In Côte d’Ivoire, HIV prevalence is higher than it is in any other West African country. The US President’s Emergency Plan for AIDS Relief (PEPFAR)’s New Partners Initiative (NPI) programme in Côte d’Ivoire is a three year, US$ 3million public-private investment...

The Power of Partnerships

In Côte d’Ivoire, HIV prevalence is higher than it is in any other West African country. The US President’s Emergency Plan for AIDS Relief (PEPFAR)’s New Partners Initiative (NPI) programme in Côte d’Ivoire is a three year, US$ 3million public-private investment between the American and Ivoirian governments and the Legatum Foundation and our grant manager, Geneva Global. It was created to establish a critical mass of community and faith-based organisations (C/FBO) that, due to their grassroots nature, are better able to reach underserved communities with HIV/AIDS interventions.


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Strategic Initiative

SECTOR

Health

TOTAL INVESTMENT

US$ 2,252,501

LOCATION

Côte d'ivoire

LIVES CHANGED

315,029

SOCIAL IMPACT INDEX

47.3 (out of 100)

AVERAGE COST PER LIFE

US$ 7.15

Expand All

SI Breakdown:

Key Achievements

  • Breadth and depth of impact – Reaching more than 300,000 unique lives, NPI overachieved its aggregate benchmarks by 100,000. The depth of impact on each of these lives is captured in measurable ways and complies with minimum standards (or what are more commonly called “best practices”).
  • ABC and VTC – Two implementing partners, Amepouh and Mudessa, work in Blolequin, a remote, war-ravaged town where risk factors abound. After three years of many challenges and capacity building by the Legatum Foundation, Amepouh reached over 12,000 people with the ABC message and referred 3,500 at-risk individuals to Mudessa’s successfully opened VCT centre.
  • Additional funds – USAID’s NPI partner agreements came in three rounds. The Legatum Foundation was in round one that started in December 2006 and ended in November 2009. Of the 22 round one partners, the Legatum Foundation was one of four that acquired a funded extension.

The Problem

In Côte d’Ivoire, HIV prevalence is higher than it is in any other West African country. The HIV prevalence rate is influenced by gender bias, early sexual debut and multiple sexual partners. Its epidemic is generalised, as poor knowledge of HIV transmission and limited access to HIV testing exacerbate the general population’s risky behaviour. Gender biases and economic vulnerability put women and girls at a higher risk of HIV infection than men. Moreover, the country is an economic and migratory hub for West Africa, thereby increasing potential for the spread of HIV infection both regionally and domestically.

Solution

The US President’s Emergency Plan for AIDS Relief (PEPFAR)’s New Partners Initiative (NPI) programme in Côte d’Ivoire is a three year, US$ 3 million dollar public-private investment between the American and Ivoirian governments and the Legatum Foundation and our grant manager, Geneva Global. It was created to establish a critical mass of community and faith-based organisations (C/FBO) that, due to their grassroots nature, are better able to reach underserved communities with HIV/AIDS interventions. The NPI vision within PEPFAR was clear: To develop new partner organisations in 15 countries to support PEPFAR’s goal of preventing seven million new HIV infections, while caring for ten million HIV-infected and-affected persons. When the Côte d’Ivoire Initiative was drafted in 2006, the goal was to reach 114,650 beneficiaries. After seeing the great success of the first year, the beneficiary goal was adjusted accordingly. There were 15 sub-partners in Côte d’Ivoire whose HIV project goals were worth investment, despite their weaker management systems. Our grant manager sought to build their organisational capacities at the onset, while simultaneously conducting rigorous programme and financial monitoring. Our grant manager and its sub-partners closely collaborated with the Ivorian national and local governments, the PEPFAR office in Abidjan, and other PEPFAR partners in Côte d’Ivoire, to integrate their annual plans and targets with the national HIV/AIDS action plan and surveillance system.

Critical Analysis

This initiative in Côte d’Ivoire was part of an integrated national (and international) approach to fight HIV/AIDS. The NPI framework was a perfect fit because of our grant manager's: (1) direct access to indigenous C/FBOs and grassroots communities, (2) insistence on measurable results, and (3) flexibility as an intermediary between small implementing C/FBOs and highly sophisticated funding organisations. Hence, to help address Côte d’Ivoire’s HIV/AIDS endemic, our grant manager managed the implementation of 15 sub-partners providing HIV prevention and AIDS care in trade hubs and transport corridors in the southern and central regions, and in mobile population gateways and post-conflict zones in the west and east.

In conjunction with NPI’s overarching vision, our grant manager had to expressly develop the technical and organisational capacity of the 15 sub-partners. In this regard, it worked with AED, a US-based nonprofit, that helped build its own capacities in technical award administration, as our grant manager in turn built our sub-partner capacities in some of the very basics, such as data quality, efficient programme reporting, and forthright financial documentation and systems. This was very time consuming work, but it is gratifying to see the dynamic changes in the sub-partners.

This initiative was scheduled for completion on March 31, 2011, but the Ivorian security crisis that began in November 2010 delayed this schedule. The crisis also engendered a moratorium on new awards, delaying the commencement of our new US$ 4 million, four-year award with USAID West Africa. USAID extended this initiative until September 2011, allowing time for the moratorium to be lifted.

Lessons Learned

Successes:

Local PEPFAR recognition – In the arena of HIV/AIDS programming, PEPFAR Côte d’Ivoire values our grant manager for its strong HIV prevention programme, efforts to build local implementer capacities, and effective sub-partner award administration.

Effective monitoring and evaluation (M&E) – Having to deal with 15 C/FBOs, most experiencing their first time as a USAID sub-partner, was a tremendous challenge. Our grant manager overcame pitfalls through rigorous M&E alongside organisational capacity building.

Sub-partner testing centres – This programme had six sub-partners that offered HIV testing and counselling, of which there is a dearth throughout the country and, in fact, throughout sub-Saharan Africa. The continuum from prevention education to testing and counselling to care and treatment was more pronounced in the locations where these testing centres operated with other sub-partners. They also provided mobile testing and counselling services for the other sub-partners.

Systematic capacity building – Among PEPFAR partners in Côte d’Ivoire, our grant manager is known for capacity building of its sub-partner organisations to meet the rigors of complying with the requirements of a USAID award. For example, every interaction during M&E activities was used for mentoring each sub-partner along continuous improvement. Equally important, our grant manager organised activities to systematically grow them in specific areas: programme delivery, M&E/data management, governance, financial resources, management and human resources, and networking and linkages.

Challenges:

Data quality – Our grant manager spent a significant amount of time going back and forth with sub-partners to verify the accuracy of the quarterly programme and financial reports. In terms of programme data, reported figures that did not adhere to PEPFAR minimum standards or “best” practices for HIV/AIDS interventions were not counted. Our grant manager also constantly looked out for double-counting of beneficiaries. In terms of financial data, US government cost regulations for award administration were strictly followed.

Fast pace – Exacerbating the issues of data verification was the short quarterly period. USAID required this reporting frequency, and our grant manager still recommends it for better management of a programme with very detailed requirements such as NPI. Yet, the cyclical work it entailed almost entirely consumed our grant manager's time.

Costly quality control – For those partners that submitted poor or non-transparent reports, our grant manager conducted an involved process of on-site validation. For those found to have unsubstantiated data, negotiations were conducted for refund or non-funded benchmarks. Due to the time that non-performing or non-compliant sub-partners require, it is much costlier to manage them than to invest these energies in top performers that produce multiplied results.

Côte d’Ivoire HIV/AIDS: Featured Projects

SII ScoreProject NameGrantLives ChangedCost Per LifeSector
64.60 Renaissance Santé Bouaké (RSB)$101,21626,686$3.79
61.20 Femme Action Developpement (FEMAD) $259,53242,542$6.10
60.80 Lumiere Action $263,37850,584$5.21
57.60 Cote d’Ivoire Prosperite (CIP)$231,39333,352$6.94
57.00 National Direction for Development (DNDAS) $184,34735,738$5.16
57.00 Group Biblique des Hospitaux (GBH)$247,67225,703$9.64
50.40 Ruban Rouge$139,03714,681$9.47
46.80 Amepouh$182,47312,286$14.85
43.20 Mudessa$83,4263,506$23.80
39.60 Alliance Biblique de Cote d’Ivoire (ABCI)$181,50228,436$6.38
39.60 African Christian Television (ACT)$173,22217,665$9.81
37.40 Espoir Cote d'Ivoir$14,1832,512$5.65
34.00 Group Biblique Universitaire Afrique (GBUAF)$162,00514,949$10.84
32.40 Sarepta$14,9324,552$3.28
27.20 New Life Cote d'Ivoire$14,1831,837$7.72
Note: The Social Impact Index Score reflects the relative social impact of a given development project. The lowest possible score is 20; the highest possible score is 100.

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