Procedures for elaborating post APOC sustainability plans for CDTI projects (of 5th and 3rd year projects)

PROCEDURES FOR ELABORATING POST APOC SUSTAINABILITY PLANS FOR CDTI PROJECTS (oF 5th AND 3',, YEAR PROJECTS) May 2003 @,v @ AFRICAN PROORA,Ui E FOR ONCHOCERCTASIS CONTROL WORLD HEALTH OR6ANTZATION tr.t!; #h {. ,.1 a,q? PROCEDURES FOR ELABORATING POST-APOC SUSTAINABILITY PLANS FOR CDTI PROJECTS (oF sth AND 3'd YEAR PROJECTS) TANZANIA CDTI PROJECTS Information notes PLEASE USE THIS GUIDE DURING THE FEEDBACK PLANNING MEETING AND TO FTNALISE THECDTI SUSTAINABILITY PLAN WHICH SHOULD BE FORWARDED TO APOC MANAGEMENT SOONAFTER THE EVALUATION REPORT HAS BEEN RELEASED. REMEMBER TO SUBMIT THE SUSTAINABILITY PLAN WITH THE ANNUAL HEALTH PLANS OF THEENDEMIC DISTRICTS. THE MANAGEMENT OF APOC WILL NOT REVIEW A SIXTH OR FOURTH YEAR WORKPLAN ANDBUDGET UNLESS A DETAILED SUSTAINABILITY PLAN HAS PREVIOUSLY BEEN APPROVED. AMENDED DEFINITION OF SUSTAINABILITY SUSTAINABILITY: The ability of a project to continue functioning effectively, using both its own resources and those from outside- provided both, in particular government resources are dependable. (APOC management, April2003). GUIDELINES The aim of the guidelines is to highlight key elements of a CDTI sustainability plan. The guidelines is intended to help evaluators and National Coordinators to facilitate a meeting of stakeholders to develop a three-year CDTI post-APOC sustainability plan for submission to ih" .rrurugement of APOC. Remember: The aim of the planning meeting should NOT be to replace APOC financing with another external donor funding. [Iltimately, the government and communities SHOULD take charge. A. To develop a CDTI sustainability plan it is crucial to adopt the recommended Process What is the recommended process? All partners supporting a CDTI project should attend the meeting and jointly develop the plan. A plan should not be developed by only a segment of the supporting parrners, the NorF or the regional/district onchocerciasis control team. The regional/district Health Management Team should chair the meeting to develop a plan. t WHO/APOC May 03 2003 iii. partners at each level - National (NOTF), Regional and Distlict members should discuss and have a good understanding of the significance of the sustainability Plan. iv. The following should be made available to the meeting: (a) The past and current District health plan (b) The pBIvIO map of the project area. Number of communities eligible for mass treatment and those being treated; total population and number of persons treated annually from Year 1- 5 or Year 1 -3 as the case may be' (c) Letters of Agreement (Year 1-5 or 1-3) and information on the financial contribution of govemment and other partners (d) The sustainability evaluation reports v. After a plan has been developed all partners should endorse, in writing, their commitment to finance the plan. The SIGNED copy should be forwarded to APOC HQ. Membershi p of the to develop CDTI sustainability olan at the level: At the District level Regional Administrator or representative Regional Medical Officer District Medical officers (DMOs) of the districts Chief of Administration & Finance of the endemic Districts District Planning Officers of the districts District Onchocerciasis Coordination teams (i.e. DOCs) National Onchocerciasis Task Force (NOTF) of Tanzania NGDO representative and any local NGo actively participating in CDTI It is expected that subsequently at the meetings for /regional and district staff, a joint sustainability plan will be developed. B. Checklist of KEY information that should appear in a post-APOC (after 5th Year or 3"d Year) sustainability plan. @ee Appendix 1 for additional guide on the framework of plan) (D Background information of the project a. REMO maP b. APOC funding Period c. CDTI implementation- achievements and challenges d. Training of ftealth personnel and CDDs - Annual Training Objectives and Results(l't to 5rh Year or 1" to 3'd Year) e. Coverage (Geographic and therapeutic) - Annual Treatment Objectives and Results (1" -5tn Year or l" to 3'd Year) the ach su st- It would be necessary at the meeting to discuss/review the roles different partners have played in the past five or three years and to determine whether there is need for olan a. b. C. d. e. f. ob' h. 2 (ii) modi fication. The should be v stated in WHO/APOC May 03 2003 a. Role of the community - their tasks should remain unchanged b. Role of the Health cenrer/First Line Health Service (FLHS), Districts c. Role of the Regional and National authorities. d. Role of the NGDO supporting parlner (if any) (iii) The plans should show evidence that all critical issues raised in the evaluation repoft are being addressed by government at all levels. (iv) The plans should conform to the conditions for further support by APOC stated in paragraph D (iii) below. (v) Written agreement that the MOH and supporting NGDO contributions to the CDTI budget will be released by the government (Region and District) and if necessary the NGDO. (vi) The Distri health plan a Check whether onchocerciasis control activities have been included and budgeted for in the Provincial/ District plan (Health Plan). If not, this error should be amended in the current and subsequent plans b. The CDTI sustainability plan should be an integral part of the MOH Health Plan. This means, CDTI activities should appear in the Regional and District Health Plans and the signed sustainabilitv plan should be s tted ro APOC m with the District Health Plan C. CDTI Sustainability Plan Budget a) The first and most important step is for the partners to determine the BASICACTMTIES required for the process of CDTI to be successful for example, maintaining ivermectin distribution at l00%o geographic coverage and treatmtnt coverage of more than 65Vo of total population. b) Secondly, the team should prepare a detailed work plan based on the defined basic activities(see (h) below). c) Time should be taken during the meeting to determine and agree on the financial support required. d) Study and comprehend APOC's criteria for further support, before proceeding to develop the budget. The critena are presented below for reference (for fifth year project only). e) The Plan should be a three-year sustainability plan 0 Insert in the year Plan a table showing amount project received from ApOC Trust Fund and other parlners during each of the preceding 5-year or 3-year life span of the project (l't, 2nd, 3rd, and 4th and 5'n years for 5th year projects) and the total. J WHO/APOC May 03 2003 g) Budget justification of the 3-year sustainability plan should be adequate and detailed. h) A detailed work plan should accompany the sustainability budget. The work plan should have the objectives, activities, expected outcome, period/timing, person(s) responsible and source of funding. D. CRITERIA FOR FURTHER APOC SUPPORT (for 5'h Year proiects only) After the fifth project year, APOC should NOT support programmatic activities This includes: - Salary top UPS - Routine CDTI activities such as CDD training, monitoring and superviston and distribution of Mectizan - Running cost for motor vehicles - Cost of consumables - Internal procurement and transport of Mectizan ii. The costs of the above activities should not feature in the APOC column of the sustainability Plan but should be taken up primarilv bv government or if absolutelY necessary bY NGDO. iii. ApOC could provide further support for up to three additional years of CDTI implementation if the projects meet the following conditions: o There should be a 3 year, post-APOC plan for sustainability . Ample evidence that the issues raised during the fifth year and, where applicable the mid- term evaluation have been (and are being) thoroughly and systematically addressed. o Evidence that resources have been used for planned activities as intended. Evidence that l0OTo geographic coverage and an acceptable (higher than657o) therapeutic coverage has been attained Written commitment that the 3-year post-APOC plan shall be followed by a ten- year post-APOC plan for sustainabilitY. iv. APOC COULD support the following activities ApOC may considei providing technical assistance and advocacy support after the fifth year, for the years 6-8, only if iertain criteria are met. Such support, for projects after the fifth year includes: Replacement of caPital equiPment Capacity building to strengthen project sustainability especially regarding effective management of Scarce resources, advocacy and local lesource mobilization as well as leadership development, and data/information management Advocacy aimed at fostering commitment of goveffIment to continue to support CDTI Teihnical assistance for external monitoring and evaluation l. 1 WHO/APOC May 03 2003 REMO Mapping Operational research to improve implementation of sustainability of CDTI There should be no column in the budget for APOC, unless absolutely necessary (for example - capital equipment NOT replaced in the 5th year can be requested; high level advocacy and activities listed above). Facilitators should guide the meeting and ensure that items listed conform to the criteria for further support. PERSONNEL AND FUNCTIONS FOR CDTI SUSTAINABILITY. After the FIFTH year of CDTI implementation the personnel required to maintain the activities at each level and their functions should be minimal. Please describe below the personnel and those functions that should remain in place for the projects to achieve the ultimate goal of APOC Appendix I A number of sustainability plans submitted to APOC management lacked vital information about the projects that should precede the section on the post-APOC CDTI sustainability work plan. We therefore recommend that the framework below be used in the preparation of the plans. The framework should have four parts (Parts I-IV) Part I (i) Introduction Provide a succinct description of the project location and geography. Briefly describe onchocerciasis in the project area and refer to publications or reports on the endemicity of the disease (one paragraph). (ii) Background information. Give background information about when onchocerciasis control efforts began in the district(s), the partners who were involved in ivermectin distribution and the roles they played. Part II Rapid Epidemiological Mapping of Onchocerciasis (REMO) Provide information about the REMO; when the exercise was carried out and attach the REMO map descnbing the results. Provide a table with the number of communities in the districts that are eligible for mass treatment based on the results of the REMO. Should the NOTF need another copy of the map please feel free to contact APOC Management. v 5 WHO/APOC May 03 2003 l_t *\'* b - rDSo Part III Part IV Part V CDTI implementation and results In this section -(a) Discuss the preceding method used for mass distribution of Mectizan in the districts prior to the launching of the CDTI strategy.(b) State when the CDTI approach was launched in the districts and the partners involved. If mass treatment did not start in all the eligible communities at the same time, please state so and give reasons.(b) Provide information and figures on important achievements of the project in CDTI core activities: e.g. training of health care personnel and the CDDs and treatment figures in the last five years. Add tables on training and treatment. The table on treatment figures of each district should contain vital information such as total population. number of persons treated and coverage.(d) Similarly, provide a brief description and a five-year table on geographical coverage showing the total number of communities eligible for mass treatment based on the REMO results, and actual number of communities that were treated in year 1,2,3,4 and 5. Financial Management of APOC Trust Funds In this section, please provide information and a table showing the total amounts released to the project for CDTI activities from Year 1 to the current year. Add in this table information about funds received from the NGDO partner and other partners during the same period. Post - APOC sustcthrubility Plan Describe succinctly in Part IV the new leadership role of the Region and Districts in funding CDTI activities, and the new roles (if any) of other participating paftners. Discuss the integration of CDTI into the district health plan. In the appropriate sections reference should be made to the work plan, post -APOC sustainability plan and the Districts health plans. These documents should be forwarded with the sustainability plan. 6 WHO/APOC May 03 2003