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��C19 Response Mechanism�Supported by The Global Fund��Updates to Country Coordinating Mechanism (CCM) –Papua New Guinea� Project: Managing Integrated TB HIV response in PNG

10^th May 2022

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Overview – C19 RM

Implementation letter dated 14^th Dec 2021
Unpacking the grant with key partners - Dec 2021 –till date
Conditions in letter included

Use of funds before 31 December 2023
Laboratory strengthening and Youth friendly spaced refurbishments – Prior approval with detailed budget assumptions
Human resources – prior to use of grant funds for HR in Year 3 (2023), prior approval from GF on list of positions that will be transitioned to PHA or National Government of PNG
CCM Endorsement for procurement of PPE and GeneXpert machines before purchase of these.

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C19 RM – Expenditure till March 2022

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TB/HIV/C19 RM activities –May –June 2022

Stakeholder engagement to support implementation of activities

NDOH
NCC
WHO
UN Agencies
SRs
Externals

Continued recruitment of vacant positions under C19 grant by PR(32/85 vacant as of 3^rd May 2022)
Ongoing recruitment by SRs for CHW MDR TB out reach workers
Ongoing Induction and training for 16 Provincial Frontline Coordinators (Surveillance)

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Activities done so far (1) – From Jan 2022

Recruitments – ongoing from Jan 2022
Planning Meeting for HIV Program (Jan 2022)
For TB program, small group meeting with technical team for supervisory visits
Data mopping Exercise (Feb 2022)
PR M&E Workshop with SR M&E team (Feb 2022)
Budget Reallocation Exercise completed (April 2022)
PUDR Review workshop with PR, NDOH (TB&HIV) April 2022
PUDR submission by PR to GF (26 April 2022)
SR Capacity Assessment Review Workshop (28-29 April 2022)

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Activities done so far (2) - From Jan 2022

National Supportive Visits (Central, EHP, WHP, Jiwaka, WNBP & Simbu) (April-May 2022)
ART Prescribers Training Batch 1 (April 2022)
FETP Visits (WNBP/WSP)
Deployment of 16 Provincial frontline coordinators ( Outbreak surveillance)
Viral Load Training (EHP/Morobe/Enga)
Pulse Check Submission by PR to GF (6^th May 2022)

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TB/HIV/C19 RM activities – May –June 2022 (2)

Workplan meeting with HIV Program (11^th May 2022)
Workplan meeting with TB Program –Date to be confirmed confirmation
Follow up

RSSH – Laboratory system strengthening
Outbreak surveillance system strengthening – Roll out of FETP Training & Outbreak surveillance system (ODK or which ever platform is being used)
Procurement monitoring of Health Products
MOU with NDOH, NCC
Rapid costed gap analysis

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HR vacancies as on 3^rd May 2022

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Procurement status (C19 RM)

Year 2 procurements – Orders placed Q4 through WAMBO
Oxygen plants – expected to receive in PNG in Aug 2022 – subject to site preparation
Oxygen concentrators 100 – received and handed over to NCC in March 2022
Local purchase - Hand-sanitizer, disinfectant, pulse oximeter – 276, monitors- 20 (Handed over to NCC – May -April 2022), Bio-hazard boxes – delivery process ongoing

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For effectiveness and efficiency

Lessons learnt

Multiple projects within C19 RM requires a re-look at staffing and operational processes, roles of technical partners must be clarified
Rushed processes are risky and can affect our compliance
PHA –SR coordination and support is essential for sustaining the results / improving program quality

Challenges / proposed solutions

Finalization of contracts/ identification of technical service providers – Follow up
Diverse set of interventions and activities – Unpacking the grant with partners
Availability of key stakeholders – Structured review meeting dates
Staff turnover/ Unfilled positions

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For effectiveness and efficiency �Quick actions

Finalize TOR/ SOW/ Contracts – additional hands on support
Technical guidelines to SRs
Revise MOUs based on Re-allocation request approvals from GF

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Outline of C19 RM activities

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1. COVID-19 control & containment interventions

Upgrading and realigning the international Epidemiologist position to lead and manage the provincial support teams and COVID-19 response
Establishment of a new national COVID-19 Response Coordinator position.

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2. Risk Communication & Community�Engagement�

Establishment of regular text messaging, social media presence, and other communication with SRs and community teams
COVID-19 risk communication integrated into TB/HIV/Malaria community outreach programs

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3. Surveillance, epidemiology &� contact tracing

Expansion of Field Epidemiology Training Program (FETP) to an additional two provinces.

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4. Mitigation for HIV Program�

Expansion of the HIV Patient Database to 15 satellite ART clinics
Additional 15 data entry staff in key ART centers to improve local tracking and provincial reporting
An additional 34 PLHIV peer treatment supporters
A PLHIV peer support program coordinator in the Highlands
An additional KP Network Coordinator position in the national KP Consortium office
An annual meeting of KP Network focal people to exchange learnings and plan activities

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5. Mitigation for TB Program�

Rollout of e-TB reporting module into 10 provinces
Additional drivers and fuel allocated to SRs/PHAs for specimen transport
Support to re-start Business4Health initiative with enterprises
National M&E Officer for the TB Program
Support for biannual proficiency testing for AFB microscopy
Training on AFB microscopy

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6. Mitigation for Malaria Program�

Securing the bed-net distribution network and mobility of Community Malaria Volunteers (replacement of unroadworthy vehicles)
Boat hire/purchase in maritime provinces
Additional COVID-19 prevention modifications in national and provincial offices
Equipment for PR and IP staff to facilitate working from home during lock-downs and office closures

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7. Expanded reinforcement of� key aspects of health systems

A national coordinator for the GeneXpert network
TOT training for 8 regional GeneXpert maintenance services providers and ongoing maintenance
An additional 2 scientists at CPHL
An additional data entry staff at CPHL

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8. Gender-based violence prevention &� post-violence care�

Training and mobilization of the HIV/TB/malaria community workforce to engage with UN Women/UNFPA/Spotlight Initiative interventions at provincial, district and local level

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9. Respond to human rights and� gender-related barriers to services �

Implementation funds to take forward the recommendations of the assessment of rights-related barriers to access to Malaria programs and services (Matchbox tool assessment completed June 2021)

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10. Community-based organizations’�institutional strengthening �

Core funding support for KP Consortium to take up a sustainable role in community mobilization, community-led monitoring (CLM), advocacy participation in national program planning and review –finance person, rent, office establishment, strategic planning and governance support

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11. Surveillance, epidemiology &� contact tracing�

PPEs for TB/HIV/malaria community workforce (for 2022)
Additional training through TB/HIV SRs and malaria program for community workforce

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Monitoring framework

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Outcome Indicators�

The current performance framework has twelve (12) outcome indicators;
TB –4 indicators looking at TB case notification rate, treatment success for DS-TB and DR-TB plus TB treatment coverage
HIV –8 indicators looking at condom use among KPs, PLHIV who know their HIV status, Viral Suppression as well as Stigma and Discrimination among KPs

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TB Coverage Indicators (5)�

Number of notified cases of all forms of TB (i.e. bacteriologically confirmed + clinically diagnosed), new and relapse cases
Treatment success rate-all forms of TB
Number of people in contact with TB patients who began preventive therapy
Number of TB cases with RR-TB and/or MDR-TB notified
Number of cases with RR-TB and/or MDR-TB that began second-line treatment

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Laboratory Coverage Indicators (3)�

Percentage of laboratories showing adequate performance in external quality assurance for smear microscopy among the total number of laboratories that undertake smear microscopy during the reporting period
Percentage of new and relapse TB patients tested using WHO recommended rapid tests at the time of diagnosis –TB
Percentage of confirmed RR/MDR-TB cases tested for resistance to second-line drugs -TB

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TB/HIV Coverage indicators (3)�

Percentage of registered new and relapse TB patients with documented HIV status -TB
Percentage of HIV-positive new and relapse TB patients on ART during TB treatment –TB
Percentage of PLHIV on ART who initiated TB preventive therapy among those eligible during the reporting period -HIV

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HIV prevention �

Number of KPs (MSM, TGs and FSWs) reached with HIV prevention programs -defined package of services -SRs
Percentage of KPs (MSM, TGs and FSWs) that have received an HIV test during the reporting period and know their results -SRs

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HIV program (2)�

Percentage of HIV-positive women who received ART during pregnancy and/or labor and delivery
Percentage of people on ART among all people living with HIV at the end of the reporting period

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Reporting Indicator�

Completeness of facility reporting: Percentage of expected facility monthly reports (for the reporting period) that are actually received
Timeliness of facility reporting: Percentage of submitted facility monthly reports (for the reporting period) that are received on time per the national guidelines