Many donor funded HIV/AIDS programmes have been known to crumble when the donor pulls out. This has largely been attributed to poor sustainability plans by most projects. Since 2008, Baylor Uganda has been implementing an HIV/AIDS programme through sub granting in 27 districts of Uganda. We describe the sub granting experience as a sustainability implementation approach to HIV/AIDS programmes.
Methods Under Sub granting we provide cash subventions to 27 districts health offices, 267 health facilities and 27 district network of people living with HIV/AIDS (PHA) to implement their own HIV/AIDS priority activities. These funds supplement the meagre government primary health care (PHC) conditional grant. Baylor-Uganda together with the partners hold annual planning meetings to identify priority areas for HIV/AIDS for funding in line with ministry of health requirements. Funds are released on a quarterly basis to the partners based on their approved work plans and budgets. Baylor staff monitors project implementation on a monthly basis. Supported districts submit technical and financial reports quarterly. Accountability of the district is reviewed and districts are annually categorised according to performance. The size of the grant in subsequent quarters is dependent upon the performance of the partner.
Results Todate all the partners able to identify their priorities, develop work plans and implement their own activities hence fostering ownership and sustainability. Sub granting has helped to create a strong sense of ownership by both the project implementers and the target beneficiaries. Ranking of districts has brought in competition which has improved service delivery as well as accountability. Late implementation and late submission of accountability are still the major challenges.
Conclusion Whereas sub granting faces some challenges, it is a fundamental step towards creating ownership and sustainability of HIV programmes in low resource settings.
- sub granting
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