September 2009

Guide to Producing Campaign to End Pediatric Aids

(CEPA) National Advocacy Action Plans

(NAAPs)

Remember CEPA’s Long-Term Goal

80% coverage for pediatric HIV/AIDS

treatment and PPTCT+ services

Focus on CEPA’s Four Core Objectives

Long-term Goal: 80%

coverage for pediatric HIV/AIDS

treatment and PPTCT+ services

Section 3: Early Infant Diagnosis and

Treatment

Section 4: Access to Medicines

Section 2: Comprehensive Family

Centered Care

Section 5: Full Funding

Structure of a NAAP Document

Section 1: Introduction and Overview of Country Context

Section 2: Core Objective 1 - Family Centered Care and Nutrition

Section 3: Core Objective 2 - Early Infant Diagnosis and Treatment

Section 4: Core Objective 3 - Access to Appropriate Medicines

Section 5: Core Objective 4 - Full Funding to Eliminate Pediatric Aids

Section 6: Review and Identify Synergies and Links Between Sections 2-5

Section 7: Monitoring Plan

Section 8: Partner Roles and Accountabilities

For Section 1 of your NAAP Document Follow These Steps:

1. Provide overview of HIV/AIDS and Pediatric HIV/AIDS country context, with HIV/AIDS and Health Statistics (See Section 10.2.1 of “On the Road…”)

2. Provide overview of country response to HIV/AIDS and Pediatric HIV/AIDS (See Section 10.1.4 of “On the Road…”)

3. Provide environmental scan and assessment of advocacy/political climate (See Sections 10.1.1, 10.1.2, and 10.1.3 of “On the Road…”)

4. Provide initial identification of potential advocacy targets (See Section 10.2.2 of “On the Road…)

For Sections 2 to 5 of NAAP DocumentFollow These Steps:

FOR EACH OF THE 4 CORE OBJECTIVES:

1. Identify Beneficiary Outcomes tied to each specific core objective which will contribute to achievement of the long-term goal (80% coverage for pediatric HIV/AIDS treatment)

2. Identify Bottlenecks that prevent achievement of beneficiary outcomes

3. Identify Advocacy Outcomes for addressing/removing identified bottlenecks that prevent achievement of beneficiary outcomes

4. Identify Advocacy Outputs that are potential shorter term steps towards the achievement of advocacy outcomes (These will often be linked to changes in advocacy target actors and institutions)

5. Identify Types of Evidence in particular Key Performance Indicators (KPIs), so that progress towards advocacy outcomes and advocacy outputs can be monitored over time

6. Identify Activities and Strategies to achieve advocacy outcomes and advocacy outputs (specifically for year 1 of the campaign)

Core Objective:Family Centered

Care and Nutrition

Steps to a NAAP – Sections 2 to 51. Identify Beneficiary Outcomes for Each Core Objective

80% Coverage

Beneficiary Outcome

Accessible health facilities offer

comprehensive quality prevention, treatment, and family care along

with broader reproductive health

services

Core Objective:Family Centered Care

and Nutrition

Steps to a NAAP – Sections 2 to 52. Identify Bottlenecks to Beneficiary Outcomes

80% Coverage

Bottleneck

Bottleneck

Bottleneck

Stigma

Lack of coordinated care

Limited number and capacity of trained health

care professionals

Beneficiary OutcomeBeneficiary Outcome

Accessible health facilities offer

comprehensive quality prevention, treatment, and family care along

with broader reproductive health

services

Steps to a NAAP – Sections 2 to 53. Identify Advocacy Outcomes that Address Bottlenecks

Advocacy Outcome

Advocacy Outcome

Advocacy Outcome

National policy strengthened to prevent discrimination against HIV positive mothers

and children.

An accredited set of National Training curricula for task shifting is established.

Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by

National Government, donors, and providers.

Bottleneck

Bottleneck

Bottleneck

Stigma

Lack of coordinated care

Limited number and capacity of trained health

care professionals

Steps to a NAAP – Sections 2 to 54. Identify Advocacy Outputs Towards Advocacy Outcomes

Advocacy Output

Advocacy Output

Advocacy Output Advocacy Outcome

Advocacy Outcome

Advocacy Outcome

National policy strengthened to prevent discrimination against HIV positive mothers

and children.

An accredited set of National Training curricula for task shifting is established.

Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by

National Government, donors, and providers.

Bottleneck

Bottleneck

Bottleneck

Stigma

Lack of coordinated care

Limited number and capacity of trained health

care professionals

Pediatric care policy guidelines drafted

by Ministry of Health

Report on national stigma index is

published

National Training curricula is drafted by relevant actors

Steps to a NAAP – Sections 2 to 55. Identify Evidence/KPIs to Monitor Progress Towards

Advocacy Outcomes and Advocacy Outputs

Advocacy OutcomeNational policy strengthened to prevent

discrimination against HIV positive mothers and children.

Advocacy OutcomeAn accredited set of National Training curricula

for task shifting is established.

Advocacy OutcomeComprehensive and harmonized pediatric care

policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers.

BottleneckStigma

BottleneckLack of

coordinated care

BottleneckLimited number and capacity of trained health

care professionals

Advocacy Output

Pediatric care policy guidelines drafted

by Ministry of Health

Advocacy OutputReport on national

stigma index is published

Advocacy OutputNational Training

curricula is drafted by relevant actors

Evidence/KPIs: Punishments for discrimination in National policy are made more severe

Evidence/KPIs: National Training curricula document

Evidence/KPIs: Draft of Pediatric care policy guidelines

Evidence/KPIs: Draft of Training Curricula

Evidence/KPIs: Stigma Report

Steps to a NAAP – Sections 2 to 56. Identify Activities to Achieve Advocacy Outputs and Outcomes

Advocacy OutcomeNational policy strengthened to prevent

discrimination against HIV positive mothers and children.

Evidence/KPIs: Punishments for discrimination in National policy are made more severe

Advocacy OutcomeAn accredited set of National Training

curricula for task shifting is established.Evidence/KPIs: National Training curricula document

Advocacy OutcomeComprehensive and harmonized pediatric

care policies, guidelines, and standard operating procedures are adopted by

National Government, donors, and providers.Evidence/KPIs: Relevant legislation

BottleneckStigma

BottleneckLack of

coordinated care

BottleneckLimited

number and capacity of

trained health care

professionals

Advocacy Output

Pediatric care policy guidelines drafted

by Ministry of Health

Evidence/KPIs: Draft of Pediatric care policy guidelines

Advocacy OutputReport on national

stigma index is published

Evidence/KPIs: Stigma Report

Advocacy OutputNational Training

curricula is drafted by relevant actors

Evidence/KPIs: Draft of Training Curricula

ActivitiesConduct research

for national stigma index

ActivitiesConduct briefing

session with MoH, donors, and health care providers on

guideline requirements

ActivitiesConduct joint

briefing session with MoH, MoL,

MoE, PS

For Section 3, Example of Core Objective 2: Early Infant Diagnoses and Treatment

Policy briefing sessions with the

MOH/PS

Activities

ActivitiesMeeting with key stakeholders and

CSOs to shape PEDs HIV/AIDS

agenda coordination and

activation

ActivitiesCommunity

mobilization with child health advocates

Advocacy OutputNational AIDS plans including specific policies and guidelines

supporting pediatric AIDS services drafted

Evidence/KPIs: Draft plans

Advocacy OutputBroad agreement by key

stakeholders to adopt early testing and treatment guidelines

Evidence/KPIs: Signed MOUs among key parties

Advocacy OutcomeMOH, MOF, MOL

promulgate national Pediatric HIV training

curriculaEvidence/KPIs: Approved training curricula

Advocacy OutcomeNational health care

centers purchase and distribute laboratory

equipmentEvidence/KPIs: health center inventory lists indicate equipment purchased and received

Advocacy OutcomeMOH Approve and

implement National pediatric EID/EIT

standards and quality assurance protocols

Evidence/KPIs: Approved standards and quality assurance protocols

BottleneckLack of access

to care

Slow test results

Bottleneck

Lack of trained healthcare

workers

Bottleneck

For Section 4, Example of Core Objective 3: Access to Appropriate Medicines

Dialogues with national drug

procurement and supply chain management authorities

Activities

Activities

Briefing sessions with MOH, DRAs,

Parliamentary committee(s), &

procurement/distribution/supply

chain mgmt authorities on

harmonizing drug registration

(PaATH, NEPAD)

Advocacy OutputGovernment reviews existing guidelines on procurement,

distribution and supply chain management

Evidence/KPIs: Report reviewing existing guidelines

Advocacy OutputMOH, DRA, Procurement authority

recommend/call for increased government funding for pediatric

ARVs, PPTCT meds and commoditiesEvidence/KPIs: Press release/announcement

Advocacy OutcomeIncreased funding for

PPTMT meds approvedEvidence/KPIs National budget, appropriate legislation

Advocacy OutcomeProcurement, distribution

and supply chain management policies and

guidelines amendedEvidence/KPIs: Amended policies and guidelines

Slow drug approval process

Bottleneck

High cost of pediatric HIV

drugs

Bottleneck

Weak national procurement

and supply chain

management guidelines

Bottleneck

Advocacy OutcomePaATH registration

process implementedEvidence/KPIs: Appropriate legislation

Advocacy OutputDRA reviews and tailors PaATH

proposal to country needsEvidence/KPIs: PaAth proposal

For Section 5, Example of Core Objective 4: Full Funding

National media campaign

highlighting need for better

utilization of PPTCT funds

Activities

ActivitiesBriefings with

donors on increased funding

allocations for PPTCT and

pediatric services

ActivitiesNational

demonstrations to pressure

governments to increase funding

Advocacy OutputHigh level committee formed to consider option for new budget monitoring institutionEvidence/KPIs: Committee report and recommendations

Advocacy OutputGovernments commit to allocate more resources to health budgets

Evidence/KPIs: Government press release

Advocacy OutcomeOverall national PPTCT

budget increased Evidence/KPIs: 50% increase in funds allocated towards PPTCT

Advocacy OutcomeInstitution for budget

monitoring establishedEvidence/KPIs: Opening announcement

Available funds not

utilized

Bottleneck

Lack of national

funding for PPTCT

Bottleneck

Pediatric HIV prevention

and treatment not perceived as a priority

Bottleneck

Advocacy OutcomeLine item within health

budgets dedicated to PPTCT and pediatric services

establishedEvidence/KPIs: National budget/appropriate legislation

Advocacy OutputDonors commit to reviewing funding allocations for PPTCT Evidence/KPIs: Decision point of donor organization board

Advocacy OutcomeOverall donor funding for

PPTCT increased Evidence/KPIs: 50% increase in funds allocated towards PPTCT

Section 6 – Review and Identify Synergies and Links Between Sections 2-5

Identify the bottlenecks that cut across more than one core objective.

Identify the advocacy outcomes that address more than one bottleneck.

Identify the advocacy outputs that link to more than one advocacy outcome.

Identify the activities that contribute to more than one advocacy output.

Section 7Monitoring Plan

Establish processes for collecting data for the evidence, especially KPIs:

How will evidence be collected? How can current baseline data be collected? How often will data be collected? Who will be responsible for data collection? Can the selected KPIs be incorporated into CEPA score cards?

Identify potential opportunities for learning and reflection that could lead to course correction.

More guidance on the monitoring plan will be provided once sections 1-6 are further developed and at the advocacy summit.

Section 8Partner Roles and Responsibilities