1 LOGFRAME TEMPLATE FOR MALAWI Linking HIV and Sexual Reproductive Health and Rights in Southern Africa (2011-2014) Overall Aim - To support Malawi in addressing barriers to efficient and effective linkages between HIV and SRHR policies and services as part of strengthening health systems 1 ; - To increase access to and use of a broad range of quality services and achieve the goals of universal access to - Reproductive health (MDGs 3, 4 and 5) and HIV prevention, treatment, care and support (MDG 6) by2015, while making relevant linkages with the education, gender and legal sectors 2. Indicators Means of Verification Baseline 2011 Target 2014 HIV prevalence among population aged 15-24 years DHS, ANC Sentinel Surveillance 5.2% 4.1% Universal access to HIV prevention, care and support: % of HIV infected pregnant women who receive ARVs to reduce the risk of MTCT HIV Programme Reports 40% 55% Universal access to reproductive health: % pregnant women attending at least one ANC HMIS 95% 100% Maternal mortality rate HMIS 675/100,000 415/100,000 Objective 1: To allow full integration of HIV and SRHR in national health and broader development strategies, plans and budgets (all countries) 1 Applies to all countries 2 Applies to Botswana, Malawi and Swaziland only
2 Objectively Verifiable Indicators Means of Verification Time Frame 3 4 Expected Result 1: Linkages between SRHR and HIV integrated in national health and development plans Number of national health policies incorporating strategies linking SRHR-HIV in systems and services in place. Baseline: 2 Target : 5 Number of Joint SHRH/HIV quarterly supervisions conducted annually by the Target:2 - National health policies and strategies (SRH Policy, HIV Policy SRH Strategy, Health Sector Strategic Plan, E-MTCT Plan) - M&E supervision tools and reports Q4Yr1 Q3 Yr4 Q1Yr2 No other competing priorities emerging within the Resources available for conducting supervisions Activities for Result 1 Objectively Verifiable Indicators Means of Verification Time Frame and Recommendations Rapid Assessment 1.1Disseminate 2009 rapid assessment for HIV and SRHR linkages Needs assessment report available Rapid assessment report Q2 Yr2 Technical Consultation with National Stakeholders 1.2.1 Review findings and recommendations of the SRHR and HIV linkages assessment 1.2.1.1 Conduct baseline and facility assessment in the 3 pilot districts Number of technical consultations organized involving national stakeholders Baseline and facility assessment conducted in the 3 pilot districts Target: 1 Technical consultation(s) proceedings Q4 Yr2 Baseline Report Q2Yr2 3 Indicate Quarter and Year throughout the logframe (e.g. avoid the term continuous ) 4 Indicate one partner responsible per activity only
3 1.2.2 Identify priorities in scaling up linkages at policy, systems and service levels (including priorities to end stigma and discrimination) 1.2.3 Define interim working arrangements (sub-committees), modus operandi and resources requirement for follow-up on the agreed priorities 1.2.3.1 Implementing agencies working arrangement and resource requirement ( including coordination with UNAIDS requirements) 1.2.3.2 Coordination agencies conducting HLM with other stakeholders for increased understanding of SRHR/HIV linkages 1.3. Increase broad understanding and support of the full scope of SRHR and HIV linkages and policy and systems barriers to them 1.3.1 Implement the SRH advocacy and community strategy to highlight importance of linking SRH/HIV services at all service delivery points 1.3.2 Present the conclusions and recommendations of the technical consultations 1.3.3 Seek endorsement for the proposed national process to strengthen SRHR and HIV linkages Priorities identified and included in the EU SRH/HIV Linkages Project Number of sub-committee meetings held annually Target: 4 Technical and finance officers in place Target: 2 Number of HLM Baseline 0 Target 2 Detailed Implementation Plan Minutes of SubcommitteeMeetings Filled posts Minutes for high level meetings Q3Yr1 Q1Y1 Throughout project life Y3 Q4 Y4 Q1 Advocacy and Meetings with High Level Representatives(Civil Society, Government, Donors, other Stakeholders) Number of district implementation plans (DIPs) with activities on linking SRH/HIV in the 3 pilot districts Number of technical consultations involving district stakeholders Country priorities for integration endorsed by national stakeholders District Implementation Plans for the 3 pilot districts Meeting proceeding/minutes (including attendance list) Annually Q4 Yr2 Signed cooperation agreement Q2 Yr1 Strategies and Consolidated Package of Actions This activity will be core funded with SIDA as mentorship comes under this item Sida funded
4 1.4 Develop strategies and consolidated package of actions to address the agreed priorities for scaling up, linked and/or integrated programs linkages 1.4.1 Develop an action plan for integration of gender into SRH/HIV programs Action plan for integration of gender into SRH/HIV programs endorsed by stakeholders Detailed Implementation Plan Q3Yr1 1.5.1 Map and review ongoing and upcoming national health and development policies and planning/reviews processes for opportunities to address agreed priorities on SRHR-HIV linkages 1.5.2 Ensure support of the key sector stakeholders and development partners 1.5.3 Incorporate priority linkages in national health and development plans 1.5.4 Review syllabi for the pre service training of nursing/para medical in SRHR/HIV linkages 1.6 Support capacities of civil society organizations, PLHIV and representatives of key populations to be meaningfully engaged in the consultations and processes 1.6.1 program support to innovate CSO on SRHR/HIV models Review of national health and development policies and strategies to identify opportunities done Country priorities for integration endorsed by national stakeholders Number of national health plans incorporating strategies linking SRHR- HIV in systems and services in place. Target :3 Review report of syllabi for pre service training of nursing/para medical personnel. Target :1 Number of civil society organizations, including PLHIV and key population groups supported Target : 7 Policies and Plans Review report, including recommendations Q2Yr2 Signed cooperation agreement Q2 Yr1 - National health policies and strategies (SRH Strategy, Health Sector Strategic Plan, E- MTCT Plan) Q4Yr1 Q3 Yr4 Review report Q2Yr2 Capacity Building Workshop Reports Activity reports Q4 Yr2 Y4 Q1 This will be co funded by both SIDA and EU
5 Objective 2: To enable three countries in Southern Africa to link efforts on integration of SRHR and HIV better and scale them up effectively 5 ; Objectively Verifiable Indicators Means of Verification Time Frame Result 2: Improved uptake and delivery of integrated quality services for HIV and SRHR % of pilot health facilities providing both SHRH and HIV comprehensive services in the 3 districts Baseline: 50% Target: 75% % of patients reporting they received all HIV and SHRH services they wanted/needed Baseline: 50% Target: 75% -Facility Assessment -Facility Assessment Q4Yr1 and Q3Yr4 Q4Yr1 and Q3Yr4 Activities for Result 2 Objectively verifiable indicators Means of verification Time Frame 2.1 Develop an operational health workforce strategy to ensure proper introduction of and support for linked/integrated services 2.1.1 Develop annual district training plans for health workers to ensure proper introduction of and support for linked/integrated services 2.2 Design programs to support rights education, access to quality health services and SRHR, address stigma/discrimination, including through redress mechanisms 2.3 Implement effective approaches to reduce/eliminate stigma and discrimination by and towards health care providers, and increase involvement of men and vulnerable Number of annual district training plans developed Target :3 Number of programs supporting rights education, access to HIV-SHRH integrated services, or to reduce stigma/discrimination District Training Plans Annually District Implementation Plans Activity reports Q3Yr3 and Q3Yr4 This activity will be co funded with Sida 5 Botswana, Malawi and Swaziland only
6 groups 2.3.1 Conduct public awareness campaigns, including male involvement to sensitize the community on the availability of integrated FP and HIV services in the 3 pilot districts 2.3.2 Improve use of DIP guidelines for SRH-HIV. 2.4 Transform stigmatizing attitudes and discriminatory behaviors of health providers through values clarification and capacity building Number of public awareness campaigns conducted in the 3 districts Target:3 Number of zonal and district staff trained on effective use of DIP Guidelines for SRH-HIV 6 Number of information and training sessions conducted for health providers District Activity Reports Training Reports Information/training sessions reports Q2,3, Y2 Q2Yr3 Q2Yr3 and Q2Yr3 and To be co funded with Sida 2.5.1 Build capacity of program managers and service providers in governmental/community-based organizations to implement HIV/SRHR integrated services 2.5.2 Support DHMT and supervisors in conducting quarterly supportive supervision and mentoring. 2.5.3 Conduct one training session in each pilot district for Community-Based Distribution Agents (CBDA) and Health Surveillance Assistants (HSA) 2.5.4 Train SRH service providers in the provision of HIV services 2.5.5 Train HIV service providers in the provision of SRH services Number of training session to program managers from CSOs Target: 4 Number of quarterly supervisions conducted with DHMT in a year Number of CBDA and HSA trained 0 Number of SRH service providers trained in SRHR/HIV integration 0 Number of HIV service providers trained in SRHR/HIV integration Target: 45 Capacity Building Training sessions reports Supervision reports Q3Yr2 and Q3Yr4 Q2Yr2, Q2Yr3 and Training report Q3Yr.3 Training report Training report Q3Yr2 to Q3Yr2to 2.5.6 Train male motivators to promote Number of male motivators trained to Training report Q3Yr2 MIAA
7 male involvement in HTC/SRHR/ gender HIV prevention 2.6.1Support pilot districts with handling fees for FP/HIV commodities 2.6.2 Support pilot districts with procurement of basic RH equipment and supplies 2.6.1.2 Support pilot districts with procurement of RH basic equipment/furniture 2.6.2 Advocate with government for an integrated and coordinated approach to supply of SRH and HIV commodities 2.7 Review existing and, if needed, pilot new integrated approaches in the 3 pilot districts 2.7.1 Provide integrated SRH and HIV services in the 15 pilot facilities from the 3 districts 2.7.2 Renovate or reorganize existing buildings at pilot health facilities to facilitate the provision of integrated services, using and/or district specific models promote male involvement Target: 45 % of pilot facilities in the 3 districts reporting no stock outs in HIV-SRHR commodities of more than a week in the last 12 months Target: 70% Number of facilities strengthened with basic equipment and supplies Baseline : 1 Target: 15 % of pilot facilities in the 3 districts reporting no stock outs in HIV-SRHR commodities of more than a week in the last 12 months Target: 70% Number of meetings with government on an integrated and coordinated approach to supply of SRH and HIV commodities District specific models on SRH/HIV linkages at facility level are developed Number of health facilities renovated Baseline : 0 Target:3 - Facilities reports - Health information system - Supervision reports Supervision/verificatio n reports on assets Yr2 to Yr4 To be co funded with Sida Y4 Q1 Meetings minutes To be co funded with Sida Action plan on district models Q2Yr2 Project report Q4Yr3
8 2.7.3Follow up on donor resource mapping exercise on SRH/HIV linkages and funding conditions Resource mapping exercise completed and report available Resource Mapping Report Q4Yr2 UNAIDS 2.8 Define the contribution of non-health sectors (especially education, law and gender) in successful models, and make recommendations for inclusion in coordinated programs of support Review of contribution of non-health sectors in national integration models performed Review report Q4Y3 UNAIDS Objective 3: To stimulate formulation and dissemination of lessons learned in the Southern African region, formulate best practices and facilitate South-South cooperation in this field (all countries). Result 3: Best practice models disseminated to support strengthening linkages between HIV and SRHR Objectively Verifiable Indicators Means of Verification Time Frame Number of country level dissemination meetings on best Best practice models Q4Yr2 to practice models document UNAIDS Best practice models incorporated in national health policies/plans Baseline: 2 Target : 5 National policies & plans (SRH Policy, HIV Policy SRH Strategy, Health Sector Strategic Plan, E- MTCT Plan) Q4Yr2 to Activities for Result 3 Objectively verifiable indicators Means of verification Time Frame 3.1 Document lessons learned and identify bottlenecks and best practice
9 models at the policy, system, and service delivery levels and disseminate them widely 3.1.1 Document lessons learned and identify bottlenecks and best practice models at the policy, system, and service delivery levels 3.1.2 Organize sensitization workshops for media personnel for proper coverage of the linkages issues 3.1.3 Produce documentation of good practices and lesson learnt from time to time through print and electronic media 3.1.4 Conduct annual reviews, midterm and final evaluation of the SHR/HIV Linkages initiative 3.2 Convene regional consultation with projects countries to share linkages/integration experience through south-south cooperation,including Via AU/SADC or other relevant continental and global framework Number of best practice and lessons learnt documentations produced Baseline 0 Number of sensitization workshops on SRH-HIV to the media Baseline 0 Target: 2 Bulletins, newsletter, leaflet and radio programs available Target: 9 Annual reviews done Target: 4 Midterm and final evaluation done Target: 2 Number of regional meetings and workshops attended Target: 4 Number of exchange visits with other countries in the EU SRH/HIV Linkages Initiative conducted Target: 2 Best Practice and Lessons Learnt Reports Media Reports Publications Review reports Evaluation reports (mid and final) Mission reports Mission reports Q4Yr2 and Q2Yr1 and Q2Yr3 UNAIDS Q2Yr2 to To be co funded with Sida Q4Yr2 and Q4Yr3 Q1Yr3 and Q2Yr1 to Q4Yr2 to Q2Yr UNAIDS