CRS meets SACBC AIDS Office and treatment partners, Zambia

CRS meets SACBC AIDS Office and treatment partners, Zambia

PEPFAR funding to CRS for the original nine country treatment programme has ended, and treatment programmes are continuing in some countries under the local and some new partners. At a meeting of Catholic Relief Services with its treatment partners held in Lusaka, Zambia in February 2013, transition issues were discussed.

CRS’s role in the new dispensation is one of increasing advocacy.

CRS has already begun advocating with the US Government. Some of the information from the Zambia meeting has become part of the congressional testimony to the House Appropriations Subcommittee on State, Foreign Operations and Related Programs.

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A Summary Report from Catholic Relief Services

 

Purpose:

The purpose of this report is to provide an overview of the lessons learned from the AIDSRelief program transition that were shared and discussed at the CRS Transition meeting with AIDSRelief local partners held in Lusaka, Zambia on February 24, 2013. Local partners that have transitioned from AIDSRelief to being a prime grant recipient for HIV Care and Treatment programs in South Africa, Uganda, Kenya, Tanzania, and Zambia were present. There were also people present from CRS and a local partner in Haiti where a faith based health network is being initiated and lessons from transition apply. A special guest, Bruce Compton from Catholic Health Association also joined us. CRS AIDSRelief staff were present as well as the CRS Vice President of Overseas Operations. Please see the attendee list in Annex 1 at the end of the report. Also included in this report are recommendations for CRS to continue to strengthen and build the capacity of local partners.Screen Shot 2013-05-14 at 1.33.27 PM

Introduction

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(L to R) Dr. Modester Bwalya, Golden Mwila, Dr. Dhally Menda, and Karen Sichinga

On February 24, 2013, CRS brought together 8 of the 19 local health partners from the AIDSRelief program to discuss their experiences of the transition and ways to sustain HIV care and treatment programs. AIDSRelief is a U.S. government funded, CRS led consortium working in 10 countries with 19 predominately faith-based local health partners that supports delivery of HIV care and treatment through 276 health facilities. During the 8 year period, 2004-2012, the program delivered HIV care and treatment to more than 700,000 people, including 395,000 patients who received anti-retroviral therapy (ART). These 8 faith-based local health partners from 5 countries (Kenya, Tanzania, Uganda, South Africa, and Zambia) included: the Christian Health Association of Kenya (CHAK), and the Kenya Episcopal Conference (KEC); the Southern African Bishops Conference (SABC) and St Mary’s Mission Hospital from South Africa; the Christian Social Services Commission (CSSC) of Tanzania; the Uganda Protestant Medical Board (UPMB); and, the Churches Health Association of Zambia (CHAZ) and Chreso Ministries from Zambia. AIDSRelief had transitioned the management of the HIV care and treatment program to these partners in 2012.

Screen Shot 2013-05-14 at 1.33.44 PMNow that more than a year has passed since AIDSRelief transitioned management of the care and treatment program, this consultation provided an opportunity for partners to share their experiences in order to identify ways to advocate for the success of their programs, and to inform CRS of the issues they want CRS to advocate with the US government. A great deal of information was shared by partners to help CRS move forward in its support and accompaniment in a number of areas such as local health partner-led advocacy, capacity building, and technical support. More than just providing a pathway forward for partnership, this consultation aired important lessons from the transition and ways for CRS to become better partners as we work to care for our brothers and sisters most in need.

Summary of Meeting Agenda: Sharing Successes and Challenges

It’s clear that the successes far outweigh the challenges. Despite your strong achievements over the years, the local partners were all quick to highlight areas for improvement which showed their unwavering commitment to serve people who are poor with integrity and the highest levels of quality care. Even though each circumstance is unique, we tried to pull together some of the commonalities and synergies in the successes and challenges you shared.

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(L to R): John Donahue, Dr. Kazadi J. C. Mwayabo, Michele Broemmelsiek, Dr. Samuel Mwenda, and Lori Warrens

In terms of successes, it was noted that transition brought about better integration between the local faith-based health network and the district and regional governments (Ministry/Departments of Health). Even with the changes that the transition caused, there were continued positive trends in patient retention on antiretroviral therapy (ART). Transition also strengthened knowledge, leadership, ownership and partnership of local faith-based partners, thus enhancing program sustainability which is vital for the hundreds of thousands of people in their care. More specifically, there was successful implementation of Year 1 activities as prime partners with CDC, including meeting CDC targets for care and treatment and increased visibility at the national level where local health partners are represented in national committees.

Screen Shot 2013-05-14 at 1.34.23 PMA few of the major challenges highlighted by the local partners were funding, human resources, and capacity. Each one is extremely important, but together they really pose significant challenges for the sustainability and high quality of their work. Reduced and or uncertainty about funding continues to be a problem, while performance targets are increased or remain at high levels. Being asked to do more with less is certainly a theme for many programs these days, and one that causes great anxiety for CRS too.

There’s no way to get around the fact that Human Resources continues to be a challenge. Two important distinctions were made about this challenge: lack of qualified staff and the high turnover of experienced program staff particularly at the local health facilities.

Both issues cause great concern because we know that well-qualified staff is needed to do this work and without them, programs and more importantly, patients suffer.

Capacity may be the all-encompassing challenge discussed at the meeting. Local partners pointed out that it includes everything from limited clinical capacity, staff shortages, poor government health infrastructure, challenges with integrating the local faith-based health program into the public system, and to negotiating with multiple governmental authorities. Each item can have huge ripple effects on programming and so acquiring and using the appropriate skills to navigate such a changing landscape is essential.

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Dr. Kwame Essah

Next Steps and Follow Ups

We were honored to hear their experiences of transition, lessons learned, and meeting, there were many follow up items for CRS HQ. One of the first items was to supply access to the following videos:

CRS Video on AIDSRelief – “They Said It Couldn’t Be Done

CRS/Catholic s Confront Global Poverty Video on U.S. advocacy for international assistance funding – “Cuts Cost Lives

In addition to the videos, we also wanted to share the exciting news that shortly after returning back to HQ, Michele Broemmelsiek was asked to testify before the U.S. House of Representatives. She was able to incorporate some of what she heard from the local partners into her written testimony. The link to that is listed below:

Congressional Testimony by Michele Broemmelsiek – Vice President, Overseas Operations of CRS to the House Appropriations Subcommittee on State, Foreign Operations and Related Programs on March 19, 2013.
CRS Newswire story – http://newswire.crs.org/crs-vice-president-tells-congress-to-fund-aid-for-the-poor/

Screen Shot 2013-05-14 at 1.35.06 PMMore importantly, after reviewing the notes and videos from the meeting, we pulled out a couple of items for CRS to consider and offer a couple of ideas for ways to continue to support and accompany our local partners:

CRS continues to advocate on behalf of our local faith based partners for sustained, adequate funding (PEPFAR and Global Fund), as well as ensuring that FBOs and NGOs have a place at the negotiating table (not just government to government initiatives).

CRS continues to assist and support local faith based partners in their work to improve their advocacy and policy capacity. CRS will look into the feasibility of assisting in the design and implementation of an in-country advocacy training for local partners.
Update or add to the appropriate CRS manuals to include the lessons learned from the AIDSRelief program transition. Such lessons include starting to prepare partners earlier, establish clear communication about roles, responsibilities and timelines, and be as transparent as possible.

CRS will continue to look for programming opportunities to support local partners and to provide technical assistance across a myriad of programming areas related to Health Systems Strengthening. It is the goal of CRS to find ways of sustainably improving health care services through local partners for the most vulnerable. We will share with you any major developments pertaining to PEPFAR and Global Fund advocacy efforts in the United States. In the meantime, if there are additional suggestions and recommendations you’d like to share with us, please don’t hesitate to contact Dr. Mwayabo J.C. Kazadi (Mwayabo.kazadi@crs.org) or John Donahue (john.donahue@crs.org). Thank you for participating in the meeting on February 24 and for your ongoing partnership with CRS!

Dr. Pastory Sekule

Dr. Pastory Sekule

Jacinta Muttegi

Jacinta Muttegi

 

 

 

 

 

 

Sister Alison Munro

Sister Alison Munro

Sister Jacqueline Picard, Jacinta Muttegi, Golden Mwila, and Sister Alison Munro

Sister Jacqueline Picard, Jacinta Muttegi, Golden Mwila, and Sister Alison Munro

 

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Attendance List CRS Pre-ACHAP Conference; Lusaka, Zambia

 

Name

Title

Organization/Country

Email Address

Dr. Douglas Ross

Chief Executive Officer

St. Mary’s Hospital – South Africa

Sister Alison Munro

Director, AIDS Office

SACBC – South Africa

Dr. Tony Tumwesigye

Executive Director

UPMB – Uganda

Jacinta Muttegi

National Executive Secretary-Health Commission

KEC – Kenya

Dr. Samuel Mwenda

Executive Director

CHAK – Kenya

Dr. Pastory Sekule

Mwanza Office Coordinator

CSSC – Tanzania

Karen Sichinga

Executive Director

CHAZ /Zambia

Dr. Dhally Menda

Head of Programs

CHAZ /Zambia

Golden Mwila

Finance Manager

CHAZ /Zambia

Dr. Modester Bwalya

Chief of Party/CHAZ- AIDSRelief Transition

CHAZ /Zambia

Dr. Ernest Mwila

Deputy Chief of Party/CHAZ-AIDSRelief Transition

CHAZ /Zambia

Yoram Siame

Advocacy Specialist

CHAZ /Zambia

Rev. Helmut Reutter

Executive Director

Chreso/Zambia

Dr. John Haloka

Clinical Manager

Chreso/Zambia

Jonas Chola

Financial and logistic Manager

Chreso/Zambia

Faith-based Health

Sister Jacqueline Picard, Religious of Jesus and Mary

Facility Network Representative, Board Member of Alma Mater Hospital

RICSH/Haiti

Bruce Compton

Senior Director, International Outreach

Catholic Health Association/USA

Michele Broemmelsiek

Vice President Overseas Operations

CRS/Baltimore

Dr. Kazadi J. C. Mwayabo

Senior Technical Advisor-HIV Care and Treatment

CRS/Baltimore

Kristin Weinhauer

Senior Technical Advisor Health and HIV

CRS/Baltimore

John Donahue

Global Chief of Party

CRS/AIDSRelief

Ana Maria Ferraz De Campos

Regional Technical Advisor-Health

CRS/SARO

Dr. Kwame Essah

Chief of Party- AIDSRelief Transition

CRS/Zambia

Dane Fredenburg

Country Representative

CRS/Zambia

Dr. Sylvester Chilaika

Deputy Chief of Party/Program Quality- AIDSRelief Transition

CRS/Zambia

John R. Munthali

Deputy Chief of Party/Management Quality-AIDSRelief Transition

CRS/Zambia

Delphine V. Sherwood

Head of Health Programs

CRS/Haiti

Georges Perrin

Health Systems Strengthening Initiative Program Manager

CRS/Haiti