Introduction

The purpose of this toolkit is to provide a practical step-by-step guide for any group in how to plan, implement, monitor, evaluate and revise programs specifically addressing the needs of children and their families, infected and affected by HIV/ AIDS and living in resource-limited settings. As such, the toolkit is organized into seven steps covering planning, implementing and evaluating. The user of the toolkit is guided through a logical planning, implementing and evaluating process, assisted wherever appropriate by carefully selected tools and resources. While the toolkit is, therefore, self-sufficient, it is understood that some users may appreciate hands-on technical assistance with certain components of their desired program and BIPAI is willing to provide this expertise on request.

The Seven Steps

Step 1 focuses on the creation of the business case for establishing an HIV pediatric care and treatment program in the resource-limited setting in question and, thereafter, utilizing this business case to engage and partner with the government and to mobilize local health and community resources to invest in the program in order to ensure effective implementation. In addition, this step describes how to establish a legal organizational framework for the program's operation.
Step 2 describes how to develop a program of pediatric care and treatment appropriate to your particular setting and context. BIPAI has extensive experience of doing this in many African countries. This experience has demonstrated the importance of carefully considering the local context and its specific needs. The best way to ensure the smooth implementation of such a program is to involve all major stakeholders in the program design.
Step 3 will help you to elaborate and finalize the basic program design you have established and place it within a comprehensive monitoring and evaluation (M&E) framework. Having done that, you will be able to define a management structure aligned with the program strategy. The resulting management structure should be able to help you pursue the program objectives, ensure quality service delivery and manage the program's human, financial and technical resources.
There are two major ways of building organizational capacity: training of personnel and upgrading of infrastructure. Both can enhance the operational capabilities of organizations allowing them to provide better service. Capacity development is particularly important in many places where the HIV/AIDS epidemic is most severe such as Sub-Saharan Africa. There is a serious shortage of skilled personnel working in public health services in these countries and the national health budgets are not sufficient to provide the required basic infrastructure. In addition to specific training on HIV/AIDS, the conduct and management of programs can be facilitated by providing training to selected individuals in areas such as program design, project management, administration and financial management.
Step 5 involves putting the program into action by launching and delivering clinical, psychosocial and community services to clients and their families.
Step 6 describes some special services relevant to pediatric care and treatment of HIV/ AIDS which may be appropriate for your clinic. They include community support services, the family unit approach to care, family planning, PMTCT, adolescent services and special considerations with regard to tuberculosis.
Step 7 describes how to monitor and evaluate your program on an ongoing basis. It emphasizes the utilization of data derived from the M&E framework developed in Step 3 as a tool for managing and improving the program. The way to evaluate the program formally is also explained.