1. Draft logframe of Round 11 HSS proposal Proposal Development Task Team (PDTT) – Executive Team Friday, 7 October 2011

2. Four proposed HSS objectives 1.Increase utilization of healthcare services in hard-to-reach rural areas 2.Increase number, competence and effectiveness of health workers in rural areas 3.Build and maintain a single, integrated health information system 4.Strengthen supply chain management for commodities

3. Objective 1 Increase utilization of healthcare services in hard-to-reach rural areas 1. Increase availability of integrated health services for hard-to-reach rural populations 2. Strengthen referral systems, with focus on healthcare workers and facilities

4. 1. Increase utilization of healthcare services in hard-to-reach rural areas 1.1 Increase availability of integrated health services for hard-to- reach rural populations Renovate primary healthcare infrastructure, targeting facilities where we are scaling-up integrated AIDS-TB care Conduct scheduled outreach to selected isolated areas from Public Health Units using dedicated staff and transport Train health motivators to increase awareness about available health services 1.2 Strengthen referral systems, with focus on healthcare workers and facilities Implement Referrals and Linkages Framework Service delivery areas (SDAs)Activities

5. Objective 2 Increase number, competence and effectiveness of health workers in rural areas 1. Increase availability of competent nurses in hard-to-reach rural areas 2. Increase availability of health motivators in hard-to-reach rural areas 3. Strengthen leadership capacity of nurses managing clinics

6. 2. Increase number, competence and effectiveness of health workers in rural areas 2.1 Increase availability of competent nurses in hard-to-reach rural areas Give nursing faculties the capacity to enroll more students Recruit and retain nurses Build capacity of nurses and doctors to perform task-shifted roles as a clinical team Provide clinical mentorship for nurses Support wellness programmes 2.2 Increase availability of health motivators in hard-to-reach rural areas Recruit & train health motivators Provide performance-based incentives Provide continuous training for health motivators, including task-shifted roles Service delivery areas (SDAs)Activities 6

7. 2. Increase number, competence and effectiveness of health workers in rural areas 2.3 Strengthen leadership capacity of nurses managing clinics Train clinic managers in leadership & management skills Introduce general performance appraisals Service delivery areas (SDAs)Activities 7

8. Objective 3 Build and maintain a single, integrated health information system 1. Design & build a functional health information system 2. Build IT infrastructure that enables the health information system to function effectively 3. Use the HIS to make evidence-based decisions

9. 3. Build and maintain a single, integrated health information system 3.1 Design & build a functional health information system Design an integrated health information system Scale-up community health information system from pilot to national level Conduct periodic reviews of functionality of the integrated health information system 3.2 Build IT infrastructure that enables the health information system to function effectively Procure essential IT support for HIS Build human resources capacity at community and regional levels to support HIS Service delivery areas (SDAs)Activities 9

10. 3. Build and maintain a single, integrated health information system 3.3 Use the HIS to make evidence-based decisions Design central dashboards that are accessible throughout the health system Design a web portal for dissemination of information reports Conduct regular reviews and evaluations of disease programs Service delivery areas (SDAs)Activities 10

11. Objective 4 Strengthen supply chain management for commodities 1. Improve infrastructure at facility pharmacies and national warehouse 2. Strengthen management capacity 3. Establish standardized quality assurance programme for commodities

12. 4. Strengthen supply chain management for commodities 4.1 Improve infrastructure at facility pharmacies and national warehouse Establish an integrated storage space at Central Level for all commodities Improve security of commodities in transit and at CMS, National Laboratory and facility pharmacies Develop and maintain physical asset- management plan 4.2 Strengthen management capacity Expansion Integration of Data Management Unit at CMS Conduct quarterly commodities review meetings Establish new operational structure of CMS Continue capacity development at procurement unit Service delivery areas (SDAs)Activities 12

13. 4. Strengthen supply chain management for commodities 4.3 Establish standardized quality assurance programme for commodities Establish medicines regulatory unit Procure equipment for quality control labs Establish disposal systems for commodities Service delivery areas (SDAs)Activities 13