Unit | Systems Performance and Monitoring
Expertise and Services
Our key mandate is the Local Fund Agent (LFA) with the Global Fund to Fight AIDS, Tuberculosis and Malaria created in 2002 to significantly increase resources to fight the three of the world's most devastating diseases (HIV and AIDS, Tuberculosis, and Malaria), and to direct those resources to areas of greatest need. As a partnership between governments, civil society, the private sector and affected communities, the Global Fund represents an innovative approach to international health financing. The Global Fund does not have a country-level presence outside of its offices in Switzerland. Instead, it hires LFAs to oversee, verify and report on grant performance. LFAs are selected through a competitive bidding process and play an important role in verifying the performance of Global Fund funded programmes. They act as advisory body and can be seen as the “eyes and ears on the ground” of the Global Fund.
The LFA is contracted to independently oversee program performance and the accountable use of funds and works closely in particular with the relevant Fund Portfolio Manager from the Global Fund, to provide the following services: work performed before the Global Fund signs a grant agreement with the Principal Recipient. This includes assessing the Principal Recipient's capacity to implement the grant, reviewing proposed budgets and work plans and otherwise assisting the Global Fund in grant negotiations; work performed during program implementation. The LFA's review of a grant as it approaches Phase 2 (years three to five of the grant's lifespan) is crucial in assisting the Global Fund to make its decision on whether to continue funding beyond the first two years; work performed with respect to grant closure. When a grant ends, the LFA is involved in assisting the Global Fund with closure of the grant; and ad hoc assignments undertaken at the request of the Global Fund, such as investigations relating to the suspected misuse of funds.
Local Fund Agent Mandate
Swiss TPH has been acting as a LFA since 2003 in a total of 23 different countries in Africa, South East Asia, Middle East, and Latin America and the REDCA region. Key personnel for each country have a background and expertise in Public Health, Program and Monitoring & Evaluation, Finance, or Procurement and Supply Management. Other Swiss TPH experts in HIV/AIDS, malaria, tuberculosis and other global health topics are involved as required. Swiss TPH is currently LFA in the following countries: Benin, Burundi Burkina Faso, Chad, Djibouti, Gambia, Guinea, Liberia, Mali, Niger, Sao Tomé and Principe, and Senegal, and for the Multi-country Middle East Response grant covering Yemen, Iraq, Palestine, Syria, Lebanon and Jordan.
Gavi Programme Capacity Assessments
Programme Capacity Assessments (PCAs) assess the (current or proposed) financing modality for receipt of Gavi cash grants, and the in-country structures to oversee the use of Gavi support provided in the form of cash, vaccines and vaccine related devices with appropriate transparency and accountability. The PCA allows Gavi to gather and assess information on a country’s Public Financial Management systems and grant recipients’ financial and programme management systems, to evaluate the potential risks and to make relevant recommendations for the management of resources provided by Gavi. Based on the PCA findings, Gavi and the government will agree on the grant management modalities as Annex to the Partnership Framework Agreement between Gavi and each country, which sets out the terms and conditions for the management of Gavi grants in that country.
Swiss TPH has been performing PCAs in the following countries: Bolivia, Liberia, Chad, Mali, São Tomé and Príncipe, and Senegal.
UNITAID Mid or End of Project Evaluations
Swiss TPH has been awarded a long-term agreement with UNITAID covering the period from June 2014 – December 2016 for mid-term and end-of-grant evaluations of UNITAID projects.
Under this agreement, several evaluations have taken place, among them the end of project evaluation of the support for MDR-TB Scale Up Initiative 2007-2013; the mid-term evaluation of the DNDi market entry of improved paediatric protease inhibitor-based fixed dose combinations project; and the end of project evaluation of the ESTHERAID project completed in December 2014.
Health Facility Assessments
Program and data quality should be evaluated through various methods. Key elements of a sound monitoring and evaluation (M&E) strategy include Health Facility Assessments (HFA), possibly combined with Quality of Care (QoC) modules, and Data Quality Review (DQR). HFA and DQR provide information for national and sub-regional planning, program improvement, assurance purposes and validation of routine systems. Done systematically, an HFA can show trends over time for key indicators. WHO guidance recommends an HFA is done every two years in a country. DQR allows for the evaluation of the data quality generated by the health information system at different levels of the health pyramid.
Swiss TPH has been awarded an three-year Indefinite Quantity Contract with the Global Fund to Fight AIDS, Tuberculosis and Malaria for the period April 2016 – April 2019 for the data Quality Assurance (QA) of the HFA, QoC and DQR funded by the Global Fund and implemented in the countries by the Ministry of Health or other related bodies. Independent assurance of the quality of the survey is important to enable the Global Fund and other stakeholders to use the results of the HFA/QoC/DQR for program information and grant improvement. The services covered by the Swiss TPH QA consist in verifying the quality of the sampling, the data collection, the analysis and the reporting of the HFA/QoC/DQR.
Within that long term agreement, Swiss TPH has been selected to perform HFAs in Vietnam, Congo, Côte d’Ivoire, Togo and Bangladesh as well as a Special Study related to the identification of factors that contribute to favourable MDR-TB treatment outcomes in Eastern Europe/Central Asia (EECA).