1. 1 MODALITIES FOR HIV/AIDS PLANNING, IMPLEMENTATION AND MANAGEMENT IN LOCAL GOVERNMENTS Stephen K. Kiirya Makerere Institute of Social Research August 6, 2007 Arua

2. 2 1. BACKGROUND No structured response to HIV/AIDS before 1985 1986 AIDS Control Program (ACP) established in MoH to spearhead HIV/AIDS actions in public sector CSO/FBO initiated organized action in community 1986 - 92, HIV/AIDS mainly coordinated & managed by ACP through Task Forces linked to a few Sectors 1988, realized that epidemic is multi-faceted & initiated discussion on a multi-sector strategy 1992, adopted policy on multi-sector Approach to the Control of AIDS (MACA) and created UAC 1994+ implementation of multi-sectoral national response with many players at national, district & lower levels

3. 3 UAC CCM WB MAP Bilaterals INGOs and Foundations National Level Action District and Local Level Action National Budgets Academic Partnerships UN Private Sector National AIDS Control Programmes CSO Partnerships Parliament Numerous challenges to institutional and coordination arrangements

4. 4 2. MANAGEMENT ARRANGEMENT Created formal arrangements, structures and functions to ensure that all stakeholders and aspects of the HIV/AIDS response work together in an organized and efficient way to achieve the national objectives Political & technical coordination structures are responsible –Political: Parliamentarian HIV/AIDS Standing Committee, DATF, SATF, parish/village councils –Technical: UAC/SCEs, SAC, DAC and SAC UAC coordinates all HIV/AIDS activities at all levels. SACs coordinate HIV/AIDS activities in line ministries. DAC and SAC coordinate AIDS activities at district and lower levels with support from national structures

5. 5 AIDS PARTNERSHIP FORUM (All Partners meet Annually:review progress, set priorities) 2.1 National Mechanism UGANDA AIDS COMMISSION & SECRETARIAT THE HIV/AIDS PARTNERSHIP COMMITTEE (4 Permanent Representatives and Representatives from all Self-Coordinating Entities (SCEs) Govt Ministries UN & Bilaterals National NGOs INGOs Private Sector FBOs PHA Networks LG Response Research Academia Science YouthMedia Post 2000 Three Ones Principle = One National HIV/AIDS Framework, Coordinating Body and M& E Framework Parliament

6. 6 2.1.1 National-Level Roles Develop national programs, policies, guidelines and materials for facilitating HIV/AIDS planning, implementation and management of interventions Mainstream AIDS in planning/budget frameworks Advocate and lobby resources and other inputs Building capacity of implementers by training, etc Quality assurance by periodic supervision, M&E National surveys, assessments, etc

7. 7 District AIDS Taskforce Chair: District Chairperson Secretary: CAO; Members: max 23; DEC, RDC, speaker, reps of CSO & PHA; Meet: Twice annually District AIDS Committee Chair: CAO; Secretary: Focal Point Officer; Members: max 23; heads of directorates, reps of CSO & PHA; Meet: At least ounce a Quarter SC AIDS Taskforce Chair: Sub-county chairperson Secretary: Sub-county chief; Members: max 15; SC executive, speaker, reps of CSOs & PHA ; Meets: Twice annually Subcounty SC AIDS Committee Chair: Sub-county chief; Members: max 15; heads of sub-county directorates, reps of CSOs & PHA; Meets: At least twice annually Parish AIDS Taskforce Combines Political and Administrative Arms; Chair: Parish chairperson; Members: max 15; Parish executive, representatives of PDC, CSOs and PHA. Meets: Twice annually 2.2 Local Govt Mechanisms Village AIDS Taskforce Combines Political and Administrative Arm; Chair: Village chairperson; Members: max 15; Village executive, representatives of VDC, CSOs and PHA; Meets: At least twice annually District Parish Village

8. 8 2.2.1 Local Govt Level Roles Develop, implement and manage local HIV/AIDS strategic and annual plans, bylaws and tools Integrate AIDS activities in local development plans, initiatives and budget frameworks Mobilise communities & resources for AIDS responses Build capacity of implementers by training, etc Implement and assure quality of activities through periodic supervision/monitoring Local situation/response analysis, surveys,etc

9. 9 3. PLANNING MODALITIES 3.1 Definition Is a process that involves assessing problems/needs and identifying feasible actions and resources for resolving them in the short and long-run Long-run: Strategic plan (more than 3 years Short-run: Work-plan (quarterly, biannual, annual

10. 10 What should be What it is Participatory from below upward Partial participation, process often starts & ends at district level staff & politicians Partial participation, process often starts & ends at district level staff & politicians Inclusion of community groups & need (go beyond LC structure) Limited participation & integration of community needs in development plan processes Decentralized management structures (DAC, CPC DAC & DDHS-led, central-led for some CSO Multi-sectoral approach Evidence-based multi-sectoral strategic plans Multi & single-sector (health) method Parallel planning/budgeting (driven by respective AIDS funding mechanisms) Mainstream AIDS in plans and budgets for organizations Mainstream AIDS in plans and budgets for organizations Limited HIV/AIDS activities/budgets in department plans Sector HIV/AIDS provisions in the District Development Plan Sector HIV/AIDS provisions in the District Development Plan HIV/AIDS activities seen in health section of district development plan HIV/AIDS activities seen in health section of district development plan 3.2Planning Principles

11. 11 What should be What it is DAC coordinates planning, budgeting, appraisal, implementation, M&E of the district multisector HIV/AIDS plan Non-participation of some CSOs in joint planning Non-participation of some CSOs in joint planning Similar lower structures not working Stakeholders often come with preconceived activities Process not replicated & linked to lower structures and leaders Process not replicated & linked to lower structures and leaders Deepen practice to SACs, etc. Start in groups/not only leaders Synthesize issues in sub- county and parish plan Synthesize issues in sub- county and parish plan Assign general needs to LG structures and special needs to interest groups Assign general needs to LG structures and special needs to interest groups Hold conference of all key LG stakeholders to plan collectively Select small team of DAC and stakeholders to synchronize activities, cost and draft plan in line with national strategic plan DAC reviews completed plan and submit it to DC for Approval DAC reviews completed plan and submit it to DC for Approval 3.3 Planning Process

12. 12 4. RESOURCE MOBILISATION AND MANAGEMENT Funds mobilised locally from communities and LGs, or externally from government, donors and civil society Multiple funding arrangements: -On-budget funding (local revenue/conditional grant) -Separate bank account for channelling project fund -Direct funding to implementers 4.1 On budget Implementers request and funds are drawn from the respective budget line Accounting done in line with public procedures

13. 13 4.2 Off-Budget CAO & CFO responsible for all financial management DFP & Sub-Accountant facilitate periodic financial operations and report preparations Implementers maintain project specific account DAC prepare/submit quarterly activity schedule (extract from approved annual work plan/budget) Funds are disbursed to LG project account with payment details (activities, amount and implementers) or directly to implementer with copies to LG Cheques written in the names of listed implementers. Next release made after accounting 75% of advance and reflecting it in the monthly accountability returns. Suspend payment if implementer fails to account well.

14. 14 4.3 Direct CBO Funding After approval of CBO proposals, CAO/DFP or the equivalent in LLG prepare/submit to financier a request with approved community plan and budget Request shows communities whose proposals are approved, location & amounts (local and requested) Guide approved communities to open bank account Pay directly to respective CBO accounts by qheque. Train management committees in implementation, fiduciary management and reporting.

15. 15 What should be What it is Respective LG-based departments, NGOs, FBOs and CBOs implement activities stipulated in the plan. Some implementer (CSO, FBO) deliberately avoid LG priorities & implement own activities Substantial external funds disbursed outside or without copy to LG mechanisms Substantial external funds disbursed outside or without copy to LG mechanisms Limited transparency and accountability of activities and budget size to LGs, communities Limited transparency and accountability of activities and budget size to LGs, communities Articulate all implementation procedures in LG plan Emphasize procedures to all financiers or implementers at negotiation, implementation and follow-up Emphasize procedures to all financiers or implementers at negotiation, implementation and follow-up Implementers develop workplan based on approved strategic plan Workplan should go through all set approval process of LG, ministry, CSO or FBO Disburse funds to implementers through or with information to LG authority Account to or give reports to LG authority CAO/DAC for verification/audit, etc 5. IMPLEMENTATION

16. 16 5.2 Community Implementation Based on community action plan and budget. Community is informed about exact disbursement Community meets and prepares a simple activity timetable, and request based on funds disbursed. Community submits request and timetable to LG authority, and cheque is paid and deposited After cheque has matured, persons assigned activity request funds and implements. Implementation & accountability reports are prepared and submitted to treasurer who compiles reports. All reports, accountabilities and requests are endorsed by CPC and forwarded to LG.

17. 17 Monitoring (check progress: Evaluation(assess outcome: Implementation of activities How they are being done, If beneficiaries are reached Identify obstacles+solutions Extent objectives are achieved Effects of activities on beneficiary well-being Weekly, monthly, quarterly,. Mid, end, after(post-audit) Checklist Evaluation/survey tool Internal: DAC, SAC, ATFs, EWs, PDC, VC, CPC, etc External: Independent Why? Improve performance Why? See change caused 6. MONITORING & EVALUATION 6.1 Definition

18. 18 6.2 LG Modalities Set measurable indicators linked to LG situation and specific NSF objectives Set/use standard monitoring tool (linked to key AIDS indicators in LG & National M&E modules) Periodic monitoring of implementers by HIV/AIDS committees, EWs, political and community leaders Respective agencies must monitor/report on activities Establish Management Information System (MIS) Periodic analysis of existing data on HIV/AIDS Periodic reporting on key AIDS indicators in the LG & national M&E module Determine activity impact through periodic Local Quality Assurance and Supervision (LQAS) surveys in district

19. 19 7. CONCLUSION LG HIV/AIDS planning, implementation and management modalities have been disseminated widely but are not functioning in all LG Joint planning is limited to districts which receive external support, and this process often starts and ends with department staff & politicians Participation & integration of community needs in development plan processes is still limited Implementation is still disjointed and weakened by incongruent procedures set by various AIDS funding mechanisms The deliberate bypassing of LG systems by several existing funding mechanisms & implementers has undermined the functioning of the set HIV/AIDS coordination and management arrangements

20. 20 8. RECOMMENDATIONS Deepen joint planning practices into LLG structures (SACs, etc) and ensure that it starts in the community groups Synthesize community issues and integrate them in parish/sub-county plans while assigning general needs to LG structure and the special needs to respective interest groups Include budget provision for HIV/AIDS in all LG sectors (not only health) Articulate all planning, funding, implementation and management procedures in LG HIV/AIDS plan Repeatedly emphasize procedures to all financiers and implementers during negotiation, implementation and follow-up Replicate the partnership arrangements in all LGs

21. 21 THANK YOU