The President‘s Emergency Plan for AIDS Relief (PEPFAR) 2 Capacity Building and Strengthening FY 201 Framework Version 2.0 President’s Emergency Plan for AIDS Relief - 1 - Table of Contents 1 Background .......................................................................................................... 3 2 Purpose ................................................................................................................ 4 2.1 How to Use the Capacity Building Framework ................................................... 5 2.1.1 Reporting Requirements .............................. Error! Bookmark not defined. 3 Capacity Building, Country Ownership, and Transition ............................................. 5 3.1 Transitioning Authority and Responsibilities ...................................................... 6 4 PEPFAR Capacity Building Framework ..................................................................... 7 5 Monitoring and Evaluating Capacity Building Strategies ......................................... 13 5.1 Monitoring Capacity Building .......................................................................... 15 5.2 Evaluating Capacity Building .......................................................................... 18 5.3 Capacity Building Technical Assistance ........................................................... 19 President’s Emergency Plan for AIDS Relief - 2 - ―A continuum [of response] requires both commitment and capacity on the part of the government. …I am encouraged that your Frameworks and Implementation Plans are focused on building the technical and managerial capacity of partner governments. NGO partners, civil society and the private sector are often in a position to impact the needed skills to Ministries, and many of you are deploying them wisely in this way‖. Ambassador Eric Goosby, Office of the Global AIDS Coordinator, 2011 1 Background Capacity building is integral to the USG‘s efforts in fighting the global AIDS epidemic. It is what we do and how we do our work. Capacity is defined as, ―the ability of individuals and organizations or organizational units to perform functions effectively, efficiently and sustainably.‖ i Capacity building is an evidence-driven process of strengthening the abilities of individuals, organizations, and systems to perform core functions sustainably, and to continue to improve and develop over time. Following on the initial emergency response from 2004–2009, the second phase of the President‘s Emergency Plan for AIDS Relief (PEPFAR) 2009–2013 emphasizes country ownership and sustainability. This approach is consistent with the Paris Declaration on Aid Effectiveness, signed by more than 100 bilateral donors and developing countries, which states that the ―capacity to plan, manage , implement and account for results … is critical for achieving development objectives.‖ ii To achieve these ambitious goals, the USG strengthens host country capacity to respond to HIV/AIDS effectively and efficiently and to build sustainable national HIV/AIDS programs. Capacity building is an inherent part of initiatives and activities underway in PEPFAR, including program activities in all technical areas covering prevention, care and treatment, and cross- cutting areas of health system strengthening and integrated health services, civil society (CSO) programs, country ownership, and transition to local partners and programs. US government investment in capacity building through PEPFAR, within the context of national HIV/AIDS plans, seeks to assist host governments‘ efforts to know their epidemics and respond strategically to prevent new infections, care for and treat infected and affected populations, and mitigate the social and economic consequences. Effective capacity building efforts target government, local research and development institutions, nongovernmental organizations, networks, communities, academia and the private sector, with a goal toward enhancing the short and long term potential for these institutions to support the local response and for host governments to lead, manage and monitor internal and external efforts to address HIV/AIDS in country. Part of this process includes a country‘s ability to drive the process to identify, source and manage on-going capacity building efforts as a sustained government-led effort to target change. President’s Emergency Plan for AIDS Relief - 3 - PEPFAR endorses a capacity building framework that addresses three integrated and reinforcing components: individual/workforce, organizational, and systems within a country setting. iii The conceptual framework for capacity building stresses the interrelationship of the three components— the individual, organizational and systems— often requiring concurrent and sustained capacity strengthening of all levels over time. As PEPFAR and host country partners strive to increase the sustainability of HIV/AIDS programs and results, the relationship between capacity building and development outputs, outcomes and impact is increasingly important. The host country‘s ability to capture and measure change in HIV/AIDS program quality, efficiency and health outcomes over time is of critical importance. 2 Purpose This document provides a framework to help USG PEFPAR teams to enhance their approaches and plans for in-country HIV/AIDS capacity building. It provides an overarching vision for the strengthening of host country capacity to respond efficiently and effectively to the HIV/AIDS epidemic through more capable government agencies and service delivery, civil society organizations (including networks of PLHA), private companies, and research and academic communities. Much has been done to promote capacity building at the country level. This framework is intended to support USG teams, in collaboration with host country partners and key stakeholders, to better articulate the full breadth and depth of their capacity building efforts and develop ways to measure the degree to which PEPFAR-supported activities improve host country capacity to appropriately respond to the epidemic and ultimately lead to measurable improvements in HIV outcomes and impact. This document specifically: Provides a high level strategic framework for capacity building within PEPFAR for use by technical working groups and country teams. Encourages strategic use of USG resources to develop capacity in the context of overall national strategic plans for HIV and the broader, health sector both public and private. Promotes the development of more strategic, systematic, and measurable approaches to capacity building at all levels. Provides illustrative approaches to monitor and communicate results on capacity building efforts by specific technical areas. President’s Emergency Plan for AIDS Relief - 4 - 2.1 How to Use the Capacity Building Framework The Capacity Building Framework is meant to complement and support current activities as well as other guidance and strategy documents (such as the partnership framework guidance, the country operational plan guidance, country strategic plan guidance, country ownership), with an operational approach to defining and monitoring capacity building strategies that are implemented within these PEPFAR initiatives. The guide is not intended to dictate or direct a single way to approach capacity building, but rather to ensure that a systematic, strategic approach is employed and documented, that effective partnerships are aligned with program efforts, and that the capacity building outputs, performance outcomes, and health program impacts are reported. This document should be used for the following: Assessing the current baseline of national and local partner contributions to the PEPFAR country portfolio. Conducting a systematic review and planning for capacity building objectives by country team technical work groups during COP/ROP planning and annual reporting results. Creating a systematic approach in-country for monitoring capacity building results and progress in country capacity to lead and manage HIV services and programs over time that integrates with on-going program monitoring approaches in-country. This framework is a conceptual guide to support country team and technical work groups to plan systematic capacity building approaches, and provides more comprehensive information how to design an integrated capacity building strategy for country teams. 3 Capacity Building, Country Ownership, and Transition PEPFAR has identified ‗capabilities‘ as an important dimension of country ownership. iv PEPFAR recognizes that for programs to be sustained and quality retained, country leadership must have the technical and management capabilities to oversee programs and make adjustments and shifts over time. Capacity building, consistent with national plans and supported through PEPFAR programs, is an essential component of strengthening country ownership of HIV/AIDS services and programs. Country ownership requires that national and local partners be capable of mobilizing, designing, implementing and monitoring, and take on greater leadership in managing HIV services, programs, and evaluation efforts. To effectively strengthen country ownership, capacity building priorities must be generated with the leadership of key stakeholders in the country, building on existing President’s Emergency Plan for AIDS Relief - 5 - infrastructure, abilities and experience, recognizing the interdependence among multiple actors, systems, and levels, and responding to political and governmental