A. TERMS OF REFERENCE (TOR)
ASSIGNMENT: CONDUCTING FUNDING LANDSCAPE ANALYSIS FOR
PAEDIATRICS AND ADOLESCENT HIV CARE AND SUPPORT IN BURUNDI,
ETHIOPIA, NIGERIA, MALAWI, UGANDA, SOUTH SUDAN AND TANZANIA
1 BACKGROUND
1.1. Introduction
The African Network for the Care of Children Affected by HIV/AIDS (ANECCA) is a not-for-profit Pan African
network of clinicians and social scientists with a mission to improve access to quality and comprehensive
HIV prevention, care, treatment and support services for children, integrated within the broader maternal
and child health framework.
ANECCA has its headquarters in Kampala Uganda where it is registered as a not-for-profit organization.
ANECCA has received a grant from the Global Fund to fight AIDS, Tuberculosis and Malaria to implement
a regional project on “Improving Coverage for quality services to Children and Adolescents living with HIV
(ICCA)”. This regional project provides a unique opportunity to capitalize on pediatric and adolescent
expertise across the continent to address disparities in access to care and treatment for children and
adolescents.
The goal of the project is to improve the coverage and quality of HIV care, treatment and support for children
and adolescents living with HIV in the seven sub-Saharan African countries. The specific project objectives
are
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To promote the adoption and implementation of policies that increase coverage and quality of
paediatric and adolescent HIV care, treatment and support;
To improve the capacity of HIV service providers in provision of HIV care, treatment and
psychosocial support to children and adolescents living with HIV;
To identify and document innovative approaches and best practices on paediatric and adolescent
HIV care, treatment and support;
To promote adoption of best practices on care, treatment and support of HIV infected children and
adolescents so as to increase identification, treatment and retention of children and adolescents
living with HIV; and
To improve monitoring and evaluation of progress and performance of project activities in the seven
countries.
1.2. Project scope
The project targets 7 countries in Africa comprising of Burundi, Ethiopia, Malawi, Nigeria, South Sudan,
Tanzania and Uganda. These countries have the least antiretroviral treatment coverage for children and
adolescents living with HIV compared to adults. They also have similar structural gaps and challenges that
impinge on coverage and quality of care for HIV infected children and adolescents. These include
inadequate policy frameworks and guidelines for facilitating children and adolescent access to HIV services,
few ART sites offering care and treatment to infected children, low competency of health care workers in
care and treatment of HIV infected children and adolescents, and inadequate knowledge and sharing of
innovative approaches and best practices that enhance coverage and quality of care, treatment and support
among children and adolescents living with HIV.
This regional project implements interventions that remove policy bottlenecks, build capacity, and ensure
access to appropriate information and services related to HIV testing, HIV care and treatment for children
and adolescent in the seven countries. Therefore, the targeted audiences for the project are the national
programmers and policy makers for these seven countries.
2 THE ASSIGNMENT
2.1 Introduction
In most of African countries, international development assistance accounts for a larger proportion (more
than 70%) of the funding for HIV and AIDs activities. The recent global economic recession resulted into
flat lining or a decline in funding from the development donor partners. In Nigeria, for instance HIV spending
by donors declined steadily from about 17.0% in 2010 to 8.2% 201225. This resulted into a growing resource
gap as the need for HIV services outstripped the resources available.
National strategic plans for HIV in the 7 countries do not indicate the amount of funding specifically for
children and adolescents living with HIV. In the absence such detailed information on funding of HIV
services for children and adolescents, funding towards PMTCT and youth programs can be used as a proxy
measure for HIV care and treatment for children and adolescents living with HIV. If this measure is used as
the basis for estimating funding allocation to paediatric and adolescent HIV care, it can be said such
services account for less than 15% of the HIV funding in the region. Moreover, most of the available funding
for HIV and AIDs were spent on commodities and supplies. Program interventions focusing on demand
creation such as policy development, advocacy, and community systems strengthening were under funded.
For instance, the Uganda National AIDS Spending Assessment (NASA) for the period 2009/10 indicate that
less than 1% of the funding was spent on interventions aimed at creating an enabling environment which
includes policy development and advocacy, and community systems strengthening, while 51% of the
funding was spent on commodities and supplies for HIV care and treatment. About 4% of the total funding
for HIV was spent on development of human resources for HIV, while less than 0.3% was spent on HIV
and AIDS research (UAC- NASA, 2012 page 54)1. This implies that little funding was committed to HIV
capacity building of human resources and documentation of innovations and best practices. The meagre
funding on these enablers is contributing to poor delivery and uptake of HIV services particularly among
children and adolescents.
2.2 Objectives of the Assignment
The objective of the consultancy is to carry out funding landscape and map the budget (funds) that are
specifically allocated for paediatric and adolescent care by both Government and Non-Government players
in the following seven countries:- Burundi, Ethiopia, Nigeria, Malawi, Uganda, South Sudan and Tanzania.
These data will be useful in policy guidance and advocacy for increased funding and enhancing coverage
of HIV care for children and adolescents.
2.3 Scope of Work
The Lead Consultant, working with National Consultants in each country, will carry out the following:-
1
I.
Literature review of documents and reports, budget policies and strategies to establish the funding
allocated for paediatric and adolescent care by both Government and Non-Government players.
II.
Quantitative and qualitative budget (funds) allocated for paediatric and adolescent care by both
Government and Non-Government players.
III.
Meeting with stakeholders to present analysis of findings
IV.
Preparation of report including lessons learned
UAC National AIDS Spending Uganda 2008/9 -2009/10
2.4 Key Deliverables
The consultant is expected to produce the following deliverables:
 An inception report;
 Draft report
 Presentation to stakeholders
 Final report
2.5 Key Qualification, Experience and Skills
The consultant is expected to have the following skills, qualifications and experience.
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Advanced degree with background in economics/finance including financial planning or other
related similar discipline
Broad knowledge and understanding of financing in health sector in Africa with a minimum of 10
years relevant experience;
A good understanding of Africa’s HIV/AIDS subsector in general and Paediatrics and Adolescent
HIV/AIDS Care;
Sound understanding and application of financial policies and budgeting;
Good analytical and report writing skills;
Good communication and facilitation skills;
Good interpersonal skills; and
Good computer literacy;
Excellent writing and communication skills in English
2.6 Timing and Duration
The total duration of the consultancy will be 30 man days including visits and workshops in the seven
countries highlighted above. Provision of the service will begin after the signature of contract between the
Consultant and ANECCA. The start date is planned for in February 2016. The whole process should be
finalized by end of April 2016.
2.7 Reporting Arrangements
The consultant will report to the ANECCA Secretariat through the Project Coordinator. He/She will work
closely with National Project Officer in each country for coordination of meeting with identified stakeholders.
B. SUBMISSION OF PROPOSALS
All proposals should be submitted by email to the Project Coordinator email: ririso@aneca.org and copied
to mail@anecca.org by close-of-business on 30 January 2016. Please ensure the email subject-line
states “Proposal – Funding Landscape Analysis”.
Proposals must include the following:
 Proposed approach and outline design for the Funding Landscape Analysis
 Project work plan reflecting the key outputs/deliverables and proposed timeframe
 CV and references
 A sample of relevant written work
 Outline budget