Bobby Jefferson Senior HMIS Advisor Futures Group The Site Capacity Assessment (SCA) Tool and other Mechanisms to Monitor Transition Status Track 1 Implementers Meeting Maputo, Mozambique August 2010 Olivier Byicaza SI Advisor Rwanda Futures Group

Transition “ Begin with the end in mind.” Steven Covey

Emerging Program Environment 1.Flat-line budgets 2.Increasing number of patients 3.Period of Transition Aligning with MOH 4.Sustainability capacity and strengthening local organizations NOT BUSINESS AS USUAL

 Environment led toward development  SCA enables targeted technical assistance (TA)  Cost Efficiencies  When to provide targeted TA Site Capacity Assessment (SCA)

 Program Monitoring tool  Monitor Site Progress Toward Sustainability  Targeting 12 Component toward Sustainability

12 Components  Adult HIV Care  Nursing  Community Based Treatment Services  Quality Improvement Program  Adolescent Care  Maternal and Child Health (PMTCT)  Finance and Compliance  Health Care Management  Pharmacy  Laboratory  Strategic Information  Advocacy, Fundraising Public Relations

7 Functional Areas  Physical Infrastructure and Equipment  Human Resources  Planning and Budgeting  Practice/Activities  Management, Supervision, and Communication  Commodities and Supplies  Record Keeping and Reporting

Scoring Red Flag Significant support needed Yellow Flag Targeted Assistance Needed Approaching Sustainability Green Flag Sustainable Blue Flag Exceeds Expectations Consider for training purposes

Components and Functional Areas Matrix

 Provides clear guidelines to sites  Identify areas for targeted technical assistance to support transition process/ site self sustain  Allows us to provide tangible data and descriptive goals to sites

 Provide information for decision on Workplan and Action Plans  A key area for successful transition use of cost efficient tools that builds ownership  Identifying and sharing best practices

SI Action Plan Progress Action Plan

Follow-up and Action Planning 1.Schedule follow-up meeting with the health facility and appropriate component experts. 2.Work with health facility and relevant component experts to develop action plans. 3.Identify and schedule component expert technical assistance needed to implement action plans. 4.Coordinate and monitor capacity strengthening.

Use SCA Dashboard to monitor health facility status relative to sustainability benchmark Monitoring

M&E HMIS DDIU Supportive Supervision Transition SI Activities

SCA Rwanda  Carried out assessments 10 sites  Provided feedback to facility  Collaboratively develop specific work plan  Targeted Technical assistance

Example: Rwanda Key performance program Indicators for DDIU have been used as measurement for site readiness for transition Olivier BYICAZA, Strategic Information Advisor AR/Futures Group International

Site Activities  ARV Missed Pickup Reports  Numbers of Patients Missing Clinics Visits  Number of Patients Missing CD4  Use of Integrated Clinical Data Management system (IQChart software)

Conclusion  Collaboration between data managers, community support team and clinical team has resulted to a consultative informed decision making for program improvement.  Key performance program Indicators for DDIU have been used as measurement for site readiness for transition  We will continue support MOH and Districts  HMIS, M&E, DDIU

Thank You