Capacity building u nder pepfar ii final cobranded template final 9 20 (2)

Getting Started – Developing a Capacity Building Program

At your tables•You are asked to design a program to support the building of the capacity of a district health team. Your main partner in the planning and development is the MOH.

•As you design the program think about what interventions would make this an optimal program (list 4 or 5).

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Some Interventions

• Country Context– Building leadership capacity of District health team– Building capacity of partners to support district response– Ensure program is in line with national priorities– CB tailored to the needs of each district

• Sustainability– Sequence of interventions should consider absorptive capacity– Program should be sufficiently long to allow capacity building to happen– Should be focused on ongoing ability to function not just to implement our programs– Coordinating with national level to ensure appropriate government funding in future– Resource mobilization is critical to sustain programs and should not wait until the last minute– Ensuring CSOs are recognized for supporting government response– Advocating for and mobilizing material, logistic and financial support from the private sector

• Monitoring and Evaluation– A strong monitoring and evaluation component is essential to ensure a quality program and

build evidence base

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3Out With the Oldwhat have we been doing wrong all these years?

Capacity Building Under PEPFAR II

Just Kidding

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Not a Wholesale Redefinition5

OLD CAPACITY BUILDING

But a Paradigm Shift

NEW CAPACITY

BUILDING

6Building on a Strong Foundation

Capacity Building Under PEPFAR II

Kenneth SklawUSAID Office of HIV/AIDS

Fred RosensweigHS2020

Agenda

• Why the sudden increased interest in capacity building?

• How are we responding?• What is the PEPFAR Capacity Building Framework?• What have we learned to build upon?• What are some of the challenges that remain?• What is the way forward?

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Why Have Things Changed

• Country ownership delineated in Paris Declaration and Accra Agenda

• Country ownership highlighted in 3-Ones has facilitated

• Prioritization of country ownership leading to National HIV/AIDS Strategies

• PEPFAR II’s has greater emphasis on country ownership and sustainability

• Our experience has brought about us to a new understanding

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PEPFAR’s Response

• Development of a capacity building framework to:– Provide guidance to country teams and TWGs on what we

mean by CB and how we can respond– Promote a more strategic, systematic and measurable

approach to capacity building– Encourage a more strategic use of USG resources

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Defining Capacity Building Under PEPFAR

An evidence-driven process of strengthening the abilities of individuals, organizations, and systems to perform core functions sustainably, and to continue to improve and develop over time.

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PEPFAR Capacity Building Framework

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Descriptions of Areas for Building Capacity

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Individual/Workforce Organizational System/Policy

Potential Effect of Capacity Building by Component

to improve performance of staff according to specific, defined competencies and job requirements

to improve performance of internal organizational systems and processes based on assessed needs

to improve the external environment in which organizations and individuals function, including supporting structures and policies and standards

Examples of Capacity Building Activities

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Individual/Workforce Organizational System/Policy

Illustrative Examples of Areas for Capacity Building

Governance/Management

Leadership/Strategic thinkingManagement skillsProfessional networkingAccess to information resourcesFinancial management skills

GovernanceStrategic planningOrganizational managementHuman resource managementFinancial management Change managementOrganizational tools and systemsProject management

Governance and StewardshipPolicies, laws, and regulationsHealth and social systemsResource generation & allocationGuidelines and systems Management and accountability CoordinationInfrastructure

Technical

Clinical and non-clinical skills Program strategic information (M&E) skillsEpidemiology and surveillance Evaluation and research skillsTraining skillsAdvocacy and mobilization skills

Technical leadershipProgram approachTechnical guidelinesStandard operating proceduresResults monitoring and reportingTechnical infrastructure/equipmentTraining

National technical leadershipHealth and social systems componentsTechnical guidelinesPolicies and standardsInfrastructure Training programs

Anticipated Changes Due to CB Framework – CSO CB

Under PEPFAR I Under PEPFAR II Beyond

•Umbrella grants project

•Project designed to address CB

•Little coordination with other stakeholders

•CB provided by international TA provider

•Direct grants from USAID to local orgs

•Strong coordination w/DACs and DCs

•CB provided by international TA provider w/local partner

•International TA provider mentors local provider

•Strong M&E component from outset

•Part of a larger CB strategy

•Local funding to local orgs

•CB provided by local TA providers

•Government coordination of local orgs

Anticipated Changes Due to CB Framework - Treatment

Under PEPFAR I Under PEPFAR II Beyond

•Training of clinical staff at individual clinic level

•External trainers

•Project provides some supplies and drugs

•Not coordinated with communities and CBOs

•Training coordinated at district or national level

•Local trainers

•Strengthened supply chain providing drugs and supplies

•Government coordination of district services (clinical and community)

•National gov’t managing policy decisions

•Government leading treatment programs

•Funding coordinated by government

•Functional supply chain managed by government

Some of the Successes We Can Build Upon

• Development of national strategic plans• Government surveillance and monitoring systems• Capacity of NGOs to support HIV/AIDS responses• Strengthened district HIV/AIDS offices to coordinate

the response• Strengthening/mobilizing CSOs/communities• Strengthening local research institutions

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Whose capacity needs to be strengthened?

Category Players

Central government organizations

MOH, NAC, NACP, Political leaders

Local government District Health Office, District AIDS Control Program

Civil Society Advocacy groups, NGOs, FBOs, private sector

Research and training institutions

Research institutions, Training institutions, Capacity building organizations

Community Structures Traditional leaders, Religious leaders, community groups

Capacities Needing Strengthening for the New Paradigm

• Leadership and management• Strategic planning and monitoring• Coordination and harmonization through effective program

management• Engagement at all levels and across all sectors

(government, civil society, private sector, volunteer orgs., etc.)

• Human resources planning and management• Financial management (accountability)• Resource mobilization• Evaluation and data use in decision-making

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Considerations in Moving Forward

• Comprehensive and based on an overall strategy

• Change in roles, especially the donor/host country paradigm

• Absorptive capacity

• Realistic timeframes

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Considerations in Moving Forward (2)

• Intentional strategy to transition responsibility for programs to countries

• Planned within available resources

• M&E at the planning stage

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Persistent Capacity Building Challenges

• Sustaining capacity building gains over time• Building meaningful capacity of government staff

and structures• Implementing a comprehensive approach across

the levels• Measuring capacity building results• Building capacity with volunteer organizations

(not trained employees)• Building sustainable human resources

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Way Forward

• Design capacity-building strategies that address all three levels of capacity-building

• Continue to build a body of knowledge about what works and what doesn’t

• Develop regional and country platforms to develop country level capacity

• Gain experience with the revised capacity-building indicators and provide feedback