1. Transitioning to a Faith-Based Health Network: The Churches Health Association of Zambia Presented by Karen Sichinga CHAZ ICASA Addis Ababa, Ethiopia December 2011

2. Presentation Outline AR-Africa :the Profile and the AR Model AIDSRelief Zambia Transition in the Zambia Context CHAZ: The Faith-Based Health Organization in Zambia and why it was selected for the transition The Vision for Transition The Process Current status of AR-Z Transition Lessons Sustainability and Scale up within CHAZ context

3. AR-Africa Profile 220+ facilities in 9 countries 696,000 people receiving care & treatment since 2004 222,000 current on ART 8% of patients < 15 yrs Viral suppression 89% - based on random sample

4. The AIDSRelief Model The goal is to provide high- quality sustainable care to people who need it through three strategic directions: medical, strategic information and site management within a strong and supportive health systems

5. AIDSRelief Zambia 96,000+ in C&T since 2004 43,000 current on ART at 19 sites 7.5% of patients <15 years 81% of patients retained in treatment 6.6% LTFU

6. Transition in the Zambia Context Involves many actors – MOH, FBOs, private for-profit and academic institutions. Any or all may play a part. AIDSRelief and CHAZ have had a close working relationship from initial 2003 proposal stage CHAZ was identified as the local partner (LP) for transition. No previous lessons on transition to learn from

7. Ecumenical ( Catholic & Protestant Churches ); provides > 50% of all health care in rural Zambia National presence with countrywide network of 146 facilities 20+ years HIV programming experience AIDSRelief is one of many projects One of 4 PRs for Global Fund in Zambia CHAZ: The Faith-Based Health Organization in Zambia

8. Why CHAZ? National presence; most AIDSRelief sites already members of CHAZ Creative and has provided culturally appropriate responses with deep knowledge of the Zambian community Strong supply chain management systems and considered and integral component of national system Longstanding relationship with government 23 years of sub-granting experience, 18 years managing large awards Importance of faith-based health system in Zambia – CHAZ is considered as an integral component of the public health system making it sustainable

9. Vision for Transition Maintain high quality, cost-effective care with Local Partners having the technical and organizational capacity to manage the program, complemented by long term clinical TA Local Partners complement each other and function as USG primes

10. Transition Process 1 Transition is gradual: CDC issued two separate 5-year awards to both CHAZ and AIDSRelief as primes CHAZ will incrementally take on management of program as capacity is strengthened AIDSRelief will work alongside CHAZ for continued capacity strengthening

11. Transition process 2 Strengthen Capacity and Support Systems of CHAZ through training and mentorship on: o Site Capacity Assessment Tool o USG Fund Management o Strategic Information o Pharmaceutical Management of ART Commodities- Pharmacy Staff o Combined visits to successfully transitioned sites

12. Where are we now? 1 Global consortium2 Grants-Local and Int’l LedLocal-led consortium

13. Where are we now?- 2 Program integrated into CHAZ’s existing structures (not a stand alone) 8 staff have been transitioned to CHAZ (clinical, grants management, strategic information and, with the entire supply chain transitioned to CHAZ 5 program sites are now managed by CHAZ

14. Lessons Need for equal partnership and mutual respect Need for all partners to be at the same level- Transition Concept No gap in information Need for greater and continuous involvement of treatment facilities(program sites) Specific model varies according to country context Transition is not a success unless it has potential for sustainability

15. YES! CHAZ is not only indigenous but is recognized by the Government of Zambia as its major partner in health service delivery. Furthermore, CHAZ health institutions are integrated into the national health system. Through an MOU between government and CHAZ, CHAZ’s health facilities have full government support (HR, grants for running cost and essential drugs). Is Scale up Feasible? YES! Due to CHAZ’s national presence and technical capacity Will the Transitioned Program be Sustained?

16. Acknowledgements Michele Broemmelsiek; Catholic Relief Services, USA Kwame Essah; CRS/AIDSRelief Zambia The Churches Health Association of Zambia (CHAZ) PEPFAR /CDC for the new Award to CHAZ PEPFAR/HRSA for their support to the transition process

17. Thank you for your attention God bless