Presentation to the ACSM Subgroup at Country Level Session 8
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2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Advocacy, Communication and Social Mobilization Sub Group at Country Level: Building a Technical Assistance Network
Presentation to the ACSM Subgroup at Country Level
Session 8
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Outline
1. ACSM 10-year Strategic Framework for Action
2. Utilization of ACSM
3. Discussion and decisions
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Utilization: Rapid growth in ACSM
19
9
0
2
4
6
8
10
12
14
16
18
20
2002 2005 2007
HBC's withNational ACSMPlans
2002 data as gathered from ACSM Needs Assessment Survey of HBC's
2006-2007 data gathered from HBC DOTS Expansion survey
*Planned
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Funding: HBCs with GFATM funding via rounds 1-5 for ACSM activities
2
12
18
0
2
4
6
8
10
12
14
16
18
20
2002 2004 2006*
Countries
2002 data as gathered from ACSM Needs Assessment Survey of HBC's 2006-2007 data gathered from HBC DOTS Expansion survey *Approved grants from 5th round GFATM
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Funds at Country Level via GFATM
Successful 5th round for ACSM: $35 million over two years $63 million over five years
(Some TA budgeted for in some 5th grants)
Challenge #1: How to access resources to maximise the impact of available GFATM funding and to achieve the targets as detailed in the GP2 and ACSM Strategic Framework for technical cooperation among partners and countries.
Country ACSM 2 year budgets
(in millions)
Bangladesh 1.8
DRC 1.7
Indonesia 9.1
Nigeria 7.3
Zimbabwe 3.5
Gambia .8
Brazil 1.02
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
6th round GFATM supported by partners and using ACSM framework
Afghanistan Congo Rep Eritrea
Ethiopia Togo Zambia Egypt
Iraq Morocco Pakistan PNG Vietnam Botswana
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Improving funding for ACSM Technical Assistance Lagging (as of Sept 2006)
00.5
1
1.5
2
2.5
3
3.5
44.5
5
Capacitybuilding
Monitoringand eval
Operationalresearch
KnownCommitment
Global PlanEstimate
Gap
US$9 million gap in ASCM projected TA needs at country level
Note: USAID is the largest single donor for ACSM technical support
In millions
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Previous discussions on TA
2004—CB meeting Beijing: Endorsement of ISAC to respond to shortage funding for TA TB/HIV: Requested funds for operational research and policy
monitoring 2005—CB meeting Addis Ababa: Agreement to support
countries with technical assistance to prepare 5th GFATM Proposals
Jan. 2006—Partners TA meeting Geneva: discussed the growing need for TA for all of technical issues
Feb. 2006—Coordinating Board presentation. TBCTA, ISAC and other channels provide needed TA
but ACSM access to those funds is limited
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Session 8: Status Report on ACSM
at Country Level Presentation to the 2nd Meeting of
the Sub-group on ACSM at Country Level
Tanya Siraa/Stop TB
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
What was the survey about?
Annual survey sent to 22 HBC's to assess needs and progress of NTP's which feeds into Global TB Control Report.
2006 was the 2nd edition to include questions on ACSM: Type of messages communicated Media types used Activities of patient-centred organizations Availability of ACSM monitoring and evaluation data Barriers to ACSM implementation
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
ACSM activities are focused primarily on public education; less on advocacy.(Average, in order of importance):
1. Educating on signs and symptoms of TB2. Educating on where to go for TB testing and
treatment3. Encouraging care seeking behaviour4. Increasing knowledge of risk factors for TB5. Combating stigma6. Calling for increased political and financial support7. Encouraging community action8. Providing a channel for the afflicted to voice their
concerns
Public education
Advocacy
Source: 2006 Stop TB strategy questionnaire (Q.N3a) from Afghanistan, Bangladesh, Brazil, China, India, Indonesia, Kenya, Myanmar, Nigeria, Pakistan, Philippines, Russia, Tanzania, Uganda, Vietnam, Zimbabwe. No data from Cambodia, Congo, Ethiopia, Mozambique, South Africa or Thailand.
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Electronic and print media Interpersonal communication Community mobilization Point of service promotion Folk media
Countries use a wide variety of media for their ACSM activities:(Average, in order of importance):
Source: 2006 Stop TB strategy questionnaire (Q.N3a) from Afghanistan, Bangladesh, Brazil, China, India, Indonesia, Kenya, Myanmar, Nigeria, Pakistan, Philippines, Russia, Tanzania, Uganda, Vietnam, Zimbabwe. No data from Cambodia, Congo, Ethiopia, Mozambique, South Africa or Thailand.
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Activities of patient-centred organisations:
1. Community mobilization (100%)2. Active case detection (89%)3. Treatment support (78%)4. Consultation with NTP regarding
policy/programme implementation (67%)5. Activism for national policy change or national
resource mobilization (56%)
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
We must enable countries to gather data for monitoring and evaluation. Only five out of 17 countries claim to have country-level
data to evaluate the efficacy of ACSM strategic plan which will allow programme improvement and dissemination of information: Brazil, China, India, Indonesia, Philippines
The remaining 12 countries claim to have no M&E system in place for ACSM: Afghanistan, Bangladesh, Kenya, Myanmar, Nigeria,
Pakistan, Russia, Tanzania, Thailand, Uganda, Vietnam, Zimbabwe.
Source: 2006 Stop TB strategy questionnaire (Q.N3a) from Afghanistan, Bangladesh, Brazil, China, India, Indonesia, Kenya, Myanmar, Nigeria, Pakistan, Philippines, Russia, Tanzania, Uganda, Vietnam, Zimbabwe. No data from Cambodia, Congo, Ethiopia, Mozambique, South Africa or Thailand.
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Countries face multiple barriers to implementing ACSM programmes.
Top six reasons across countries:
1. Limited staff capacity
2. Limited resource availability
3. Geographic/linguistic/cultural diversity
4. Administrative or managerial constraints
5. Identifying and reaching priority target groups
6. Stigma
Source: 2006 Stop TB strategy questionnaire (Q.N3a) from Afghanistan, Bangladesh, Brazil, China, India, Indonesia, Kenya, Myanmar, Nigeria, Pakistan, Philippines, Russia, Tanzania, Uganda, Vietnam, Zimbabwe. No data from Cambodia, Congo, Ethiopia, Mozambique, South Africa or Thailand.
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Countries face multiple barriers to implementing ACSM programmes.
Other top reasons (average across countries):
7. Lack of health sector coordination
8. Poor understanding of TB risk factors
9. Lack of commitment from health care providers
10. Lack of commitment from civil society
11. No action plan
12. Lack of political commitment from central government
Source: 2006 Stop TB strategy questionnaire (Q.N3a) from Afghanistan, Bangladesh, Brazil, China, India, Indonesia, Kenya, Myanmar, Nigeria, Pakistan, Philippines, Russia, Tanzania, Uganda, Vietnam, Zimbabwe. No data from Cambodia, Congo, Ethiopia, Mozambique, South Africa or Thailand.
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Questions?
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Unique opportunity
Technical assistance program
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Unique Opportunity
USAID and Stop TB developed a TA proposal and secured $507K in funding from OGAC to support countries with rounds 1-6 ACSM implementation.
Funding is designed to remove obstacles and accelerate implementation.
Funding conditional on: Type of TA need Country needs
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Examples of TA requeststhat could be funded
Formative behavioral/demographic/market research
Data interpretation Project management strengthening Monitoring and evaluation planning Micro-planning
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Program outline
Only countries with GFATM rounds 1-6 funding are eligible for catalytic TA
Component 1: Technical Assistance Mechanism
Component 2: Country-specific Program Evaluation
Component 3: Program Management
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Monitoring and evaluation of TA
Two tier systemTier one: Standardized matrix of ACSM
elements as suggested in 10-Year Strategic Framework with respect to county TA needs
Progress towards implementation as detailed in GFATM Grant.
Increased NTP capacity
Tier two: Partner progress reports
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Next Steps
Survey of country needs TA applications from country Subgroup to discuss/agree on basic standards
for rendering TA. Priority countries, utilization of the Framework,
compliance with terms of the grant.
TA to be country/TA partner and coordinated by Stop TB
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Recap
Challenge #1: How to coordinate effectively among partners to maximise gains, measure outcomes and advance the GFATM Grants in assisted countries?
Challenge #2: What should be the guiding principles governing the USAID-funded Technical Assistance program?
2nd Meeting of the Subgroup on Advocacy, Communications and Social
Mobilizationat Country Level
Proposed Guiding Principles
1) TA for ACSM will be focused on assisting counties in the initial phases of their GFATM ACSM grants.
2) TA for ACSM must accelerate the absorptive capacity and improve the performance of the ACSM component in those projects approved by the GFATM.
3) TA for ACSM must be catalytic in nature and will be targeted to remove obstacles to successful ACSM implementation and build local capacity.
4) TA for ACSM must be in alignment with the standards, methodologies, objectives as articulated in the component 5 of the Stop TB Strategy.
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