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Annex 6: Implementation arrangements.

Jamaica Second HIV/AIDS Project

115. Institutional Arrangements. The project will be organized at three levels and include the following institutions: (a) The Council for Health and Social Development (COHSOD) reporting to the Cabinet, will be responsible for setting policy, overall coordination, and monitoring and evaluating the performance of the national HIV/AIDS program; (b) The Project Coordination Unit (PCU) located within the National HIV/STI Program (NHP) of the Ministry of Health (MOH), will coordinate the activities of and provide fiduciary support to the implementing agencies; and (c) Implementing agencies will be divisions of the Ministry of Health, the four Regional Health Authorities, four non-health line ministries, civil society entities (including the National AIDS Council, an umbrella NGO, other NGOs, CBOs, churches and other FBOs), and the private sector (including employer associations, trade unions, and media).

116. Implementation Arrangements. The project will be coordinated by the PCU within the National HIV/STI Program (NHP) of the MOH. The PCU consists of an experienced team of professionals that have coordinated the activities of the first HIV/AEDS project. The staff has been trained in World Bank procedures and has performed satisfactorily under the first project. The Unit is headed by Senior Medical Officer, a civil service position, who directs a core staff that includes: (a) a coordinator for policy and advocacy (financed by the Global Fund); (b) a director of M&E with a staff of biostatistician, data base officer, M&E officer and HEV information officer; (c) a coordinator of health systems and capacity development; (d) a director of prevention assisted by a youth intervention officer and a BCC officer who is assisted by two BCC coordinators, one for NGOs and one for vulnerable populations; (e) a line ministry coordinator reporting to the director of prevention; (f) a coordinator for treatment and care with technical assistant; (g) a national program administrator to manage the fiduciary functions carried out by: (i) a senior finance and administration officer assisted by a finance officer, two assistant finance officers (one paid by USAID and one paid by the GFATM), two account assistants; and (ii) a senior procurement officer assisted by two assistant procurement officers. The fiduciary unit also manages the grant funds from the GFATM.

117. Sustainability. Most PCU staff--as shown in the table below--have been paid with donor funds including the World Bank loan. The process to convert some of these positions into permanent establishment posts has been initiated with the intended outcome of creating an institutionalized and sustainable core group of professionals to coordinate and support the implementation of the national HIV/AEDS Program. In addition, the Government is proposing to create a HIV Division within the MOH reporting to the CMO and staffed by the institutionalized professional staff.
National HIV/AIDS Program Staff


National Program Staff 2 16 12 3 33
Other National Level Staff 1 7 4 6 17
National AIDS Committee -- 4 2 -- 6
Field Staff: WRHA -- 13 9 22 44
 SERHA -- 13 51 15 79
 NERHA -- 7 20 3 30
 SRHA -- 7 7 12 26
Total Field Staff NA 40 87 52 179

TOTAL 3 67 105 61 236

118. Three types of implementing entities will implement the project: (i) the Ministry of Health through its centralized functions (National laboratory, blood bank, waste management) and through the four decentralized RHAs; (ii) four key non-health line ministries: Education; Tourism, Entertainment and Culture; Labour and Social Security; and National Security; (iii) CSOs, and (iv) the private sector.

119. The implementation strategy has been agreed on and is detailed in the Operations Manual. Implementation of project activities will be preceded by the elaboration of annual work plans for the public sector entities and by proposals for the civil society entities. The Government Ministries will prepare annual work plans which are aligned with the Government annual budgets. CSOs will be funded through a demand-driven process based on the system that has been put in place under the ongoing Bank-financed project. A consolidated annual work plan will be prepared by the PCU and reflected in the MOH annual budget for submission to the MOFPS. The work plan will include the MOH's own work plan, plans of other Line Ministries, and a budget line for subprojects of CSOs.


120. Implementation Strategy for Line Ministries and Regional Health Authorities. A set of steps comprises the elaboration and implementation of activities at the national level for non-health line ministries and at the regional level for Regional Health authorities. The following steps summarize the strategy:

a) The Project Operations Manual will present a general Project Implementation Plan. This plan is indicative and planned activities should be adjusted every year. Between June and July, the PCU will allocate funds for Line Ministries and RHA according to the NHSP updated policies and project approved cost tables. PCU will prepare guidelines to elaborate work plans.

b) The PCU will organize workshops in each region for RHAs and at the central level for line ministries. Guidelines will be distributed and used to prepare work plans for each public sector implementing agent. It will have the mandate for approving funding work plans submitted by implementing agents.

c) Focal persons and working teams of each implementing agent will be responsible for preparing and submitting the work plans to PCU. Work plans for line ministries need to be signed by the Permanent Secretary of the respective line ministries. Work plans for RHAs need to be signed by the Regional Director.

d) PCU applies criteria to appraise and adjust the work plans. Activities are organized in the MIS and proper financing arrangements are consolidated in annual implementation and procurement plans.

e) PCU submits consolidated annual work plan to financiers for No-Objection.

f) After receiving the No-Objection, implementing agencies receive the first advance of financial resources and start implementing the work-plan. PCU staff and facilitators (contracted by the PCU) perform periodic monitoring visits to evaluate progress and oversee the correct application of finance and procurement policies according to donor rules.

g) PCU releases subsequent funding advances according to progress reports and presentation of statement of expenditures (SOEs).

h) Each implementing agent submits an implementation report before the end of the Jamaican fiscal year.

This implementation strategy is repeated each year.

121. Funds Pre-Allocation. In order to set up transparent rules and equity among all stakeholders it is suggested to use a simple model for fund distributions: RHAs will receive funds based on regional needs and regional implementation capacity as expressed in the annual work plans. Non-Health Line Ministries will receive funds according to approved yearly work programs.

122. HIV/AIDS Demand-Driven Subprojects. Small grants will be given to non-public sector implementing agencies on a demand-driven basis. This support will encourage community-based activities, particularly innovative initiatives--to be known as demand-driven "subprojects".

a) Eligible Beneficiaries

NGOs, CBOs, and private organizations in charge of carrying out subprojects will target activities to eligible beneficiaries:

* Youth groups.

* Commercial Sex Workers

* Intimate Entertainment Workers


* Drug Users

* People living with HIV/AEDS

* Prison Inmates

* Other vulnerable sub-population or groups

b) Sub-Projects. A subproject is an organized instrument containing at least: i) Justification for an intervention; ii) Identified beneficiaries; iii) Cost breakdown; iv) Counterpart (local contribution); v) Implementation plan; and vi) results based on performance indicators. Complex subprojects will contain additional requirements.

c) Implementing Agencies. To prepare and to manage a subproject requires certain level of experience and skills. In that sense the demand-driven subprojects' strategy will ask for the support of NGOs, CBOs, and private organizations (Implementing Agencies) to carry out activities related with HIV/AEDs initiatives.

d) Principal Actors. Several actors will be involved within these operating and funding mechanisms. Involved bodies or entities and their roles are:

Community Beneficiaries (CB)--Rural or urban community residents who will benefit directly from subproject investments. They should be supported and represented by an Implementing Agency to receive benefits.

Implementing Agency (IA)--Eligible entities selected according to specific criteria. Information of each Implementing Agency will be part of the subproject proposal.

Selection Committee (SC)--The Selection Committee for the demand-driven subprojects will consist of the Director of the National HIV/STI Program or his nominee, 1 representative of the NAC, 1-2 representatives from the PCU and 1-2 members of civil society (1 PWLHA, 1 PAC, 1 NGO etc.).

f) Eligible Criteria for Implementing Agencies

Eligible Implementing Agencies may be classified by groups:
Private Sector Enterprises with at least twenty (20) employees and
Enterprises in existence for at least 3 years, managing budget
 with annual turnover of more than US$50,000 with
 good financial management systems in place. Two or
 more years of Experience in HIV/AIDS or community

National National coverage (more than one region) with
NGOs experience in HIV/AIDS or social development
 program implementation experience (minimum 2 years
 experience) and with annual budgets [greater than
 or equal to] US$20,000 with good financial
 management systems in place.

Other civil With a minimum of 1 year experience in HIV/ADDS
society program or development implementation and budgets
organizations [greater than or equal to] US$10,000 and basic
(CBOs, financial management systems in place.

In addition IA should demonstrate:

* Management Capability: Proven human and financial management systems and have managed a 1/3 of the funds requested.

* Community Participation: demonstrated consultation and participatory process to mobilize and empower target communities
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Publication:Jamaica - Second HIV/AIDS Project
Date:Apr 1, 2008
Previous Article:Annex 5: Project costs.
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