PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2007 2008 2009
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
New activities in FY09 include:
- Initiate HIV/AIDS-related activities in primary schools through hygiene committees.
- Initiate debates and activities within existing youth associations in order for them to become advisory
entities to village action committees.
- Support specific interventions by the national network of religious leaders ARSIP to strengthen religious
leaders' capacities to contribute to the fight against HIV/AIDS in villages.
- Sensitize women's organizations so as to empower them to discuss AB-related issues with their children
and young counterparts.
- Educate women/men and girls/boys on reproductive health, self-esteem, and nutrition as a vehicle for
addressing AB issues.
- Monitor village action committees through quarterly meetings with ANADER specialists.
- Reproduce and disseminate AB sensitization materials developed by other partners (Hope Worldwide,
JHU/CCP, and Ministry of Education).
- Begin a pilot Sports for Life activity in Abengourou and San Pedro.
- Evaluate the AB component of the project.
COMPLETE NARRATIVE
This activity is part of a broad four-year project launched in FY05 to build a local response to HIV/AIDS in
underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate.
The project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health,
social, and education services, accompanying expansion of these services as national programs scale up.
The implementing consortium brings together and applies the expertise of:
- The National Agency for Support to Rural Development (ANADER) for rural community mobilization and
HIV prevention based on participatory risk-mapping and village HIV/AIDS action committees
- The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC,
including local outreach and radio, training, and use of its lexicon to communicate about HIV/AIDS in 16
local languages
- PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for
palliative care
- ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care
provision and referral to ARV treatment. EGPAF intervenes in Abengourou and Tanda instead of ACONDA.
In the program area of AB Sexual Prevention, FY09 funds will be used to continue and strengthen FY08
activities in 10 departments (Dabou, Jacqueville, Sikensi, San Pedro, Abengourou, Tanda, Koun Fao,
Bondoukou, Soubré, and Daloa). These activities, implemented through village HIV/AIDS action committees
in 146 village sites, draw on ANADER's risk-mapping approach, which includes segmenting village
populations to allow young women, young men, older women, and older men to discuss sexuality and HIV-
related risks and risk-reduction strategies separately and together. Within local village action committees,
three members (including at least one woman) are chosen by village authorities and committee members to
become community counselors, based on several criteria: literacy level, time availability, willingness to
engage in volunteer work, proven ability to be discreet, and acceptance among community groups. Local
HIV/AIDS action committees and community counselors are supported, with the help of JHU/CCP, in
applying culturally appropriate BCC strategies, curricula, and educational materials with abstinence,
faithfulness, and gender-based violence-prevention messages. Specific programs are being developed for
and with youth groups, with an emphasis on vulnerable girls and young women. Within the ANADER
project, community counselors also link HIV prevention with promotion of HIV counseling and testing
(through the project's mobile CT units and fixed-site CT services at rural health centers) and with provision
of care and support services and OVC care and support.
Activities include coordinated BCC campaigns mediated by influential figures and peers and designed to a)
delay sexual debut among youth, b) decrease number of sexual partners and c) promote mutual fidelity with
knowledge of one's own and one's partners' serostatus. Use of methods of proximity (debates, sketches,
videos, peer education, traditional events, etc.) in the community, schools, sporting fields, mosques, and
churches are reinforced by radio in local languages. Community counselors, traditional and religious leaders
are empowered through tools such as the HIV/AIDS lexicon, interactions with networks such as ARSIP (a
religious leaders' association), and use of participatory approaches to lead communities to address
HIV/AIDS in their socio-cultural context, including addressing issues of negative gender attitudes and HIV-
related stigma and discrimination. Community counselors visit individual homes and discuss issues related
to mutual fidelity and secondary abstinence with couples. ANADER works with teachers to reach youth in
primary and secondary schools, drawing on Ministry of Education (MEN) life-skills materials and
approaches.
In FY09, a particular emphasis will be placed on encouraging youth and women's associations to become
actors in the fight against HIV/AIDS by empowering them to discuss issues related to safer behavior and
gender norms in the community and to serve as advisory entities to the village action committees.
Project activities complement and build on other initiatives, including PEPFAR-funded efforts, such as
Ministry of AIDS (MLS) and JHU/CCP activities to develop effective BCC approaches and mobilize faith-
based communities and opinion leaders; Ministry of Education (MEN) and Ministry of Family and Social
Affairs (MFFAS) activities in support of youth and OVC; Care International support for CBO/FBOs and
PLWHA; and Ministry of Health (MOH) and EGPAF/ACONDA support for expanded PMTCT, CT, and
treatment. Activities are coordinated through relevant village, district, regional, and national forums.
Activities conducted with FY05-08 funds include:
- Identification of 146 village sites (each serving multiple surrounding villages) for intervention
- Baseline needs assessments in three departments: Tanda, Soubré, and Daloa
- Training of 130 ANADER staff in AB-targeted prevention
Activity Narrative: - Training of 36 ANADER workers/facilitators (three to five per department) and 528 community counselors
(three per village site) in use of the local-language HIV/AIDS lexicon and AB-targeted prevention
- Training of 144 schoolteachers in AB-oriented prevention
- Training of 12 local radio announcers (two per department) in AB prevention, with REPMASCI providing
the training and drawing on IRIN/JHU/CCP materials
- Delivery of video campaigns with community mobilization (at least three per village) and prevention
campaigns on local radio (at least two per village)
- Creation of linkages among village action committees and agricultural cooperatives by involving members
of cooperatives in village action committees
- Broadcast of 1,584 radio spots and 72 radio programs (in FY08) with AB prevention messages in all 10
departments
- Development, with technical assistance from JHU/CCP, of the Sports for Life program with youth
organizations in two departments (San Pedro and Abengourou).
In FY09, AB activities will be guided by quantitative and qualitative assessments conducted in FY07 and the
2005 national AIDS Indicator Survey. To improve on the quality of AB and other prevention and care
activities, ANADER will emphasize work with focus groups. ANADER will partner with ARSIP (religious
leaders' network) to increase participation of rural religious leaders in the fight against AIDS. ANADER will
continue to work with schoolteachers while seeking to increase youth participation as actors through school
hygiene committees and village youth associations, and will work to build REPMASCI's sustainable
organizational capacity and ability to identify and creatively meet the needs of rural families, particularly
women and youth without access to mass media, for HIV and other health-related information.
Between April 2009 and March 2010, activities supported by FY09 funding will reach 120,000 people
(including 44,000 youth (37%) with A-only messages) through community outreach that promotes AB-
oriented prevention and will train 1,129 people to promote AB-oriented prevention. FY09 funds will also be
used to perform a general participatory evaluation of the project.
Specific activities with FY09 funds will include:
1. Training of trainers for 30 ANADER facilitators (five per department) and training for 438 village action
committee members (three per village site in 146 villages) in AB-targeted prevention using the new national
training guide.
2. Training of 146 schoolteachers in life skills and Sports for Life approaches.
3. AB sensitization through youth and women's associations (in all departments) and health clubs in
secondary schools (Tanda, Abengourou, Jacqueville, Daloa, and Soubré).
4. On-site BCC training of five committee members per village in 146 village action committees.
5. Sensitization of members of agricultural cooperatives on fidelity and secondary abstinence, in "farmer
field schools."
6. Initiation of HIV/AIDS-related activities through 12 pilot primary school hygiene clubs ,with assistance
from the MEN.
7. Implementation of a Sports for Life activity in two village sites (Abengourou, San Pedro).
8. Broadcast of AB prevention spots (1,108 in the six departments) and educational programs (36
emissions) on local radio;
9. At least two video campaigns in each village (a total of 292 video film projections in 10 departments).
10. Education of young women/men and girls/boys on reproductive health, self-esteem, and nutrition. These
sessions will serve as a vehicle for addressing AB issues.
11. Training of 150 religious leaders in BCC, community mobilization, and reduction of stigma and
discrimination.
12. Reproduction of educational materials on AB prevention, with assistance from JHU/CCP, Hope
Worldwide, the MEN, and the National OVC Program (PNOEV)
13. Facilitation of thematic quarterly meetings with village action committee members (four per year).
14. Evaluation of knowledge on HIV transmission and AB prevention methods (comparative analysis
between project sites and villages outside the project).
15. Evaluation of the effect of AB sensitization on the communities.
16. Evaluation of community counselors' mastery of A and B training tools and messages.
17. Production of a 26-minute documentary film on the project's four years of activities and results.
18. Exploration of potential new departments/districts to be included in the program, with a view to project
extension.
The project will continue to implement an M&E plan based on national and USG requirements. ANADER
will report to the USG strategic information team quarterly program results and ad hoc requested program
data. To participate in the building and strengthening of a single national M&E system, ANADER will
participate in quarterly SI meetings and will implement decisions taken during these meetings.
ANADER strives to strengthen capacity among CBOs and village and district AIDS action committees to
achieve local ownership and sustainability of activities. Training of community counselors, other members of
village HIV/AIDS action committees, and rural health center staff is designed to enable communities to carry
on prevention, CT, and care activities after PEPFAR funding for the project has ceased. In 2009, ANADER
will work to transfer to village action committees the capacities necessary to organize and perform most
community outreach events (e.g. cine-village for HIV prevention and CT promotion).
New/Continuing Activity: Continuing Activity
Continuing Activity: 15143
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15143 5475.08 HHS/Centers for National Agency of 7060 5315.08 U62/CCU02512 $562,401
Disease Control & Rural 0-01 ANADER
Prevention Development
9932 5475.07 HHS/Centers for National Agency of 5315 5315.07 U62/CCU02512 $485,000
5475 5475.06 HHS/Centers for National Agency of 3731 3731.06 U62/CCU02512 $350,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Family Planning
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $300,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.02:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS :
- Reproduce and disseminate OP sensitization materials developed by other partners (Hope Worldwide,
- Develop a package of activities for prevention targeting PLWHA, with the support of RIP+
- Evaluate Other Prevention activities.
underserved rural areas, where 60% of Côte d'Ivoire's population lives, much of it functionally illiterate. The
project is expanding access to HIV/AIDS prevention, care, and treatment and improving links to health,
- ANADER for community mobilization and HIV prevention based on participatory risk-mapping and village
HIV/AIDS action committees
including training, local radio and community outreach, and use of its lexicon to communicate about
HIV/AIDS in 16 local languages
- ACONDA-VS CI for health-provider training in CT, and PLWHA support, as well as palliative-care
In Other Sexual Prevention, FY09 funds will be used to continue and strengthen FY08 activities in 10
departments (Dabou, Jacqueville, Sikensi, San Pedro, Abengourou, Tanda, Koun Fao, Bondoukou, Soubre,
and Daloa). These activities, implemented through village HIV/AIDS action committees in 146 village sites,
draw on ANADER's risk-mapping approach. Within local village action committees, three members
(including at least one woman) are chosen by village authorities and committee members to become
communitycounselors, based on several criteria: literacy level, time availability, willingness to engage in
volunteer work, proven discretion, and acceptance among community groups. Community counselors,
traditional and religious leaders are empowered through tools such as the HIV/AIDS lexicon and use of
participatory approaches to lead communities to address HIV/AIDS in their socio-cultural context, including
addressing issues of negative gender attitudes and HIV-related stigma and discrimination. Local HIV/AIDS
action committees and community counselors are supported in applying culturally appropriate BCC
strategies and materials with messages about abstinence, faithfulness, and prevention of infection through
other safe practices.
Activities include coordinated BCC campaigns mediated by influential figures and peers. Use of methods of
proximity (debates, sketches, videos, peer education, traditional events, etc.) in the community, schools,
sporting fields, mosques, and churches are reinforced by radio in local languages. ANADER and community
counselors work with teachers to reach youth in primary and secondary schools, drawing on Ministry of
Education (MEN) life-skills materials and approaches. In FY09, a particular emphasis will be placed on
encouraging youth and women's associations to become actors in the fight against HIV/AIDS by
empowering them to discuss issues related to safer behavior and gender norms in the community and to
serve as advisory entities to the village action committees.
Activities complement and build on other PEPFAR-funded initiatives, such as Ministry of the Fight Against
AIDS (MLS) and JHU/CCP activities to develop effective BCC approaches; MEN and Ministry of Family and
Social Affairs (MFFAS) activities in support of youth and OVC; Care International support for CBO/FBOs
and PLWHA; and Ministry of Health (MOH) and EGPAF/ACONDA support for expanded PMTCT, CT, and
treatment. Activities are coordinated through village, district, regional, and national forums.
The project trains action committee members and community counselors to provide information to adults
about the correct and consistent use of male and female condoms as part of a comprehensive HIV/AIDS
prevention package that also includes behavior-change communication promoting delay of sexual debut
among youth, partner reduction, and mutual fidelity with knowledge of one's own and one's partners'
serostatus. The project supports or helps establish condom vending points at sites selected by the village
action committees. An initial supply of male condoms is provided free of charge, and a restocking structure
ensures that the adult community has a continuous supply of condoms.
Other Prevention linkages with the project's CT services (at rural health centers and through mobile CT
units) emphasize testing for couples. HIV-positive people are provided counseling and access to support
groups of PLWHA, which focus on secondary prevention messages and healthy lifestyles, drawing on RIP+
(network of PLWHA organizations) expertise and materials. Community counselors work with support
groups to facilitate PLWHA disclosure of their status to optimize protection of HIV-free partners and
encourage psychological support through the family. Community outreach events (e.g. video projections
with community discussion) address barriers to CT and disclosure, including stigma. Existing tools such as
films on PLWHA testimonials support communication activities to promote acceptance and minimize stigma.
Activity Narrative: Discordant couples are a target population for prevention counseling, CT promotion, and free condoms; it is
estimated that 240,000 male condoms will be distributed in FY09 to discordant and HIV-positive couples.
Community-awareness sessions will deal with reducing other risk factors for HIV infection, often revealed
during risk-mapping sessions, such as sharing knifes and razors for male circumcision, female genital
mutilation, and scarification. Whenever possible, traditional "doctors" and midwives will be trained, based on
materials developed by JHU/CCP, to reduce the risk of HIV infection through unsafe practices. The project
will work to build REPMASCI's sustainable organizational capacity and ability to identify and creatively meet
the HIV-information needs of rural families, particularly women and youth without access to mass media.
Within the ANADER project, community counselors will also link HIV prevention with promotion of HIV
counseling and testing (through the project's mobile CT units and fixed-site CT services) and with provision
of care and support services, including OVC care and support, and ART adherence support.
The project is also piloting income-generating activities for community counselors and village committee
members to help support their HIV/AIDS prevention work (including transport and lodging when they work in
distant villages), motivate them to continue working, and help ensure the sustainable functioning of the
action committees. IGAs are selected by committee members and implemented with ANADER agricultural
technical assistance.
Activities conducted with FY08 funds include:
1. Community-wide, small-group, and individual outreach promoting condom use and other HIV prevention
methods, as well as HIV counseling and testing, including 288 theatrical presentations
2. Training of 25 ANADER agents and 96 community counselors in prevention for PLWHA and STI
prevention and care
3. Delivery of 432 video campaigns with community mobilization and discussion (three per village)
4. Community outreach reaching 45,000 people with Other Prevention messages
5. Broadcast of 612 ABC prevention spots on local radio
6. Broadcast of 40 radio programs with ABC prevention messages, including village competitions broadcast
on local radio with an HIV prevention theme to generate attention and interest
8. Strengthening of linkages between village action committees and agricultural cooperatives
9. Expansion of income-generating activities for community counselors and village committee members to
48 villages in Soubre and Daloa
10. Production of educational materials targeting potentially risky traditional cultural practices, with the
technical assistance of JHU/CCP.
11. Production of a documentary film on the project's activities and results.
FY09 Other Sexual Prevention activities will be informed by assessments in FY06 and FY07 and the 2005
AIDS Indicator Survey. Between April 2009 and March 2010, activities will reach 180,000 people through
community outreach that promotes HIV prevention through condoms and other prevention methods beyond
AB and will train 400 people to promote such prevention.
Activities with FY09 funds will include:
methods, as well as HIV counseling and testing, including 292 theatrical presentations
2. Training of 50 community counselors (one per village in Jacqueville, Daloa, and Soubre) in prevention for
PLWHA and STI prevention and care
3. Training of 72 ANADER agents in prevention for PLWHA
4. Training of at least 60 PLWHA support-group leaders in prevention for PLWHA
5. 72 exchange workshops with action committees on prevention for PLWHA
6. Two workshops (one per three ANADER zones) on creation and management of PLWHA associations
7. Training of 72 traditional healers and 146 religious leaders in prevention for PLWHA
8. Delivery of 438 video campaigns with community mobilization and discussion (three per village)
9. Community outreach reaching at least 180,000 people (April 2009-March 2010) with Other Sexual
Prevention messages
10. Broadcast of 1,600 prevention spots on local radio (400 ABC, 400 PMTCT, 800 gender-based violence
and prevention for PLWHA)
11. Broadcast of 36 radio programs with ABC prevention messages
12. 36 village youth radio programs with an HIV prevention theme to generate attention and interest
13. Sensitization of at least one existing women's organization per village (146) so as to empower it to
discuss other sexual prevention related issues among the members, with their older children, and with
young female counterparts.
14. Education of youth and women's groups on reproductive health, self-esteem, and nutrition as a vehicle
for addressing OP issues.
15. Monitoring of village action committees through quarterly meetings with ANADER specialists (expertise
of other partners may be sought)
16. Supply of 138,240 male condoms for sale, demonstrations, and distribution to 146 action committees
(five boxes per year)
17. Capacity building for 438 community counselors in support to PLWHA for status disclosure to their
partner
18. Evaluation of the results attained by village action committees for OP activities
19. Extension of income-generating activities to two new village action committees in Jacqueville.
20. Reproduction and dissemination of OP sensitization materials developed by the program or by other
partners (Care Int., JHU/CCP, APROSAM, Alliance CI, etc.)
21. Strengthening of linkages between village action committees and agricultural cooperatives
22. Identification of potential new departments, with a view to expanding the project.
Activity Narrative: will report to the USG strategic information team quarterly program results and ad hoc requested program
Continuing Activity: 15144
15144 5477.08 HHS/Centers for National Agency of 7060 5315.08 U62/CCU02512 $200,000
10051 5477.07 HHS/Centers for National Agency of 5315 5315.07 U62/CCU02512 $130,000
5477 5477.06 HHS/Centers for National Agency of 3731 3731.06 U62/CCU02512 $125,000
* Increasing women's access to income and productive resources
* Reducing violence and coercion
Estimated amount of funding that is planned for Human Capacity Development $100,000
Table 3.3.03:
New activities in FY09 will include:
- Train community counselors and ANADER agents in psychological support of PLWHA
- Train religious leaders in psycho-spiritual support of PLWHA
- Create care and support networks extending to villages
- Provide nutritional kits to PLWHA who are on ART or who are undernourished
- Equip community counselors for community care and support of PLWHA (adults and a few children)
- Evaluate project activities.
COMPLETE COP09 NARRATIVE:
This activity is part of a four-year project launched in FY05 to build a local response to HIV/AIDS in
- ANADER for rural community mobilization and HIV prevention based on participatory risk-mapping and
village HIV/AIDS action committees
including training, local radio, and use of its lexicon to communicate about HIV/AIDS in 16 local languages
- PSI-CI for HIV counseling and testing (CT) activities, including training and CT promotion, and
procurement for palliative care
- ACONDA-VS CI for health-provider training in CT and PLWHA support, as well as palliative-care provision
and referral to ARV treatment. EGPAF intervenes in Abengourou and Tanda instead of ACONDA.
In the program area of Adult Care and Support, FY09 funds will be used to continue and strengthen FY07
and FY08 care and support activities in seven health districts (San Pedro, Dabou, Jacqueville, Tanda,
Abengourou, Soubré, and Daloa). Care and support activities are led by ACONDA or EGPAF at rural and
urban health centers and by ANADER at the community level. Building on ANADER's structure of HIV/AIDS
action committees in 146 village sites (24 per region + two villages in Jacqueville beginning in 2008), the
project uses nationally approved approaches and materials to train actors at the village level - community
counselors, ANADER rural development agents, and rural health center and mobile CT unit staff - to
provide facility and home-based care and support services, including psychosocial support, prevention-for-
positives counseling (including referral for partner/family testing, "ABC" behavior-change communication,
and counseling for sero-discordant couples), ARV adherence monitoring, and referral and counter-referral
to medical (including TB) and social services for children and adults identified as HIV-positive through CT at
rural health centers and the project's mobile CT units.
Community actors distribute care kits containing a 20-liter jerry can, two long-duration pesticide-
impregnated bed nets, a positive-living brochure, and products replenished on a monthly basis, including
male condoms (32), rehydration salts, water-purification solution, and cotrimoxazole tablets. They also
promote the creation of peer-support groups for PLWHA and their families and work to ensure linkages
between care services and other health care (including HIV, TB, and STI treatment), CT, HIV prevention,
and OVC services. To improve effectiveness and efficiency, community counselors have been cross-trained
to provide both palliative care and OVC care at the home level. Community leaders have been trained to
sensitize populations on the issues of stigma and discrimination against PLWHA and OVC.
Project activities complement and build on other PEPFAR-funded efforts, including palliative-care policy and
guidelines for clinic- and home-based care as part of a continuum of care as well as HIV prevention, care,
and treatment activities by ministries (AIDS, Health, Education, Social Affairs) and other PEPFAR partners
(Care International, Alliance CI, EGPAF). Activities are coordinated through local, national, and district
forums, with involvement of the district health management teams to maximize capacity-building and
coordination with the MOH.
FY07- and FY08-funded activities are supporting 146 service outlets (one per rural health center or village,
plus two mobile CT units) and providing HIV-related care and support services for about 2,000 PLWHA.
Activities include:
1. Identification of 146 village sites in the health districts of Dabou, Jacqueville, San Pedro, Abengourou,
Tanda, Soubre, and Daloa for intervention, each village site serving multiple surrounding villages and
encampments.
2. Identification of 31 rural health centers (one in Jacqueville, five to seven in each other district) where care
and support activities are aligned with fixed-site CT services
3. Training of 54 ANADER agents to provide support for the use of care kits
4. Training of 438 community counselors to provide home-based community support and care services
5. Training of 128 health care workers ( 56 from fixed-site CT health centers, 72 from other health centers)
in care and support
6. Supply of care and support services and kits for identified PLWHA
7. Training of 576 community leaders for the fight against stigma and discrimination against PLWHA and
OVC
8. Provision of home-based support and care for about 2,000 PLWHA and their families, including
psychosocial support, nutritional kits, referral to district health centers and social services, and occasional
financial support for medical care
9. Support for the establishment and operation of 30 PLWHA support groups
10. Supply through peer-support groups of nutritional kits to PLWHA who are on ART or who are
undernourished
11. Reinforcement of the referral and counter-referral processes and linkages between health facilities and
community services
Activity Narrative: 12. Distribution of 1,000 posters and 3,000 brochures with messages designed to reduce stigma and
discrimination against PLWHA.
In 2009, emphasis will be placed on setting up and strengthening care and support networks (consisting of
community counselors, a family care provider, an ANADER agent, a religious leader, a rural health center
nurse, and a district physician) and linkages among CT, health care, palliative care, and OVC care services.
Stigma-reduction sensitization through local radio and community outreach will be conducted. Collaboration
with JHU/CCP, the Ministry of Education, and other partners will ensure synergy and avoid duplication with
other BCC and IEC media and outreach activities.
FY09 funds will support 149 service outlets (one per village site plus three mobile units) providing care for
3,568 PLWHA by March 2010 and will ensure training for 481 care providers between April 2009 and March
2010. Activities with FY09 funds will include:
1. Setting up and equipment (for community counselors) of seven care and support networks (around the 31
health centers providing care in seven health districts)
2. Provision of home-based care and support, including kits, psychosocial support, and referral to district
health centers, social services, and OVC services
3. Training of 146 community counselors and 126 ANADER agents in psychological support, support group
therapy for PLWHA, and care and support for children
4. Training of 150 religious leaders (25 per department for six departments) in psycho-spiritual support of
PLWHA and HIV-affected people
5. Training in care and support for 34 health workers from rural health centers with integrated CT (28 from
Abengourou, six from recently started CT sites) and 25 health workers from rural health centers without
integrated CT services
6. Supply of care and support services and kits for 2,957 PLWHA by September 2009 and 3,568 PLWHA by
March 2010 (estimated number of identified PLWHA given implementation of a door-to-door CT strategy)
7. Support for the establishment of 30 new PLWHA support groups and operation of 60 support groups
8. Income-generating activities for 30 PLWHA groups (five per district) established around rural health
centers. The activities will be designed by the groups, with technical assistance and training from ANADER.
Part of the income will help fund operations of the support group.
9. Broadcast of 654 stigma and discrimination spots on local radio
10. Production and distribution of 1,500 posters and 50,000 brochures with messages designed to reduce
stigma and discrimination against PLWHA and OVC
11. Participation in the national care and support technical working group, in order to ensure that rural
issues are taken into account.
12. Evaluation of care and support activities.
ANADER will continue to implement an M&E plan based on national and USG requirements and tools. Data
will be collected by village action committees using simple tools and will be transmitted to district, regional,
and central units. Project reporting will occur monthly at the regional level and quarterly at the central level.
ANADER will report to the USG strategic information team quarterly program results and ad hoc requested
program data. To participate in the building and strengthening of a single national M&E system, ANADER
will participate in quarterly SI meetings and will implement decisions taken during these meetings.
Sustainability and project effectiveness are enhanced by consortium members' past and current
collaborations with multiple ministries (Health, National Education, Family and Social Affairs, and others) as
well as RIP+ (Network of Organizations of Persons Living with HIV/AIDS), Lumière Action (an NGO of
PLWHA), Ruban Rouge, youth NGOs, and faith-based communities. Project partners have been successful
in mobilizing internal resources and attracting Global Fund, MSD, and other funds/partners to support their
activities. ANADER has a broad rural development mandate with initiatives to address poverty, gender
inequities, and food insecurity and seeks to maximize opportunities for wraparound activities. The World
Bank, UNICEF, WFP, AfriJapan and others have offered or do offer ANADER such opportunities.
Continuing Activity: 15145
15145 5479.08 HHS/Centers for National Agency of 7060 5315.08 U62/CCU02512 $360,000
9930 5479.07 HHS/Centers for National Agency of 5315 5315.07 U62/CCU02512 $420,000
5479 5479.06 HHS/Centers for National Agency of 3731 3731.06 U62/CCU02512 $350,000
* Malaria (PMI)
Estimated amount of funding that is planned for Human Capacity Development $150,000
Estimated amount of funding that is planned for Economic Strengthening $20,000
Estimated amount of funding that is planned for Water $51,000
Table 3.3.08:
- Train traditional healers and religious leaders in HIV/AIDS to promote referral (and counter-referral) to
appropriate health-care facilities
- Evaluate project activities
COMPLETE COP09:
underserved rural areas, where 60% of Côte d'Ivoire's population lives and most are illiterate. The project is
expanding access to HIV/AIDS prevention, care, and treatment and improving links to health, social, and
education services, accompanying expansion of these services as national programs scale up. The
implementing consortium brings together and applies the expertise of:
• The National Agency for Support to Rural Development (ANADER) for rural community mobilization and
• The Network of Media Professionals and Artists Fighting Against HIV/AIDS (REPMASCI) for BCC,
• PSI-CI for HIV counseling and testing activities, including training and CT promotion, and procurement for
• ACONDA-VS CI for health-provider training in CT, PMTCT, and PLWHA support, as well as palliative-care
Funds in the Adult Treatment program area are used to promote treatment literacy, facilitate access to ART,
and provide treatment monitoring and support in rural areas in 10 departments (Dabou, Jacqueville, Sikensi,
San Pedro, Abengourou, Tanda, Koun Fao, Bondoukou, Soubre, and Daloa). This includes development
and promotion of linkages between the comprehensive clinical care for PLWHA delivered at EGPAF- and
ACONDA-supported health facilities at district and village levels and community-based HIV counseling and
testing, palliative care, OVC care, and HIV prevention activities conducted by ANADER in surrounding rural
areas.
Referrals are made to district general hospitals and other public and private health-care centers that are
adequately equipped to provide HIV/AIDS care, including ART. Clients who test HIV-positive at rural health
centers are referred to the nearest accredited care and treatment site. Clients who test HIV-positive through
ANADER's mobile CT units are referred to the nearest rural health center providing CT services and/or to
an appropriate care and treatment site as needed. Nurses at rural health centers that have integrated CT
are trained to monitor the follow-up of ARV treatment at community health centers and to provide
psychological support to PLWHA under the supervision of the district health team. Community counselors
are trained to provide psychosocial support and to monitor and support patients on ART, as well as to
provide home-based palliative care and OVC care and support. Community counselors and peer-support
groups monitor adherence to treatment, contribute to referral activities, and promote treatment literacy. The
project works to establish linkages between services provided by PEPFAR-funded NGOs, networks and
FBOs, the Global Fund, EGPAF, ACONDA, AIBEF, and other partners.
FY08 funds supported activities that include:
1. Training of 196 health workers in rural health centers in ART referral, monitoring, and support
2. Promotion of adherence to treatment and secondary prevention with linkages to ART services
3. Referral of about than 1,225 PLWHA for care and treatment services, including ART if eligible.
4. Broadcast of 306 radio spots on ARV treatment and adherence.
FY09 funds will complement and build on other PEPFAR-funded efforts, including Ministry of the Fight
Against AIDS (MLS) and JHU/CCP activities to develop effective BCC materials and approaches and
mobilize faith-based communities and opinion leaders and Ministry of Health (MOH) and EGPAF/ACONDA
support for expanded ART, palliative care, and CT.
Key activities and approaches during FY09 will include:
1. Assessment of stigma and treatment literacy in six departments, with prioritization of needs and available
support. These will be conducted in partnership with the national network of PLWHA organizations (RIP+),
and results will complement other available sources of data, including the 2005 AIDS Indicator Survey.
2. Training of 116 health workers in the two new departments, including 40 in rural health centers, in ART
referral, monitoring, and support
3. Training of 96 community counselors to provide counseling and education on treatment, positive living,
and prevention for positives using local languages, in partnership with RIP+
4. Training of 72 traditional healers and 150 religious leaders in HIV/AIDS to promote referral and counter-
referral to appropriate health care facilities
5. Training of 22 nurses from Abengourou in treatment adherence
6. Training of 24 community counselors from Abengourou in treatment adherence
7. Promotion of awareness and adherence to treatment and secondary prevention with establishment of
linkages between community-based and ART services
8. Referral of 1,190 newly identified PLWHA to care and treatment, including ART if eligible
9. Broadcast of 400 radio spots on ARV treatment and adherence
10. Evaluation of the project's treatment adherence and support services
ANADER will continue to support and strengthen a community-based M&E system to track implementation
of activities using national and USG tools in order to improve the quality of service provision and to provide
data on management of care and treatment for PLWHA at the community level. These data will be collected
by the village action committees using simple tools and will be transmitted to district, regional, and central
units. The reporting will occur monthly at the regional level and quarterly at the central level.
Activity Narrative: ANADER strives to strengthen capacity among CBOs and village and district AIDS action committees to
Continuing Activity: 15148
15148 5485.08 HHS/Centers for National Agency of 7060 5315.08 U62/CCU02512 $100,000
9927 5485.07 HHS/Centers for National Agency of 5315 5315.07 U62/CCU02512 $85,000
5485 5485.06 HHS/Centers for National Agency of 3731 3731.06 U62/CCU02512 $75,000
Construction/Renovation
Estimated amount of funding that is planned for Human Capacity Development $60,000
Estimated amount of funding that is planned for Food and Nutrition: Commodities $30,000
Table 3.3.09:
Continuing Activity: 15146
15146 5480.08 HHS/Centers for National Agency of 7060 5315.08 U62/CCU02512 $1,050,000
9934 5480.07 HHS/Centers for National Agency of 5315 5315.07 U62/CCU02512 $800,000
5480 5480.06 HHS/Centers for National Agency of 3731 3731.06 U62/CCU02512 $450,000
* Child Survival Activities
Estimated amount of funding that is planned for Human Capacity Development $430,000
Estimated amount of funding that is planned for Food and Nutrition: Commodities $150,000
Estimated amount of funding that is planned for Economic Strengthening $180,000
Estimated amount of funding that is planned for Education $200,000
Table 3.3.13:
The activity narrative is basically the same as in COP08, with updated numbers. Part of the FY08 strategy
relying on finger-prick testing has not yet been implemented because of delays in approval of a new
algorithm permitting the finger-prick technique.
The implementing consortium brings together the expertise of:
ANADER's CT activities complement the integrated and free-standing CT services provided by PEPFAR-
funded partners ACONDA, EGPAF, PSI, and FHI by extending mobile and fixed-site CT services and
promotion to rural areas while strengthening a referral network linking CT services to HIV prevention,
PMTCT, palliative care, OVC care, and treatment services.
Overall project strategies rely on village HIV/AIDS action committees in 24 to 26 villages in each of six
ANADER interventions areas covering ten departments and draw on ANADER's risk-mapping approach,
which includes segmenting village populations to allow young women, young men, older women, and older
men to discuss sexuality and HIV-related risks and risk-reduction strategies separately and together. Local
HIV/AIDS action committees and community counselors are trained and supported in applying culturally
appropriate BCC strategies, curricula, and educational materials with ABC prevention and CT promotion
messages. Activities include coordinated BCC campaigns mediated by influential figures and peers and
using methods of proximity (debates, sketches, videos, peer education, traditional events, etc.) in the
community, schools, sporting fields, mosques, and churches, reinforced by radio in local languages.
Traditional and religious leaders are empowered through tools such as the HIV/AIDS lexicon and use of
addressing issues of negative gender attitudes and HIV-related stigma and discrimination.
Trained community counselors (three per village site) and ANADER rural development agents conduct
community-mobilization, CT uptake-promotion, and stigma-reduction activities (using existing tools such as
a documentary film on PLWHA testimonials). They join the mobile-unit staff in providing counseling and
testing, TB screening, HIV prevention education, and referrals for ART and care. They also provide
psychosocial support for PLWHA and follow up with home-based care and support, OVC care, and ART
adherence support.
With FY06, FY07, and FY08 funds, the project initiated and is providing mobile-outreach CT and basic
health and support services at 146 village sites in the departments of San Pedro, Dabou, Jacqueville,
Sikensi, Abengourou, Tanda, Koun-Fao, Bondoukou (Sandégué), Soubré, and Daloa, covering five regions.
Two mobile CT units serving seven districts were installed in FY06, with training for 444 community
counselors (from village action committees and ANADER) and other community members, and a third
mobile CT unit is expected to begin services with FY08 funding.
In addition, CT services are provided at rural health centers supported by subpartner ACONDA. ACONDA
has trained 30 health providers from rural health centers in CT screening and 60 health workers in
counseling, and 31 rural health centers have been equipped for CT services.
HIV/AIDS action committees have been strengthened in all 146 villages through training and provision of
one sensitization kit per committee. REPMASCI developed and broadcast 18 radio spots in six local
languages using its HIV/AIDS lexicon, as well as preparing and delivering video/film projections with
community discussion. Communication campaigns were conducted in 2007 and 2008 to promote CT in the
146 rural sites.
From the beginning of the project's mobile CT services to the end of June 2008, 24,894 people in the
villages had received HIV counseling and testing with receipt of test results, including 20,581 through
mobile CT service delivery. The project's target of testing 31,130 people between April 2008 and March
2009 assumed that a third mobile unit would begin service and that a new algorithm permitting finger-prick
testing would be approved - neither of which had occurred as of October 2008.
CT quality assurance is provided through supervisory visits with regional and local health district teams.
Quality assurance for HIV tests is provided by the RETRO-CI laboratory in collaboration with the National
HIV/AIDS Care and Treatment Program (PNPEC) and local health authorities. Project activities were
coordinated through village, district, regional, and national fora, in consultation with relevant ministries and
other PEPFAR partners.
FY09 funds will be used to continue and strengthen FY07 and FY08 activities in all departments. Activities
will incorporate lessons learned and sustainability strategies identified during the first three project years,
including the importance of retraining community counselors; of conducting regular supervision of these
Activity Narrative: counselors to ensure quality service provision; of repeated exposure to health messages (particularly in
small-group or individual settings) to achieve behavior change; of communication and coordination with
partners at the local, regional, and national levels; and of finding ways to motivate community counselors.
The project will seek to take advantage of a simplified national testing algorithm (expected within the year)
permitting the use of finger-prick, whole-blood rapid tests by lay personnel. Once rapid tests are available,
ANADER will work with the USG team to devise and implement a strategy for their introduction and use in
coordinated, carefully monitored approaches that may include community- and home-based testing, with the
mobile units switched to a supervisory function.
The project expects to test 33,000 people by September 2009 if finger-prick testing is approved and
routinely available by December 2008. This includes 19,200 via the mobile CT units, 8,500 via door-to-door
CT, and 5,300 at the rural health centers.
1. Refresher and/or updated training in CT for 292 community counselors and 146 nurses.
2. Training for 34 health workers (replacement health workers) in CT and for 62 health workers (two per
center) in counseling.
3. Training of 144 community counselors (two per village selected) in the new algorithm using the finger-
prick technique
4. Training of 97 health workers from rural health centers without integrated CT services in counseling and
testing (including training in the new algorithm and rapid tests, if approved) for on-site supervision of
community counselors
5. Mobile CT services to 19,200 clients by September 2009, in 146 villages.
6. CT services to 5,300 clients by September 2009 at 31 rural health centers with integrated CT.
7. Door-to-door CT services to 8,500 clients (30 per month in each of 72 villages selected) if the approach is
validated
8. On-site coaching and supervision of community counselors and health workers
9. Supervision by PSI and ACONDA, in collaboration with health district and ANADER staff, of all CT
activities.
10. Referral of an estimated 1,657 clients tested HIV-positive (1,225 if the door-to-door approach is not
implemented) to health facility-based care and treatment
11. Ensuring CT service quality using referral laboratory services
12. Equipment of 146 village action committees with one motorcycle per village to facilitate CT, prevention,
and care activities in surrounding villages
13. Reinforcing referral systems among CT services and community- and home-based palliative care and
OVC services.
14. Broadcast of 400 radio spots on voluntary CT
15. Evaluation of CT activities.
ANADER will continue to implement an M&E plan based on national and USG requirements and tools and
will contribute to implementation of an integrated M&E system in collaboration with national and
international stakeholders, including the ministries of AIDS, Health, and Social Affairs.
Continuing Activity: 15147
15147 5482.08 HHS/Centers for National Agency of 7060 5315.08 U62/CCU02512 $350,750
9933 5482.07 HHS/Centers for National Agency of 5315 5315.07 U62/CCU02512 $350,000
5482 5482.06 HHS/Centers for National Agency of 3731 3731.06 U62/CCU02512 $300,000
Estimated amount of funding that is planned for Human Capacity Development $382,000
Table 3.3.14:
