Planning for
Sustainability of MMC
Programs
Panel discussion
Dr. Alex Opio
Arusha, Tanzania (June 2010)
1
Background
• MMC will only have long-term impact on
HIV prevention if the services are
developed in a sustainable manner
• Thus, the planning process for MMC
programs should take into consideration
the factors that facilitate sustainability
• Some thoughts on the above
2
Key Facilitating Factors for
Sustainability of MMC Programs
•
•
•
•
•
•
Advocacy
Appropriate leadership
Strategic planning based on evidence of
needs
Integrated implementation approach
Working in partnership
Innovative implementing approaches
3
Advocacy
• Advocacy needed at international, national
and community levels to build consensus
on developing sustainable MC programs
• Advocacy for MC services is vital right
from the beginning of establishment of MC
programs and during the implementation
– Builds support for key decisions on policies
– Encourages involvement of high level
leadership
4
Appropriate Leadership
• Leadership can champion development and
implementation of sustainable MMC programs
• High political support is conducive for sustainability
of MC interest and keep MC high on the national
health agenda
• Leaders who are on board of MMC programs will
advocate for support and provide or mobilization
resources
• Supportive leaders can set enabling policy and
regulatory environment. Leadership is expected to
provide the required direction and guiding
principles and set national goals
5
Strategic Planning Based on
Evidence of Needs
• Clear MC strategies facilitate advocacy and
resource mobilization; hence sustainability
• Ensuring that national MC strategies
complement or are part of the existing HIV
prevention strategy can promote
sustainability
• Implementing situational analysis is an
important method for creating stakeholder
support, engaging leaders and ensuring
informed policies and programs
6
Integrated Implementation Approach
• Leveraging all MC service delivery sectors
(public and private) is vital for the
sustainability of MC programs
– Integration across sectors
• Many levels of the existing health systems
may be able to provide MC services with
little additional investment
7
Working in Partnership
• The scale-up of MC services requires
actions at many levels and across different
sector
• Partnership facilitates advocacy, resource
mobilization and bringing knowledge and
experiences from different program areas
• Partners can contribute to MC services
based on their comparative advances
8
PEPAR budget allocation
IP
Agency
Geog
coverage
No.
sites
Activities
Targets Model of
service
delivery
Budget
Walter
Reed
DOD
Kayunga &
Mukono
districts
2 sites
-Establish
training
satellite
-provide MMC
10,000
Static,
outreach
$1,150,000
UPDF
DOD
Countrywide
6 sites
-Site
preparation
-provide MMC
6,000
Static
$372,000
HIPS
USAID
Country wide
10 sites Site
preparation
-provide MMC
4,000
Static
$354,580
HCP
USAID
National level
Policy,
Communication strategy,
job aides, IEC
516,587
MOH
CDC
National level
Policy
development
$100,000
PEPAR budget (1)
IP
Agency Geog coverage
No.
sites
Activities
Targets Model of
service
delivery
Budget
STAR E
USAID
Kapchorwa,
Sironko, Bududa,
Pallisa, Busia,
Bukwo, Budaka,
Butaleja, Mbale
TBD
Site
preparation
Provide
MMC
TBD
Static
$50,000
STAR
SW
USAID
Kisoro, Kabale,
Ibanda, Isingiro,
Rukungiri,
Ntungamo,
Kiruhura,
Kanungu
TBD
Site
preparation
Provide
MMC
TBD
Static
$50000
STAR
EC
USAID
Iganga,
Bugiri, Mayuge,
Kaliro,
Kamuli, Jinja
8
sites
Site
preparation
Provide
MMC
16,000
Static,
outreach
$850,000
PEPAR budget (2)
IP
Agency
Geog
coverage
No.
sites
Activities
Targets
Model of
service
delivery
Budget
MUSPH
CDC
Rakai,
Lyantonde,
Masaka
14 sites
-TOT
-training
service
providers
-MMC
8,000
Static,
outreach
1,900,000
TBD
Comprehensive
prevention
CDC
8 districts
40 sites
-Site
preparation
Provide
MMC
10,000
Static,
Outreach
$500,000
TBD
Prevention
USAI
D
TBD
TBD
-Site
preparation
-Surgery
TBD
Static,
Outreach
$500,00
TBD-KCC
CDC
Kampala
district
7 sites
-Site
preparation
-Surgery
6,000
Static,
Outreach
$300,000
TBD-Mbarara
CDC
Mbarara Reg
hosp,
8 sites
-Training
Satellite
-provide
MMC
8,000
Static,
Outreach
$423,420
Innovative Implementing Approaches
•
Implementing a mix of both vertical and integrated
approaches

•
•
Vertical approach at the beginning to attain high MC volumes
Task-shifting approach to sort out human resource
problems; especially at peripheral health facilities
Ensuring the incorporation of the MMC commodities
into lists of national essential medicines and
equipment and in the procurement and distribution
systems used by service delivery sites
12
I thank you
13