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September 2009
Guide to Producing Campaign to End Pediatric Aids
(CEPA) National Advocacy Action Plans
(NAAPs)
Focus on CEPA’s Four Core Objectives
Long-term Goal: 80%
coverage for pediatric HIV/AIDS
treatment and PPTCT+ services
Section 3: Early Infant Diagnosis and
Treatment
Section 4: Access to Medicines
Section 2: Comprehensive Family
Centered Care
Section 5: Full Funding
Structure of a NAAP Document
Section 1: Introduction and Overview of Country Context
Section 2: Core Objective 1 - Family Centered Care and Nutrition
Section 3: Core Objective 2 - Early Infant Diagnosis and Treatment
Section 4: Core Objective 3 - Access to Appropriate Medicines
Section 5: Core Objective 4 - Full Funding to Eliminate Pediatric Aids
Section 6: Review and Identify Synergies and Links Between Sections 2-5
Section 7: Monitoring Plan
Section 8: Partner Roles and Accountabilities
For Section 1 of your NAAP Document Follow These Steps:
1. Provide overview of HIV/AIDS and Pediatric HIV/AIDS country context, with HIV/AIDS and Health Statistics (See Section 10.2.1 of “On the Road…”)
2. Provide overview of country response to HIV/AIDS and Pediatric HIV/AIDS (See Section 10.1.4 of “On the Road…”)
3. Provide environmental scan and assessment of advocacy/political climate (See Sections 10.1.1, 10.1.2, and 10.1.3 of “On the Road…”)
4. Provide initial identification of potential advocacy targets (See Section 10.2.2 of “On the Road…)
For Sections 2 to 5 of NAAP DocumentFollow These Steps:
FOR EACH OF THE 4 CORE OBJECTIVES:
1. Identify Beneficiary Outcomes tied to each specific core objective which will contribute to achievement of the long-term goal (80% coverage for pediatric HIV/AIDS treatment)
2. Identify Bottlenecks that prevent achievement of beneficiary outcomes
3. Identify Advocacy Outcomes for addressing/removing identified bottlenecks that prevent achievement of beneficiary outcomes
4. Identify Advocacy Outputs that are potential shorter term steps towards the achievement of advocacy outcomes (These will often be linked to changes in advocacy target actors and institutions)
5. Identify Types of Evidence in particular Key Performance Indicators (KPIs), so that progress towards advocacy outcomes and advocacy outputs can be monitored over time
6. Identify Activities and Strategies to achieve advocacy outcomes and advocacy outputs (specifically for year 1 of the campaign)
Core Objective:Family Centered
Care and Nutrition
Steps to a NAAP – Sections 2 to 51. Identify Beneficiary Outcomes for Each Core Objective
80% Coverage
Beneficiary Outcome
Accessible health facilities offer
comprehensive quality prevention, treatment, and family care along
with broader reproductive health
services
Core Objective:Family Centered Care
and Nutrition
Steps to a NAAP – Sections 2 to 52. Identify Bottlenecks to Beneficiary Outcomes
80% Coverage
Bottleneck
Bottleneck
Bottleneck
Stigma
Lack of coordinated care
Limited number and capacity of trained health
care professionals
Beneficiary OutcomeBeneficiary Outcome
Accessible health facilities offer
comprehensive quality prevention, treatment, and family care along
with broader reproductive health
services
Steps to a NAAP – Sections 2 to 53. Identify Advocacy Outcomes that Address Bottlenecks
Advocacy Outcome
Advocacy Outcome
Advocacy Outcome
National policy strengthened to prevent discrimination against HIV positive mothers
and children.
An accredited set of National Training curricula for task shifting is established.
Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by
National Government, donors, and providers.
Bottleneck
Bottleneck
Bottleneck
Stigma
Lack of coordinated care
Limited number and capacity of trained health
care professionals
Steps to a NAAP – Sections 2 to 54. Identify Advocacy Outputs Towards Advocacy Outcomes
Advocacy Output
Advocacy Output
Advocacy Output Advocacy Outcome
Advocacy Outcome
Advocacy Outcome
National policy strengthened to prevent discrimination against HIV positive mothers
and children.
An accredited set of National Training curricula for task shifting is established.
Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by
National Government, donors, and providers.
Bottleneck
Bottleneck
Bottleneck
Stigma
Lack of coordinated care
Limited number and capacity of trained health
care professionals
Pediatric care policy guidelines drafted
by Ministry of Health
Report on national stigma index is
published
National Training curricula is drafted by relevant actors
Steps to a NAAP – Sections 2 to 55. Identify Evidence/KPIs to Monitor Progress Towards
Advocacy Outcomes and Advocacy Outputs
Advocacy OutcomeNational policy strengthened to prevent
discrimination against HIV positive mothers and children.
Advocacy OutcomeAn accredited set of National Training curricula
for task shifting is established.
Advocacy OutcomeComprehensive and harmonized pediatric care
policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers.
BottleneckStigma
BottleneckLack of
coordinated care
BottleneckLimited number and capacity of trained health
care professionals
Advocacy Output
Pediatric care policy guidelines drafted
by Ministry of Health
Advocacy OutputReport on national
stigma index is published
Advocacy OutputNational Training
curricula is drafted by relevant actors
Evidence/KPIs: Punishments for discrimination in National policy are made more severe
Evidence/KPIs: National Training curricula document
Evidence/KPIs: Draft of Pediatric care policy guidelines
Evidence/KPIs: Draft of Training Curricula
Evidence/KPIs: Stigma Report
Steps to a NAAP – Sections 2 to 56. Identify Activities to Achieve Advocacy Outputs and Outcomes
Advocacy OutcomeNational policy strengthened to prevent
discrimination against HIV positive mothers and children.
Evidence/KPIs: Punishments for discrimination in National policy are made more severe
Advocacy OutcomeAn accredited set of National Training
curricula for task shifting is established.Evidence/KPIs: National Training curricula document
Advocacy OutcomeComprehensive and harmonized pediatric
care policies, guidelines, and standard operating procedures are adopted by
National Government, donors, and providers.Evidence/KPIs: Relevant legislation
BottleneckStigma
BottleneckLack of
coordinated care
BottleneckLimited
number and capacity of
trained health care
professionals
Advocacy Output
Pediatric care policy guidelines drafted
by Ministry of Health
Evidence/KPIs: Draft of Pediatric care policy guidelines
Advocacy OutputReport on national
stigma index is published
Evidence/KPIs: Stigma Report
Advocacy OutputNational Training
curricula is drafted by relevant actors
Evidence/KPIs: Draft of Training Curricula
ActivitiesConduct research
for national stigma index
ActivitiesConduct briefing
session with MoH, donors, and health care providers on
guideline requirements
ActivitiesConduct joint
briefing session with MoH, MoL,
MoE, PS
For Section 3, Example of Core Objective 2: Early Infant Diagnoses and Treatment
Policy briefing sessions with the
MOH/PS
Activities
ActivitiesMeeting with key stakeholders and
CSOs to shape PEDs HIV/AIDS
agenda coordination and
activation
ActivitiesCommunity
mobilization with child health advocates
Advocacy OutputNational AIDS plans including specific policies and guidelines
supporting pediatric AIDS services drafted
Evidence/KPIs: Draft plans
Advocacy OutputBroad agreement by key
stakeholders to adopt early testing and treatment guidelines
Evidence/KPIs: Signed MOUs among key parties
Advocacy OutcomeMOH, MOF, MOL
promulgate national Pediatric HIV training
curriculaEvidence/KPIs: Approved training curricula
Advocacy OutcomeNational health care
centers purchase and distribute laboratory
equipmentEvidence/KPIs: health center inventory lists indicate equipment purchased and received
Advocacy OutcomeMOH Approve and
implement National pediatric EID/EIT
standards and quality assurance protocols
Evidence/KPIs: Approved standards and quality assurance protocols
BottleneckLack of access
to care
Slow test results
Bottleneck
Lack of trained healthcare
workers
Bottleneck
For Section 4, Example of Core Objective 3: Access to Appropriate Medicines
Dialogues with national drug
procurement and supply chain management authorities
Activities
Activities
Briefing sessions with MOH, DRAs,
Parliamentary committee(s), &
procurement/distribution/supply
chain mgmt authorities on
harmonizing drug registration
(PaATH, NEPAD)
Advocacy OutputGovernment reviews existing guidelines on procurement,
distribution and supply chain management
Evidence/KPIs: Report reviewing existing guidelines
Advocacy OutputMOH, DRA, Procurement authority
recommend/call for increased government funding for pediatric
ARVs, PPTCT meds and commoditiesEvidence/KPIs: Press release/announcement
Advocacy OutcomeIncreased funding for
PPTMT meds approvedEvidence/KPIs National budget, appropriate legislation
Advocacy OutcomeProcurement, distribution
and supply chain management policies and
guidelines amendedEvidence/KPIs: Amended policies and guidelines
Slow drug approval process
Bottleneck
High cost of pediatric HIV
drugs
Bottleneck
Weak national procurement
and supply chain
management guidelines
Bottleneck
Advocacy OutcomePaATH registration
process implementedEvidence/KPIs: Appropriate legislation
Advocacy OutputDRA reviews and tailors PaATH
proposal to country needsEvidence/KPIs: PaAth proposal
For Section 5, Example of Core Objective 4: Full Funding
National media campaign
highlighting need for better
utilization of PPTCT funds
Activities
ActivitiesBriefings with
donors on increased funding
allocations for PPTCT and
pediatric services
ActivitiesNational
demonstrations to pressure
governments to increase funding
Advocacy OutputHigh level committee formed to consider option for new budget monitoring institutionEvidence/KPIs: Committee report and recommendations
Advocacy OutputGovernments commit to allocate more resources to health budgets
Evidence/KPIs: Government press release
Advocacy OutcomeOverall national PPTCT
budget increased Evidence/KPIs: 50% increase in funds allocated towards PPTCT
Advocacy OutcomeInstitution for budget
monitoring establishedEvidence/KPIs: Opening announcement
Available funds not
utilized
Bottleneck
Lack of national
funding for PPTCT
Bottleneck
Pediatric HIV prevention
and treatment not perceived as a priority
Bottleneck
Advocacy OutcomeLine item within health
budgets dedicated to PPTCT and pediatric services
establishedEvidence/KPIs: National budget/appropriate legislation
Advocacy OutputDonors commit to reviewing funding allocations for PPTCT Evidence/KPIs: Decision point of donor organization board
Advocacy OutcomeOverall donor funding for
PPTCT increased Evidence/KPIs: 50% increase in funds allocated towards PPTCT
Section 6 – Review and Identify Synergies and Links Between Sections 2-5
Identify the bottlenecks that cut across more than one core objective.
Identify the advocacy outcomes that address more than one bottleneck.
Identify the advocacy outputs that link to more than one advocacy outcome.
Identify the activities that contribute to more than one advocacy output.
Section 7Monitoring Plan
Establish processes for collecting data for the evidence, especially KPIs:
How will evidence be collected? How can current baseline data be collected? How often will data be collected? Who will be responsible for data collection? Can the selected KPIs be incorporated into CEPA score cards?
Identify potential opportunities for learning and reflection that could lead to course correction.
More guidance on the monitoring plan will be provided once sections 1-6 are further developed and at the advocacy summit.