Abstract
The United States President's Emergency Plan for AIDS Relief (PEPFAR) emphasizes health systems strengthening as a cornerstone of programmatic success. Health systems strengthening, among other things, includes effective capacity building for clinical care, administrative management and public health practice. Avante Zambézia is a district-level in-service training program for administrative staff. It is associated with improved accounting practices and human resources and transportation management but not monitoring and evaluation. We discuss other examples of successful administrative training programs that vary in the proportion of time that is spent learning on the job and the proportion of time spent in classrooms. We suggest that these programs be more rigorously evaluated so that lessons learned can be generalized to other countries and regions.
Highlights
The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has moved from its initial emergency response in which HIV prevention, care, and treatment services were rapidly expanded through partnerships with countries, international organizations, and non-governmental implementing partners, to an emphasis on country ownership and sustainability with an ambitious agenda of demonstrating impact, efficient implementation of effective interventions, and epidemic control.[1]
Schwarcz et al building capacity for health systems in low- and middleincome countries (LMIC)? Field-based approaches to human resource development play a critical role in meeting the objectives of PEPFAR
As an alternative model to the 2-year fellowship, Makerere University School of Public Health offers an 8-month training program in monitoring and evaluation (M&E) and continuous quality improvement for full-time mid- and senior-level management staff.[7]. In this program fellows work with academic mentors and institutional supervisors to enhance their skills through a combination of short modular coursework at the university interspersed with activity-based on-the-job training in either M&E or quality improvement
Summary
The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has moved from its initial emergency response in which HIV prevention, care, and treatment services were rapidly expanded through partnerships with countries, international organizations, and non-governmental implementing partners, to an emphasis on country ownership and sustainability with an ambitious agenda of demonstrating impact, efficient implementation of effective interventions, and epidemic control.[1]. These areas for improvement were identified by provincial health authorities in Zambézia.[2] The health management mentoring (HMM) program was developed by a non-governmental organization funded by PEPFAR and working with assistance from the Vanderbilt Institute for Global Health to provide district-level technical assistance for HIV care and treatment.
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