Structural, Policy and Legal Assessment Presented by Ms. Kokuteta Mutembei HIV/AIDS BI-ANNUAL REVIEW 2008

Outline of the Presentation Objectives of the study Methodology and Key Questions Findings (Structure, Policy, Legislation) Recommendations

Objectives of the study To assess the HIV and AIDS institutional arrangement and progress made for the implementation of the national response To assess the coordination structure, policy and legal environment Document challenges Recommend structural, Policy and legal environment for smooth implementation of the national response

Methodology Review of TACAIDS documents Review of selected policies and legislation Interview – CSOs (Help age, save the children, wama, Wamata) Interview with selected Ministries – Finance, Home Affairs, Justice, Community Development, HRGGC, Infrastructure, Education, Culture and sports Tool for development partners- USAID, GTZ, UNICEF, UNAIDS Interview with selected TACAIDS officials

Key Research Questions Have there been mainstreaming of HIV and AIDS in other sector policies, guidelines? Policy implementation challenges Is there a monitoring system that measures progress of policy implementation? How does the monitoring system work? Do the strategies/plans and programmes have budgets? Is the legislation establishing TACAIDS realistic?

Key Research Questions Are there supporting regulations? What is the current institutional set up? How do lower level structures link up with the higher level structures Challenges in institutional arrangements what do other actors think of TACAIDS coordination role?

Findings- Policy Achievements: HIV and AIDS Policy in Place There is a body of clear policy guiding implementation of multisectoral strategies ◦ HOWEVER, Many of the problems evolving out of implementation are a result of weak policy implementation HIV and AIDS Policy - role of TACAIDS as a coordination body need to be streamlined.

Policy Lack of policy clarity- delineation between he role of TACAIDS and local government, weak accountability structure Inconsistencies – eg. Age of children, definition of orphan Overall no comprehensive protection of vulnerable groups – particularly orphans and women (across policies)

Policy An opportunity to mainstream HIV and AIDS in all community development interventions – but community Development Policy needs improvements Gender equality and discrimination still a challenge The prevention element is weak key policies with the exception of the HIV and AIDs policy

Policy Inability of TACAIDS to coordinate the various policy interventions is a result of weaknesses within the HIV and AIDS policy and the Act

M&E Achievement: A national HIV-Monitoring and Evaluation System (HIV-MES) has been developed by TACAIDS monitoring of the HIV and AIDS policy and other policies that support the national response is relatively weak. At the national level, the various HIV and AIDS programmes being implemented are monitored through different monitoring systems. GF (TNCM); SADC; Monitoring not harmonized and still under development

Structures ◦ Structures within TACAIDS Achievements: The TACAIDS Act - established as an independent unit within the Prime Minister’s office Structures have been established within central and local levels

Structures Challenges Policy and Act does not elaborate on reporting/accountability structures within TACAIDS Some of the divisions are implementing activities and NOT coordinating or providing strategic leadership or facilitating implementation

Structures ◦ National Structures achievements - facilitation of MDAs to establish HIV and AIDS focal points- strategies developed, activities appear in MTEF, guidelines developed ◦ HOWEVER Some of the focal points do not understand their specific roles

Structures Focal points do not report to TACAIDS directly TACAIDS does not follow up strategic plans are not adequately funded Some focal points do not participate in all TACAIDS coordination meetings limited support from higher level decision making bodies

Structures Bureaucracy and delays in receiving funding for activities ◦ LOCAL LEVEL STRUCTURES Achievements: Structures established at every local level and there are HIV and AIDS coordinators ◦ Challenges Some of the structures function well while others do not Lack of funds

Structures Some of the key actors are said not to be attending meetings at CMAC level, for example MPs who play a significant political role. Limited capacity of WMAC Committees not well functioning and misuse of funds donor assistance and CSO coordinated – but could be improved

Structures no vertical or horizontal coordination of HIV and AIDS activities at local levels lack of clear accountability structures at local levels

Legislation TACAIDS ACT- has limited powers in terms of decision making regarding powers that are provided in the TACAIDS Act.. The role of TACAIDS in the Act is not very clear HIV AIDS (P&C) ACT- Does not impose a duty on the government to provide orphans and PLHIV basic health services, ARVs or an adequate standard of living

Legislation Access to social services is not legally guaranteed for various groups (though mentioned in policies) Low legal security for women Inconsistencies regarding rights of women and children

Recommendations Overall, great achievements. The first NMSF set the foundation for effective implementation of NMSF II but more work needs to be done to improve the enabling environment There is need to closely evaluate the relevance of all the structures TACAIDS needs to review its internal structures (be realistic)- need to review policy? Act? re-assess the entire concept and value of HIV and AIDS focal points

Recommendations Acts should make it obligatory for decision makers to take concrete measures to address HIV and AIDs in MDAs Annual performance reviews should be undertaken

Recommendations TACAIDS should first take stock of what the committees at been able to do, the lessons, challenges and opportunities discussions with local government on how to integrate committees in the local government structures Need to strengthen coordination and strategic leadership role

Recommendations TACAIDS needs to disseminate the HIV and AIDs policy and NMSF widely follow up on developments in implementation of sector policies that support the national response advocacy support provided to CSOs should be geared at upstream activities/strategies that aim at influencing policy change or policy implementation and change in legislation

Recommendations CSOs that implement gender equality programmes should be supported to promote change in behavior at community level

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