Building sustainable organizational capacity to deliver HIV programs in resource-constrained settings: stakeholder perspectives

Autor: José Rafael Morales, Katherine K. Thomas, Philippe Chiliade, Stephen R. Collens, Anjali Sharma, E Michael Reyes
Přispěvatelé: Cooperative Agreement U91HA06801 from the US Department of Health And Human Services, Health Resources and Services Administration (HRSA).
Rok vydání: 2013
Předmět:
Program evaluation
Male
Quality management
International Cooperation
8.1 Organisation and delivery of services
wc_503
HIV Infections
Medicine
f0e481db
media_common
wa_30
wa_546
program transition
Health Policy
capacity building
lcsh:Public aspects of medicine
Stakeholder
Capacity building
Health Services
Public relations
Middle Aged
Infectious Diseases
Anti-Retroviral Agents
Public Health
Global Health
Health Systems
Public Health and Health Services
HIV/AIDS
Female
Thematic analysis
Health and social care services research
Reputation
Adult
Capacity Building
media_common.quotation_subject
participatory assessment
Developing country
Zambia
Nigeria
Public-Private Sector Partnerships
technical assistance
Clinical Research
Humans
Organizational Objectives
local partner
RA643-645
business.industry
Prevention
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
Kenya
United States
Sustainability
business
Delivery of Health Care
Program Evaluation
Zdroj: Global health action, vol 6, iss 1
Global Health Action; Vol 6 (2013): incl Supplements
Global Health Action, Vol 6, Iss 0, Pp 1-8 (2013)
Global Health Action
ISSN: 1654-9880
1654-9716
Popis: Background : In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) should shift from US-based international partners (IPs) to registered locally owned organizations (local partners, or LPs). The US Health Resources and Services Administration (HRSA) developed the Clinical Assessment for Systems Strengthening (ClASS) framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs’ strengths and needs for technical assistance. Objective : This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. Design : All stakeholders ( n =68) in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC), and, in Nigeria, HIV/AIDS treatment facilities (TFs) were interviewed individually or in groups ( n =42) using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Results : Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services. Conclusions : The well-timed adaptation and implementation of ClASS successfully engaged stakeholders who committed their own resources toward strengthening organizational capacity. The sustainability of built capacity depends on continued investment in leadership, staff retention, and quality improvement. Keywords : local partner; capacity building; participatory assessment; technical assistance; HIV/AIDS; program transition (Published: 13 December 2013) Citation : Glob Health Action 2013, 6 : 22571 - http://dx.doi.org/10.3402/gha.v6i0.22571
Databáze: OpenAIRE
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