Periodic Review ccm request template
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CCM Request for HIV Renewal [31 May 2013] CCM Request for HIV Renewal ACRONYMS xi ACRONYMS xi SECTION 1: SUMMARY OF REQUEST 1 SECTION 1: SUMMARY OF REQUEST 1 1.1 General Programme Information 1 1.2 CCM Approval of Request for Renewal 1 1.3 Summary of CCM Request for Renewal 4 1.3.1 Summary of Request 4 1.3.2 Proposed Changes in Programmatic, Budgetary and Implementation Arrangements 10 People living with disabilities, as there is an increased focus on major key populations as identified by the NSP and the KYEKYR report; and 14 TB case finding in TB crisis districts as we move to combination prevention which includes a broader package of services. 14 1.3.3 CCM Request for Renewal 15
2.1 CCM Governance Overview 16 2.1.1 Last funding applied for 16 2.1.2 CCM Membership 18 2.1.3. Programme Oversight 18 2.1.4 Managing Conflicts of Interest and Constituency Engagement 19 2.1.5 Processes in chances for Programmatic, Budgetary and Implementation arrangements 19
3.1 Epidemiological situation 21 3.2 Country Context 24 3.3 Health Systems Analysis 28 SECTION 4: PROGRAMME OVERVIEW 41 SECTION 4: PROGRAMME OVERVIEW 41 4.1 Financial Gap Analysis, Counterpart Financing and Additionally 41 4.1.1 Overview of Government Financing of the National Programme 42 4.1.2 Estimation of Current and Anticipated Domestic and External Funding 42 4.1.3 Financial Gap and Counterpart Financing Data Sources 43 The intervention was not yet fully conceptualized at the time of costing; 44 No programmatic targets for the intervention were available; 44 No cost data was available for the intervention; 44 4.1.4 Compliance with Counterpart Financing Requirements 44 4.2 Progress towards Proposal Goals and Impact/Outcome 46 4.3 Programme Effectiveness 50 4.3.1 Aid Effectiveness 50 4.3.2 Equity 51 4.3.3 Value for Money 53 4.4 Quality of Services Assessment 55 4.5 Partnerships 57 4.5.1 NDOH Partnerships 57 Programmes quarterly financial and programmatic reporting with detail variances; 58 Quarterly forecasting of programmes financial and programmatic needs; 58 Programmes training plan and forecasting with justification for scale-up in case of underperformance of activities; and 58 Monthly performance dashboard which incorporates both programme and financial performance indicators. 58 4.5.2 WCDOH Partnerships 58 4.5.4 NRASD Partnerships 60 4.5.5 Right to Care Partnerships 61 OVERVIEW OF SECTIONS 5 AND 6: PAST PERFORMANCE AND REVISED ACTIVITIES 62 OVERVIEW OF SECTIONS 5 AND 6: PAST PERFORMANCE AND REVISED ACTIVITIES 62 SECTION 5: CURRENT PHASE/IMPLEMENTATION PERIOD PERFORMANCE (PR 1 - NDOH) 79 SECTION 5: CURRENT PHASE/IMPLEMENTATION PERIOD PERFORMANCE (PR 1 - NDOH) 79 5.1 Programmatic Achievements and Management Performance 79 5.1.1 Programmatic Achievements 79 5.1.2 Grant/SSF Risk Management 82 5.1.3 Grant Performance Rating 83 5.2 Financial Performance 83 5.2.1 Financial situation at cut-off date 83 5.2.2 Analysis of expenditures versus budget 84 SECTION 6: CCM REQUEST FOR RENEWAL (PR 1 - NDOH) 85 SECTION 6: CCM REQUEST FOR RENEWAL (PR 1 - NDOH) 85 6.1 Programmatic Proposal 85 6.1.1 Programme Objectives, SDAs, Indicators and Targets 85 6.1.2 Pharmaceutical and Health Product Management (if applicable) 86 6.2 Financial Proposal 86 6.2.1 Resources available to finance the grant/SSF after cut-off date 86 6.2.2 Summary funding request from cut-off date to end of next Phase/Implementation Period 87 6.2.3 CCM Budget Request for the next Phase/Implementation Period 87 6.3 Compliance with Focus of Proposal Requirement 88
5.1 Programmatic Achievements and Management Performance 90 5.1.1 Programmatic Achievements 90 5.1.2 Grant/SSF Risk Management 95 Fiduciary austerity; 95 Discussions with both the LFA/KPMG and GF; 95 Short term use of temporary structures such as park homes; 95 Decanting of patients to lower levels of care, for example, once compliance of required ART treatment regimens is reached; 95 Working closely with the City of Cape Town; 95 5.1.3 Grant Performance Rating 96 5.2 Financial Performance 96 5.2.1 Financial situation at cut-off date 96 5.2.2 Analysis of expenditures versus budget 96
6.1 Programmatic Proposal 98 6.1.1 Programme Objectives, SDAs, Indicators and Targets 100 6.1.2 Pharmaceutical and Health Product Management (if applicable) 102 6.2 Financial Proposal 104 6.2.1 Resources available to finance the grant/SSF after cut-off date 104 6.2.2 Summary funding request from cut-off date to end of next Phase/Implementation Period 104 6.2.3 CCM Budget Request for the next Phase/Implementation Period 105 6.3 Compliance with Focus of Proposal Requirement 106
5.1 Programmatic Achievements and Management Performance 108 5.1.1 Programmatic Achievements 108 5.1.2 Grant/SSF Risk Management 112 5.1.3 Grant Performance Rating 113 5.2 Financial Performance 113 5.2.1 Financial situation at cut-off date 113
6.1 Programmatic Proposal 115 6.1.1 Programme Objectives, SDAs, Indicators and Targets 115 6.1.2 Pharmaceutical and Health Product Management (if applicable) 117 6.2 Financial Proposal 117 6.2.1 Resources available to finance the grant/SSF after cut-off date 117 SECTION 5: CURRENT PHASE/ IMPLEMENTATION PERIOD PERFORMANCE (PR 4 - NRASD) 120 SECTION 5: CURRENT PHASE/ IMPLEMENTATION PERIOD PERFORMANCE (PR 4 - NRASD) 120 5.1 Programmatic Achievements and Management Performance 120 5.1.1 Programmatic Achievements 120 5.1.2 Grant/ SSF Risk Management 122 5.1.3 Grant Performance Rating 129 5.2 Financial Performance 129 5.2.1 Financial situation at cut-off date 129 5.2.2 Analysis of expenditures versus budget 129 SECTION 6: CCM REQUEST FOR RENEWAL (PR 4 - NRASD) 131 SECTION 6: CCM REQUEST FOR RENEWAL (PR 4 - NRASD) 131 6.1 Programmatic Proposal 131 6.1.1 Programme Objectives, SDAs, Indicators and Targets 131 6.1.2 Pharmaceutical and Health Product Management (if applicable) 133 6.2 Financial Proposal 133 6.2.1 Resources available to finance the grant/SSF after cut-off date 133 6.2.2 Summary funding request from cut-off date to end of next Phase/Implementation Period 134 6.2.3 CCM Budget Request for the next Phase/ Implementation Period 134 6.3 Compliance with Focus of Proposal Requirement 135
5.1 Programmatic Achievements and Management Performance 136 5.1.1 Programmatic Achievements 136 Indicator tied to other donors (e.g. partners with other funding) where need is no longer apparent and/or other donor funding is no longer available 137 Late/no start (TB Crisis Districts including the CCM decision to no longer support Nelson Mandela Bay Metropole (NMMB) and slower uptake generally 137 Implementing partners withdrawing due to budget constraints 137 5.1.2 Grant/SSF Risk Management 138 5.1.3 Grant Performance Rating 140 5.2 Financial Performance 140 5.2.1 Financial situation at cut-off date 140 5.2.2 Analysis of expenditures versus budget 140
6.1 Programmatic Proposal 142 6.1.1 Programme Objectives, SDAs, Indicators and Targets 142 6.1.2 Pharmaceutical and Health Product Management (if applicable) 144 6.2 Financial Proposal 145 6.2.1 Resources available to finance the grant/SSF after cut-off date 145 6.2.2 Summary funding request from cut-off date to end of next Phase/Implementation Period 145 6.2.3 CCM Budget Request for the next Phase/Implementation Period 145 6.3 Compliance with Focus of Proposal Requirement 146 PRINCIPAL RECIPIENT 6: STILL TO BE FINALISED 146 PRINCIPAL RECIPIENT 6: STILL TO BE FINALISED 146 REFERENCES 152 REFERENCES 152 ANNEXES: SUPPORTING DOCUMENTATION 154 ANNEXES: SUPPORTING DOCUMENTATION 154 List of Tables Table 1: Summary Principal Recipients 1 Table 2: Members of the South Africa Global Fund CCM 1 Table 3: changes in the Implementation Arrangements 11 Table 4: Comparison Phase 1 (SDA, PR and Budget) with Phase 2 (SDA, PR and budget) 11 Table 5: CCM Requested Budget for Renewal 15 Table 6: Annual rate, estimated number and percentage of new infections by province, 2010 21 Table 7: Key Mortality Indicators 22 Table 8: HIV infections amongst some key populations 23 Table 9: Funding gap ART, TB and HCT 42 Table 10: Impact/outcome indicators included in the Performance Framework 46 Table 11: 2011 National SAPMTCT Survey Results 49 Table 12: Technical Assistance NDOH 57 Table 13: Technical Assistance WCDOH 58 Table 14: Technical Assistance NACOSA 59 Table 15: Technical Assistance NRASD 60 Table 16: Summary PR per Service Delivery Area 62 Table 17: Log frame 64 Table 18: Geographical Coverage of the Prevention and Care and Support programmes 71 Table 19: Programmatic performance using performance framework indicators NDOH 79 Table 20: Table 17: Cash at cut-off date NDOH 83 Table 21: Liabilities NDOH 83 Table 22: Performance Framework NDOH 85 Table 23: CBR Programme WCDOH 90 Table 24: Performance Programme among youth at secondary schools WCDOH 92 Table 25: Performance level indicator on strengthen palliative in-patient and home-based care services WCDOH 92 Table 26: Performance for development and implementation of local support projects WCDOH 93 Table 27: Cash in hand WCDOH 96 Table 28: Budget Analysis Summary WCDOH 96 Table 29: Programmatic Performance against target WCDOH 97 Table 30: Performance Framework WCDOH 100 Table 31: Products available on tender H13 2013 102 Table 32: Risk matrix of treatment interruptions WCDOH 103 Table 33: Resources available to finance the grant/SSF after cut-off date 104 Table 34: Summary funding request from cut-off date to end of next Phase/Implementation Period 104 Table 35: Performance against key programmatic indicators NACOSA 108 Table 36: Performance Framework NACOSA 115 Table 37: Resources available to finance the grant/SSF after cut-off date 117 Table 38: Performance on key programmatic indicators NRASD 120 Table 39: Operational risk management NRASD 123 Table 40: Cash at cut-off date NRASD 129 Table 41: Performance Framework NRASD 131 Table 42: Summary funding request from cut-off date to end of next Phase/Implementation Period 134 Table 43: Performance against targets RTC 137 Table 44: RTC High Risk matrix 138 Table 45: Performance Framework RTC 142 Table 46: Resources available to finance the grant/SSF after cut-off date 145 Table 47: Summary funding request from cut-off date to end of next Phase/Implementation Period 145 Table of Figures Figure 1: Organogram of the newly constituted SANAC Governance Structure 2012-2017 17 Figure 2: HIV prevalence by gender/province 22 Figure 3: Trends in HIV incidence, prevalence and mortality, South Africa, 1990-2009 23 Figure 4: HIV & TB Spending by Public Depts (ZAR millions, 07/08 – 2009/10)27 30 Figure 5: Available resources and funding gap 41 Figure 6: Line B of the ‘Financial Gap Analysis and Counterpart Financing 45 Figure 7: Government contribution towards financing the health sector 45 Figure 8: Consolidated government health and HIV and AIDS allocations 46 Figure 9: Unit Expenditures on HCT for various Donors and Government (2011/12) 54 Figure 10: Cost Effectiveness of Southern African HIV Programmes 54 Figure 11: Remaining in Care (RIC): Target vs. Achievement 91 Figure 12: HIV+ rate per district amongst young pregnant women 91 Figure 13: CPI index in South Africa 118 Figure 14: Risk heat map RTC (September 2012) 138 Figure 15: Risk Heat Map – Self Assessment (March 2013) 139
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