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Malaria Control Scale Up for Impact for 2010 and lessons learned from round 8

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Title: Malaria Control Scale Up for Impact for 2010 and lessons learned from round 8


1
Malaria Control Scale Up for Impact for
2010 and lessons learned from round 8
  • HWG mock TRP
  • Nairobi, Kenya
  • April 2009

2
Presentation overview
  • Scaling up for impact
  • Public Health programming cycle
  • Planning, Resourcing, Implementing, Monitoring
    Evaluating
  • Being comprehensive, raising the bar and moving
    to sustained high coverage
  • Consider programming for SUFI while keeping
    sustained control elimination in your sights

3
Scaling up for Impact
4
Global Strategic Objectives
  • RBM Partnership (1998) halve the burden of
    malaria by 2010
  • Millennium Development Goals (2000) by 2015
  • MDG 4 Reduce Child Mortality
  • MDG 5 Improve Maternal Health
  • MDG 6 Combat HIV/AIDS, Malaria and Other
    Diseases
  • UN Special Envoys Call (2008) by 2010, 100 of
    at-risk populations benefit from major preventive
    and curative interventions particularly
    coverage with LLINs

5
GF/B17/DP18 Building the Demand for a Scaled-up
Malaria Response
  • The Board commends the call by the UN Secretary
    General to help countries achieve the RBM targets
    to achieve universal coverage of an essential
    malaria control intervention package by December
    31, 2010.
  • Given the urgency of the need to devote
    additional resources and to increase
    implementation capacities at country level to
    achieve universal coverage, the Board urges
    countries to submit ambitious Round 8, Round 9,
    and RCC proposals aimed at scaling up
    comprehensive malaria control programs
    (particularly the distribution of long-lasting
    insecticide treated nets (LLINs) and ACTs) and
    are linked to broader health systems
    strengthening.

6
Scaling up for impact
  • Scale up achieving high coverage with a full
    package of proven malaria interventions (ITNs,
    IRS, prevention in pregnancy, prompt diagnosis
    and case management with effective drugs).

7
Scaling up
  • Systems for achieving high coverage vary by
    intervention
  • ITNs campaigns, antenatal clincs, child health
    clinics, etc
  • IRS teams addressing target areas
  • Prevention in pregnancy (IPTp ITNs) antenatal
    clinic
  • Prompt Dx and Tx facility and community outreach

8
Scaling up for impact
  • SUFI principles
  • Respecting the Three Ones
  • One plan
  • One coordination mechanism for implementation
  • One monitoring and evaluation system

9
Cycle of Planning-Resourcing-Implementing-Monitori
ngEvaluating
Resourcing
Planning
Program Performance Improvement
Monitoring Evaluating
Implementing
10
Scaling up for impact
  • SUFI principles
  • Being comprehensive and raising the bar
  • Sustained SUFI is the basis for transition to
    the E words (elimination and eradication).

11
Programming for sustained control with
elimination as an ultimate goal
Assuring stable and consistent resources both
financial and human
Good planning to assure and sustain high coverage
Document high and sustained coverage expand
surveillance (with diagnosis so we are tracking
malaria) and respond to gaps and specific
local needs
With sustained coverage, transmission will drop
dramatically and further attention to
transmission reduction will be important
12
Summary
  • SUFI has proved to be robust for describing the
    way forward
  • As you seek resources from the Global Fund
  • First, show that your program is comprehensive
  • Second, demonstrate progress to establish
    credibility
  • Then focus on your gaps, your needs, and your
    budgeted request. The future needed resources
    will only be secured with good stewardship now.

13
Proposal templates
  • Lessons learned/recommendations from 2008

14
Gap Analyses Tables/Tableau danalyse des
carences 4.4
  • Tables 4.4 do not include space for the
    assumptions underpinning the numbers used.
  • STRONGLY recommend that under each gap analysis
    table, countries put bullets explaining any
    assumptions. Countries should over-explain,
    rather than under-explain.
  • Tels quils sont présentés dans le formulaire de
    proposition, les tableaux ne donnent pas
    lopportunité de décrire les hypothèses derrière
    les chiffres.
  • Nous vous recommandons vivement de rajouter du
    texte sous chaque tableau afin dexpliquer vos
    calculs. Il vaut mieux trop de détails que pas
    assez!

15
Universal coverage/access? Couverture/accès
universels et budget
  • Countries should budget for 100 coverage, when
    aiming for 80 utilization of LLINs, ACTs, or
    IRS.
  • Il faut soumettre des budgets permettant
    dobtenir 100 de couverture afin datteindre 80
    dutilisation pour les MILDs, les CTA ou lAID.

16
Comments from TRP Commentaires du TRP
  • Your answers to each of the comments made by the
    TRP (from your last Global Fund submission)
    should be included, even if you are not
    resubmitting the same application. Include these
    comments in the template and in an attached
    summary
  • Vos réponses à chacun des commentaires reçus du
    TRP (lors de votre dernière soumission au FM)
    doivent figurer dans la proposition, même si vous
    ne re-soumettez pas la même proposition.

17
Impact of prevention coverage on ACT forecasting
Impact de la couverture des méthodes de
prévention sur les besoins prévus en CTA
  • After the 80 utilization target is reached,
    countries should budget for a 10 reduction in
    ACT procurement for the following year. Assuming
    coverage is maintained, 20 reduction can be
    assumed for the year after that, and 30 the year
    after that.
  • This is an interim solution recommended by the
    RBM HWG, and it is recommended that countries
    collect data to refine forecasts in future years.
  • Une fois que lobjectif de 80 dutilisation est
    atteint, les pays devraient prévoir une réduction
    de 10 de leurs besoins en CTA pour lannée
    suivante. Si la couverture est maintenue, 20 de
    réduction peuvent être prévus lannée daprès,
    puis 30 lannée suivante.
  • Ceci est une solution provisoire recommandée par
    le HWG, et il est recommandé à chque pays de
    collecter des données permettant dévaluer ceci
    de façon spécifique.

18
Absorptive Capacity Capacité dabsorption
  • Global Fund clearly stated its desire to support
    countries in their rapid scale-up to achieve the
    December 31, 2010 RBM targets.
  • We understand that some countries may be aiming
    for lower targets by the end of 2010, due to
    absorptive capacity constraints.
  • However, please think twice before downgrading
    the targets, we would urge you to use the HSS
    portion of the application to explore ways of
    expanding absorptive capacity (for instance,
    financing community health workers).
  • Le FM a clairement indiqué quil souhaite
    soutenir les pays dans leurs efforts pour
    atteindre les objectifs RBM du 31 décembre 2010.
  • Nous sommes conscients que certains pays visent
    des objectifs réduits pour 2010, dû à leur
    capacité dabsorption.
  • Toutefois, nous vous demandons de réfléchir à
    deux fois (voire trois!) avant de réduire vos
    objectifs. Plutôt, nous vous conseillons
    dutilser loutil de RSS pour augmenter votre
    capacité dabsorption.

19
Selection of Principal Recipient Choix du
Récipiendaire Principal
  • Principal Recipients must be competitively
    selected, with the process clearly documented.
    Simply noting that the Government will be the PR,
    without a documented competitive process will not
    be acceptable.
  • Recommended that there are 2 PRs one from
    Government and one from Civil Society (Dual Track
    Financing). Not mandatory, but a justification
    must be submitted as to why you have chosen not
    to.
  • Le Récipiendaire Principal doit être sélectionné
    de manière compétitive, et le procédé clairement
    documenté. Si le Récipiendaire Principal est le
    gouvernement, il faut quil ait été choisi
    suivant un processus compétitif et ceci doit être
    expliqué.
  • Il est recommandé davoir deux Récipiendaires
    Principaux (principe du financement à deux
    voies). Ceci nest pas obligatoire, mais une
    explication doit être fournie si vous choisissez
    de ne pas le faire.

20
Presentation of the Proposal Présentation de la
Proposition
  • The TRP takes, on average, about 3 hours to read
    and decide on each proposal.
  • We have found that graphs, pictures, visuals are
    very effective ways of communicating information
    to the TRP.
  • Le TRP consacre, en moyenne, trois heures à la
    lecture de chaque proposition.
  • Les graphiques, figures et tous supports visuels
    sont des moyens efficaces de communiquer avec le
    TRP.

21
Tables less relevant for malaria Tableaux moins
appropriés au paludisme
  • We have found that Table 4.2.1b (Size of
    Population Groups Targeted in Round 8) and 4.2.2
    (Malaria epidemiology of target populations) may
    be difficult/not possible to fill in, and are
    largely not relevant for malaria.
  • If you decide to leave them blank, we strongly
    suggest you include a line stating that These
    data are not available and not collected by the
    country…or something like it.
  • Please dont leave this table (or any table)
    blank without an explanation, as the TRP may
    think youve just forgotten to fill in the table.
  • Les tableaux 4.2.1b et 4.2.2 sont difficiles ou
    impossibles à compléter et généralement peu
    relevant pour le paludisme.
  • Si vous ne les complétez pas, nous vous
    conseillons fortement de rajouter une ligne
    expliquant que ces données ne sont pas
    disponibles et ne sont pas collectées.
  • Ne laissez pas le tableau incomplet sans fournir
    dexplications, car le TRP risque de penser quil
    sagit dun oubli.

22
Guidelines Directives
  • We have seen that many read the guidelines once
    at the beginning of proposal drafting, and then
    not again. We suggest that you keep the
    guidelines by your side at all times, and refer
    to them often. Please also use the checklists
    provided for you in the proposal form.
  • En général les directives sont lues au début de
    lexercice de rédaction et pas après!
  • Nous vous conseillons de toujours garder les
    directives à vos côtés et de vous y référer le
    plus souvent possible.
  • Pensez aussi à utiliser les checklists dans le
    formulaire!

23
TRP comments from round 8
  • Malaria proposals were particularly strong.
  • In contrast to the more formulaic tuberculosis
    proposals, the TRP felt that a concerted effort
    had been made in malaria proposals to identify
    the priority interventions needed in differing
    epidemiological and entomological settings. The
    large budgets associated with some of these
    proposals are driven by commodities.
  • Based upon the Roll Back Malaria (RBM) pre-TRP
    meeting presentation materials, the TRP believes
    that the partnership's provision of targeted
    proposal development support is instrumental to
    the presentation of increasingly stronger
    proposals

24
TRP comments from round 8
  • Once a grant is negotiated, the implementation of
    the program may reveal specific contextual
    constraints and operational challenges that have
    not always been anticipated during the proposal
    preparation process.
  • Accordingly, while the TRP strongly encourages
    countries to seek appropriate technical
    assistance when it is needed, the TRP recommends
    that sufficient emphasis is placed on building
    local capacity relevant to submitting strong,
    fundable proposals. Such capacity consists of not
    only public health experts and consultants, but
    also individuals well-trained in proposal
    development frameworks, planning and budgeting
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