▁then ▁developed ▁the ▁ 3 rd ▁Str ateg ic ▁Framework ▁ 2 0 1 5 - 2 0 ▁that ▁foc uss ed ▁on ▁quality ▁H IV ▁treatment ▁and ▁care ▁services . ▁ ▁L ack ▁of ▁the ▁ability ▁to ▁measure ▁the ▁out comes ▁or ▁impact ▁of ▁inter vent ions ▁in ▁real ▁time ▁( so ▁that ▁this ▁knowledge ▁can ▁inform ▁program ▁direction ) ▁was ▁likely ▁the ▁most ▁important ▁factor ▁in ▁the ▁low ▁performance ▁of ▁the ▁first ▁En hanced ▁Program . ▁Other ▁challeng es ▁that ▁must ▁be ▁overcome ▁include ▁establishment ▁of ▁a ▁transparent ▁financial ▁management ▁and ▁a ▁smooth ▁log ist ical ▁and ▁proc ure ment ▁system . ▁Much ▁of ▁the ▁En hanced ▁Program ▁services ▁are ▁contract ed ▁out ▁and ▁del ays ▁in ▁proc ure ment ▁of ▁these ▁services ▁meant ▁that ▁many ▁of ▁the ▁cities ▁went ▁without ▁services ▁for ▁months ▁to ▁years . ▁More ▁complex ▁( and ▁longer ▁term ) ▁challeng es ▁will ▁include ▁determ ining ▁how ▁to ▁integrate ▁many ▁of ▁H IV ▁activities ▁within ▁other ▁health ▁activities , ▁improve ▁planning ▁to ▁anticip ate ▁future ▁direction ▁of ▁the ▁ep ide mic ▁and ▁its ▁response ▁and ▁to ▁enh ance ▁efficiency ▁and ▁effect iveness ▁of ▁the ▁inter vent ions . ▁For ▁these ▁research ▁must ▁become ▁part ▁of ▁the ▁inter vent ions ▁to ▁guide ▁their ▁implementation ▁using ▁local ▁context ▁and ▁to ▁involve ▁ep ide mi ological ▁tools ▁such ▁as ▁routine ▁analysis ▁of ▁available ▁data ▁and ▁even ▁mathematical ▁model ing ▁to ▁guide ▁program ▁planning . ▁After ▁de volution ▁in ▁ 2 0 1 1 ▁the ▁Provin ces ▁mobil ized ▁their ▁own