Development of a tool for
assessing site-readiness for the
provision of vaginal microbicides
and oral PrEP in South Africa
Aims of the talk
• Provide an overview of the project
• Introduce proposed outline of the tool and
planned approach to its implementation
THE PROJECT
Project objective
The objective of this project is to develop tools
for assessing site/provider readiness to provide
vaginal microbicides and oral PrEP
Phase 1: Pre-project stakeholder
meeting
Phase2: Development of piloting of
the tool (Feb to Sept 2012)
• Create implementation scenarios for
populations in which interventions have
demonstrated efficacy, as well as potential
utility in additional populations following
subsequent RCTs.
• Further engage/interview experts as needed
• Develop site-readiness assessment tool and
guide
Tool development process
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Literature
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The intervention type and formulations
Implementation scenarios for various populations
Legal frameworks
Who will prescribe?
Success and implementation of other interventions
Develop implementation scenarios for populations.
Interview relevant experts, stakeholders and provincial staff.
Review of processes through interviews with relevant staff working at the 3 sites.
Site visits and observation (3 identified sites).
Development of draft assessment tool and guide.
Piloting of and feedback on tool and guide
Finalise draft of detailed guide/report summarizing process for tool development
and instructions for use.
Present draft tool and guide to previously identified stakeholders, additional
leaders, and CDC.
Finalise tool and guide
Phase 3: Post-project stakeholder
meeting ( Sept 2011)
• Update of on recent developments with
respect to biomedical prevention in South
Africa and internationally
• Present the developed site-assessment tool
and implementation guide for review by key
stakeholders.
Tool outline
Sections A to C
Tool section A- Background
information
Purpose of the tool
The tool has been developed for the purposes of preparing
service points for the introduction of vaginal microbicides and
oral PrEP.
South African clinical guidelines
Reference to the relevant DOH guideline; which will provide a
guide to the model for service delivery – how to bridge this gap
in the meantime?
Tool section B- Clinic competency
assessment
Comparison of facility resources against the set
standards, namely:
– Staffing (staff, patient ratio by cadre)
– Patient management requirements (space, package of
services, monitoring, adverse event reporting, referrals)
– Commodities (storage/refrigeration, stock, cost,
procurement, dispensation)
– Data management and data use
– Facility (health facility vs. non-health facility based
implementation)
– External partners and relationships (government, AIDS
councils, NGOs/CBOs)
Tool section C- Summary and
recommendations
• Primary recommendation – ready to provide
vaginal microbicides and oral PrEP- yes or no?
• Identification of improvement interventions
and improvement implementation plans.
• Set date for follow up visit by assessment
team.
User guide
This will outline:
• By whom should the site- assessment tool be
implemented? To whom should it be introduced – which
are the key personnel?
• Methodological principles for implementation: CPG & QI
implementation principles. The supportive supervision
approach?
• Different models of introduction in health facilities based
on various prevention models? Ideal versus pragmatic
• Linked key documents
• Link between readiness assessment and ‘package of care’
and ‘treatment guidelines’.
• Costs?
Discussion