AIDS Prevention Initiative Nigeria
AIDS Prevention Initiative in Nigeria (APIN):
Development and Status
Prosper Okonkwo. MDAPIN, Nigeria
8th Annual Track 1.0 ART Program MeetingMaputo, Mozambique
August 11, 2010
Friday, April 21, 2023
AIDS Prevention Initiative Nigeria
Outline
Development Introduction Governance Phases of Transition Management Systems
Status Lessons learned Questions from the field
Friday, April 21, 2023
AIDS Prevention Initiative Nigeria
Introduction
History
APIN was established as a program of HSPH in 2000 with a grant from the Gates Foundation
The Harvard PEPFAR(APIN Plus) Program
APIN LLC was incorporated as a local NGO in 2007 to gradually assume HSPH’s work in Nigeria.
Triggers of NGO formation
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AIDS Prevention Initiative Nigeria
Governance
Two tiered structure
HRSA’s recommendations on governance
New board Composition More diversified board Meeting transition guidelines (85 % Nigerians) Broadened scope of activities
E.g. Resource mobilization for sustainability
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AIDS Prevention Initiative Nigeria
Phases of Transition
APIN as sub contractor managing all HSPH sites.
APIN as sub contractor for all HSPH sites and an independent IP ( RFA PS07- 730).
APIN as sub contractor for some sites and IP with more sites transferred from HSPH each year.
APIN to soon absorb all “available” HSPH sites.
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AIDS Prevention Initiative Nigeria
APIN Ltd and Harvard PEPFAR Sites
Nigerian states that currently include sites under APIN Ltd & Harvard PEPFAR
11
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AIDS Prevention Initiative Nigeria
APIN/Harvard PEPFAR Sites: as of 2007
APIN Program OfficeSites Under Harvard PEPFAR
Sites Under Harvard PEPFAR
Sites Under APIN LtdSites Under APIN Ltd
68 Nigerian Army Reference Hospital Nigerian Institute for Medical Research
National Military Hospital, ‘Creek’ Lagos University Teaching Hospital
University of Lagos, College of Medicine Mushin General Hospital
PHC-Iru Victoria Island Onikan Women’s Hospital
68 Nigerian Army Reference Hospital Nigerian Institute for Medical Research
National Military Hospital, ‘Creek’ Lagos University Teaching Hospital
University of Lagos, College of Medicine Mushin General Hospital
PHC-Iru Victoria Island Onikan Women’s Hospital
Sacred Heart Catholic Hospital Lantoro
Sacred Heart Catholic Hospital Lantoro
Federal Medical Centre Makurdi
Federal Medical Centre Makurdi
Jos University Teaching Hospital
Our Lady of Apostles Hospital Jos
8 Satellite Hospitals, 44 PHCs
Jos University Teaching Hospital
Our Lady of Apostles Hospital Jos
8 Satellite Hospitals, 44 PHCs
University of Maiduguri Teaching Hospital
State Specialist Hospital MaiduguriNursing Home Maiduguri
University of Maiduguri Teaching Hospital
State Specialist Hospital MaiduguriNursing Home Maiduguri
University of Nigeria Teaching Hospital
University of Nigeria Teaching Hospital
Ahmadu Bello University Teaching Hospital
Ahmadu Bello University Teaching Hospital
Widowcare Abakiliki Ebonyi
Widowcare Abakiliki Ebonyi
Federal Medical Centre Nguru
Federal Medical Centre Nguru
University of Ibadan College of Medicine
3 Satellites under UCHAdeoyo Maternity Hospital
University of Ibadan College of Medicine
3 Satellites under UCHAdeoyo Maternity Hospital
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AIDS Prevention Initiative Nigeria
Site Allocation: 2007-2008Harvard PEPFAR APIN Ltd
+ Oyo 43 Oyo State DOTS Centres
Benue: Federal Medical Centre Makurdi Borno
University of Maiduguri Teaching Hospital State Specialist Hospital Maiduguri Nursing Home Maiduguri
Ebonyi: Widowcare Abakiliki Enugu: University of Nigeria Teaching Hospital Ituku-Ozalla Kaduna: Ahmadu Bello University Teaching Hospital Lagos
68 Nigerian Army Reference Hospital Nigerian Institute for Medical Research National Military Hospital, ‘Creek’ Lagos University Teaching Hospital University of Lagos, College of Medicine
Mushin General Hospital PHC-Iru Victoria Island Onikan Women’s Hospital
Ogun: Sacred Heart Catholic Hospital Lantoro Oyo
University of Ibadan College of Medicine 3 Satellites under UCH
Adeoyo Maternity Hospital Plateau
Jos University Teaching Hospital
8 Satellite Hospitals, 44 PHCs Our Lady of Apostles Hospital Jos
Yobe: Federal Medical Centre Nguru
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APIN/PEPFAR Sites: August 2010
Nigerian Institute for Medical Research Lagos University Teaching Hospital
Mushin General Hospital PHC-Iru Victoria Island Onikan Women’s
Hospital
Nigerian Institute for Medical Research Lagos University Teaching Hospital
Mushin General Hospital PHC-Iru Victoria Island Onikan Women’s
Hospital
Sacred Heart Catholic Hospital Lantoro
Sacred Heart Catholic Hospital Lantoro
University of Ibadan College of University of Ibadan College of MedicineMedicine
3 Satellites under UCHAdeoyo Maternity Hospital
43 Oyo DOTS Centres
University of Ibadan College of University of Ibadan College of MedicineMedicine
3 Satellites under UCHAdeoyo Maternity Hospital
43 Oyo DOTS Centres
APIN Program Office
Federal Medical Centre Federal Medical Centre MakurdiMakurdi
Federal Medical Centre Federal Medical Centre MakurdiMakurdi
Jos University Teaching Jos University Teaching HospitalHospital
Our Lady of Apostles Hospital Jos
8 Satellite Hospitals, 44 PHCs
Jos University Teaching Jos University Teaching HospitalHospital
Our Lady of Apostles Hospital Jos
8 Satellite Hospitals, 44 PHCs
University of Maiduguri Teaching Hospital
State Specialist Hospital MaiduguriNursing Home Maiduguri
University of Maiduguri Teaching Hospital
State Specialist Hospital MaiduguriNursing Home Maiduguri
University of Nigeria Teaching Hospital
University of Nigeria Teaching Hospital
Ahmadu Bello University Teaching Ahmadu Bello University Teaching HospitalHospital
Ahmadu Bello University Teaching Ahmadu Bello University Teaching HospitalHospital
Widowcare Abakiliki Ebonyi
Widowcare Abakiliki Ebonyi
Federal Medical Centre Nguru
Federal Medical Centre Nguru
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AIDS Prevention Initiative Nigeria
Indicator Year 1 Year 2 Year 3
Cumulative On Care
Adult 1500 21,350 33,341
Pediatric 200 1,050 2.270
Current On ART
Adult 550 13100 16,854
Pediatrics 200 1050 1,561
No of Sites 1 5 11
PMTCT Services
Pregnant women tested for HIV and received their results
5,000 14,200 50,000
HIV positive pregnant women receiving prophylaxis to reduce mother to child transmission
852 1,702
No of Sites 2 6 11
Annual Budget $1.705m $12.325m $14.864m*
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Management Systems
Improvement imperative to: Receive and manage US funding directly Provide direct oversight to many big sites
Objectively verifiable systems improvement
Responses to HRSA’s recommendations, especially HR related.
Systems adjudged adequate by other assessments
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Status
Management Systems (HR, finance, procurement etc.).
Plans are on to recruit for key positions.
Programs SI
Data Management M&E QI/QA
Supply Chain Management APIN 5 Yr. Strategic Plan. Moving from HIV/AIDS
focus to the broader public Health domain.
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AIDS Prevention Initiative Nigeria
Lessons learned
Effective Communication and early buy-in among key stakeholders is crucial.
Building on already existing structures makes for smoother transition.
Building the capacity of the site personnel reduces the potential challenges of future TA.
Willingness to modify implementation models to suit the transition plan
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AIDS Prevention Initiative Nigeria
Questions
How does the transition to local NGOs fit into program ownership by National Governments?
What effects (if any) would regionalization, finalization of the partnership framework ,etc.have on the implementation models of independent NGOs?
What are the expected outcomes of transition ? How do we know if we have been successful or not?
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AIDS Prevention Initiative Nigeria
THANK YOU THANK YOU