Supporting USAID’s HIV Care and Treatment Program through Local Partner Development in South Africa

(Originally published in October 2022 CIDC Monthly Newsletter)

South Africa has the largest HIV epidemic in the world, affecting an estimated 7.5 million people,[1] which has been exacerbated by other diseases and the COVID-19 pandemic. Since March 2019, our team has been supporting USAID/South Africa to strengthen HIV and TB service delivery at public health facilities in priority districts that serve thousands of people living with HIV per month, with the ultimate goal of achieving HIV epidemic control. To do this, our technical experts work with USAID to engage local partners and the Department of Health staff to identify performance gaps, build capacity, and identify interventions to improve service delivery. The interventions implemented are further assessed to inform ongoing quality improvement.

Anova Health Institute

In 2019, USAID requested that we provide additional support to one of its local South African partners, Anova Health Institute (Anova), which needed to rapidly scale its program and workforce for a new USAID award. In just a few months, they had to expand from 850 staff supporting three districts, to 4,000+ staff supporting five districts across three provinces. Our team was tasked with supporting Anova to meet immediate technical needs to achieve service delivery targets, while also addressing its organizational development needs for rapid and sustainable growth.

Over the course of a year, we utilized our signature collaborative team approach to provide intensive capacity building and process reengineering support to Anova. We embedded a policy and procedures benchmarking specialist on-site with Anova, supported by a bench of skilled and experienced technical advisors, including strategic information (SI) specialists. The team worked closely with Anova’s executive committee on three key areas:

  • Human resource (HR) capacity development for recruitment and retention of top talent: During the rapid scale-up, Anova created new positions without adequate time or resources to incorporate these roles into the organization’s larger context. We supported Anova’s HR team to revise the organizational structure, recruit nine upper and middle-managers, and standardize job titles and salary grades for 194 positions. This HR support provided Anova with clear and consistent guidelines for each role’s requirements, contributing to retaining and attracting top talent.
  • Comprehensive review and revision of policies and procedures for efficient management of staff and resources: We reviewed over 49 organizational policies and procedures and worked to consolidate, align, and streamline them, ensuring compliance with South African law, USAID rules and regulations, and international best practices. These were incorporated into a comprehensive employee handbook and informed the development of a business continuity plan. The new suite of tools reinforce Anova’s efficient and consistent management of a diverse workforce across hundreds of locations.

    Panagora team members providing data management support to Anova staff at their Head Office in Johannesburg, South Africa.

  • Strengthened data management processes and systems to support program decision-making and reporting: Our team supported Anova’s recruitment of more than 130 SI/M&E team members and delivered a series of training modules to middle managers. We worked closely with Anova to better define data management processes and roles, addressing gaps which were contributing to under-reporting of service provision. Our team met with Anova staff at appropriate levels to identify challenges and co-create practical solutions, such as a tool assisting Anova to triangulate data sources. Better data management resulted in efficient and accurate reporting of results and enhanced the organization’s system for long-term performance and sustainability. Based on this collaborative process, the detailed data management processes developed were adopted as standard guidance by USAID/South Africa.

After a twelve-month partnership, we concluded our capacity building and process reengineering support to Anova. The success of this process demonstrates how our agile and responsive team is well-placed to boost local capacity and illustrates the power of our collaborative team approach to successfully engage and strengthen local partners for sustainable outcomes. Ultimately, Panagora’s support helped Anova scale to manage an effective and efficient 4,000-person workforce to expand the delivery of high-quality HIV and TB services in health facilities in five districts across three provinces and reaching many more thousands of people who need critical care and treatment.