PEPFAR Transitions

In 2013, USAID/Barbados and the Eastern Caribbean requested SHOPS’ assistance to help frame the transition of PEPFAR programming to country ownership in the Caribbean by conducting a literature review. This study identifies key themes and lessons learned to guide Caribbean nations to plan, develop, and implement transition strategies. Through a review of existing literature, six key steps were identified in planning an effective transition to country ownership: (1) develop a roadmap; (2) communicate the plan through high-level diplomacy; (3) invest in stakeholder participation; (4) support mid-term evaluations; (5) provide technical assistance throughout the process; and (6) provide long-term monitoring and evaluation support. In addition, four key dimensions for successful country ownership were identified: (1) political ownership and stewardship; (2) institutional and community ownership; (3) capabilities; and (4) mutual accountability, including financing. The study concluded that activities geared toward greater private sector engagement, ranging from fostering sustainable partnerships and policy dialogue to increasing access to training, will be crucial to sustaining health outcomes.