Noted April 17, 2008: AVSI will also provide subgrant funding and technical assistance to several

subpartners formerly supported through Alliance National Contre le SIDA.

About 864,000 children in Cote d'Ivoire, or 16% of the country's population under age 18, have been

orphaned or otherwise made vulnerable by HIV/AIDS (National AIDS Indicator Survey, 2005), including

about 80,000 who are living with HIV. These OVC rates do not vary significantly by gender or urban/rural

residence, but they increase markedly with age, from about 9% of infants to 25.3% of the 15-17 age group.

OVC rates are lowest in the North (4.2%) and Northwest (7.2%) and highest in the South (18.4%) and in

Abidjan (18.2%).

Institutional and community-based services for HIV-affected families are limited, especially outside Abidjan.

The country's extended politico-military crisis disrupted social, health, and education services and economic

activity, increasing child vulnerability, and PEPFAR is the only major donor for OVC activities in the country.

This lack of major partners has presented challenges for identifying and serving large numbers of OVC. As

of March 2007, 24,234 children were receiving OVC services with direct USG support, less than 3% of the

OVC population.

With USG support, the country has taken important steps toward ensuring OVC care and support within

families and communities through policy, standard criteria for services, coordination, capacity-building for

NGO/CBO/FBOs, and training of trainers and caregivers. Under the leadership of the National OVC

Program (PNOEV) of the Ministry of the Family, Women, and Social Affairs (MFFAS) and the national think

tank on OVC (CEROS-EV), PEPFAR partners are preparing to scale up OVC services by building the

capacity of local organizations to identify, assess, and meet the needs of OVC while strengthening systems

to coordinate, manage, and track progress at the local, district, and national levels. The PEPFAR target for

FY08 is to reduce the vulnerability of 63,000 OVC.

To help reach this ambitious goal, the USG in FY08 will fund an experienced international or national

partner to provide direct care for OVC as well as sub-grants, capacity building, and mentoring for local sub-

partners and leadership in district-level and regional coordination and quality assurance.

Intervention sites in underserved parts of the country will be selected in consultation with the PNOEV and

USG team based on mapping of OVC needs and resources. All project activities will be coordinated with the

PNOEV and will follow and support the national HIV/AIDS and OVC strategic plans. The partner will work

with other PEPFAR partners (CARE International, ANADER, Hope Worldwide Cote d'Ivoire, Alliance Cote

d'Ivoire) and other donors to avoid duplication and maximize synergies.

The partner will serve both as a model provider of direct OVC care, using evidence-based and innovative

approaches reflecting international best practices and lessons, and as financial and technical assistance

provider and mentor to local sub-partners providing direct care. Altogether, project activities will provide

primary direct services for at least 3,500 OVC in the first year.

Identification of OVC will be conducted at service entry points in PMTCT, CT, and health-care settings and

by community committees and local NGO/FBO/CBOs. Initial needs assessment and household follow-up

will be conducted using the Child Status Index. A central part of the project strategy will be to build linkages

that allow any child living in an HIV-affected household to receive comprehensive services, including

pediatric HIV treatment if needed, with referrals and follow-up to ensure integrated care.

Based on assessment of individual needs, the project will ensure that OVC receive comprehensive care and

support, including health care, social protection, psychosocial and spiritual support, educational support,

nutritional assessment and support, legal assistance, and HIV prevention services.

To help build sustainable systems of care, the partner will provide financial and technical assistance and

training to strengthen the organizational, management, M&E, and technical capacities of local sub-partners

to identify OVC, assess their needs, and provide referrals and quality care with appropriate monitoring of

the children's status. The partner will create or reinforce links to health care (including HIV testing, PMTCT,

and ART sites), educational, and social services to ensure that children benefit from effective referrals

within a continuum of care. Local caregivers will be cross-trained to provide home-based palliative care

services.

The partner will participate actively, and will require sub-partners to participate actively, in building PNOEV-

supported collaborative "platforms" using social centers as a base for coordinating OVC-related activities in

a given geographic area.

The partner will work with the PNOEV and CEROS-EV to develop strategies for meeting the needs of

especially vulnerable children and youth, including training and preparation for work for older OVC,

nutritional support for younger children, and income generation, psychosocial support, and HIV prevention

for girls and young women.

The project will implement an M&E plan tracking project-specific as well as PEPFAR and national indicators

and will participate in harmonizing indicators and building a national OVC database. The partner will report

to the USG strategic information team quarterly program results and ad hoc requested program data. To

help build a unified national M&E system, the partner will participate in quarterly SI meetings and will

implement decisions taken during these meetings.