1. Health System Strengthening(HSS) Health System Trust(HST ) Free State Province, Isibalo Symposium on Evidence based decision making, hosted by Stats SA Date:11 October 2013

2. Outline Background Defining HST Mission of HST Core values How is HST organised SA-SURE Overview and supported districts Vision Objectives Streams implementing SA SURE service package Provincial Coordinator & District Coordinators Provincial Epidemiologist District Leadership Mentors District M&E, Clinical and Facility Mentors Use of Stats SA data for health system strengthening

3. Background(1) Health Systems Trust (HST) is a dynamic not-for-profit organisation established in 1992 to support transformation of the health system in post- democratic South Africa. Subscribing to a primary health care approach, HST actively supports the current and future development of a comprehensive health system, through strategies designed to promote equity and efficiency in health and health care delivery in South and southern Africa.

4. Background(2) HST Mission To contribute to building comprehensive, effective, efficient and equitable national health systems by supporting the implementation of functional health districts in South Africa and the southern African region. Core Values Transparency and accountability Innovation and responsiveness Integrity and nurturance Embracing diversity Participatory management Continuous Quality Improvement

5. Background(3) How is HST organised Health Systems Research The unit undertakes innovative health systems research to strengthen the district health system, its support systems and priority programmes. HIV and AIDS, tuberculosis. Improving knowledge management, translating research into policy or practice Health Systems Strengthening CDC: South Africa Sustainable Response to HIV/AIDS (SA-SURE ) EU: Supporting PHC Re-engineering Corporate Services The Corporate Services unit provides an array of services to the Programmes directorate and management

6. SA SURE Overview Strengthening local capacity to provide sustainable HIV and TB related care and treatment services in South Africa under PEPFAR This grant aims to strengthen effectiveness of DHS by building local capacity in supported districts, sub-districts and up to facility level. Decrease burden of HIV, AIDS, STIs and TB and reduce related child and maternal deaths

7. Map of Free State Province SA SURE Project: Serves 73.2% of the 2,745,590 population Census 2011 Municipal report, Free State, Report 03-01-52 22.9% 26.8% 17.8% 5.3% 27.2%

8. SA SURE Vision

9. Project Objectives Build capacity of managers and technical staff through mentoring and technical assistance to: Do population-based planning, target setting and monitoring and evaluation; Delivery of integrated HIV and TB services;

10. Objectives continued!! Develop, implement and maintain referral networks that will contribute to improved quality of service delivery; Use information as a key driver to decision making to improve health outcomes, through implementation of the three tier health information system Build local ownership to ensure sustainability when the project concludes

11. SA SURE Service Package Health systems strengthening WHO Building blocks Approach Leadership mentoring Clinical governance (training and mentoring) Support use of routine HIS and use of information for planning

12. SA SURE Project data Sources Stats SA DHIS Statistical Models ASSA Model Spectrum Model Research results data Community surveys etc.

13. ASSA MODEL Projections Projections used for planning and budgeting in grants proposals for HIV prevention and treatment ASSA Model, 2008 version.

14. SPECTRUM MODEL Projections HIV/AIDS Summary 200420052006200720082009201020112012201020112012 FS HIV population (Thousands) Total326.57330.8334.4339344.66348.17351.66357.67364.7351.66357.67364.7 Male144.63145.2145.53146.4147.78148.33148.95150.54152.54148.95150.54152.54 Female181.94185.6188.88192.61196.88199.84202.71207.13212.16202.71207.13212.16 Prevalence (15-49)18.818.8718.8818.9319.0319.0919.1819.3619.5719.1819.3619.57 New HIV infections (Thousands) Total33.7432.2231.4330.8230.1728.8228.832822.7328.832822.73 Male14.6413.9913.6313.3413.112.4312.3812.079.8412.3812.079.84 Female19.0918.2417.817.4717.0716.3916.4415.9312.8916.4415.9312.89 Annual AIDS deaths (Thousands) Total22.9323.923.9522.7221.8322.823.3720.2313.2123.3720.2313.21 Male10.8611.28 10.7710.3810.6310.79.436.610.79.436.6 Female12.0812.6212.6711.9511.4512.1712.6710.86.6112.6710.86.61 Spectrum Model, August 2013 updated version.

15. THANK YOU Name Surname: Motshabi Modise FS Provincial Epidemiologist Email:motshabi.modise@hst.org.za Cell:071682 7578/0833328764 http://www.hst.org.za