“These tools put the power in the community’s hands. People get to decide what they want to do in their community.” – Delegate, AIDSImpact 2017 Conference
Paediatric-Adolescent Treatment Africa (PATA) and Positive Action for Children Fund (PACF) officially launched a Clinic-Community Collaboration Toolkit and accompanying Be Connected e-learning course at the 13th International AIDSImpact Conference in Cape Town, South Africa, on Monday, 13 November.
Through their partnership on the three-year Clinic-CBO Collaboration (C³) programme, the two organisations worked across nine sub-Saharan African countries and strengthened 36 community-clinic collaborations. This programme demonstrated how transformative local-level collaboration can be to the health response. Informed by the C³ programme’s successes and lessons learnt, PATA and PACF developed a Clinic-Community Collaboration Toolkit and an accompanying Be Connected e-learning course. Through the launch of these new tools, they hope to continue empowering and capacity-building health providers, CBOs and local coordinators to initiate, expand and improve upon joint activities and action plans to strengthen paediatric case finding, improve access to treatment and reduce mother-to-child transmission (MTCT) and paediatric HIV.
“Taking forward the learnings from the C³ programme in a sustainable way requires an approach that is grounded in district level planning, delivery and evaluation. We need to build the capacity of the community to become an integral element of health services through developing and promoting innovative, high quality, user-responsive differentiated models of care that link facility and community,” explains PATA Executive Director, Luann Hatane.
The Clinic-Community Collaboration Toolkit and Be Connected course were developed as a way for community engagement to be informed by local information and data, ensuring that resources and collaboration are leveraged to scale up quality services.
“Incremental improvement is what C³ is all about. Small improvements in hundreds, or even thousands of clinic-community collaborations, can lead to improvements in the quality of care and the health and well-being of children living with HIV. This in turn can greatly contribute to our global targets to end MTCT and paediatric HIV by 2020, strengthen paediatric HIV case finding and improve access to treatment,” adds Hatane.
The toolkit focuses on six practical ‘how-to’ steps towards collaboration: assess and identify; initiate and formalise; plan and resource; collaborate and implement; document, review and monitor; and messaging for broader impact. Throughout the toolkit there are more than 30 accompanying exercises and templates to support the step-by-step process. To translate theory into practice, Patience, the toolkit tour guide, models effective use of the toolkit through illustrative examples.
The accompanying Be Connected e-learning course aims to further scale the results of collaboration by providing an easily accessible, two-hour online course that highlights key elements of the toolkit by offering insights through a practical ‘how to’ application of the toolkit, guided by two C³ partners from Zambia – Eugene Mupakile, the Executive Director of Kabangwe Creative Initiative Association (KCIA) in Lusaka and Maureen Tembo, a midwife and nurse at the Mother, Child and Neonatal Department at Chazanga Clinic in Lusaka – with accompanying instructional and reflective videos. The course provides transferable building blocks for cooperative planning, implementation and monitoring of community engagement strategies and activities. The e-learning course can be stand-alone or supplemented by the more detailed content in the toolkit.
While the course is based on lessons from C³, which aimed to strengthen linkage and retention along the PMTCT and paediatric treatment cascade, its intention is to be applicable to all target populations and service areas.
Access to the toolkit and Be Connected course will be scaled up through innovative approaches during the second phase of the C³ programme, providing a community of practice on community engagement that is open-source, online and widely available.
“It will only be together, with local communities, that we end AIDS by 2020. We must therefore scale up clinic-CBO initiatives, gathering evidence on the impacts of such collaboration, and advocating for appropriate resource allocation, technical capacity-building and ongoing support at a global, regional and local level,” says PACF Director, Dominic Kemps.
At the official launch of these two tools, experts in the field came together to talk on: “Why we need to adapt our ways of working and funding in the community space”. In front of an audience of at least 75, the role of community in achieving the Sustainable Development Goals (SDGs) and global targets to end AIDS by 2020 was a key theme. Tools that empower this collaboration, such as the Clinic-Community Collaboration Toolkit and Be-Connected e-learning course, were acknowledged.
Doortje ‘t Hart, Senior Advisor Children Affected by AIDS, Aidsfonds said, “What is going to make it work, apart from trust, time and transparency, is the tools.”
Peter McDermott, Chair of the Positive Action for Children Fund (PACF) Advisory Board reminded us that it was the community that provided support and care and was central to demanding services and advocating for access to treatment at the height of epidemic. He explained that for far too long, there has been a focus on biomedical models, and communities have not been involved as they should have been in the treatment agenda. “It is fundamental that communities are central to the effort.”
Georgina Caswell from International HIV/AIDS Alliance and Khanyisa Balfour Western Cape Department of Health also emphasised the importance of relationships and the building of trust between communities and clinics, with limited funding for building meaningful capacity for communities touched on, as Caswell pointed out, “The work we do with CBOs is really about people. It’s not just funding programmes, it’s about funding people and funding people on time. Without investments in people, we cannot achieve our targets and reach SDGs.” There was an overwhelming sense that more needs to be done to call for global action on increasing resources for community involvement and community development.
During a discussion between delegates, key challenges that were discussed included appropriate remuneration and funding for cadres of lay frontline health providers; the importance of involving community leaders for sustainability; and how to capacitate and empower communities to take ownership of documentation and build stronger evidence of the work that they do. It was also noted that policy-makers and donors need to be more flexible in their monitoring and evaluation requirements based on community capacity.
Kemps concluded the session by reiterating that PATA and PACF worked in 36 sites with 72 different partners over three years and experienced optimisation of working relationships through the use of C³ methodology: “This is a proven model; it works.”
PATA and PACF are grateful to Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Aidsfonds and Engender Health, which have each contributed significant time and effort in to the development of the toolkit and e-learning course.
Visit www.teampata.org/c3/ to download to the toolkit or access the course.