COMPASS 1.0
About COMPASS 1.0
Coalition to build Momentum Power Activism Strategy and Solidarity (COMPASS Africa) is an ad-hoc coalition of United States of America and Africa-based advocacy organizations took on the task of designing a transnational advocacy effort that would both respond to and generate evidence. The group committed to combining data with strategic, impact-oriented activist and advocacy tactics to remove barriers to comprehensive HIV efforts that reduce AIDS deaths and HIV infections. COMPASS focused on combining evidence, activism, and strategic campaigns to remove barriers to effective HIV responses. It emphasized coalition-building, community-led advocacy, and influencing decision-making at both country and global levels. COMPASS also developed tools and approaches (such as MERL systems and the C-CAAT tool) to measure advocacy impact and strengthen accountability.
Outcomes
- Growing country-level coalitions in size, scope and diversity.
- Increased use of evidence and policy analysis/ideas by decision makers to guide resource allocation and design, implementation and evaluation of programs in Malawi, Tanzania and Zimbabwe
- Contributing to the evidence-base and funding for country-based, data-driven advocacy, and for a sustained global response
- Building a transnational advocacy structure that is resilient, responsive and honest about areas for growth
- Flexibility and resilience in the context of COVID-19
Results and Impact
Differentiated Service Delivery
- Coalition of Women Living with HIV (COWLHA) surveyed Women Living with HIV (WLHIV) on experiences accessing Dolutegravir-based regimens after Malawi policy change allowing prescription for women of child-bearing age; identified issues and found site- and system-level solutions.
- Zimbabwe scaled up adoption of an out of facility community ART model, increasing TB Preventive Therapy uptake in select districts, and secure funding to increase viral load access all saw wins in United States President’s Emergency Plan for AIDS Relief (PEPFAR) process; work to detect, prevent and mitigate stock outs saw success in reports from facilities on first-line medications; second, third-line and Pre Exposure Prophylaxis all had supply issues at various times.
AGYW/SRHR
- PEPFAR Country Operational Plan (COP) win: Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) expansion to 46 additional sites across the targeted 3 districts in COP 20.
- PEPFAR COP win: Expansion of cervical cancer screening and treatment for WLHIV from 41 to 80 facilities in COP 20.
Primary Prevention
- In Malawi, VMMC expanded to three additional districts; PrEP treatment targets increased from 6,000 in COP 2019 to 16,048 in COP 2020 in the PEPFAR COP, with community-led literacy supported in the Global Fund grant.
Human Resources for Health
- Government of Zimbabwe lifted a Human Resources for Health (HRH) hiring freeze due to wage bill policy restrictions imposed by the World Bank and International Monetary Fund (IMF), allowing the hiring of 4,000 health care workers (currently pending actual recruitment). Additional health worker salary support was included for lab technicians from 1.5 Full-Time Equivalent (FTE) to 2 FTEs per viral load machine, along with viral load champions, peer counsellors, data clerks, nurses, pharmacists, and Community Adolescent Treatment Supporters (CATS) increasing from 2 to 12–20 per district. These were included in both the PEPFAR COP and Global Fund (GFATM) concept note.
- Sikika and Benjamin Mkapa Foundation (BMF) worked together to push the Government of Tanzania to recruit an additional 1,000 health care workers and used the COP20 process to secure a PEPFAR commitment to recruit 5,000 health care workers, including Community Health Workers (CHWs). BMF also leveraged the COVID-19 pandemic to secure an additional 3,000 CHWs from non-traditional HRH funders such as UNICEF, Irish Aid, and DFID/FCDO, strengthening health service delivery and mitigating COVID-19 impacts on essential services, particularly at community level, including RMNCH and HIV services such as ART linkage and tracing clients lost to follow-up.
- Malawi expanded HRH investment commitments, adding 380 additional health workers in the PEPFAR COP 20 planning cycle.
Global Fund
- Malawi Civil Society Advocacy Forum (CSAF) developed a “Civil Society Charter” that established priorities for national strategic planning and Global Fund concept note development and led to the adoption of community-led prevention (PrEP) and treatment literacy and monitoring interventions, additional funding for CSO coordination, expansion of Voluntary Medical Male Circumcision (VMMC) services to 5 additional districts, and an increase within the HIV Component Budget for community-led services.
