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
Since its creation in 2002, the Ivorian NGO of health professionals, ACONDA-VS, has provided innovative,
comprehensive, family-based care services in support of the Ministry of Health PMTCT and HIV treatment
programs. ACONDA defines a holistic approach to care . It seeks to provide a complete and integrated
package of quality services that includes prevention (CT, PMTCT, secondary sexual prevention); adult,
child, and family care (ART, OI prevention and treatment, and promotion of "positive living"); and
psychosocial support and a continuum of care through links with local PLWHA and community
organizations. ACONDA is rapidly expanding its family-based model. After working as a sub-partner to
EGPAF (Project HEART) starting in 2004,
From October 2007 to September 2008, ACONDA provided HIV counseling and testing to 21,878 pregnant
women, of whom 1,977 (9%) were found to be HIV-positive. Among these, 811 (41%) were provided with
ARV prophylaxis. ACONDA also trained 169 health providers at 70 sites.
By September 2009, ACONDA aims to extend services to 22 more sites, for a total of 92 PMTCT sites. At
these sites, ACONDA expects to provide HIV counseling and testing to at least 43,000 pregnant women
and ARV prophylaxis to at least 1,720 HIV-infected pregnant women. To support these sites, ACONDA will
train 263 health workers in the provision of PMTCT services using the previously developed national
PMTCT training materials.
In FY09, ACONDA will continue to support its FY08 PMTCT sites while contributing to the scale-up and
decentralization of PMTCT linked with HIV care and treatment services. ACONDA aims to improve access
to PMTCT services to underserved and rural populations, enhance uptake of services, improve population
coverage, promote quality and evidence-based practices, and integrate PMTCT and HIV care into routine
health services with involvement of the district health team. ACONDA will adhere to national standards, will
remain a member of the PMTCT technical consultative forums, and will provide input to national policies
according to evidence-based practices. ACONDA will also remain a member of the national committee for
HIV-related commodities. ACONDA will create a permanent collaboration framework with the National
HIV/AIDS Care and Treatment Program (PNPEC), EGPAF, ICAP-Columbia University, and other PMTCT
stakeholders (UNICEF, WHO, ESTHER, UNFPA) to harmonize PMTCT technical procedures and manuals.
In FY09, primary interventions will include:
•Train nurses and midwives in rural areas to perform HIV rapid testing (finger prick) using the new algorithm
and monitor their performance.
•Train midwives and staff in delivery rooms to perform HIV rapid testing in all PMTCT sites in order to
improve uptake of HIV testing at the time of delivery
•Provide ongoing technical support to all sites and ensure that sites have and adhere to national standards
and protocols by conducting on-site training, regular site assessments,supportive supervision, and
laboratory quality assurance, and.
•ACONDA will implement provider-initiated counseling and testing (PICT) in all PMTCT sites, antenatal
clinics, labor and in-patient or out-patient pediatric wards, nutritional rehabilitation and family planning
centers.
•ACONDA will strive to provide the prophylactic ARV combination regimen to all HIV-infected pregnant
women before the CD4 count results are availble at all supported sites. ART eligible women will initiate
antiretroviral therapy during pregnancy or after delivery as appropriate.
•All ART-eligible women will initiate treatment based on national guidelines and receive ongoing care and
support at HIV clinics and community-based sites. ACONDA will provide care for HIV-infected women and
their babies during postnatal visits.
•Systematic referrals of all HIV-infected pregnant women to clinical and home-based care and treatment
services by linking PMTCT sites with care and treatment services.
•Improve infant follow-up and provide early infant diagnosis and clinical monitoring to all HIV-exposed
children and subsequently link mothers and children to community-based care and support services. The
program will also encourage HIV-positive women to bring their family members in for CT.
•Work with the Partnership for Supply Chain Management (SCMS) and the Public Health Pharmacy (PSP)
to procure and regularly supply PMTCT sites with drugs and laboratory commodities
•Be involved in the revision of the medical charts and registers, incorporating data related to the monitoring
of PMTCT activities.
•Hire and train community counselors to provide PMTCT services starting in sites with a high patient volume
in order to strengthen linkages with care and treatment services
Support MOH staff in each district to integrate PMTCT with other services, such as family planning and
nutritional support. MOH staff will also provide training, supportive supervision, and M&E assistance to aid
the progressive transfer of capacity to the district health team.
•ACONDA will support health districts with equipment, rehabilitation, and technical assistance for the
management of data. ACONDA will improve the quality of data gathered at sites through supervision and
training of data managers. ACONDA will help each site develop and implement a comprehensive M&E plan
that will also identify collaborations with key partners. ACONDA will report to the USG strategic information
team quarterly program results and ad hoc requested program data. To help build a national M&E system,
ACONDA will participate in quarterly SI meetings and will implement decisions taken during these meetings.
•Strengthen collaboration with other organizations supported by PEPFAR (FANTA-PATH) for the nutrition of
the women and children from the PMTCT services and/or from the paediatric Care and Treatment at sites
backed by Aconda.
•Work with URC and JHPIEGO and in collaboration with PNPEC to improve the quality of PMTCT services.
The collaboration with JHPIEGO aims to meet the performance standards set by the National Program
(PNPEC). In FY08, 5 sites were supported and 10 additional sites will be included in FY09. URC will provide
assitance in improving the quality of the overall HIV care and treatment services. CDC/Retro-CI will help in
improving the quality of laboratory testing at all ACONDA supported-sites.
•Raise public awareness in the general population and among health care providers to reduce stigma and
discrimination related to PLWHA
At all sites, ACONDA will provide - either through direct hire or by contracting with individuals or local
organizations - counselors dedicated to providing a comprehensive package of HIV prevention
Activity Narrative: interventions for all clients and effective referrals for persons living with HIV/AIDS and their children.
ACONDA will engage enough counselors (funded in part through AB, Condoms and Other Prevention,
OVC, and palliative care funds) to allow every site to provide this prevention and referral package to all
clients.
All clients who test HIV-negative will be referred (on an opt-out basis) to a counselor for behavior-change
communication interventions, delivered individually or in small groups, focusing on risk reduction through
abstinence and fidelity, with correct and consistent condom use for those engaged in high-risk behavior, as
well as partner testing and STI prevention and care.
HIV-positive clients will be referred (on an opt-out basis) to a counselor for individual counseling that will
include HIV prevention interventions and referral to community-based OVC and palliative care services to
address family and individual care needs. Targeted HIV prevention counseling will focus on risk reduction
through abstinence, fidelity, correct and consistent condom use, disclosure, testing of partners and children,
and STI prevention and care. Where possible, family-planning counseling and services will be provided to
patients and their partners through wraparound programming by other non-PEPFAR funded partners, and
condoms will be provided free of charge.
In addition, all HIV-positive clients will be offered information about and referrals to specific community-
based OVC care and palliative care services tailored to their needs. With assistance from the National OVC
Care Program (PNOEV) and the PEPFAR in-country team, ACONDA will ensure that community-based
services capable of meeting these needs are identified, and ACONDA will be responsible for monitoring and
reporting on referrals according to a nationally standardized referral system.
Despite impressive growth and achievements, the expansion of ACONDA's program faces two main
challenges: the need to improve the quality of services and the effective involvement of local actors.
ACONDA is committed to addressing these challenges in the coming year in order to sustain the program
by implementing the following strategies:
- Reinforce the district approach: Develop procedure manuals and planning tools to strengthen technical
capacities of the district; entirely shift training and coaching of field staff to the district team; implement
performance-based financing in selected districts and sites; and establish micro-planning activities with
districts.
- Mobilize human resources at the decentralized and local levels to provide ongoing support to sites:
Develop local expertise at district and/or regional levels by establishing pools of regional and/or district
trainers who will be tasked to monitor and improve service quality.
- Strengthen capacities of community-based organizations to provide care and support to patients in the
community
- Strengthen coordination with the National HIV/AIDS Care and Treatment Program (PNPEC) and
decentralized entities at the district and /or regional levels.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16759
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16759 10040.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $1,750,000
Disease Control &
Prevention
10040 10040.07 HHS/Centers for ACONDA 5309 5309.07 ACONDA CoAg $1,100,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Safe Motherhood
* TB
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $200,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $20,000
and Service Delivery
Food and Nutrition: Commodities
Estimated amount of funding that is planned for Food and Nutrition: Commodities $30,000
Economic Strengthening
Education
Water
Table 3.3.01:
Facility-based health services represent a critical opportunity to impact client behavior through clear,
authoritative health messages delivered in one-on-one or small-group settings, as well as to connect clients
efficiently and effectively with community-based care services. To use the opportunity to reduce risk
behavior and thus HIV transmission, all PEPFAR Cote d'Ivoire ART and PMTCT service providers will
ensure that their package of services includes HIV prevention behavior-change communication promoting
risk reduction through abstinence, fidelity, correct and consistent condom use, status disclosure, partner
testing, and STI prevention and care targeting both HIV-positive and HIV-negative clients. In addition, they
will ensure that all HIV-positive clients are offered effective, monitored referrals to community-based OVC
and palliative-care services.
This entry represents the Abstinence and Being Faithful portion of the comprehensive prevention package.
Counselors will be trained to assess and address sexual risk behavior and to deliver tailored AB messages
using culturally appropriate visual aids. In each of these interventions, patients are encouraged to remain
abstinent to protect their own health and avoid transmission to partners. Patients who are sexually active
are also encouraged to remain faithful to one partner. Abstinence is also promoted in the family planning
and STI trainings as a method of preventing pregnancy and STI transmission.
ACONDA will implement prevention strategies involving abstinence in close collaboration with other national
and PEPFAR partners with experience in this domain. Community health workers will play a key role in
delivering prevention messages and in making these activities sustainable, with their involvement from the
beginning to the end of these activities. ACONDA has signed agreements with community based NGOs and
will work with each of them to develop individual operational plans.
Activities related to prevention targeting youth will be developed and implemented in close collaboration
with implementing partners, such as Hope WW and PSI. ACONDA's activities targeting youth will include
the establishment of community networks of peer educators in coordination with school based activities
supported by the Ministry of Education; these youth groups will focus on addressing issues related to
abstinence and reduction of risky sexual behavior.
ACONDA's activities targeted towards parents will include HIV prevention education; strengthening
interpersonal communication skills to help them encourage their children to choose abstinence and delayed
sexual debut; and support for creation of parent focus groups to discuss problems related to the education
of adolescents.
ACONDA will support training on prevention through abstinence and fidelity in responsible relationships for
the local health workers engaged in supporting this activity in their communities in association with care and
treatment sites. The NGOs engaged by ACONDA to deliver these community based prevention services will
be encouraged to sign agreements with health centers to ensure a coordinated referral process for HIV
counseling and testing.
HIV-negative clients at PMTCT and CT sites:
All clients who test HIV-negative will be referred (on an opt-out basis) to a counselor for behavior change
abstinence, fidelity, minimized alcohol use, partner testing and STI prevention and care. For those engaged
in high-risk behavior, the OP section of this COP notes condom availability and support for correct and
consistent condom use.
HIV-positive clients at PMTCT and ART sites:
At all clinical visits, clients who are HIV-positive will be referred (on an opt-out basis) to a counselor for
individual support to analyze and reduce risk through healthy living, abstinence or fidelity, partner testing,
STI prevention and care, participation in PLWHA groups and adherence to treatment as needed. These
prevention interventions can substantially improve quality of life and reduce rates of HIV transmission.
In addition, ACONDA will ensure that community-based services capable of meeting these needs are
identified and will be responsible for monitoring and reporting on referrals. Family-planning counseling and
services will be provided to patients and their partners through wraparound programming by other non-
PEPFAR funded partners. For those engaged in high-risk behavior, the OP section of this COP notes
condom availability and support for correct and consistent condom use.
ACONDA will engage enough counselors to allow every site to provide this prevention and referral package
to all clients. Funding to support staffing and training of these counselors; training of physicians and nurses
to refer clients to the counselors; and adaptation and reproduction of job aids and prevention materials will
be split at approximately 50% Abstinence/Being faithful, 10% Condoms/Other Prevention, 10% Palliative
Care, and 30% Orphans and Vulnerable Children. The reason for dividing the funding is to allow the
program to address an array of HIV prevention needs for HIV-positive and HIV-negative persons as well as
to provide effective linkages to OVC and palliative-care services.
In its support for activities focused on HIV prevention, ACONDA will ensure that stigma and gender issues,
in particular those related to the increased vulnerability of women, are addressed concurrently.
ACONDA will gather data on a monthly basis from its sub-partners involved in HIV prevention activities,
including sex-disaggregated data on group attendance and activities conducted. ACONDA 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, ACONDA will participate in quarterly SI meetings and will implement
decisions taken during these meetings.
Continuing Activity: 16522
16522 16522.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $150,000
* Reducing violence and coercion
Estimated amount of funding that is planned for Human Capacity Development $25,000
Table 3.3.02:
Since its creation in 2002, the Ivorian NGO of health professionals ACONDA has provided comprehensive,
family-based care services in support of the Ministry of Health PMTCT and HIV treatment programs.
ACONDA defines a holistic approach to care and seeks to provide a complete and integrated package of
quality services that includes prevention (CT, PMTCT, secondary sexual prevention); adult, child, and family
care (with provision of ART, OI prevention and treatment, and promotion of "positive living"); and
psychosocial support with a continuum of care through links with local PLWHA and community
organizations.
In addition to providing medical care and treatment, facility-based health services represent a critical
opportunity to affect client behavior through clear, authoritative health messages delivered in one-on-one or
small-group settings, plus connect clients efficiencly and effectively with community-based care services.
This will be done through direct hire or by contracting with individuals or local organizations - counselors
dedicated to providing a comprehensive package of HIV prevention interventions for all clients (opt-out for
those testing positive or negative). In fact, ACONDA will engage enough counselors to allow every site to
provide this prevention and referral package to all clients. A rule of thumb is that per day, one counselor
might provide HIV prevention interventions in small-group sessions for up to 80 HIV-negative clients or HIV
prevention and OVC and palliative care referral services in individual sessions for up to 10 HIV-positive
All PEPFAR Cote d'Ivoire CT, TB, ART and PMTCT service providers will ensure that their package of
services includes HIV prevention behavior-change communication promoting risk reduction through
abstinence, fidelity, correct and consistent condom use, status disclosure, partner testing, reducing multiple
concurrent partners, minimizing alcohol use, and promoting STI prevention and care targeting both HIV-
positive and HIV-negative clients. Furthermore, they will ensure that all HIV-positive clients are offered
effective, monitored referrals to community-based OVC and palliative-care services. With assistance from
the National OVC Care Program (PNOEV) and the PEPFAR in-country team, ACONDA will ensure that
community-based services capable of meeting these needs are identified, and ACONDA will be responsible
for monitoring and reporting on referrals according to a nationally standardized referral system. Where
possible, family-planning counseling and services will be provided to patients and their partners through
wraparound programming by other non- PEPFAR funded partners, and condoms will be provided free of
charge.
Funding to support staffing and training of these counselors; training of physicians and nurses to refer
clients to the counselors; and adaptation and reproduction of job aids and prevention materials will be split
at approximately 50% Abstinence/Being faithful, 10% Condoms/Other Prevention, 10% Palliative Care, and
30% Orphans and Vulnerable Children. The reason for dividing the funding is to allow the program to
address an array of HIV prevention needs for HIV-positive and HIV-negative persons as well as to provide
effective linkages to OVC and palliative-care services for persons living with HIV. The program's effort will
reflect the funding and proportions noted here.
of adolescents. For the community health workers supporting this activity, ACONDA will include training on
prevention through abstinence, fidelity in responsible relationships and correct and consistent use of
condoms for those engaged in risk behavior. This will help strengthen community based activities in
association with care and treatment sites supported by ACONDA. The NGOs engaged by ACONDA to
deliver these community based prevention services will be encouraged to sign agreements with health
centers to ensure a coordinated referral process for HIV counseling and testing.
Continuing Activity: 16767
16767 16767.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $30,000
Table 3.3.03:
Since its creation in 2002, the Ivorian NGO of health professionals ACONDA has provided innovative,
programs. ACONDA defines a holistic approach to care and seeks to provide a complete and integrated
child, and family care (with provision of ART, OI prevention and treatment, and promotion of "positive
living"); and psychosocial support and a continuum of care through links with local PLWHA and community
organizations. After working as a sub-partner to EGPAF (Project HEART) starting in 2004, ACONDA in
September 2006 graduated to become a PEPFAR prime partner providing comprehensive family care and
PMTCT services. ACONDA is rapidly expanding its family-based model. As of September 2008, ACONDA
provided care and support to more than 18,861 people.
With FY09 funds, ACONDA will continue to support 90 FY08 sites and expand to an additional 15 sites with
a total of 105 sites providing adult care and support at health care facilities and in the community. In FY09,
ACONDA plans to provide care and support services to at least 35,400 adult patients.
Priority interventions will include:
- Train 180 physicians, paramedics, social workers, and community counselors in prevention and treatment
of OIs, adherence to ART, and provision of psychosocial support.
- Ensure that adult patients who test HIV-positive undergo clinical and biological assessments (CD4 count)
to determine clinical staging and eligibility for ART initiation. Patients who are eligible are put on ART
according to national guidelines. They will be followed up after three months and every six months to
monitor side-effects and assess adherence and efficacy of treatment (based on CD4 count assessment).
- Symptomatic adult patients will be provided care to alleviate symptoms: Pain will be treated with opiates or
non-opiates (according to WHO guidelines); patients with fever, diarrhea, or anemia will be managed using
national guidelines (or international/WHO guidelines when national guidelines are not yet adopted) with
appropriate medications Asymptomatic patients will be assessed every six months for clinical staging and
ART eligibility. All HIV positive patients will receive cotrimoxazole free of charge according to national
guidelines (currently for patients with CD4 <350).
- Provide baseline and follow up biological monitoring to all adult patients receiving HIV care and support
services. Support care and treatment of OIs according to national guidelines.
- Provide water sterilizing tablets and insecticide treated mosquito nests (ITN) to the most vulnerable adult
patients.
At all sites, ACONDA will provide - either by hiring or by contracting with individuals or local organizations -
counselors dedicated to providing a comprehensive package of HIV prevention interventions for all clients
and effective referrals for persons living with HIV/AIDS and their children. ACONDA will engage enough
counselors (funded in part through AB, Condoms and Other Prevention, OVC, and palliative care funds) to
allow every site to provide this prevention and referral package to all clients.
All clients will be referred (on an opt-out basis) to a counselor for behavior-change communication
interventions, delivered individually or in small groups, focusing on risk reduction through abstinence and
fidelity, with correct and consistent condom use for those engaged in high-risk behavior, as well as partner
testing, reduction of multiple partners, alcohol use, amd prvention and treatment of STIs. HIV-positive
clients will be referred (on an opt-out basis) to community-based OVC and palliative care services to
address family and individual care needs. Counselors will provide adherence support, prevention-for-
positives counseling, and advice and help for disclosure of HIV status to partners and family, with a specific
focus on sero-discordant couples. Patients will also undergo a systematic psychosocial assessment to
identify barriers and obstacles to adherence and will then be referred to support groups. Further targeted
HIV prevention counseling will focus on risk reduction through, disclosure, testing of partners and children,
and positive living. Where possible, family-planning counseling and services will be provided to patients and
their partners through wraparound programming by other non-PEPFAR funded partners, and condoms will
be provided free of charge.
ACONDA 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, ACONDA will participate in quarterly SI
meetings and will implement decisions taken during these meetings.
Continuing Activity: 15089
15089 10053.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $510,000
10053 10053.07 HHS/Centers for ACONDA 5309 5309.07 ACONDA CoAg $150,000
Estimated amount of funding that is planned for Human Capacity Development $80,000
Table 3.3.08:
ACONDA-VS began its scale-up of HIV/AIDS care and treatment activities supported by PEPFAR in 2004
as a subgrantee of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). In April 2007, ACONDA-VS
became a prime implementing partner of PEPFAR. By March 2009, ACONDA anticipates having expanded
its program to more than 90 sites providing family-centered and integrated CT, PMTCT, care and support,
TB/HIV, ART, prevention, and OVC services. The infrastructure and human resources of each of these sites
is being strengthened by renovations, and provision of supplies, equipment, and data management tools,
including tools to help ensure a regular supply of drugs and laboratory commodities. ACONDA provides
regular monitoring and supervision of these activities.
As of September 2008, ACONDA was providing ART to 11,544 adult patients at 61 sites. With FY09 funds
ACONDA will continue to support FY08 sites and expand to an additional 33 sites, for a total of 94 sites
providing ART to adult patients.
With FY09 funding, ACONDA will initiate 6,000 people on ART to reach a total of 28,226 patients ever
receiving ART and at least 14,500 actively receiving ART by September 2009 at all 94 sites. ACONDA will
provide high-quality ART services following national guidelines. The focus will be on treating families - not
just the individual - to better meet patient needs and to assure better adherence and clinical outcomes.
Sites will be supported to shift the organization of their facility from a traditional episodic model of care to a
chronic model of care for HIV patients, using a multi-disciplinary team of providers. ACONDA will
emphasize the involvement of PLWHA in programs through peer-support interventions and strong linkages
to community resources. ACONDA's capacity-building approach, focusing on district- and facility-level
systems strengthening and provider training and mentoring, will help ensure sustainability.
Key activities and approaches will include:
• Support sites to recruit and retain staff for ARV service provision. ACONDA will work with districts and
facilities to identify staff needs and find creative solutions for augmenting staff. Providing the training,
resources, and tools needed for staff to provide quality ART services will help also motivate staff and
increase retention.
• Train 282 doctors, nurses, social workers, counselors, and outreach workers to provide ART, intensive on-
site mentoring during the initiation of services, and periodic follow-up training and mentoring thereafter.
• Support sites to identify HIV-positive patients by strengthening CT interventions, including routine provider-
initiated CT. ACONDA will support sites to publicize the availability of ART services in the communities they
serve.
• Support sites to develop patient-flow algorithms, patient-appointment systems, and protocols related to the
initiation of ART (e.g. number of pre- and post-ARV initiation appointments, standard ARV prescriptions,
etc.).
• Develop protocols and systems for clinical staging of HIV patients and establishing eligibility for ART using
national guidelines and clinical staging, when appropriate.
• Support the formation and functioning of multidisciplinary team meetings to discuss complicated cases and
coordinate individual patient care.
• Help sites to provide effective support to patients prior to ARV initiation, such as counseling about
disclosure, adherence, and peer support.
• Support sites to develop patient-tracking systems that will help to identify patients who have not returned
for pharmacy or other appointments. Protocols for patient home visits will be developed. ACONDA will
develop a program to train PLWHA as peer educators/counselors to support and track patients enrolled in
ART. Peer educators will be supervised by social workers or other staff.
• Ensure strong linkages within the facility and with community-based services. Referral mechanisms will be
developed between ART services and other services. HIV testing will be routinely offered to all patients. HIV
program management committees will meet regularly to coordinate services and cross-referrals.
• Support sites to establish/strengthen links with community-based organizations to ensure patient support
for home-based care, OVC services, adherence support, nutritional support, and other services. ACONDA
will introduce a community resource mapping tool and support sites to develop formal agreements and
referral systems with relevant organizations.•
• Ensure availability of lab services for CD4 testing and to monitor drug toxicity. ACONDA plans to upgrade
all district hospital labs so they can provide CD4 testing for the entire district. ACONDA will support each
district to develop an effective sample transportation system to ensure that patients at the health center
receive CD4 results in a timely manner. Labs at all levels will have enhanced biochemistry and hematology
capacity.
• Work with SCMS and the Public Health Pharmacy (PSP) to support site pharmacies to establish systems
for ARV quantification, stock management, and patient appointments and to train pharmacists in counseling
patients about ART, including side effects and adherence. All ARV, OI drugs, and other commodities will be
procured by SCMS and distributed to sites via the PSP.
• Provide regular, supportive supervision, clinical updates, and refresher training to multidisciplinary care
teams and ART program managers, including the integration of M&E data into program planning and
improvement.
• Support sites to implement patient record-keeping systems and databases and to summarize and analyze
data for routine reporting using national tools. A data QA system will be implemented, and ACONDA
technical advisers will assist sites to analyze data regularly to assess program quality. ACONDA will meet
regularly with the MOH to provide feedback on ART-related M&E tools and approaches to help improve the
national system of data collection and reporting. To build and strengthen a single national M&E system,
To improve retention of patients on ART, ACONDA will:
• Participate in revising treatment guidelines in collaboration with PNPEC
• Support the establishemnt of a pool of regional experts who will be tasked to improve the quality of
services at the local level
• Strengthen district teams to enable them to better coordinate, implement and supervise care and
treatment services
• Improve the quality of treatment services in collaboration with PNPEC and URC
• Strengthen capacities of existing laboratory in performing hematolgy, immunology, and biochemistry tests
Activity Narrative: and improve the quality of laboratory testing, and to establish laboratory networks.
At all ART, PMTCT, and CT sites, ACONDA will provide - either through direct hire or by contracting with
individuals or local organizations - counselors dedicated to providing a comprehensive package of HIV
prevention interventions for all clients and effective referrals for PLWHA and their children.
include ABC prevention interventions (including disclosure, partner and family testing, and STI prevention
and care) and referral to community-based OVC and palliative care services to address family and
individual care needs. Where possible, family-planning services will be provided through wraparound
programming by non-PEPFAR funded partners, and condoms will be provided free of charge.
Within the framework of the decentralization of its activities and the scaling up of the HIV screening the
patients attending health centers or within the community, ACONDA will rely on the expertise of the national
structures in addition to PNPEC. These structures basing on their attributions and own competence will
allow us to reach our qualitative objectives.
Aconda will support all the initiatives aiming at establishing a successful collaboration between SCMS, PSP
and the health centers, taking part in all the meetings called by these structures. The pharmacy team will
still provide assistance to sites pharmacies (upgrading, coaching and supervizing) to enable them to meet
the requirements of PSP (monthly reports, reports - orders, and other supports.); and ensure a frequent
provision of drugs and intrants to sites.
The strategy for the extension of testing will consist in using community workers or peers for a door-to-door
approach. The reference and counter reference of the patients will be strengthened and the focus will be on
the effective filling out of the forms made available to the health workers. Besides, community workers will
be in charge of acccompanying the patients from the testing centers to the care and treatment centers.
During the mass awareness campaigns, the staffs in health centers will be involved by the NGO/CBO in
order to make the care and treatment of the patients tested positive easier. This involvement will be seen
through the information before mass awareness activities and their effective presence at the site.
ART will be delivered to patients in compliance with the new therapeutic strategies that have become
effective since February 2008 and which we are spreading at all the sites. Therapeutic updates meetings
will be held in order to continue the assistance to care givers. They will gather 25 people per area and be
delivered by national experts.
Therapy adherence will be strengthened during therapeutic education sessions prior to care giving and
maintained during monthly visits. Community members will complete an educative aid showing how the
medication should be taken, the latest dates of treatment interruption, the remaining pills will be counted.
The monthly visit period will be shortened for the patients.
Continuing Activity: 15092
15092 10070.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $3,360,000
10070 10070.07 HHS/Centers for ACONDA 5309 5309.07 ACONDA CoAg $1,850,000
* Malaria (PMI)
Estimated amount of funding that is planned for Human Capacity Development $350,000
Table 3.3.09:
organizations. After working as a sub-partner of EGPAF (Project HEART) starting in 2004, ACONDA in
PMTCT services. ACONDA is rapidly expanding its family-based care and treatment model. In FY08
ACONDA anticipates supporting 90 sites providing comprehensive, family-centered CT, PMTCT, TB/HIV,
and care and treatemnt services. As of June 2008, ACONDA provided care to more than 14,000 people in
58 sites.
With FY09 funds ACONDA will continue to support FY08 sites and expand to an additional 15 sites with a
total of 105 sites providing care and support to 4,070 HIV-infected children in the facility and the community.
In FY09, interventions include:
-Train 180 physicians, nurses, social workers, and community counselors in prevention and treatment of
OIs, adherence to ARVT, and provision of psychosocial support.
- Provide infants diagnosis (using DNA-PCR or serological test) to all HIV-exposed children in suppoted
sites. All HIV-infected children will be assessed for ART eligiblity and provided with a complete package of
care.
- Provide Cotrimoxazole prohlylaxis to all HIV-exposed children from 2 weeks to 18 months (or until the
confirmation of non-infection) and to all HIV-infected children with CD4<25%. ACONDA will provide care
and mangement for OIs.
- Provide nutritional support through non-USG funds, wrapping around ACONDA's efforts to provide HIV-
infected families with cooking kits (containing rice, milk, flour, oil, etc,) and cooking classes geared toward
proper nutrition for PLWHA. These cooking kits will be distributed by counselors at the health centers and
during home visits. ACONDA will provide targeted nutritional support to malnourished patients. ACONDA
will work to identify local foods that can be substituted in the diets for HIV-infected and/or exposed children
who are being weaned off breast milk. Counselors will provide information to patients nutrion counseling
and support,
and effective referrals for persons living with HIV/AIDS and their children.
ACONDA will closely work with MFFAS and PNOEV in providing care and support to children. An
agreement will be signed with MFFAS to establish a framework of collaboration with ACONDA. Main
activities will include:
-Assess the need of HIV infected children living in institutions such nurseries, orphanage etc.
-Assess the training need of staff working in those centers in the provision of care and support for children
- Strengthen capacities of this population based on the needs especially with regard to medical, and
nutritional, and psychological support.
-Establish links with care and treatment services.
ACONDA will collaborate with the National Nutrition Program (PNN) to update the nutrition guidelines and.
ACONDA will also provide HIV counseling and testing services in nutrition centers using the finger prick
algorithm. All HIV-infected children diagnosed in the nutrition center will be referred to the nearest care and
treatment sites.
ACONDA will strengthen its collaboration with URC and other institutions to improve the quality of nutrition
services for HIV-infected or HIV-exposed children.
New/Continuing Activity: New Activity
Continuing Activity:
Estimated amount of funding that is planned for Human Capacity Development $40,000
Table 3.3.10:
As of June 2008, ACONDA provided ART to 1,019 HIV-infected children in 58 sites. With FY09 funds
ACONDA will continue to support FY08 sites and expand to an additional four sites, for a total of 94 sites
providing ART for adult patients.
ACONDA will initiate at least 1,569 HIV-infected children on ART in FY09 and by September 2009 will be
providing ART for at least 2,085 children.
Pediatric support care and treatment services will focus on increasing availability of infant HIV diagnostics,
enhancing pediatric case finding and referral, ensuring comprehensive care and treatment services for HIV-
exposed infants and for HIV-infected infants and children, and increasing access to pediatric ART.
Emphasis will be placed on full involvement of families. Key activities and approaches will include:
• Training of all the health workers in infected child care
• Produce and disseminate national pediatric care and treatment guidelines, tools, and materials at all sites
• Help sites to provide effective support to children and their parents prior to ARV initiation, such as
counseling about disclosure, adherence, and peer support.
developed between ART services and other services (inpatient and outpatient departments, CT, PMTCT,
TB, under-5 clinic, family planning). HIV testing will be routinely offered to all patients. HIV program
management committees will meet regularly to coordinate services and cross-referrals.
for home-based care, OVC services, adherence support, nutritional support, and other services.
• Strengthen care services (including staging, cotrimoxazole prophylaxis, nutrition and growth monitoring,
parental counseling, social and adherence support) for all HIV-exposed and HIV-infected children.
• Assess feasibility of co-located services and/or coordinated appointment scheduling for HIV-infected
women and their children.
• Work closely with SCMS and PSP to ensure a seamless supply of pediatric ARV and OI drug formularies
• Ensure the availability of pediatric ARV drugs at all sites.
• Establish pediatric and family support groups.
• Establish or strengthen links to community-based services for infants and children, including nutritional
support and OVC services.
• Implement national guidelines, tools, and protocols for pediatric care and treatment
• Improve access to Early Infant Diagnosis through DNA PCR using DBS technique, and serogical testing
using finger prick rapid algorithm for children above 18 months.
• Establish a good tansportation system for DBS samples bewteen sites and the reference laboratories
• Improve post natal follow up of HIV-exposed children until final HIV diagnosis
• Ensure availability of pediatric ARV drugs at all sites.
• Strengthen capacities of the pediatric ward at the Univesrity Teaching Hopsital (CHU) of de Yopougon to
fully act as a pediatric reference center
ACONDA will rwork with Ivorian Pediatric Society (SIP) to review and improve the quality of pediatric care
and treatment services, in collaboration with URC and PNPEC.In collaboration with EGPAF, quarterly
meetings were organized since 2007 for medical and paramedical care givers on pediatric care and
treatment in order to share lessons , challenges, and address issues related to pediatric care and treatment.
This initiative will continue to be supprted by ACONDA at all sites.
Provide nutrition support to HIV-infecte and HIV-exposed children on ART in collaboration with PATH,
FANTA, and PAM and the PNN. The strategy will be to provide practical and theorical training of
counselors, and nutrition support (distribution of food kits made up of cereals - oil - flour - milk products and
other nutrients).
Activity Narrative: Despite impressive growth and achievements, the expansion of ACONDA's program faces two main
Table 3.3.11:
PMTCT services. ACONDA is rapidly expanding its family-based care and treatment model.
By the end of the FY08 project period ACONDA anticipates supporting 90 sites providing comprehensive,
family-centered CT, PMTCT, TB/HIV, and care and treatment services. As of June 2008, ACONDA was
providing care to more than 14,000 people in 58 sites. In FY09, ACONDA will continue to support FY08
care and treatment sites and expand to an additional 15 sites for a total of 105 sites, 28 of which will be TB
diagnostic and treatment centers (CAT or CDT).
FY09 funds will support the following activities:
-In collaboration with PNLT, ACONDA will train all the TB clinic staff in TB HIV co-management and
program implementation.
-ACONDA will strive to ensure routine HIV testing of 80% of TB patients at its 28 sites (for an estimated
5,816 TB patients) using a routine counseling and testing approach and will ensure coordination of the
provision of HIV testing supplies from the national pharmacy (PSP).
-Cotrimoxazole prophylaxis will be offered to all HIV/TB co-infected patients at these sites.
-In line with its holistic approach, ACONDA will link HIV care and treatment services at its 94 ART
prescription and 28 refill sites with TB services. Supervisions will be organized at TB and HIV/AIDS sites
supported by ACONDA in collaboration with the National TB Control Program (PNLT), the national HIV care
and treatment program (PNPEC) and the health districts.
-ACONDA plans to strengthen the existing referral system between HIV and TB in coordination with the
national TB Program. A system of reference and linkage between TB centers and ARV service sites will be
strengthened.
- Formal agreements with community- based organizations involved in the care of TB/HIV co-infection will
be negotiated to ensure appropriate follow-up of patients receiving treatment for TB.
- Patients co-infected with TB/HIV will be linked to community services at both the TB clinic and the
HIV/AIDS clinic. The number of community- based organizations involved in the care of the TB/HIV co-
infection will be increased. CBOs and NGOs will receive sub-grants, in conjunction with Alliance CI, to
guarantee DOTS adherence and to retrieve patients lost to follow-up. ACONDA will improve referral forms
and counter-referral forms to establish stronger links between clinics, to improve the ability of clinics and
CBO/NGOs to follow up with patients, and to improve monitoring and data analysis. ACONDA will work to
strengthen its monitoring and evaluation system and to support an integrated national M&E system.
- In FY09, ACONDA will promote screening of 100% of HIV-infected patients for TB based on their clinical
symptoms at all HIV/AIDS care and treatment sites supported by ACONDA. A total of 356 staff members
from both existing and new sites will be trained on-site to diagnose TB in HIV-positive patients using
guidelines from the National TB program. Other professionals (140) will attend training in holistic case
management of TB/HIV co-infected patients (the same training listed above for TB clinic staff). About 50
paramedics from the various sites will receive refresher training in TB care.
-According to the national guidelines, TB suspects will be referred for sputum smear microscopy and chest
x-ray and active TB cases will be treated. During FY09, ACONDA expects to increase the coverage of TB
diagnosis and treatment services to 2,090 patients in HIV clinics (an estimated 5% of all HIV patients at
each clinic). To accomplish this, ACONDA will ensure that health professionals at both old and new sites
are trained to clinically manage HIV and common opportunistic infections, including TB.
-Professionals from TB clinics will be offered training on the holistic case management of TB/HIV co-
infected patients, using materials validated by the national TB program (PNLT) and the national HIV care
and treatment program (PNPEC).
-Additionally, ACONDA will provide INH prophylaxis to eligible HIV-infected patients as per the national
guidelines.
-ACONDA will provide TB diagnosis and treatment services to children aged < 5 years following national
ACONDA in collaboration with the national TB program will conduct facility assessments at all HIV and TB
care and treatment facilities for TB infection control (to reduce nosocomial infections) and will implement
corrective action as per the national guidelines. Supervision will be organized at TB and HIV/AIDS sites in
collaboration with PNLT and the health districts.
Activity Narrative: community
Continuing Activity: 15090
15090 10338.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $400,000
10338 10338.07 HHS/Centers for ACONDA 5309 5309.07 ACONDA CoAg $150,000
Estimated amount of funding that is planned for Human Capacity Development $60,000
Table 3.3.12:
organizations. After working as a treatment sub partner to EGPAF (Project HEART) starting in 2004,
ACONDA in September 2006 graduated to become a PEPFAR prime partner by winning a competitive
award to provide comprehensive family care and PMTCT services. With FY09 funds ACONDA will continue
to support FY08 sites and expand to an additional 15 sites with a total of 105 sites providing care and
support to 4,070 HIV-infected children in the facility and the community. In FY09 ACONDA will provide care
and support to 1,800 OVC.
Besides providing medical care and treatment, facility-based health services represent a critical opportunity
to affect client behavior through clear, authoritative health messages delivered in one-on-one or small-group
settings, as well as to connect clients effectively with community-based care services. All ACONDA sites will
ensure that HIV-positive clients are offered effective, monitored referrals to community-based OVC and
palliative-care services.
to all clients. A rule of thumb is that per day, one counselor might provide HIV prevention interventions in
small-group sessions for up to 80 HIV-negative clients or HIV prevention and OVC and palliative care
referral services in individual sessions for up to 10 HIV-positive clients In individual sessions, the counselor
will seek to obtain contact information (e.g. address, telephone number) for the client and briefly assess
needs and available resources. Following an assessment of risk and vulnerability, the counselor will provide
the client with a brochure or other illustrated materials showing what the palliative care and OVC care
services might include, such as clean water and bed nets for palliative care and educational, medical,
nutritional, legal, and psychosocial support for OVC. The counselor will then ask the client whether she or
he would like to provide the names of people in the household who might need referral to such services.
With assistance from the National OVC Care Program (PNOEV) and the PEPFAR in-country team,
ACONDA will ensure that community-based services capable of meeting these needs are identified, and
ACONDA will be responsible for monitoring and reporting on referrals according to a nationally standardized
referral system.
Continuing Activity: 17114
17114 17114.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $130,000
Table 3.3.13:
In FY09, ACONDA will equip and provide CT services at four additional sites (for a total of 94 sites), and
testing will be provider-initiated based on the national testing algorithm, which is expected to be simplified
within the year to allow rapid tests using whole blood and finger-prick techniques. New sites will include 17
district hospitals and four urban health centers or antenatal/maternity sites. All CT personnel will be trained
on the new algorithm using finger prick technique.All HIV-positive adults will be counseled and asked
whether their families, including children, can also be tested. When a child is tested positive, the parents will
be asked to be tested and to have tests done for all siblings. In collaboration with the rural development
agency ANADER, ACONDA will also pilot community-based counseling services that are delivered via
mobile testing units in rural areas. In all, ACONDA expects to provide counseling and test results for at least
66,000 people with direct PEPFAR support and will direct all those who are seropositive to the appropriate
services within its comprehensive program, as well as to community-based palliative care and OVC
services. ACONDA will emphasize strategies for couples testing and for prevention and support services for
discordant couples.
ACONDA's activities will be linked with stand-alone CT services operated by other organizations or the
government. ACONDA will accept all referrals for counseling, psychosocial support, clinical prevention,
prevention education, care, and treatment services.
interventions for all clients and effective referrals for persons living with HIV/AIDS and their children.
clients. A rule of thumb is that per day, one counselor might provide HIV prevention interventions in small-
group sessions for up to 80 HIV-negative clients or HIV prevention and OVC and palliative care referral
services in individual sessions for up to 10 HIV-positive clients.
reporting on referrals according to a nationally standardized referral system
ACONDA will also provide training in CT according to the national algorithm to 100 community advisers and
health providers within the community and will work closely with CBOs and NGOs to provide them with
technical assistance. Local organizations will be given sub-grants, in conjunction with Alliance CI, to provide
psychosocial support and community-based CT. This will generate innovative ways of reaching out to
greater numbers of people with CT services in communities. These organizations also help ACONDA
leverage additional funding, because the reach that ACONDA has through these partnerships is attractive to
many donors. In terms of community-based services, activities performed by the community advisers will
include counseling for testing (including family testing) and ART adherence, home visits, establishment of
support groups, and sensitization designed to fight against stigmatization in the community.
The community advisers are integrated in the health-care system and work in collaboration with the district
team. They are the links between health centers and the community for counseling, testing, ARV services,
M&E, and all care provided for PLWHA. They participate in all the meetings organized by ACONDA and the
district team and produce a monthly report of their activities.
ACONDA will work to strengthen its monitoring and evaluation system and to support an integrated national
M&E system. It will adhere to national standards, will remain an active member of the CT and other
technical consultative forums, and will provide input to improve national policies according to evidence-
based practices. ACONDA will also remain an active member of the national commodities coordination
committee for HIV-related commodities. ACONDA will involve the district team in all CT activities. In
collaboration with ACONDA, the district team will support and supervise activities by ACONDA-supported
NGO/CBOs.
Other FY09 activities will include:
1) Training 400 providers in new rapid-testing approaches to provide community- and family-based CT (in
accordance with the new algorithm).
Activity Narrative: 2) Strengthen referral system, with the involvement of other stakeholders, to HIV prevention, PMTCT,
palliative care, OVC services, and treatment services,
3) Targeting at least 90% of patients in clinical settings (including TB and PMTCT services) for counseling
and testing.
4) Strengthening the district approach through consistent involvement of the health district team in planning,
supervision, and coordination. New sites will be provided with tools for record-keeping, and the staff will
receive training to use these tools. Staff at the new sites, and new staff at existing sites, will be brought up
to speed on national guidelines.
5) Strengthening the continuum of care, especially for orphans and vulnerable children, and supporting
implementation of a "risk reduction plan" for HIV-negative people.
The number of new sites to be opened under COP 09 is 4 increasing the sites backed by ACONDA to 94
by the end of the period.
Continuing Activity: 15091
15091 10063.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $352,000
10063 10063.07 HHS/Centers for ACONDA 5309 5309.07 ACONDA CoAg $150,000
Table 3.3.14:
NOTE: With funding reprogrammed in April 2009, ACONDA will also support deployment of the SIGVIH
patient-tracking system, working in conjunction with the Department of Information, Planning, and
Evaluation (DIPE) within the Ministry of Health (MOH) and with ICAP. These additional FY09 funds will be
used to:
1) Assist electronic patient-monitoring system stakeholders (ACONDA, EGPAF, ICAP, DIPE, and Global
Fund principal recipient Care International) to harmonize and install a central-level data-management
system.
2) Ensure the technical governance and maintenance of the electronic patient-monitoring system.
3) Provide follow-up training of local data managers to develop local statistical capacities to analyze
program outcomes.
4) Continue to monitor the data quality through direct supervision and cross-matching of data. All data will
be analyzed at each site in order to monitor progress, and results will be summarized in a monthly report.
5) Ensure continuing communication among stakeholders, including non-PEPFAR partners.
6) Produce and submit publications to peer-reviewed journals, in collaboration with the USG team.
To promote sustainability, the hiring of staff will be done in close collaboration with the MOH and other
government decentralized entities (mayors, general counsels).
comprehensive, family-based care services in support of the Ministry of Health (MOH) PMTCT and HIV
treatment programs. ACONDA defines a holistic approach to care and seeks to provide a complete and
integrated package of quality services that includes prevention (CT, PMTCT, secondary sexual prevention);
adult, child, and family care (with provision of ART, OI prevention and treatment, and promotion of "positive
award to provide comprehensive family care and PMTCT services. ACONDA is rapidly expanding its
comprehensive family-based model for HIV care and treatment and will provide ART to approximately
26,000 patients, including at least 5,000 children, by March 2009.
The main objective of ACONDA's M&E strategy is to use all relevant tools and procedures to ensure that
patients can be effectively managed within the comprehensive-care system. ACONDA has been using a
data-management system at all of its sites for the past three years. The system, based on a 10-year history
of providing services and doing research in Cote d'Ivoire, was designed to optimize the capability of sites to
follow patients closely. ACONDA assigns one focal point to each of the district hospitals where it works; this
person in turn will train others and provide regular supportive supervision to review the data that is
recorded. In FY07, ACONDA trained 36 data clerks (called AMDs), three focal points, and three nurses who
specialize in epidemiology (called CSEs). Through its data-management system, ACONDA monitors patient
tracking information as well as information that is needed by PEPFAR, the National HIV/AIDS Care and
Treatment Program (PNPEC), and the MOH.
This data-management system will be made available to all the health centers at which ACONDA will add
HIV/AIDS activities in FY09. In many cases, this will require ACONDA to provide computers, other
equipment, and training that will allow the new sites to use the system. In addition to rolling this system out
at new care and treatment sites, ACONDA will strengthen monitoring activities at all ART sites—old and
new—by providing refresher training and monthly supervision. In FY09 ACONDA plans to train 300
individuals in strategic information and provide 34 local organizations with technical assistance for strategic-
information activities. ACONDA will also implement the following activities:
ACONDA Headquarters Activities
In collaboration with national counterparts, the USG team, and other PEPFAR partners, ACONDA SI
officers will:
1) Adapt the country's data-collection tools (paper and electronic)
2) Provide ongoing technical support and training to AMD/CSE/focal points
3) Train multidisciplinary care teams to use program data to assess the quality of care at their sites
4) Provide semi-annual program results, annual program results, and ad hoc data sets as requested by the
USG team
5) Participate in quarterly SI meetings organized by the USG strategic information branch and implement
decisions agreed upon during these meetings
6) Organize a quarterly workshop with the ACONDA M&E team and field staff to discuss practical issues in
the field and appropriate solutions
7) Organize an annual meeting to review M&E activities at all sites
8) Attend appropriate workshops, conferences, and trainings that strengthen M&E staff members' technical
capacity
9) Articles submitted for publication in peer-reviewed journals with be developed in collaboration with the
USG team.
Site-Level Activities
1) A team made up of AMDs, CSEs, and focal points, who serve on district health teams, will be trained to
better manage data. The training, provided by the ACONDA M&E team, will consist of a five-day theoretical
session followed by a 10-day practicum.
2) ACONDA will provide SI-related materials to each site, including computer hardware and software,
printers, registers and forms, and support internet connectivity
3) ACONDA M&E field staff will attend appropriate workshops, conferences, and trainings that strengthen
their technical capacity
4) ACONDA will support the SI capacity development of all personnel at health facilities hosting ACONDA
sites.
In support of strengthening the national SI system, ACONDA will:
Activity Narrative: 1) Design or adapt additional management tools to improve follow-up of patients, based on each district's
data-management needs. These tools will include forms and registers that allow comprehensive collection
of information on morbidity, ART treatment follow-up, laboratory investigations, and drug-supply
management;
2) Train and support district teams that will be responsible for ensuring and supervising data recording, data
transfer to the district-team location, electronic recording and processing, and report editing. District teams
will prepare monthly reports covering all aspects (quantitative and qualitative) of ACONDA's program.
Reports will be sent to the regional level and to the central level (PNPEC) to be integrated into national data
-collection efforts;
3) Set up a network between ACONDA and the district teams;
4) Develop and execute a data-quality improvement plan with technical assistance from external contractors
and in close collaboration with the RETRO-CI SI team and district data managers;
5) Work with the DIPE, the PNPEC, and other implementing partners to develop and implement a unique
patient identifier as a way of tracking patients;
6) Submit field based data to national data-collection systems for drug and supply-chain management. The
patient-management system that is currently used at ACONDA-supported sites will be interfaced with the
system that the Partnership for Supply Chain Management Systems will be sharing with all care and
treatment programs in Cote d'Ivoire in FY09;
7) Participate in ongoing national efforts to maintain and improve a harmonized national longitudinal HIV-
positive patient-monitoring system.
To promote sustainability, the hiring of staff will be done in close collaboration with the MOH and district
health officials. ACONDA will support HMIS activities at more than 80 sites.
Continuing Activity: 15093
15093 10075.08 HHS/Centers for ACONDA 7038 5309.08 ACONDA CoAg $900,000
10075 10075.07 HHS/Centers for ACONDA 5309 5309.07 ACONDA CoAg $200,000
Table 3.3.17:
