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Applied Leadership Development Program for District HIV & AIDS Coordination

Facilitator Guide

Republic of Botswana Ministry of Local Government and Rural Development

2014

In partnership with the US Centers for Disease Control and Prevention (CDC) National Alliance of State & Territorial AIDS Directors (NASTAD)

Disclaimer

The curriculum for the Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination was developed in 2012-13 by the National Alliance of State and Territorial AIDS Directors (NASTAD) and the Sustainable Management Development Program (SMDP) at the Centers for Disease Control and Prevention (CDC), for the Ministry of Local Government and Rural Development, Botswana with funding through the CDC cooperative agreement PS001617.

Acknowledgements

The Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination is supported by Centers for Disease Control and Prevention (CDC) Cooperative Agreement PS001617. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

NASTAD and SMDP thank members of the technical working group for providing the oversight and feedback needed to make this a publication representative of the District AIDS Coordinators (DACs). Thanks are also given to the Ministry of Local Government and Rural Development staff, the Ministry of Health staff, the National AIDS Coordinating Agency, and especially the DACs that contributed time, expertise and content for the publication.

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Table of Contents

Disclaimer ...... ii Acknowledgements ...... ii Abbreviations ...... iv Overview ...... 1 Applied Public Health Program Management Training ...... 1 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 3 Applied Leadership Development Program for District HIV & AIDS Coordination – Training Sessions ...... 5 ALDP Facilitator Guide Overview ...... 8 Session Content ...... 10 Welcome & Introductions ...... 10 Introduction to Public Health ...... 32 HIV in Botswana ...... 65 Implementing National Strategies and Policies ...... 97 Collaborating and Engaging Partners to Mobilize Resources ...... 140 Reprioritizing and Reallocating Resources ...... 173 Communicating Effectively ...... 230 Planning and Facilitating Effective Meetings ...... 279 Preparing for Implementation ...... 324 Building Teams and Managing Employees ...... 362 Managing Budgets ...... 415 Data for Monitoring, Evaluation and Decision Making – Part I: M&E, Data Sources and Characteristics ...... 471 Data for Monitoring, Evaluation and Decision Making – Part II: Analysis and Interpretation ...... 512 Data for Monitoring, Evaluation and Decision Making – Part III: Program Evaluation ...... 555 Field Assignment Guidance ...... 588 Resources ...... 622 Agenda and Sign-in Sheet Templates ...... 623 Icebreaker and Energizer Suggestions ...... 626 Pre-, Post-, and Follow-up Training Assessments ...... 630

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Abbreviations

APHPMT Applied Public Health Program Management Training ALDP Applied Leadership Development Program for District HIV & AIDS Coordination ANC Antenatal Clinic BHRIMS Botswana HIV Reporting Information Management System CBO Community based organization DAC District AIDS Coordinator ADAC Assistant District AIDS Coordinator DMSAC District Multi-Sectoral AIDS Committee EBP Evidence Based Planning HOP Headquarters Operational Plan IP Implementing Partners MLG&RD Ministry of Local Government & Rural Development MoH Ministry of Health NASTAD National Alliance of State and Territorial AIDS Directors NSF National Strategic Framework SMDP Sustainable Management Development Program TAC Technical Advisory Committee ToR Terms of Reference TWG Technical Working Group PDP Personal Development Plan PMTCT Prevention of Mother to Child Transmission SOP Standard Operating Procedure NGO Non-governmental organization NACA National AIDS Coordination Agency NSF National Strategic Framework VMSAC Village Multi-Sectoral AIDS Committee

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Overview

Applied Public Health Program Management Training Developed in collaboration with the National Alliance of State and Territorial AIDS Directors (NASTAD) and the Centers for Disease Control and Prevention (CDC)- Sustainable Management and Development Program (SMDP), the Applied Public Health Program Management Training (APHPMT) utilizes a standardized process to assess target cadre roles and responsibilities, and tailor a set of applied public health management curricula components to address identified needs and increase the ability to apply those competencies to existing job duties.

Since it is not possible to develop a single, standardized curriculum, the APHPMT is tailored to support the very specific job functions and responsibilities of target groups of HIV/AIDS managers at national and local levels in different countries.

These goals are accomplished by:  Conducting field-level training o Short intensive off-site training interspersed with field level assignments o Participatory training methods: peer education, case studies, supported use of existing data o Adult learning techniques

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

District AIDS Coordinators (DACs) In Botswana, District AIDS Coordinators (DACs) are critical to the management and coordination of the district response to HIV. As secretariats to the District Multi- Sectoral AIDS Committees (DMSACs), they manage inputs, facilitate the development of a multi-sectoral annual HIV/AIDS Action Plan, support local level capacity building for implementation, mobilize resources, coordinate strategic implementation partnerships across sectors, and monitor and document district responses. Since 2000, as the national HIV/AIDS response evolved, the role of the DAC has changed significantly as the DAC’s Office adjusted to expectations on the part of different national and local stakeholders.

Applied Leadership Development Program | Overview 1

Coordinating Partners NASTAD is an alliance of the United States’ (U.S.) chief state health agency staff with programmatic responsibility for administering HIV/AIDS and viral hepatitis health care, prevention education, and support services programs funded by the states and the federal government. NASTAD strengthens state and territory-based leadership, expertise and advocacy and brings them to bear on reducing the incidence of HIV and viral hepatitis infections and on providing care and support to all who live with HIV/AIDS and viral hepatitis. NASTAD global Program works to build the organizational, programmatic and human resource capacity of its regional/state public sector AIDS program counterparts across the world; with field offices in Botswana, Ethiopia, Haiti, South Africa and Zambia, and programs in the Bahamas and Trinidad.

SMDP works with ministries of health, educational institutions, nongovernmental organizations, and other partners to strengthen leadership and management skills and systems to improve public health in low resource countries. SMDP strengthen leadership and management skills and systems through; integration with country public health priorities, strategic partnerships, technical assistance and training, policy and systems development, advocacy and education, and evaluation.

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Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination The Ministry of Local Government & Rural Health (MLG&RD) was seeking ways to better equip and support DACs and other staff in responding to the dynamic national HIV epidemic. The National Alliance of State and Territorial AIDS Directors (NASTAD) in collaboration with CDC’s Sustainable Management Development Program (SMDP) were asked by MLG&RD to support them in the development and implementation of a skills-based needs assessment. Based on the assessment findings, a tailored Applied Public Health Program Management Training was developed for the DACs to address the identified gaps relating to management and leadership and their expected job duties/tasks. The program title is Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination.

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

Development Process 1. Initial assessment of DACs’ job duties and functions, and skills development needs and gaps a. Self-administered questionnaire b. Structured conversations c. Literature review of existing trainings in Botswana to avoid duplication 2. Development workshop to identify the structure and content for the training a. DACs and Assistant District AIDS Coordinators (ADACs) b. MLG&RD staff c. National AIDS Coordination Agency (NACA) staff 3. Development of the training framework 4. Training content development a. Two-week course b. Twelve sessions c. Botswana based technical working group (TWG) d. Training of Local Master Trainers e. Field assignments f. Mentoring 5. Pilot of training a. Ten Master Trainers trained b. Eight DACs and ADACs trained c. Evaluation summary d. Finalizing the curriculum 6. Evaluate the training a. Predictive evaluation b. Follow-up post training 7. Completion of training curriculum packet a. Initial assessment report and tools

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b. Evaluation summary c. Final ALDP framework d. Master Trainer facilitator guide and presentations e. Orientation packet f. All remaining DACs, ADACs, M&E Coordinators complete two-week training curriculum

Applied Leadership Development Program | Overview 4

Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

TIMES SESSION TITLE SESSION DESCRIPTION 1 hour Welcome & The Welcome and Introduction session seeks to Introduction provide DACs with an opportunity to introduce them, and meet the other facilitators and participants. The session will provide an overview of the agenda and session topics, introduce the core competencies and objectives of the ALDP, and allow participants to share their expectations for ALDP. 1.5 Introduction to Public The Introduction to Public Health session seeks hours Health to provide an overview of the basic public health principles and how they influence the work of DACs in the districts. DACs will gain or reinforce their roles in the public health system, and how public health differs from the science of medicine. 2.5 HIV in Botswana The HIV in Botswana session seeks to provide hours an overview of HIV disease progression, as well as the facilitators for the disease. Additionally this session will discuss the Botswana strategy for ending HIV and the “AIDS-Free Generation” initiative. The purpose of the session is to provide a review of the key elements that all DACs should know about HIV and the progression in the community, to be effective public health stewards. 3 hours Implementing National The Implementing National Strategies and Strategies and Policies Policies session seeks to provide an overview and tools for utilizing the Botswana national HIV and AIDS strategy for district program planning and implementation.

3.5 Collaborating and The Collaborating and Engaging District hours Engaging Partners to Partners to Mobilize Resources session seeks to Mobilize Resources provide an overview and tools for engaging with district-level stakeholders for the purpose of implementing the national and district HIV and AIDS priorities. Training attendees will participate in identifying stakeholders and the necessary degree of interaction.

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TIMES SESSION TITLE SESSION DESCRIPTION 3 hours Reprioritizing and The re-prioritization and re-allocation session Reallocating Resources seeks to provide the knowledge and skills necessary to prioritize district budgets and response activities based on evidence based planning and the national HIV/AIDS priorities. 6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and hours Facilitating Effective Facilitation session seeks to provide an Meetings overview of the DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives.

3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

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3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Interpretation session seeks to provide a Analysis and review of organizing and summarizing data; Interpretation preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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ALDP Facilitator Guide Overview About the Facilitator Guide This guide is designed to provide you with the materials and direction needed to successfully deliver the Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination in a classroom environment. It assumes the instructor has functional proficiency in the subject matter.

This guide includes notes for you to say and do during the training, as well as materials to help you prepare and conclude the course. The guide is created such that it can be delivered as a complete training or as individual, stand-alone sessions.

Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

Master Trainer Roles & Responsibilities Master Trainers are expected to:  Review and learn all session content as described in the facilitator guide for the ALDP  Complete preparation for each session, as outlined in the facilitator guide, prior to administering the session (i.e., sign-in sheets, participant handouts, flip charts)  Monitor time given to each session and/or activity  Collect and review evaluation surveys after administering each session, submit completed evaluations to MLG&RD  Schedule and confirm training room location and set-up

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Facilitation Notes The following notes refer to slides in the PowerPoint presentations. Each slide is numbered and includes detailed facilitator instruction immediately following the slide. The facilitator instructions are labeled and represented in the guide as follows:

FACILITATION GUIDE TERM DESCRIPTION TERMS Speaker Notes The content here describes what is on the slide and should be said or read by the training facilitator. At minimum the training participant needs to get the information included here. Pre-Session Preparation The content here describes the materials and/or activities that should be in place prior to facilitating a session and/or activity. Expected Activity Time Appears with activity instructions. Indicates the approximate time needed to complete the activity. Activity Instructions The content here specifically describes an activity that the facilitator is to take the training participants through. The materials needed are also indicated here. Small/Large Group Activity Describes how to facilitate the activity based on group size. For example, a large group activity is the entire group engaged in the activity together. A small group activity divides to participants into smaller clusters. Small/Large Group Indicates that a large or small group discussion Discussion is to take place. Additional Facilitator The content here indicates additional Guidance information relevant to the slide that the facilitator might want to mention before moving to the next slide. Click Indicates a “transition” or “animation” within a slide.

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Welcome & Introductions

Expected Session Time: 1 hour

Module Content Overview ...... 11 Applied Public Health Program Management Training ...... 11 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 13 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 15 ALDP Facilitator Guide Overview ...... 18 Session Overview ...... 20 Description of Session ...... 20 Materials & Equipment ...... 20 Preparation ...... 20 Pre- and Post- Training Assessments ...... 20 Presenter’s Notes: Welcome and Introductions ...... 21

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

Applied Leadership Development Program | Welcome & Introductions 11

Applied Leadership Development Program | Welcome & Introductions 12

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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a. Initial assessment report and tools b. Evaluation summary c. Final ALDP framework d. Master Trainer facilitator guide and presentations e. Orientation packet f. All remaining DACs, ADACs, M&E Coordinators complete two-week training curriculum

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Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

TIMES SESSION TITLE SESSION DESCRIPTION 1 hour Welcome & Introduction The Welcome and Introduction session seeks to provide DACs with an opportunity to introduce them, and meet the other facilitators and participants. The session will provide an overview of the agenda and session topics, introduce the core competencies and objectives of the ALDP, and allow participants to share their expectations for ALDP. 1.5 Introduction to Public The Introduction to Public Health session seeks hours Health to provide an overview of the basic public health principles and how they influence the work of DACs in the districts. DACs will gain or reinforce their roles in the public health system, and how public health differs from the science of medicine. 2.5 HIV in Botswana The HIV in Botswana session seeks to provide hours an overview of HIV disease progression, as well as the facilitators for the disease. Additionally this session will discuss the Botswana strategy for ending HIV and the “AIDS-Free Generation” initiative. The purpose of the session is to provide a review of the key elements that all DACs should know about HIV and the progression in the community, to be effective public health stewards. 3 hours Implementing National The Implementing National Strategies and Strategies and Policies Policies session seeks to provide an overview and tools for utilizing the Botswana national HIV and AIDS strategy for district program planning and implementation. 3.5 Collaborating and The Collaborating and Engaging District hours Engaging Partners to Partners to Mobilize Resources session seeks to Mobilize Resources provide an overview and tools for engaging with district-level stakeholders for the purpose of implementing the national and district HIV and AIDS priorities. Training attendees will participate in identifying stakeholders and the necessary degree of interaction.

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and Facilitating The Effective Meeting Planning and Facilitation hours Effective Meetings session seeks to provide an overview of the DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives.

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TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: Program session seeks to provide an overview of Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Applied Leadership Development Program | Welcome & Introductions 19

Session Overview

Description of the Session

Begin each week of the ALDP by welcoming participants, and allowing them to introduce themselves to each other. Also, provide a brief review of the agenda for your time together, document expectations for the sessions and answer any questions about the program. The welcome should include an introduction to the ALDP, including the rationale, key competencies and objectives.

This 1 hour session is designed to provide ALDP participants with an opportunity to introduce them, and meet the other facilitators and participants. The session will: 1) provide an overview of the agenda and session topics; 2) introduce the core competencies and objectives of the ALDP; and 3) allow participants to share their expectations for ALDP.

Materials & Equipment

□ Computer □ Flip charts (3)

□ LCD projector □ Markers and pens

□ Facilitator guide □ Note papers

□ Power Point presentation uploaded to □ Tape or adhesive computer and working □ Sign-in sheet □ Room set-up

□ Pre/post-training evaluation □ Participant handouts assessments

Preparation

□ Write Group Agreements on a flip chart (see page 30)

Pre- and Post- Training Assessments

Ongoing monitoring and evaluation of the ALDP is critical to the continued success of the training program. Therefore, pre- and post-training assessments should be conducted each time the training is delivered, whether as a whole training or individual sessions. Data collected from the training assessments can and should be utilized to monitor and evaluate the effectiveness of the training and increases in the participants’ leadership and management skills and knowledge. Pre- and post- training assessments are provided in the Resource section of this guide.

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Presenter’s Notes: Welcome and Introductions

Slide 1: Welcome and Introductions

Speaker Notes:  Begin with a quote from Nelson Mandela, “Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure”  Ask the participants to share what that quote means to them (share what it means to you) (wait for responses) If you have not already, take time to…  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course, They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers)  Conduct an icebreaker if needed  Instruct everyone to write their names on name tents, complete pre-training assessment and sign-in  Give time for dignitaries to speak

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Slide 2: ALDP Logistics

Speaker Notes:

 Go over the agenda for week two training start time (8:30am), break times (morning and afternoon, as needed) and finish time (4:30pm)  Lunch is provided at the training site  Dinner is on their own

Slide 3: Quick Review & Update

Speaker Notes:

During this session we will review content from other sessions, field assignments, and mentoring

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Slide 4: Applied Public Health Program Management Training: Development Model

Speaker Notes:

 Inform the participants that the ALDP was developed based on the APHPMT model

 Developed in collaboration with the National Alliance of State and Territorial AIDS Directors (NASTAD) and the Centers for Disease Control and Prevention (CDC)- Sustainable Management and Development Program (SMDP) and MLG&RD

 APHPMT is tailored to support the very specific job functions and responsibilities of target groups of HIV/AIDS managers at national and local levels in different countries

 APHPMT is intended to provide applicable skills enhancement for public health personnel, utilizing the process outlined on the slide; assessment, design, development, delivery and evaluation

Additional Facilitator Guidance

 APHPMT utilizes a standardized process to assess target cadre roles and responsibilities, and tailor a set of applied public health management curricula components to address identified needs and increase ability to apply those competencies to existing job duties

 Since it is not possible to develop a single, standardized curriculum the APHPMT is tailored to support the very specific job functions and responsibilities of target groups of HIV/AIDS managers at national and local levels in different countries

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Slide 5: DAC Comprehensive Public Health Management & Leadership Training

Speaker Notes:

 The MLG&RD made the Applied Public Health Program Management Training (APHPMT) its own and renamed it the Applied Leadership Development Program for District HIV & AIDS Coordination (ALDP)

 The training was designed using the APHPMT model, but specifically for DACs

Slide 6: DAC Comprehensive Public Health Management & Leadership Training

Speaker Notes:

 Applying the APHPMT model, the following describes the process for developing the ALDP specifically for DACs

 Why do they think MLG&RD decided to prioritize the DAC offices (wait for responses)

 Possible answers include:

o District AIDS Coordinators responsible for planning and coordination of non-clinical HIV activities at the district level

o Roles and responsibilities rapidly become more complex

o Better equip and support DACs and other staff in responding to the dynamic national HIV epidemic and response

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Slide 7: Assessment: Methodology

Speaker Notes:

 This approach focuses on aligning expected skills and behaviors with the mission of the organization. So, let me tell you how we did this

 DACs completed self- assessments; indicating their comfort and capacity to perform the duties outlined in the job description

 DAC supervisors (DMs) and higher level management participated in structure conversations; providing information about the expected roles and responsibilities of the DAC offices

Slide 8: Assessment: Findings

Speaker Notes:  Overall findings from the assessment process: o DAC Offices are functional o Findings in the two assessments are consistent and complementary; DACs and supervisors are in agreement on job functions and expectations o Findings are consistent with MLG expectations o Significant DAC competency needs exist and merit intervention o No training systems are currently addressing these needs in a systematic way  The slide provides a list of the gaps that were identified  Ask the participants if they agree with these competency areas o Are there any competencies that might be missing?

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Slide 9: From Assessment to Development

Speaker Notes:  A Development Workshop was hosted in June 2012 to determine the structure for the ALDP. The following participated in the workshop: o MLG&RD, NACA o CDC o NASTAD  ALDP structure includes: o Comprehensive two week training-at the core of the curriculum and includes several modular continuing education topics, discussed later, that were identified as either a core competency in the role of DACs or a topic for additional capacity building o Orientation Package-(To be developed) the orientation package will provide basic information critical for DACs to understand in order to perform immediate and fundamental tasks of their new positions o Assessment-Formal survey distributed to all active DACs, and key informant interviews. The assessment captured the DACs perceptions understanding of their roles and responsibilities. The interviews provided additional information on the expectations for DACs. The result was the framework for the curriculum o Field Assignments-DACs participating in week 1 training are tasked to complete a field project that combines the knowledge and skills you learned during the classroom-based course and your understanding of the needs of your district. The field projects undertaken by trainees may vary significantly but must demonstrate understanding and use of information/skills covered during the APHPMT training modules. Field assignment reports and presentations are due at the start of the week 2 classroom course work o Mentorship- Mentors have a key role to play supporting participants to successfully develop their APHPMT competencies and successfully accomplish their Field Project and reports on time o Follow-up-monitoring and evaluation to identify outcomes and the application of materials covered during the training. Also, identifying additional training needs and opportunity for further capacity building and support o Refresher Training-Based on identified needs of trainers, past participants and new DACs, offer refresher training to supplement initial training.

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This could be done in person, one-on-one or as a group (nationally, regionally, and locally). It could also be online

Slide 10: ALDP: Pilot Process

Speaker Notes:

 The pilot was implemented between November 2012 and April 2013

Slide 11: Criteria for Success

Speaker Notes:

 Review content on the slide (components of ALDP)

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Slide 12: Technical Working Group

Speaker Notes:  The technical working group was convened to provide feedback and input on the content  They provided relevant materials  Approved all final products

Slide 13: Master Trainers

Speaker Notes:  The Master Trainers were identified by MLG&RD  Skilled trainers  Provided with facilitation and presentation capacity-building exercises

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Slide 14: Evaluation Strategy

Speaker Notes:  Paper and electronic distribution  Lessons-learned: o Better response with paper distribution

Slide 15: Week 1 Sessions

Speaker Notes:

 The following sessions were piloted and determined to be the content, and best order for week 1 by the technical working group

 Ask participants to reflect upon their experience during week 1 o What have they used that they learned? o What were their highlights?

Slide 16: Week 2 Sessions

Speaker Notes:

 The following sessions were piloted and determined to be the content, and best order for week 2 by the technical working group

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Slide 17: Preliminary Evaluation Feedback

Speaker Notes:  Evaluation from the pilot provided useful information to finalize the curriculum  Information obtained during each phase of evaluation has been used to update and modify the content  Review content on the slide

Slide 18: ALDP Participation: Expectations & Evaluations

Pre-Session Preparation:  Prepare a flip chart paper with the Group Agreements listed: o Respectful interactions o Full engagement o Step up/Step back o We are here to help each other o Be open to learn new things and be willing to share your knowledge o All comments are intended to move our knowledge and skills forward o Have FUN!

Speaker Notes:  Full participation includes: o Show up every day ready to be engaged and engage o Be on time o Listen to each other/respect opinions of others

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o Actively share o Respect others as they actively share  Complete evaluations at the beginning and end of the training (give participants time to complete evaluation if they have not done so) o The intent is to collect not only process but outcome evaluation, and to the extent possible impact evaluation o We ask that you complete all the evaluations so that we can continue to use your input and feedback for the development and finalization of the curriculum  Review the Group Agreements listed on flip chart paper  Ask the participants to suggest other agreements, not listed on the flip chart (wait for responses)

Slide 19: Questions or Comments

Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Introduction to Public Health

Expected Session Time: 1.5 hours

Module Content Overview ...... 33 Applied Public Health Program Management Training ...... 33 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 35 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 37 ALDP Facilitator Guide Overview ...... 40 Session Overview ...... 42 Description of Session ...... 42 Materials & Equipment ...... 42 Preparation ...... 42 Pre- and Post- Training Assessments ...... 42 Presenter’s Notes: Introduction to Public Health ...... 43 Appendices ...... 59 Appendix A: Path to Public Health Activity Wall Labels ...... 60 Appendix B: 10 Essential Services Template ...... 64

Applied Leadership Development Program | Introduction to Public 32 Health

Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

Applied Leadership Development Program | Introduction to Public 33 Health

Applied Leadership Development Program | Introduction to Public 34 Health

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

Applied Leadership Development Program | Introduction to Public 35 Health

Applied Leadership Development Program | Introduction to Public 36 Health

Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

Applied Leadership Development Program | Introduction to Public 37 Health

6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives. 3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

Applied Leadership Development Program | Introduction to Public 38 Health

TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

Applied Leadership Development Program | Introduction to Public 39 Health

Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

Applied Leadership Development Program | Introduction to Public 40 Health

Applied Leadership Development Program | Introduction to Public 41 Health

Session Overview

Description of the Session

This 1.5 hour session is designed to introduce participants to the field of public health. The session will: 1) identify the roles DACs play in public health; 2) discuss the difference between public health and medicine; 3) identify the determinants of health; and 4) identify the 10 essential services of public health.

Materials & Equipment

□ Computer □ Flip charts (3)

□ LCD projector □ Markers and pens

□ Facilitator guide □ Note papers

□ Power Point presentation □ Tape or adhesive uploaded to computer and working □ Participant handouts

□ Pre/post-training evaluation □ Sign-in sheet assessments □ Room set-up

Preparation

□ Print and set up Path to Public Health Wall Labels (Appendix A)

□ Prepare flip chart with the 10 essential services (Appendix B)

Pre- and Post- Training Assessments

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Presenter’s Notes: Introduction to Public Health Welcome and In Slide 1: Introduction to Public Health Speaker Notes: If you have not already, take time to…  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course. They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers)  Conduct an icebreaker if needed

Slide 2: Learning Objectives Speaker Notes:  Take a minute to look around the room at your colleagues  As you look around the room, it is important to keep in mind that you all come from varying educational and professional backgrounds and work settings  Based on this fact, this session is designed to introduce you to the field of public health by covering the: o Roles DACs play in public health o Difference between public health and medicine o Determinants of health o 10 essential services of public health.

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Slide 3: Exercise: Path to Public Health

Pre-Session Preparation:  Label each corner of the room with one of the following: Public Health, Social Work, Education, Clinical, Statistical, and Science (Appendix A) Large Group Activity (20 minutes): Activity Instructions:  Inform the participants that you want them to stand in front of the sign that best aligns with their professional background  If your educational or professional background is not represented by one of the signs, please come and stand in the middle of the room  This group will be called “Other”  Ask the participants, what field do you represent? Allow the participants time to move to a sign  Once the participants are in front of a sign, ask them the following questions: By a show of hands, o How many of you believe you are public health professionals? (wait for responses) . If no one raises their hands, ask all the participants to raise their hands . Inform them that you asked them all to raise their hands because everyone in this room is a public health professional . There are many paths into the field of public health as represented in this room . Public Health is a field with a rich multidisciplinary workforce o Ask-How many of you knew you would end up working in public health? (wait for responses) . Formal public health education is not required to work in public health (one of few professions where this is true) . People with varied backgrounds have much to contribute o How many of you believe most people know what public health is and how it impacts their lives? . People typically don’t know what public health is and are only aware of it when an outbreak occurs

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Slide 4: DACs are Public Health Professionals

Speaker Notes:  Despite the fact that we all come from varying disciplines, we still are public health professionals  Health has many facets, with each one dependent on the other  As a result, public health is built upon expertise and skills from many areas, including biology, environmental and earth science, sociology, psychology, government, medicine, statistics, communication, and many others  This complexity makes it difficult for the public at large to understand exactly what public health is and what it does  The work you do as District AIDS Coordinators (DACs) is essential to the field of public health because you help to prevent HIV from occurring and spreading through: o Coordinating/Implementing district programs/activities o Informing policy makers of local issues and strategies o Linking the community to health services o Conducting research

Slide 5: What is Public Health Large Group Discussion:  Ask if someone asked you “what is public health,” how would you describe it? (wait for responses)

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Slide 6: Definition of Public Health

Speaker Notes:  There are many definitions for public health; but in essence public health is the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of: o Society, o Organizations (public and private), o Communities and individuals

Slide 7: Public Health versus Medicine

Speaker Notes:  The fields of public health and medicine overlap, as demonstrated on this slide  The two disciplines must work together to create a healthy community, which will lead to a healthier world  I am sure you all know this first hand because much of the work you do is not possible without the help of community partners, Ministry of Health, etc. Medicine:  Medicine focuses on the best outcome for the individual Public Health:  Public Health is population-based, while medicine is based on the health of the individual  Ideally, public health attempts to prevent the diseases that medicine treats.  However, public health cannot address every risk/problem

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 In order to be successful, public health must focus on areas considered most important and/or where resources might have maximum impact  Later in this training, you will learn some techniques for identifying and prioritizing problems and/or priorities

Slide 8: Determinants of Health Speaker Notes:  The health of an individual and/or a community is based on a combination of different factors

Slide 9: Basic Human Needs Speaker Notes:  Take a moment to think about the basic needs of humans  Ask-What are some of those needs? (wait for responses)  The basic requirements for survival are: o Air – poor quality can cause sickness or death, often in minutes o Water – poor quality or lack of water can cause sickness or death in days o Food –poor quality or lack of food can cause sickness or death in days or weeks o Shelter – must have, at least on a seasonal basis o Care and mutual support – especially around birthing and protecting the new generation

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 All these requirements continue to be essential for individual and group (population) survival and success

Slide 10: 4 Major Determinants of Health Speaker Notes:  In addition to the basic needs of humans, there are four major factors that determine human health  Genetics, behavioral, environmental, and access to health care services make up the four determinants of health  It is the interrelationships among these factors that determine individual and population health  Because of this, interventions that target multiple determinants of health are most likely to be effective  Sectors such as education, housing, transportation, agriculture, and environment can be important allies in improving population health  Botswana clearly understands the importance of allies and taking a collaborative approach to public health. This is demonstrated and described in detail in the National Strategic Framework for HIV & AIDS (NASF II) Biology and Genetics:  We all are made of genes, which are genetically transferred from parents to offspring  Some biological and genetic factors affect specific populations more than others  Sickle cell disease is a common example of a genetic determinant of health. Sickle cell is a condition that people inherit when both parents carry the gene for sickle cell  The gene is most common in people with ancestors from West African countries, Mediterranean countries, South or Central American countries, Caribbean islands, India, and Saudi Arabia Environment:  The environment consists of factors that are outside the human body  For example: o Life support – food, air, water, etc.

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o Physical factors – climate, rain, etc. o Biological factors – toxins, biological waste, etc. o Psycho-social and economic – crowding, income level, location o Chemical factors – industrial wastes, agricultural wastes, air pollution, etc. Health Services:  Both access to health services and the quality of health services can impact health  Lack of access, or limited access, to health services greatly impacts an individual’s health status  For example, when individuals do not have health insurance, they are less likely to participate in preventive care and are more likely to delay medical treatment  Examples of barriers to accessing health services include: o Lack of availability o High cost o Lack of insurance coverage  These barriers to accessing health services lead to: o Unmet health needs o Delays in receiving appropriate care o Inability to get preventive services o Hospitalizations that could have been prevented Life Style (Behavior):  Individual behavior also plays a role in health outcomes  For example, if an individual is practicing safe sex (using condoms), his or her risk of contracting HIV is greatly reduced  Many public health and health care interventions focus on changing individual behaviors such as substance abuse, diet, risky sexual behavior, and physical activity. Positive changes in individual behavior can reduce the rates of chronic disease and HIV/AIDS rates in this country

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Slide 11: Practice of Public Health Speaker Notes:  Because public health is a multidisciplinary field, the public health system is quite complex  It is important to note that although governmental departments of health are at the core of public health, many community organizations contribute to public health too

Slide 12: Three Core Functions of Public Health Speaker Notes:  These three functions are the core functions, how public health serves… the practice of public health o Assessment – collection and analysis of health data o Policy Development – lead/participate in policy development o Assurance – ensure quality services

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Slide 13: 10 Essential Services of Public Health Speaker Notes:  Public health serves communities and individuals within them by providing an array of essential services  Many of these services are invisible to the public  Typically, the public only becomes aware of the need for public health services when a problem develops (e.g., an epidemic occurs)  The practice of public health becomes the list of "essential services"

Slide 14: Exercise: DAC Work and PH Services Pre-Session Preparation:  Prepare a flip chart paper with the 10 sessional services listed in a table format (see Appendix B) Large Group Activity Activity Instructions (10 minutes):  Allow participants to use a pen/marker or small post-it notes for this exercise  Post the pre-prepared flip chart paper on the wall  Ask participants to place a checkmark or post-it note under the 10 essential services that aligns with their work as DACs or is a part of their work  Give the participants 10 minutes to complete this exercise  Let’s explore these services together and see how they align with your work

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Slide 15: Assessment – Monitor Health Speaker Notes:  Monitor health status to identify and solve community health problems  This service includes: o Accurate diagnosis of the community’s health status; o Identification of threats to health and assessment of health service needs; o Timely collection, analysis, and publication of information on access, utilization, costs, and outcomes of personal health services; o Attention to the vital statistics and health status of specific-groups that are at higher risk than the total population; and o Collaboration to manage integrated information systems with private providers and health benefit plans  Ask-Can you give me some examples of how a DAC might monitor health? (wait for responses)  Click to reveal examples of how DACs might monitor health

Slide 16: Assessment – Diagnose and Investigate Speaker Notes:  Diagnose and investigate health problems and health hazards in the community  This service includes: o Epidemiological investigations conducted for disease outbreaks, patterns of infectious and chronic diseases and injuries, environmental hazards, and other health threats; o Public health laboratory capability using modern technology to conduct rapid screening and high volume testing; o Active infectious disease epidemiology programs; and

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o Technical capacity for epidemiologic investigation of disease outbreaks and patterns of chronic disease and injury  Ask-Can you give me some examples of how a DAC might diagnose and investigate? (wait for responses)  Click to reveal examples of how DACs might diagnose and investigate disease

Slide 17: Policy Development – Inform, Educate, and Empower Speaker Notes:  Inform, educate, and empower people about health issues  This service involves: o Social marketing and targeted media public communication to inform the public and/or other relevant stakeholders; o Providing accessible health information resources at community levels; o Active collaboration with personal health care providers to reinforce health promotion messages and programs; and o Joint health education programs with schools, churches, and worksites  Ask-Can you give me some examples of how a DAC might inform, educate, and empower? (wait for responses)  Click to reveal examples of how DACs might inform, educate and empower

Slide 18: Policy Development – Mobilize Community Partnerships Speaker Notes:  Mobilize community partnerships and action to identify and solve health problems  This service involves: o Convening and facilitating community groups and associations, including those not typically considered to be

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health-related, in undertaking defined preventive, screening, rehabilitation, and support programs; and o Skilled coalition-building ability in order to draw upon the full range of potential human and material resources in the cause of community health  Ask-Can you give me some examples of how a DAC might mobilize community partnerships? (wait for responses)  Click to reveal examples of how DACs might mobilize community partnerships

Slide 19: Policy Development – Develop Policies Speaker Notes:  Develop policies and plans that support individual and community health efforts  This service requires: o Leadership development at all levels of public health; o Systematic community- level and state-level planning for health improvement in all jurisdictions; development and tracking of measurable health objectives as a part of continuous quality improvement strategies; o Joint evaluation with the medical health care system to define consistent policy regarding prevention and treatment services; and o Development of codes, regulations and legislation to guide the practice of public health  Ask-Can you give me some examples of how a DAC might develop policies? (wait for responses)  Click to reveal examples of how DACs might develop or influence health policies

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Slide 20: Assurance – Enforce Laws Speaker Notes:  Enforce laws and regulations that protect health and ensure safety  This service involves: o Full enforcement of sanitary codes, especially in the food industry; o Full protection of drinking water supplies; o Enforcement of clean air standards; o Timely follow-up of hazards, preventable injuries, and exposure-related diseases identified in occupational and community settings; o Monitoring quality of medical services (e.g. laboratory, nursing homes, and home health care); and o Timely review of new drug, biologic, and medical device applications  Ask-Can you give me some examples of how a DAC might enforce laws? (wait for responses)  Click to reveal examples of how DACs might participate in the enforcement of laws

Slide 21: Assurance – Link to and Provide Care Speaker Notes:  Link people to needed personal health services and assure the provision of health care when otherwise unavailable  This service (often referred to as "outreach" or "enabling" services) includes: o Assuring effective entry for socially disadvantaged people into a coordinated system of clinical care; o Culturally and linguistically appropriate materials and staff to assure linkage to services for special population groups;

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o Ongoing "care management"; o Transportation services; o Targeted health information to high risk population groups; and o Technical assistance for effective worksite health promotion/disease prevention programs  Ask-Can you give me some examples of how a DAC might link to and provide care? (wait for responses)  Click to reveal examples of how DACs might link to and provide care for individuals and communities in need

Slide 22: Assurance – Assurance a Competent Workforce Speaker Notes:  Assure a competent public and personal health care workforce  This service includes: o Education and training for personnel to meet the needs for public and personal health service; o Efficient processes for licensure of professionals and certification of facilities with regular verification and inspection follow-up; o Adoption of continuous quality improvement and life-long learning within all licensure and certification programs; o Active partnerships with professional training programs to assure community-relevant learning experiences for all students; and o Continuing education in management and leadership development programs for those charged with administrative/executive roles  Ask-Can you give me some examples of how a DAC might ensure a competent public and personal health care workforce? (wait for responses)  Click to reveal examples of how DACs might help to ensure a competent public and personal health care workforce

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Slide 23: Assurance – Evaluate Speaker Notes:  Evaluate effectiveness, accessibility, and quality of personal and population- based health services  This service includes: o Ongoing evaluation of health programs based on analysis of health status and service utilization data, o Assess program effectiveness and o Provide information necessary for allocating resources and reshaping programs  Ask-Can you give me some examples of how a DAC might evaluate? (wait for responses)  Click to reveal examples of how DACs might evaluate

Slide 24: Assurance – Research Speaker Notes:  Research for new insights and innovative solutions to health problems  This service includes: o Continuous linkage with appropriate institutions of higher learning and research and an internal capacity to mount timely epidemiologic and economic analyses and o Conduct needed health services research  Ask-Can you give me some examples of how a DAC might research? (wait for responses)  Click to reveal examples of how DACs might contribute to research

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Slide 25: Session Highlights Speaker Notes:  As we bring this session to a close, let’s do a quick recap of what we covered  We discussed how the fields of public and medicine overlap. However, public health focuses on the public, while medicine is driven by the care of the individual  We also talked about how health is determined by four areas: Genetics, Environment, Life Style (Behavior), and Health Care Services  I hope you walk away from this session knowing that the work you do as DACs is vital to the practice of public health  We spent some time identifying the 10 essential services of public health and how they align with your work

Slide 26: Questions and Comments Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix A: Path to Public Health Wall Labels

Appendix B: 10 Essential Services Template

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Appendix A: Path to Public Health Wall Labels

Public Health

Education

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Clinical

Social Work

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Statistical

Science

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Social Work

Other

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Appendix B: 10 Essential Services Template

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

HIV in Botswana

Expected Session Time: 2.5 hours

Module Content Overview ...... 66 Applied Public Health Program Management Training ...... 66 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 68 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 70 ALDP Facilitator Guide Overview ...... 73 Session Overview ...... 75 Description of Session ...... 75 Materials & Equipment ...... 75 Pre- and Post- Training Assessments ...... 75 Presenter’s Notes: HIV in Botswana ...... 76

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

Applied Leadership Development Program | HIV in Botswana 66

Applied Leadership Development Program | HIV in Botswana 67

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program | HIV in Botswana 69

Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives. 3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

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TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

Applied Leadership Development Program | HIV in Botswana 73

Applied Leadership Development Program | HIV in Botswana 74

Session Overview

Description of the Session

This 2.5 hour course is designed to provide participants with up-to-date information on HIV, specifically HIV in Botswana. The course will cover 1) the natural progression and life cycle of HIV; 2) Botswana’s epidemiological data and national strategies for combating HIV/AIDS; 3) factors contributing to the spread of HIV; and 4) concepts and components of an “AIDS Free Generation”.

Materials & Equipment

□ Computer □ Flip charts (3)

□ LCD projector □ Markers and pens

□ Facilitator guide □ Note papers

□ Power Point presentation □ Tape or adhesive uploaded to computer and working

□ Pre/post-training evaluation □ Participant handouts assessments

□ Sign-in sheet □ Room set-up

Pre- and Post- Training Assessments

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Presenter’s Notes: HIV in Botswana

Slide 1: HIV in Botswana

Slide 2: Learning Objectives

Speaker Notes: This session is designed to provide you with statistical data on the HIV epidemic in Botswana and introduce the components of an AIDS Free Generation  We will: o Review the natural progression and life cycle of HIV o Review Botswana’s epidemiological data and national strategies for combating HIV/AIDS o Identify factors contributing to the spread of HIV o Identify concepts and components of an “AIDS Free Generation”

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Slide 3: HIV Review

Speaker Notes:  We are going to take some time to do a quick review of HIV  If you are a DAC who has substantial experience in your position, please bear with us during the next few slides as we may cover information you already know

Slide 4: Human Immunodeficiency Virus (HIV)

Speaker Notes:  Ask-What can you all tell me about HIV? (wait for responses)  Click the mouse once to reveal answers  Human Immunodeficiency Virus (HIV): o A virus that causes AIDS o Invades the CD4 cells in the body (defense mechanism of a person) o Limits the body’s ability to fight infection o Predisposes an HIV-positive person to multiple opportunistic infections o Preventable, manageable but not curable

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Slide 5: HIV Life Cycle

Speaker Notes:  As the DAC in your district, I am sure people are expecting you to know any and everything about HIV and how it affects the body  This slide provides a quick look at how HIV invades the body in order to replicate and multiple A. HIV (red) attaches to cell-surface receptors (the CD4 antigen and a specific chemokine receptor) B. The virus and cell membrane fuse, and the virion (virus particles) core enters the cell C. The viral RNA and core proteins are released from the virion (virus particles) core and are then actively transported to the nucleus D. The viral RNA genome is converted into double-stranded DNA through an enzyme unique to viruses, reverse transcriptase (red dot) E. The double-stranded viral DNA moves into the cell nucleus F. Using a unique viral enzyme called integrase, the viral DNA is integrated into the cellular DNA

Slide 6: HIV Life Cycle

Speaker Notes: A. Viral RNA is synthesized by the cellular enzyme RNA polymerase II using integrated viral DNA as a template. Two types of RNA transcripts shorter spliced RNA (H) and full-length genomic RNA (J) are produced B. Shorter spliced RNAs are transported to the cytoplasm and used for the production of several viral proteins that are then modified in the Golgi apparatus of the cell (I)

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C. Full-length genomic RNAs are transported to the cytoplasm (K) D. New virion (virus particles) is assembled and then buds off E. Mature virus is released

Slide 7: Natural Progression of HIV in the Body

Speaker Notes:  Ask-Can someone tell me what this slide is telling you? (wait for responses)  In essence, this slide is showing: o HIV can be transmitted throughout the life of the disease o As the CD4+ cells weaken, the virus progresses overtime o Body is susceptible to opportunistic infections

Slide 8: Viral Load

Speaker Notes:  Ask-What is this graphic showing? (wait for responses)  This graphic shows how the body is unable to destroy the virus at the same rate it is replicating o More viruses replicated and fewer destroyed  The severity of the disease is determined by the amount of virus in the body (increasing viral load) and the degree of immune suppression (decreasing CD4+ counts)  A higher the viral load means the sooner immune suppression will occur

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Slide 9: Global Snapshot of HIV/AIDS

Speaker Notes:  Let’s look at the global statistics on HIV and AIDS

Slide 10: 2011 Estimation: Adults and Children Living with HIV

Speaker Notes:  As of 2011, there are 33 million people (adults and children) living with HIV

Slide 11: Treatment Gap in Low/Middle Income Countries

Speaker Notes:  This chart shows the gap in 2011 between the number of people receiving antiretroviral therapy and the number of people eligible for treatment  People receiving HIV treatment (000 000) ∕

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People eligible for HIV treatment (000 000)  For the first time (in 2011), majority (54%) of the people eligible for antiretroviral therapy in low- and middle-income countries received it  But as you can see, there is still much to do in ensuring people are receiving antiretroviral therapy Source: UNAIDS 2012 Global Report

Slide 12: Botswana HIV Epidemic

Speaker Notes:  Now let’s look at how HIV is affecting Botswana  Keep in mind, data is essential to the coordination of district response activities  We collect data to help us understand the epidemiology of a disease  Ask-What is epidemiology? (wait for responses)  Click the mouse once to reveal the answer  Epidemiology is the study of causes, distribution and control of health and disease in a population  In essence, epidemiology looks at o WHAT the disease is (i.e., collecting information to describe the PROBLEM/disease), o WHO gets the disease (i.e., collecting information to describe the PERSON impacted), o WHERE is the disease is (i.e., collecting information related to the PLACE of the disease), o WHEN the disease is (i.e., is the data describing a trend over TIME, or an instance in time?)  As we go through the data, I want you to think about how this data can be used to coordinate district activities

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Slide 13: Botswana 2011: Estimated HIV Prevalence

Speaker Notes:  Here is the prevalence rate for Botswana in 2011  Ask-Before we look at the numbers, can you tell me what prevalence means? (wait for responses)  Click the mouse once to reveal answer  Prevalence is the number of cases (old and new) of a specific disease present in a given population at a certain time  The high prevalence of HIV/AIDS in Botswana threatens the many developmental gains we have achieved since our independence in 1966  Despite encouraging economic growth, political stability, a rise in life expectancy, the HIV prevalence rate among adults ages 15 to 49 is 23.4 percent - the second highest in the world

Slide 14: HIV Prevalence by Geographic Location

Speaker Notes:  Here is our prevalence data by geographic location  Ask-What is it telling you? (wait for responses)  As you can see, HIV prevalence varies by geographic locations (such as: districts and rural-urban areas)  Bobirwa and Selibe Phikwe recorded the highest HIV prevalence rates at 41.8% and 41.2%  The southeast recorded the lowest HIV prevalence rate at 15.8%  “The 2008 BAIS III results indicate geographic differentials by urban rural HIV prevalence where HIV prevalence was 17.9 % in urban areas compared to 17.1% in rural areas”  2011 surveillance data show a similar difference in HIV prevalence by district

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 Ask-How can this data be helpful in coordinating response activities? (wait for responses) Source: Progress Report of the National Response to the 2011 Declaration of Commitments on HIV and AIDS 2012

Slide 15: HIV Prevalence by Marital Status

Speaker Notes:  Ask-What is this slide telling you about prevalence by marital status? (wait for responses)  Women who reported living with their partner had the highest HIV prevalence at 35.5%  The lowest prevalence was among married women at 26.2% and women reporting that they were single had an HIV prevalence of 30.1%  Ask-How can this data be helpful in coordinating response activities? (wait for responses) Source: Progress Report of the National Response to the 2011 Declaration of Commitments on HIV and AIDS 2012

Slide 16: HIV Prevalence among Pregnant Women

Speaker Notes:  Ask-What is this slide telling you about prevalence among pregnant women? (wait for responses)  This shows that over the years, HIV prevalence among pregnant women aged 15-49 years attending antenatal clinic has been declining.  It declined from 37.4% in 2003 to 30.4% in 2011.

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Slide 17: HIV Prevalence by Occupation

Speaker Notes:  Ask-What is this slide telling you about prevalence by occupation? (wait for responses)  This slide shows that laborers had the highest HIV prevalence at 43.9%.  While students showed the lowest prevalence at 12.7%.  Ask-How can this data be helpful in coordinating response activities? (wait for responses) Source: Progress Report of the National Response to the 2011 Declaration of Commitments on HIV and AIDS 2012

Slide 18: HIV Prevalence by Education

Speaker Notes:  Ask-What is this slide telling you about prevalence by education? (wait for responses)  According to the 2011 Sentinel Surveillance results, women with primary education have the highest HIV prevalence at 44.6%, while women with university education have the lowest prevalence estimated at 17%.  Ask-How can this data be helpful in coordinating response activities? (wait for responses) Source: Progress Report of the National Response to the 2011 Declaration of Commitments on HIV and AIDS 2012

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Slide 19: Botswana Achievements

Speaker Notes:  Over the years, Botswana has progressed greatly in addressing HIV and AIDS.  Let’s take some time and look at some of those successes.

Slide 20: Sustained Progress

Speaker Notes:  The rate of new HIV infections has dropped by 71% among adults (15-49 years) between 2001 and 2011.  Click mouse once to reveal next statistics.  The number of people dying from AIDS-related causes was cut by 71% in between 2005 and 2011.

Slide 21: Sustained Progress, cont.

Speaker Notes:  Currently, Botswana is extremely successful in preventing mother to child transmission.  We use what is known as the Plan B approach and most recent figures on its success were released by

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UNAIDS at the 2012 conference.  However, note that there is still room for improvement in the area of treatment while breast feeding.

Slide 22: HIV Incidence Estimates and Trends

Speaker Notes:  Here is the HIV incidence among pregnant women between 2007 and 2011.  Ask-What does the term incidence mean? (wait for responses)  Incidence refers to the number of new cases per population in a given time period.  Here it shows a declining trend in HIV incidence among pregnant women between 2007 and 2011.

Slide 23: Botswana: Factors Influencing the Spread of HIV

Speaker Notes:  In order to continue the success that we just covered, we have to identify the factors that contribute to the spread of HIV.

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Slide 24: Five Key Drivers of HIV

Speaker Notes:  There are five key factors contributing to the spread of HIV in Botswana.  Remember earlier, we spoke about how important data is to making decisions.  Data is the foundation for determining the causes of diseases and the best methods used to address them.  The National Strategic Framework (NSF) is a great resource because it is a compilation of information gathered from the districts about HIV and AIDS.  Specifically, the National Strategic Framework 2011-2016 (NSF II) identified five key drivers of the epidemic that still present major obstacles to preventing new HIV infections.  Ask-Can you name them? (wait for responses)  Click the mouse to reveal first answer.  Multiple and Concurrent Sexual Partnerships: o In the BAIS III, males (21%) reported having sex with more than one sexual partner (multiple partnerships) in the 12 months preceding the survey compared to females (2.3%). o Click the mouse to reveal next answer.  Adolescent and Intergeneration Sex: o A 2006 study revealed that about 55% of the total population was initiated to sexual intercourse by age 19 and around 8% have had sex by age 15. o Adolescent girls have been identified as more at risk of HIV infection than boys; due to early exposure to older men with longer sexual history. o This fact brings into play intergenerational sexual intercourse as a significant factor in hopes of monetary gain and the material support that they receive from their older sexual partners. o Click the mouse to reveal next answer.  Alcohol and High-Risk Sex: o The consumption of alcohol has been identified to be associated with several risks, including that of contracting HIV.

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o The misuse of alcohol and other recreational drugs have been consistently correlated with a number of social and health-related problems such as gender violence, risky sexual behaviors and non-adherence to treatment for AIDS and TB for both men and women. o Click the mouse to reveal next answer.  Stigma and Discrimination: o The fear of being identified as HIV-positive prevents people from learning their status, changing unsafe sexual behaviors, etc. o Stigma and discrimination severely restricts access to and utilization of relevant services and products, thereby increasing the risk and vulnerability to HIV infection. o Click the mouse to reveal next answer.  Gender Violence and Sexual Abuse: o The position of women in society, especially adolescent girls, is one of the drivers of the AIDS epidemic. o In some cases/places, women generally tend to possess little power over their own bodies. o They are put at risk of HIV infection by a combination of the social acceptance of male partners having more than one sexual relationship, inability to negotiate condom use and sexual exploitation, especially the younger girls. o Botswana provides alarming statistics on the prevalence of gender based violence (GBV). o Almost 70% of women interviewed had experienced GBV at least once in their lifetime.

Slide 25: Multiple and Concurrent Partnerships

Speaker Notes:  There are two parts to why MCP are a problem for HIV transmission:  Click the mouse once to reveal answer. o Dense Sexual Networks  Click the mouse once to reveal answer: Viremia

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Slide 26: Sexual Networks

Speaker Notes:  Sexual networks are groups of persons who are connected to one another sexually.  The number of persons in a network, how central high- risk persons are within it, the percentage in monogamous relationships and the number of “links” each has to others all determine how quickly HIV/STDs can spread through a network.  In these figures, it is important to understand that the networks are pictured at one point in time.  These are ongoing partnerships that people have with more than one person. (i.e., they are concurrent partnerships).  In figure 2-1, we see a network in which about half the people have more than one sexual partner, however all but two of them are linked to each other (this is a dense sexual network).  In the second network each person has only one partner and so they are not linked to anybody but that partner.

Slide 27: What Contributes to Dense Networks?

Speaker Notes:  Ask-What contributes to dense sexual networks? (wait for responses)  Click the mouse once to reveal answer. o Mobility and physical separation (village, cattle post, lands) o One night stands o Having “small houses” o Material gain, survival sex, sugar daddies o Stigma and taboo prevents open discussion with youth

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Slide 28: Viremia – Presence of Virus in the Blood

Speaker Notes:  Now let’s talk about viremia.  Ask-does anyone know what viremia is? (wait for response)  Viremia means “the presence of virus in the bloodstream”.  The more HIV you have in your bloodstream the more likely it is that you can transmit it to someone else.  As you can see from this slide, the amount of the virus in the bloodstream changes over time.  It is most present in the first weeks after infection.  The time when someone is least likely to know that they have been infected, because standard HIV tests look for antibody to the virus (not the virus itself), and it takes time for antibodies to be produced by the body.  At the time that you are infected with the virus, the virus replicates very fast, so you have high levels of virus in your bloodstream (you are very viremic).  After a while your immune system kicks in and tries to fight off the virus, and the levels of virus decrease in your bloodstream.  Depending on how well you take care of yourself, this low viremic state can last for years.  However, your immune system cannot eliminate the virus, and, because HIV specifically attacks the immune system, eventually the immune system begins to fail, the level of the virus increases again, and you progress to AIDS.

Slide 29: Viremia + Sexual Networks

Speaker Notes:  So what happens when we combine dense sexual networks, with viremia?  The bright red squares show HIV positive viremic males (i.e., men who have recently been infected by HIV).

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 The bright red circles show HIV positive viremic females.  The blue figures show HIV negative men and women.  The grey figures show HIV positive non-viremic people.  From the top left hand corner, there is only one recently infected HIV positive person.  As we continue from network to network, we see the number of HIV-positive people increase.  Ask-What would happen if these relationships were not concurrent, but instead were sequential? (wait for responses)

Slide 30: Viremia + Sexual Networks, cont.

Speaker Notes:  This is what happens in a de-linked network.  This de-linked network does not mean that people do not have more than one partner – but that the partners are spread out over time (serial monogamy, or non- concurrent partnerships).  Starting in the top left corner, again we have one recently infected HIV positive person.  In May two HIV infected people initiate new sexual relationship; but because they are no longer viremic, the likelihood of transmission is reduced (only one person is infected, and it takes several months for that person to become infected).  Compared to the previous slide, the number of HIV positive people remains low.

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Slide 31: Working Towards an AIDS Free Generation

Speaker Notes:  Collectively, countries across the world have taken a pledge to work towards an AIDS free generation.  You may be asking, what does that mean?

Slide 32: AIDS Free Generation

Speaker Notes:  An AIDS Free Generation looks like a world with dignity, free from stigma and discrimination, where leaders commit to and follow through on actions that result in the end of new HIV infections and a healthier global community.

Slide 33: Strategies for AIDS Free Generation

Speaker Notes:  Recent scientific advances have proven that using existing HIV prevention tools can dramatically drive down the rate of new infections and virtually eliminate them in babies and children.

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 Click the mouse once to reveal answer.  This “combination prevention” strategy consists of three key interventions: o Scaling up treatment of HIV-positive persons o Preventing mother-to-child transmission o Expanding voluntary medical male circumcision  When used in combination with each other, along with condoms and other prevention tools, these interventions put us on a plausible path for eliminating new infections among children.

Slide 34: Botswana: Strategies to Combat HIV/AIDS

Speaker Notes:  Again, this is where the NSF and other guiding documents can be helpful in knowing the country’s strategies for combating HIV/AIDS.

Slide 35: Scaling-Up Treatment

Speaker Notes:  Recent science has shown that when people are HIV positive, treatment with antiretroviral drugs helps prevent the transmission of the HIV virus to others.  Effective treatment of a person living with HIV reduces the risk of transmission to a partner by up to 96%, a success rate similar to that of a vaccine.  Currently Botswana has a very effective ART program, providing life-long treatment to every HIV positive person with a CD4 count of 350 or less.

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 But changes in guidelines require support for an additional 22,000 people per year.  This will require a Test and Treat approach (i.e., treating everyone as soon as they test positive for HIV, regardless of their CD4 count).  Total infections in Botswana are calculated at between 300,000 and 350,000.

Slide 36: Preventing Mother-to-Child Transmission

Speaker Notes:  An HIV-positive mother is at risk of transmitting the HIV virus to her child during pregnancy, labor, delivery, or breastfeeding.  Identifying and treating HIV-positive pregnant women with antiretroviral drugs is very effective in eliminating new pediatric infections.  This approach is also critical for saving the lives of mothers and preventing other children in the family from being orphaned.  Currently, Botswana is extremely successful in preventing mother to child transmission.  Botswana uses what is known as the Plan B approach and most recent figures on its success were released by UNAIDS at the 2012 conference  To improve our rates, a test and treat policy would need to include what is known as Plan B+ for pregnant women.  This means that all HIV positive pregnant women receive ART for life, continuing after their pregnancy, regardless of CD4 count.

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Slide 37: Safe Male Circumcision

Speaker Notes:  Randomized controlled trials show that male circumcision reduces the risk of heterosexually acquired HIV by about 60%.  Since the male circumcision is only effective in reducing heterosexually transmitted HIV by 60%, a comprehensive prevention package must also be made available.  It is also important to note that circumcised men are still at risk for acquiring HIV during every sexual encounter.

Slide 38: Session Highlights

Speaker Notes:  As we bring this session to a close, let’s do a quick recap on what we covered.  We reviewed the natural progression and life cycle of HIV.  We talked a lot about the current state of HIV in Botswana.  All of the information provided in the NSF and other national documents are collected from the district and used to form strategies and communicate challenges.  The NSF also provided information on the five contributing factors to the spread of HIV in Botswana:  They are: o Multiple and Concurrent Sexual Partnerships o Adolescent and Intergeneration Sex o Alcohol and High-Risk Sex o Stigma and Discrimination

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o Gender Violence and Sexual Abuse  Much of the concepts and components that lead to an AIDS Free Generation is being implemented in Botswana, including: o Scaling up treatment of HIV-positive persons o Preventing mother-to-child transmission o Expanding voluntary medical male circumcision

Slide 39: Questions or Comments

Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Implementing National Strategies and Policies

Expected Session Time: 3.5 hours

Module Content Overview ...... 98 Applied Public Health Program Management Training ...... 98 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 100 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 102 ALDP Facilitator Guide Overview ...... 105 Session Overview ...... 107 Description of Session ...... 107 Materials & Equipment ...... 107 Preparation ...... 107 Pre- and Post- Training Assessments ...... 107 Presenter’s Notes: Implementing National Strategies and Policies ...... 108 Appendices ...... 127 Appendix C: Sample District Plan ...... 128 Appendix D: Fishbone Diagram ...... 138 Appendix E: ALDP Case Study and Instructions ...... 139

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

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Applied Leadership Development Program | Implementing National 99 Strategies and Policies

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program | Implementing National 101 Strategies and Policies

Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives. 3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

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TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Session Overview

Description of the Session

This 3.5 hour course is designed to equip participants with the skills and tools needed to implement national strategies and policies. The course will require participants to: 1) translate national strategies and policies into district/sub-district response activities; 2) identify the roles of the DAC, DMSAC, CSOs and other district implementing partners/stakeholders in implementing national policies; and 3) identify factors that impact the implementation of national policies at the district level.

Materials & Equipment

□ Computer □ Flip charts (3)

□ LCD projector □ Markers and pens

□ Facilitator guide □ Note papers

□ Power Point presentation uploaded to □ Tape or adhesive computer and working

□ Pre/post-training evaluation □ Participant handouts assessments

□ Sign-in sheet □ Room set-up

Preparation

□ On a flipchart, draw the head of a fish (Appendix D)

□ Have the district plan available (Appendix C)

□ Make copies of the ALDP Case Study and Instructions for each group (Appendix E)

Pre- and Post- Training Assessments

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Presenter’s Notes: Implementing National Strategies and Policies for HIV and AIDS

Slide 1: Implementing National Strategies & Policies for HIV & AIDS

Slide 2: Learning Objectives Speaker Notes:  When you think about the work that you do on a day- to-day basis, it is important for you to realize how much your work impacts the national strategies/policies, which in turn impacts the HIV and AIDS epidemic in Botswana  Based on the importance of your work and the results from the DACs needs assessment, the objectives for this course are to: o Translate national strategies and policies into district/sub-district response activities

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o Identify the roles of the DAC, DMSAC, CSOs and other district implementing partners/stakeholders in implementing national policies o Identify factors that impact the implementation of national policies at the district level

Slide 3: Botswana National Strategic Framework II for HIV and AIDS Speaker Notes:  In order to implement the national strategies and policies at a district level, we must first have a clear understanding of the National Strategic Framework

Slide 4: Botswana National Strategic Framework II for HIV and AIDS Speaker Notes:  It is amazing to think about how much things have changed in relation to HIV/AIDS. When it was first discovered, limited policies and strategies were in place to address the awareness, spread, treatment and prevention of the disease  However over time, great strides have been made to eliminate the incidence of HIV and reduce the impact of AIDS  Ask what current policy and/or strategy documents exist in Botswana that provide guidance and structure for the national and district response to HIV and AIDS (wait for a response)  Click to reveal table with policy and strategy documents  Specifically in Botswana, policies and/or strategies for addressing the HIV/AIDS epidemic are outlined in:

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o National Strategic Framework (NSF) II o National Development Plan o HIV/AIDS Policies o Community Mobilization Strategy o DMSAC & VMSAC/WMSAC Terms of Reference o DMSAC Communication Strategy o CSO Capacity Building Strategy o Workplace & Wellness Strategy o Faith-Based Strategy o District Plans o Etc.  As you can see (point to the list of documents you just mentioned), much of the work we do in public health is guided by different policies and strategies

Slide 5: Botswana Strategic Framework II for HIV and AIDS Large Group Discussion:  Ask-Why is it important to have these policies and strategies (specifically the National Strategic Framework)? (wait for response)

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Slide 6: Purpose of the NSF Speaker Notes:  The National Strategic Framework serves two purposes: 1. To articulate, disseminate, and educate the public on agreed national priorities and strategies 2. To provide clear guidance to Ministries, districts, NGOs, and the private sectors on working collaboratively toward achieving the intended goals  In essence, the National Strategic Framework is a road map for addressing HIV/AIDS

Slide 7: Translating National Strategies and Policies Speaker Notes:  As DACs, it is important that you translate the framework in a way that articulates the vision, goals and expected outcomes for the nation’s HIV/AIDS response activities

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Slide 8: Steps for Translating National Strategies into Action Speaker Notes:  You may be asking yourself, how do I go about translating the national strategies and polies into action?  As coordinators, you are part of a district team that is responsible for planning and implementing activities that will effectively address HIV/AIDS at the district/local level  It is essential that you know the process for translating strategies into successful results and communicating it to your implementing partners  Click to reveal the stepped process for translating strategies into results.  They are: o Articulate the goal o Apply the priorities o Clarify the roles and responsibilities o Know the strategies in order to align them to district activities o Link district response activities to national strategies

Slide 9: Articulating the Goal Speaker Notes:  The overall goal for Botswana’s national response to HIV and AIDS is the “Prevention of New HIV Infection by 2016”  Click to reveal the NSF goal.  Imagine if we did not have a goal for combating HIV and AIDS  Ask-Where would we be in reducing the rates of new infections or providing treatment and care for those living with AIDS? (wait for response)

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 Ideally, it would be similar to us sailing a ship across the Atlantic Ocean without a map  Goals, like maps, help us get from one place to another (our destination) much faster and more efficiently. Without maps (or goals) we would be sailing aimlessly around the world hoping to reach our destination

Slide 10: Articulating the Goal, cont. Speaker Notes:  Knowing the goal outlined in the NSF, allows us to… o Give clarity on the end vision (what we ultimately want); o Provide focus on what we are trying to achieve; o Improve collaboration amongst ministries, districts and communities; and o Monitor and evaluate the impact of the work

Slide 11: Applying the Priorities Speaker Notes:  Prioritization is a method of ranking or putting things in order of importance  Please keep in mind that priorities will change based on the needs and/or strategic direction of the program/intervention  Ask-What are some ways you can stay abreast of changing mandates/guidelines/policies? (wait for responses)  Click to reveal possible answers: o Seek the information o Familiarize yourself with the changes o Learn the purpose behind the document and/or changes o Determine your role

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Slide 12: National Strategic Framework Priorities Speaker Notes:  For example, the NSF II has four priority areas (as shown on the screen)  These four priority areas can change or remain the same once the NSF III is released Large Group Activity: (5 minutes) Activity Instructions:  Inform the participants that you are going to read each priority area description aloud and you want them to tell you which priority area it describes  After the participants provide an answer for each description  Click to reveal the correct answer Answers:  Priority Area 1: Preventing New Infections o The focus of this priority area is to reduce the incidence of sexual transmission of HIV among females and males aged 10-49 years.  Priority Area 2: Systems Strengthening o The focus of this priority area is to strengthen health and community systems for improved provision of and access to HIV and AIDS services by building the capacity of institutions, structures, and creation of an enabling policy and legal environment  Priority Area 3: Strategic Information Management o The focus of this priority area is to strengthen the information management system of the national response to enhance information sharing and utilization for evidence based planning  Priority Area 4: Scaling Up Treatment, Care and Support o The focus of this priority area is to increase access to HIV/AIDS comprehensive quality treatment care and support services. These services include: integrated HIV/TB/SRH services, adolescent HIV and AIDS services, universal HAART, CHBC services and OVC programmes Speaker Notes:  These priorities are based on data that was accumulated locally  So much of the information you gather at the district level from stakeholders, implementing partners, and community members drives much of the focus for Botswana’s national response

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Slide 13: Clarifying the Roles and Responsibilities Speaker Notes:  Another important step in translating national strategies/polices is clarifying the roles, responsibilities, and authority of those involved  Knowing the roles and responsibilities that you and others play is essential to success  Click to reveal five key roles necessary for successful change  Click again to reveal the descriptions of the roles  They include the roles of: o Development Partners or Sponsors: . Direct authority over the individuals/organizations who will implement the action or change; and . Clear vision, identified goals and measurable outcomes for the change initiative; o Resource Providers: . Access to and/or control over the resources (money, time and people) needed to implement action or change o Implementers: . Authority to implement the change (and often are also expected to change something about the way they are doing their work); . Inform sponsors with information about issues that might block or impede success – thereby providing essential feedback; . Seek and requests necessary resources that leverage and reinforce success o Change Agents: . Work with both the sponsor and the implementers but does not take on their roles (e.g. functions as a Consultant or Coach); . Can be internal or external to the organizations; . Is focused on helping the sponsor and implementers stay aligned with each other may act in a number of roles - data gatherer, educator, advisor, facilitator or coach in order to aid sponsors and implementers in achieving success;

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. Has no direct-line of authority over the Implementers o Advocates: . Publicly support or recommend a specific cause and/or program

Slide 14: Exercise: Name that Partner Pre-session Preparation:  Write on separate sheets of flip chart paper the responsibilities of each of the following 7 partners; NAC, NACA, MLG&RD, DMSAC, MOH, private sector and civil society (descriptions for each included with instructions)  Post the flip chart papers around the room  Have post-in notes and markers available Speaker Notes:  At the national level, there are 19 different organizations, agencies, etc. outlined in the NSF that are involved in the fight against HIV and AIDS  Because there are so many entities involved, it is essential that everyone has a clear understanding of each other’s roles and responsibilities  Ask the participants to name the different national partners (wait for response)  For the purposes of this training, we will only focus on 7 of the 19 partners based on your direct involvement with them  Let’s take a moment to identify some of the key partners at the national level and the roles they play Small Group Activity Activity Instructions (15 minutes):  Inform the participants that you are going to break them up into pairs. Give each pair post-it notes and markers  Ask the groups to write the names of the coordinating partners on the post-in notes and post them on the flip chart with the corresponding description  Then ask the groups to identify partners by their role in the national response (i.e., supporter, implementer, resource provider, change agent, advocate). Put their responses on post-in notes and affix to the appropriate flip chart paper

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 Allow the participants 15 minutes to complete the exercise. Once time is up, ask each pair to explain their selection  Below is the answer key for this exercise Speaker Notes:  Each pair will be responsible for doing the following: o Naming the partner (i.e. NACA, DMSAC, etc.) on the flip chart o Clarifying their role (i.e. sponsor, implementer, etc.) using post-it notes o Explaining why the identified partners was given each role Answers:  National AIDS Council (NAC): o Highest coordinating body with overall authority in the National Response o Articulate the national priorities that are to be addressed o Assure accountability of stakeholders for performance and progress o Receive and appraise quarterly progress reports from the monitoring of the joint operational plan  National AIDS Coordinating Agency (NACA): o Serve as Secretariat to the National AIDS Council o Oversee the day-to-day management of the implementation of the NSFII o Oversee the development of the National Operational Plan o Oversee financial monitoring, mobilize alternative resources and make recommendations on appropriate allocations per priority o Manage the multi-sectoral Joint Planning and Review process  District Multi-Sectoral AIDS Committees (DMSACs): o Coordinate all responses at the local level o Manage the planning and implementation of local initiatives and integrating vertical, sector-based plans into the national priorities o Manage local participation in a peer review mechanisms to assist with the development and review of the Joint National Operational Plan o Facilitate the mobilization of local level structures and groups across sectors for implementation of the national response o Monitor programme and policy implementation and financial utilization at the district level and ensure quality of data collection and processing at the local level  Ministry of Health (MOH):

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o Manage and implements many of the major clinical/biomedical programmes o Ensure the health sector is optimized so as to maximize the impact of the national response and other specific roles and responsibilities as outlined in the National Operational Plan o Develop and strengthen guidelines and protocols for service outreach and mobile services for key health sector activities o Strengthen monitoring, surveillance, clinical trials and health research activities o Strengthen the Ministry’s leadership role in the advocacy for and the development of HIV and AIDS related policy and legislation  Ministry of Local Government & Rural Health(MLG&RD): o Share responsibility with the MOH to link the central and local levels of the national response and manages the Orphan Care and the Community Home Based Care programmes o Identify and mobilize community structures in support of HIV and AIDS planning and programme implementation o Coordinate local level knowledge management and information dissemination o Strengthen the role of the DMSAC and the office of the DAC  Private Sector: o Responded to HIV and AIDS epidemic through implementation of the Minimum Implementation Package (MIP) o Undertake mainstreaming of HIV/AIDS into the internal and external domains of private sector enterprises and, through partnerships and experience sharing, in the public sector as well o Utilize private sector products, logistical networks, and advertising channels to support implementation of HIV and AIDS plans o Support the national monitoring and evaluation system by supplying private sector tools information and sharing best practices  Civil Society: o Play an increasingly important role in the expansion of programme through outreach and targeting marginalized populations o Identify and assist community organizations and structures to mobilize human, financial and material resources o Participate in local level peer review mechanisms to assist with the development and review of the Joint National Operational Plan o Improve coordination among Civil Society Organizations at all levels, and between Civil Society and other stakeholders in the national response

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Slide 15: Aligning District Activities to National Strategies Speaker Notes:  Aligning district activities to national strategies is essential for showing impact on a national level

Slide 16: Linking District Activities to National Strategies Speaker Notes:  For many, the thought of localizing national strategies into district response activities can seem like a difficult task.  This may sound challenging, but if we approach it using a simple formula we can break it down into more manageable pieces  A (national strategies) + B (district issues) = C (district activities that address national priorities).  Click to reveal the formula  When it comes to the national strategies, keep in mind that each strategy is linked to one of the four priority areas (Preventing New Infections, Systems Strengthening, Strategic Information Management, and Scaling up Treatment, Care and Support

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Slide 17: DMSAC Planning Committee Speaker Notes:  Annually, districts are responsible for developing an Evidence Based Plan that addresses the specific situation and needs of the people in their district. Much of this information can be found in a district profile  The process of identifying and analyzing local problems/issues begins with the DMSAC Planning Committee  Click to reveal the EBP process (step 3)  As part of the EBP process (Step 3), the DMSAC Planning Committee works to: o Identify the issues, o Pick the priorities, o Clarify the objectives, and o Plan activities

Slide 18: Analyzing District Issues Speaker Notes:  However, before this can take place, a few key questions should be asked: o What is the problem? o Who is impacted? o What is contributing to the problem?  Once you are able to answer these questions, you can start doing a cause and effect analysis

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Slide 19: Cause and Effect Analysis Speaker Notes:  Imagine you went to the doctor complaining about severe pain in your right leg and the doctor prescribes you painkillers as a solution to the problem  Ask-Would the painkillers solve your problem? (wait for response)  Of course it does not solve the problem. In fact, it might make the problem worse because the painkillers only addressed the symptoms and not the problem  Had the doctor asked a few questions like what happened and why did it happen; she would have discovered that you sprained your ankle, which is the root cause for your pain  A cause and effect analysis is a process used to identify, sort, and/or display (via a Fishbone Diagram) causes of a specific problem  Click the mouse once display the image

Slide 20: Cause and Effect Analysis, cont. Speaker Notes:  This diagram-based technique combines brainstorming with a method called mind mapping (a diagram to visually outline information) in order to: o F – Find the problem o I – Identify the contributing factors o S – Specify the TPN (Totally, Partially, or Not) o H – Highlight potential response activities

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Slide 21: Steps for Building a Fishbone Diagram Speaker Notes:  Find the Problem - What happened or what is the problem?  Inform participants that the answer to this question refers to the effect (the result of), which is head of the fish  This information can be gathered from your District Profile  Make sure the issue identified can be tied back to the national strategies  The problem statement describes the severity of the problem  Click to reveal second bullet  It answers the questions, what, who, where, when, and how much  Click to reveal third bullet Optional Large Group Activity Activity Instructions (30 minutes):  As a large group, complete a fishbone diagram  As a group, use the sample district profile to identify a problem  Write the problem statement in head of the fishbone diagram

Slide 22: Steps for Building a Fishbone Diagram Speaker Notes:  Step 2 is to identify the Contributing Factors/Challenges - Why it happened?  Inform participants that this question allows you to determine what contributed to the problem, which represents the bones of the fish  Start by brainstorming a list of possible contributing

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factors or challenges  Click to reveal second bullet  Write each contributing factor/challenge on a posit-it note; this will allow you to move and put them into similar groups more easily  Click to reveal third bullet  After brainstorming, group the similar contributing factors on the bones of the fishbone diagram  Finally, give each of the bones a name to represent the major cause category Large Group Activity cont. Activity Instructions:  As a large group, complete a fishbone diagram  Use the sample district profile and/or district knowledge to identify the contributing factors  Write the contributing factors on post-it notes  Arrange them on the bone of the fish by similar groups  After they have been grouped, label the bone category

Slide 23: Steps for Building a Fishbone Diagram Speaker Notes:  Specify the TPN - What type of control do I have to address the issue?  Click to reveal TPN definitions  Inform participants that this question allows them to determine the level of control you have in addressing each contributing factor/challenge, which is represented on the fish bone with a T, P, or N  Keep in mind; it is better to focus on contributing factors/challenges which you have total (T) or partial control (P) over  The factors you do not (N) have control over can be assigned to other teams or individuals Large Group Activity cont. Activity Instructions:

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 As a large group, complete a fishbone diagram  Use the sample district profile and/or district knowledge to determine the TPN  Write the T, P or N on the post-it note of each contributing factor

Slide 24: Steps for Building a Fishbone Diagram Speaker Notes:  Highlight the possible district response activities – How do I prevent it from occurring?  Inform participants that this question allows you to start brainstorming potential response activities for addressing the problem

Large Group Activity cont. Activity Instructions:  As a large group, complete a fishbone diagram  Use the sample district profile and your district knowledge to identify potential response activities

Slide 25: Exercise: Time to FISH Speaker Notes:  Now that we have done the cause and effect process together, it is time for you all to follow the same steps in addressing a different problem in smaller groups  You have 30 minutes to complete this exercise  Once time is up, I will ask each group to report back. Small Group Activity Activity Instructions (30 minutes):

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 Divide the participants into small groups of 3 to 6 people (ideally, 3 groups of 3-4 people for a total of 10 participants)  Make sure each group has some flipchart paper, markers and post-it notes  Give each group a copy of the instructions/case study  The instructions will ask the participants to localize the national strategy based on the information provided in the case study Large Group Activity Activity Instructions (20 minutes):  Ask each group to report back on their progress  Discuss any concerns or questions  Ask the participants how they felt about the steps introduced in this session  It is important for people to gain a sense of control, especially if they usually feel powerless

Slide 26: Session Highlights Speaker Notes:  As we bring this session to a close, let’s do a quick recap of what we covered  Click to reveal summary bullets  In our role, it is important that we are able to translate the national strategies for planning purposes and to communicate expectations to our partners  Then we must be able to align our district response activities to those national strategies  This is done by conducting a cause and effect analysis… FISH  You may be asking yourself, how do I use what I learned in my district? o Consider introducing your staff to the steps of linking district response activities to national strategies o Build a fishbone diagram with your DMSAC Planning Committee or DAC office staff using the worksheet in your handouts o Use the District Response Activity Diagram as a brainstorming tool to identify potential response activities for your district o Learn more about your national strategies by reviewing the NSF II and other guidance documents

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Slide 27: Questions or Comments Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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AppendixAppendices C

Appendix C: Sample District Plan

Appendix D: Fishbone Diagram

Appendix E: ALDP Case Study and Instructions

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Appendix C: Sample District Plan

Kgalagadi South

DMSAC Plan

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DMSAC Evidence-based Planning Process Financial Year 2010-2011

Submitted on behalf of the DMSAC by the District AIDS Coordinator’s Office:  DAC  ASS. DAC  M&E Officer  PCV

EXECUTIVE SUMMARY

The DMSAC elected the TAC Committee to carry out the evidence based planning process for fiscal year 2010-2011. The TAC Committee included representatives from Minister’s Fraternal, Counseling Center, Motheo Support Group, Tebelopele, DHT and central government departments. Our district was assisted by Ms. Gawa from NASTAD and Mrs. Mahatelo from the Ministry of Local Government, Department of Primary Health Care Services.

The TAC identified the following prioritized list of issues:  High incidence rate  High rate of teenage pregnancy  High number of women with STI’s  Low HIV testing uptake  Men defaulting on ARV

Please find attached the objectives and activities laid out to address the above issues. Also included are the activities to address the NSF Goal 3: Strengthening Management, Capacity Building as well as National Commemorations. The total budget requested is: P 1,051,032.50.

SECTIONS

Section 1: District Profile District Overview page 3 Relevant Assessments page 3 Summary of Community Services pages 3 - 4 HIV/AIDS Data Summary Worksheet pages 5 - 6 Section 2: Community Service Inventory pages 7 - 10 Section 3: Summary of Priorities page 11 Section 4: Summary of Proposed Activities 2010 – 2011 pages 12 - 28 Attachment A: DMSAC Annual Plan Budget page 29 Attachment B: Detailed Activity Proposals page 30 - 42

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SECTION 1: DMSAC DISTRICT PROFILE

District Overview Location: In the North South corner of Botswana, the District covers an area of approximately 110,110 square kilometers. Geographic Features: The district is comprised of rural farm areas and small communities of 1,000 people or less. West of downtown, the district administrative village, there is little or no communication network, poor road conditions and scarce access to amenities (water and food). However, ongoing road construction and telecommunication services are scheduled for completion by the beginning of 2010. Villages often exhaust their water supply and can go without water for periods of three weeks. They then are solely dependent upon support from Council. Such remote villages continue to experience shortages of resources such as water.

Major Villages Populations: (2001 Census) Tsabong: 7,228 Middlepits: 657 Werda: 2,237 Bokspits: 575 Population Characteristics: The 2009 projected population is 27,199, based upon the 2001 census survey and annual growth rate (Central Statistics Office). There are a total of 22 villages and six major villages. The district is a diverse district with numerous tribes. Primary Ethnic groups: Batswana, Baherero, Coloreds, Bakgothu, Barolong, Basarwa, Bangologa, Afrikaners, Batlhaping, Bahurutshi, Batlhware, Bakgalagadi and others. Primary languages are Setswana, Afrikaans and Sekgalagadi; west of Middlepits Afrikaans is the majority and preferred language. Predominant Occupations: The Government of Botswana employs a number of individuals in the administration of the district and health fields. Farming and hunting continue to provide subsistence however most populations depend on government aided schemes due to the vast remote areas of desert land and lack of diverse employment opportunities.1 “Unemployment rates are high particularly among youth.”2

Relevant Assessments The recent results from the BAIS III 2008 revealed an increase in District HIV Prevalence from 11.8% to 19.1%.

Summary of Community Resources DAC OFFICE – District Administration DAC ADAC M&E Officer Peace Corps Volunteer Driver

1 District Demographic Profile 2 District Development Plan 7 Draft One

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Active VMSAC Villages: VMSAC’s were established in 2004 but were never fully functioning.

Health Care Facilities  1 Primary Hospital (ARV)  5 Clinics  State Prison Clinic  13 Health posts

NGO’s: Counseling Center – a BOCAIP centre, is a NGO within North South. District facilitates support groups, workshops, OVC outreach & other activities. The center is a member of both TAC and DMSAC.

Voluntary Counseling & Testing Centre (VCTC)– provides VCTC, attends many activities in the district and involved in both the DMSAC and TAC committee.

FBO’s: The Minister’s Fraternal works in partnership with the Counseling Center and facilitates Minister’s Fraternal DMSAC activities such as Candlelight and Month of Prayer.

MenSector: The MenSector core members are active. The MenSector hold many activities throughout the year that are mostly targeting men with the aim to involve them in HIV/AIDS related issues.

Support Groups: Community Based Organization - Support Group [Revived] Motheo Support Group - Primary Hospital [Active] PMTCT Support Group - [Not Active] Support Group - [Active] Support Group - Peer Mother [Active] Support Group – Werda [Not Active]

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Source: Preliminary BAIS III, 2008 Adapted From Table 7 Estimated HIV Prevalence Rate by Gender Male Female Total 17.0% 20.7% 19.1%

Source: Preliminary BAIS III, 2008 Adapted From Table 9 Estimated HIV Prevalence Rate by District, Youth Age-group & Gender Age 15-19 20-24 25-29 30-35 Male - 4.6% 19.1% 15.1% Female - 22.1% 23.5% 48.6% Total - 15.6% 21.3% 32.7%

HIV INCIDENCE

Source: Preliminary BAIS III, 2008 Adapted From Table 15 Estimated Incidence Rate by Gender Male Female Total 3.75% 2.81% 3.2%

HIV Testing Source: (Combined statistics for Tebelopele & DHT ) RHT Males % of males Females % of females Total % of all for JAN - SEPT 2009 & VCT for JAN - JUN 2009 Persons tested for HIV 1,760 2,555 4,315 Persons found to be HIV positive 133 8% 220 9% 453 10%

ARV Therapy (Source: KS District cumulative figures, Aug 2009) Males % of eligible Females % of eligible Total % of all males females eligible persons Persons eligible for ARV 771 1,221 1,992 Persons who started on ARV 746 97% 1,200 98% 1,946 98% Persons currently taking ARV 637 83% 1,096 90% 1,733 87% Persons lost to follow-up 19 2% 17 1% 36 2%

Perinatal Transmission (Source: District Health Team figures for Jan - Sept 2009) Females % New ANC clients 659 ANC clients tested for HIV 540 99.2 Testing rate ANC clients found to be HIV+ 38 7% ANC prevalence rate Infants of HIV+ mother tested 142 Infants found to be HIV+ 0 0% MTCT rate

Teenage Pregnancies (Source: District Health Team figures for Jan - Sept 2009) Females ANC clients under age 20 96 New ANC clients 659 Percent of ANC clients <20 15%

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Perinatal Transmission (Source: District Health Team figures for Jan - Sept Females % 2009) New ANC clients 659 ANC clients tested for HIV 540 99.2 Testing rate ANC clients found to be HIV+ 38 7% ANC prevalence rate Infants of HIV+ mother tested 142 Infants found to be HIV+ 0 0% MTCT rate

Teenage Pregnancies (Source: District Health Team figures for Jan - Sept Females 2009) ANC clients under age 20 96 New ANC clients 659 Percent of ANC clients <20 15%

Sexually Transmitted Infections Source: District Health Team figures for Jan - Sept Males % of males Females % of Total % of all 2009 contracting females contracting sti contract sti sti New STI cases 611 4% 999 7% 1,610 6%

Tuberculosis Source: District Health Team figures for 2007 Males % of Females % of Total % total total New TB cases #DIV/0! #DIV/0! - #DIV/0!

Isoniazid Preventative Therapy Source: District Health Team figures for 2007 Males % of Females % of Total % total total Persons currently taking IPT #DIV/0! - #DIV/0! - 100%

Home Based Care Source: District Health Team cumulative figures, Sept Males % of Females % of Total 2009 males femalesl Persons currently registered for HBC 46 33% 93 67% 139 HBC clients receiving psycosocial support 46 33% 93 67% 139

Orphans Source: KS Social & Community Development Males % of males Females % of Total % cumulative figures, Aug 2009 females Number of registered orphans 499 52% 459 48% 958 Number of orphans receiving psycosocial support 499 52% 459 48% 958

Known Ways to Avoid HIV Infection Source: Botswana AIDS Impact Survey 2004 Technical % identifying the method Report, page 152 to avoid HIV Abstain from sex 43%

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SECTION 2: COMMUNITY SERVICES INVENTORY page 1 of 4 Type Key Target Group

Postal school yth Other Organization Contact Person(s) Address/Location Activities/Services - (who?)

Government Health Sector NGO/CBO/FBO OVCs In Out school yth Men Women Gen. Community PLWHA District Health Gov/Hlth Mma Diseko - Matron Private Bag 005, PMTCT, CHBC, VCT, Pregnant Team Sct Mma Pone - Ast. Tsabong ARV, IPT & mothers Ph: 6540061 Matron Mma Martin - Awareness x x x CHBC Fx: 6540259 OVC Mma patients

ARV Clinics Gov/Hlth Tsabong - Dr. Wamba Box 5 Tsabong ARV Distribution, Sct Middlepits - Dr. health services x x Mutamba Makopong -

S&CD Gov/Hlth Mma V. Toto OVC, CHBC CHBC x Ph:6540061 Sct O.Matlhare patients Primary Gov/Hlth Dr. Murindoko P.O. Box 5, All HIV/AIDS Hospital Sct Tsabong programmes, support x x x x Ph: 6540235/241 group, ARV Therapy Fax: 6540242 Resource Gov/Hlth Calvin Matsapa - Asst. P.O. Box 5, Psychosocial support, Center TPH Sct Social Worker Tsabong Resource Center X x Ph: 6540235/241 Fx: 6540242 DAC Office Gov Mma Tuelo Chibana- P.O. Box 1, DMSAC Secretariat, AIDS service Ph: 6540247 DAC S.Gaseleme Tsabong coordination, providers Fx: 6540452 - Ast. DAC monitoring & X Kenosi Sethaile - M&E evaluating district Neo Casey Moreau-PC HIV/AIDS response District Gov J. Kgomoetsile District P.O. Box 1, Chairman to DMSAC Administration Officer Tsabong X Ph: 6540292 Fx: 6540215

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SECTION 2: COMMUNITY SERVICES INVENTORY FOR KGALAGADI SOUTH continued page 2 of 4 Type Key Target Group

h Sector

Postal school yth Other Organization Contact Person(s) Address/Location Activities/Services - (who?)

Government Healt NGO/CBO/FBO OVCs In Out school yth Men Women Gen. Community PLWHA Council Gov M. Council Private Bag 1, Chairman to DMSAC Ph: 6540061 Secretary Tsabong x Fx: 6540215 BNYC Parastatal L. Gaarekwe P.O. Box 95, Counseling, Youth 12-29 Ph: 6540805/815 71611449 Tsabong Distribution of IEC X X materials, MYAA Women's Affairs Gov Ms. Motshubi Private Bag 25, Gender Advocacy, 16 Department Tsabong days Activism against x x Ph: 6540671 Violence on Women Peace Corps CBO Tumelo Paul S&CD at Clinic Volunteer x x x Ph: 72945522 Fx: 6543019 Peace Corps CBO Peo Mary Middlepits Clinic Clinic Volunteer x x

Phone: 72346628 Peace Corps CBO Tebogo Derek P.O. Box 57, S&CD Volunteer Werthmann Middlepits Ph:+2779807504 X x x 7 Vcom 75014190 Orange Counseling NGO Lebakeng Private Bag 003, Counseling, CHBC Center Tsabong Awareness, Care & patients X x x x x Ph: 6540305 Support, Peer Mother, Male Project

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SECTION 2: COMMUNITY SERVICES INVENTORY FOR KGALAGADI SOUTH continued page 3 of 4 Type Key Target Group

Postal

Address/Locatio school yth Other Organization Contact Person(s) n Activities/Services - (who?)

Government Health Sector NGO/CBO/FBO OVCs In Out school yth Men Women Gen. Community PLWHA VCTC NGO Ms. Tsholo Private Bag 11, Voluntary Counseling Couples Ph: 6540759 Gaotswake 71407084 Tsabong and Testing, Training x x x Families Fx: 6540760 Ministers' FBO Nelson Motsewapuo c/o DMSAC Month of Prayer, Fraternal Candlelight x Phone: 72986355 DistrictMaleAction CBO G. Mosweu Kokotsa Health Male Involvement Group (DMAG) Post X Ph: 6545502 Motheo Support CBO Mpho Matswiri - P.O. Box 5, Support for PLWHA & Group Chairperson Tsabong affected x x Ph. 6540235 71280430 CBO CBO x x Support Group CBO Draihoek x x Support Group CBO Omaweneno x x Support Group CBO Werda x x Condom CBO VACANT Distribution ------Officer VMSAC CBO Rachel Magalie x 0782404999 Conven VMSAC CBO Fredrick Titus 08277 Convenor – DAC Planning, x implementation, VMSAC CBO Hilda Kamboer coordination, monitoring 0726781732 of HIV/AIDS related x Convenor – DAC activities at village level

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VMSAC CBO Fredrick Matthys 0027798136033 x Convenor – DAC VMSAC CBO Teko Chimbombi 72713721 Convenor x S&CD VMSAC CBO C.K. Kaekwe - x Convenor S&CD VMSAC CBO Convenor – DOCET x

VMSAC CBO Convenor – DOCET x VMSAC CBO Neo Kgaodi Convenor - Economic Planning x

VMSAC CBO Convenor -Culture and x Youth Planning, VMSAC CBO Convenor -Culture and implementation, x Youth coordination, monitoring VMSAC CBO Convenor -Culture and of HIV/AIDS related x Youth activities at village level VMSAC CBO Rea Motsewapuo Convenor - Economic x Planning VMSAC CBO Itumelo Lentshikang Convenor - Economic x Planning

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Appendix D: Fishbone Diagram

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Appendix E: ALDP Case Study and Instructions

You have been the DAC for the Mango District for three months. Before becoming a DAC, you had a long career as a teacher in a high school in Moshupa. You helped manage anti-AIDS clubs there, and worked closely with the DAC and DMSAC in that district when the school was involved in World AIDS Day and other community activities. When you were hired, you went through DAC orientation and training delivered by MLG with the help of NASTAD Botswana. Since you started your work, you have met with the District Commissioner once, attended one District Health Team meeting, and met with the DMSAC Planning Committee once or twice to begin preparing for the DMSAC planning retreat which will happen in the next quarter. National Strategies Module

You have received feedback from MLG DPHCS on the quality of the evidence-based plan that was submitted by your predecessor last year. One strong criticism is that the strategies that were identified in the plan to address priority issues did not reflect national priorities closely enough, and that it did not appear that the activity plans included stakeholders or that they had a good sense of how they could best contribute to implementing those strategies.

Fortunately, you and some of your Planning Committee members have received training in the FISHbone process to help you identify which strategies and activities it makes most sense for district partners to implement to contribute to national goals.

As a group you decide that you would like to train the rest of the DMSAC on the use of this tool, and you decide that together you will practice the process together, to make notes for yourselves on what you might change or highlight in the exercise before preparing a presentation for the entire DMSAC.

Modify the existing small group exercise to - 1. Provide a specific national priority for the team to work on

- 2. Have the group provide a report back on what worked and did not work in the exercise, and what they would emphasize if they were to use this with a full DAC (this way, we get feedback on our training, and they get to think about not just DOING, but also TRAINING someone else)

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Collaborating and Engaging Partners to Mobilize Resources

Expected Session Time: 3.5 hours

Module Content Overview ...... 141 Applied Public Health Program Management Training ...... 141 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 143 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 145 ALDP Facilitator Guide Overview ...... 148 Session Overview ...... 150 Description of Session ...... 150 Materials & Equipment ...... 150 Preparation ...... 150 Pre- and Post- Training Assessments ...... 150 Presenter’s Notes: Collaborating and Engaging Partners to Mobilize Resources .....151 Appendices ...... 170 Appendix F: Stakeholder Profile Summary ...... 171 Appendix G: District Response Inventory Form ...... 172

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

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Applied Leadership Development Program | Collaborating and 142 Engaging Partners to Mobilize Resources

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives. 3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

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3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Applied Leadership Development Program | Collaborating and 149 Engaging Partners to Mobilize Resources

Session Overview

Description of the Session

This 3.5 hour course is designed to equip participants with the skills and tools needed to effectively collaborate and engage district partners to mobilize resources. The course will require participants to: 1) identify key stakeholders (internal and external) in addressing HIV/AIDS response activities and implementing national and local strategies/policies; 2) create a stakeholder profile; and 3) use a district- specific tool to identify resources, resource providers, and mechanisms for mobilizing resources.

Materials & Equipment

□ Computer □ Flip charts (3)

□ LCD projector □ Markers and pens

□ Facilitator guide □ Note papers

□ Power Point presentation □ Tape or adhesive uploaded to computer and working

□ Pre/post-training evaluation □ Participant handouts assessments

□ Sign-in sheet □ Room set-up

Preparation

□ Make copies of the Stakeholder Profile Summary Matrix (Appendix F) and District Response Inventory Form (Appendix G)

Pre- and Post- Training Assessments

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Presenter’s Notes: Collaborating and Engaging Partners to Mobilize District Resources

Slide 1: Collaborating and Engaging District Partners to Mobilize Resources Speaker Notes: If you have not already, take time to…  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course. They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers)  Conduct an icebreaker if needed

Slide 2: Learning Objectives

Speaker Notes:  During this session, we will: o Identify key stakeholders (internal and external) in addressing HIV/AIDS response activities and implementing national and local strategies/policies o Create a stakeholder profile o Use a district-specific tool to identify resources, resource providers, and mechanisms for mobilizing resources

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Slide 3: Stakeholder Importance

Speaker Notes:  Our success in implementing national strategies through district response activities is dependent upon the committed participation of stakeholders

Slide 4: What is a Stakeholder?

Speaker Notes:  Ask-By a show of hands, how many of you have experienced stakeholders promising to support your efforts within your district, but nothing happens or overtime they slowly start to become less involved? (wait for a response)  As you all know, getting and keeping stakeholders involved in your activities/efforts can be a difficult task, especially with competing interest, causes and limited local resources  That is why careful and thorough planning is essential in identifying the right stakeholders. However, we must first have a clear definition of what a stakeholder is  Ask-What is a stakeholder? (wait for responses)  Click to reveal answer  Basically, a stakeholder is a person, group or organization with an interest or concern in a specific issue or subject matter area, either because: o They are going to be or is affected by; o They have influence, which refers to their power; and

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o They have knowledge and experience  Stakeholders can greatly influence the intended outcome and success of a public health intervention or in your case, a district response activity  Their involvement can take place during any stage of the project. However, performing a stakeholder analysis during the planning stage can greatly influence the development of an effective strategy  This course will help you identify key stakeholders and explore ways they can participate successfully

Slide 5: Why is it Important to Involved Stakeholders?

Large Group Discussion:  Ask-Why should you involve stakeholders in your work? (wait for responses)  Click to reveal possible answers: o Stakeholders can provide money, technical assistance, volunteer time, goods/products, sponsorship, assets, marketing, equipment, facility space, transportation, etc.

Slide 6: Why Involve Stakeholders?

Speaker Notes:  Stakeholders can: o Provide valuable information regarding needs, resources, realistic objectives, and practical considerations for a project; o Recognize hidden items that might not be obvious in the planning stage;

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o Identify points of opposition and prevent problems during implementation; o Encourage a sense of ownership in the project and involvement during the implementation stage; and o Ensure the focus of a project remains on the people it is meant to support/serve

Slide 7: Conducting a Stakeholder Analysis

Speaker Notes:  All stakeholders carry a certain degree of power, whether it is: o Formal – associated with a position of power or o Informal/Social – ability to persuade others to support or oppose an issue

Slide 8: Steps of a Stakeholder Analysis

Speaker Notes:  Conducting a stakeholder analysis is an important process for understanding a stakeholder’s attributes and influence (power), interest and knowledge related to the issue and their inter- relationship with other stakeholders,  There are four major steps in a Stakeholder Analysis: 1. Identify the stakeholders; 2. Profile the stakeholders; 3. Create a relationship model; and 4. Establish participation categories and methods

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 During this session, we will talk about each one of these steps and practice them together. However, much of step 4 is discussed during the Communication session

Slide 9: Step 1: Identify the Stakeholder

Speaker Notes:  When conducting a stakeholder analysis, one of the main objectives is to identify key stakeholders  The good news is that we already have a broad list of pre-identified stakeholders to consider. This list of pre- identified stakeholders can be found in numerous documents, such as: the NSF, district profile, DMSAC Comprehensive HIV/AIDS Plan, etc.  Using the information provided, we can start narrowing down the list to identify specific stakeholders that will be instrumental in implementing district activities  In other words, we want to identify issue or project-specific stakeholders  As you start to think about stakeholders, you should also consider the different types of stakeholders you need  Click to reveal types of stakeholders  The types of stakeholders are: o Beneficiaries; o Supporters; o Opponents; o Resource Providers; and o Vulnerable Groups Additional Facilitator Guidance: Example: Imagine a new strategic document was just released emphasizing the need for coordination, harmonization and alignment of stakeholder support around gender violence and sexual abuse. As the DAC, you are responsible for leading this effort. Your first thought is to sit down and develop a list of stakeholders. However, you remember that the more involved stakeholders are in the project, the more likely the project will succeed. Rather than sitting at your desk alone, you call a meeting

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with local staff to brainstorm and develop a list of stakeholders for the project. During the meeting a Community Worker notes that some community men believe that having sex with a virgin girl will cure them of HIV. Based on what she has heard in the community, she believes this is a direct link to the high numbers of rape amongst young girls in the district. You quickly realize that without the involvement of this important stakeholder, the project could have failed. As we move into our next exercise, remember this example and try to think about identifying key and specific stakeholders that will bring district/community knowledge, experience, and resources to the table.

Slide 10: Step 2: Profile the Stakeholder

Speaker Notes:  Step 2 in the stakeholder analysis process is to create a profile for each identified stakeholder; typically, in the form matrix with stakeholder information  Ask-what type of information is needed about a stakeholder in order to involve them in the planning and implementation of a project? (wait for responses) o Role in the organization o Perceived goals and expectations for the project o Level of influence on project and decisions o Expected level of participation and any potential negative impact on the project

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Slide 11: Stakeholder Profile Summary Matrix Speaker Notes:  In a Stakeholder Profile Summary Matrix, each stakeholder is prioritized using a simple scale of 1-10 to rank their importance to the project’s success.  Click to reveal priority level  This information will also help you later in determining what level of participation each stakeholder should play, which is Step 4, highlighted in blue

Slide 12: Exercise: Profile Stakeholder

Speaker Notes:  It is time for you all to profile your stakeholders using the Stakeholder Profile Summary Matrix (Appendix F)  The purpose for the matrix is to document their key stakeholders’ perceived goals and expectations for the project, their level of importance to the success of the project and their level of influence over decisions Small Group Activity (15 minutes):  Break the participants up into small groups; ideally the same groups they have been working in  Inform participants that you want each group to complete a Stakeholder Profile Summary Matrix  Inform them to prioritize the stakeholders in order of influence by: o Assigning level 1 to the highest stakeholder of influence o Assigning level 10 to the lowest stakeholder of influence  Continue until all stakeholders are ranked accordingly

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 Give them 15 minutes to complete this exercise  Walk around the room to answer any questions

Slide 13: Steps 3: Creating a Relationship Model

Speaker Notes:  Creating a relationship model is step 3 of the stakeholder analysis process  This step provides a visual picture (Venn Diagram) of what the project will look like in terms of stakeholders and their influence  The relationship model addresses the following questions: o What is the relationship among stakeholders? o Who influences whom? o Who has control over whom?

Slide 14: Venn Diagram

Speaker Notes:  Here is an example of a Venn Diagram  Creating a Venn Diagram is pretty simple o The Project is drawn as the big circle o The smaller circles inside and along the big circle are the stakeholders o The location and size of each stakeholder circle represents their level of influence on the project o If the circles are drawn interlocking, it shows the stakeholders have interactions and relationships with one another

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Slide 15: Exercise: Stakeholder Relationship Model

Pre-session Preparation:  Flipchart paper  Markers Speaker Notes:  It is time for each group to develop their own district stakeholder relationship model (Venn Diagram)  Based on the information in your District Stakeholder Profile Summary Matrix, draw a relationship model for your project  You have 15 minutes to complete this exercise Small Group Activity: (15 minutes)  Give each small group a sheet of flipchart paper and 2-3 markers  Give the participants 15 minutes to complete the exercise

Slide 16: Step 4: Ladder of Participation

Speaker Notes:  Looking at your group’s Venn Diagram, ask do you think all stakeholders have the same level of involvement in a project? (wait for responses)  We can all see that each stakeholder has a different level of influence on the success of a project, which in turns affects their level of participation  A stakeholder’s level of participation can be determined by a process called Ladder of Participation  Ladder of Participation allows you to determine what type of participation is appropriate for each stakeholder

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 The ladder contains six levels starting with the lowest level of participation – Information Sharing and climbs to the highest level of participation – Self- Actualization/Empowerment  Click the mouse once to display content  Information Sharing: o Stakeholders are provided information about a project but do not have the opportunity to influence the project because the information is shared with them after the decisions have been made

Slide 17: Ladder of Participation

Speaker Notes:  Click the mouse once to display content  Stakeholders are consulted for their views, which are then incorporated into the project at the discretion of the project planner (or DACs)  The project planner defines both the problems and solutions, and may modify them after considering the stakeholders’ views  However, the project planner is under no obligation to agree with or incorporate the stakeholders’ thoughts

Slide 18: Ladder of Participation Speaker Notes:  Click the mouse once to display content  Stakeholders participate by conducting an activity or providing labor in return for food, cash, or other material incentives

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Slide 19: Ladder of Participation Speaker Notes:  Click the mouse once to display content  Stakeholders participate by forming groups to meet predetermined objectives related to a project  Their involvement usually occurs after major decisions have been made  These groups tend to be dependent on external factors (e.g., donor funding), but may become independent

Slide 20: Ladder of Participation Speaker Notes:  Click the mouse once to display content  Stakeholders participate in joint analysis with the project planner  Typically, this leads to joint goal and objective setting, action planning, and the formation and strengthening of groups  This level involves multiple perspectives between all members of the group and the planner  Groups can take control over project planning decisions, thus allowing stakeholders to influence the implementation and structure of a project; which is similar to the roles of the DMSAC members

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Slide 21: Ladder of Participation Speaker Notes:  Click the mouse once to display content  Stakeholders have control over decisions and resources and participate in lead roles for the project  Stakeholders are the original designers of the project ideas and may take control at a given point in the project  Now that we have gone through all levels of participation, let’s look at a completed Stakeholder Profile Summary Matrix to see what it tells us  Remember the Stakeholder Profile Summary Matrix is a great tool to use for determining how to best communicate with each stakeholder

Large Group Activity (15 minutes): If time permits, complete the last column of the Stakeholder Profile Summary Matrix as a large group  Ask one group to volunteer their Stakeholder Profile Summary Matrix  For each stakeholder identified, determine their level of participation and how you might communicate with each stakeholder. Possible communication methods: o Workshops o Questionnaires o Interviews o Dramas, role plays o Brainstorming discussions o Open-ended discussions o Round robin discussions (i.e., everyone in the group shares one or more ideas) o Small group discussions o Surveys

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Slide 22: Resource Mobilization Speaker Notes:  Now that you have identified different ways to engage your stakeholder, let’s look at how we can start to mobilize our resources

Slide 23: What is Resource Mobilization? Speaker Notes:  Ask what is resource mobilization? (wait for responses)  Click to reveal answer  Resource mobilization can be described to as a process of identifying resources needed to achieve the organization/project’s mission through the utilization of knowledge, skills, equipment, services, etc.

Slide 24: Importance of Resource Mobilization Speaker Notes:  We must understand the importance of mobilizing resources  Ask why do you think it is important to mobilize resources? (wait for responses)  The importance of resource mobilization is to:

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o Carry out the organization/project’s ongoing work; o Achieve the organization/project’s mission and goals; o Undertake new work and initiatives; o Maintain and increase linkages with the community, individuals, government agencies, private organizations, and funding organizations; o Maximum use of local resources and skills; and o Influence and take control over the HIV/AIDS epidemic

Slide 25: Strategies for Resource Mobilization Speaker Notes:  Now let’s talk about strategies

Slide 26: 4 Q’s to Resource Mobilization Speaker Notes:  You may be asking yourself, how do I go about mobilizing the resources in my district to achieve the national strategies outlined in the NSF?  In order to answer this question, you must first think about the 4 Q’s to mobilizing resources: (Click mouse once to reveal each answer) o What resources are available? o What resources are not available, but needed? o Who are the resource providers/holders? o What are the various mechanisms for resource mobilization?

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Slide 27: Resources, Providers, and Mechanisms Speaker Notes:  Based on these questions, resource mobilization can be broken down into three categories called RPM: (Click mouse to reveal answer) o Resources – What are the needed resources? o Resource Providers – Who have the resources? o Mechanisms – What are the mechanisms for resource mobilization?

Slide 28: R = Resources Speaker Notes:  Thus far, we have only talked about one type of resource, human  Ask can you name the other types of resources? (wait for response)  Resources are the materials, things, and services (financial and non- financial) that help to fulfill an organization’s/project’s needs

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Slide 29: Types of Resources Speaker Notes:  Basically, resources can be classified as the following: o Money; o Human (their skills, time, contributions and services); and o Equipment and materials  Ask what are some examples of money? (wait for responses)  Click the mouse once to reveal answer  Ask what are some examples of human? (wait for responses)  Click the mouse once to reveal answer  Ask what are some examples of equipment and materials? (wait for responses)  Click the mouse once to reveal answer

Slide 30: P = Providers Speaker Notes:  Earlier today we spent some time talking about stakeholders. Many of the stakeholders identified could also be considered resource providers  Resource Providers are individuals and/or organizations that provide materials, goods, and/or services… resources needed to help accomplish an organization/project’s mission

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Slide 31: M = Mechanisms Speaker Notes:  As DACs, you have to decide where and how (mechanisms) to mobilize resources  Each resource requires a certain level of time and energy  Typically the type of mechanism used for mobilization is dependent on the capacity of the organization and/or district and the nature of the required resources  You may discover that some resources do not fit within an allotted time period, causing it to be less desirable  For example: A DAC just received news that his/her funding was cut by 15%. He/she has to decide whether it is worthwhile to write and submit a grant proposal based on the limited time to implement district response activities and the limited man power available to write the proposal  Here is a list of mechanisms for resource mobilization: o Grant proposals (comprehensive) o Special events o Donations o In-kind services o Personal meetings o Membership campaign o Raising fees o Self-contribution o Advocacy o Formal tea party o Case Study and Success stories o Media o Advisors and Ambassadors  Ask are there any additional mechanisms that are not listed? (wait for responses)

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Slide 32: Tool: District Response Inventory Form Pre-session Preparation:  Make copies of the District Response Inventory Form (Appendix G) Speaker Notes:  One organizational tool that can be used for mobilizing resources is an inventory form  This inventory form allows you to develop a more detailed list of the: o Needed resources; o Resource providers; and o Various ways of receiving or mobilizing resources

Slide 33: Session Highlights Speaker Notes:  As we bring this session to a close, let’s do a quick recap of what we covered  We discussed that stakeholders play a vital role in the success or non- success of a project  In order to collaborate and engage stakeholders in district response activities, we must have a clear understand of the stakeholder  This can be done by conducting a stakeholder analysis: o Identify the key/project specific stakeholders o Profile the stakeholders using a Summary Matrix o Create a Relationship Model using a Venn Diagram o Determine their level of participation  We also discussed using the District Response Inventory Form to identify: o Resources,

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o Resource providers, and o Mechanisms for mobilizing resources

Slide 34: Questions or Comments Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix F: Stakeholder Profile Summary Matrix

Appendix G: District Response Inventory Form

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Appendix F: Stakeholder Profile Summary Matrix

Stakeholder Type of Motivation Perceived Influence Potential Levels of Stakeholder Expectations on Challenges Participation and Goals project (Level of 1-10)

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Appendix G: District Response Inventory Form

Resources Resource Providers Mechanisms

Needed Available Name Address Type of Resource (Place √) Mechanism

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Reprioritizing and Reallocating Resources

Expected Session Time: 3 hours

Module Content Overview ...... 174 Applied Public Health Program Management Training ...... 174 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 176 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 178 ALDP Facilitator Guide Overview ...... 181 Session Overview ...... 183 Description of Session ...... 183 Materials & Equipment ...... 183 Preparation ...... 183 Pre- and Post- Training Assessments ...... 183 Presenter’s Notes: Reprioritizing and Reallocating Resources ...... 184 Appendices ...... 199 Appendix H: Kgalagadi South DMSAC Plan ...... 200 Appendix I: Budget Modification Guideline Template...... 227

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

Applied Leadership Development Program | Reprioritizing and 174 Reallocating Resources

Applied Leadership Development Program | Reprioritizing and 175 Reallocating Resources

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program | Reprioritizing and 177 Reallocating Resources

Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives. 3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

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TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Applied Leadership Development Program | Reprioritizing and 182 Reallocating Resources

Session Overview

Description of the Session

This 3 hour course is designed to equip participants with the skills and tools needed to effectively prioritize activities and allocate resources as they develop and modify their budgets. The course will require participants to: 1) articulate their evidence- based planning processes, and the methods they use to identify and prioritize issues and develop implementation strategies 2) articulate their budget development and modification strategies, 3) practice using a tool for modifying a budget, and 4) develop a communication strategy and talking points for stakeholders on the issue of budget modification

Plan to budget 1.5 hour to review the material with the participants, and 1.5 hours to review and complete the exercise

Materials & Equipment

□ Computer □ Flip charts (3) □ LCD projector □ Markers and pens □ Facilitator guide □ Note papers □ Power Point presentation □ Tape or adhesive uploaded to computer and working □ Pre/post-training evaluation □ Participant handouts assessments □ Sign-in sheet □ Room set-up

Preparation

□ Make copies of the District Plan (Appendix H)

□ Make copies of the Budget Modification Guideline Template (Appendix I)

Pre- and Post- Training Assessments

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Presenter’s Notes: Reprioritizing and Reallocating Resources

Slide 1: Reprioritization and Reallocation

Speaker Notes:  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course. They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers.)  Conduct an icebreaker if needed  Ask-can anyone describe the budget process: o How are budgets developed? o What are the key considerations? o When and why are budgets revised? o Is there a process for re-prioritizing and reallocating funds once funds are received? Describe  This session will provide some suggestions and tools that you may use to manage the budget modification process. However, we recognize that there is no one way to go about budget modification, and we hope that you will share your own experiences, suggestions and tools with one other Additional Facilitator Guidance:  We will be talking about budget revision and the re-prioritization and reallocation of resources  DACs and ADACs have developed annual comprehensive HIV plans for the district for many years, using the Evidence Based Planning Toolkit  It is understood that the plans that are submitted to NACA for funding include budgets that reflect district “need” rather than budgets that reflect available funding

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 When NACA funding levels are shared with DACs, they are usually significantly less than requested, requiring budget modifications. However, DACs lack guidelines as to how to manage the budget modification process

Slide 2: Learning Objectives

Speaker Notes:  Review slide  Answer any questions that may arise

Slide 3: Review of Evidence Based Planning

Speaker Notes: Proceed to next slide

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Slide 4: EBP Review – Issues Identification

Speaker Notes:  We will begin this session by reviewing the Evidence Based Planning (EBP) process and existing EBP tools  We will look in particular at the EBP steps that take place at the Planning Subcommittee retreat, after the district profile has been developed and any needs assessment conducted  Following review of the needs assessment, the Planning Subcommittee considers Issue Identification  Review slide and explanation of Issue Identification, and ask the participants: o How is Issue Identification conducted by your DMSAC? o Are DMSAC members encouraged to justify the issues they select based on the district profile? o When such issues are listed, are these justifications attached? These justifications can often help with the prioritization/re-prioritization process

Slide 5: EBP Review - Priority Setting

Speaker Notes:  Once the DMSASC has identified issues, the next step is to set priorities.  Ask the participants: o How does the DMSAC conduct priority setting? . The EBP Toolkit suggests ranking issues, or voting on issues as a prioritization method . Do these methods work well? If not, why not?

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o Do DMSACs use any other methods for prioritization? How well do these work? o Do you use any agreed upon criteria to justify your prioritization? o How does prioritization relate to the district profile?

Slide 6: EBP Review – Defining Objectives

Speaker Notes:  Once the DMSAC has set priorities, the next step is to develop objectives by which these issues can be addressed  In the toolkit, the process of setting objectives is described as “taking the priority issues and turning them into action statements that will describe a solution  We would like to quickly review what we mean by SMART objectives.  Ask the participants: o “What are SMART objectives”? o Answer: SMART is a mnemonic for S=Specific; M=Measurable, A=Achievable, R= Relevant T=Timebound o For example, if a high priority issue is “too many young people do not consistently use condoms”, then a SMART objective could be stated as “By October 31, 2013, the proportion of young people using condoms consistently and correctly in the district will increase from 65 to 75% Large Group Activity (10 minutes):  Write the following issues on a flipchart, and in the large group ask participants to produce one or two SMART objectives with which to address the identified issues: o “Not all women identified as HIV positive in the ANC clinic are being referred to PMTCT services” o “DMSAC members are not submitting accurate and complete monitoring reports to the DMSAC on a timely basis” Additional Facilitator Guidance:  Review the objectives with the group and modify as needed to ensure that they are truly SMART. Following this review of SMART objectives, ask the participants:

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o How does the DMSAC conduct this step of the planning process? o Does the DMSAC produce SMART objectives? Does this work well? If not, why not?

Slide 7: EBP Review – Strategy Development

Speaker Notes:  After the DMSAC has developed objectives, the next step is to develop strategies by which those objectives can be met.  Ask the participants: o How does the DMSAC work together to identify strategies? o To what extent are these based on the promising prevention practices document, and monitoring and evaluation of existing strategies (in other words, based on data?) o Are DMSACs able to document the justifications they use to select strategies? o To what extent are strategies selected based on who is at the table? o Do strategies get selected that might be implemented by people not at the table? o Are agencies identified in the DMSAC process to conduct these strategies?

Slide 8: EBP Review – Gather and Summarize Activity Proposals

Speaker Notes:  Finally, agencies are asked to develop one or more detailed activity proposals that will ensure that the identified strategies are actually implemented.  Ask the participants: o How does your DMSAC work to gather Activity Proposals?

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o Are agencies other than those identified by the DMSAC in the prioritization retreat approached to submit an activity proposal? o Are agencies given guidance by the DMSAC on the budget levels they should include in their activity proposals? If so, how does the DMSAC set these budget levels?  Thank you for providing your experience and insights on the Evidence Based Planning Process  We will now spend some time talking about Budget Development

Slide 9: Budget Development

Speaker Notes:  Proceed to next slide

Slide 10: Budget Development

Speaker Notes:  Ask the participants: o How is the budget determined for the plan that is submitted? o If an amount is predetermined, is that amount communicated to the sectors when they develop their project proposals?  There are two approaches to developing a budget – a “conservative” approach, and an “optimistic” approach

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 Both have advantages and disadvantages. We will begin by discussing the conservative approach  Ask the participants if they have a preferred approach to budget development, and why(wait for responses)  Review the slide, and discuss all points regarding conservative budgeting

Slide 11: Conservative Budgeting

Speaker Notes:  Review the slide. Explain that the advantages and disadvantages of the conservative approach as listed on the slide. Ask the participants: o Ask-Can you think of any other pros and/or cons that are not listed on the slide? (List any additional pros and cons on the flipchart)

Slide 12: Budget Development – Optimistic

Speaker Notes:  The second budget development approach is an optimistic approach  Review the slides. Read through the points as outlined on the slide  Ask the participants: o Is the optimistic budget development approach used by DMSACs for budget development? Does the DMSAC approach differ in any way? If so, how?

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Slide 13: Optimistic Budgeting

Speaker Notes:  Review the slide  Explain that the advantages and disadvantages of the optimistic approach as listed on the slide  Ask the participants: o Can you think of any other pros and/or cons that are not listed on the slide? (List any additional pros and cons on the flipchart)

Slide 14: Budget Modification

Speaker Notes:  Because budget modifications are usually needed regardless of the budget development process you choose to use, we will now review and discuss methods for budget modification

Slide 15: Budget Modification

Speaker Notes:  Proceed to next slide

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Slide 16: Budget Modification

Speaker Notes:  There is no one perfect method for modifying budgets. However, we can identify two issues we think you should consider when discussing budget modification: o How are you going to engage and work with stakeholders to ensure that the process is transparent and to avoid conflict? o What criteria are you going to use to cut your budget that will be evidence based and consistent with the plan?

Slide 17: Communicating to Stakeholders

Speaker Notes:  Review the slide  Ask the participants these questions, and post their answers on the flipchart

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Slide 18: Communicating to Stakeholders

Speaker Notes:  Review the slide  Review all of the recommendations on the slide, noting when points have already been made by participants, and highlighting those not mentioned

Slide 19: What should you communicate?

Speaker Notes:  Review the slide  Review all of the recommendations on the slide, noting when points have already been made by participants, and highlighting those not mentioned

Slide 20: When should you communicate?

Speaker Notes:  Review the slide  Ask the questions as outlined on the slide  Point out that there is no correct answer to these question  Ask the participants: o Who is it that would decide when to communicate this information to stakeholders?

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Slide 21: Budget Modification Process

Speaker Notes:  As was discussed, the second issue to take into consideration during budget modification is the process that will be used  Facilitate a discussion using the talking points outlined on the slide and note comments on the flipchart

Slide 22: Issues for Consideration

Speaker Notes:  Remember that there truly is no one right way to cut a budget  It is often helpful to have some objective criteria and processes laid out for the budget cutting process  In addition, as you cut a budget, it may be helpful to keep a few key issues in mind: o The size of the budget cut: A large cut might require cutting entire issues, or entire activities, while a smaller cut might be absorbed by reducing activity budgets o Fixed Costs: There may be fixed costs in a budget that cannot be changed (e.g. rent, or salary) o Ask the participants: . Can you think of fixed costs that are usually included in district plan budgets that cannot be changed? o Political or Strategic Considerations: An example might be continuing to fund an activity that is a critical component of another donor or partner effort (i.e., defunding of one activity may result in withdrawal of much more extensive support)

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o Ask participants: . Do you have any additional examples?

Slide 23: Issues for Consideration, cont.

Speaker Notes:  Additional considerations include: o Objective Criteria: It is best to try to use objective criteria related to the scope and seriousness of the epidemic to make budget cuts. These criteria can be communicated to stakeholders, and help those impacted by the cut to accept the difficult decision. The list on the slide just gives some examples. Ask the participants: . Are there any additional criteria participants would like to add? (List these on the flipchart)

Slide 24: Exercise: Budget Modification

Pre-session Preparation:  Make copies of the District Plan (Appendix H)  Make copies of the Budget Modification Guideline Template (Appendix I) Speaker Notes:  We will now do a budget modification exercise  The exercise is 1.5 hours  We will begin the exercise as a large group, and then the large group will be divided into 3 small groups  The exercise will end with each small group reporting back to the large group  Review the objectives of the exercise as outlined on the slide.

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Slide 25: Exercise Part 1: Large Group Activity

Speaker Notes:  Review the slide  Read the scenario on the slide  Ask the group to individually review the plan and budget and think about how they might go about making the 20% cut Large Group Discussion (30 minutes):  Facilitate a conversation with the large group, soliciting input from individuals as to how they would cut the budget  Ask individuals to justify their recommendations  Probe to see if individuals would take into consideration fixed costs, make cross-the-board cuts or selected cuts, and what kinds of criteria they might use if they did so Additional Facilitator Guidance:  Distribute copies of the budget modification guideline template and give the participants a few minutes to review it  Explain that the budget modification guideline template provides a way to document your thought process as you make budget changes. The order of the questions helps you to narrow down your options, and the requirement to justify each step in writing prepares you to develop talking points for when you communicate with your stakeholders

Slide 26: Exercise Part 2: Small Group Activity

Small Group Discussion (30 minutes):  Divide the large group into three small groups  Review the slide  Read the instructions on the slide, and leave the slide up while the groups do the exercise

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Slide 27: Exercise Part 3: Report Back

Large Group Activity – Report Back (30 minutes):  Ask one group to present their budget modifications to the large group  Ask the remaining participants to interact during the presentation as if they were real stakeholders, asking questions and raising concerns as might occur during a real stakeholder meeting  At the end of the presentation, ask the presenting group if there was anything they would change about their process or their talking points  Ask the “stakeholder group” to share constructive criticism of the process with the presenting group, noting where they thought the process could have been improved, or where the communications could have been improved  Ask all participants if they found the guideline template helpful, and if any modifications should be made

Slide 28: Session Highlights

Speaker Notes:  Review the summary of what the participants: o We discussed the development and modification of a budget that takes into consideration . Key considerations of the size of the cut, fixed costs, political considerations and district priorities . Stakeholder response and impact o We discussed reallocating funds based on the actual funds made available versus the requested amount

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Slide 29: Summary

Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix H: Kgalagadi South DMSAC Plan Appendix I: Budget Modification Guideline Template

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Appendix H: Kgalagadi South DMSAC Plan

Kgalagadi South DMSAC Plan

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DMSAC Evidence-based Planning Process Financial Year 2010-2011

Submitted on behalf of the DMSAC by the District AIDS Coordinator’s Office:  DAC  ASS. DAC  M&E Officer  PCV

EXECUTIVE SUMMARY

SECTIONS

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SECTION 1: DMSAC DISTRICT PROFILE

Major Villages Populations: (2001 Census) Tsabong: 7,228 Middlepits: 657 Werda: 2,237 Bokspits: 575 Population Characteristics: The 2009 projected population is 27,199, based upon the 2001 census survey and annual growth rate (Central Statistics Office). There are a total of 22 villages and six major villages. The district is a diverse district with numerous tribes. Primary Ethnic groups: Batswana, Baherero, Coloreds, Bakgothu, Barolong, Basarwa, Bangologa, Afrikaners, Batlhaping, Bahurutshi, Batlhware, Bakgalagadi and others. Primary languages are Setswana, Afrikaans and Sekgalagadi; west of Middlepits Afrikaans is the majority and preferred language. Predominant Occupations: The Government of Botswana employs a number of individuals in the administration of the district and health fields. Farming and hunting continue to provide subsistence however most populations depend on government aided schemes due to the vast remote areas of desert land and lack of diverse employment opportunities.2 “Unemployment rates are high particularly among youth.”2

Relevant Assessments The recent results from the BAIS III 2008 revealed an increase in District HIV Prevalence from 11.8% to 19.1%.

Summary of Community Resources DAC OFFICE – District Administration DAC ADAC M&E Officer Peace Corps Volunteer Driver

2 District Demographic Profile 2 District Development Plan 7 Draft One

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Active VMSAC Villages: VMSAC’s were established in 2004 but were never fully functioning.

Health Care Facilities  1 Primary Hospital (ARV)  5 Clinics  State Prison Clinic  13 Health posts

Voluntary Counseling & Testing Centre (VCTC)– provides VCTC, attends many activities in the district and involved in both the DMSAC and TAC committee.

FBO’s: The Minister’s Fraternal works in partnership with the Counseling Center and facilitates Minister’s Fraternal DMSAC activities such as Candlelight and Month of Prayer.

MenSector: The MenSector core members are active. The MenSector hold many activities throughout the year that are mostly targeting men with the aim to involve them in HIV/AIDS related issues.

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Source: Preliminary BAIS III, 2008 Adapted From Table 7 Estimated HIV Prevalence Rate by Gender Male Female Total 17.0% 20.7% 19.1%

HIV INCIDENCE

Source: Preliminary BAIS III, 2008 Adapted From Table 15 Estimated Incidence Rate by Gender Male Female Total 3.75% 2.81% 3.2%

Teenage Pregnancies (Source: District Health Team figures for Jan - Sept 2009) Females ANC clients under age 20 96 New ANC clients 659 Percent of ANC clients <20 15%

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Teenage Pregnancies (Source: District Health Team figures for Jan - Sept Females 2009) ANC clients under age 20 96 New ANC clients 659 Percent of ANC clients <20 15%

Tuberculosis Source: District Health Team figures for 2007 Males % of Females % of Total % total total New TB cases #DIV/0! #DIV/0! - #DIV/0!

Isoniazid Preventative Therapy Source: District Health Team figures for 2007 Males % of Females % of Total % total total Persons currently taking IPT #DIV/0! - #DIV/0! - 100%

Known Ways to Avoid HIV Infection Source: Botswana AIDS Impact Survey 2004 Technical % identifying the method Report, page 152 to avoid HIV Abstain from sex 43%

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SECTION 2: COMMUNITY SERVICES INVENTORY page 1 of 4 Type Key Target Group

Postal school yth Other Organization Contact Person(s) Address/Location Activities/Services - (who?)

ARV Clinics Gov/Hlth Tsabong - Dr. Wamba Box 5 Tsabong ARV Distribution, Sct Middlepits - Dr. health services x x Mutamba Makopong -

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SECTION 2: COMMUNITY SERVICES INVENTORY FOR KGALAGADI SOUTH continued page 2 of 4 Type Key Target Group

Postal school yth Other Organization Contact Person(s) Address/Location Activities/Services - (who?)

Government Health Sector NGO/CBO/FBO OVCs In Out school yth Men Women Gen. Community PLWHA Council Gov M. Council Private Bag 1, Chairman to DMSAC Ph: 6540061 Secretary Tsabong x Fx: 6540215 BNYC Parastatal L. Gaarekwe P.O. Box 95, Counseling, Youth 12-29 Ph: 6540805/815 71611449 Tsabong Distribution of IEC X X materials, MYAA Women's Affairs Gov Ms. Motshubi Private Bag 25, Gender Advocacy, 16 Department Tsabong days Activism against x x Ph: 6540671 Violence on Women Peace Corps CBO Tumelo Paul S&CD at Clinic Volunteer x x x Ph: 72945522 Fx: 6543019 Peace Corps CBO Peo Mary Middlepits Clinic Clinic Volunteer x x

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SECTION 2: COMMUNITY SERVICES INVENTORY FOR KGALAGADI SOUTH continued page 3 of 4 Type Key Target Group

Postal

Address/Locatio school yth Other

- Organization Contact Person(s) n Activities/Services ut school yth (who?)

Government Health Sector NGO/CBO/FBO OVCs In O Men Women Gen. Community PLWHA VCTC NGO Ms. Tsholo Private Bag 11, Voluntary Counseling Couples Ph: 6540759 Gaotswake 71407084 Tsabong and Testing, Training x x x Families Fx: 6540760 Ministers' FBO Nelson Motsewapuo c/o DMSAC Month of Prayer, Fraternal Candlelight x Phone: 72986355 DistrictMaleAction CBO G. Mosweu Kokotsa Health Male Involvement Group (DMAG) Post X Ph: 6545502 Motheo Support CBO Mpho Matswiri - P.O. Box 5, Support for PLWHA & Group Chairperson Tsabong affected x x Ph. 6540235 71280430 CBO CBO x x Support Group CBO Draihoek x x Support Group CBO Omaweneno x x Support Group CBO Werda x x Condom CBO VACANT Distribution ------Officer VMSAC CBO Rachel Magalie x 0782404999 Conven VMSAC CBO Fredrick Titus 08277 Convenor – DAC Planning, x implementation, VMSAC CBO Hilda Kamboer coordination, monitoring 0726781732 of HIV/AIDS related x Convenor – DAC activities at village level

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VMSAC CBO Fredrick Matthys 0027798136033 x Convenor – DAC VMSAC CBO Teko Chimbombi 72713721 Convenor x S&CD VMSAC CBO C.K. Kaekwe - x Convenor S&CD VMSAC CBO Convenor – DOCET x

VMSAC CBO Convenor – DOCET x VMSAC CBO Neo Kgaodi Convenor - Economic Planning x

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SECTION 3: PRIORTIY ISSUES

Priority Issue 1: High HIV incidence rate Objective: To reduce incidence rate in the District from 3.2% to 3% by March 2011

Priority Issue 2: High rate of teenage pregnancy Objective: To reduce teenage pregnancy in the District from 15% to 10% by March 2011

Priority Issue 3: High number of women with STIs Objective: To reduce percentage of STI cases amongst women in the District from 7% to 5% by March 2011

Priority Issue 4: Low HIV testing uptake Objective: To increase the number of people tested for HIV from 4,315 to 6,473 by March 2011

Priority Issue 5: Men defaulting on ARV treatment Objective: To reduce the percentage of men defaulting on ARV in the District from 2% to 1% by March 2011

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Priority Issue 1: HIGH HIV INCIDENCE RATE Objective: To reduce incidence rate in the District from 3.2% to 3% by March 2011 Activity & Target Group Organization Impleme Expected Annual Budget Breakdown Budget Total Source of Funds nting Qtr Outputs

ACTIVITY # Other

1 2 3 4 MLG&RD /NACA ACHAP BOTUSA (who?) 1 Talk shows on ways to BNYC / Youth & X X X To have reached 1,500 Conference hall P42,000.00 X avoid HIV infection Culture / youth (500 each P500.00 MenSector / DAC quarter) and given the Office information materials Promotional Materials on HIV infection. One P500.00 session per qtr Flip Chart P150.00 x2 = P300.00 Markers P100.00 x 2 packs =P200.00 Snacks P25.00 x 500 people =P12,500.00

Activity total P14,000.00 x 3 qtr

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ACTIVITY # Other

1 2 3 4 MLG&RD /NACA ACHAP BOTUSA (who?) 2 a Female and male Prisons X 130 Inmates and 40 Tea for officers and P1,300.00 X condom education and officers educated on facilitators 40 people demonstration campaign proper use of condom. @P15.00 each = P600.00 Snack 130 Inmates P700.00

Activity total

P1,300.00 2 b Female and male DHT Health X 300 people per village Subsistence P129.50 x 4 P37,590.00 X condom education and Education Div. educated on proper use people x 5 days = demonstration campaign of condom. P2,590.00

Promotional materials P30,000.00

DJ with PA system P1,00.00 x 5 days = P5,000.00

Activity total

P37,590.00 3 Health talks during MenSector / X 150 Men attend Kgotla Kgomo/Meat = P4,000.00 X National men’s chilling sessions Tebelopele / DAC and fireside chat on P4000.00 MenSec Office HIV/AIDS related Food = P2,000.00 tor issues. P2,000. Activity total 00

P6,000.00

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ACTIVITY # Other

1 2 3 4 MLG&RD /NACA ACHAP BOTUSA (who?) 4 Health talks during Women’s Affairs, X 80 people reached and Tea P15.00 x 20 people P5,200.00 X women’s chilling Tebelopele participate in health x 4 sessions = sessions talks on HIV/AIDS P1,200.00 related issues. Lunch P50.00 x 20 people x 4 sessions = P4,000.00

Activity total

P5,200.00 5 Life skills training and Kgomotso, CJSS X X X Reach 14 abstinence Meeting Snacks P20,085.00 X motivational meeting for clubs and 3 CJSS 30 members x 6clubs x PACT and abstinence PACT clubs (30 P30.00 per person = club members members per club) P5,400.00 Subsistence 6 clubs per quarter, 5 2 people x P129.50 x 5 clubs last quarter. 5 villages = P1,295.00 villages targeted per quarter Activity total Conduct one day P6,695.00 x 3 qtr workshop on life skill

training.

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ACTIVITY # Other

1 2 3 4 MLG&RD /NACA ACHAP BOTUSA (who?) 6 Road shows in two MenSector, DHT. X X 300 people per Artist/Entertainer P 14,800.00 X National catchment areas to BNYC, Tebelopele catchment area per P5,000.00 MenSec address MCP quarter reached with Accommodation for artist tor MCP message & driver P4,000. 2rooms @ P400.00 x 2 00 nights = P1,600.00 Food for artist & driver P200.00 per/person x 2 people x 2days = P800.00 Promotional Burners & posters P2,000.00 (National MenSector)

Activity total P9,400.00 x

2 Qtrs 7 Purchase laptop, Tsabong Primary X X X Resource Center Laptop = P7,000.00 P 38,000.00 X projector, video and Hospital Equipped Projector = P5,000.00 photo camera and books Digital Camera = for Resource Center P3,000.00 Video Camera = P3,000.00 Resource Books, VHS, DVDs = P20,000.00

Activity Total

P38,000.00 PRIORITY ISSUE 1: HIGH HIV INCIDENCE RATE TOTAL P 162,975.00

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Priority Issue 2 :HIGH RATE OF TEENAGE PREGNANCY Objective: To reduce teenage pregnancy in the District from 15% to 10% by March 2011 Activity and Target Organization & Impleme Expected Annual Budget Breakdown Budget Total Source of Funds

Group Contact Person nting Outputs Quarters

ACTIVITY#

Other

1 2 3 4 MLG RD ACHA ACA P BOTU SA (who?) 1 Monthly supportive DHT, Kgomotso X X X 14 abstinence clubs Subsistence Allowance P5,827.50 X meetings with & Tebelopele supported 15 days x P129.50 x 3 abstinence clubs Visit 5 schools/clubs people =P5,827.50 for five days

Activity total P1,942.50 x 3 qtr

2 Implement Youth Matron DHT X X 2 porta camps P70,000.00 x 2 P140,000.00 X Friendly Services purchased for the implementation of youth friendly services

for specific locations 3 Distribution of Tebelopele / X X X X Intensify condom Stipend P300.00 per P75,600.00 X condoms DHT/DAC Office distribution in the month x 21 villages x 3 district both male and months = P18,900.00 female condoms at public areas, bars Activity total P18,900.00 x 4 qtr

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4 Supportive meetings BNYC, Culture X X Provide support to 3 Conference hall P7,400.00 X for out of school youth and Youth youth groups with P500.00 x 3 = groups follow up in the 4th P1,500.00 quarter. Flipchart P150.00 x 2 = P300.00 Markers 1 packets= P100.00 Snack 20 people x 3 groups x P30.00 = P1,800.00 Activity total

P3,700.00 x 2 qtr 5 Boys and girls street BNYC, CJSS X X To reach 1,000 youth Promotional materials P41,000.00 X bash in the district through P500.00 the street bash Music System P6,000.00 Snacks P25 x 500 people = P12,500.00 Burners P3,000.00 (one qtr only)

Activity total

P22,000.00 x 2 qtr

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6 Youth camp BNYC, X To reach at least 100 School hall P47,100.00 X Kgomotso, CJSS youth P250.00 x 3= P750.00 Class accommodation P100.00 x 3 nights = P300.00 Food Breakfast & tea P50.00 x 100 youth x 3 days = P15,000.00 Lunch P50.00 x 100 x 3 days = P15,000.00 Super P50.00 x 100 x 3 days = P15,000.00 Flip Chart P150.00 x 3 = P450.00 Marker P100.00 Promotional Material P500.00 for copies

Activity Total

P47,100.00

PRIORTIY ISSUE 2 HIGH RATE OF TEENAGE PREGNANCY TOTAL P316,927.50

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Priority Issue 3:HIGH NUMBER OF WOMEN WITH STIs Objective: To reduce percentage of STI cases amongst women in the District from 7% to 5% by March 2011 Activity and Target Organization Implementin Expected Annual Budget Breakdown Budget Total Source of Funds Group and Contact g Quarters Outputs

Person

/NAC

1 2 3 4 MLG&R D ACHAP A BOTUS OtherA (who?) 1 Condom campaigns Tebelopele x x X 50 VMSAC 10 Male Condom models P79,500.00 X on both female and participants in 10 Female condom models male condom half day (NACA) workshop Entertainment P500.00 followed by Food 200 people x P100.00 condom = P20,000.00 education & ½ day Workshop for demonstration VMSAC with 50 participants with 200 x P120.00 = P6,000.00 attending. Conduct in one Activity Total catchment per P26,500.00 X 3 Qtrs

qtr. 2 House to house DHT X X X To reach out and 1 Day Workshop P10,800.00 X visits on SRH and empower 105 40 people (35 VMSAC issues of gender BONEPWA VMSAC members + 5 facilitators) x through support members to visit P90.00 = P3,600.00 group. women and sensitize them Activity total on reproductive P3,600.00 x 3 quarters

health .

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3 Health talks on DHT, TPH, X X Conducting No budget P00.00 X Safe Male MenSector Health talks Circumcision during kgotla meetings and focus group

discussions 4 Train health TPH /DHT X 40 health 40 Health workers x P97 P4,180.00 X workers on workers trained meals = P3,880.00 syndromic on syndromic Venue conference rooms = management of management of P300.00 STIs STIs Activity total

P4,180.00

PRIORITY ISSUE 3 HIGH NUMBER OF WOMEN WITH STIs TOTAL P 94,480.00

Priority Issue 4: LOW HIV TESTING UPTAKE Objective: To increase the number of people tested for HIV from 4,315 to 6,473 by March 2011 Activity and Organization Implementing Expected Annual Budget Breakdown Budget Total Source of Funds Target Group and Contact Quarters Outputs Person

1 2 3 4 MLG&RD NACA ACHAP BOTUSA Other (who?)

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Priority Issue 4: LOW HIV TESTING UPTAKE Objective: To increase the number of people tested for HIV from 4,315 to 6,473 by March 2011 1 Football for life, MenSector, X X 100 people tested Football kits, medals, balls, P59,600.00 X National test for life Tebelopele, and counseled for referee kit, printing of kit, MenSector DAC Office HIV present for guest speaker 60,000.00 P30,000.00 (Nat. MenSector) 60 people attend workshop on HIV ½ day Workshops 60 people x & other health P60.00 x 3 days =P10,800.00 related topics Pageant prizes P2,000.00 One catchment Meat per quarter P10,000.00 Food 20 facilitators x P50.00 x 7 days = P7,000.00

Activity total NACA P29,800.00 x 2 qtr

Nat.MenSector P30,000.00 x 2 2 Run for life, test BNYC, DHT, X 70 people tested Food P16,000.00 P22,000.00 for life DCY, and counseled for Prizes for participants Tebelopele HIV P6,000.00

Create Activity total awareness about P22,000.00

healthy lifestyles.

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Priority Issue 4: LOW HIV TESTING UPTAKE Objective: To increase the number of people tested for HIV from 4,315 to 6,473 by March 2011 3 Red Rose Tebelopele X X Increase the Food P29,600.00 X Couple testing number of P120.00 x 100 people (50 dinner couples who test couples) P12,000.00 together 100 Red roses P500.00 couples = 200 Cups P1,400.00 people (50 Dinner candles (4 x 10 tables) couples per P400.00 quarter) Music DJ P500.00

Activity Total

P14,800.00 x 2 qtr 4 Village couple Tebelopele X X Reach 3000 Promotional materials P53,000.00 X counseling and individuals P5,000.00 testing Food 200 people x P100.00 competition Reach 20 couples per person = P20,000.00 in each village – Trophy for winning village total 100couples P3,000 (one qtr only)

Activity Total

P28,000.00 x 2 qtr

PRIORITY ISSUE 4: LOW HIV TESTING UPTAKE TOTALS P164,200.00

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Priority Issue 5: MEN DEFAULTING ON ARV Objective: To reduce the percentage of men defaulting on ARV in the District from 2% to 1% by March 2011 Activity and Organization and Implementin Expected Budget Breakdown Budget Total Source of Funds Target Group Contact Person g Quarters Annual Outputs

1 2 3 4 MLG&RD NACA ACHAP BOTUSA Other (who?) 1 Training TPH/DHT/ DAC X X X 70 VMSAC 1 Day Workshop P18,900.00 X workshops for Office members per 70 participants x P90.00 = VMSACs on quarter total P6,300.00 ARV adherence 210 for the year to be Activity total trained on P6,300.00 x 3 qtrs adherence

counseling 2 Bi-annual ARV ARV Sites X X Each site to No funds requested P 00.00 group Managers hold 2 group adherence Support Groups adherence counseling counseling meetings per year with patients on HAART and

caregiver for 3 “Bua Mompati” ARV Site X X Support for 25 Tea and lunch P10,500.00 debriefing Managers Adherence 25 people x P70.00 = meeting for partners with P1,750.00 x 3 ARV sites = adherence debriefing P5,250.00 meeting 3 sites per Activity total

quarter P5,250.00 x 2 qtr

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1 2 3 4 MLG&RD NACA ACHAP BOTUSA Other (who?) 4 ARV adherence DHT/TPH/DAC X X Adherence No funds requested P 00.00 week within the week District conducted in 6 ARV sites

PRIORTIY ISSUE 5: MEN DEFAULTING ON ARV TOTAL P 29,400.00

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NSF Goal 3: Strengthening Management, Capacity Building Objective: DAC Office Coordinating District Response Activity and Organization and Implementin Expected Annual Budget Breakdown Budget Total Source of Funds Target Group Contact Person g Quarters Outputs

Other

1 2 3 4 MLG &RD ACHA NACA P BOTU SA (who?) 1 District DAC Office X X X X Furnish office Materials & Supplies P50,000.00 X HIV/AIDS (DAC, ADAC, with supplies P5,000.00 x 4 qtr = Management M&E Officer, and materials. P20,000.00 PCV) Provide tea & Subsistence (Workshop sandwiches for traveling & imprest) meetings P30,000.00

2 District DMSAC X X X District 5 page newsletter P20,000.00 X Newsletter Newsletter

3 VMSAC DAC Office X X X Implementation 21 villages x P2,500.00 each P52,500.00 Activities of VMSAC evidence based Activity Total

plans P52,500.00 4 District Annual DAC Office X District Plan Accommodation P46,350.00 X Plan (Evidence 20 people x P500.00 per Based Planning room x 3days Session) P 30,000.00 Food 20 people x P250 per day x 3 days P 15,000.00 Conference room P450 x 3 days P1,350.00

Activity Total

P46,350.00 NSF GOAL 3: STRENTHENING MANAGEMENT, CAPACITY BUILDING TOTALS P168,850.00

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National Commemorations Objective: Activity and Organization and Implementin Expected Annual Budget Breakdown Budget Total Source of Funds Target Group Contact Person g Quarters Outputs

Other

1 2 3 4 MLG &RD ACHA NACA P BOTU SA (who?) 1 Minister’s Ministers X Officiate 40 people x P120 x 2 days P19,200.00 X Fraternal Fraternal candlelight and 2 P 9,600 x 2 Villages Candlelight day workshop Memorial for 40 people in

two villages 2 Month Of Ministers X Officiate Month 2 villages P30,000.00 X Prayer Fraternal of Prayer in two -Launch villages

-Close 3 District World VMSAC X Commemorate Food, pageant prizes P25,000.00 X AIDS Day WAD

4 Month of Youth BNYC, DCY X Musician P7,000.00 P40,000.00 X Against AIDS Promotional Materials P8,000.00 Burners P3,000.00 Lunch P55.00 x 400 people = P22,000.00

Activity Total

P40,000.00 NATIONAL COMMEMORATIONS TOTAL P114,200.00

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SUMMARY

Totals Priority Issue 1 162,975.00 Priority Issue 2 316,927.50 Priority Issue 3 94,480.00 Priority Issue 4 164,200.00 Priority Issue 5 29,400.00 NSF GOAL 3 168,850.00 National Commemorations 114,200.00

GRAND TOTAL 1,051,032.50

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Appendix I: Budget Modification Guideline Template

District ______

Planning Year ______

1. Who will you involve in your budget modification process? List the individuals, their positions, and 1-2 sentences explaining why you will include them.

Individual Position Why will you include them?

2. When and where will you meet with these individuals?

3. Are there any fixed costs that cannot be changed? Yes ___ No ____

4. If there are fixed costs, list them below. For each fixed cost, provide an explanation for your stakeholders as to why they cannot be changed.

Fixed Cost Why can it not be changed

5. Will you conduct across-the-board cuts, or selective cuts? Explain why.

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6. If you choose selective cuts, what was your process? Circle (A), (B), (C), and or (D), and provide an explanation for how you made your cuts.

A) Did you cut out an entire priority area?  Which priority area did you cut out?

 What was your justification for cutting this area?

B) Did you cut out duplicative activities?  List the activities you cut:

 Which activities did they duplicate?

 Why did you cut this activity rather than the one it duplicated?

C) Did you cut weak or unevaluated activities?  List activities you cut:

 What data did you use to determine these activities were weak?

D) Did you combine or link activities?

 Which activities did you combine?

 Why do you think these activities could be combined?

E) Scored and rank all activities according to objective criteria? For example:

Criteria Score (5 = highest, 1= lowest) The problem that this activity addresses is ranked as a high priority in the plan The activity is likely to be effective as it is Promising Prevention Practices The activity is likely to be effective because monitoring and evaluation data show success (numbers reached, changes in KAB) Continuation of this activity is critical for the success of other related

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activities (e.g., provides referral services ) This activity fills a gap in the district response that no other activity addresses. This activity is not being funded by any other source This activity responds to NSF and National Priorities Others

7. Sharing information with stakeholders.

 Will stakeholders/IPs have the opportunity to provide input or will your decisions be final? Why?

 Which stakeholders need to be informed of your decisions?

 Who will inform them?

 When will you inform them?

 List your talking points below.

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Communicating Effectively

Expected Session Time: 6.5 hours

Module Content Overview ...... 231 Applied Public Health Program Management Training ...... 231 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 233 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 235 ALDP Facilitator Guide Overview ...... 238 Session Overview ...... 240 Description of Session ...... 240 Materials & Equipment ...... 240 Preparation ...... 240 Pre- and Post- Training Assessments ...... 240 Presenter’s Notes: Communicating Effectively ...... 241 Appendices ...... 269 Appendix J: Exercise: Communication Style Inventory ...... 270 Appendix K: Sample Email ...... 274 Appendix L: Principles of Effective Writing ...... 275 Appendix M: Communication Strategy ...... 277

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

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Applied Leadership Development Program | Communicating Effectively 232

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program | Communicating Effectively 234

Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives.

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3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Applied Leadership Development Program | Communicating Effectively 239

Session Overview Description of the Session

This 6.5 hour session is designed to provide an overview of basic communication styles and methodologies. The session will 1) provide the knowledge and skills necessary to translate evidence-based information; 2) provide education on how to make oral presentations; 3) discuss how to effectively deal with disruptive meeting behaviors; and 4) provide basic guiding principles for effective writing.

Materials & Equipment

Preparation

□ Make copies of the Communication Style Inventory (Appendix J)

□ Make copies of the Sample Email (Appendix K)

□ Make copies of the Principles of Effective Writing handout (Appendix L)

□ Make copies of the Communication Strategy handout (Appendix M)

Pre- and Post- Training Assessments

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Presenter’s Notes: Communicating Effectively

Slide 1: Communicating Effectively

Slide 2: Learning Objectives

Speaker Notes:  Read the slide  In your work on a daily basis, you need to communicate with others. It is important to communicate effectively if you want to be successful in implementing programs and making an impact. This session will help increase your communication skills  There are also times in your jobs when you need to prepare written communications. This session will also help increase your ability to prepare various business documents

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Additional Facilitator Guidance:  There are specific objectives that you will achieve by the end of the course  You will understand: o Communication Styles and have the opportunity to look at your own style o Tailoring messages for specific audiences to better meet their needs o Using tools to strategically plan communication with stakeholders/partners o How to prepare and deliver an effective presentation o How to prepare written business communication

Slide 3: Participant Introductions

Speaker Notes:  Ask each participant to answer the questions on the slide Additional Facilitator Guidance:  Follow up questions could include: o Why do you think you communicate well with that person? o Why do you think you can improve communication with that person?

Slide 4: Communication Styles

Speaker Notes:  Explain that the first portion of this session will deal with the different communication styles that people exhibit

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Slide 5: Quote from Lao Tzu

Large Group Discussion:  Ask for a volunteer to read the quote on the slide  Ask the two to three people from the group to share their interpretation of the quote

Slide 6: Definition of Communication

Speaker Notes:  This slide contains progressions  Do not click until the large group discussion is completed  At the conclusion of the discussion affirm the wealth of knowledge in the room  Click to reveal definition of communication; read the definition for communication  Click to reveal the types of communication and explain that we will discuss each of these types of communication with particular attention to verbal and non-verbal communication Large Group Discussion (10 minutes):  Ask the participants to define communication and kinds of communication  Brainstorm a list of ineffective communication strategies and effective strategies

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Slide 7: Communication Styles

Speaker Notes:  People have different communication styles that affect how they relate to others  These styles determine how we use information and view things  Styles have been grouped into major types. There are different models for studying communication styles, but there are general similarities among the models  Today we will look at one model and determine our own styles  No one style is good in all circumstances, so one style is right or wrong  We can have the same commitment and goals as another person, but still see things differently  Knowing our own styles helps us understand our own behavior better, as well as that of others. It can help us see when miscommunication is occurring  Keep in mind that each individual is unique and communication style can only tell us so much

Slide 8: Exercise: Communication Style Inventory

Pre-Session Preparation:  Print enough copies of the Communication Style Inventory (Appendix J) for each participant  Write the name of each style on a sheet of flip chart paper and hang in each of the four corners of the room Large Group Activity Activity Instructions (20 minutes):  Hand out the Communication Styles Inventory to participants  Read through the instructions on how to complete the inventory  Tell participants that each style will be reviewed in detail after they have finished

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Slide 9: Exercise: Communication Styles, cont.

Speaker Notes:  Make sure that all participants were able to complete the inventory without problems and have determined their own style Small Group Activity:  Ask the participants to go to the corner that matched which style they were on the inventory  Identify the four major styles, and ask the participants to share whether they were surprised at their results or whether they confirmed what they already thought  Tell the participants that each communication style has positive and negative aspects  Brainstorm in your group about the pros and cons of your style

Slide 10: Communication Styles, cont. – Supporter/Relater

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Slide 11: Communication Styles, cont. – Analyzer/Thinker

Slide 12: Communication Styles, cont. – Promoter/Socializer

Speaker Notes:  While participants are still in the corners of the room corresponding to their communication style, review the characteristics on the slide  In addition to what participants may have also shared, the following characteristics may be true as well: o Strengths: Maintains a positive attitude when others are discouraged, supports a hopeful outlook on solving problems, contributes ideas o Weaknesses: May not be able to concentrate on getting a difficult task accomplished, may not be seen as serious enough for the situation, may not be realistic about how negative a situation may be

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Slide 13: Communication Styles, cont. – Controller/Director

Speaker Notes:  While participants are still in the corners of the room corresponding to their communication style, review the characteristics on the slide  In addition to what participants may have also shared, the following characteristics may be true as well: o Strengths: Makes decisions, can provide specific direction to others, keeps focused on the end product o Weaknesses: May take over without authority, may give others assignments and not do work himself/herself, may be focused on personal gain Additional Facilitator Guidance:  Additional follow-up questions, once all the pros and cons of each style has been discussed: o Have you seen any of these styles in the people you work with? o Given your own style, how has it been to work with people of other styles? o Do you work better with one style over another? Why?

Slide 14: Non-Verbal Communication

Pre-Session Preparation:

 Print out the “Nonverbal Communication” handout Speaker Notes:  It is important to understand your own non- verbal communications and the intended or unintended impressions that you are making  It is equally important to

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understand how others are communicating non-verbally: o Are they frustrated o Nervous o Not interested Large Group Activity (5 minutes):  Using the Nonverbal Communication handout as your guide, pick two to three examples from the sheet and act them out (i.e., stand with fists clenched, arms crossed and wide stance (aggressive) or tap feet and continually look at your watch (bored)  Ask the participants what your body and face are conveying (wait for responses)

Slide 15: Communication: Verbal and Non-Verbal

Pre-Session Preparation:  Make sure that the “Not So Effective Communication” video is saved to the laptop that is being used for this presentation Speaker Notes:  Click on the box to start the short video  Once the video is complete discuss the video and ask: o What non-verbal communication is observed (speaker and audience)? o Was the speaker effective in conveying his message? Why or why not? . Jargon . Acronyms . Not observing audience response o How could the speaker been more effective?  It is important to observe both the verbal and non-verbal communications

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Slide 16: Communication Skills

Speaker Notes:  Communicating well helps build trust and respect, foster learning, and help accomplish tasks  Oral, written, and non- verbal (body language) are all important, but often the non-verbal communication is the most important in communicating how we feel to others  The section will include specific detail and examples of effective verbal and non-verbal communication skills

Slide 17: Why is Communication Important?

Speaker Notes:  Ask for answers to the question “Why is communication Important?” o Get two to three answers  Click to reveal the answers to the question Additional Facilitator Guidance:  We are communicating constantly  Communication is inevitable and vital to our survival  How we get our needs met and get information

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Slide 18: Communication Skills (non-verbal)

Speaker Notes:  This slide lists a number of communication skills that are non-verbal. Non-verbal communication is how people act and appear rather than the word they use  Demonstrate for participants how non-verbal communication can change a verbal statement. “This is just wonderful” can be said in an excited, supportive way or in an angry manner (as thought the person is not really happy)  Review examples on non-verbal communication

Slide 19: Communication Skills (verbal)

Speaker Notes:  The items on this slide are examples of verbal communication skills  Review examples of communication techniques  Simplify thoughts before you start: o Important to know the points you want to get across. Too wordy or detailed, you can lose the audience  Be aware of tone: o If your voice sounds nervous, irritated, or sad, that is what will come through clearly to your audience  Ask questions: o It is important to hear from the other person or persons. You get the best information when you don’t just ask “yes or no” questions, but ones that are open-ended  Use active listening:

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o Really listening can be your most important skill. If you pay attention to what the other person is saying (as well as demonstrating non-verbally) you can get the information you need and assess a situation accurately. Takes practice to really hear others. Try not to spend the time that someone is speaking thinking about your next statement. Avoid interrupting the speaker  Paraphrase what has been said: o This is an active listening skill. You can say back to the person what you hear him or her saying, so that the person knows you are listening. Paraphrasing is not the same as interpreting what has been said, but rather saying it back in slightly different words  Provide an example: o “So let me clarify – your position is…?”  Use “I” statements: o Instead of saying “you are wrong,” say “I see it differently than you do”

Slide 20: Exercise: Communication Skills (cont.)

Pre-Session Preparation:  Have flip chart paper and markers available Speaker Notes:  The goal of this exercise is to help participants understand that there are a few common difficulties and that they can have some strategies to address them  Acknowledge that conflict, especially in a meeting setting, is very anxiety provoking for most people and it is one of the biggest challenges during a meeting/interaction Small Group Activity (15 minutes):  Break the participants into groups of 5 to 7 people  Ask them to brainstorm a list of difficult situations  As a small group, work together to rank the top 5 most common difficult situations during a meeting  Report back to the larger group what they found  Document the similarities across the groups on flip chart paper

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 With the shared list of top 5 most common difficult situations, ask the small groups to brainstorm the most effective ways to resolve them

Slide 21: Dealing with Conflict

Speaker Notes:  Review the list with participants  Acknowledge where they came up with similar solutions in their small groups  Discuss any other solutions that were suggested

Slide 22: Effective Presentations

Speaker Notes:  During this session we will discuss methods, strategies and best-practice for planning and delivering effective presentations  While there are many things that can make presentations more effective, keep in mind that your own style will also help determine what works best for you  This material is presented from the standpoint of the leader of a group, but you will see that some points apply to participants as well

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Slide 23: Effective Presentations

Speaker Notes:  Before you Click to reveal the general presentation guidance/suggestions, ask the participants: o How they know a presentation was effective (i.e., audience asked engaging questions, nods of approval, etc.) o What are some of their insights about the keys of effective presenting  Click to review suggestions for an effective presentation  Review slide content Large Group Discussion (10 minutes):  Create a checklist with the participants for preparing for a presentation (TOR as a guide)  Record participant responses on flip chart  Some possible points include: o Meeting with the meeting conveners beforehand and asking about . The objectives of the meeting . Who is the audience? . The political climate about the topic . How much time? . AV needs and room set-up

Slide 24: Presentation Skills

Speaker Notes:  Let the participants know that we are going to focus on four key elements in presenting

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Slide 25: Presentation Skills, cont. – Audience

Speaker Notes:  Review items to consider about the audience  Provide an agenda or outline  Gives audience an idea of what to expect  Know who they are (age, gender, experience) o The more you know about your audience, the more you can tailor your presentation to their needs  Know their expectations o You can start by asking them what they expect to get out of the presentation or training o Can send out something ahead for input  Use examples they understand o Try to relate your examples to something they might have experienced either professionally or personally  Be appropriate in what you say; don’t offend o Humor is often helpful in getting an audience comfortable, but be careful that it is appropriate o If you have any doubt about something, don’t say it  Keep the stress down o Try to involve participants, but don’t make them so uncomfortable they get stressed o Don’t focus too much attention on any one person o Don’t let one person try to speak for the whole group. Each person needs to speak as an individual o Audiences retain more if they aren’t stressed  Deal directly with anger o Don’t let angry statements go unaddressed o Respond without getting angry yourself

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Slide 26: Presentation Skills, cont. – Content

Speaker Notes:  Review the items to consider about content  Prepare, prepare, prepare o The more comfortable you are with the material, the better you will present. o The more you have thought about the flow, possible responses, questions, and similar items, the better prepared you will be  Select key points o Know the main points you want to convey and make sure you get these across  Be clear o You may be so familiar with what you are saying that you assume everyone else understands. Think about what might be confusing and how you can be clear in conveying the message  Be concise o If you say too much, the audience will forget the key messages  Use examples o Examples help with understanding

Slide 27: Presentation Skills, cont. – Process/Delivery

Speaker Notes:  Review the items to remember about process/delivery  Practice, practice, practice o The more you review what you are going to say and do, the smoother your presentation will be

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 Follow a natural sequence o Think about how your thoughts connect o The more you jump around with your presentation, the more confused the audience is likely to be  Think through possible questions o You may be able to have answers ready o If you get a question you can’t answer, it is okay to say you will check into it  Anticipate problems o The more you anticipate, the more prepared you can be when something does happen o Think about alternatives if things go wrong  Manage the silence o Don’t panic if things get quiet o Wait a little while, ask a question if it fits, then move on  Effectively use visuals o People are used to seeing something while they listen  Make it helpful to the presentation

Slide 28: Presentation Skills, cont. – Environment

Speaker Notes:  Review the list of items to remember about the environment  Check out space in advance o Make sure it is the right size o Make sure it can handle your electronic equipment  Arrive early o Don’t start out by feeling pressured from rushing o Make sure things are set up as they need to be  Ensure equipment is working o Test it out ahead of time

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 Dress appropriately o Know what is considered acceptable business dress for the audience and the event

Slide 29: PowerPoint

Speaker Notes:  Ask for a show of hands by the participants if they have experience preparing a PowerPoint presentation. Let them know that the pointers for PowerPoint can also be applied to handouts  Ask the participants what they like and don’t like about seeing PowerPoint presentations  Review the main points listed on the slides: o Gives the basic information . It helps a presentation by giving it structure . Does not duplicate the presentation material, but supports the material o Makes a visual connection . People often follow a presentation better if they can see and hear o Guides the presenter . Helps the presenter stay focused on the material to be covered

Slide 30: PowerPoint, cont.

Speaker Notes:  Review the list of basics of PowerPoint:  Less is more o Too much material will be difficult to follow  Use contrasting colors o Don’t let your text fade into the background

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 Use phrases, not complete sentences o Remember that the PowerPoint just highlights key points o You don’t want the audience spending a lot of time reading the slides

Slide 31: PowerPoint, cont.

Speaker Notes:  Review the suggestions for PowerPoint presentations:  Distracting animation  While the slides should be interesting, animation can take away from the points you are trying to make. o Sound effects  Too much text o It should not be a struggle for the audience to read the slides o If the audience is concentrating on reading, they may not be listening.  Too many photos o Photos should be used strategically to make a point o Too many photos and they can become the most important part of the presentation, not the information  Too many slides o Be aware of the length of the presentation in relation to the number of slides. o A short presentation does not need a lot of slides  ALL CAPITAL LETTERS o Words should be capitalized when necessary for a point. All capitals can be distracting

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Slide 32: Example Slide

Large Group Discussion (5 minutes):  Ask the participants to identify what is good or bad about this slide.  Possible responses o This is not a good example of a PowerPoint o The font is in a difficult to read color o There are typos o The bullets are in long, complete sentences o There is too much text on the page

Slide 33: Example Slide, cont.

Large Group Discussion (5 minutes):  Ask the participants to identify what is good or bad about this slide  Possible responses: o Easy to read o Short list of bullets o Guides the presentation, but doesn’t take long to read o Visual added o No typos

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Slide 34: Written Communication

Speaker Notes:  This session will focus on developing various types of written materials

Slide 35: Methods for Written Communication

Speaker Notes:  The several types of written materials you might need to prepare include: o Email o Program Reports o Proposals o Meeting Minutes o Success Stories o Data Reports  Ask if there are other types of written reports that they prepare?  Due to time restrictions this session will focus primarily on emails and progress reports  Meeting minutes will be discussed in the next session

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Slide 36: Methods for Written Communication: Email

Speaker Notes:  Ask participants what they like about emails and what they do not like about emails (wait for responses)  Review the list of email “dos”  Make sure it is the best method o The reader cannot tell tone from an email, so it may not be best if in- person or telephone communication might be clearer o If something is very detailed, it might be hard to explain in an email o People who use email a lot may rely on it too much  Get to the point o People don’t always read an entire email, so your main messages need to be near the beginning so they aren’t overlooked  Think about who should be copied o Don’t just automatically copy people o Copy those who need to know or who you need to keep informed  Be clear about what you need o The reader should not have to guess o If you need a response, be very specific about what you need them to answer  Use good grammar o Even though an email is not as formal as some other communications, it should still be written in a professional manner  Be aware of the tone that come across in the email o Use polite expressions like thank you and please  Think before forwarding  People who send you emails often don’t expect them to go to others. There may be something there that you don’t remember and that should not be forwarded

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Slide 37: Email, cont.

Speaker Notes:  Review the list of email “don’ts”  Send an email when emotionally charged o Emails should be professional, and you are likely to say something you will regret later  Use “reply all” unless necessary o Keep in mind the earlier advice to only send emails to those who need to know o Most people do not want to take the time to read unnecessary emails  Include confidential information o Emails are not a secure method of communication  Include too many different topics o The reader is likely to miss important messages if too many things are in the email  Forward other messages without a summary o People often forward a string of emails and the important information is in the earliest one or two messages. People often don’t read all the way back to the beginning. If you have to forward the string, summarize what you are sending

Slide 38: Principles of Effective Writing

Pre-Session Preparation:  Copies of Principles of Effective Writing handout for participants (Appendix L)  Copies of Example Emails for participant activity (Appendix K)

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Speaker Notes:  Let participants know that effective writing takes planning, practice and time  Click to reveal the five C’s of effective writing  These principles are very basic but can serve as a good foundation for writing effectively. Review each point: o Clear-is your message easily understood by the target audience? Use standard and familiar language o Concise-Keep it short and to the point. People are busy o Complete-are you giving the reader the information they need o Correct-is the information factual and grammatically correct? o Courteous-writing should contain the same level of respect that you would communicate in person

Small Group Activity (15 minutes):  Hand out copies of a poorly written email to the participants. Give them a few minutes to read over the email and then ask them to identify the weaknesses. Note the responses on a flipchart  Break the participants into small groups of about three to four per group and ask each group to rewrite the email to improve it. Give each group 10 minutes to do so. They should be told that it is okay to include other facts they want to include as needed to make the email clear  Each group should report on how they improved the email

Additional Facilitator Guidance:  Examples that may be cited include: o Highlighting the significant facts o Avoiding jargon or acronyms that might not be understood o Using concise, complete sentences o Only including the necessary information o Providing just the amount of background information necessary to make the document clear o Providing a logical sequence to the information o Proof-reading for typos and correct grammar

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Slide 39: Documenting Progress

Speaker Notes:  These reports should be familiar to everyone  Beyond the quantitative data collected, what information is shared for each of these reports?  How can the effective writing skills be applied?  The BHRIMS forms serve as progress reports o They can and should be used to communicate with management success, challenges and suggestions  We are going to look at some actual BHRIMS reports and talk about the use of effective writing skills

Slide 40: BHRIMS Form 003B

Speaker Notes:  This form provides the information requested Large Group Discussion (5 minutes):  What does this section of the BHRIMS form tell us? o No Home Based Care was reported for the 4th quarter  It is “concise”. Is it too concise?  Is there any other information that would be helpful here? o Why are is there no report for the 4th quarter? o Was there an issue with the report? o Do you have suggestions for how you can get better reporting for the home based care program?  Using the effective writing principles how could this BHRIMS form response be improved?

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Slide 41: BHRIMS Form 003B, cont.

Speaker Notes:  Let’s look at one more example from the BHRIMS Form 003B Large Group Discussion (5 minutes):  Looking at the information in bold print—it is obvious that the information is important  Is there additional information that could be included that would be helpful to management and the national HIV response? o What are the potential reasons that mothers are missing appointments? Do you have any suggestions on how to reach those mothers? o Is there any additional information that could be provided regarding the 11 exposed babies that died? Was prenatal care accessed early enough? Did the mother’s refuse services? Could more intensive outreach have helped?

Slide 42: Preparing a Proposal

Speaker Notes:  As was discussed during the “Mobilizing Resources” session, proposal writing is an important part of the DACs job, and a particular skill-set that only gets better with practice  Ask the participants for a show of hands for how many have written and submitted a formal proposal for funding (wait for responses)  Ask the participants what they found to be the most challenging part of writing a proposal (wait for responses)  Review the following tips for proposal writing:

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o If you have specific instructions for preparing the proposal, it is very important to read each word carefully and follow the instructions exactly as given. o Reviewers of proposals will specifically look for the items requested in the order specified. Even if the information is there, if it isn’t easy to find and follow, the proposal will not be as effective o If there is a page limit, stick to it o Preparing a proposal usually takes longer that you think it will, so build in some extra time to handle any unexpected delays o Making it longer in length does not necessarily make a proposal better. Any material that is not needed or does not help support your request should not be included o If you don’t have a piece of information that the guidance requests, it is better to state how you will approach getting it than try to include something else that really doesn’t address the question. The reviewer will realize what you have done o As you plan how to approach your proposal writing, keep the reader in mind. Develop your ideas with an awareness of what the reader needs to see. Make the finished product attractive, with a logical flow

Slide 43: Writing a Proposal

Speaker Notes:  Make sure you clearly identify the purpose for your proposal up front  Background information is necessary for the reader to understand your proposal. However, no more background should be included than is necessary to provide the facts or foundation for your program  Make sure what is written is clear to the reader. If the reader has to spend time trying to figure out what you mean, it will detract from the effectiveness of your proposal  Don’t include anything that doesn’t directly relate to your proposal or support it  Do include any necessary information that will help you make your case. Don’t be so brief that the reader might not understand

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Slide 44: Exercise: Case Study Writing Assignment

Pre-Session Preparation:  Print copies of the Communication Strategies handout (Appendix M) Speaker Notes:  Now we are going to do a short exercise to practice the effective communication and writing skills we have discussed during this session Small Group Activity (30 minutes)  Refer to the case scenario and assign a person in each group a role  Each group should have 45 minutes to: o Decide what are the most important pieces of information to communicate to their chosen stakeholder and why (what do you want the stakeholder to do with this information? What do you hope their response will be? What is your “ask”? o Decide what is the best method of communicating this information (report, e-mail, PowerPoint presentation) to achieve the desired result, and take notes so that they can explain why o Prepare a draft of the communication. The group may elect to develop more than one method if that is the most effective means of communicating it  Bring the participants back into the large group and have a discussion about the process  Each group will present on what they prepared  The entire group should critically respond to each small group presentation as if they were the target audience, and answer the following questions o Why do you think that the group was sharing this information with you? o Was the information clearly and concisely shared? o Would you have liked to have received it in a different way? o What did it make you want to do next?

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Slide 45: Session Highlights

Speaker Notes:  Review the summary of discussion o Communication styles o Tailoring messages for specific audiences o Use of tools to strategically plan communication with stakeholders/partners o Preparing an effective presentation o Writing a proposal

Slide 46: Questions or Comments

Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix J: Exercise - Communication Style Inventory

Appendix K: Sample Email

Appendix L: Principles of Effective Writing

Appendix M: Communication Strategy

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Appendix J: Exercise: Communication Style Inventory

This is an informal survey, designed to determine how you usually act in everyday situations. The idea is to get a clear description of how you see yourself. On the answer sheet, circle A or B in each pair of statements below, which shows the one that MOST describes you.

1. A) I’m usually open to getting to know people personally and establishing relationships with them. B) I’m not usually open to getting to know people personally and establishing relationships with them.

2. A) I usually react slowly and deliberately. B) I usually react quickly and spontaneously.

3. A) I’m usually guarded about other people’s use of my time. B) I’m usually open to other people’s use of my time.

4. A) I usually introduce myself at social gatherings. B) I usually wait for others to introduce themselves to me at social gatherings.

5. A) I usually focus my conversations on the interests of the people involved even if that means straying from the business or subject at hand. B) I usually focus my conversations on the tasks, issues, business, or subject at hand.

6. A) I’m usually not assertive, and I can be patient with a slow pace. B) I’m usually assertive and at times I can be impatient with a slow pace.

7. A) I usually make decisions based on facts or evidence. B) I usually make decisions based on feelings, experiences or relationships.

8. A) I usually contribute frequently to group conversations. B) I usually contribute infrequently to group conversations.

9. A) I usually prefer to work with and through others, providing support when possible. B) I usually prefer to work independently or dictate the conditions in terms of how others are involved.

10. A) I usually ask questions or speak tentatively and indirectly. B) I usually make empathic statements or directly expressed opinions.

11. A) I usually focus primarily on ideas, concepts, or results. B) I usually focus primarily on persons, interactions, and feelings.

12. A) I usually use gestures, facial expressions, and voice intonations to emphasize points. B) I usually do not use gestures, facial expressions, and voice intonations to emphasize points.

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13. A) I usually accept others’ points of view (ideas, feelings, and concerns). B) I usually don’t accept others’ points of view (ideas, feelings, and concerns).

14. A) I usually respond to risk and change in a cautious or predictable manner. B) I usually respond to risk and change in dynamic or unpredictable manner.

15. A) I usually prefer to keep personal feelings and thoughts private, sharing only when I wish. B) I usually find it natural and easy to share and discuss my feelings with others.

16. A) I usually seek out new or different experiences and situations. B) I usually choose known or similar situations and relationships.

17. A) I’m usually responsive to others’ agendas, interests, and concerns. B) I’m usually directed toward my own agendas, interests, and concerns.

18. A) I usually respond to conflict slowly and indirectly. B) I usually respond to conflict quickly and directly.

Survey taken from The Platinum Rule by Tony Alessandra, Ph.D. & Michael J. O’Connor, Ph.D., New York, New York, Warner Brooks 1996

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Answer Sheet

O G D I

1A 1B 2B 2A 3B 3A 4A 4B 5A 5B 6B 6A 7B 7A 8A 8B 9A 0B 10B 10A 11B 11A 12A 12B 13A 13B 14B 14A 15B 15A 16A 16B 17A 17B 18B 18A

Totals______

Total the numbers of items circled in each column and write it on the spaces above.

Now, compare the “O” column with the “G” column and circle the letter that has the highest total.

O or G

Then compare the “D” column with the “I” column and circle the letter that has the highest total.

D or I

So What’s the Verdict?

If you circled the G and D, you tend toward being a Controller/Director.

If you circled the O and D, you show many qualities of a Promoter/Socializer.

If you circled the O and I, you’re predominantly a Supporter/Relater.

If you circled the G and I, you have lots of Analyzer/Thinker characteristics.

Supporter/Relater  Harmonizer  Values acceptance and stability in circumstances  Slow with big decisions; dislikes change  Builds networks of friends to help do work  Good listener; timid about voicing contrary opinions; concerned for others’ feelings

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 Easy-going; likes slow, steady pace  Friendly & sensitive; no person is unlovable  Relationship oriented

Analyzer/Thinker  Assessor  Values accuracy in details &being right  Plans thoroughly before deciding to act  Prefers to work alone  Introverted; quick to think and slow to speak; closed about personal matters  Highly organized; even plans spontaneity!  Cautious, logical, thrifty approach  Thoughtful; no problem is too big to ponder  Idea oriented

Promoter/Socializer  Entertainer  Values enjoyment and helping others with the same  Full of ideas and impulsive in trying them  Wants work to be fun for everyone  Talkative and open about self; asks others’ opinions; loves to brainstorm  Flexible; easily bored with routine  Intuitive, creative, spontaneous, flamboyant approach  Optimist; nothing is beyond hope  Celebration oriented

Controller/Director  Commander  Values getting the job done  Decisive risk taker  Good at delegating work to others  Not shy, but private about personal matters; comes on strong in conversation  Likes to be where the action is  Take charge, enterprising, competitive, efficient approach  Fearless; no obstacle is too big to tackle  Results oriented

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Appendix K: Sample Email

DATE:

TO:

FROM:

SUBJECT: Various Topics

Hi, everyone. I hope you are doing well. I know that everyone is as busy with work as I am, so I appreciate your taking the time to read this email.

As you already know, the minutes of our last meeting were sent out recently, and I hope that everyone has read them. As stated in the minutes, Mrs. B recommended that we meet at least every other month instead of four times a year. Mr. G would like the meetings to be a little shorter. We have so much business to cover that I don’t know if that is possible. I was so sorry to hear about Mr. H’s granddaughter’s cancer.

I will be sent you a report over the next three weeks with the latest regional HIV date. I am pleased that our programs are encouraging more people to protect themselves against infection.

Please send me your latest program data within the next three days so I can incorporate it into my quarterly report. Thank you very much.

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Appendix L: Principles of Effective Writing

Effective writer use the five C’s of writing: clear, concise, complete, correct, and courteous. Is the message clear? Is it concise? Does it include? All the information needed? Is it grammatically correct? Finally, is the letter courteous?

1. Is the Message Clear? Will your reader understand what you are trying to communicate? For example: Unclear: Our agency has a suggestion program in which employees provide suggestions and are paid if they are’ adopted. (Does this mean that only adopted employees are paid for suggestions?) CLEAR: Our agency has a suggestion program in which employees are paid for suggestions that are implemented.

2. Is the Message Concise? Concise writing eliminates irrelevant and unnecessary words. Professional writing should convey messages as efficiently as possible. The messages should be brief, with clarity and courtesy. For Example: WORDY: Did you have an opportunity to make a decision regarding the job offer we spoke about by phone several weeks ago? CONCISE: Have you decided to accept our job offer?

3. Is the Message Complete? Complete writing involves thinking about your reader and the reader’s purpose. You must also consider how much information the reader requires to have his or her questions answered or to understand the intended message. INCOMPLETE: We plan to meet on Tuesday at eight in the conference room. COMPLETE: We will meet at 8 am on Tuesday, April 16, in the conference room in Darbar Hall.

4. Is the Message Correct? Is the information factual? Is the message grammatically correct? To ensure that the message is correct, pay attention to details. Learn and practice proofreading techniques. Check for typical errors, including errors about time, place, and people. Refer to any previous correspondence and verify information. For example:

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5. Is the Message Courteous? Letters convey the agencies’ image as well as the writer’s to people outside the organization. Letter writers have a responsibility to create and maintain goodwill. Letters must convey the same tone of courtesy and respect that would be expressed in face-to-face communication. For example: DISCOURTEOUS: I do not believe you have made an attempt to pay your bill. If you have a good reason, you certainly have not communicated it to us. COURTEOUS: You have a good reason for being unable to meet your obligation. If you wish to arrange a payment schedule. Please phone me at (804) 555-1616. If not, may we expect your check for the balance by June 1st?

“Effective Written Communication and Principles of Effective Writing.” Business Communication Articles. 22 July, 2013. Webbased, http://www.businesscommunicationarticles.com/effective-written-communication-and- principles-of-effective-writing/.

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Appendix M: Communication Strategy

Facilitator Instructions

For this exercise at least four computers will be needed.

Scenario: The Ditshegwane support group is supported by the DMSAC. They are showing good progress and you wish to highlight their successes and challenges with different partners in the community. (see attached handouts describing Ditshegwane background and progress)

1. Divide the participants into four groups. One group will communicate this information to the funder. One group to the Ministry of Local Government. One group will communicate this information to the DMSAC. One group will communicate this information to the VMSAC.

2. Each group should: a. Decide what are the most important pieces of information to communicate to their chosen stakeholder and why (what do you want the stakeholder to do with this information? What do you hope their response will be? What is your “ask”?) b. Decide what is the best method of communicating this information (report, e- mail, power point presentation, success story) to achieve your desired result, and take notes so that you can explain why. c. Prepare a draft of that communication d. Deliver that communication to the entire group by way of report back.

3. Bring the groups back together.

4. The entire group should critically respond to each small group presentation as if they were the target audience, and answer the following question a. Why do you think that the group was sharing this information with you? b. Was the information clearly and concisely shared c. Would you have liked to have received it in a different way? d. What did it make you want to do next?

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Ditshwegwane Support Group Background and Overview

The organization was started in November 2007 and registered in August 2008. The group has 12 members that include both people living with HIV and those who are negative. The group meets weekly on Mondays at a small house and garden plot that has been allocated by the Village Development Committee (VDC).

The mission statement in the organization’ s constitution reads thus: “To provide basic nutrional and prevention information on risk reduction and promotion of positive living to HIV infected and affected people of Ditshwegwane and surrounding catchment areas through the production of vegetables from our garden and education workshops.”

Ditshegwane Support group works with other committees like the Home Based Care (HBC) Health Committee, Tsholofelo Trust, DMSAC as well as other support groups in their surrounding villages to strengthen their prevention strategies. The group has a close working relationship with Pogiso Marks, Community Mobilizer with Tsholofelo Trust, who provides some organizational assistance and guidance.

All members are unpaid volunteers.

The committee meets and works from a very old VDC house without electricity or water. They use the same plot for vegetable production, though the fencing is inadequate. The members would like to obtain better work space in the village which could be rented for a reasonable price.

The organization’s other assets are: one spade, one hose pipe, one fork, and two watering cans. They won this equipment through a competition organized by DMSAC.

Proposed Prevention Activities

Ditshwegwane Support Group intends to conduct the following activities: . Establish a focus group and gardening project for 20 pregnant women aimed at reducing stigma and encouraging enrolment in PMTCT. . Conduct focus group workshops for 30 male and female youth to promote behaviour change. . Invite 30 village leaders to attend a workshop to equip them to disseminate correct prevention information. Conduct a door-to-door campaign to encourage people to go for testing and counseling

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Planning and Facilitating Effective Meetings

Expected Session Time: 3.5 hours

Module Content

Overview ...... 280 Applied Public Health Program Management Training ...... 280 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 282 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 284 ALDP Facilitator Guide Overview ...... 287 Session Overview ...... 289 Description of Session ...... 289 Materials & Equipment ...... 289 Preparation ...... 289 Pre- and Post- Training Assessments ...... 289 Presenter’s Notes: Planning and Facilitating Effective Meetings ...... 290 Appendices ...... 312 Appendix N: Meeting Checklist Handout ...... 313 Appendix O: Tips for Facilitating Discussion ...... 315 Appendix P: Meeting Minutes Handout ...... 316 Appendix Q: Facilitating Challenging Behaviors Handout ...... 318 Appendix R: Case-Scenario – Meeting Facilitation ...... 322

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

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Applied Leadership Development Program | Planning and Facilitating 281 Effective Meetings

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives. 3.5 Building Teams and The Building Teams and Managing Employees hours Managing Employees session seeks to enhance DACs knowledge and skill necessary to build effective teams and manage employees. The session requires DACs to consider the characteristics of high- performing teams and contrast these with teams that have problems, identify the components of team leadership, develop skills in performance management, and practice giving an employee a performance review.

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TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Applied Leadership Development Program | Planning and Facilitating 288 Effective Meetings

Session Overview

Description of the Session

This 3.5 hour session is designed to provide basic information on meeting preparation and facilitation. DACs will have the opportunity to discuss their best practices and challenges in facilitating DMSAC and other meetings. The session will: 1) discuss meeting preparation tips; 2) provide guidance and tools for effective meeting note taking; and 3) provide suggestions for dealing with disruptions during meetings.

Materials & Equipment

Preparation

□ Make copies of Meeting Checklist handout (Appendix N) □ Make copies of the Tips for Facilitating Discussion handout (Appendix O) □ Make copies of the Meeting Minutes handout (Appendix P) □ Make copies of the Facilitating Challenging Behaviors handout (Appendix Q) □ Make copies of the Case-Scenario – Meeting Facilitation handout (Appendix R)

Pre- and Post- Training Assessments

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Presenter’s Notes: Planning and Facilitating Effective Meetings

Slide 1: Effective Meeting Planning and Facilitation

Speaker Notes: If you have not already, take time to…  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course. They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers)  Conduct an icebreaker if needed Additional Facilitator Guidance: o Acknowledge that meeting planning and facilitation is a primary role and responsibility for DACs o This session provides basic tips and suggestions for planning and facilitating effective meetings o DACs are experts in the area so some of the material discussed will be review but there will be plenty of opportunity to share experiences and practice skills

Slide 2: Learning Objectives

Speaker Notes: o Review the learning objectives for the session o Ask if anyone has questions or comments. (wait for a response)

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Slide 3: DMSAC Meeting: Structure and Purpose

Speaker Notes:  Explain that this part of the training will briefly review the structure and purpose of the DMSAC, and the role of the DACs in its implementation  Let them know that this is review for them so not a lot of time will be spent on this part, but it will be relevant for the rest of the session

Slide 4: DMSAC Structure & Activities

Speaker Notes:  Acknowledge that the information presented on this slide should be familiar; it is directly from the Term of Reference  Click to review the role of the of the DMSAC in applying the national strategies and prioritizing local needs: o Coordinate, plan and monitor activities o Mobilize resources o Advocate against stigma and discrimination o Design strategies for an effective response o Advocate for the mainstreaming in social and economic development  Click to review required schedule of activities: o Must meet four times a year o Regularly scheduled meetings are scheduled in advanced, in coordination with co-chairs, and the schedule distributed by DAC to members and MLG&RD by April 30th o Reporting

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o Implementation of Annual HIV/AIDS Comprehensive Plan o Sub-committee reports on topics/assignments  Ask the participants if this is their understanding of the DMSAC and the role that the DMSAC plays in a comprehensive HIV/AIDS response. (Wait for a response) o Review discussion from the National HIV/AIDS Strategy and Resources and Reallocations sessions if applicable, and 2 and how those topics/activities fall under the list of things that the DMSAC does o What is the relevance of these activities and why is important that the DMSAC be a part of the process?

Slide 5: DMSAC Meeting Checklist

Large Group Discussion (10 Minutes):  Ask participants to create a checklist of activities that a DAC should do before, during and after a DMSAC meeting o Capture the responses on flipchart. Have a separate page for before, during and after o Ask for a volunteer to capture the participant responses Speaker Notes:  Add whatever items from ToR that the participants did not say. For example (per the ToR): o Before: . Develop agenda based on standard format, discuss it and agree to it with the co-chairs . Additional agenda items contributed by members submitted to DAC two weeks before the meeting . Discuss additional agenda items with chairs . Distribute agenda and minutes from previous meeting to DMSAC members in advance (no later than two weeks before the meeting)

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. Ensure at all times that action items from the previous meeting have been dealt with, and will prepare a written report on the status of the actions in advance . Ensure all subcommittee reports are prepared . Ensure enough copies of the reports are made for distribution . Hold advance meeting with co-chairs one to two days before the meeting to brief them o During: . Ensure members have the meeting agenda and copies of the reports . Provide technical direction to issues discussed in the DMSAC meeting o After: . Prepare and distribute the action sheet to all members within seven days after the meeting . Ensure that persons responsible for action items do them within the stipulated time . Prepare and distribute the minutes within two weeks after the meeting Additional Facilitator Guidance:  Refer participants to the job aid (handout) and suggest that they create a DMSAC meeting checklist for themselves if they have not already done so

Slide 6: Effective Meeting Planning & Facilitation: Basic Principles

Speaker Notes:  Explain that now the training is going to offer some general suggestions for effective meeting planning and facilitation that will hopefully assist them in their role as DMSAC meeting coordinators and DACs

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Slide 7: Before the Meeting: Agenda Preparation

Speaker Notes:  Acknowledge that the participants are experts at agenda development but that these are just a few universally shared tips for agenda development  Ask the participants what they do in preparation for the DMSAC meeting (wait for a response)  Click to reveal some suggestions for preparing an agenda  Emphasize that effective meetings have a specific purpose and objectives  Clearly state the purpose of the meeting. These can include: o Exchanging information and ideas o Solving problems o Making decisions o Gathering data  State the objectives in a way that describes the desired end result. For example: o The objective of this meeting is to review three alternative proposals for reducing costs o We will select one candidate for the new position that is supported by everyone  Ask if the DACs follow any of these steps? Are there any other steps or content that should be included when preparing the DMSAC or other meeting agendas? Additional Facilitator Guidance:  The important point in this section is to stress that they should always have a purpose and objectives. State them in the invitation to the meeting and at the beginning of the meeting. If they create an agenda, the purpose and objectives should be included on it. The purpose of the meeting drives the type of meeting it is. It also determines many of the logistical issues, such as size of room, room layout, etc.  Encourage participants to use the job aid and add to the checklist. No detail is too big or too small

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Slide 8: Before the Meeting: Meeting Preparation

Speaker Notes:  Point out that the basic principles listed on the slide are almost identical to the protocols in the ToR  Send an invitation with the meeting date, location, goals and additional administrative details  Ask meeting invitees requesting an agenda item to contact you before (two weeks) with their requests  Send meeting reminder email with final agenda, include: meeting goals, location, time and duration. Per the ToR, the agenda should be reviewed and approved by the chairperson before sending to DMSAC members  Ask participants what materials they need and other pre-meeting things that should be done. Some examples: o Send invitations o Invite special guest o Print agendas, sign-in sheets, evaluations, presentations, etc. o Gather materials-flip charts, markers, computers, LDC projectors, folders, etc. o Check room set up

Slide 9: During the Meeting: Facilitation

Large Group Discussion (5 minutes):  Ask participants to describe a good experience facilitating a meeting and a challenging experience facilitating. Try to get 2-3 examples of each  Let the participants know that we will talk in greater detail about the challenging experiences later in the session

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Slide 10: During the Meeting: Facilitation

Speaker Notes:  Read slide and explain that these are very basic definitions of facilitation  The definitions may not be relevant for every meeting—including DMSAC

Slide 11: Facilitation Dimensions

Speaker Notes:  Walk participants through the diagram and explain that facilitation involves a balance between each of these elements  It is necessary to follow a process so that expectations are established but is equally important to maintain the professional relationships and work towards results.  To have too much of one and not enough of another can cause conflict  Ask participants if this has been their experience. If so, describe the experience and the outcome

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Slide 12: During the Meeting: Steps in Conducting a Meeting

Speaker Notes:  Ask the participants what components/steps are useful in conducting meetings (keeping the previous slide in mind; process, results and relationships)? (wait for a response)  Referring to the slides, how and why are these steps important for a successful meeting? Additional Facilitator Guidance:  Instead of going through the slide point by point, conduct an interactive discussion about how to conduct an effective meeting  The information below is for your information as the facilitator and provides suggested components/steps in facilitating effective meetings. Note: not all DACs facilitate DMSAC meetings. Some have active co-chairs that facilitate but it is still good for the DACs to know for professional development  Suggestions include: o Start on time o Set the context of the meeting, review the agenda . Meeting purpose . Meeting objectives . Agenda topics and timeframes o If appropriate, assign meeting roles. (You can say: If you don’t assign roles, people will assign roles for themselves.) o Time keeper – Tracks the timeframes given in the agenda o Note taker – Records decisions and action items o Agree on ground rules and processes o Ground rules – Agreements on how the group will operate. This is especially important in recurring meetings. Examples include: . Only one person at time talking . Meetings will start and finish on time . Confidential information will “stay in the room”

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. No jargon or in-talk . No discussion of ideas until all ideas heard . Encourage full participation from all attendees . Keep discussion on topic, and focused . If you agree to do something, do it. . If you can’t attend, send a suitable, informed, delegate instead. o Communicate meeting processes – Participation, decision making, etc. o Follow the agenda and document decisions o Track the agenda items as they are discussed and get closure on each item before going on to the next item o Decisions should be tracked and included in meeting documentation o Record all action items, including the responsible person and due dates o Create a parking lot, temporary holding areas for ideas or suggestions that are not directly on topic with the issue facing the group o Maintain a visible list to capture these ideas o Keep a running list during the meeting o At the end of the meeting, review the items to see if any have been resolved during the meeting o Poll the group for those parking lot items that should be discussed at the next meeting o End on time o Track the agenda items as they are discussed and get closure on each item (not a final decision) before going on to the next item

Slide 13: During the Meeting: Basic Facilitation Skills

Pre-Session Preparation:  Make copies of the Tips for Facilitating Discussion handout (Appendix O) Speaker Notes:  Explain that facilitation also requires utilizing interpersonal skills (to maintain the professional relationships). This should be done while keeping

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meeting attendees focused, promoting inclusion, clarifying confusion and important points; all the while ensuring that the meeting objectives are met Additional Facilitator Guidance:  Handout the Basic Facilitation Skills handout as a reference and tool for participants

Slide 14: During the Meeting: Taking Minutes

Pre-Session Preparation:  Make copies of the DMSAC Meeting Minutes handout (Appendix P) Speaker Notes:  Explain that taking minutes was identified as an area that is a key activity for the DACs during meetings therefore some time is given to providing tools, resources and a guide for taking effective meeting minutes  Ask the participants what challenges they have taking minutes during meetings. Suggest that the steps presented here could help with some of those concerns. (wait for a response)  Acknowledge that some participants might have some of their own strategies and techniques for taking minutes. Invite them to share them once you have gone through all the steps  Refer participants to the job aid (handout)

Additional Facilitator Guidance:  Being assigned the task of taking minutes at a meeting is viewed by some people as a thankless task. However, mastering the art of taking effective meeting minutes is not only helpful for participants to understand the issues, discussion and agreed to action items, but it can also help others who weren't at the table in their decision making  Don't underestimate the power and effectiveness of learning how to master this writing skill

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Slide 15: During the Meeting: Taking Minutes, cont.

Speaker Notes:  Ask participants to explain why minute taking is so important. (wait for a response)

Slide 16: During the Meeting: Taking Minutes, cont.

Speaker Notes:  Tips & Warnings o It's important to have an accurate list of those in attendance since it may be important to know later who was present and took part in making key decisions in the meeting o Always remember to write both your name and the date you took the minutes along with the file name path of where the minutes can be found if stored electronically on a computer o It's OK to take shorthand but try not to paraphrase or interject your own words, comments or opinions about what you think someone said, felt or thought -- write the minutes as the person stated it  Ask participants if they have any additional strategies or steps for taking meeting minutes. (wait for a response)  If the steps provided did not speak to some of the challenges that were described on slide 14, ask the participants for potential suggestions to address the challenges

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Slide 17: Post-Meeting Activities

Speaker Notes:  Review the slides  Without follow-up, progress can die after a meeting  Evaluate the outcomes against the objectives for the meeting  Before going on to the next section-ask the participants if they have any additional questions regarding meeting planning and facilitation

Slide 18: Group Dynamics and Conflicts

Speaker Notes:  Explain that the rest of the session is going to continue to address the process, results and relationship aspects of meeting, but look more broadly at the stages of group development and how conflict can arise and be addressed

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Slide 19: Inhibitors to Team Building

Speaker Notes:  Explain that these issues can prevent group cohesion; stall the process, prohibit results and definitely impact relationships  One of the main inhibitors of a team obtaining its goal optimally is knowledge hoarding rather than knowledge sharing. There are many cultural factors that inhibit knowledge transfer  Another inhibitor are the spoken and unspoken power hierarchies

Slide 20: Inhibitors to Team Building, cont.

Speaker Notes:  A basic tenet of communication theory states that a network's (team) potential benefit grows exponentially as the nodes it can successfully interconnect expand numerically o For example, if two team members share information, both gain information and gain linear growth. And if both then share their new knowledge with other team members, and in turn get questions, amplifications, and modifications, then the benefits become exponential  Ask the participants if they have had experience with any of these inhibitors. (wait for a response)

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Slide 21: Group Dynamics: Forming, Storming, Norming, Performing, Adjourning

Speaker Notes:  Explain the diagram, four stages of group development, five if you include adjourning  There is a relatively large body of literature from education, psychology, and the private sector that talks about the ways that teams develop (e.g., Friend & Cook, 2003; Tuckman & Jenson, 1977). Most researchers agree that teams generally move through four stages of development: forming, storming, norming, and performing.  Ask participants if they are familiar with these stages. If so, ask if they are comfortable describing each stage o Forming refers to the first stage of development in which teams come together and begin to identify what they want to accomplish and how they will work together o Storming refers to the second stage, in which teams encounter some differences of opinion that occasionally lead to a more uncomfortable form of conflict o In stage three, norming, teams develop strategies for working through conflict and using it in more positive and creative ways o Finally, stage four, or performing refers to the highest stage of team development in which teams are highly effective and make excellent use of creative problem solving. It is important to note that teams develop at different rates o Not all go through the four stages in a linear way . It is important to note that leadership is critical in team development . The leader of a stage one or two team may need to play a stronger role in helping the team establish its structure and processes . By the time a team gets to stage four, however, there is less need for one person to take responsibility for leading the team. At this stage, leadership may be shared by all team members

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Slide 22: Group Dynamics: Forming

Speaker Notes:  Instead of reading the slides, describe this stage: o Team members are introduced o They state why they were chosen or volunteered for the team and what they hope to accomplish within the team o Members cautiously explore the boundaries of acceptable group behavior o This is a stage of transition from individual to member status, and of testing the leader's guidance both formally and informally Additional Facilitator Guidance:  Activities at this stage include abstract discussions of the concepts and issues; and for some members, impatience with these discussions  There is often difficulty in identifying some of the relevant problems as there is so much going on that members get distracted  The team often accomplishes little concerning its goals. This is perfectly normal

Slide 23: Group Dynamics: Storming

Speaker Notes:  Describe this stage as: o The team's transition from the "As-Is" to the "To-Be" is called the Storming phase o All members have their own ideas as to how the process should look, and personal agendas are often rampant o Storming is probably the most difficult stage for the team

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o They begin to realize the tasks that are ahead are different and more difficult than they previously imagined o Impatient about the lack of progress, members argue about just what actions the team should take o They try to rely solely on their personal and professional experience, and resist collaborating with most other team members

Slide 24: Group Dynamics: Storming, cont.

Speaker Notes:  These pressures mean that team members have little energy to spend on progressing towards the intended goal  But they are beginning to understand each other. This phase can often take 3 or 4 meetings (or longer) before arriving at the next phase

Slide 25: Group Dynamics: Norming

Speaker Notes:  Describe this stage as: o When the team reaches a consensus on the "To-Be" process o Everyone wants to share the newly found focus. o Enthusiasm is high, and the team is often tempted to go beyond the original scope of the process o During this stage, members reconcile competing loyalties and responsibilities

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o They accept the team, ground rules, roles, and the individuality of fellow members. Emotional conflict is reduced as previously competitive relationships become more cooperative o As team members work out their differences, they have more time and energy to spend on the project

Slide 26: Group Dynamics: Performing

Speaker Notes:  Describe this stage as: o The team has settled its relationships and expectations o They can begin performing by diagnosing, problem solving, and implementing changes o At last, team members have discovered and accepted other's strengths and weakness o In addition, they have learned what their roles are o The team is now an effective, cohesive unit o You can tell when your team has reached this stage because you start getting a lot of work done  These stages can be cyclical once changes occur, such as the introduction of a new team member or the change of some other team variable that can modify how the team works  The last stage of group development is "Adjourning" o In this stage that the group members put closure on tasks and relationships and prepare for a new group experience o Within this stage, group members may procrastinate or sabotage projects due to unspoken feeling of "closure" (UCSB) o This stage is simply about completion and disengagement, both from the tasks and the group members (2001)  Ask-Do you have an idea as to what stage your group (DMSAC) life cycle is in?  I'd love to hear your thoughts on this. What's your experience of team dynamics within your work? Would you add any additional stages into the life cycle of a group?

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Slide 27: Conflict

Speaker Notes:  Let the participants know that the potential for conflict exists whenever people have different needs, values or interests  Click to reveal first question  Ask participants to share the challenges that they have encountered while facilitating meetings (wait for responses)  Click to reveal second question  Ask participants to share how they have dealt with those challenges and for suggestions (wait for responses) Additional Facilitator Guidance:  This is where you can discuss the challenges of dealing with problem behaviors and/or challenging people in meetings. This topic is likely to have already come up throughout the training so, you may just take the opportunity to bring previous discussions to some sort of resolution

Slide 28: Challenging Behaviors Pre-session Preparation:  Make copies of the Facilitating Challenging Behaviors handout (Appendix Q) Speaker Notes:  Explain that these are examples of challenging meeting behaviors  Refer participants to the handout and talk about some of the suggestions offered to deal with difficult behaviors/personalities.  Ask if participants can to suggest any additional strategies to address these behaviors or others that they have encountered? (wait for a response) Additional Facilitator Guidance:

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 Additional suggestions include: o Be prepared to deal with difficult behaviors and the people who exhibit them. You know who they are o Meet individually with persons before the meeting to discuss what behaviors they might stop and behaviors they might continue to contribute to a successful meeting o When talking with persons who typically exhibit difficult behaviors in meetings, be clear about what you need while asking them how they can help you accomplish your goals o Model effective listening and convey that you are seeking the same from them o Meet with other group members who have a history of responding inappropriately to disruptive behaviors o Discuss how they can confront the behavior calmly and honestly, keep the agenda, and avoid encouraging further disruptive behavior

Slide 29: Strategies for Addressing Challenging Behaviors

Speaker Notes:  Explain that to the best of their ability they should take measures to avoid or minimize conflict  Emphasize that conflict can be useful in that relevant perspectives are potentially shared and debated  Offer that it is often more helpful to acknowledge the disagreement and explore in more detail  Point out how useful the discussion is (value both opinions) Additional Facilitator Guidance:  Offer additional suggestions for addressing conflict o Put a time limit on the discussion o In addition to what they disagree on help identify areas of agreement o Ask for other examples of disagreement and agreement o Ask what a good resolution would look like

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o If the final decision rests with someone else state so

Slide 30: Strategies for Addressing Challenging Behaviors

Speaker Notes:  Provide the following explanation for each point as additional strategies: o Talk at a break with people who seem to be seeking attention by their behavior. Give them feedback in private as to how their behavior affects you and how you think it affects the group. Ask their help in improving the situation o Be honest, direct, and let persons know the impact of their actions on you. For example, say, "I feel powerless to accomplish what we need to be doing when you get so angry or talk so much during the meeting" o Give persons with disruptive behaviors a special task or role in the meeting that is valued by the group o Avoid getting into a debate with anyone during the meeting and watch your choice of words and tone of voice. Use active listening techniques in order to show respect o Draw out non-contributing attendees by asking their opinion and complimenting them after they've spoken. Some facilitators begin with an activity that solicits every person's opinion. This makes it easier for more reticent attendees to contribute later o Keep everyone focused on the agenda. If attendees continue to focus on small points and miss the larger picture, refer again to the agenda. Suggest that distracting issues be set aside for later discussion. Sometimes facilitators write such details on an easel sheet titled the "parking lot," which is posted for later discussion (time permitting)  Now we are going to do a small group activity.

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Slide 31: Exercise Meeting Facilitation

Pre-session Preparation:  Make seven copies of the Case Scenario—Meeting Facilitation (Appendix R) Large Group Activity (15 minutes):  Ask for six volunteers  Give them the Meeting Facilitation case scenario o Assign each person in the group a role o The meeting facilitator should go back to the purpose, objectives and agenda provided and use it to lead the beginning of the meeting  Have the volunteers role-play the scenarios o This is a chance for someone to practice skills in leading meetings. They should choose something they want to practice  Some additional questions the mock meeting participants can consider include: o What skills would be useful for them to practice in a safe environment? o What ground rules are needed? o What topics might come up? o How will they process decisions? o What actions can they take to help the group be more effective?  Ask the volunteers to report out on the experience  Questions for the mock meeting facilitator: o What was the experience like for the facilitator? How do you think you did? o What skills were you able to practice? For example: . Set ground rules . Limit time . Reflecting responses heard . What challenges still need to be addressed?  Questions for the mock meeting attendees: o What was the experience like? Was it realistic?

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o Did the how effective as the facilitator (constructive feedback)? o What strategies would you have used?  Questions for the audience: o What would you have done differently? o How does this scenario resemble meetings they have facilitated or participated in? Speaker Notes:  Remind the volunteers that the point of the exercise is to practice the skills discussed in this section  They should try to be realistic in their role-playing and not overact  Remind the group that feedback should be constructive

Slide 32: Session Highlights

Speaker Notes:  Review the points on the slide

Slide 33: Questions or Comments

Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix N: Meeting Checklist Handout

Appendix O: Tips for Facilitating Discussion

Appendix P: Meeting Minutes Handout

Appendix Q: Facilitating Challenging Behaviors Handout

Appendix R: Case-Scenario – Meeting Facilitation

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Appendix N: Meeting Checklist Handout

Meeting Date:______Meeting Time:______Meeting Location: ______Meeting Co-Chairs: ______Meeting Coordinator and Region: ______

TO DO: BEFORE THE MEETING □ Develop agenda and include purpose □ Review and get approval for agenda □ Send meeting notification with agenda, time and location □ Make a copy of the agenda for everyone attending the meeting explaining the importance of what you are going to discuss □ Send out a reminder the day before the meeting establishing a start and end time □ Arrange for meeting space □ Print meeting materials o Agendas o Reports o Meeting minutes o Sign-in sheets o Meeting evaluations o Other: ______□ Get needed equipment o LCD projector o Computer o Flip chart(s) o Markers o Other: ______□ Room set-up □ Arrange for travel expenses □ Hotel Rooms □ Site rental for meeting □ Food and beverages □ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______

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TO DO: DURING THE MEETING □ Start on time □ Have everyone sign in □ Handout meeting materials o Agenda o Reports o Meeting minutes o Evaluations o Other: ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______

TO DO: AFTER THE MEETING □ Prepare and distribute the meeting minutes and action sheet to all members within fourteen days after the meeting □ Ensure that persons responsible for action items do them within the stipulated time □ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______□ Other : ______

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Appendix O: Tips for Facilitating Discussion

Getting Discussion Started

1. Everyone should know what the discussion is about and the reason for having it

2. Give participants room to be involved

3. Be a model - If discussion calls for personal examples provide one in a relaxed tone

4. Use questions to stimulate discussion

5. Listing - Brainstorm and then list all ideas

6. Go around the room - Ask each person for a response

7. Write things down - Recorder

8. Relate discussion to people's experiences - The more people relate to a topic the more they will participate

9. Use humor to break the tension/silence if appropriate

10. Trust your intuition

Facilitating During Discussion

1. Equalize participation

2. Keep on the subject

3. Clarify and interpret and then ask for responses

4. Summarize, let the group hear where you think they are or what they have done

5. Pacemaking -Slow them down or speed them up if necessary

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Appendix P: Meeting Minutes Handout

[Date] DMSAC Meeting Minutes [Time] [Location] Meeting called by: Type of meeting: Co-Chairs: Note taker: Timekeeper: Attendees:

Materials

provided:

Minutes

Agenda item: Presenter: Discussion:

Conclusions:

Action items Person responsible Deadline

Agenda item: Presenter: Discussion:

Conclusions:

Action items Person responsible Deadline

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Agenda item: Presenter: Discussion:

Conclusions:

Action items Person responsible Deadline

Agenda item: Presenter: Discussion:

Conclusions:

Action items Person responsible Deadline

Other Information

Observers:

Resources:

Special notes:

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Appendix Q: Facilitating Challenging Behaviors Handout

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Applied Leadership Development Program | Planning and Facilitating 319 Effective Meetings

Applied Leadership Development Program | Planning and Facilitating 320 Effective Meetings

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Appendix R: Case-Scenario Exercise: Meeting Facilitation

Facilitator Instructions

1. Ask for six volunteers willing to role play in front of the full group. Each person will receive a separate description of the role they are to play. Explain to the full group that they will perform the role play for about five minutes, and that the full group will be asked to observe and then comment on the role play.

Scenario: The DAC convenes a meeting of your Technical Advisory Committee to inform them that funding has arrived from NACA, but that it is significantly less than requested. The DAC has decided that three major activity plans need to be cut from the plan. You want to tell them which plans will be cut and ask them to help you communicate this information to the full DMSAC

2. Assign roles to each volunteer. a. The DAC You want to tell them which plans will be cut and ask them to help you communicate this information to the full DMSAC

b. TAC member 1 You are the head of one of the agencies whose funding will be cut. You are extremely upset about the loss of funds. You do not care at all about communicating to the rest of the DMSAC, but only about how you can get your money back. You act aggressively (try to dominate the conversation).

c. TAC member 2 Even though you do not have a personal stake in the budget cuts, you are concerned that there has not been an objective or transparent decision making process. You act assertively (continue to bring up the same points).

d. TAC member You are also the head of one of the agencies whose funding will be cut, and are upset about the loss of funds. You have no faith in the process at all, and are finding TAC member 1 annoying. You have a sick child at home, and are worried about him. You just want the meeting to end quickly so you can go home. You act passive aggressively (side-conversations).

e. TAC member 4 You are the ADAC. You feel sorry for the DAC, but you are young, and very new in your position, don’t know the other TAC members very well, and find them all a little intimidating. You act passively (sit silently, but us body language to communicate frustration).

3. Instruct volunteers to act out the scenario for five minutes

4. At the end of the role play:  Ask the observers what happened in the role play? What were the roles that the TAC members were playing? What skills or approaches did the DAC use to manage the TAC? What advice might you have for the DAC for the future?

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 Ask the DAC how he/she felt about the experience? What did he/she learn?  Ask the TAC members how they felt? How did the DAC manage the conflict between them?

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Preparing for Implementation

Expected Session Time: 3.5 hours

Module Content Overview ...... 325 Applied Public Health Program Management Training ...... 325 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 327 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 329 ALDP Facilitator Guide Overview ...... 332 Session Overview ...... 334 Description of Session ...... 334 Materials & Equipment ...... 334 Preparation ...... 334 Pre- and Post- Training Assessments ...... 334 Presenter’s Notes: Preparing for Implementation ...... 335 Appendices ...... 356 Appendix S: Sample District Plan – Proposed Activities ...... 357 Appendix T: Gantt Chart ...... 359 Appendix U: Risk Response Form ...... 361

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

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Applied Leadership Development Program | Preparing for 326 Implementation

Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Session Overview

Description of the Session

This 3.5 hour course is designed to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. The course will require participants to: 1) use their district plan (EBP) to determine the deliverables (products, services, and/or activities) needed to meet objectives, 2) develop tools that will identify the roles, responsibilities, budget and time required to implement response activities, and 4) articulate challenges and potential solutions in the implementation process.

Materials & Equipment

□ Computer □ Flip charts (3) □ LCD projector □ Markers and pens □ Facilitator guide □ Note papers □ Power Point presentation □ Post-it notes uploaded to computer and □ Tape or adhesive working □ Pre/post-training evaluation □ Participant handouts assessments □ Sign-in sheet □ Create labels for exercise

Preparation

□ Make copies of the Sample District Plan (Appendix S)

□ Make copies of the Gantt Chart (Appendix T)

□ Make copies of the Risk Response Form (Appendix U)

Pre- and Post- Training Assessments

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Presenter’s Notes: Preparing for Implementation

Slide 1: Preparing for Implementation

Speaker Notes: If you have not already, take time to…  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course. They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers)  Conduct an icebreaker if needed Additional Facilitator Guidance:  We all know how difficult it is to coordinate the implementation of district programs and activities  Through effective preparation and utilization EBP resources, we can identify what needs to be done, who will do it, when and how it will get done, and at what cost. All the information needed to prepare for implementation

Slide 2: Learning Objectives

Speaker Notes:  Based on the importance of DAC’s work and the results from the DACs needs assessment, the objectives for this course are to: o Use a district plan (EBP) to determine the deliverables (products, services, and/or activities)

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needed to meet objectives o Develop tools that will identify the roles, responsibilities, budget and time required to implement response activities o Articulate challenges and potential solutions in the implementation process

Slide 3: What is Implementation?

Speaker Notes:  In order to implement or prepare for implementation, first we must be able to accurately define the term implementation  Implementation is the carrying out, execution, or practice of a plan, a method, or any design for doing something  As such, implementation is the action that must follow any preliminary thinking in order for something to actually happen Additional Facilitator Guidance:  This slide contains transitions  The Part I heading will appear first  Click to bring up the second part of the slide. The remainder of the speaker notes can then be stated

Slide 4: Implementation & the Project Management Life Cycle

Speaker Notes:  When thinking about executing activities, we must first consider the stages of the Project Management Life Cycle  Here is an illustration of the Project Management Life Cycle

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 The cycle is in the shape of a circle  The cycle represents the fact that these four stages (initiation, planning, execution, and closure) are a part of a continuous process  As District AIDS Coordinators (DACs), you play a critical role in ensuring the coordination and execution of response activities within your district  In order to effectively coordinate the implementation of activities, it is important to know that implementation is just one portion of the life cycle of a project/program  Ask if they have implemented programs in this or other jobs, and describe the experience

Additional Facilitator Guidance:  The Project Management stages are: o Initiate: . Begins when an idea, issue or problem has been identified - the idea may be internally generated or may be the consequence of a contract/understanding with outside customers/stakeholders . Data is gathered to provide background information on the idea/issue/problem . Ends when a preliminary scope has been agreed and a statement has been prepared o Plan: . Begins with the outputs from the initiation (i.e. preliminary scope statement, project manager (DAC), etc.) . Ends when the entire project has been thought through (including the scope, time, and cost) - what will be done; how; in what order; and at what cost o Execute/Implement: (click to reveal answer) . Implementation/Execution cannot begin until there is a plan. It is the act of doing what is outlined in the plan. . Ends when all the work is completed o Close: . Organizations learn by documenting what occurred during the project’s life cycle - what went right and what went wrong — and making these documents available for evaluation purposes and future planning . Begins when deliverables are accepted . It continues until a project’s activities have been compiled and archived – archiving not only includes a complete set of project records but also a critical review of lessons learned . It involves evaluating and ensuring paperwork is completed

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Slide 5: Characteristics of a Successful (Implementation) Project

Speaker Notes:  The successfully implementation of a project involves three characteristics… scope, time and cost  These three characteristics should be considered during the planning stage, monitored during implementation and evaluated at the end of the project  It is important to take note that these three characteristics are in the shape of a triangle o The triangle represents the need for these characteristics to be equally balanced throughout the life of the project, especially during implementation o The more these characteristics are balanced, the more likely you are of implementing a high quality project. These characteristics address the core of any project: . What will be done and how… the scope . In what order and by when… the time . At what cost… the cost  Ideally, your goal is to implement a quality project that is “On TIME, On SCOPE, and On BUDGET”  These three characteristics have a direct effect on the quality of the project, which is why the word quality is located in the middle of the triangle  When one characteristic is altered or changed, it could potentially affect the quality of the project Additional Facilitator Guidance:  Provide a pertinent example, such as: o You receive money to implement a community outreach project for female teens, between 13-24 years. You develop your scope of work based on the money and time available, as well as the needs of the target group o Ask participants for examples

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Slide 6: Characteristics of a Successful (Implementation) Project – Scope

Speaker Notes:  Scope: o In general, the scope is the overall description of what the project is supposed to accomplish o It is the list of deliverables that need to be implemented by the project team o As a member of the project team and coordinator of district response activities, it is your responsibility to monitor the scope and any changes to the scope that impact the quality, cost, and time  The scope is determined during the initiation and planning stage by: o Identifying what will be done and how based on an idea, issue, or problem that was identified . Remember in week 1, we used the FISHBONE tool (cause and effect analysis) to identify, sort, and display the cause of a specific issue/problem Additional Facilitator Instructions:  Inform participants that the EBP Toolkit also talks about scope in the Evidence Based Planning Process section under Step 3

Slide 7: Characteristics of a Successful (Implementation) Project - Time

Speaker Notes:  Time: (also known as timeframe or schedule) o The time represents the length of the project and its activities o It also specifies what should happen when and which activities

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must precede others to complete the work o Your role is to develop a detailed schedule and monitor the progress of the activities/tasks according to the time allotted o If more or less time is required for each activity/task, be sure to document the changes o Documenting the changes will provide additional information during the evaluation process and for future planning of similar deliverables/goals  The time is determined during the initiation and planning stage by: o Assigning the amount of time needed to implement each activity in your district plan, each activity is expected to be completed within a certain quarter o The quarter outlines a timeframe for when the project should be completed o However, a more detailed timeline needs to be developed that highlights which activities must precede others and when they should be completed by o Later in this course, I will be introducing you to a tool that will help you develop a more detailed timeline for project/program activities

Slide 8: Characteristics of a Successful (Implementation) Project – Cost

Speaker Notes:  Cost: (also known as budget) o For the purpose of this training, we will be using the words cost and budget interchangeably. When planning a project/program, an anticipated budget or cost is developed based on resources, staff, equipment, etc. o This anticipated budget is then monitored during the implementation stage

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o When implementing, it is important to document the amount of money that is being spent (the actual cost) to accomplish the scope o Your district plan provides a budget breakdown for each activity o The cost to execute the budget could be the same or different from the anticipated budget o Your role is to ensure the project/program is implemented within budget o If this is not possible, the actual cost and reason for deviation should be documented for evaluation purposes and future planning o However, I want to acknowledge that the final decision about the budget is not made by the DAC office, but the information provided by the DAC office can help explain and justify the need for certain funds

Slide 9: Exercise: Balance of Power Pre-session Preparation:  Use tape to draw a life size triangle on the floor  Label each corner with one of the three characteristics (Scope, Time and Cost) Large Group Activity Activity Instructions (15 minutes):  Divide the participants into 3 groups representing each characteristic (one group for each category)  Inform them to stand near the corner of the triangle they have been assigned  Read the scenario and ask the participants how they would solve the problem based on their experience o Encourage them to only provide solutions that affect the characteristics (scope, time and cost)  After the answers have been provided, ask the participants which characteristic(s) does it impact  Explain to the participants that each time 1 characteristic is affected; it has a direct effect the remaining 2 characteristics o In order to illustrate this point and based on the answers provided, ask some participants from the impacted area(s) to move to one or both of the other areas or vice versa

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 Sample Scenarios (depending on time, use 1 or both scenarios): o Due to some recent floods, the DAC office and the offices of your implementing partners have been closed for two weeks o You have received notification from MLG informing you that there will be a delay in the dispersal of program funds Speaker Notes:  Remember, when one characteristic is altered or changed, it directly affects the overall project/program (positively or negatively) because collectively the three characteristics determine the quality of the project

Slide 10: From EBP to Implementation

Speaker Notes:

 Now that we have a better understanding of the role implementation plays in the Project Management Life Cycle, let’s look at how the evidence-based planning process can be used in preparation for implementing a project/program

Slide 11: Evidence-Based Planning

Speaker Notes:  You all have had training on evidence based-planning (EBP) and I’m sure you are aware of how valuable the EBP process is for developing a district comprehensive plan  Let’s take a brief moment to talk about what EBP does Large Group Discussion:  Inform the participants that you are going to start a sentence and you want them to finish it  EBP helps to ensure…  Click to reveal answers

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Slide 12: From EBP to Implementation

Speaker Notes:  The EBP process leads to the development of a comprehensive district plan  Click to reveal the district plan: The district plan then provides the information needed to implement, such as the (Click to reveal components): o Scope . The scope is determined during the initiation and planning stage by… . Identifying what will be done and how based on the idea, issue, or problem that was identified. Remember in Week 1 we used the FISHBONE tool (Cause and Effect Analysis) to identify, sort, and display the cause of a specific issue/problem . Determining the roles and responsibilities - the more specific you can get about who is doing what, the better off you will be when it is time to implement o Time . The time is determined during the initiation and planning stage by… . Assigning the amount of time needed to implement each activity: In your district plan, each activity is expected to be completed within a certain quarter. The quarter outlines a timeframe for when the project should be completed. However, a more detailed timeline needs to be developed that highlights which activities must precede others and when they should be completed by. Later in this course, I will be introducing you to a tool that will help you develop a more detailed timeline for project/program activities o Cost/Budget . The budget is determined during the initiation and planning stage by… . Determining the cost: Your district plan provides a budget breakdown for each activity  As you can see, implementation could not effectively take place without the development of your district comprehensive plan

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Slide 13: The Path toward Implementation

Speaker Notes:  The hardest part about implementation is the planning process  Once the plan has been established, the path toward implementation is quite simple

Slide 14: Path from Planning to Implementation

Speaker Notes:  This slide illustrates the steps needed to move from the planning stage of the Project Management Life Cycle to the Implementation stage  It involves the following: o Defining the scope in order to develop a more detailed list of activities/tasks o Confirming the budget – allows you to accost for every line item listed from the detailed activities/tasks. Budgets will not be discussed in great detail in this course. You will learn about managing budgets later this week o Developing a detailed schedule for activities/tasks o Anticipating risks/challenges that may interfere with the implementation of project/program activities Additional Facilitator Guidance:  Provide an example, or reference an example previously used

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Slide 15: Define the Scope

Speaker Notes:  The first step is defining the scope  Scope is the work that needs to be accomplished to deliver a product, service, or result. In order to do this, you must: o Define the deliverables (products and/or services the project will deliver), which are derived from the objectives in your District Plans . For example: One of my district’s objectivities is to “increase the number male circumcision from 344 to 800 by March 2014.” Based on our objective, my scope would be to Scale Up Safe Male Circumcision (SMC).  Define the activities (main steps required to complete each deliverable). The activities can be found in your district plans, where they are clearly labeled  Define the tasks (elements/sub-activities that need to be accomplished within a defined period of time)

Slide 16: Example: District Plan

Pre-session Preparation:  Be sure to have post-it notes available  Make copies of the sample district plan (Appendix S) Speaker Notes:  Let’s work through one example together  Remember in order to confirm the scope, we must identify or define the deliverables, activities, and tasks Large Group Discussion: Activity Instructions:  Provide each participant with a copy of the sample district plan

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 Inform the participants that you are going to read aloud one of the deliverables and its associated activities from the sample district plan  Explain how the deliverable is derived from the objective and highlight the location of the activities  Ask the participants if they can identify the tasks from the sample district plan. (Wait for responses)  Click to reveal tasks  Inform the participants that this level of detail is not provided in the district plan because the district plan offers an overview of all district response activities  Tell them, if the information is not provided, allow yourself some time to gather the information  Brainstorm the tasks needed to do the activity  Be sure to capture each task on post-it notes

Slide 17: Exercise: Define Scope

Pre-session Preparation:  Have flip chart paper and post-it notes available  On flip chart paper, make a table with the following columns (the results from this group discussion will be used later in the training): o Deliverable o Activities o Tasks Small Group Activity: Activity Instructions (20 minutes):  Divide the participants into 2 groups  Provide each group with one copy of the pre-prepared flip chart paper, markers and post-it notes Speaker Notes:  As a small group, review the district plan and use the pre-prepared flip chart paper to write down 1 deliverable and all the activities and tasks (tasks should be written on post-it notes) associated with the deliverable

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Slide 18: Determine Task Order

Speaker Notes:  Now that we have defined the tasks needed to accomplish our activities, we can start determining the order of each task  Here are some questions to ask when determining task order: o Which elements start first? o What elements need to be completed before moving to the next ones? o Which elements can overlap?  Knowing the order of your tasks is essential for preventing duplications and helping to keep the project/program on focus and on time

Slide 19: Tool: Network Flow Diagram Speaker Notes:  One of the most powerful project management tools for determining tasks order is the Network Diagram  It serves as a road map for which tasks should be implemented and in what order  The time needed to implement each task can also be captured by simply writing the start date in the left-hand corner and the end date in the right- hand corner  Using the information (specifically the tasks) from our example district data, we will be developing a network flow diagram  This is done by first identifying which task or tasks must be done first and positioning the remaining tasks accordingly  Please keep in mind that some tasks can be done simultaneously

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 In addition to positioning the tasks according to order, it is also helpful to include the start and end dates for each tasks  After you have confirmed the order of each task, write the start date in the top left-hand corner and the end date in the top right-hand corner  Let’s try one example together. I am going to read the tasks aloud and I want you all to tell me where to place it. Once we put all of the tasks in order, I will write in the start and end date for each task Large Group Discussion (10 minutes):  Gather the post-it notes from the example district plan exercise. Only choose the tasks associated with the “Train New Mobilisers” activity  Allow the participants to tell you which order the tasks should go  Post the participants responses on the wall  After you have posted all of the tasks on the wall and captured the start and end dates for each, inform the participants that they have just created a Network Flow Diagram  Click once to reveal the answer Additional Facilitator Guidance:  Please explain to the participants that the Network Flow Diagram is a tool. This is a tool they can choose (optional) to use when preparing for implementation

Slide 20: Exercise: Network Flow Diagram

Small Group Activity: Activity Instructions (30 minutes):  Put the participants back into their small groups  Ask the participants to gather their post-it notes from the “Define the Scope” exercise  Explain to them that they will be using the post-it notes to create a Network Flow Diagram Speaker Notes:  As a small group, you all will be creating a Network Flow Diagram with the tasks you identified from the “Define the Scope” exercise

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 As you create the diagram you may identify tasks that were initially overlooked  Remember to capture the start and end date for each task

Slide 21: Develop a Schedule

Speaker Notes:  Step 3 of the planning to implementation process is to develop a schedule  Once you have determined the sequence of activities, you can now develop more detailed schedule  The best way to show the activities/tasks and their order is graphically via a Gantt Chart  The basic purpose of a Gantt Chart is to break a large project into a series of smaller tasks in an organized way. The chart allows you to assess: o How long a project and its activities/tasks should take, o Resources needed, o Cost or allotted budget for each task, and o Order in which tasks need to be carried out.  Earlier, I mentioned the scope, time, and cost should be considered throughout the project/program period. The Gantt Chart allows you to capture all of this information in one place. For example, it is a great tool that can be used for: o Reporting and sharing the status of response activities at DMSAC meetings o Holding people/organizations accountable for implementing activities/tasks in a timely manner Additional Facilitator Guidance:  Click once to reveal the Gantt Chart sections (Scope, Time and Cost)  Please reference the Gantt Chart handout when introducing this tool

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Slide 22: Tool: Gantt Chart

Speaker Notes:  Please take note that this slide only focuses on the tasks and schedule of a Gantt Chart  To create a Gantt Chart: o Begin with a list of tasks. Typically each task is grouped under the activity it is associated with, as shown here with the activity being shaded a light grey color and called “Conduct Interviews” o Illustrate time estimates for each task and activity in the bar chart form. You may divide the timeline in the Gantt Chart into days, weeks, or months depending on the time scale of your project . For example, if the project activities will not take more than 3 months, create a timeline that measures progress by weeks. For a longer intervention (one year or more), use months and quarters to track progress. However, when you are managing the specific tasks of a project/program, you will find it more useful to set up your Gantt chart by day o Remember to include and allow for weekends and holidays. This can be done by slightly shading these days o Place a triangle on the day/week/month/quarter each task was completed . It is important to notate (with a triangle) the actual completion date, whether it was completed on the expected end date or not . For example, if you look at the Gantt Chart on the screen. One of the tasks listed was not completed on time . Ask which task was not accomplished by the expected end date and its impact on the project/program (wait for response) . Due to the delay in completing the identify interviewers task, you cannot start the design workshop on Day 5  Complete the remaining two columns (not illustrated here): o Person(s) assigned to/responsible for each task. Many of these persons may already be identified in your district plan. If not, you can use the Stakeholder Analysis process (learned in week 1 of APHPMT) to assist in identifying people

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o Budget allotted for each task  During implementation, Gantt Charts are useful for monitoring the project’s progress  You can immediately see what should have been achieved at a point in time, and can therefore take timely action to bring the project back on course. This can be essential for the successful implementation of a project Additional Facilitator Guidance:  Relative to the DAC planning process, there is usually only 2 weeks for planning  Budget will be discussed in another session

Slide 23: Exercise: Gantt Chart

Pre-Session Preparation:  Make copies of the Gantt Chart handout (Appendix T)

Speaker Notes:  Now it is time for you to develop a Gantt Chart based on the information you gathered from the Network Flow Diagram exercise

Small Group Activity: Activity Instructions (30 minutes):  Give each participant a copy of the Gantt Chart handout  Divide the participants up into the same small groups they have been working in  Give the participants 30 minutes to complete this activity

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Slide 24: Anticipate Risks

Speaker Notes:  The last step in the planning to implementation process is to anticipate risks that could impact the project/program  It is the process of anticipating what could go wrong and how to mitigate its negative impact

Slide 25: 5 Potential Risks

Speaker Notes:  A good rule of thumb is to review the project with your team and think about factors or events which could negatively impact the project  Ask yourselves: o Schedule - What could cause delays in the schedule? o Scope - What might threaten the quality of the scope (i.e. deliverables, activities, and tasks)? o Budget - What might increase costs beyond the budget? o Resources - Are there any limitations regarding resources that could impact the project? o External Factors - What external events could impact the project?

Large Group Discussion (10 minutes):  Ask participants to identify some risks that fall under each of these categories. (Wait for response)  Possible answers: o Schedule – unrealistic timeframe and reliant on external dependencies

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o Scope – changing priorities, unidentified deliverables, activities, and tasks o Budget – shifts in budget priorities and uncertain budget resources o Resources – too many people assigned, using limited resources, and human resources issues: illness, staff turnover, etc. o External Factors – policy changes, political, economic, or organizational crises

Additional Facilitator Guidance:  Explain to the participants that it is wise to think of the possible risks/challenges that are inherent to your project’s success  You should always think about what risks/challenges might occur and the best way to deal with them  Also consider the possibility of these risks/challenges in your timeline, scope, budget, and overall quality

Slide 26: Minimize Risks

Speaker Notes:  Listed are 4 ways to minimize the impact of a risk on your project/program  Identify the potential risks (similar to what we just did)  Quantify the impact of each risk by determining the probability of it occurring as well as the gravity of impact on the project. But how do you quantify risk? This can be done by (Click to reveal risks): o Using the knowledge and expertise of your stakeholders o Gathering data (whether it is epidemiological, historical, logistical, etc.) on the issue o Reviewing lesson learned from other projects/programs  Prioritize which risks are most important to contain o The ability to control the outcome of an event may also affect the priority you assign it

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 In week 1, we discussed TPN (totally, partially, not in control). Use the TPN process to help you determine your priority o For example, if there is an event which is completely outside of your control, you may not want to include it in your response planning since you will be unable to take preventive measures  Develop strategies to address the risks/challenges. For each major risk/challenge, ask yourself what are some approaches I can use?

Slide 27: Tool: Risk Response

Pre-Session Preparation:  Make copies of the Risk Response form (Appendix U)

Speaker Notes:  Here is a simple tool to help you plan for potential risks/challenges. The Risks Response Tool allows you to: o Identify the potential risks o Quantify the impact of each risks o Prioritize which risks are most important to contain o Develop strategies to help minimize its effect on the project  For example, earlier we spoke about floods and its effects on the scope, budget and time. Based on its potential impact on the project/program, I would consider it a high probability and high impact risk because my project will be implemented during the rainy/flood season and due to the location of my district. Please keep in mind, each risk/challenge is program and district specific

Large Group Activity: Activity Instructions (10 minutes):  As a large group, use the sample district plan to develop strategies that will minimize the risk(s) impact on the project  Don’t spend a lot of time on this exercise because it is simply designed to show them how the tool can be used. Complete one row as a large group

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Slide 28: Session Highlights

Speaker Notes:  As we conclude this session of your training, I hope you have found the tools and approaches introduced useful  It is important to remember that much of the information needed to prepare for and monitor the implementation process is found in your district plan  Now you should be ready to implement!

Slide 29: Questions or Comments

Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix S: Sample District Plan

Appendix T: Gantt Chart

Appendix U: Risk Response Form

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Appendix S: Sample District Plan – Proposed Activities 2013/2014

Activity & Target Group Organization Quarters Expected Budget Breakdown Budget Source & Contact Annual Outputs Total of Funds Person 1 2 3 4

Train new mobilisers X 22 new Lunch: P3,600.00 ACHAP mobilisers 60 people x P60.00 x 1 day=P3,600.00

Conduct Door-Door campaign HEO X X X X 30 mobilised Meal allowance for P23,520.00 MLG targeting the 19 villages (by and registered mobilisers 30 people x community mobilisers) for SMC P56.00 x 14days = P23,520.00 SMC campaigns to 4 MEN X X X X 2000 men Radio prime time slots P13,700.00 MEN catchment areas SECTOR circumcised P2500 x 4 SECTOR slots=P10000.00 (token of appreciation to the Floating trophy village which has circumcised 1st prize @ P1500 more men. 2nd prize@ P1200 Prime time media adverts 3rd prize@ (Radio and TV) P1000=P3700 Establishment a static SMC DHMT X MOVE Site NIL NIL ACHAP Site established

SMC launch in village X 100 people *Crowd puller (1 per P25,200 ACHAP circumcised day) @ P7500 during the *IEC materials

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launch day 150 water bottles x P40.00 =P6000 150 umbrellas x P50.00=P7500.00 *Stage and sound system P3000 Refreshment of intervention team P60.00 per person x 20 = P1,200.00 =P25,200.00 School Outreach Campaign DHMT X X X X All schools NIL NIL MoH

(34 schools)

Community conversations on CCEPO X X X X 2000 people NIL NIL MLG SMC in 4 catchment areas reached

Total: P66,020

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Appendix T: Gant Chart

Steps for Creating a Gantt Chart

Tasks Column: On the attached Gantt chart worksheet, fill in your project’s tasks.

Schedule Column: Estimate how long it will take to complete each task by filling in the start and end date.

Fill in the time schedule by placing horizontal bars/lines for each task and activity to show its duration. Be sure to select a time frame that is appropriate (e.g. days, weeks, months, and quarters). Don’t forget to include weekends and holidays, if appropriate.

Place a triangle on the day/week/month/quarter each task was completed. It is important to notate (with a triangle) the actual completion date, whether it was completed on the expected end date or not.

Remember the Network Flow Diagram can be used to determine tasks order and timeframe.

Assigned to Assign staff to each task listed. Column:

Budget Column: Fill in the allocated budget for each task listed.

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Tasks Schedule Assigned To Budget

Start Date End Date Horizontal Bar Chart Area

* Place a triangle on the day/week/month/quarter each task was completed.*

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Appendix U: Risk Response Form

High High Risk Areas Probability? Impact? Risk Strategies (Explain why) (Y/N) (Y/N) 1.

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Applied Leadership Development Program for District HIV & AIDS Coordination

SESSION CONTENT:

Building Teams and Managing Employees

Expected Session Time: 3.5 hours

Module Content

Overview ...... 363 Applied Public Health Program Management Training ...... 363 Applied Leadership Development Program (ALDP) for District HIV & AIDS Coordination ...... 365 Applied Leadership Development Program for District HIV & AIDS Coordinator – Training Sessions ...... 367 ALDP Facilitator Guide Overview ...... 370 Session Overview ...... 372 Description of Session ...... 372 Materials & Equipment ...... 372 Preparation ...... 372 Pre- and Post- Training Assessments ...... 372 Presenter’s Notes: Building Teams and Managing Employees ...... 373 Appendices ...... 401 Appendix V: Communication Style Inventory ...... 402 Appendix W: Assignments for Team Role Play Exercise ...... 405 Appendix X: Getting to Know Your Team ...... 410 Appendix Y: MLG Performance and Development Plan and Review ...... 411 Appendix Z: Essential Key Components of Performance Management ...... 414

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Overview

 Following up with training participants for integration o Mentorship and one-on-one follow up and support o Supportive supervision o Review meetings and refresher trainings

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Goal The training will build and strengthen the identified capacity and skill needs for DACs to be effective in addressing the HIV epidemic in Botswana.

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Applied Leadership Development Program for District HIV & AIDS Coordination-Training Sessions

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6.5 Communicating The communications session seeks to provide hours Effectively the knowledge and skills necessary to translate evidence-based information for the DMSAC and other public health decision makers and partners. Additionally the intent of the session is to provide education on how to make oral presentations to community groups, health professionals and/or political groups, including dealing with difficult and disruptive meeting behaviors. 3.5 Planning and The Effective Meeting Planning and Facilitation hours Facilitating Effective session seeks to provide an overview of the Meetings DACs role in the planning and facilitation of DMSAC meetings, and provides basic suggestions, guidance and skills to be effective. DACs will be able to share and discuss their experiences in preparing for meetings. 3.5 Preparing for The Preparing for Implementation session hours Implementation seeks to equip participants with the skills and tools needed to effectively coordinate the implementation of project/program activities. DACs will use their district plans to determine deliverables, and meet program objectives.

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TIMES SESSION TITLE SESSION DESCRIPTION 3.5 Managing Budgets The Managing Budgets session seeks to equip hours DACs with the knowledge and skills necessary to manage district program budgets. The session requires DACs to develop a budget and utilize budget data to develop a quarterly report. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part I: M&E, Data Sources Making-Part I: M&E, and Characteristics session seeks to provide a Data Sources and basic understanding and review of monitoring Characteristics and evaluation, where and how to gather data and how to ensure quality reporting on the data at the district-level. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part II: Analysis and Making-Part II: Analysis Interpretation session seeks to provide a review and Interpretation of organizing and summarizing data; preparing tables, charts, and graphs to assist in interpreting and communicating data; and applying data for program management and planning. 3.5 Data for Monitoring, The Data for Monitoring, Evaluation and hours Evaluation and Decision Decision Making-Part III: Program Evaluation Making-Part III: session seeks to provide an overview of Program Evaluation program evaluation and how and why it is important to monitor and evaluate program activities. Also, DACs will discuss how to use program evaluation to make decisions regarding planning and implementation of activities.

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Please read the description of the target audience carefully, as well as the learning objectives.

Target Audience This guide is intended for use by “Master Trainers” that have been identified by MLG&RD to deliver the ALDP training to DACs, ADACs and/or M&E Coordinators.

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Session Overview

Description of the Session

This 3.5 hour course is designed to equip participants with the knowledge and skills necessary to build effective teams and manage employees. The course will require participants to: 1) consider the characteristics of high-performing teams and contrast these with teams that have problems, 2) identify the components of team leadership, 3) develop skills in performance management, and 4) practice giving an employee a performance review.

Materials & Equipment

□ Computer □ Flip charts (3) □ LCD projector □ Markers and pens □ Facilitator guide □ Note papers □ Power Point presentation □ Tape or adhesive uploaded to computer and □ Wall signs working □ Pre/post-training evaluation □ Participant handouts assessments □ Sign-in sheet □ Room set-up

Preparation

□ Make copies of the Communication Style Inventory (Appendix V) □ Make copies of the Assignments for Team Role Play Exercise (Appendix W) □ Make copies of the Getting to Know Your Team handout (Appendix X) □ Make copies of the MLG Performance and Development Plan and Review (Appendix Y) □ Make copies of the Essential Key Components of Performance Management (Appendix Z)

Pre- and Post- Training Assessments

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Presenter’s Notes: Building Teams and Managing Employees

Slide 1: Building Teams and Managing Employees Speaker Notes: If you have not already, take time to…  Welcome the participants and introduce yourself  Introduce any dignitaries in the room  Explain any housekeeping items, such as break times, fire drill, restroom locations, etc.  Inform participants that they are free to ask questions throughout the course. They can also write their questions on the parking lot sheet for us to come back and answer later  Ask the participants to introduce themselves and identify one expectation for the session (record answers)  Conduct an icebreaker if needed

Slide 2: Learning Objectives Speaker Notes:  Review the learning objectives for the participants  Ask if there are any other points or objectives for the session that they would like to discuss

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Slide 3: Building Teams Speaker Notes:  The first part of this training session will look at how managers can effectively build and support the work of teams  The second portion will focus on working with individuals

Slide 4: What is a Team? Speaker Notes:  Review the definition of a team  While a manager may think about developing team work within their staff, teams can be made up of lots of different people  They come not only from employees in a particular work group, but other individuals that come together to work on a shared project or task  Your role in a team can change depending on the type of team.  At times you are leading the team, and at other times you are a member without a leadership role

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Slide 5: Building Teams Large Group Discussion (5 minutes):  Ask the participants to think about the types of teams that they work with. Have a brief discussion in which participants identify some of those teams  Ask them which ones are they responsible for and in which ones are they a participant without responsibility?

Slide 6: Working in Teams, cont. Speaker Notes:  Review the list of benefits of working in a team to ensure that all have been covered in the previous conversation.

Slide 7: Group Dynamics: Forming, Storming, Norming, Performing, Adjourning Speaker Notes:  Remind the participants that in a previous session they learned about the steps that teams go through as they develop  Briefly review the steps for the group: o Forming (first stage of development in which teams come

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together and begin to identify what they want to accomplish and how they will work together). o Storming (second stage, in which teams encounter some differences of opinion that occasionally lead to a more uncomfortable form of conflict). o Norming (stage three, in which teams develop strategies for working through conflict and using it in more positive and creative ways). o Performing (fourth stage, the highest stage of team development in which teams are highly effective and make excellent use of creative problem solving. Teams develop at different rates and not all go through all stages. The stages do not always go straight through in this order either.

Slide 8: High-Performing Teams Speaker Notes:  Review the list of items that make a team successful o Common purpose: clear task, mission directed, team is not an end in itself o Clear roles: each person knows his or her role, each role supports the work of the team, each person contributes to the process o Accepted leadership: staff does not feel the need to challenge the leader, and is confident in the leader’s ability. Inadequate leadership is probably most often the reason for team ineffectiveness o Effective processes: needed for such things as managing a meeting, making decisions, solving problems. Effective teams constantly ask: how are we doing? o Solid relationships: members of a team don’t have to know each other well, diversity can have advantages in bringing opinions into the process. Need to be able to channel the differences so they work together. Need trust and respect o Excellent communication: immediate, clear, accurate communication is essential o Cross Training: team members have different experiences and knowledge to bring to the team. Members can learn from each other

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Slide 9: Working in Teams Large Group Discussion (10 minutes):  Ask the participants to think again about the types of teams that they work with. Have a brief discussion in which participants identify some of those teams  Ask them for an example of one challenge they have encountered while working with a team

Slide 10: Team Challenges Speaker Notes:  If the team leader does not make sure that teams function effectively as described on the previous slide, then the team often develops challenges  Conflicts are normal, but being able to spot and address them is critical to effective management  Even if the leader has addressed the basics of leadership by making sure everyone knows the purpose and goals and each person’s role, other problems may arise  On this and the following slide, we will look at common challenges, what might be causing them, and how effective management can address those challenges Large Group Discussion (10 minutes):  Review the list on this slide and ask the group what might be causing these symptoms  Suggested responses: o Group does not support the goals of the team, o Members do not have enough information to understand the task, or o Members do not feel they are given enough input into the process  Ask-What a good manager would do (wait for responses)

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Slide 11: Suggestions Speaker Notes:  Review the bullets on the slide  By trying these suggestions, leaders can increase participation and interest  Leaders need to understand that challenges are inevitable. Some leaders do not like to deal with conflict, but they have to address it. Some leaders want to be liked always but it is not possible always  In previous sessions, we learned about different personality styles. These styles influence how people interact with others. Recognizing your own style as well as others can help with good communication

Slide 12: Exercise: Communication Style Inventory Pre-Session Preparation:  Print enough copies of the Communication Style Inventory (Appendix V)  Write the name of each style on a sheet of flip chart paper and hang in each of the four corners of the room Large Group Activity Activity Instructions (10 minutes):  Hand out the Communication Styles Inventory to participants  Read through the instructions on how to complete the inventory  Allow participants a few minutes to complete the survey, and score themselves Speaker Notes:  Remind participants that they completed the inventory during the “Communications” session  Completing the assessment again in case people forgot their communication style

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Slide 13: Communication Styles Speaker Notes:  Review the various communication styles to refresh participants’ memories  Supporter/Relater o Harmonizer o Values acceptance and stability o Slow with big decisions; dislikes change o Builds networks of friends o Good listener; timid with contrary opinions o Easy going o Friendly & sensitive o Relationship oriented  Analyzer/thinker o Assessor o Values accuracy o Plans thoroughly o Works alone o Introverted; quick to think and slow to speak o Highly organized o Cautious o Thoughtful o Idea oriented  Promoter/Socializer o Entertainer o Values enjoyment o Full of ideas o Wants work to be fun o Talkative o Flexible o Intuitive o Optimist o Celebration oriented  Controller/Director o Commander o Values getting the job done o Good at delegating o Not shy, but private on personal matters o Likes to be where the action is o Takes charge

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o Fearless o Results oriented

Slide 14: Team Communication Problems Speaker Notes:  Review the list and ask the participants what might be causing the problems on this slide  Possible responses: o There may be conflicts among members, members may feel powerless to make a difference o Team members may have inadequate knowledge, members may not understand the steps they need to reach the goal o Group discussions may be poorly coordinated  Ask-What would a good manager do? (wait for responses) Additional Facilitator Guidance  Additional suggestions on the next slide

Slide 15: Suggestions Speaker Notes:  Review the bullets on the slide

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Slide 16: Getting to Know Your Team Speaker Notes:  For this portion of the session, the participants should think about their team at work, and how, as a manager of that team, they should get to know the individuals  A number of ways have been suggested by professionals, not all of which work in all settings  Ask them to share successful strategies former managers or supervisors have implemented Large Group Discussion (5 minutes):  Ask the question on the slide to the participants, listen to their responses, and then review the suggested responses on the following slide.

Slide 17: Suggestions Speaker Notes:  Review the bullets on the slide

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Slide 18: Getting to Know Your Team Large Group Discussion (5 minutes):  Ask the question on the slide to the participants, listen to their responses, and then review the suggested responses on the following slide

Slide 19: Suggestions Speaker Notes:  Review the bullets on the slide

Slide 20: Getting to Know Your Team Activity Instructions (10 minutes):  Handout the “Getting to Know Your Team” worksheet (Appendix X)  Give participants a few minutes to complete the worksheet  Ask for participants to share their responses (limit to 2-3 participants)

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Speaker Notes:  Review the suggestions below: o Have a group luncheon and include an easy fun activity. One example of such an activity would be to ask for a volunteer to tell the group something they have always wanted to do, but haven’t had the chance. Then find out if anyone in the group has done that particular activity. The question is then asked of other staff. Staff who have done each activity might be given a piece of candy, with the staff getting the most candy at the end winning o Ask staff to “shadow” another staff for a period of time so they can get a better idea of what that staff does. New managers may also want to try this with their staff o Make sure that your staff meetings are meaningful for the staff. If they do not seem helpful, ask for staff input into how they might be useful. Staff meetings should be a good opportunity to provide new information, hear updates, and clear up any misconceptions o It is good for a manager to show interest in their staff’s lives outside of work. This shows recognition that employees need to take care of their personal life. However, managers must be careful not to get overly involved with employees’ lives and they should not ask very personal questions

Slide 21: Exercise: Team Role Play Pre-Activity Preparation: Pre-print six roles on separate pieces of paper (Appendix W)

Large and Small Group Activity Activity Instructions (10 minutes):  Request six volunteers for a role play  The facilitator should meet briefly with the participants, letting them know that the role play will demonstrate a poor way to manage a team meeting  Each participant is given a piece of paper with a specific role to play. The facilitator will hand out roles for the role play as follows: o Leader: You are the District AIDS Coordinator and your job is to lead the team and help it work on the assignment. The participants come from a variety of community organizations, and the task of the team is

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to develop educational materials that support HIV testing activities. The leader should show weak leadership and not lead the group well. Examples could be jumping right in without introducing any of the members, not being clear about the task, not maintaining control of the conversation, not showing a lot of interest in the assignment, etc. The leader does not let others know who will function as recorder o Recorder: You have the role of team secretary and are responsible for documenting the work of the team, including issues that are raised, decisions made, etc. Your role has not been made clear to the group. You sometimes criticize other people’s comments o Argumentative person: You know that you are not the leader, but you have strong opinions and voice these forcefully o Quiet person: You are very shy and won’t contribute unless you are directly asked to do so. The group will ignore you o Positive contributors (two individuals): You attempt to offer positive suggestions for the assignment, but your ideas are put down or ignored.

Speaker Notes:  Let all participants know that the leader had been given an assignment of being a weak team leader. Have a discussion with all participants about how the meeting could have been handled better. Compare with the general guidance for team leadership on the following slide

Slide 22: Characteristics of Team Leadership Speaker Notes:  Ask participants to define each circle (wait for responses)  Provide participants with the following unstated explanation and definitions: o As the leader of the team, there are ways that you can help ensure that the team functions well. These characteristics would have improved the role play exercise and include: . Communication: Be clear. The leader needs to make sure everyone is clear about the task and their role. Information and

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expectations should be presented in a way that participants understand. The leader needs to listen to the input from others. A good leader can draw out quiet members and directly address problems caused by aggressive members . Organization: Good leaders are organized. They make sure new members are introduced. They present an organized agenda and stay within the allocated time frame. They put systems in place to assist the team process and keep the work moving toward the goals and objectives . Confidence: Good leaders have confidence in their ability to get the work done. They are secure in the decisions they make . Respectful: Good leaders are respectful of the team members. He or she encourages others to offer up ideas, and then respects those ideas or opinions. This is more effective than just giving orders and expecting them to be carried out . Fair: A quality leader is consistent with how the members are treated. This includes positive rewards as well as disciplinary actions

Slide 23: Characteristics of Team Leadership, cont. Speaker Notes:  Ask participants to define each circle (wait for responses)  Provide participants with the following unstated explanation and definitions: o Integrity: The leader is honest and open with members. In this way, he or she earns their trust o Influential: Influential leaders gain the confidence of team members because they believe the decisions will be effective. The members will show more commitment to the process o Delegation: Effective leaders know how to share leadership through delegation. Delegation improves the process by allowing the leader to focus on the most important aspects of the work, while also helping to increase the skills of those who handle the delegated tasks. It is important to know when to delegate. If you don’t delegate at all, team members may think you want to control everything and do it yourself. On the other hand, if you delegate too much, they may feel that you

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are not sharing the load. When a manager delegates a responsibility, it is important to be very specific about what is being asked, define the time frame for accomplishing the task, be realistic in what is being requested, and make sure that the team member is clear on the assignment. The delegated responsibility should be documented o Facilitation: As a facilitator, effective leaders help members understand their goals. They help organize an action plan to get the work completed o Negotiation: Effective leaders know how to use negotiation to address team conflict. Good negotiators help resolve issues with the best interest of all involved

Slide 24: Performance Management Speaker Notes:  We have been discussing how you as a manager can build strong teams  You need to understand and acknowledge the strengths and weaknesses in your staff’s skills in order to develop and manage a high-performing team  You supervise other positions, such as the ADAC and M & E Officer, and it is important to help these individual employees improve their performance  Today we will look at ways you as a supervisor can assist your employees to perform at their best possible levels

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Slide 25: What is Performance Management? Speaker Notes:  Managers need to be knowledgeable of the agency’s mission and goals so they can ensure that the work of staff is in line with and supports those goals

Large Group Discussion (5 minutes):  Ask-What they think managers do that leads to good employee performance (wait for responses) o Some possible examples: . Acknowledge good work . Address issues immediately and directly . Encourage professional development . Let them know you value them

Slide 26: Essential Key Components of Performance Management Speaker Notes:  Employees who supervise staff face the challenge of how to get the best performance possible from their staff  Key components of successful performance management have been identified that apply across the board to any managers who oversee the work of others  As a DAC, you will find that implementing these key components will improve your ability to guide staff to perform at their best  Review the five components of performance management o Planning work and setting expectations: For staff to perform their best, they need to have a clear plan for how they will perform their job. They

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need to have an understanding of the agency mission and goals whether or not they have the opportunity to have input into them o Employee Development: Most staff do not come into their jobs proficient in every part. Giving them the opportunities to learn how to perform their duties better is a necessary part of managing staff o Monitoring performance: While managers want staff to function well independently, it is important for them to monitor the staff performance throughout the year o Performance Review: Informal feedback is great, but it is important for staff to also receive more formal ratings of their performance at least once a year. This provides an opportunity for both staff and manager to discuss the staff performance o Rewarding good performance: Most individuals function better when they have some outside validation of the worth of the work they are performing. Without feedback from the managers, they may be unclear whether their performance is satisfactory Additional Facilitator Guidance:  Each component will be discussed in more detail later  Emphasize that all five aspects work together to support each other, and each is important to the process

Slide 27: Exercise: Performance Management Pre-Session Preparation:  Write each component name on separate sheets of paper and post around the room, labeled as followed: o Planning o Employee development o Monitoring o Performance review o Rewarding Small Group Activity Activity Instructions (15 minutes):  Ask the participants to count off by five  Assign each group one of the components and have them move to where the corresponding label is posted

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 Ask the participants to discuss in their groups: o What these components mean to them, o Why they are important, o What they could do (or currently do) to incorporate these aspects into their work with employees , and o Why these elements can be challenging  Each group will be asked to report back to the larger group. Additional Facilitator Guidance:  After each group reports, review the information on the following slides that relate to their key element (e.g., after the planning group presents, review the planning slide; after the monitoring group presents, review the monitoring slide)  Groups should report out when their corresponding slide (i.e., Planning, Monitoring, Developing, Rating and Reward) are presented and explained; which occur in the next slides

Slide 28: Planning Speaker Notes:  Planning group reports out on their discussion from previous exercise  After the group reports out, review slide and explain: o Subordinates may or may not have the opportunity to help shape overall agency goals and objectives. Either way, they need to understand those goals so they know how their job fits within the structure o Each subordinates needs to start the year with a Performance and Development Plan that identifies the individual performance objectives, performance measures, and performance targets. These provide both the plan that the employee can follow, as well as specific items to be measured and discussed with supervisors. Setting objectives each year ensures that the employee’s work addresses current challenges and needs. Objectives should be specific, measurable and achievable. Since circumstances can affect even the best plans, external factors that have affected achievement need to be

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documented and/or objectives modified. Employees should have the opportunity to meet in a quiet space with their supervisors prior to the development of the plan so that they can provide input and discuss any concerns

Slide 29: Employee Development Speaker Notes:  Employee development group reports out  After the group reports out, review slide and explain: o Employee development is an important aspect of ensuring good performance in all employees. Helping employees function at their best can improve morale because people enjoy work better when they feel good about how they handle their jobs. Training, whether in person or through self-study, can improve upon strengths or address deficiencies. Sometimes giving an employee a new challenging project can help them improve their skills also

Slide 30: Monitoring Speaker Notes:  Monitoring group reports out  After the group reports out, review slide and explain: o The supervisor should review with the employee progress on projects and assignments. The employee may not realize that they have gotten off track, and supervisory feedback can be very helpful in getting them back where they need to be. Any feedback to employees should be objective, not based on an employee’s personality

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o Providing feedback to improve performance when that feedback may be viewed negatively by the employee can be stressful for both the manager and employee. The manager needs to present the information in a calm manner, and should not let his or her own emotions get involved. Feedback should always be given in a specific, clear way so that the employee realizes what needs to change to make the performance more effective.

Slide 31: Monitoring, cont. Large Group Activity Activity Instructions (5 minutes):  After the presentation and discussion about monitoring, present the participants with this scenario: o Ask them if they think that this was an effective way to handle the situation. If not, how could she have addressed the employee better? o Ideas for handling the situation better: . Ask her to come into your office or go to a private area to talk . Keep the emotions out of the conversation and present the facts . Remind her about how important it is to start work on time and ask if there is something that would help her do better . Be careful about using absolutes like “never.” It is better to say something factual: You have been coming to work late frequently in the past few weeks  It is the supervisor’s responsibility to try to handle situations so that they do not escalate. Problems are sometimes taken to the next level because the supervisor did not act when needed to address the issue

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Slide 32: Performance Review Speaker Notes:  Performance review group reports out  After the group reports out, review slide and explain: o Performance reviews are a good way to encourage and develop staff, address issues and provide feedback (both from supervisor to employee and from employee to supervisor). In your practice, you are expected to provide employees with quarterly reviews, using the Performance and Development Plan, which enable you to address issues in a timely manner. It can sometimes be hard to find the time to conduct those reviews each quarter on time. Even if you end up meeting late, it is better than missing the meeting for the entire quarter  Bullet 1: The supervisor needs to look at the entire review period. Sometimes if a significant event just occurred, there is a tendency to give too much weight to that item as opposed to looking at the performance throughout the cycle  Bullet 2: The performance review needs to be based on the performance plan that has been developed for that employee. The targets and milestones that were set for performance are objective items that the supervisor monitors with the employee. In addressing these, as well as other items that need to be raised with the employee, the supervisor needs to make sure that the facts are clear and the information is not subjective opinion  Bullet 3: Any feedback to an employee should be given in a helpful manner so that the employee can use it to improve performance. Also, if you are dealing with serious performance issues, you should have already discussed these with the employee o Ask the participants who they supervise. Have they given formal performance reviews? Are they comfortable doing so? This can be difficult for some managers when the performance needs to be corrected o Ask participants who have had performance reviews and what they liked about the feedback

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Additional Facilitator Guidance:  Even if participants don’t have supervisory responsibility, they can still use much of the information when they provide other guidance to employees  Performance reviews are supposed to happen quarterly o If time, ask why they might not happen as planned

Slide 33: Performance Review, cont. Speaker Notes:  Review the guidelines on this and the following slide for how to give a performance rating  A supervisor might consider requesting employees to give input prior to the formal review or prepare a self-evaluation  Remember that an employee performance review should be a two-way process between the supervisor and the subordinate. It is a chance for each to have input into the review, not just for the supervisor to talk to the subordinate

Slide 34: Performance Review, cont. Pre-Activity Preparation:  Print copies of the MLG Performance and Development Plan and Review document (Appendix Y) Speaker Notes:  Review the bullets on the slide Pairs Exercise Activity Instructions (25 minutes):  Break the participants into pairs  Ask each pairs to assign a manager/supervisor and an employee

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 Give each pair a copy of the MLG Performance and Development Plan and Review document, with pre-populated fields o Reference the scenario in slide 8 and ask the supervisor to conduct a performance review with the employee based on the performance information in this document, include performance improvement objectives  Give the groups 15 minutes for the review and choose three to four pairs to report out on what was in the performance plan and on the experience Additional Facilitator Guidance:  There is an additional tool entitled, Essential Key Components of Performance Management available as a handout (pg. 517)

Slide 35: Rewarding Speaker Notes:  Reward group to report out  After the group reports out, review slide content  Ask the group what types of rewards they have given to staff. Based on the previous performance review how would they recognize/reward staff for previous good performance?

Slide 36: Mentoring and Coaching Speaker Notes:  In addition to formal supervision, employees can be assisted to perform well through mentoring or coaching them in their jobs  Sometimes the mentor or coach is not the direct supervisor, although the supervisor will have input into the process. While mentoring and coaching are not exactly the same thing, they have similarities and both can be helpful depending on the situation

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 Ask participants if anyone has been mentored and/or coached (wait for responses) o What was beneficial about the experience?  We will look at the mentor role first

Slide 37: Mentor Speaker Notes:  Review the definition of a mentor

Slide 38: Mentoring Speaker Notes:  A mentor is someone who guides the mentee through a job or assigned project. This person may not have all the answers, but has experience that is helpful to the mentee. He or she uses that experience to provide guidance and advice over time

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Slide 39: Purpose of Mentoring Speaker Notes:  For a mentor relationship to work, the time frame and the expectations should be clearly defined. Often, a supervisor may decide that a staff member would benefit from a mentor relationship with another staff where one has experience and skill to share with the other  The supervisor does not have to always be the mentor, but can maintain involvement without doing the mentoring directly

Slide 40: Coach Speaker Notes:  Read the definition of a coach  While the role has similarities to a mentor, there are differences

Slide 41: Coaching Speaker Notes:  Review the definition of a coach  While a coach is similar to a mentor, a coach is seen as more of the “expert” in the field  This person will pose questions to the coach-ee to consider, with the coach

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providing the answers when needed  The coach will expect the coach-ee to perform as instructed and will hold that person responsible for getting the job done

Slide 42: Purpose of Coaching Speaker Notes:  While coaching and mentoring are similar, coaching tends to be more task oriented. Mentoring takes a broader approach to improving skills  But both processes assist employees with improving their performance. In reality, supervisors often use some aspects of both in their work

Slide 43: Characteristics of Mentoring and Coaching Speaker Notes:  Discuss the essential aspects to coaching and mentoring that make the process successful. Coaching or mentoring of staff can help provide them with guidance and help to develop their skills and improve performance. Key aspects are: o Effective communication: remind the participants to think back on the Week One training and the skills they learned for effective communication. It is important to communicate information clearly and to hear what the other person is saying to you. In Week One, participants learned to recognize what others were communicating not only in their words, but with their body language. They learned to pay attention to the tone of their voice when speaking so their communications would have the desired effect o Planning: the process will be most effective if the coach or mentor plans with the person being assisted so that both know what they are hoping to accomplish and how they will know they have succeeded

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o Acknowledgement: the coach or mentor provides feedback to the coachee or mentee. They recognize others for what they are, not just how they handled a particular situation. E.g., “you show such a passion for public health” vs. “You did a good job with that report.” Let’s the person know that his or her strengths are recognized.

Slide 44: Mentoring and Coaching Large Group Discussion (10 minutes):  Ask the participants to think about people who have coached or mentored them o What did they do that they admired?  Review the summary of the key skills of coaching and mentoring on the slide o May need to be both a coach and mentor depending on the situation. The manager or supervisor may also not be the expert in every situation and can ask others to play those roles o Coaching and mentoring require that the manager or supervisor be willing to hear new approaches from the employee, versus solely instructing or directing o Remember that people are your most valuable assets Additional Facilitator Guidance:  Suggest that the participants consider looking for a mentor or coach to continue to develop in their role

Slide 45: Delegation of Tasks Speaker Notes:  Another important aspect of managing or supervising is being able to delegate  In the earlier section on team building, we discussed delegation of responsibilities. Similar to working with a team, a good supervisor also needs

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to know when and where to delegate to employees  If the manager does not delegate very much, employees may think that he or she wants to handle it all. On the other hand, a manager who delegates too frequently may have employees who feel that the manager is not contributing enough  If a manager decides that delegation is appropriate, that delegation should be: o Specific: the employee needs to be clear on what you are asking. Too many supervisors don’t take the time to clearly detail the expectation, then the assignment is not done correctly o Measurable: both the employee and the supervisor need to understand how they will know when the assignment has been completed o Realistic: a supervisor should not assign more than is reasonable for the employee to do o Time framed: the employee needs to know when the assignment needs to be completed o Documented: delegated tasks should be documented in employee plans whenever possible

Slide 46: Session Highlights Speaker Notes:  Review slide

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Slide 47: Questions and Comments Speaker Notes:  Thank the participants for their participation and discussion  Ask-Are there additional comments or questions

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Appendices

Appendix V: Communication Style Inventory Appendix W: Assignments for Team Role Play Exercise Appendix X: Getting to Know Your Team Appendix Y: MLG Performance and Development Plan and Review Appendix Z: Essential Key Components of Performance Management

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Appendix V: Communication Style Inventory This is an informal survey, designed to determine how you usually act in everyday situations. The idea is to get a clear description of how you see yourself. On the answer sheet, circle A or B in each pair of statements below, which shows the one that MOST describes you.