PCI builds upon work started in FY09. Through the Building Bridges program, PCI is strengthening the capacity of civil society organizations (CSOs) in the delivery of integrated Adult Care and Treatment, OVC Support and Pediatric Care and Treatment support services. Focus is on the needs of infected/affected children, adolescents and adults, using a family-centered approach that builds the capacity of affected families to care for their members. The program is also working to strengthen partnerships between government systems and CSOs to expand service reach and follow-up.

PCI will provide sub-grants to and build the organizational and technical capacity of 10 NGO partners to deliver a comprehensive package of integrated services to affected families. Additionally PCI will continue to provide training and technical assistance to BORNUS and Otse to provide integrated HIV services. PCI in partnership with MOH/MASA and MASCOM will continue to support Botswana Association for Positive Living (BAPL) to conduct a feasibility study on the use of SMS to provide ART adherence support adolescents and adults, as well as to create stronger data linkages related to ART support. Assuming favorable study results, in COP10 BAPL will be supported to scale-up the service. PCI is also extending training and technical assistance to other NGOs identified by Districts where PCI has NGO subgrant partners.

PCI will form strategic partnerships and provide technical assistance to umbrella bodiesBONEPWA, BONASO and Marangto enable them to strengthen the technical and organizational capacity of their affiliates. Additionally PCI will continue to work in collaboration with Ministry of Health (MOH), Ministry of Agriculture (MOA) and Ministry of Local Government (MLG) to strengthen coordination structures, quality service delivery and effective referral.

PCI will use community mobilization through Journey of Life (JoL) as a strategy for reaching more families with services at low cost. The JoL aims at activating communities to take voluntary action and tap into existing resources (VDC, small business, churches and retired professionals) to care for vulnerable children, PLHIV and their families. Project activities with infected/affected adolescents will emphasize peer approaches, the development of life skills and livelihood/career opportunities, and sexual and reproductive health interventions. PCI will in COP10 integrate Food Nutrition and Livelihoods Security (FNLS) initiatives in the current programs of NGO partners, which will include backyard vegetable gardens, small livestock, and nutrition education.

Goal: Improve and expand CSO delivery of integrated HIV/AIDS services for affected/infected children and families.

Objectives:

1. Strengthened technical/programmatic capacity of CSOs to deliver integrated HIV/AIDS services;

2. Strengthened organizational capacity of CSOs to manage and sustain integrated HIV/AIDS service delivery;

3. Strengthened collaboration and referral among government and CSOs to deliver integrated HIV/AIDS services;

4. Strengthened government capacity to support CSO delivery of integrated HIV/AIDS services;

5. Improved documentation and sharing of promising practices and lessons learned in delivering integrated HIV/AIDS services.

Project Sites: Building Bridges operates in the following districts: Kgatleng District, Kweneng District, Central District, Gaborone, Southern District, South East District, and North East District.

Project Beneficiaries:

Civil society organizations

OVC

Children with HIV

Adults with HIV

Adults as caregivers of infected OVC

Key Activities: PCI will provide training, technical assistance and mentoring to build NGO partners' capacity to deliver effective, integrated services. Services include PSS, ART adherence and support, adherence counseling, food and nutrition, child protection activities, health care, livelihoods opportunities, prevention including VCT. In partnership with key MOH and MLG PCI will develop an integrated curriculum for training NGOs to provide a comprehensive package of services to the families.

Each NGO partner will be assisted to deliver as many of this services as realistic for their organization, and to ensure that clients can access the full range of services through linkages and referrals, and collaborative case management with government and other service providers.

Following on capacity assessments conducted in COP 09, PCI will support the NGO partners to implement individual capacity building plans to address their organizational development (OD) needs. Emphasis will be placed on key areas of Sustainability/Resource Mobilization, Governance and Leadership, Finance Management, Human Resources Management and the use of Information Communication Technology (ICT). PCI will work closely with BONASO and AED to develop guidelines and tools for these key OD areas.

Linkages with other PEFPAR Funded Programs:

Baylor/MOH MASA/Harvard - finalize and roll out the Pediatric ART access and Adherence curriculum developed in FY09

Marang/DSS - refine and implement the Journey of Life methodology and work towards national roll out of the methodology

Other PEPFAR-funded NGO Partnerships - in developing and in implementing strategic activities in support of project objectives: AED, RTI, JHU, FHI, CRS, and Tebelopele

MLG-DSS and PHC - will assist these partners to operationalize the family care model

PCI will continue to provide subgrants, technical assistance (TA) and organizational development services to enable 11 NGOs to deliver adult care and support. Training and mentoring will also be provided to BORNUS and OTSE (they are funded by NPI). PCI will continue to include additional NGOs identified by DACs in training and TA activities.

Building on training conducted with MOH using the MOH national palliative care curriculum, emphasis will be on post-training follow-up and mentoring of NGO partners to deliver effective care and support services. These include: Psychosocial support, ART adherence counseling and support, food and nutrition, health care, social and legal services, livelihood opportunities and prevention including VCT. Each NGO partner will be assisted to deliver as many of these services as realistic for their organization, and ensure that clients can access the full range of services through linkages and referrals and collaborative case management with Government and other service providers.

PCI will capacitate NGOs to conduct community mobilization using the Journey of Life (JOL) tool to identify and strengthen community support structures for identification and provision of basic care and support services to adults living with HIV/AIDS. PCI will also provide nutrition/food security and economic empowerment interventions to help ensure sustainable access to proper nutrition for infected adults and their families. Strategic partnerships include DSS Home Economics Unit, MOH Nutrition Department, Women's Affairs Department, Ministry of Agriculture, BONEPWA+.

10.C.OV11: PCI - OVC - 1,792,039.00

Through the Building Bridges program, PCI is strengthening the capacity of civil society organizations (CSOs) in the delivery of integrated adult care and treatment, OVC support, and pediatric care and treatment support services. The focus is on the needs of infected/affected children, adolescents and adults, using a family-centered approach that builds the capacity of affected families to care for their family members.

The Building Bridges program (OVC section) has a link with Goal 4 of the Partnership Framework. The work that they do through the different partners is on providing care and support to infected and affected OVC and their family members.

The PCI partners who are implementing the Building Bridges program are based in various parts of the country with their main target population being the infected and affected OVC and their family members.

In FY10, PCI will continue to provide subgrants, technical assistance (TA), and organizational development support to enable 11 NGOs to deliver OVC services. Training and mentoring will also be provided to Botswana Retired Nurse Society (BORNUS) and Otse Community Home Based Care Trust (they are funded by NPI). PCI will continue to include additional NGOs identified by DACs in training and TA activities.

OVC technical service strengthening will continue to focus on ensuring the health, education, protection, socialization, and emotional well being of children infected and affected by HIV/AIDS. Services will continue to be tailored to the age of the child, with specific interventions for the under-fives, primary school age and pre-teen children, and adolescents.

Building on the partnerships between the DSS, Marang, and Hope World Wide, PCI will roll out training on OVC Basics to volunteers at the NGO level and provide on-going TA to trained NGO staff. Similarly for pediatric care and support, emphasis will be on post-training follow up and mentoring of NGO partners in order to improve the quality of services provided to OVCs at the family and community levels. PCI will work with districts to strengthen referrals and linkages between CSOs and S & CD to ensure that all eligible families and children are registered and receiving all available social welfare and health services, in order to ensure a continuum of care across PMTCT, ART, OVC, MCH, and other health and social services. PCI will also adapt the Baylor Teen club model for rollout through selected NGO partners.

Also in partnership with the DSS, Marang, Hope World Wide, and REPSSI, PCI will build capacity among NGOs to conduct community mobilization using the Journey of Life (JOL) tool to identify and strengthen community support structures for the identification and provision of care and support to OVC. PCI will also provide nutrition, food security and economic empowerment interventions to help ensure sustainable access to proper nutrition for infected children and their families. Strategic partnerships include the DSS Home Economics Unit, S & CD, and the MOH Nutrition Department.

10.C.CT13: PCI - Integration of HTC with other NGO services - 250,000.00

The PEPFAR portfolio currently supports many local community-based organizations (CBOs) to provide HIV prevention, care and treatment services to their clients. Integration of HIV testing and counseling (HTC) and prevention services will enable providers to reach more people with a broader range of services. PEPFAR will provide funding to Project Concern International (PCI) to integrate testing, counseling, and referral services into the existing services provided by their partnering CBOs. Currently, PCI supports CBOs that provide activities in behavior change communication, that work with orphans and vulnerable children, and that offer home-based care. These activities target men, women, youth, couples, partners of people living with HIV/AIDS and family members. PCI will select three CBOs to be trained and mentored to provide HTC services.

In FY10, PCI will:

Conduct an "HTC site assessment" to determine CBO needs and challenges in an effort to develop an implementation plan, including minimum requirements such as space, staffing, protocols, and a monitoring and evaluation framework.

Train 20 lay counselors on how to perform a rapid HIV test. After the training, these counselors will do a month-long practicum at a Tebelopele VCT (TVCT) center before resuming work with their CBOs.

Liaise with TVCT to train counselor supervisors and develop tools for observation of sessions and provision of feedback.

Provide minimal facility upgrading (e.g., installation of hand wash basins in counseling rooms and ensuring adequate infection control).

Visit each CBO at least twice a month for the first three months and subsequently quarterly to provide on-the-job support and mentoring to counselors. PCI will also review and modify registers to allow for routine collection of the required HTC information.

Ensure that sites participate in the lab external quality assurance (EQA) for rapid HIV testing.

The three selected CBOs will offer parallel, rapid HIV testing with same-day results as per the MOH approved algorithm. During palliative care home visits, HIV testing for partners and family members will be offered. It is also envisioned that client-initiated testing will be provided at some of the CBO sites. Other approaches, such as community-based and youth-focused services, will be provided depending on the CBOs selected. PCI will provide each CBO with HIV prevention materials that are audience specific.

Effective methods of referral are essential to ensure that patients and clients access prevention, care and treatment services. PCI will provide technical support to the CBOs to establish referral linkages with government facilities.

10.C.PC02: PCI - Pediatric Palliative Care - 400,000.00

PCI will continue to provide subgrants, technical assistance (TA) and organizational development support to enable 11 NGOs to deliver OVC services. Training and mentoring will also be provided to BORNUS and OTSE (they are funded by NPI). PCI will continue to include additional NGOs identified by DACs in training and TA activities.

OVC technical service strengthening will continue to focus on ensuring the health, education, protection, socialization, and emotional well being of children infected/affected by HIV/AIDS. Services will continue to be tailored to the age of the child, with specific interventions for under-fives, primary school age and pre-teen children, and for adolescents.

Building on the partnership between DSS, Marang, Hope World Wide, PCI will roll out training on OVC Basics to volunteers at NGO level, and provide on-going TA to trained NGO staff. Similarly for pediatric care and support, emphasis will be on post training follow up and mentoring of NGO partners in order to improve the quality of services provided to OVCs at family and community level. PCI will work with districts to strengthen referrals and linkages between CSOs and S & CD to ensure that all eligible families and children are registered and receiving all available social welfare and health services, to ensure continuum of care across PMTCT, ART, OVC, MCH, other health and social services. PCI will also adapt Baylor Teen club model for rollout through selected NGO partners.

Also in partnership with DSS, Marang, Hope World Wide, and REPSSI, PCI will capacitate NGOs to conduct community mobilization using Journey of Life (JOL) tool, to identify and strengthen community support structures for identification of and provision of care and support to OVC. PCI will also provide nutrition/food security and economic empowerment interventions to help ensure sustainable access to proper nutrition for infected children and their families. Strategic partnerships include DSS Home Economics Unit, S & CD, and MOH Nutrition Department