1. Essentials Policy Protocols Training Technical Mentorship
Monitoring & Evaluation
Communication links/Referral
Appoint Counsellors
Situational Analysis
Strengthened collaboration
Management
Logistics
Infrastructure

2. Nice to haves… Additional Nurses, co-ordinators, mobilisers
IEC/Advocacy
Operational Research

3. Referral Mechanisms Scheduled regular meetings led by DMT
Partnership Development
Ownership – definition of roles & responsibility
Standardised referral forms
Problem solving
Addressing gaps in service and evolution of both epidemics

4. Measuring Impact of support
M&E process
Freq of meetings
minutes & action points
Reviews/ Outcomes, VCT;TB;HIV care; prophylaxis;STI; HIV prevention
Resource deployment ..human, financial & material

5. Developing Health Service capacity through partnership
District Co-ordinating Committee
Situational analysis (who does what; what are the gaps)
Ownership/partnership development
Defining roles and responsibility
Capacity development of stakeholders
- District Managers, logistics, QA and community

6. Should community workers be paid?
Need a clear national policy on the roles and responsibility of volunteers as a complement to paid staff
Counsellors should be paid

7. Should we have dedicated TB/HIV staff?
Health reform requires multiskilled staff
Functional integration into district health services
Need for focal person at facility and district levels (gatekeeper & referral point)

8. Culture of performance management/accountability
Constructive criticism
Ownership
Support visits/skills rotation
District operational planning cycle & review
Data capture – quality of data; mobilise remedial resources
Feedback data (charts in facilities etc)
Individual staff appraisals
Peer Review
Reward best practice ( e.g. certificates)
Ongoing training

9. Accountability Remove/move/sideline ineffective staff Stop funding
Capacity building
Performance improvement plan

10. Benefits of TB/HIV collaboration
improves morale because staff can make a difference
Rapid test
Prophylaxis
Optimise use of resources
One stop shop/ user
Resource sharing

11. Uninterrupted Supplies
Adequate funding
Define roles & responsibilities for procurement & distribution
Stock control systems
Standardised protocols for test & drugs
Budgetary adjustments based on supply & need
Support & Strengthen existing systems

12. Research Impact of VCT on risk behaviour & HIV transmission
Intervention research to improvement in adherence in IPT/CPT
Cost effectiveness
Impact of ARVS on TB
TB/HIV collaboration as a carrier programme for health system improvement
Multi disciplinary health systems research