Periodic Review ccm request template

The following needs to be noted with regards to objective programmatic performance:

1. 
   Remaining in Care (RIC) and Number of HIV+ pregnant women receiving PMTCT regimes within the WCDOH ART programme is continually encouraging. To ensure that ART was continued, despite the challenges in procurement of GF QAP compliant medicines, the WCDOH utilized funds from the WCDOH’s conditional grant. Please note: This was a temporary solution and cannot continue further as it has restricted service delivery in other service delivery areas.
   
2. 
   The Peer Education programme has been a successful endeavour within the Western Cape. Challenging 100% achievement of indicators relate to indicator targets being tied to forecast number of students not actual students within schools.
   
3. 
   The number of people admitted to Palliative / Step-down care facilities is impacted by the average length of stay (ALOS). A complication relating to illness, as well as slow transferring out of recovered patients out of facilities which is related to inappropriate post-facility accommodation increases the ALOS thereby decreasing the number of patients able to be admitted. This is being addressed within increasing success. Closer working between facilities, relevant hospitals and the Hospice Palliative Care Association of South Africa (HPCASA) has been a contributing factor.
   
4. 
   Due to the large distances between projects within the Central Karoo region and to ensure efficient monitoring & evaluating of GF projects an additional Multi-Sectoral Action Team (MSAT) was formed. There have been challenges relating to the manner in which CBOs, OVC and those reached through income generation projects have been recorded. This has impacted the historical context of the indicator within the RCCI period. Therefore achievement is recorded as over 100%. Note that this is also indicative of need not over-allocation of resources.
   

SECTION 6: CCM REQUEST FOR RENEWAL (PR2 – WCDOH)

6.1 Programmatic Proposal

Background

As this is a long-standing grant it is useful to summarise the timelines and objectives:

Timeframe of Phases

• 
  Phase 1 & 2: 1 July 2004- 30 June 2010
  
• 
  Rolling Continuation Channel (RCC) Funding: July 2010 - 31 March 2016 (original)
  

Current Period of implementation:

• 
  July 2010 – 30 June 2013
  
• 
  No cost extension 1 July 2013 – 30 September 2013
  

Renewal Period: 1 October 2013 – 31 March 2016

Outcome Indicator: Percentage of Adults and Children with HIV, known to be on treatment 12 months after initiation of ARV treatment

Impact Indicator: Reduction in the proportion of HIV exposed infants, born to HIV positive mothers, who test PCR positive at 6 weeks

Impact Indicator: Reduction in the HIV positivity rate of young women aged 15-19yrs

Rational

The Western Cape (WC) GF Grant’s goal is to Strengthen, Expand & Sustain the Western Cape HIV/AIDS Prevention, Treatment and Care Programme. The original application to the GF was in 2004 during Round 3 of the GF call for proposals. The WC GF grant is a bridge funding mechanism. Its purpose is to fund the gap between what services are needed within the province, at the time of grant implementation, until the expected time when the WCDOH would be able to allocate its own funding for these services. Therefore, the WC GF grant is a strategic intervention focused on those who are most at risk and vulnerable, due to the prevalence and impact of the HIV/AIDs epidemic. Specifically these people are located within geographical areas which, due to budget constraints, the WCDOH currently cannot provide the full scope of Health Care Services needed to address the disease burden.

The original Western Cape Grant Programme comprised of four intervention Objectives:

• 
  ARV Treatment Programme (ART)
  
• 
  Peer Education HIV Prevention Programme
  
• 
  Palliative / Step-Down Care Programme for AIDS Patients
  
• 
  HIV/AIDS & TB Community Based Response (CBR) Projects
  

The purpose of the Peer Education Programme was to focus on learners ahead of their sexual debut. The learners were provided with the relevant information to make informed decisions and protect them from HIV infection. This was inclusive of HIV prevention and life skills issues. This programme has culminated earlier than expected due to the adoption of the National Peer Education Programme by the Western Cape Education Department from 1 April 2013 onwards. Notable is that the National Peer Education Programme has adopted many of the elements of the GF Peer Education Programme. As such the material developed through the GF Peer Education Programme can be used throughout South Africa. Thus this Objective / Programme will not be included in the Western Cape’s application for continuation of funding.

Therefore going forward there will be three objectives within the Western Cape GF proposal for continuation of funding:

• 
  ARV Treatment Programme (ART)
  
• 
  Palliative / Step-Down Care Programme for AIDS Patients
  
• 
  HIV/AIDS & TB Community Based Response (CBR) Projects
  

Coverage

• 
  The Western Cape GFART programme accounts for 20% of the ART needs within the province
  
• 
  The Palliative and Step-down Care facilities are located in the rural areas of the Western Cape
  
• 
  The Community Based Response projects are adjudicated at district level with successful projects being those that best respond to the specific needs within each district
  

Exit Strategy

From the third year of the current funding period (July 2012 – June 2013), there is a planned exit strategy and this continues until the culmination of the funding period in relation to the application for continuation of funding: 31st of March 2016. The purpose of the exit strategy is to ensure sustainability of the investment of the GF once the grant ends. The exit strategy is planned such that the WCDOH will incrementally take over the funding of elements within three of the objectives: ARV Treatment Programme, Palliative and Step-down Care for AIDS Patients and HIV/AIDS & TB Community Based Response (CBR) Projects. The WCDOH medium term budget has been planned accordingly. Similarly, the Western Cape Education Department (WCED) was to take over the HIV Prevention Peer Education Programme in High Schools. The latter exit strategy overseen by the WCED has been expedited due to the implementation of the National Department of Basic Education’s Peer Education Programme by the WCED. This new framework has drawn elements from WC GF Peer Education’s framework.

For further information relating to the success of the Peer Education Programme please refer to: WCDOH Annex 6: Stories of Innovation and Impact (as published by the Global Fund).