LOGFRAME FOR LESOTHO Linking HIV Sexual Reproductive Health Rights in Southern Africa (2011-2014) Outcome: Lesotho has addressed barriers to efficient effective linkages between HIV SRHR policies services as part of strengthening health systems to increase access to use of a broad range of quality services achieve the goals of universal access to reproductive health (MDGs 3, 4 5) HIV prevention, treatment, care support (MDG 6) by 2015, while making relevant linkages with the education, gender legal sectors Output Indicators: Objectively Verifiable Indicators Means of Verification Baseline Country Target by 2015 Maternal mortality rate for 15-49 HMIS LDHS 11% 3% HIV prevalence among population aged 15-49 years DHS, ANC Sentinel Surveillance 23% 10% Proportion of women receiving ANC LDHS, UNGASS 92% 100% Proportion of women delivering with the assistance of a doctor or nurse LDHS, UNGASS 62% 75% % pregnant women attending at least one ANC HMIS 70% 90% Objective 1: To allow full integration of HIV SRHR in national health broader development strategies, plans budgets. Result Area Objectively Verifiable Indicators Means of Verification Time Expected Result 1: Linkages between SRHR HIV integrated in national health development plans Number of national health policies plans incorporating strategies that link SRH HIV Baseline: 2 policies Strategies currently integrate SRH HIV/AIDS Target: 7 policies Strategies by end of project period - National health policies strategies:(lesotho National Health Social Welfare Policy 2011, Lesotho National Adolescent Health Policy 2006,National HIV AIDS Policy 2006, National HIV Prevention Strategy for a Multi-Sectoral Response to the HIV Epidemic in Lesotho (Sept 2010 version) Health Sector Policy on 1 Responsibl e Partner 2011-2014 MOH Existing policies that integrate HIV SRH are harmonized by the MOH.
Comprehensive HIV Prevention 2010, emtct Strategy, Condom Strategy Reproductive Health Policy Implementation Strategic work (Draft 2010) # of costed strategies to link HIV SRHR (Baseline 0) (Target 1) # of operational plans which incorporate scaling up HIV SRHR (Baseline 0) (Target 1) Existence of a joint SHRH/HIV coordination planning mechanisms: Target:1 Costed Strategy 2014 MOH/UNFP A Operational Plan 2014 MOH/UNFP A - MOHSW organograms - MOHSW MTEF expenditure reviews - Training curricula integrated - M&E supervision tools reports -Endorsed annual work plans. -Minutes of the coordination meetings MOH willing to review existing strategies adopt linked approaches. 2012 MOH The two units of Family Health Disease Control are willing to plan budget their programmes jointly. 2
Number of civil society organizations/groups (e.g. PLHIV key populations) involved in technical support to SRHR/HIV linkages programming List attendance of key populations 2011-2014 MOH Key populations groups are willing to participate are welcomed by other structures in SRH HIV linkages programming. Activities for Result 1 Objectively Verifiable Indicators Means of Verification Time Rapid Assessment 1.1 Conduct a rapid assessment for HIV SRHR linkages 1.1.1 Finalize RA study to update the assessment to include all TWG inputs. 1.1.2 Printing dissemination of 500 copies rapid assessment study Availability of a needs assessment report Target:1 Existence of an updated needs assessment report Target:1 Number of copies printed disseminated Target: 500 Technical consultation with national stakeholders Responsibl e Partner Recommendations Rapid assessment report Q2-2012 MOH Rapid assessment findings are accepted by the implementing partner as true reflection of the linkages status recommendations are implemented Updated needs assessment report accordingly. Q2-2012 MOH The study will be accepted by the MOHSW. Activity reports Q3-2012 MOH Copies will be used to develop action plans future linkages strategies. Activities for Result 1 Objectively Verifiable Indicators Means of Verification Time Responsible Partner Recommendations 3
1.2.1. Hold stakeholders meeting to validate the study 1.2.2 Identify priorities in scaling up linkages at policy, systems service levels (including priorities to end stigma discrimination) 1.2.3 Define interim working arrangements modus operi resources requirement for follow-up on the agreed priorities 1.3.1 Increase broad understing support of the full scope of SRHR HIV linkages policy systems barriers to them 1.3.2 Present the conclusions recommendations of the technical consultations Number of meeting(s) held with stakeholders Baseline:1 Existence of list of priorities. Target:1 Existence of an approved strategy Target:1 Technical consultation(s) proceedings Approved meeting(s) report - Technical consultation(s) proceedings - Approved meeting(s) report - Technical consultation(s) proceedings - Approved meeting(s) report - Strategy document Q2-2012 MOH Participants will relate to the study input to the findings recommendations. Q2-2012 MOH Priorities for linking HIV SRH will adopted by the MOHSW. Q4-2012 MOH s SRH Technical Working Committee Advocacy Meetings with High Level Representatives (Civil Society, Government, Donors, other Stakeholders) Number of advocacy meetings organized involving high level representatives: Target:2 Number of technical consultative meetings held. Target: 4 Meetings proceedings or minutes (including attendance list) Meeting proceeding/minutes (including attendance list) The existing RH committees ready to take up added responsibility of linking HIV SRH. On going MOH More donors are willing to support the linkages initiatives. Q2-2012 MOH Technical structures accepts recommendations suggest own inputs. 4
1.3.3 Seek endorsement for the proposed national process to strengthen SRHR HIV linkages Existence of endorsed country priorities for integration Target: 1 Strategies Consolidated Package of Actions 1.4 Develop strategies consolidated package of actions to address the agreed priorities for scaling up, linked /or integrated programs linkages Policies Plans 1.5.1 Map review ongoing upcoming national health development policies planning/reviews processes for opportunities to address agreed priorities on SRHR-HIV linkages Number of strategies packages formulated Baseline:0 Target: 1 Number of policies reviewed. Baseline:2 Target:7 - Strategies/actions endorsement document - Priorities reflected in draft or finalized national policies plans - Strategies/actions document - Strategies/actions reflected in draft or finalized national policies/plans Review report of the following policies: Lesotho National Health Social Welfare Policy 2011, Lesotho National Adolescent Health Policy 2006,National HIV AIDS Policy 2006, National HIV Prevention Strategy for a Multi-Sectoral Response to the HIV Epidemic in Lesotho (Sept 2010 version) Health Sector Policy on Comprehensive HIV Prevention 2010 Reproductive Health Policy Implementation Strategic work (Draft 2010)) Q2-2012 MOH Endorsement is secured from MOHSW principals. Q2-4-2012 MOH MOHSW is able to develop strategies within the project timeframe. Q2-Q3-2012 MOH The existing policies plans are reviewed during the project time span in order to influence the linkages agenda. 5
1.5.1.1 Support TA for 1.5.1 activity above 1.5.2 Ensure support of the key sectoral stakeholders development partners Existence of TA TA review report Q2-Q3-2012 -Number of meetings conducted to present identified opportunities to key national stakeholders -Proportion of stakeholders participating ( MOHSW Committees, Development partners forum) Meetings minutes List of attendants List of committee members Monthly meetings UNFPA MOH MOH Ability to secure the local TA within the minimum time frame Stakeholders value the linkages concept for scale up. Baseline:0 1.5.3 Incorporate priority linkages in national health development plans Capacity Building 1.6 Support capacities of civil society organizations, PLHIV representatives of key populations to be meaningfully engaged in the consultations Existence of country priority linkages in national health development plan. Number of sessions conducted to inform civil society on plans to improve HIV-SHRH integration Target: 1 National Plans Strategies 6 Q3-Q4-2012 MOH The existing policies plans are reviewed during the project time span in order to influence the linkages agenda. Sessions minutes Q4-2012 MOH Existence of CSO s engaged in linkages programming who are willing to build their capacities.
processes. 1.6.1 Develop stardized information advocacy package for linkages service provision. 1.6.2 Identify CSO with less capacity on linkages Number of advocacy package developed Target: 1 Copies of the developed packages Q2-2013 MOH Advocacy packages are consumed by stakeholders as relevant appropriate materials to upscale linkages. Number of CSOs identified List of CSOs. Q3-2012 MOH CSOs are providing true reflection of their capacity status. Objective 2: Enable Lesotho to link efforts on integration of SRHR HIV better scale them up effectively Result Area Objectively Verifiable Indicators Means of Verification Time Responsible Partner Result 2: Improved uptake Proportion of PHC service delivery Annual health joint review 2012-2014 MOH delivery of points that offer six or more of the report. integrated quality following SRH HIV services: HMIS monthly reports services for HIV FP, ANC, PNC STI, HCT, PITC SRHR ARVs. Target: 4 Proportion of PHC service delivery points that are adolescent friendly promote male involvement in SRH Target: 4 Annual health joint review report. HMIS monthly reports 2012-2014 MOH 7
Building capacity of programme managers service providers in governmental community-based organizations to implement SRHR HIV integrated services Review existing, if needed, piloting new integrated approaches in selected districts, e.g. regarding district primary health care services community health workers. Number of managers service providers trained: Target: 50 Number of health facilities with integrated SRH HIV approaches. Baseline: 3 Target: 12 Training workshop report 2012-2014 MOH/UNFPA MOHSW s departments of Family Health Disease Control are able to identify pioneers of HIV SRH linkages trainees for replicating the programme countrywide Review reports 2012-2014 MOH/UNFPA Objective 3: To stimulate formulation dissemination of lessons learned in the Southern African region, formulate best practices facilitate South-South cooperation in this field (all countries). Result 3: Best practice models disseminated to support strengthening linkages between HIV SRHR Objectively Verifiable Indicators Number of country level best practice models disseminated Means of Verification Time Responsible Partner Best practice models document Q1-2014 UNFPA Unique practices captured at policy, system service levels accepted endorsed by the MOHSW 8
Number of best practice documentation developed during project period (Baseline 0) Target 1 Existence of best practice models in health strategies plans Best practice documentation developed National health strategies plans 2014 UNFPA Q4-2014 UNAIDS Activities for Result 3 Objectively verifiable indicators 3.1 Document lessons Existence of a document with learned identify lessons learned bottlenecks bottlenecks best practice models at the Target: 1 policy, Number of site visits to project system, service areas undertaken: delivery levels disseminate them widely Target: 6 Number of project reviews held Baseline:0 Existence of an end of project evaluation Target: 1 3.2 Convene regional consultations with project countries to share their Number of regional visits undertaken Means of verification Time Responsible Partner Lessons reports Q4-2013 UNAIDS Unique practices captured at policy, system service levels accepted Mission reports Once quarterly every year MOHSW/UNF PA Workshop reports Q4-2012 UNFPA Q4-2013 Evaluation report Q4-2014 UNFPA Mission reports Once Quarterly MOHSW, UNFPA UNAIDS endorsed by the MOHSW Other countries are willing to host share linkages lessons with the Lesotho 9
linkages/integration experiences through South-South cooperation, including via the AU/SADC other relevant continental global frameworks. Target: 6 Visibility, Communication Advocacy delegation. Visibility Activities Objectively verifiable indicators Facilitate an increased, Number of promotional broad support better materials developed understing of the disseminated: project its aim Target: 8 Number of media houses engaged publicizing project activities Target: 3 Monitoring Number of technical working Evaluation groups meeting held. Target: 4 Monthly, quarterly annual reports produced shared. Baseline: 1 Target: 4 Means of verification Time Responsible Partner Promotional materials Q3-2012 MOHSW EU is acknowledged as the donor key messages are captured understood by the audiences. Public debate on the project On going MOHSW/UNF The media houses are concepts PA willing to air key messages free of charge. Meeting minutes of the committees On going MOHSW/ UNFPA Implementation progress reports On going UNFPA Technical working committees provide oversight role to the project 10