Detailed Mechanism Funding and Narrative

Years of mechanism: 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 16691
Country/Region: Côte d'Ivoire
Year: 2013
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health
Organizational Type: University
Funding Agency: USAID
Total Funding: $2,150,000

This new mechanism (JHU.CCPs HC3 project) will build on, continue, expand, and refine activities by the same partner previously funded through a bilateral award (ending in 2013) while also providing technical assistance for the establishment of an Ivoirian NGO to which this work can be transitioned over the next two years.

The goals of these activities continue to be a reduction in the number of HIV infections and stronger national capacity to provide high-quality HIV/AIDS prevention, care, and treatment services and improve the lives of people living with or affected by HIV/AIDS. With COP 2013 funding, CCP will build on activities under the bilateral award (described in previous COPs), refine them to reflect emerging data on the epidemic in Côte dIvoire (e.g. DHS 2012), and enhance the effectiveness of communication in promoting HIV service uptake, ART adherence, community-based care/support efforts, healthy social norms, and couple communication.

Project objectives include:

Delayed sexual debut (ages 15-19).

Partner reduction and increasing consistent and correct condom use (ages 19-24).

Reduced high-risk behaviors through increased knowledge, risk perception, skills, and access to quality services (ages 18+).

Dialogue and reflection that encourages healthy social and gender norms (ages 18-30).

Reducing stigma/discrimination and increasing psychosocial support for marginalized groups (e.g. MSM, sex workers) and other groups affected by HIV (e.g. OVC).

Increasing uptake and adherence in HIV/AIDS services.

Increasing HIV risk perception among adults and HIV testing by couples

Building the capacity of the Ivoirian government, technical working groups, NGOs, and associations to develop, implement, coordinate, and monitor effective HIV preventi

Funding for Care: Orphans and Vulnerable Children (HKID): $50,000

This new mechanism (JHU.CCPs HC3 project) will continue, expand, and refine activities by the same implementing partner funded and described in previous COPs under a bilateral award (ending in 2013).

With COP 2013 funding, CCP will continue to support the ministries in charge of social affairs, including the National OVC Program (PNOEV), in efforts to provide care and support to OVC and their families. CCP will continue to provide technical assistance in the areas of capacity building, BCC material development, implementation, and evaluation. The learning by doing and on-the-job training approach will enable CCP to strengthen and expand the capacity of PNOEV staff to deal with issues such as developing and implementing awareness campaigns for the general public on issues related to OVC and human rights and creating high-quality BCC materials to raise awareness about the vital need for OVC protection and care in post-conflict situations.

Funding for Health Systems Strengthening (OHSS): $200,000

This new mechanism (JHU.CCPs HC3 project) will build on, continue, expand, and refine activities by the same partner previously funded through a bilateral award (ending in 2013) while also providing TA for the establishment of an Ivoirian NGO to which this work can be transitioned over the next two years.

Using COP 2013 funds, CCP will continue activities to strengthen national capacity to design, produce, implement, coordinate, evaluate, and scale up high-quality social and behavioral change communication (SBCC) tools, materials, and strategies. CCP will work to build this capacity at the Ministry for Health and AIDS (MSLS) and in local NGOs and networks through targeted training , materials development, and ongoing guidance and mentoring.

Using measurable outcomes for capacity building, CCPs approach will emphasize the devolution of interventions, learning by doing, formal training within the University of Abidjan, and specific capacity and coordination strengthening at the MSLS. Illustrative activities include:

TA to build the capacities of the MSLS, the Prevention BCC Technical Working Group, and the National Program for Highly Vulnerable Populations (PLS-PHV) in evaluation design, research methods, analysis of qualitative and quantitative data, and results dissemination. At the community level, the project will provide TA to local implementing partners focused on behavioral interventions.

TA to the PLS-PHV) to update its communication strategy and produce BCC materials targeting key populations and other higher-risk sub-populations.

Support for the University of Abidjan to conduct CCPs Leadership in HIV/AIDS Strategic Communication workshop annually, targeting program managers at ministries, key civil society groups, and journalists.

Continued side-by-side work with project staff to develop multimedia campaigns, ensuring message harmonization and building partner capacity at the same time.

TA to the MSLS for the effective implementation of the National HIV/AIDS Communication Strategy.

Continued assistance and mentoring to the Ivoirian NGO Ruban Rouge to expand its free national InfoSIDA hotline services to reach and serve key populations (such as MSM), with a focus on documented links to referral for HIV testing or other services, and potential use as a feedback source about quality of care and service delivery access barriers for patients.

Work to identify and foster public-private partnerships, with the aim of strengthening the national HIV/AIDS response through co-financing, capacity building, and broad stakeholder engagement.

Strengthen post-exposure prophylaxis (PEP) capacities at the national level through an assessment of the implementation of PEP guidelines and development of job aides for health professionals to facilitate guideline implementation.

Finally, in alignment with USAID/PEPFAR CI strategies for transitioning to national/local structures, CCP in 2013 is beginning the process of establishing an Ivoirian NGO that is expected to take over program activities in 2014 or 2015. CCP's Baltimore headquarters will provide technical support for this process and will sit on the board of directors of the new NGO. A transition plan will guide the creation of the NGO by the end of 2013. JHUs in-country staff will gradually be transitioned to the new NGO.

Funding for Biomedical Prevention: Blood Safety (HMBL): $50,000

This new mechanism (JHU.CCPs HC3 project) will continue, expand, and refine activities by the same implementing partner funded and described in previous COPs under a bilateral award (ending in 2013).

In Cote dIvoire, the availability and safety of blood transfusion remain critical concerns for the government and its partners. As part of its strategy to decrease the number of new HIV infections in Cote dIvoire, CCP will continue to support the Ministry of Health and AIDS and the National Blood Bank (CNTS) in their efforts to ensure a safe blood supply. CCP will provide technical assistance to the MSLS and CNTS to assess, develop, update, produce, and evaluate BCC materials; revitalize safe blood donation campaigns based on CNTSs recent KAP (Knowledge, Attitude and Practice) study and a future formative study; and develop a strategic communication plan to improve mobilization and retention of new blood donors around renovated CNTS sites.

Funding for Biomedical Prevention: Injection Safety (HMIN): $50,000

This new mechanism (JHU.CCPs HC3 project) will continue, expand, and refine activities by the same implementing partner funded and described in previous COPs under a bilateral award (ending in 2013).

Although no longer a primary vehicle for HIV infection, injections continue to be an important transmission risk that must be addressed in any comprehensive HIV prevention strategy. CCP will provide technical assistance to build the capacity of relevant Ministry of Health and AIDS (MSLS) entities and other PEPFAR implementing partners to provide appropriate messages promoting injection safety

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $500,000

This new mechanism (JHU.CCPs HC3 project) this will build on, continue, expand, and refine activities by the same implementing partner funded and described in previous COPs under a bilateral award (ending in 2013).

Project planning is based on available data and knowledge, including:

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Disproportionate risk of HIV infection for women and girls, and high HIV prevalence rates among older women and men.

A lack of focus on men in many previous HIV prevention efforts

A practice deeply rooted in the local culture of having multiple sexual partners, particularly overlapping or concurrent partnerships

The widespread practice of transactional/intergenerational sex between older men and younger women.

Low HIV risk perception and low condom use among adult populations (estimated at 30% among women and 33% among men, DHS 2012)

Fear, stigma, and discrimination associated with HIV status and sexual orientation that prevent victims from seeking help, care, and treatment.

Prevention activities targeting youth will continue to address both developing risk behaviors and norms. Priority topics include social/gender norms, risk perception, transactional sex, delay of sexual debut, couple and parent-child communication, pregnancy prevention, partner reduction, and condom use. Young people will be segmented and prioritized by gender, age bracket, and risk factors (e.g. uneducated/out of school, poor, etc.).

Continuing interventions will include SuperGo (targeting out-of-school girls), Sports for Life (girls and boys ages 15-24) including parent-child communication, and African Transformation (young women and men). They will be implemented by seven of JHU.CCPs historically strongest local NGO subpartners and will focus on two higher-prevalence areas (Yopougon and Abengourou), in an effort to achieve and measure significant local impact.

CCP will consider participants as sentinel communities that will provide: a) ongoing data to inform the projects understanding of priority behaviors; b) assessments of change in social and gender norms and other community-level characteristics that may influence individual and collective behaviors; and c) rapid assessments of reactions to community-level communication messages and activities.

Subpartner peer educators or community health workers will refer participants to HIV testing and counseling services after community activities, and participants will be encouraged to share their experience to benefit their communities.

Tools such the Sports for Life Captains Guide and Extra Time magazine will be revamped to integrate issues such sexual and reproductive health, condom use, alcohol, and gender norms.

Activities will be assessed through a project evaluation to determine whether target populations have made targeted changes in behavior.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $1,000,000

This new mechanism (JHU.CCPs HC3 project) will build on, continue, expand, and refine activities by the same partner funded and described in previous COPs under a bilateral award (ending in 2013).

Activities in the HVOP budget code will continue to address both risk behaviors and norms. Priority topics include social/gender norms, risk perception, transactional sex, couple communication, pregnancy prevention, partner reduction, multiple concurrent partnerships, alcohol use, and condom use.

Activities (building on previous activities by the same partner) will include a TV miniseries that addresses multiple issues in an entertaining way and serves as an umbrella/air support/reinforcement for other activities and communication interventions addressing risky behaviors, capable of being repurposed and used in a variety of settings beyond the broadcast media. After the conception, production, pre-test and diffusion of the six first episodes in late 2013, the series will continue to be broadcast on national broadcast channels.

CCP will work to obtain support from other partners such as large communication companies and to mobilize policy makers from the Ministry of Health and AIDS (MSLS) and the Ministry of Communication to leverage discounted broadcast time.

A radio version of the TV series will be developed for rural audiences, and a discussion guide will accompany the DVD of the series. DVDs and discussion guides will be distributed to partners; screenings and facilitated discussions will be organized at workplaces.

A multi-channel, multi-level campaign around risk and prevention behaviors will accompany the TV series and will serve as learning in action opportunity for local partners. The campaign will include radio, TV talk shows, print materials, a Web site, bus campaigns, and social media.

CCP will also assess and adapt HIV risk assessment tools that have been developed in other countries to be used by health providers, peer educators/coaches, and community mobilizers to approach and maintain relationships with target audiences and ensure proper risk assessment.

CCP will link activities with existing condom social marketing promotion programs to ensure that target groups (including MSM, female and male sex workers, and people living with HIV) know where to get free condoms and how to use them correctly.

CCP will engage non-health sector policy makers, civil society leadership in addressing social norms and raising awareness on gender issues among the general population by promoting African Transformation profiles and organizing TV talk shows around the six themes.

CCP will provide technical support to the national rural development agency ANADER to use radio to address gender norms in rural areas.

CCP will also work with national TWGs to harmonize and set gender standards in HIV messages based on the National BCC Strategy; work to facilitate community dialogue through radio and TV on cultural factors and norms that perpetuate discrimination and gender-based violence; and strengthen the gender component of the Friday Package (for Muslim leaders) and Sunday Package (for church leaders).

All the projects interventions will address social and cultural norms that underlie discriminatory attitudes toward PLWHA, MSM, and CSW. Positive deviants will be identified as public role models. Given the significant number of sero-discordant couples in CI, an emphasis will be placed on involving men in supporting and empowering women.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $200,000

This new mechanism (JHU.CCPs HC3 project) will continue, expand, and refine activities by the same implementing partner funded and described in previous COPs under a bilateral award (ending in 2013).

Access to high-quality social and behavioral change communication (SBCC) tools, materials, and strategies is important in order to be effective in mobilizing and providing quality services for clients. JHU/CCP supports HIV/AIDS services (testing and counseling (TC), ART, PMTCT, care and support) through development, provision, and evaluation of client and provider materials; provider training in interpersonal communication/counseling (IPC/C), strengthening of health protocols through communication indicators; and promotion of HIV/AIDS services.

As a complement to PEPFAR-funded service-delivery programs, CCP will use COP2013 funding to identify and fill needs for communication materials and approaches for PMTCT (including rollout of new WHO recommendations), ART, TC, and stigma reduction to health service providers and community organizations. CCP will support training for service providers to strengthen their skills, knowledge, and practices, and for PLWHA organizations, religious leader associations, and local NGOs to carry out community activities, e.g. through use of radio diaries, existing films on PMTCT and ART, and talk shows on stigma and care/support. Existing radio diaries will be expanded to include other target audiences such us MSM, sex workers, and OVC, and will be broadcast on community radio to support community activities (listener groups).

CCP will provide technical assistance to service delivery partners to supervise their projects achievement of communication quality indicators.

To address low levels of male-partner involvement in PMTCT and other womens health issues, CCP will continue to work with EngenderHealth and other PEPFAR partners to promote HIV testing targeting men ages 25- 45, including the use of new Ivoirian role models and giant-screen projections of matches during the soccer World Cup, with on-site HIV testing and counseling.

Funding for Treatment: Adult Treatment (HTXS): $100,000

This new mechanism (JHU.CCPs HC3 project) will continue, expand, and refine activities by the same implementing partner funded and described in previous COPs under a bilateral award (ending in 2013).

CCP support for HIV/AIDS services (HIV testing, ART, PMTCT, care and support) has included development and provision of client and provider informational materials, videos, provider training in interpersonal communication and counseling, and promotion. With COP 2013 funding, CCP will build on these activities and continue support to service delivery partners, with a focus treatment adherence and stigma reduction.

CCP will work with the PEPFAR CI team, other PEPFAR partners, and the national counterparts to support and complement ongoing activities to identify and address barriers to ART initiation and adherence, including the role of stigma. Illustrative activities include development of an ART behavior change communication strategy designed to de-stigmatize HIV services, promote referrals to HIV testing and counseling, strengthen contact tracing, and support positive living and ART adherence; strengthened initiatives with PLWHA networks to better track and support HIV patients and treatment defaulters. CCP will work to foster a supportive environment for ART services via the mass media, including TV, radio, and videos. CCP will emphasize de-stigmatization and access to testing, care, and treatment services for men who have sex with men.

Subpartners Total: $0
Groupe Biblique des Hopitaux: NA
Mouvement Action Jeunes: NA
Reseau de la Jeunesse pour la Promotion de l'Aphabetisation et la Lutte contre le VIH sida: NA
Ruban Rouge: NA
Secours Plus: NA
Sidalerte International: NA
Univers Sante: NA
Cross Cutting Budget Categories and Known Amounts Total: $1,445,000
Education $50,000
Gender: Gender Equality $300,000
Human Resources for Health $895,000
Key Populations: FSW $100,000
Key Populations: MSM and TG $100,000
Key Issues Identified in Mechanism
Implement activities to change harmful gender norms & promote positive gender norms
Increase gender equity in HIV prevention, care, treatment and support
Increasing women's access to income and productive resources
Child Survival Activities
Tuberculosis
Family Planning