Capacity Assessment Tool for Country Ownership of HIV Care and Treatment: Part III–Interpretation and Use of Results

The tool is intended to help stakeholders and PEPFAR implementing partners determine the current level of national or state capacity along five stages of readiness to assume greater country ownership of HIV care and treatment. The five stages of readiness are defined as follows: Stage 1, Minimum Capacity, represents little or no capacity, no systems in place, and no leadership, with a dependence on external support. Stage 2, Basic Capacity, indicates minimum standards and systems, with political will but little capacity or means. Stage 3, Growing Capacity, shows growing capacity, some progress made, but no systematic application, with systems needing strengthening. Stage 4, Strong Capacity, represents systems in place, growing capacity, but some elements still needing strengthening. Stage 5, Full Capacity, signifies systems fully established, well implemented, and effective in building a strong national response. The capacity assessment tool is based on ratings achieved using Part II, which provides an indication of the general readiness for country ownership. The mean overall percentage score is used to determine the stage of readiness, with guidance provided in Table 1. The table illustrates the scoring for stages of readiness, with corresponding brief descriptions. The following sections provide a more detailed description of each stage of readiness, along with specific activities and recommendations that would help national or provincial programs progress to the next stage of readiness. This guidance, along with an understanding of specific areas of strengths and weaknesses in the subdomains, can help inform the development of an action plan for moving to the next stage of readiness. The tool is designed to be used in conjunction with Parts I and II, and is intended to help country and implementing partners reach agreement on priority areas for strengthening and develop a work plan or action plan to move them to the next stage of readiness. The publication is the result of a collaborative effort between AIDSTAR-One, John Snow, Inc., and other implementing partners, with funding provided by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID). The capacity assessment tool is a critical component of the AIDSTAR-One project, which provides technical assistance services to the Office of HIV/AIDS and USG country teams in knowledge management, technical leadership, program sustainability, strategic planning, and program implementation support. The tool is designed to be used in a facilitated, participatory process with national- or provincial-level stakeholders to rate capacity on eight major domains and subdomains. The publication includes an overview of the tool, as well as detailed descriptions of each stage of readiness, specific activities and recommendations, and guidance relative to each of the eight domains. The tool is intended to be a valuable resource for stakeholders and PEPFAR implementing partners working to build greater capacity for country ownership of HIV care and treatment.