Papua New Guinea
Komuniti wok, Senis Kamap
Key population communities in PNG leading,Β monitoring, and empowering the community to improve the coverage and quality of HIV and other services for the community.
VISIT
www.kpacpng.org
PARTNERS
This effort is supported through funding and technical support from theΒ
Joint U.N. Programme for HIV/AIDS (UNAIDS),
U.S. Agency for International Development (USAID),
Australian Department of Foreign Affairs (DFAT), and
Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM)Β
in collaboration with the
National Department of Health (NDoH) and
Provincial Health Authorities (PHA).
Objective 1:
Coordinate, strengthen, and manage the CLM mechanism in the National Capital District [1.1. Coordination: Engage stakeholders and government partners in the implementation of, and accountability for, CLM quality-improvement recommendations; 1.2. Management: Support and maintain the CLM team, ensuring mechanisms, activities, and implementers are funded to carry out plans and service quality improvements, especially as these benefit key populations. ]
Objective 2:
Conduct capacity-building and training for KPAC Community Champions (community monitors) to implement CLM. [2.1. Capacity-building training and development for a cadre of CLM data collectors (Community Champions)]
Objective 3:
Support KPAC Community Champions (community monitors) to collect and analyze qualitative and quantitative data from communities. [3.1. Data collection and analysis: Collect and analyze CLM data, and translate insights into actionable recommendations to increase the quality of service provision]
Objective 4:
Guide advocacy with national and provincial leaders for the improvement of HIV services. [4.1. Advocacy and action planning: Engage government partners and local stakeholders in line with the advocacy plan, and build capacity to communicate demands for change; 4.2. Monitoring and accountability: Monitor improvements in the quality of HIV services to reach targets set by community stakeholders, including CSOs and organizations of people living with HIV and key populations.]
The CLM in PNG led by KPAC aims to accomplish 3 expected results by end of 2023:
A national and provincial level platform for KPs is in place to raise issues affecting KP access to HIV and other health services.Β
Friendliness to KPs, quality of HIV and health services and environment of health clinics are assessed.
Reasons or barriers leading to non-return or non-access of HIV services by KPs are documented.
7 Categories of Service Quality
(adopted from 72 global CLM indicators, June 2022 draft)
Awareness about the services - Information about the facility services are disseminated outside the facility (catchment area); Providers are providing additional information about the service and the facility.Β
Accessibility of services - Clients did not wait for more than one hour before the service was provided; Clients did not hesitate to go to the facility (because of accessibility issues).Β
Availability of services - The intended service was available and provided; For services that were not, clients were provided information where to avail it (or referred).Β
Affordability of services - Client did not pay for or use its own money for the service provided (for services that are free).Β
Appropriateness of services - Services specific to KP was provided; Services specific to young person (24 and younger) was provided.Β
Acceptability of services - Client did not feel stigmatized or discriminated when the service was provided; Client did not feel afraid to access the service (did not worry about people knowing its KP or HIV status).Β
Accountability of Service Providers - Client is aware of mechanisms to report complaints about the service; Client feels confident that the provider made him/her fully aware of the service provided.Β
(see Facility Exit Interview Tool [word] [pdf])
14 Individual Quality Indicators
(adopted from 72 global CLM indicators, June 2022 draft)
Β A1. You had information on the service before going to the facility.
Β A2. You were given more information on the service when you were at the facility.Β
Β B3. You did not wait for more than 1 hour before being served at the facility.
Β B4. You did not delay going to this facility the moment you felt that you needed the service (did not hesitate because of inaccessibility like distance).
Β C5. You were provided with the service you intended to avail in the facility.Β
Β C6. You were given information (became aware) on how or where to avail for services that were not available in the facility.Β
Β D7. You were not asked to pay for the services availed to you.Β
Β D8. You were not expected to use your personal money (expected service to be free) to spend on items (medicines, etc) related to the service.
Β E9. You were provided with at least one service specific to your need as KP.Β
Β E10. You were provided with at least one service specific to my need as a Young Person (<25yo).
Β F11.Β You did not feel stigmatized or discriminated at the facility.Β
Β F12. You did not feel afraid to avail of the service as you did not worry that someone may learn your status (as KP or PLHIV).Β
Β G13. You were aware of a mechanism or a person to make complaints related to the services at the facility .
Β G14. You fully understand the information provided by the service providers at the facility.
(see Facility Exit Interview Tool [word] [pdf])
Scorecard - Quality Score
Each of the 14 quality indicators are scored between 1-4
4 - Extremely Satisfactory - Strongly Agree
3 - Satisfactory - Agree
2 - Unsatisfactory - Disagree
1 - Extremely Unsatisfactory - Strongly Disagree
(see Facility Exit Interview Scorecards [webpage dashboard])
Non-access and Demand for Services
(locally developed indicators)
Awareness about the services - Ever heard of any HIV and health services (by type, by facility).
Demand for the services that are known - If these services are available today, which ones will the KP avail (and why).
Demand for other services - As KP - MSM, TG, SW, PWID, partners of KP - are there any other services needed (eg legal, other health, etc).
(see Community Forum Tool [word] [pdf])
RESULTS DASHBOARDS (Power BI)
CLM 3 - Round 1, June 2022 [webpage dashboard]
CLM 3 - Round 2, September 2022 [webpage dashboard]
Preliminary results of CLM 3 - Facility Exit Interviews (Round 1 - June 2022) - download HERE
There are 5Β interlinked CLM Models across 3 platforms:
CLM in Virtual Spaces (continuous)
CLM 1 - KPAC National Response Center (calls, visits, and messages)
CLM 2 - Social Media (Facebook Page, Facebook Messenger, Whatsapp Groups)
2. CLM in Communities (routine)
CLM 3 - Facility Exit Interviews (1-3 times a year)
CLM 4 - KP Community Forums (1-3 times a year)
3. CLM in Facilities (continuous)
CLM 5 - Facility Observations through KP Mystery Clients (1-3 times a year)
See the CLM Recipes (documentations) HERE
Modes of data dissemination and utilization :
Same-day Feedback - real-time data utilization, same-day, immediate feedback at the facility for urgent issues.
Facility Visits - Summary Feedback and Awarding of Certificates of Recognition, approximately 2-4 weeks from data collection.Β
Dissemination Workshops - province-level gathering of facilities and community members.
Online (KPAC website) and Social Media communications (Facebook page, Whatsapp group) for general findings.
You can access knowledge products, tools, documents, and updates from here: https://www.kpacpng.org/elibrary
Round 2 of Facility Exit Interviews in NCD
16 Facilities, 12-24 September 2022
Training on the use of Facility Scorecards for Service Quality (CLM Platform 3)
Lamana Hotel, 06 May 2022
Multi-platform National Response Center Simulation Training
Lamana Hotel, 07 May 2022
KPAC PNG and partners updating the CLM workplan for 2022
Stanley Hotel, 13 May 2022
Training on the use of Facility Scorecards for Service Quality (CLM Platform 3)
Stanley Hotel, 25 May 2022
Program and Quality Team from World Vision training the CLM team on the use KOBO Toolbox webforms
Stanley Hotel, 26 May 2022
Finalization of Facility Scorecards for Service Quality (CLM Platform 3)
Grand Papua Hotel, 08 June 2022
Round 1 of Facility Exit Interviews in NCD
15 Facilities, 14-24 June 2022
Presentation of Findings of the Facility Exit Interviews (Round 1)
Holiday Inn Hotel, 13 July 2022
Holiday Inn Hotel, Port Moresby
8 September 2022, 9am to 4pm
Results: 9 monitors retrained | Tools and plans for Round 2 finalized | CLM 3 form reviewed
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PARTNERS
This effort is supported through funding and technical support from the Β
Joint U.N. Programme for HIV/AIDS (UNAIDS),
U.S. Agency for International Development (USAID),
Australian Department of Foreign Affairs (DFAT), and
Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM)Β
in collaboration with the
National Department of Health (NDoH) and
Provincial Health Authorities (PHA).
Objective 1
To design and finalize the multi-year CLM Design and workplan for PNG Coordination and Outreach [consultation meetings, consultants, design workshops, coordinators, communication channels, hotline].
Objective 2
To train the national and provincial KPAC members as data collectors to implement the community-led monitoring work and provide institutional strengthening support to CSOs implementing CLM. [ training design, skills training, operational consultants, program management]
Objective 3
To support the KPAC data collectors to collect qualitative and quantitative data from communities. [mystery client, exit interviews, data analysis, workshops, promotion, demand creation, report mechanism]
Objective 4
To guide advocacy for improvement of HIV services with national and provincial leadership. [advocacy, dissemination, monitoring visits]
Still early to capture key CLM implementation challenges but the following are noted in NCD CLM:
Challenges of KPAC as CLM implementing organization:
Received funds only in April 2022. KPAC needed to implement the 12-month plan into just 6-months
Challenges in data collection:Β
KPAC monitors and champions, especially on CLM 3 - Facility Exit Interviews, are being capacitated as "survey research" learning scientific data collection, effective interviewing, proper use of mobile and online data encoding tools (KOBO webform), data analysis using statistical softwares and visualization tool (KOBO, STATA, Excel Pivot, Power BI), data dissemination platforms (website, powerpoint). Learning by mistakes.
Challenges in data validation and triangulation:Β
Need to work with NCDPHA and FHI360 to link CLM data with routine services statistics (prevention, testing, ART, viral load, GBV, stigma, discrimination)
Challenges in engaging decision makers:
Understanding of PNG CLM design and objectives need to be clarified - as government partners, in the beginning, thought CLM would be in conflictΒ with or a duplication of the current M&E and reporting system.
Challenges in financing and sustainability of CLM:
Currently supported through grants from development partners. Need to get financing and partnership with private and business sector (B4H)
