September 2009

1. Guide to Producing Campaign to End Pediatric Aids (CEPA) National Advocacy Action Plans (NAAPs) September 2009

2. Remember CEPA’s Long-Term Goal 80% coverage for pediatric HIV/AIDS treatment and PPTCT+ services

3. Focus on CEPA’s Four Core Objectives Section 2: Comprehensive Family Centered Care Section 3: Early Infant Diagnosis and Treatment Long-term Goal: 80% coverage for pediatric HIV/AIDS treatment and PPTCT+ services Section 4: Access to Medicines Section 5: Full Funding

4. Structure of a NAAP Document Section 1: Introduction and Overview of Country Context Section 2: Core Objective 1 - Family Centered Care and Nutrition Section 3: Core Objective 2 - Early Infant Diagnosis and Treatment Section 4: Core Objective 3 - Access to Appropriate Medicines Section 5: Core Objective 4 - Full Funding to Eliminate Pediatric Aids Section 6: Review and Identify Synergies and Links Between Sections 2-5 Section 7: Monitoring Plan Section 8: Partner Roles and Accountabilities

5. For Section 1 of your NAAP Document Follow These Steps: • Provide overview of HIV/AIDS and Pediatric HIV/AIDS country context, with HIV/AIDS and Health Statistics (See Section 10.2.1 of “On the Road…”) • Provide overview of country response to HIV/AIDS and Pediatric HIV/AIDS (See Section 10.1.4 of “On the Road…”) • Provide environmental scan and assessment of advocacy/political climate (See Sections 10.1.1, 10.1.2, and 10.1.3 of “On the Road…”) • Provide initial identification of potential advocacy targets (See Section 10.2.2 of “On the Road…)

6. For Sections 2 to 5 of NAAP Document Follow These Steps: FOR EACH OF THE 4 CORE OBJECTIVES: Identify Beneficiary Outcomes tied to each specific core objective which will contribute to achievement of the long-term goal (80% coverage for pediatric HIV/AIDS treatment) Identify Bottlenecks that prevent achievement of beneficiary outcomes Identify Advocacy Outcomes for addressing/removing identified bottlenecks that prevent achievement of beneficiary outcomes Identify Advocacy Outputs that are potential shorter term steps towards the achievement of advocacy outcomes (These will often be linked to changes in advocacy target actors and institutions) Identify Types of Evidence in particular Key Performance Indicators (KPIs), so that progress towards advocacy outcomes and advocacy outputs can be monitored over time Identify Activities and Strategies to achieve advocacy outcomes and advocacy outputs (specifically for year 1 of the campaign)

7. Steps to a NAAP – Sections 2 to 51. Identify Beneficiary Outcomes for Each Core Objective Core Objective: Family Centered Care and Nutrition Beneficiary Outcome Accessible health facilities offer comprehensive quality prevention, treatment, and family care along with broader reproductive health services 80% Coverage

8. Steps to a NAAP – Sections 2 to 52. Identify Bottlenecks to Beneficiary Outcomes Core Objective: Family Centered Care and Nutrition Bottleneck Beneficiary Outcome Accessible health facilities offer comprehensive quality prevention, treatment, and family care along with broader reproductive health services Stigma Bottleneck 80% Coverage Lack of coordinated care Bottleneck Limited number and capacity of trained health care professionals

9. Steps to a NAAP – Sections 2 to 53. Identify Advocacy Outcomes that Address Bottlenecks Advocacy Outcome Bottleneck National policy strengthened to prevent discrimination against HIV positive mothers and children. Stigma Bottleneck Advocacy Outcome Lack of coordinated care An accredited set of National Training curricula for task shifting is established. Bottleneck Advocacy Outcome Limited number and capacity of trained health care professionals Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers.

10. Steps to a NAAP – Sections 2 to 54. Identify Advocacy Outputs Towards Advocacy Outcomes Advocacy Outcome Bottleneck Advocacy Output National policy strengthened to prevent discrimination against HIV positive mothers and children. Stigma Report on national stigma index is published Bottleneck Lack of coordinated care Advocacy Output Advocacy Outcome National Training curricula is drafted by relevant actors An accredited set of National Training curricula for task shifting is established. Bottleneck Limited number and capacity of trained health care professionals Advocacy Outcome Advocacy Output Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers. Pediatric care policy guidelines drafted by Ministry of Health

11. Steps to a NAAP – Sections 2 to 55. Identify Evidence/KPIs to Monitor Progress Towards Advocacy Outcomes and Advocacy Outputs Advocacy Outcome Bottleneck Advocacy Output National policy strengthened to prevent discrimination against HIV positive mothers and children. Stigma Report on national stigma index is published Bottleneck Evidence/KPIs: Stigma Report Evidence/KPIs: Punishments for discrimination in National policy are made more severe Lack of coordinated care Advocacy Output Advocacy Outcome National Training curricula is drafted by relevant actors An accredited set of National Training curricula for task shifting is established. Bottleneck Evidence/KPIs: National Training curricula document Evidence/KPIs: Draft of Training Curricula Limited number and capacity of trained health care professionals Advocacy Outcome Advocacy Output Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers. Pediatric care policy guidelines drafted by Ministry of Health Evidence/KPIs: Draft of Pediatric care policy guidelines Evidence/KPIs: Relevant legislation

12. Steps to a NAAP – Sections 2 to 56. Identify Activities to Achieve Advocacy Outputs and Outcomes Advocacy Outcome Bottleneck Advocacy Output National policy strengthened to prevent discrimination against HIV positive mothers and children. Evidence/KPIs: Punishments for discrimination in National policy are made more severe Stigma Report on national stigma index is published Evidence/KPIs: Stigma Report Bottleneck Lack of coordinated care Advocacy Outcome Advocacy Output National Training curricula is drafted by relevant actors Evidence/KPIs: Draft of Training Curricula An accredited set of National Training curricula for task shifting is established. Evidence/KPIs: National Training curricula document Bottleneck Limited number and capacity of trained health care professionals Advocacy Outcome Advocacy Output Comprehensive and harmonized pediatric care policies, guidelines, and standard operating procedures are adopted by National Government, donors, and providers. Evidence/KPIs: Relevant legislation Pediatric care policy guidelines drafted by Ministry of Health Evidence/KPIs: Draft of Pediatric care policy guidelines Activities Activities Activities Conduct research for national stigma index Conduct briefing session with MoH, donors, and health care providers on guideline requirements Conduct joint briefing session with MoH, MoL, MoE, PS

13. For Section 3, Example of Core Objective 2: Early Infant Diagnoses and Treatment Bottleneck Activities Advocacy Outcome Lack of access to care Policy briefing sessions with the MOH/PS MOH, MOF, MOL promulgate national Pediatric HIV training curricula Evidence/KPIs: Approved training curricula Advocacy Output Bottleneck National AIDS plans including specific policies and guidelines supporting pediatric AIDS services drafted Evidence/KPIs: Draft plans Activities Slow test results Meeting with key stakeholders and CSOs to shape PEDs HIV/AIDS agenda coordination and activation AdvocacyOutcome Bottleneck MOH Approve and implement National pediatric EID/EIT standards and quality assurance protocols Evidence/KPIs: Approvedstandards and quality assurance protocols Lack of trained healthcare workers Advocacy Output Broad agreement by key stakeholders to adopt early testing and treatment guidelines Evidence/KPIs: Signed MOUs among key parties Activities Advocacy Outcome Community mobilization with child health advocates National health care centers purchase and distribute laboratory equipment Evidence/KPIs: health center inventory lists indicate equipment purchased and received

14. For Section 4, Example of Core Objective 3: Access to Appropriate Medicines Activities Dialogues with national drug procurement and supply chain management authorities Advocacy Output Advocacy Output Bottleneck DRA reviews and tailors PaATH proposal to country needs Evidence/KPIs: PaAth proposal Government reviews existing guidelines on procurement, distribution and supply chain management Evidence/KPIs: Report reviewing existing guidelines Activities Slow drug approval process Briefing sessions with MOH, DRAs, Parliamentary committee(s), & procurement/distribution/supply chain mgmt authorities on harmonizing drug registration (PaATH, NEPAD) Advocacy Outcome Advocacy Outcome Bottleneck Procurement, distribution and supply chain management policies and guidelines amended Evidence/KPIs: Amended policies and guidelines PaATH registration process implemented Evidence/KPIs: Appropriate legislation High cost of pediatric HIV drugs Advocacy Output MOH, DRA, Procurement authority recommend/call for increased government funding for pediatric ARVs, PPTCT meds and commodities Evidence/KPIs: Press release/announcement Bottleneck Advocacy Outcome Weak national procurement and supply chain management guidelines Increased funding for PPTMT meds approved Evidence/KPIs National budget, appropriate legislation

15. For Section 5, Example of Core Objective 4: Full Funding Activities National media campaign highlighting need for better utilization of PPTCT funds Advocacy Output Advocacy Output Bottleneck Donors commit to reviewing funding allocations for PPTCT Evidence/KPIs: Decision point of donor organization board High level committee formed to consider option for new budget monitoring institution Evidence/KPIs: Committee report and recommendations Activities Available funds not utilized Briefings with donors on increased funding allocations for PPTCT and pediatric services Advocacy Outcome Advocacy Outcome Bottleneck Institution for budget monitoring established Evidence/KPIs: Opening announcement Line item within health budgets dedicated to PPTCT and pediatric services established Evidence/KPIs: National budget/appropriate legislation Lack of national funding for PPTCT Advocacy Output Governments commit to allocate more resources to health budgets Evidence/KPIs: Government press release Activities Bottleneck Advocacy Outcome Advocacy Outcome National demonstrations to pressure governments to increase funding Pediatric HIV prevention and treatment not perceived as a priority Overall national PPTCT budget increased Evidence/KPIs: 50% increase in funds allocated towards PPTCT Overall donor funding for PPTCT increased Evidence/KPIs: 50% increase in funds allocated towards PPTCT

16. Section 6 – Review and Identify Synergies and Links Between Sections 2-5 • Identify the bottlenecks that cut across more than one core objective. • Identify the advocacy outcomes that address more than one bottleneck. • Identify the advocacy outputs that link to more than one advocacy outcome. • Identify the activities that contribute to more than one advocacy output.

17. Section 7Monitoring Plan Establish processes for collecting data for the evidence, especially KPIs: • How will evidence be collected? • How can current baseline data be collected? • How often will data be collected? • Who will be responsible for data collection? • Can the selected KPIs be incorporated into CEPA score cards? Identify potential opportunities for learning and reflection that could lead to course correction. More guidance on the monitoring plan will be provided once sections 1-6 are further developed and at the advocacy summit.

18. Section 8Partner Roles and Responsibilities