of ARV drugs, laboratory monitoring and some staff salaries, thus enabling RTC to shift funds to other sites in need of support.

 

 

The Right to Care (RTC) Umbrella Grants Management (UGM) mechanism provides technical program, grant management, and capacity building support to local NGOs through sub-award agreements. RTC is a locally controlled and operated organization. For the COP 2012 period, three sub-recipients are currently planned: AgriAids, South to South, and Lifeline Rustenburg. The primary technical areas of focus of these sub-recipients are HCT for rural, migrant populations, and PMTCT delivery strengthening through provincial community healthcare worker training. The RTC program coordination team provides technical program support to sub-recipients according to the program areas they are involved in. A unique ability of the RTC UGM is the ability of the program team to leverage the expertise of in-house clinical specialists in TB/HIV, Pediatric HIV/AIDS, Adult HIV/AIDS, Pharmacy Operation and Cervical Cancer. A dedicated monitoring and evaluation (M&E) unit provides sub-recipients with support, training, and technical assistance. The RTC UGM financial team conducts award management training with focus on USAID regulations, financial management and reporting, and audit readiness. In addition, the team provides regular oversight and support to the sub-recipients in completing their monthly financial reports.

 

 

The Sexual HIV Prevention Program (SHIPP) is a bilateral partnership agreement between USAID and SAG. SHIPP supports SAG to deliver measurable HIV prevention outcomes by building capacity at national, and select provincial, district, and community levels to coordinate, implement, and evaluate HIV prevention programs. SHIPP provides technical assistance (TA) to strengthen strategic and operational leadership capacity in NDoH, DBE, DSD, DHET, and SANAC with a focus at local level to increase the demand for and access to high-quality HIV prevention services. SHIPP’s TA builds SAG capacity to understand the local epidemic and implement an optimal combination of HIV prevention approaches, biomedical, behavioral, structural, addressing drivers of the epidemic. TA includes long and short term staffing support, training, mentoring and coaching based on SAG needs. SHIPP’s TA is focused in local areas that are in the most impoverished sub-districts with high prevalence in KZN, Mpumalanga, and Gauteng provinces. In these areas SHIPP strengthens DAC and LAC leadership to improve HIV prevention responses. The DAC/LACs will use the Local Epidemic Assessment Process, a data collection and analysis tool, designed to help understand the local epidemic to improve planning, budgeting, and monitoring systems. SHIPP will support SAG’s PHC re-engineering and build capacity for community outreach programs amongst MARPs and vulnerable populations as defined by the epidemic in the focus areas. SHIPP’s Small Grants component will build capacity of CBOs and focus on scaling HIV prevention support beyond health facilities, including supporting innovative interventions for individual and social norm change to address gender dynamics, keeping girls in school, and violence against women.

 

 

Social Sectors Development Strategies Inc. has partnered with Tulane University and IRI to evaluate a selected number of USAID funded programs targeting adolescent OVC in order to provide an evidence base for informing current and future OVC programming in South Africa. In doing so, this project will promote expansion of evidence-based interventions, which is a key priority of the USG-SAG Partnership Framework and the National Strategic Action Plan. The research is targeting OVC adolescent aged 12 – 17 and their caregivers who are enrolled or participating in selected OVC programs.

The objectives of this evaluation are to: (1) Identify key points of intervention for adolescent OVC; (2) Assess the effectiveness (including cost effectiveness) of interventions or combinations of interventions in reducing HIV risk and improving the wellbeing of adolescent OVC; and (3) Develop, test and document an overall approach for evaluating adolescent OVC programming that will guide program managers in developing, improving and scaling up effective programs for adolescents. The results of this evaluation including recommendations will be disseminated through the National Action Committee for Children Affected by AIDS (NACCA) Research Working Group and presented to various stakeholders, policymakers and service delivery partners. The evaluation findings will contribute to the South Africa’s national research agenda and promote evidence-grounded policies and practices.

 

 

Strengthening Pharmaceutical Systems (SPS) will assist the National Department of Health TB sub-directorate to strengthen drug supply management for TB and more specifically the management of TB patient on ARVs by training health workers supporting the TB program on clinical pharmacology related to TB/HIV coinfection, and improving infection control, adherence monitoring, adverse drug-event reporting, medication errors and referral system(s) at selected government institutions (hospitals, community health centers, primary health care clinics). SPS will also train pharmacists on estimating requirements for ARV and TB medicines. The major area of emphasis include training and task shifting, as pharmacists and pharmacist assistants will take on greater roles in TB/HIV care.

 

 

The Systems for Improved Access to Pharmaceuticals and Services Program (SIAPS) is a 5-year cooperative agreement managed centrally by the Health Systems Division of USAID and awarded in October 2011. SIAPS will assure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes consistent with the Global Health Initiative. SIAPS will provide “next generation” technical leadership and assistance in pharmaceutical system strengthening with a deliberate focus on patient-centered services and health outcomes. Importantly, SIAPS will assist USAID and the SAG to reconcile the long-term goals of country ownership, system strengthening, and sustainability with the immediate requirements for continuing scale-up and expansion of prevention and treatment programs without adversely affecting health outcomes. SIAPS result areas will address the intersections of five health systems components (governance, human resources, information, financing, and service delivery) and the ways they interact with the medical products building block to expand access to quality pharmaceutical products and effective pharmaceutical services. As SIAPS develops its technical program, it will identify issues associated with each health system component and consider its necessary contribution to potential interventions supporting HIV/AIDS. The five Intermediate Results are:

•       IR1: Pharmaceutical sector governance strengthened

•       IR2: Capacity for pharmaceutical supply management and services increased and enhanced

•       IR3: Utilization of information for decision-making increased

•       IR4: Financing strategies and mechanisms strengthened to improve access to medicines

•       IR5: Pharmaceutical services improved to achieve desired health outcomes

 

The URC TB Project is a provincial support partner working in Northwest, Limpopo, Northern Cape, Free State, Eastern Cape, KwaZulu Natal, and Mpumalanga. The target population includes PLHIV. The project’s objective is to strengthen TB/HIV collaboration and provide PLHIV with continuum of care. The activities for FY 2012- 2014 have been amended in line with the functions of a PEPFAR provincial partner as per the Partnerships Framework between the USG and SAG and the NSP. Activities include: 1: Health systems strengthening in public and private sectors: together with NDoH, URC will strengthen TB/HIV M&E through review of TB/HIV policies and monitoring of referral systems for TB/HIV services between NDOH facilities and private sector. 2. Prevention of new TB, HIV and STI infections through the adaptation and dissemination of TB/HIV IEC material with messages of prevention, early presentation, and treatment adherence. URC will monitor the scale-up of IPT to all PLHIV. 3: Adult Care and treatment: Together with DOH, URC will monitor implementation of the 5I’s. PLHIV will be screened to exclude TB, and will be started on IPT and ART as per guidelines. Co-infected patients will be monitored for CD4 counts, CPT, and ART initiation. Local NGOs will be engaged to improve adherence to treatment and reduce treatment default. 4: Reduce stigma and discrimination: URC will support grassroots advocacy to counter stigma and promote a supportive environment for co-infected people. 5: Monitoring and evaluation and surveillance: Jointly with DOH, URC will conduct district TB/HIV review exercises and provide technical support supervision. 6: Training: Together with RTC, URC will coordinate and trainings and post training mentoring.

 

The goal of the project is to improve the care, support, and protection of OVC through increased knowledge, abilities, and wellbeing of those responsible for the care and protection of OVC at the household and community level across all of South Africa by addressing the often unmet psychosocial and skills development needs of 500 caregivers annually. With a dual focus on community caregiver support and child protection, the project incorporates the best and most promising practices from Africa. It is designed to become an enduring part of South Africa's child protection efforts. The project is now in the fourth year of its five-year pilot phase.

 

The Thogomelo project provides community caregivers (CCGs) in South Africa with three accredited skills development programs, which have been approved by the Health and Welfare Sector Educational Training Authority: Psychosocial Support for CCGs, Child Protection and Supportive Supervision for supervisors of CCGs.   This ensures that participants get credits for the training, thus improving their qualifications and potential career growth. The project is becoming cost efficient as provinces are also contributing to the training. To facilitate this process, the project developed a user-friendly budgeting tool for districts and provinces to estimate appropriate funding requirements. The project is monitored by using pre- and post-test results of the trainees and overall program reviews are held semi-annually with all stakeholders.

CCGs have the potential to be one of South Africa’s most powerful resources in prevention, early intervention and identification of child abuse, yet insufficient knowledge of child protection and societal norms may be preventing this potential from becoming reality.  However, through enhanced training, caregivers are given the appropriate tools to demonstrate increased knowledge and improved practice in child protection.

 

 

 

Tulane University’s goal under this project is to contribute to the evidence-base concerning programming for orphans and vulnerable children (OVC). By conducting case studies and assessments of existing OVC programs, this project will provide data on the priority needs of OVC, lessons learned from interventions, as well as evidence concerning the effectiveness of program models. In doing so, this project will promote expansion of knowledge-based interventions, which is a key priority of the USG-SAG Partnership Framework and the National Strategic Action Plan. Assessments and case studies will focus on identified priorities of USAID and SAG, including family strengthening, gender, and adolescents. It is expected that such information will guide efforts to develop, improve and scale-up programs for OVC in South Africa. Results will be disseminated through the OVC Research Working Group and the NACCA, contributing to the national research agenda and promoting evidence-grounded policy and practices. In addition, outcomes of the project activities as well as other emerging research in the field will be shared with local stakeholders, policymakers, and service delivery partners through program guidance papers that include recommendations as well as presentations at national and international forums. This is a time-limited project that will not be transitioned directly. However, the substantial time investment in capacity-building, results-sharing, and related action planning will create a transition from this project into improved local practices. Tulane University currently leases a 2010 Jeep Patriot purchased with PEPFAR funds from John Snow Incorporated for use in project activities, including planning and monitoring site visits as well as dissemination events.

 

 

Wits Reproductive Health & HIV Institute
Implementer:	Wits Health Consortium, Reproductive Health Research Unit
Duration:	October 1, 2007 through September 30, 2012
Total Cost:	$115,405,000