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Multi-sectoral collaboration improves community engagement, service delivery, and data-informed decision making

Ernest Takomana, Assistant Environmental Health Officer

Bangwe Health Centre, Blantyre DHO

The principal goal of the Network Model approach is to implement the core capabilities of the HIV prevention cascade and through linked networks — in sub-geographies of the district — of political and community leaders, local governance and public health structures, public health clinics, private (for-profit and not-for-profit) clinics and other service delivery, community-based and civil society organizations, under the coordination of the district and city health offices.

 

BPS aimed to highlight how multiple, fragmented channels across sectors can be linked and strengthened; identify core program elements to inform the replicable mode; elucidate the functions of a network that need to be in place for effective operation of the prevention cascade and demonstration of the systems enablers; and understand how the model is localized in different contexts to distill a set of archetypes for what seems to work in different settings.

Grace Kumwenda,  Former Chief of Party for Pakachere

The BCT selected four pilot geographies using data from PALMS, the CSO network analysis, public and private service delivery channel mapping exercise, BPS work stream data, as well as characteristics of each location, such as risk level, migratory patterns, urban vs. rural, and ongoing social activities that could increase risk of transmission. Facility Network Model committees were formed in each cluster with multi-sectoral representatives. Each committee developed an action plan for the year specific to their cluster with indicators to track progress.

 

A central objective of the approach was to ensure that local entities are equipped to coordinate with other entities within their catchment area to ensure coordinated resource allocation and referrals. Each cluster reported an increase in coordination between the public facility and local stakeholders operating in the facility catchment area, particularly with private facilities. For example, the Mpemba network was able to review STI data from private facilities for the first time, and in Bangwe, Pakachere stepped in to provide 7,200 condoms to the public health center, which had run out of condoms.
 
Committees also used PALMS data and their own programmatic observations to trigger actions in their communities often in partnership with the Konda Blantyre, Konda Moyo health communications campaign. For example, the Mpemba committee and Konda Moyo Konda BT identified a hot spot within the catchment area and committee planned a coordinated outreach to conduct HIV testing and provision of other HIV prevention services at the hot spot in collaboration with staff from Mpemba Health Facility. In Chirimba, the Network Model committee collaborated with the Konda Moyo Konda BT committee to conduct road shows that provided health education and distributed 6,000 condoms to 15 bars.
 
The approach successfully demonstrated that the local management system envisioned by the project is not only possible but can thrive. It has demonstrated how multi-sectoral stakeholders can come together – under the leadership of the DHO – to use data, link service delivery, and address challenges in their communities for a more effective HIV response. The networks are the optimized system in action – capacitated with the prevention cascade capabilities and health system enabler capacities. The approach forms a framework for articulating Blantyre’s future unified HIV response in the sustainability plans and district-level toolkit.

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