Transitioning an internationally managed HIV program to local ownership: The Experience of Elizabeth Glaser Pediatric AIDS Foundation Tanzania

1. Transitioning an internationally
managed HIV program to local
ownership: the experience of EGPAF
-Tanzania
John Stephen, BVM, MSc & MBA
Associate Director, Field Programs – EGPAF
HIV Capacity Summit, Birchwood
Hotel
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19 Mar 2013

2. Presentation outline
• Introduction
• Why transition to local affiliate
• Phases of transition process
• Establishment of a local affiliate
• Criteria for selection of the region
• Program implementation
• Capacity building initiatives
• Evidence for achievements
• Challenges and counter strategies
• Lessons learnt
• Conclusions

3. 1.0 Introduction
• Local ownership of HIV service delivery and HSS
programs in sub-Saharan Africa is critical to
ensure long-term sustainability.
• In 2004, EGPAF received Track One funding from
CDC to implement Project HEART.
• Transition was mandated as part of the Track 1.0
re-authorization by the US Congress in 2008.
• EGPAF believes in country ownership.
• Transition is the EGPAF’s process of transferring
existing programs and services to local partners.

4. 2.0 Why transition to local affiliates ?
• Promote local capacity and sustainability of
programs.
• Accountability through affiliation agreement.
• Monitoring of quality through regular accreditation
system.
• Capacity building and transfer of EGPAF systems.
• Guided by principles and standards for affiliation.
• Shared elements (logo, mission) facilitate the
development of a strongly linked global network
and synergy.
• Promotes common purpose and shared strategy
to achieve mission.

5. 3.0 Phases of transition process

6. 4.0 Ariel Glaser Pediatric AIDS
Healthcare Initiative (AGPAHI)
• Non profit and autonomous organisation organized
locally at both the grassroots and national levels.
• Registered on 21 Feb 2011 as local NGO under
NGO Act No 24 of 2002 of Tanzania and launched
on 18 May 2011.
• Vision: envisions a world where children and
families have access to quality health services and
live free from HIV/AIDS to realize their full
potential.

7. 5.0 Establishment of AGPAHI
• A founding committee of six members formed.
• Stakeholders involvement.
• Drafted paperwork for registration of the new
NGO.
• Ten BoD candidates screened through the
developed criteria, eight members selected.
• Procedures and policies developed.
• AGPAHI official inauguration on 18 May 2011.
• Affiliation agreement btn EGPAF & AGPAHI
signed.
•

8. 6.0 Criteria for selection of Shinyanga
• High HIV prevalence - high 7.4%.
• Underserviced HIV program – potential for
programmatic expansion.
• Strong leadership and local government support.
• Potential for donor to support expansion of the
program.
• Less number of NGOs/CSOs working on HIV
programs.

9. EGPAF
AGPAHI

10. 7.0 Program implementation
• EGPAF transitioned one of six regions; 41 HIV
C&T clinics with 20,272 patients.
• AGPAHI adopted EGPAF’s implementation
model.
• AGPAHI received a C&T sub award from EGPAF
• AGPAHI received direct funding from CDC.
• Annual accreditation review.
• In January 2012 AGPAHI received a sub award
from EGPAF on PMTCT/ RCH.
• July 2012, AGPAHI received a USAID funding on
“Innovations in family planning, reproductive

11. 8.0 Capacity building initiatives for
AGPAHI
• Secondment of EGPAF staff to AGPAHI.
• Policies and procedures (fin, M&E,CGIS, HR).
• Board members orientation workshop.
• AGPAHI staff trained and administered tools;
OCVAT, SCP & CCA in Shinyanga.
• Accreditation review in Sept 2011, Jun & Sept
2012
• Technical / operations support from EGPAF.
• Bilateral management training – Aug 2011.
• Effective Leadership and Gov training in Oct 2011.
• AGPAHI participated in NBD workshop in 2012.
• Quarterly DAW and sub grantee monitoring

12. 9.0 Conceptual Framework for AGPAHI
Capacity Building Plan

13. 10.0 Evidence for achievements
• A full fledged independent local NGO.
• Four funding sources within two years.
• HIV Care and Treatment clinics expanded from 41
to 68 with over 61,546 patients.
• Program expanded to new regions of Geita &
Simiyu within two years.
• Good support and collaboration with Government.
• Integration of HIV and family planning programs.

14. 11.0 Challenges and counter strategies
• Narrow funding base for AGPAHI, mostly USG and
lack of unrestricted funds. Strategy – prospecting
for non USG donors.
• Supply chain management challenges - test kits.
Strategy – sourcing for local suppliers.
• Higher services demands with limited resources.
Strategy – integration for HIV services.
• Stigmatization of local NGOs in Tanzania. Strategy
– evidence good work by results.
• Transition lacked clarity, appropriate guidance and
donors keep changing their focus. Strategy –
EGPAF and AGPAHI worked on best practices.

15. 12.0 Lessons learnt
• Establishing an organization as an affiliate shortens
the turn round processes for the organization to
take off smoothly.
• Affiliation enables local NGOs access funds within
short time.
• Choice of board members is critical to success.
13.0 Conclusions
• Establishment of AGPAHI as a local partner is step
toward ensuring sustain of HIV programs in Tz.
• Affiliation helps to leverage financial, programmatic
and technical resources.

16. Asante
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