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Stronger health systems. Greater health impact.




 HIV Prevention CommunicationManagement Sciences for Health
                              Training: New evidence, new thinking




MSH Building Local Capacity Project                                              1
BLC Project Overview:

  • BLC supports local and regional institutions to
    improve health care and HIV prevention services by
    strengthening both technical leadership and
    management capacity
  • Regional and country activities
       • 6 countries
       • Regional organizations
  • Key Program Areas         Management Sciences for Health


          • Capacity Building,
          • Care & support for
              OVC
          • HIV prevention
          • Community-based
              care
MSH Building Local Capacity Project                            2
BLC Project: HIV prevention

   • BLC supports the SADC HIV Unit to strengthen
     its strategic leadership role for HIV Prevention
     and build the HIV prevention capacity of
     member states.
   • Partnership with SADC HIV Unit and Centre for
     AIDS Development Research and Evaluation
     (CADRE)                          Management Sciences for Health



   • Target group: HIV program managers in
     Government
      ( Ministry of Health, Education), National AIDS
      Council, and CSO partners
MSH Building Local Capacity Project                                    3
New evidence – new thinking
   • Based on extensive review of literature and existing
     materials
   • Facilitation processes and communication materials
     piloted in five trainings in Tanzania, Zimbabwe, and
     South Africa
   • 115 individuals involved representing 50 CSOs,
     international NGOs, and government departments
                                      Management Sciences for Health


   • Modularized training curriculum with 10 half-day
     presentations and workshop processes with
     exercises

MSH Building Local Capacity Project                                    4
What have we learned about
    existing prevention capacity?
    • Significant gaps and missed opportunities: HIV care
      and support, HBC, OVC programs, family
      planning, HCT
    • Widespread difficulty in grasping more abstract
      concepts: partial protection, targeting general
      population, sero-discordance
                                      Management Sciences for Health
    • Significant variation by country
    • Little diffusion of understanding of new thinking to
      local levels and little evidence of learning from or
      sharing of experiences
MSH Building Local Capacity Project                                    5
What have we learned (Cont)

    • Direct community prevention interventions are usually
      project-based rather than strategic or continuous
    • Low dose, opportunistic, event-focused HIV prevention
      efforts with little consideration of local dynamics of
      transmission, selection, or targeting
    • Largely information based; little understanding or use of
      communication or socialManagement Sciences for Health
                                 and behavioural
      methodologies, multilevel or combination
      strategies, results-based management, or local level
      collaboration or long-term strategic thinking


MSH Building Local Capacity Project                               6
Foundations of prevention
    thinking in the training program
   Oriented and focused on:
   • Theory of change, combination prevention, social
     ecology framework, results-based management
     approaches
   • Addressing modes and dynamics of transmission
   • Role of communication in social and behavioral
     change                           Management Sciences for Health


   • Evidence-based thinking at local level (KYE, KYR)
   • ‘Options’ for prevention and offering combination
     prevention options
   • Basic science of HIV/AIDS
MSH Building Local Capacity Project                                    7
Format

    • Participants seated at tables of four people to allow
      for small group discussion at key moments in the
      presentations
    • Each presentation is followed by a practical exercise
      conducted in small groups to localize, contextualize,
      and develop practical understanding of key concepts
                                      Management Sciences for Health
    • Each day begins with a review of overnight questions
      and ends with a reflection on the day’s learning
      experiences


MSH Building Local Capacity Project                                    8
Structure

    BLOCK 1 – Know your epidemic - Know your response
        Module 1: Know your epidemic - Big picture and country picture
        Module 2: How HIV works
        Module 3: Reviewing prevention options - Know your response
    BLOCK 2 – Plan your response
        Module 4: A social ecology approach to prevention planning
        Module 5: Communication for HIV prevention
        Module 6: Combination prevention Sciences for Health
                                    Management

        Module 7: Managing for outcomes
    BLOCK 3: Targeting key drivers of infection
        Module 8: Addressing dynamics of generalized epidemics
        Module 9: Addressing the needs of high-risk populations
        Module 10: PHDP
MSH Building Local Capacity Project                                       9
BLOCK 1 –
                                                            Know your
                                                            epidemic -
                                                            Know your
                                                             response




                                      Management Sciences for Health




MSH Building Local Capacity Project                                      10
BLOCK 2 –
                                      Plan your
                                      response


                                         Management Sciences for Health




MSH Building Local Capacity Project                                       11
BLOCK 3: Targeting key drivers
                of infection
                                      Management Sciences for Health




                                                                       Image: Faraja Trust
MSH Building Local Capacity Project                                                 12
Challenges

    • National strategic frameworks may reflect new advances
      in HIV prevention, but may not outline how advances
      may be incorporated in implementation plans at a
      programme, project and community level.
    • Need for concerted efforts to translate new evidence
      about HIV prevention needs and effectiveness into
      practice
    • This may require departure from standard approaches;
                               Management Sciences for Health

      and the need to ‘reboot’ in some areas (paradigm shift)
      rather than ‘infuse’ new understanding
    • Approach may require some departure from existing
      commitments and programmatic approaches and this
      can prove challenging to secure.
MSH Building Local Capacity Project                             13
Solutions

    • Adapt the program in each country, keeping with local
      HIV dynamics and implementation conditions or
      opportunities
    • Allow for considerable lag-time before capacity building
      efforts to support the approach are adopted by most-
      relevant country-level agencies
    • Approach appears to be best supported by existing plans
      to implement combination prevention and existing
                               Management Sciences for Health

      communication frameworks which cut across a range of
      implementing agencies
    • Social ecology approach allows bridging the gap
      between developmental and ‘topical’ approaches to
      prevention in country level prevention approaches
MSH Building Local Capacity Project                          14
Stronger health systems. Greater health impact.




       Saving lives and improving the health
       of the world’s poorest and most vulnerable people
                                  Management Sciences for Health



       by closing the gap between knowledge and action in public
       health.



MSH Building Local Capacity Project                                               15

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Kevin Kelly - CADRE, South Africa

  • 1. Stronger health systems. Greater health impact. HIV Prevention CommunicationManagement Sciences for Health Training: New evidence, new thinking MSH Building Local Capacity Project 1
  • 2. BLC Project Overview: • BLC supports local and regional institutions to improve health care and HIV prevention services by strengthening both technical leadership and management capacity • Regional and country activities • 6 countries • Regional organizations • Key Program Areas Management Sciences for Health • Capacity Building, • Care & support for OVC • HIV prevention • Community-based care MSH Building Local Capacity Project 2
  • 3. BLC Project: HIV prevention • BLC supports the SADC HIV Unit to strengthen its strategic leadership role for HIV Prevention and build the HIV prevention capacity of member states. • Partnership with SADC HIV Unit and Centre for AIDS Development Research and Evaluation (CADRE) Management Sciences for Health • Target group: HIV program managers in Government ( Ministry of Health, Education), National AIDS Council, and CSO partners MSH Building Local Capacity Project 3
  • 4. New evidence – new thinking • Based on extensive review of literature and existing materials • Facilitation processes and communication materials piloted in five trainings in Tanzania, Zimbabwe, and South Africa • 115 individuals involved representing 50 CSOs, international NGOs, and government departments Management Sciences for Health • Modularized training curriculum with 10 half-day presentations and workshop processes with exercises MSH Building Local Capacity Project 4
  • 5. What have we learned about existing prevention capacity? • Significant gaps and missed opportunities: HIV care and support, HBC, OVC programs, family planning, HCT • Widespread difficulty in grasping more abstract concepts: partial protection, targeting general population, sero-discordance Management Sciences for Health • Significant variation by country • Little diffusion of understanding of new thinking to local levels and little evidence of learning from or sharing of experiences MSH Building Local Capacity Project 5
  • 6. What have we learned (Cont) • Direct community prevention interventions are usually project-based rather than strategic or continuous • Low dose, opportunistic, event-focused HIV prevention efforts with little consideration of local dynamics of transmission, selection, or targeting • Largely information based; little understanding or use of communication or socialManagement Sciences for Health and behavioural methodologies, multilevel or combination strategies, results-based management, or local level collaboration or long-term strategic thinking MSH Building Local Capacity Project 6
  • 7. Foundations of prevention thinking in the training program Oriented and focused on: • Theory of change, combination prevention, social ecology framework, results-based management approaches • Addressing modes and dynamics of transmission • Role of communication in social and behavioral change Management Sciences for Health • Evidence-based thinking at local level (KYE, KYR) • ‘Options’ for prevention and offering combination prevention options • Basic science of HIV/AIDS MSH Building Local Capacity Project 7
  • 8. Format • Participants seated at tables of four people to allow for small group discussion at key moments in the presentations • Each presentation is followed by a practical exercise conducted in small groups to localize, contextualize, and develop practical understanding of key concepts Management Sciences for Health • Each day begins with a review of overnight questions and ends with a reflection on the day’s learning experiences MSH Building Local Capacity Project 8
  • 9. Structure BLOCK 1 – Know your epidemic - Know your response  Module 1: Know your epidemic - Big picture and country picture  Module 2: How HIV works  Module 3: Reviewing prevention options - Know your response BLOCK 2 – Plan your response  Module 4: A social ecology approach to prevention planning  Module 5: Communication for HIV prevention  Module 6: Combination prevention Sciences for Health Management  Module 7: Managing for outcomes BLOCK 3: Targeting key drivers of infection  Module 8: Addressing dynamics of generalized epidemics  Module 9: Addressing the needs of high-risk populations  Module 10: PHDP MSH Building Local Capacity Project 9
  • 10. BLOCK 1 – Know your epidemic - Know your response Management Sciences for Health MSH Building Local Capacity Project 10
  • 11. BLOCK 2 – Plan your response Management Sciences for Health MSH Building Local Capacity Project 11
  • 12. BLOCK 3: Targeting key drivers of infection Management Sciences for Health Image: Faraja Trust MSH Building Local Capacity Project 12
  • 13. Challenges • National strategic frameworks may reflect new advances in HIV prevention, but may not outline how advances may be incorporated in implementation plans at a programme, project and community level. • Need for concerted efforts to translate new evidence about HIV prevention needs and effectiveness into practice • This may require departure from standard approaches; Management Sciences for Health and the need to ‘reboot’ in some areas (paradigm shift) rather than ‘infuse’ new understanding • Approach may require some departure from existing commitments and programmatic approaches and this can prove challenging to secure. MSH Building Local Capacity Project 13
  • 14. Solutions • Adapt the program in each country, keeping with local HIV dynamics and implementation conditions or opportunities • Allow for considerable lag-time before capacity building efforts to support the approach are adopted by most- relevant country-level agencies • Approach appears to be best supported by existing plans to implement combination prevention and existing Management Sciences for Health communication frameworks which cut across a range of implementing agencies • Social ecology approach allows bridging the gap between developmental and ‘topical’ approaches to prevention in country level prevention approaches MSH Building Local Capacity Project 14
  • 15. Stronger health systems. Greater health impact. Saving lives and improving the health of the world’s poorest and most vulnerable people Management Sciences for Health by closing the gap between knowledge and action in public health. MSH Building Local Capacity Project 15

Notas del editor

  1. Our philosophy/ approach:To Understand local priorities –BLC acknowledge that there are many people working in the Southern Africa region to improve the lives of orphans and vulnerable children, expand HIV prevention services and offer community based care. They know what is most needed in their countries and communities. BLC is working with these partners to provide strengthen their skills, provide tools and supportleadership development they need to more effectively address their priorities, and improve the delivery and quality of health services in their communities.BLC promote a coordinated approach at regional, country and facility level to HIV prevention and care tohelp the Southern Africa region to gain and sustain momentum in the fight against HIV and AIDS.• {Learning together}: In the process of building capacity, we continuously adapt, modify and develop new tools and approaches to meet local needs in changing local and regional environments.
  2. Our philosophy/ approach:To Understand local priorities –BLC acknowledge that there are many people working in the Southern Africa region to improve the lives of orphans and vulnerable children, expand HIV prevention services and offer community based care. They know what is most needed in their countries and communities. BLC is working with these partners to provide strengthen their skills, provide tools and supportleadership development they need to more effectively address their priorities, and improve the delivery and quality of health services in their communities.BLC promote a coordinated approach at regional, country and facility level to HIV prevention and care tohelp the Southern Africa region to gain and sustain momentum in the fight against HIV and AIDS.• {Learning together}: In the process of building capacity, we continuously adapt, modify and develop new tools and approaches to meet local needs in changing local and regional environments.
  3. First we’ll start with the big picture and then move down to look at smaller pieces.It’s important to try to find the balance between a distant view and close proximity. A vital part of any process of understanding is to step back and see the broader picture
  4. Idea of working together in a way that is organised, but responsive to change