Febbe Amutenya, Jhpiego
This post is part of a series about the real-life use and impact of technical tools, resources, technical assistance strategies, and other materials developed by the Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) project.
Namibia’s government plans to introduce a new HIV prevention method—long-acting injectable cabotegravir, or CAB PrEP—this year. To prepare for CAB PrEP introduction, the Ministry of Health and Social Services (MoHSS), with support from the PEPFAR- and USAID-funded MOSAIC project, recently conducted a value chain situation analysis (VCSA).
A VCSA assesses five foundational elements of product introduction: planning and budgeting, supply chain management, delivery, uptake and effective use, and monitoring. It also serves as an important planning tool by assessing the existing PrEP landscape through a series of stakeholder interviews. Questions are framed across the five key elements and analyzed to understand how best to leverage lessons learned from oral PrEP rollout and to identify opportunities or gaps that should inform planning for introduction and scale-up of CAB PrEP.
The VCSA process can take several months. But the VCSA in Namibia—including 20 stakeholder interviews, data analysis, and report production—was completed in fewer than two weeks thanks to strong leadership from the MoHSS, exceptional coordination, excellent planning, and of course, technology.
LEVERAGING TECHNOLOGY
Organizing interviews with multiple stakeholders can be a logistical challenge. MOSAIC Namibia and the MoHSS turned to technology for a solution. We used an online scheduling tool to coordinate the virtual interview sessions and shared a web link to the tool with all participants, allowing them to select convenient times for their interviews. Using this tool simplified the scheduling process, ensuring maximum participation and minimizing conflicts.
The MoHSS also played a critical role in leading communication and cooperation by creating a WhatsApp group, which became the primary platform for rapid communication, information sharing, and real-time discussion. This group enabled the planning team to stay connected, share insights, and address emerging issues promptly, ensuring a smooth and efficient process.
ENGAGING DISCUSSIONS
The VCSA interview sessions were held via Zoom with representatives from the MoHSS, USAID Namibia, IntraHealth Namibia, the Walvis Bay Corridor Group, Project HOPE Namibia, the Global Fund, and the World Health Organization (WHO). Out of the 23 interviewees nominated by MoHSS, 20 actively participated in one-hour individual interviews, contributing their unique perspectives and expertise to discussions about the five key elements of the product introduction framework.
The discussions were rich, and common themes emerged: CAB PrEP eligibility criteria and target populations given the limited supply of the new product, the sustainability of a multimethod national prevention program, challenges related to service integration, and the need for refined policy and monitoring and evaluation resources.
IMPACTFUL COLLABORATION AND PLANNING
The efficiency of the VCSA process enabled key stakeholders to make timely, informed decisions about how to prepare health systems for CAB PrEP introduction. Truly a testament to the power of collaboration and planning, the success of the VCSA was driven by:
- MoHSS leadership: The high level of engagement and leadership from the MOHSS was instrumental in securing active participation from interviewees, whose responsiveness and insightful contributions demonstrated a collective commitment to enhancing HIV prevention strategies in Namibia.
- Effective communication: The WhatsApp group facilitated continuous engagement, allowing for real-time feedback and swift solution of any logistical challenges.
- Inclusive approach: By involving a wide range of stakeholders in the process, the MOHSS and MOSAIC ensured the VCSA reflected a holistic understanding of the current HIV prevention landscape in Namibia and primed partners to contribute to the planning process.
- Detailed planning: Clear objectives for each session ensured all relevant topics were thoroughly discussed.
This activity not only set the stage for the planned introduction of CAB PrEP as an HIV prevention option in Namibia, but also serves as an example of how effective communication, detailed planning, and strong collaboration can lead to efficient and meaningful outcomes. The VCSA has been successfully used in multiple other countries to prepare for new PrEP product introduction, and now Namibia joins the ranks of those countries poised to accelerate access to CAB PrEP.
Featured Image: Canva