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TCC Evaluation: Prelim Findings

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Transcript of TCC Evaluation: Prelim Findings

The Global Fund TCC Programme: Process Evaluation
Setting the Scene...
The Purpose of Today
Some Key Themes
PEP Adherence & Follow-Up
Service Quality
Prelim Thinking
TCC System
What would be useful for SANAC?
NGO Dynamics
Preliminary Presentation of Findings
What we've done so far
What we're still going to do
17 of 18 sites visited
131 interviews conducted
* 2 x survivors at Karl Bremer
* 2 x SR Director & PM Telephonics
* 4 x KIIs
* +-6 KDH Interviews
Translation & transcription of interviews
Qualitative & quantitative data analysis
Synthesis & report writing (including case studies)
Do you have any specific questions for us or points for discussion at this stage?
High-level overview of key qualitative themes & concepts emerging from the data

Inform the Global Fund concept note

Identify key themes of interest for further & more rigorous examination in data analysis process

Further engagement around presentation of more rigorous evaluation findings for SANAC in May

Has not undergone any systematic analysis process

Based only on perceptions gathered from team debriefing meetings over course of data collection period
Data Limitations
Service Quality
NGO Dynamics
What would be useful for AFSA & NACOSA?
Specific questions or points for discussion at this stage?
PEP Follow-Up & Adherence
Prelim Thinking
TCC System
NGO psychosocial services highly valued
Appreciated and contributing to well-being of survivors in holistic manner
Psychosocial services strengthen complainants emotionally before court appearances
Psychosocial services assist patients in adhering to PEP medication
Containing traumatised survivors is seen a particular strength of NGO psychosocial
service provision
Not all NGOs demonstrate same skills & training, but quality of services is better than government
NGOs vital for 24-hour service
Service quality diminishes when survivors not seen at TCC after hours
Lack of essential resources needed to provide quality services
Office space
Survivors generally very happy with psychosocial services provided by first responders
Survivors value both short and long term psychosocial support provided at TCCs and would like this to be extended into communities
Survivors specifically accessing TCC to attend longer term support groups which a number of TCCs are running
Survivors had little knowledge of TCCs prior to visiting Centers
Survivors' ability to visit TCC for follow-up strongly affected by transport issues
HCPs not undertaking much follow-up on PEP adherence
Some HCPs unsatisfied with NGO's level of training in HTS and PEP counselling
NGOs often filling gaps here
Others see this as a
in services that NGOs can fill, especially during night shifts
PEP follow up challenging when HCPs are understaffed, overworked, neglected and unsupported by hospital management
Lack of finalisation of policies, protocols, and management guidelines
Little sharing of information and knowledge on PEP initiation, follow-up and adherence practices within TCCs
District, provincial and national levels within DoH
HCPs feel that NGOs and funding organisations do little to share information on PEP resulting in HCPs having little understanding of their role within TCCs
Large gap in knowledge around what is happening with PEP in TCCs
Echoed in some KIIs

Maintains compartmentalised thinking which needs to be combated to promote holistic operation of services provided by different stakeholders in TCCs
TCCs that serve large areas struggle with follow-up support
Services are functioning well when...
Hierarchy within TCC system amongst all stakeholders frustrates staff working on the ground as voices frequently go unheard
Services are not functioning well when...
Survivors referred to smaller centers or clinics and main centers at which TCCs are based lose clients to follow-up



Put the interests of survivors 1st

Overlap and duplication
NGO services undervalued
DoH and NPA dynamics
Channels of communication
Issue of personalities
TCC system is at risk of collapse and quality of services will be greatly diminished without NGO psychosocial services
TCC stakeholders feel that working with NGOs who rely on haphazard funding can be risky and disruptive
Some consequences of funding ceasing...
No provision of psychosocial services
No follow-up
Longer waiting times
Government departments cannot fund psychosocial service provision currently
New staff and inexperienced graduates
Some TCCs have high staff turnover and there are some tensions between first responders and Social Workers
Identified need for additional training on HTS and handling children
First responders then play a minimal role in TCC which may affect service quality
Other TCC stakeholders stop referring cases as may cause clients more harm
Particular training for staff to develop skills in specified areas?
Adherence counselor?
Number of staff sometimes not enough in TCCs with high client loads
Some Social Workers not based at TCC due to space constraints which affects involvement in TCC system
Further in-service training
More/better resources
Ensuring 24-hour service better outcomes
Transference of good practices between TCCs
Further clarity on lines of authority and roles of TCC stakeholders
Beneficial for AFSA and NACOSA to provide quarterly reports on:
Number of clients assisted
Kind of support offered
Number of clients who return for follow-up
Enhance communication between TCCs and smaller clinics or centers that survivors access

GF work alongside government and longer term partners
Full transcript