Joint Un Programme of Support on Aids in Zambia

JOINT UN PROGRAMME OF SUPPORT ON AIDS IN ZAMBIA

8th January 2008

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Executive Summary

This report summarizes the key achievements, challenges and opportunities experienced whilst supporting the national AIDS response from October to December, 2007. The report is based on the endorsed monitoring and evaluation (M&E) matrix of the Joint UN Support Programme on AIDS work plan for 2007

The main achievements:

1.  AN EFFECTIVE EFFICIENT NAC THAT IS ABLE TO ACHIEVE ITS MANDATE

1.  Improved institutional and human capacity building of the National AIDS Council (NAC) and the decentralized response.

2.  Expansion of PMTCT and paediatric ART services to all 72 districts of Zambia

3.  Improved commodity security for both male and female condoms

4.  Development of a costed 2008 multisectoral work-plan for Zambia

5.  Commenced analysis of the epidemic in Zambia

6.  Increased capacity for rolling out treatment and care services, including quality assurance strengthened

Key challenges:

·  The institutional location of NAC within the Ministry of Health limits the coordinating authority of the multisectoral response on AIDS

·  The human resource and technical capacity in some agencies needs to be enhanced

·  Some agencies suffered reduced resource allocations and were not able to support implementation of the annual work plan of 2007.

·  There is still inability to pool resources although some agencies (Excom) have initiated a Harmonized Cash Transfer (HACT) to NAC in order to reduce UN transaction costs.

·  There will need to have serious review of the results in the 2008 work-plan including the need for agencies to do more upstream work than downstream

·  Poor financial monitoring linked to programme implementation

Issues requiring UN Heads of Agencies’ Input

1.  Increase agency programmatic and financial accountability

2.  Need to streamline expenditure related to the joint programme commitments.

3.  Need to commission a piece of work that looks into how we can best utilise parallel funding mechanisms to better support the joint programme of support including implementation of a joint financial monitoring system

4.  Practical commitment towards development of a joint programme for young people and PMTCT is required as these are some of our key result areas for 2007

1.  Background

The Joint UN Programme of Support on AIDS was developed with the main aim of providing one UN collective, coherent and integrated support to the Zambia AIDS Strategic Framework 2006 – 2010 based on existing national and international priorities. It is a joint support programme by thirteen UN organizations present in Zambia.

The support anchors on four outcomes areas selected based on the comparative advantages of the UN agencies:

·  An effective, efficient NAC that is able to achieve its mandate

·  Access to an effective and comprehensive package of prevention services, based on approaches that address the underlying drivers of the epidemic, is increased;

·  Access to treatment, care and support increased;

·  The National Institutional Capacity to Mitigate the Socio-economic Impact for People Infected and Affected by HIV and AIDS is strengthened.

The implementation of the support programme was designed to be monitored collectively through quarterly reports based on the agreed indicators in the plan. The second quarter progress report documents key achievements of the joint UN support work plan from April to June, 2007. The report highlights main outcome and output areas, joint programming experience, challenges faced during the reporting areas and key actions needed at the UN policy level to enhance support of the national response.

The membership of the joint UN team in Zambia is indicated in Table 1 below. Overall, thirty technical experts are involved in the implementation of the 2007 joint UN annual programme of support work plan from thirteen UN Organizations.

Table 1: COMPOSITION OF THE JOINT UN TEAM ON AIDS IN ZAMBIA

Organization / Technical support area(s) / No. staff
IOM / Migrants / 1
UNHCR / Refugees and IDP / 1
UNECA / Demographic surveys, Projections, Impact Assessments and M&E / 1
ILO / Workplace, Private sector / 2
WFP / Dietary and Nutrition Support / 1
FAO / Agriculture and AIDS / 1
UNDP / Mainstreaming, Development and Capacity Building / 1
Gender / 1
Macro Policy and Millennium Development Goals / 1
Governance, Decentralization and Human Rights / 1
UNICEF / PMTCT, Care and Support for PLHIV / 1
Procure Supply Management / 1
OVC / 1
Pediatric ART / 2
WHO / ART / 1
PEP, Blood Safety, Counseling & Testing, STI, Surveillance / 1
Health Promotion and Information / 1
UNFPA / Condoms, Prevention, women and girls, Young People / 1
Reproductive health and HIV / 1
Women, Girls and HIV / 1
WB / Strategic Planning, Costing, Financial Management, Human Resources, Capacity & Infrastructure Development, Impact Alleviation & Sectoral Work / 2
IMF / Macroeconomics and AIDS / 1
UNAIDS secretariat / Coordination, advocacy and resource mobilization / 1
Civil society, partnerships, Most-at-risk populations including IDU & SW / 1
M&E, research, surveillance and strategic information / 1
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2. PROGRESS MADE IN QUARTER THREE OF 2007

Key agencies involved

This outcome areas was led by UNDP in collaboration with WB, UNAIDS, ILO, IMF, UNICEF, WFP, UNFPA, UNICEF, WHO, UNHCR, UNECA, FAO, ECA.

Key outcome areas attributable to the UN

·  Existence of costed 2008 multisectoral AIDS workplan

·  Existence of a peer review report to inform the developmenrt of the 2008 multisectoral AIDS workplan

·  NAC now has operational framework with clear coordination and management responsibilities

·  Strengthening of NARF and programme supervision

·  New NAC Board appointed and had two meetings

·  Performance assessment of AIDS indicators done following which the UA indicators have been revised

·  Scale of capacity building among policy makers

·  Mobilization of partners on UNGASS

·  Commencement of NASA

·  Advocacy to complete HSS and DHS

Key output areas

Indicator / Baseline
December 2006 / Quarter 1
Jan-March / Quarter 2
April-June / Quarter 3
July-Sept, 2007 / Quarter 4
October-December, 2007
1.1 Capacity of the Cabinet Committee of Minister on AIDS, NAC board, NAC secretariat at national and sub-national levels to lead, plan, coordinate, monitor and evaluate the national multi-sectoral response is strengthened
Annual action plan developed / 2006 Annual work plan / 2007 Annual work plan developed. / On-going / Draft 2007 AWP peer review / 2008 Annual work plan developed
Annual action plans costed / 2006 Costed Annual action plans / 2007 costed annual action plan developed / On-going / Draft costed 2007 action plan / 2008 costed annual action plan developed
1.2 The NAC and Sub national institutional capacity to mainstream AIDS, gender and human rights into the development framework including the capacity to develop and implement work place policies and programmes and programmes in the response to AIDS
Capacity of cabinet ministers on AIDS developed / No capacity building programme for cabinet committee of Ministers / Data not available / Draft Roles and responsibilities of the cabinet committee of ministers developed. / New NAC board appointed, date set 12-13 October for leadership and team building workshop. / No capacity building programme for cabinet committee of Ministers
Institutional capacity frameworks in place / No mainstreaming institutional frameworks in place / 6 work place policies launched in the public sector / 3 Work place policies launched in the private sector and 4 in the public sector. / No data / Data not yet available
Policies and guidelines on coordination in place / No national mainstreaming tool kits and hand book and coordination guides in place / Draft coordination guidelines developed. / Developed Coordination guidelines validated. / Operational framework for NAC developed / Coordination guidelines to be printed in 2008
1.3 A national Framework to support capacity development within key institutional capacity for M&E including harmonized resource tracking, database and information systems in place and linked to the central Statistics office
Number of districts with M&E systems / 72 / Data not available / 72 districts reporting using National AIDS Reporting Forms / 72 districts reporting using National AIDS Reporting forms / 72 districts reporting using National AIDS Reporting Forms
Number of UNVs trained in CRIS / 20 / Data not available / 9 PACAs trained in CRIS / CRIS roll plan in the 9 provinces completed / 20 DACAs oriented in CRIS
Resource tracking systems in place / 0 / Financial availability to the national response study conducted.
Financial availability: Civil society component study conducted. / Data not available / TOR developed for NAC to commission consultancy in resource tracking in 4th Quarter. / ToR developed and all expression of interest for AIDS trust fund feasibility study done.
Number of provinces submitting quarterly NARF reports using CRIS / 9 / 9 / 9 / 9 / 9
1.4 A national Framework to support capacity development within key institutions addressing the impacts of AIDS involving people living with HIV operationalized 2010
Framework for capacity development developed and implemented / No framework in place / 3 impact assessment studies conducted in MoE, MoH and MACO. / Data not available / TOR for peak Performance Programme and leadership skills training for NZP+ Board and secretariat developed. / Data not yet available
Number of key government officials trained on gender, HIV and AIDS mainstreaming / 23 Line ministries planners and 72 DACAs oriented / 72 (National, provincial and District level staff from MoE, MoH and MACO trained in internal and external mainstreaming strategy development) 3 Strategy documents developed. / 60 (3PPOs, 3PACAS, 28 DPOs and 28 DACAs trained as trainers in mainstreaming / ·  Cumulative – 6 provinces completed
·  6 PPOs and 6 PACAs
·  46 DPOs and 46 DACAs trained as trainers in HIV and AIDS mainstreaming.
·  UNJT sensitized on concepts and basics of Mainstreaming.
·  Senior police officers and HIV focal point persons sensitized to mainstreaming concepts. / Cumulative totals
72 DACAs
72 DPOs
9 PACAs
9 PPOs
1.5 Macro-economic framework including harmonized resource tracking system that integrate HIV developed by 2008 and implemented by 2010
Expenditure framework for NASF 2006-2010 developed / No Expenditure framework in place / Data not available / Data not available / Data not available / Not done
Macro-economic framework incorporating HIV developed / HIV incorporated in the draft FNDP 2006-2010 / FNDP 2006-2010 launched by the State President with a Chapter on HIV and AIDS and integrated in some sector plans. / Data not available / Data not available / Not done
Number of government ministries sensitized / 23 Line ministries / 23 Line Ministries UNVs and 23 HIV and AIDS Focal point persons sensitized tracking resources for HIV in their sectors. / Ministry of Finance and National planning, Central statistical office, Ministry of Labour, Ministry of Health and Public Service management Division launched HIV and AIDS work place policies / Data not available / Data not available
Mechanisms for financing and pooling of resources to ensure the access to treatment care and support developed. / No mechanism for pooling resources available / Data not available / Data not available / Data not available / Data not yet available
1.6 Making the money work within thematic area
Total fund absorptive rate during the quarter (total amount spent/total funds earmarked x 100) / $2,320,000
Allocated in 2006
$4,320,000 spent from UNDP 2006) / UNDP Allocated
$200,000
Spent
$145,045.52 / UNDP Allocated
$ 300,000
Spent
$201,681.00 / Expenditure:
$370,825.21-UNDP
$136,000-UNAIDS
Cumulative total Expenditure
$ 717,551.79 / Will be available 1st quarter 2008
Total UN fund absorption rate (total amount of UN funds spent/total fund spent x 100) / Data not available

Joint UN programming experience within the Outcome Group

o  Joint programming is taking place

Key challenges faced during the quarter by team members

o  Difficulties in gathering financial information

Main action areas by HOA

o  Continued advocacy on the re-location of the National AIDS Council to a multisectoral institution of government

o  Improve access to financial information at the agency level in order generate information on financial absorption

Key agencies involved

This outcome area was led by UNFPA in collaboration with UNICEF, WHO, UNHCR, ILO, UNDP, WFP, UNAIDS

Key results attributable to the UN

·  Tools provided to know the Zambia epidemic better

·  Support to the finalisation and launch of the National PMTCT scale up plan

·  Provision of HIV prevention services and condoms to refugee communities in Zambia

·  Deepening knowledge of know your epidemic

·  Finalization of TOR for development of prevention strategy

·  Female condom phase II scale-up

·  Strengthening NAC Prevention techinical working groups

·  Commodity security for both male and female condoms

·  Support to institutions providing prevention services and commodities to vulnerable groups: Prisons Service, GIDD, UNHCR partners

·  Strengthening of workplace programmes in zambia

Key output areas

Indicator / Baseline
December 2006 / Quarter 1
Jan-March, 2007 / Quarter 2
April-June, 2007 / Quarter 3 July-Sept, 2007 / Quarter 4 October to December, 2007
2.1 capacity to provide quality prevention services and commodities in all districts strengthened
Number of facilities supported to provide commodities and preventive services / 883 VCT
568 PMTCT
Total # facilities 1,327(2002 Health facility survey) / 883 VCT
568 PMTCT / 883 VCT
568 PMTCT / 4 facilities supported among refugee populations / 7 districts supported in VCT, condoms, STI drugs in North-western province.
3 refugee camps supported with condoms, VCT, STI treatment
Number of workplaces supported to provide commodities and preventive services / 1,011
(NARF) / UN supported 32 workplaces through ZHECT
and UNZA / UN still supporting
32 workplaces through ZHECT
and UNZA / 5 supported in internal mainstreaming.
15 provided with PEP kits / 52 workplaces in Lusaka, Mpika and North-Western province supported
Workplace Policies developed in two York farms in Kashima