Lessons learned in the elaboration of Global Fund Proposals in Guatemala: 2009 - 2010 experience
N.P. Rivera Scott1,2,3,4, L. Castillo5, M. Castro6, B. Hernández7, F. Cano8, S. Ortega9, E. Stolz10, E. Zelaya7, R. Boyle11
1UNAIDS, Monitoring and Evaluation - EVA, Guatemala, Guatemala, 2IAS, Geneva, Switzerland, 3National University of Honduras, Tegucigalpa, Honduras, 4Honduran National Medical Association, Tegucigalpa, Honduras, 5USAID, Guatemala, Guatemala, 6Ministry of Health, Guatemala, Guatemala, 7UNAIDS, Guatemala, Guatemala, 8USAID / PASCA, Guatemala, Guatemala, 9Asociación de Salud Integral, Guatemala, Guatemala, 10Guatemalan Medical Association, Guatemala, Guatemala, 11UNAIDS, Paris, France
Issues: Guatemala has received GF grants for HIV, TB and Malaria since Round 3, which were well evaluated during their implementation. TB and malaria GF grants are now beginning Phase II, while the second phase of the HIV grant recently ended. Considerable resources have been invested to elaborate the new HIV proposals. However, results to date, have not met national expectations.
Description: The CCM, with support from UNAIDS and other key stakeholder, has identified key areas of improvement, with two workshops, one in May 2008 (proposal elaboration process) and one in January 2010 (CCM´s structure and functions). The main problems identified are:
1) Lack of effective leadership / coordination
2) CCM (limited managerial and oversight capacity and civil society representativeness, conflict of interest);
3) Fragmented HIV response (prevention versus treatment / care; public - private, etc.)
4) Limited national M&E structures and resources (affecting definition of MARP sizes and targets).
Lessons learned: The creation of a functional CCM is a national priority, related to the sustainability of the AIDS response. Institutional and personal interests prevail over national interests. As there is no functional NAC, the CCM has assumed to some extent, NAC functions, which distracts and thus limits, adequate performance. The tendency to define MoH as PR is an opportunity for health system strengthening but implies a strong investment in capacity-building, to ensure transparency, timeliness and quality of programmatic and financial processes to meet agreed targets.
Next steps: Next steps include:
a) the recruitment of a CCM manager,
b) the development of an annual operational work plan,
c) the provision of a budget line for its functioning,
e) review and adaptation of CCM structure, roles and functions,
f) training of CCM members for improved managerial performance and representation and
g) creating M&E capacity within the MoH to avoid parallel systems.
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