Quarter 2, FY17 Progress Report
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Clinical & Community HIV & AIDS Services Strengthening (CHASS) Quarter 2, FY17 Progress Report LIFE OF PROJECT SUMMARY Implementing Partner: Family Health International (FHI 360) Activity Name: Clinical and Community HIV/AIDS Services Strengthening (CHASS) Project Activity Goal: CHASS’s goal is to improve the quality, coverage, and effectiveness of high-impact, evidence-based HIV/AIDS interventions in four provinces. Activity Objectives: To contribute toward HIV/AIDS epidemic control in Mozambique, CHASS seeks to: 1) Increase coverage of antiretroviral treatment (ART) to 90 percent. 2) Increase retention on ART to 80 percent and 70 percent at 12-month and 36-month follow-up, respectively. 3) Increase the average CD4 count at initiation of ART from 350 to 500 cells per cubic millimeter. 4) Complete tuberculosis (TB) treatment for 90 percent of people living with HIV (PLHIV) diagnosed with TB. 5) Operationalize viral load testing. Life of Activity (start and end dates): August 2010–July 2018 Total Estimated Contract/Agreement Amount: US$137,982,152[1] Total Amount Obligated (to date): US$115,310,555.00 Current Pipeline Amount: US$24,573,149 Actual Expenditure through This Quarter: US$79,120,423 Estimated Expenditures Next Quarter: US$24,573,149 Geographic Focus: Niassa, Tete, Manica, and Sofala Provinces, Mozambique Report Submitted by: Dr. Joaquim Fernando Submission Date: May 8, 2017 [1] After de-obligation of funding for voluntary medical male circumcision. 2 FHI 360 Moçambique │ Rua Beijo da Mulata Plot # 5900 │ Somersheild, Maputo, Mozambique T: +258 21241100 │ F: +258 21485499 │ www.fhi360.org Contents LIST OF FIGURES ............................................................................................................................................. 6 LIST OF TABLES............................................................................................................................................... 7 LIST OF ACRONYMS AND ABBREVIATIONS ..................................................................................................... 8 EXECUTIVE SUMMARY ................................................................................................................................. 10 PROJECT OVERVIEW ..................................................................................................................................... 14 PROGRESS BY INTERMEDIATE RESULT AND PROGRAM AREA ....................................................................... 16 IR1: STRENGTHEN FACILITY-BASED HIV SERVICES ........................................................................................ 16 HIV Testing and Counseling ............................................................................................................. 16 Performance in counseling and testing .............................................................................. 16 Variation by geographic area ............................................................................................. 19 Performance against HTC targets ....................................................................................... 19 Challenges related to HTC .................................................................................................. 21 Key HTC activities for the next quarter ............................................................................... 21 Care and Treatment ........................................................................................................................ 21 Performance in care and treatment ................................................................................... 22 Variation by geographic area and interventions ................................................................. 25 Performance against care and treatment targets ............................................................... 28 Challenges related to care and treatment .......................................................................... 28 Key care and treatment activities in the next quarter ........................................................ 29 Pediatric Antiretroviral Therapy ...................................................................................................... 29 Performance in pediatric care and treatment .................................................................... 30 Variation by geographic area and Intervention .................................................................. 31 Performance against pediatric care and treatment targets ................................................ 31 Challenges related to pediatric care and treatment ........................................................... 32 Key pediatric care and treatment activities for the next quarter ........................................ 32 Laboratory Services ......................................................................................................................... 32 Performance in lab testing ................................................................................................. 32 Challenges related to lab ................................................................................................... 33 Key lab activities for the next quarter ................................................................................ 33 Pharmaceutical Care Systems and Services ..................................................................................... 33 Strengthening drug and commodity management ............................................................. 34 Decentralization of ARV drug distribution and dispensing .................................................. 35 Support for the three-month dispensing initiative ............................................................. 35 Strengthening the use of FILAs to identify and track defaulters ......................................... 36 Promoting and supporting pharmacovigilance and patient safety ..................................... 37 National-level pharmacy-related activities ......................................................................... 37 Key pharmacy activities for the next quarter ..................................................................... 38 Prevention of Mother-to-Child Transmission .................................................................................. 38 Performance in PMTCT ...................................................................................................... 39 Variation by geographic area and Intervention .................................................................. 41 Performance against PMTCT targets .................................................................................. 42 Challenges related to PMTCT ............................................................................................. 43 Key PMTCT activities for the next quarter .......................................................................... 43 3 FHI 360 Moçambique │ Rua Beijo da Mulata Plot # 5900 │ Somersheild, Maputo, Mozambique T: +258 21241100 │ F: +258 21485499 │ www.fhi360.org TB/HIV Integration .......................................................................................................................... 43 Performance in TB/HIV Integration .................................................................................... 44 Variation by geographic area and Intervention .................................................................. 45 Performance against TB/HIV targets .................................................................................. 46 Challenges related to TB/HIV ............................................................................................. 46 Key TB/HIV activities for the next quarter .......................................................................... 46 Nutrition Support ............................................................................................................................ 46 Challenges related to nutrition .......................................................................................... 47 Key nutrition activities planned for next quarter ................................................................ 47 Gender ............................................................................................................................................ 47 Performance in GBV ........................................................................................................... 49 Challenges related to gender ............................................................................................. 49 Key gender activities for the next quarter .......................................................................... 50 Health System Strengthening .......................................................................................................... 50 Governance and leadership at DPS, SDMAS, and HF levels ................................................ 50 Logistics supply chain management ................................................................................... 51 Financial management ....................................................................................................... 52 Human resources for health .............................................................................................. 52 Private-public partnerships ................................................................................................ 53 Quality Improvement