ACTION FRAMEWORK No child born with HIV by 2015 and improving t he health and well being

1. ACTION FRAMEWORK No child born with HIV by 2015 and improving the health and well being of Mothers, partners and Babies in South Africa Precious Robinson,Deputy Director National Dept of Health South Africa ICASA December 7th2011

2. LET’S ANSWER SOME QUESTIONS….

3. QUESTION 1: WHAT IS THE ACTION FRAMEWORK FOR pmtct INTEGRATED WITH MCH?

4. Direct link between current policy and implementation of PMTCT services integrated with MNCWH services • Built from nine provincial and 52 district frameworks. • Reinforces linkages for a multi sectoral response in the country with clear targets for the next five years. • Costed, time bound, results oriented operational plan to facilitate systematic implementation in synergy with National Strategic Plan for HIV and AIDS, STIs and TB (2012-2016).

5. ACTION FRAMEWORK (NSP 2012-2016) No child born with HIV by 2015 and improving health and wellbeing of mothers, partners and babies in South Africa

6. Strategic objective, targets, costing 2012-2016

7. AIMS of the action framework • Identify key gaps in policy and programme implementation for achieving the elimination targets in PMTCT and Paediatric AIDS programmes integrated with MNCHW. • Provide a simple monitoring framework to track progress and measure results towards virtual elimination of new HIV Paediatric infections at national, provincial, district and facility levels ensuring alignment with existing plans (NSDA, APP, NSP) • Serve as a guide for the development of annual elimination work plans at the national, provincial, district from 2011-2016

8. QUESTION 2: How did we develop the action framework?

9. Bottleneck analysis completed at provincial and district levels • Data used as the starting point • Review of issues related to availability of services, access, coverage, human resource, systems (supply) completed • Participation of all key Stakeholders • Result: Priority actions/cost/responsible person/timeline agreed and included in the action frameworks at district and provincial levels. • The bottleneck analysis will be ongoing in 2012: done each quarter based on the Data for Action reports.

10. Question 3:What is the structure of the framework?

11. ACTION FRAMEWORK FOR eMTCT Key components

13. Activities and tasks identified for each of the five areas • Key focus areas (Implementation drill activities) identified for inclusion in work plans each year

14. e MTCT TRACKER ROBOT DASHBOARD CASCADE INDICATORS

16. DASHBOARD: National (DHIS data)

17. Synergizing provincial and district priorities at national levels

18. PMTCT Cascade priorities • Late booking • Family planning • ART/ARV for eligible women • Retesting for negatives • Post natal follow up • Safer infant feeding • Early infant ART • Enabling + engaging community priorities • Male partners • Couple counseling • Social mobilization • Community engagement Clear Standards for operation Getting to scale Quality enhanced Data quality + capacity enhanced Foster innovation e-MTCT Targets achieved

19. Critical policy/programme issues to be addressed in 2011-2012 • ARV regimens + eligibility • Post natal testing schedules for mother and child • Data - quality + use regularly • Need for SOPs for the PMTCT and Pediatric ART cascade • Community involvement and engagement

20. Question 4: how will we know and measure our progress?

22. DASHBOARDS: DATA FOR ACTION REPORTS • Each quarter for national, provincial and all 52 districts • Analyze DHIS and NHLS data • Prioritize key issues and actions • Focus on priority districts / underperforming districts and provinces

23. Monitoring and Mentoring System

24. Question 5: how will we manage the framework?

25. Management oversight - National PMTCT unit within MCH - Provincial Focal persons - District focal persons • Technical oversight - PMTCT TWG (newly set up) - SANAC TTT • Implementation oversight - PMTCT Steering committee (national) - Coordination/working group (provincial) - Coordination/working group (district) WORK WITH PARTNERS AT ALL LEVELS

26. Partner coordination at field level: tool

27. Partnership Framework Tool Eg – district from Eastern Cape province

28. Question 6: how will we set up regular mechanisms of tracking progress and addressing bottlenecks?

29. Data for Action – reports from national Cascade Indicators Robot Dashboard Discussion/review at district/provincial/national level meetings (quarterly) Response to robot dashboard (within a month) Quarterly Review partnership framework ACTION Discussions/review with all partners /shared accountability Review expenditure rates Review progress against work plan

30. CHALLENGES • Getting the buy – in at all levels • Other competing priorities (NSP) • DATA (quality, missing data) • Taking the global vision/plan – tailoring it to the country context, needs and how it meets/fits with the priorities on the ground • Getting all stakeholders together • Set way of working (challenges with integration and role clarity)

31. What worked? • Leadership at all levels • Team committment • Using data as the starting point • Creating a space for learning and knowledge sharing in a participatory way • Developing and using simple tools tailored to South Africa • Leveraging partnerships to create synergy at all levels

32. South africa is committed to achieving elimination of new hiv infections in children and keeping the mothers and babies alive and healthy by 2015 political driveand responsibility + +

33. ACKNOWLEDGEMENTS • PMTCT Technical working group • PMTCT Steering committee • All provincial and district stakeholders • UNICEF • CDC – South Africa • UNFPA • Clinton Health Access Initiative • MAC AIDS Foundation • PEPFAR • Members of the civil society • All partners working in PMTCT/MCH

34. Thank you