Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 7078
Country/Region: Côte d'Ivoire
Year: 2009
Main Partner: Network of People Living with HIV/AIDS - Cote d'Ivoire
Main Partner Program: Cote d'Ivoire
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $50,000

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $50,000

Note: Country funds have been added to this NPI mechanism.

RIP+ (Réseau Ivoirien des Organisations de Personnes Vivant avec le VIH), a nationwide umbrella network

of PLWHAs organizations created in 1997, works to establish and protect the legal rights and improve the

quality of life of persons living with HIV/AIDS. Through fund raising, sub-granting, advocacy, and mentoring,

RIP+ seeks to strengthen the capacities of its 50 active affiliates to build national and local responses to the

HIV/AIDS pandemic. A partner of the Ministry for the Fight Against AIDS (MLS), Ministry of Health (MOH),

and Ministry of Family, Women, and Social Affairs, as well as many other technical ministries, RIP+

participates in the design and implementation of national policies and strategies as a member of various

technical working groups and committees.

In late 2006, RIP+ was awarded a three-year grant, one of three Ivorian organizations selected in the first

round of the New Partners Initiative (NPI). Through the NPI program, RIP+ is implementing Project SERVIR

in Côte d'Ivoire to achieve the following objectives: (1) build administrative capacity of PLWHA

organizations, (2) train the members of all PLWHA NGOs in positive HIV prevention, (3) implement positive-

prevention activities, (4) institutionalize a national HIV testing day, (5) provide care and support to newly

diagnosed PLWHA, and (6) provide home-based care and support to those in need.

RIP+ manages the project and provides sub-grants and organizational and technical capacity-building to its

affiliate organizations. Direct care and support, as well as CT promotion and services, are delivered by local

staff members of affiliate PLWHA organizations. Over three years, the project is expected to result in HIV

counseling and testing (CT) for at least 100,000 youths and adults through Cote d'Ivoire Testing Day and to

provide direct care and support services to at least 17,500 PLWHA nationwide.

With FY07 and FY08 NPI funds, RIP+ has collaborated with JHU/CCP, MLS, MOH, and other national key

stakeholders to develop, launch, and institutionalize a Côte d'Ivoire Testing Day (CITD). The first CITD is

planned for Dec. 15, 2008.

In FY09, RIP+ will build on its experience and on outreach activities of its affiliates to continue to strengthen

and expand the capacity of local PLWHAs organization to respond to HIV/AIDS in their communities,

including strengthening access to and uptake of CT as a critical component of prevention, care, and

treatment strategies. RIP+ has worked with a variety of partners (including RIP+ affiliates, local NGOs,

JHU/CCP, the District of Abidjan, PSI, Hope Worldwide, Alliance CI, Clinique de Confiance, and the private-

sector network CGECI) to mobilize communities and increase demand for CT, using innovative approaches

such as door-to-door, family-centered services provided by mobile units. At least 4,503 persons were

reached through community mobilization activities. These community mobilization efforts highlighted the

need to harmonize stakeholder understanding of scale-up to support a national testing day. RIP+ worked in

support of a new simplified algorithm allowing whole-blood, finger-prick rapid testing and promoted

understanding of home- and community-based service-delivery approaches. In FY09, the MLS and MOH

will spearhead the national testing day, and RIP+ will lead community mobilization efforts. RIP+ will ensure

that an effective, client-friendly national referral system is put in place to ensure a continuum of quality care

for PLWHA newly diagnosed during the second CITD (2009).

Working with the MLS and national stakeholders, RIP+ will continue to make prevention technologies more

available to highly vulnerable populations. RIP+ will procure condoms and lubricant and distribute them to

highly vulnerable populations including men who have sex with men, people living with HIV and AIDS, and

CSW. For specific groups including MSM and CSW, some condoms and lubricant will made available as an

income generating source to ensure sustain renewal of stocks. Condoms and lubricant will also be

distributed in conjunction with outreach, community-based prevention and positive prevention programs.

With FY08 and FY09 NPI funds, RIP+ will provide logistic, technical and financial support for community

mobilization activities involving PLWHA, NGOs, and other HIV/ AIDS organizations sponsoring community-

awareness activities and promoting HIV prevention for negative people and positive prevention for

PLWHAs . JHU/CCP and Alliance will continue to assist RIP+, providing technical assistance to assure

quality, prevention-related communication and community-mobilization activities.

RIP+ will continue to promote uptake of voluntary counseling and testing (VCT) by highly vulnerable

populations by linking condom and lubricant distribution to awareness-raising activities and VCT services.

People living with HIV who are on treatment will be linked to these outreach activities, and those who test

positive will be referred to existing care and treatment activities through RIP+ referral network, which

includes MLS, Alliance CI, and FHI.

With FY09 funding, RIP+ will collaborate through a partnership agreement with ANANDER to complement

and support the national rural development program with a comprehensive, positive prevention component

implemented by RIP+. RIP+ contribution will focus on three activities: 1) Individual level counseling and

activities intended to develop PLWHA self esteem, 2) Organizational support to build a strong structure that

mobilizes, manages and sustains resources, and 3) Awareness raising activities at the community level to

create an enabling environment for PLWHA. These interventions will result in a greater involvement of

PLWHAs (GIPA).

Based on its previous collaboration with PACT, RIP+ will enhance community coping mechanisms through

smart communication strategies and support for a Côte d'Ivoire Media Exchange (CIMEX). CIMEX will be a

year-long activity to increase awareness and reduce HIV/AIDS stigma and discrimination. CIMEX will

promote media involvement through a partnership with the network of journalists. The CIMEX Advisory

Committee will be composed of key stakeholders from civil society, the media, and the public and private

sectors. The CIMEX Advisory Committee will develop a media action plan that lays out strategies, key

activities and timeframes. Some of the planned activities include broadcast talk shows and mass media

advertisements on positive prevention. CIMEX messages will focus on HIV prevention among youth and

reducing HIV stigma and discrimination in the general population. The culmination of CIMEX will be a

highly publicized ceremony covered by the national mass media channels with three major awards: (1)

award of the best media contribution to the HIV/AIDS fight, (2) award for the best NGO for its contribution to

the fight against HIV/AIDS and (3) award for the most committed company. RIP+ expects this activity to

Activity Narrative: reach the entire country and generate enough interest and enthusiasm to become financially self-

sustainable within the lifespan of the project. CIMEX will help reach at least 10, 000 young people

throughout the country.

FY09 funding will also support the hiring of a staff person to coordinate activities related to lay

counselors/community workers and volunteers.

The RIP+ project will be monitored by ongoing data collection and a periodic feedback meeting among

stakeholders. A final evaluation combining a focus group discussion with PLWHAs, key stakeholder

interviews, and routine data analysis will assess the project's effectiveness. Final evaluation will include

external evaluation of project's process, effect and impact.

New/Continuing Activity: Continuing Activity

Continuing Activity: 17293

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

17293 17293.08 U.S. Agency for Network of People 7078 7078.08 NPI RIP+ GHH- $0

International Living with A-00-07-00016-

Development HIV/AIDS 00

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's legal rights

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

* TB

Military Populations

Workplace Programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.03:

Funding for Care: Adult Care and Support (HBHC): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS

The SERVIR program will continue its efforts to reach infected children, infected adolescents and PLWHA

adults as described in the project description. Based on a collaboration framework established in FY08 with

DMOSS and UNICEF, RIP+ will expand its work in schools to reach adolescents within school settings.

RIP+ will develop a network of school health care facilities, social workers, health clubs, and school

authorities in order to make prevention services, CT, and post-test counseling available within school

settings. RIP+ will apply for additional resources from UNICEF and DMOSS to provide complementary

holistic prevention and care services to adolescents within school settings.

COMPLETE NARRATIVE

RIP+ (Réseau Ivoirien des Organisations de Personnes Vivant avec le VIH), a nationwide umbrella network

of PLWHAs organizations created in 1997, works to establish and protect the legal rights and improve the

quality of life of persons living with HIV/AIDS. Through fund raising, sub-granting, advocacy, and mentoring,

RIP+ seeks to strengthen the capacities of its 50 active affiliates to build national and local responses to the

HIV/AIDS pandemic. A partner of the Ministry for the Fight Against AIDS (MLS), Ministry of Health (MOH),

and Ministry of Family, Women, and Social Affairs, as well as many other technical ministries, RIP+

participates in the design and implementation of national policies and strategies as a member of various

technical working groups and committees.

In late 2006, RIP+ was awarded a three-year grant, one of three Ivorian organizations selected in the first

round of the New Partners Initiative (NPI). Through the NPI program, RIP+ is implementing Project SERVIR

in Côte d'Ivoire to achieve the following objectives: (1) build administrative capacity of PLWHA

organizations, (2) train the members of all PLWHA NGOs in positive HIV prevention, (3) implement positive-

prevention activities, (4) institutionalize a national HIV testing day, (5) provide care and support to newly

diagnosed PLWHA, and (6) provide home-based care and support to those in need.

RIP+ manages the project and provides sub-grants and organizational and technical capacity-building to its

affiliate organizations. Direct care and support, as well as CT promotion and services, are delivered by local

staff members of affiliate PLWHA organizations. Over three years, the project is expected to result in HIV

counseling and testing (CT) for at least 100,000 youths and adults through Cote d'Ivoire Testing Day and to

provide direct care and support services to at least 17,500 PLWHA nationwide.

With FY07 and FY08 NPI funds, RIP+ has collaborated with JHU/CCP, MLS, MOH, and other national key

stakeholders to develop, launch, and institutionalize a Côte d'Ivoire Testing Day (CITD). The first CITD is

planned for Dec. 15, 2008.

In FY09, RIP+ will build on its experience and on outreach activities of its affiliates to continue to strengthen

and expand the capacity of local PLWHAs organization to respond to HIV/AIDS in their communities,

including strengthening access to and uptake of CT as a critical component of prevention, care, and

treatment strategies. RIP+ has worked with a variety of partners (including RIP+ affiliates, local NGOs,

JHU/CCP, the District of Abidjan, PSI, Hope Worldwide, Alliance CI, Clinique de Confiance, and the private-

sector network CGECI) to mobilize communities and increase demand for CT, using innovative approaches

such as door-to-door, family-centered services provided by mobile units. At least 4,503 persons were

reached through community mobilization activities. These community mobilization efforts highlighted the

need to harmonize stakeholder understanding of scale-up to support a national testing day. RIP+ worked in

support of a new simplified algorithm allowing whole-blood, finger-prick rapid testing and promoted

understanding of home- and community-based service-delivery approaches. In FY09, the MLS and MOH

will spearhead the national testing day, and RIP+ will lead community mobilization efforts. RIP+ will ensure

that an effective, client-friendly national referral system is put in place to ensure a continuum of quality care

for PLWHA newly diagnosed during the second CITD (2009).

In FY09, in coordination with the National HIV/AIDS Care and Treatment Program (PNPEC) and the

National TB Treatment Program (PNLT), RIP+ will provide 17 sub-grants worth $5,000-15,000 to affiliate

organizations to provide home-and community-based palliative care services to alleviate psychosocial,

physical, and spiritual distress; promote positive living; and support bereavement for at least 10 000

PLWHA and their family members countrywide. Affiliates will work to improve community support for

persons living with HIV or HIV/TB co-infection and their families to address stigma and discrimination;

promote treatment literacy and adherence; and link clients to comprehensive services, including medical

care (ART, TB treatment, and others) community-based palliative care and care for positive children.

In FY09, in coordination with the National HIV/AIDS Care and Treatment Program (PNPEC) and the

National TB Treatment Program (PNLT), RIP+ will provide 17 sub-grants worth $5,000-15,000 to affiliate

organizations to provide home-and community-based palliative care services to alleviate psychosocial,

physical, and spiritual distress; promote positive living; and support bereavement for at least 10 000

PLWHA and their family members countrywide. Affiliates will work to improve community support for

persons living with HIV or HIV/TB co-infection and their families to address stigma and discrimination;

promote treatment literacy and adherence; and link clients to comprehensive services, including medical

care (ART, TB treatment, and others) community-based palliative care and care for positive children.

Affiliates will work to improve community support for persons living with HIV or HIV/TB co-infection and their

families to address stigma and discrimination; promote treatment literacy and adherence; and link clients to

comprehensive services, including medical care (ART, TB treatment, and others) and community-based

palliative and positive children and adolescent care. For OVC, the Servir program plans to provide care and

support to 1000 positive OVC. Those not infected will be referred to existing services using the guidelines

developed by the national OVC program. As a member of CEROS, a national body to coordinate OVC

interventions, RIP+ will help address OVC referral issues.

RIP+ and its affiliates will apply a family-centered approach in implementing this program. RIP+ will involve

the family in identifying and referring those in need to comprehensive services (care and reference of OVC,

Activity Narrative: counseling and reference for testing). The family-centered approach to OVC will forge the link to other

services based on the needs of the individual and family. Program sub-grantees will concentrate their work

on home visits, psychological support, nutritional counseling and education and support to parents including

treatment literacy provided by by community peer counselors.

The "Servir" program will continue its efforts to reach infected children, infected adolescents and PLWHA

adults as described in the project description. Based on a collaboration framework established in FY08 with

DMOSS and UNICEF, RIP+ will expand its work in schools to reach adolescents within school settings.

RIP+ will develop a network of school health care facilities, social workers, health clubs, and school

authorities in order to make prevention services, CT, and post-test counseling available within school

settings. RIP+ will apply for additional resources from UNICEF and DMOSS to provide complementary

holistic prevention and care services to adolescents within school settings.

RIP+ will work to link community mobilization, treatment literacy, and palliative care and other support

services, including TB-related home- and clinic-based palliative care, with related services in the geographic

area and to promote coordination at all levels through the district, regional, and national HIV and other

coordination and technical forums like GTTSP. As member of this technical body RIP+ has contributed to

the elaboration of the national guide of community based palliative care. RIP+ will ensure that accurate and

timely M&E reports are provided to the relevant bodies and will contribute to building a single national M&E

system.

RIP+ will continue to provide technical assistance and share its experience to assist national authorities and

key stakeholders, including its affiliate members in the use of a simplified monitoring and evaluation plan for

community-based palliative care. RIP+ will provide technical and management assistance to ensure that

local PLWHA organizations receive adequate information and assistance to access funding opportunities

supported by PEPFAR and other donors. RIP+ will also promote using of a simplified national referral

system for community-based palliative care to address the high rate of lost to follow up within the care and

treatment program. Acting as watch dogs on this issue, RIP+ will report to the national body (PNPEC) any

GAP within the system and assist PNPEC in organizing periodic meeting to review the assessment report

and make recommendations for way forward. RIP+ will coordinate with the Ministry of Health's strategy for

decentralizing care and treatment services to ensure synergistic impact. A fund-raising strategy will be put

in place to ensure the sustainability of project activities. The project will be monitored by ongoing data

collection and a periodic feedback meeting among stakeholders. A final evaluation combining a focus group

discussion with PLWHA, key stakeholder interviews, and routine data analysis will assess the project's

effectiveness. The final evaluation will also include an external evaluation of the project's process, effects,

and impact.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16779

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

16779 16779.08 U.S. Agency for Network of People 7078 7078.08 NPI RIP+ GHH- $0

International Living with A-00-07-00016-

Development HIV/AIDS 00

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's legal rights

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

* TB

Military Populations

Workplace Programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08:

Funding for Care: TB/HIV (HVTB): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS

Following discussions with the National Malaria Program (PNLP), RIP+ initiated a number of activities,

including establishing a partnership framework with PNLP for HIV/Malaria co-infection that will be formalized

with an MOU in FY09. RIP+ has laid out areas of collaboration and PNLP has been granted Global Fund

resources through to support implementation. RIP+ will be responsible for strengthening the community

mobilization components of these programs Activities planned include developing audio broadcasts and

TV spots; elaboration, validation and distribution of a training manual dealing with care of the co-infected;

and TOT for a pool of national trainers on co-infection. RIP+ will also contribute to the organization of

Malaria/ HIV world day and strengthen the capacity of NGOs to provide patient follow up. ROLPCI, the

umbrella for organizations fighting against Malaria will be involved in the implementation of this activity with

support from PNLP.

COMPLETE NARRATIVE

RIP+ (Réseau Ivoirien des Organisations de Personnes Vivant avec le VIH), a nationwide umbrella network

of PLWHAs organizations created in 1997, works to establish and protect the legal rights and improve the

quality of life of persons living with HIV/AIDS. Through fund raising, sub-granting, advocacy, and mentoring,

RIP+ seeks to strengthen the capacities of its 50 active affiliates to build national and local responses to the

HIV/AIDS pandemic. A partner of the Ministry for the Fight Against AIDS (MLS), Ministry of Health (MOH),

and Ministry of Family, Women, and Social Affairs, as well as many other technical ministries, RIP+

participates in the design and implementation of national policies and strategies as a member of various

technical working groups and committees.

In late 2006, RIP+ was awarded a three-year grant, one of three Ivorian organizations selected in the first

round of the New Partners Initiative (NPI). Through the NPI program, RIP+ is implementing Project SERVIR

in Côte d'Ivoire to achieve the following objectives: (1) build administrative capacity of PLWHA

organizations, (2) train the members of all PLWHA NGOs in positive HIV prevention, (3) implement positive-

prevention activities, (4) institutionalize a national HIV testing day, (5) provide care and support to newly

diagnosed PLWHA, and (6) provide home-based care and support to those in need.

RIP+ manages the project and provides sub-grants and organizational and technical capacity-building to its

affiliate organizations. Direct care and support, as well as CT promotion and services, are delivered by local

staff members of affiliate PLWHA organizations. Over three years, the project is expected to result in HIV

counseling and testing (CT) for at least 100,000 youths and adults through Cote d'Ivoire Testing Day and to

provide direct care and support services to at least 17,500 PLWHA nationwide.

With FY07 and FY08 NPI funds, RIP+ has collaborated with JHU/CCP, MLS, MOH, and other national key

stakeholders to develop, launch, and institutionalize a Côte d'Ivoire Testing Day (CITD). The first CITD is

planned for Dec. 15, 2008.

In FY09, RIP+ will build on its experience and on outreach activities of its affiliates to continue to strengthen

and expand the capacity of local PLWHAs organization to respond to HIV/AIDS in their communities,

including strengthening access to and uptake of CT as a critical component of prevention, care, and

treatment strategies. RIP+ has worked with a variety of partners (including RIP+ affiliates, local NGOs,

JHU/CCP, the District of Abidjan, PSI, Hope Worldwide, Alliance CI, Clinique de Confiance, and the private-

sector network CGECI) to mobilize communities and increase demand for CT, using innovative approaches

such as door-to-door, family-centered services provided by mobile units. At least 4,503 persons were

reached through community mobilization activities. These community mobilization efforts highlighted the

need to harmonize stakeholder understanding of scale-up to support a national testing day. RIP+ worked in

support of a new simplified algorithm allowing whole-blood, finger-prick rapid testing and promoted

understanding of home- and community-based service-delivery approaches. In FY09, the MLS and MOH

will spearhead the national testing day, and RIP+ will lead community mobilization efforts. RIP+ will ensure

that an effective, client-friendly national referral system is put in place to ensure a continuum of quality care

for PLWHA newly diagnosed during the second CITD (2009).

In FY09, in coordination with the National HIV/AIDS Care and Treatment Program (PNPEC) and the

National TB Treatment Program (PNLT), RIP+ will provide 17 sub-grants worth $5,000-15,000 to affiliate

organizations to provide home-and community-based palliative care services to alleviate psychosocial,

physical, and spiritual distress; promote positive living; and support bereavement for at least 10 000

PLWHA and their family members countrywide. Affiliates will work to improve community support for

persons living with HIV or HIV/TB co-infection and their families to address stigma and discrimination;

promote treatment literacy and adherence; and link clients to comprehensive services, including medical

care (ART, TB treatment, and others) community-based palliative care and care for positive children.

RIP+ will continue to develop and strengthen community mobilization efforts to address HIV/TB co-infection.

Activities will include development and airing of radio and TV spots on the co-infection; elaboration,

validation and distribution of a training manual dealing with co-infection; and TOT for a pool of national

trainers on co-infection. RIP+ will contribute to organization of TB/ HIV world day activities. RIP+ will also

work with COLTMER-CI, the umbrella organization for the fight against TB, to build the capacity of NGOs to

provide quality patient follow up

RIP+ expectsto provide direct care to at least 2000 people with HIV TB in FY09 and train 50 new people to

provide direct care. RIP+ will build on it partnership with the national TB program for implementation of

integrated, community based palliative care services

RIP+ will work to link community mobilization, treatment literacy, and palliative care and other support

services, including TB-related home- and clinic-based palliative care, with related services in the geographic

area and to promote coordination at all levels through the district, regional, and national HIV and other

coordination forums. RIP+ will ensure that accurate and timely M&E reports are provided to the relevant

bodies and will contribute to building a single national M&E system.

Activity Narrative: RIP+ will continue to provide technical assistance and share its experience to assist national authorities and

key stakeholders, including its affiliate members, in the use of a simplified monitoring and evaluation plan

for community-based palliative care activities developed in FY08. RIP+ will provide technical and

management assistance to ensure that local PLWHA organizations receive adequate information and

assistance to access funding opportunities supported by PEPFAR and other donors.

RIP+ will also promote using of a simplified national referral system for community-based palliative care to

address the high rate of lost to follow up within the care and treatment program. Acting as a watchdog on

this issue, RIP+ will report to the national body (PNPEC) any gap within the system and assist PNPEC in

organizing periodic meetings to review the assessment report and make recommendations for the way

forward.

RIP+ will coordinate with the Ministry of Health's strategy for decentralizing care and treatment services to

ensure synergistic impact. A fund-raising strategy will be put in place to ensure the sustainability of project

activities. The project will be monitored by ongoing data collection and periodic feedback meeting with

stakeholders. A final evaluation combining a focus group discussion with PLWHA, key stakeholder

interviews, and routine data analysis will assess the project's effectiveness. Final evaluation will also include

external evaluation of project's process, effect and impact.

New/Continuing Activity: Continuing Activity

Continuing Activity: 17292

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

17292 17292.08 U.S. Agency for Network of People 7078 7078.08 NPI RIP+ GHH- $0

International Living with A-00-07-00016-

Development HIV/AIDS 00

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's legal rights

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

* Family Planning

* Malaria (PMI)

* Safe Motherhood

* TB

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Program Budget Code: 13 - HKID Care: OVC

Total Planned Funding for Program Budget Code: $10,053,368

Total Planned Funding for Program Budget Code: $0

Program Area Narrative:

Background

The 2005 AIDS Indicator Survey (AIS) estimated adult HIV prevalence in Cote d'Ivoire at 4.7%, with higher rates among woman

than men (6.4% vs. 2.9%). Geographic differences included marginally higher HIV prevalence in urban vs. rural settings and

marked regional differences, from 1.7% in the Northwest to 5.8% in the East and 6.1% in Abidjan. Sexual debut was reported by

age 15 for 23% of females and 10% of males, by age 18 for 71% of females and 48% of males. Among unmarried women aged

15-19, 31% reported having a sex partner who was at least 10 years older, with female OVC at high risk of transactional or

intergenerational sexual relationships.

The AIS estimated that 16% of children were orphaned or vulnerable, including 8% who had lost father, mother, or both. These

OVC rates did not vary significantly by gender or urban/rural residence, but they increased markedly with age, from about 9% of

infants to 25.3% of the 15-17 age group. OVC rates were lowest in the North (4.2%) and Northwest (7.2%) and highest in the

South (18.4%) and in Abidjan (18.2%). HIV-related OVC are estimated to number 540,000, including 80,000 children living with

HIV (UNAIDS 2004).

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 food insecurity

and other child vulnerabilities, and resulted in significant decreases in donor funding and in potential for local private-sector

partnerships for OVC. Although UNICEF and the World Food Program contribute to the national OVC strategy, PEPFAR remains

the only major donor for OVC activities in the country, with the World Bank re-engaging as the country stabilizes. The PEPFAR

team continues to explore leveraging and wrap-around opportunities, including collaboration with UNICEF to maximize assistance

for the national response as well as increasing coordination with the UNFPA to use existing and new research on gender-based

violence, girls' education, and women's income generation to inform projects with adolescent female OVC and female caregivers.

Although the lack of major donors has presented challenges in identifying and serving large numbers of OVC, Cote d'Ivoire has

taken important steps, with PEPFAR assistance, toward ensuring OVC support through policy, coordination, capacity-building for

NGO/CBO/FBOs, training of caregivers, and delivery of direct services. As of September 2008, 68,061 OVC were being provided

services with PEPFAR support, exceeding the target of reducing the vulnerability of 63,000 children. OVC care is coordinated

through the Ministry for the Family, Women, and Social Affairs (MFFAS) and its National OVC Program (PNOEV) in cooperation

with the national think tank on OVC (CEROS-EV). With support from PEPFAR and UNICEF, the PNOEV has led the participatory

development and dissemination of a new National OVC Strategic Plan (2007-2010), the Ministry of AIDS sector plan, and a

national OVC policy and M&E plan (2007-10). These documents define the national priority of supporting OVC within families and

communities. PEPFAR funds contribute by engaging partners with a mandate to build the capacity of local organizations to

identify, assess, and meet the needs of OVC while strengthening systems to coordinate, manage, and track progress at local,

district, and national levels

FY05-08 Response

Based on the national OVC policy, standard criteria for services to be provided for OVC were developed and disseminated.

Identification of OVC is conducted at service entry points in PMTCT, CT, and health-care settings and by community committees

and local NGO/FBO/CBOs, which provide an initial needs assessment and household follow-up. A central part of the OVC

strategy is 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. In FY05-06, the district pilot project of

San Pedro (IRIS) was designed as a model for providing a continuum of linked health services (palliative care, CT, PMTCT,

HIV/TB, ART, and STI treatment) and social services with a focus on OVC. PEPFAR funds allowed the PNOEV to pilot and

reinforce the use of social centers as platforms for coordinating OVC-related activities (including education support with the

Ministry of Education) and sharing lessons among organizations in the public and private sectors within a geographic area.

Twelve more platform sites are being added with FY08 funds, and another 12 will be added with FY09 funds, bringing the total to

40.

In FY05-08, PEPFAR, Global Fund, and UNICEF funded the rapid expansion of sub-grants to C/F/NGOs to support expanded

decentralized services for OVC and their host families and communities. PEPFAR partners are implementing grant programs,

training, and referral systems to ensure local ability to identify OVC, assess their needs, and provide comprehensive care. Hope

Worldwide provides strong mentoring and capacity building for small partner organizations that identify OVC and provide direct

services, while ANADER is strengthening rural OVC identification and service delivery through creation and training of village

committees and FHI continues to work with the PNOEV to improve district-level coordination and begin harmonizing data

collection among government agencies and civil society. The PNOEV continues to advocate for OVC legal rights, no-fee legal

documentation, and reduced expenses for social services for OVC. The Ministry of Education has used PEPFAR funds to help

OVC stay in school and succeed in their studies through social worker and teacher training, scholarships, the provision of basic

learning materials, and nutrition programs. New partners such AVSI and Save the Children UK joined the PEPFAR CI team to

strengthen child protection, especially for vulnerable girls; improve early childhood nutrition and care; and increase coverage for

OVC direct care services in the underserved West.

Under the coordination of PNOEV, PEPFAR partners are working to adapt the Child Status Index while improving reporting

through harmonized indicators and a national OVC database. This included a review of partners' tools and resources to improve

consistency of capacity building and organizational assessments, with the aim of "graduating" local organizations to become sub-

partners or larger implementers, as well as training in use of the CSI and quality assurance for local NGOs, service providers,

teachers, and social workers.

FY09 Priorities

PEPFAR and national priorities for FY09 focus on systems strengthening, coordination, and capacity building to enhance

sustainability of programs. Altogether, at least 80,000 OVC will receive direct services by September 2009. Planned activities will:

1. Build on progress in strengthening the ability of local organizations to identify OVC, assess their needs, and provide referrals

and quality care with appropriate monitoring of the children's status. A consultant will continue to work with the PNOEV and

CEROS-EV to map OVC services and needs, ensure strategic placement of service providers, and define and implement a

strategy for rapidly scaling up quality services.

2. Reinforce 28 social center platform sites (including 12 sites being added with FY08 funding) and add 12 more sites (for a total

of 40) to continue capacity building and coordination of local service providers, formalize referral systems, and strengthen the

standardizing of data collection started in FY08. This will build on steps that MFFAS is taking in 2008 to expand state support of

social centers by purchasing buildings, assigning salaried staff, providing operating resources, and working at the cabinet level to

institutionalize the model. PEFPAR will continue to work with the PNOEV SI team, CEROS-EV, and platform directors to ensure

that by September 2009, data-entry systems are easy to use and local N/C/FBOs may begin entering data directly at the platform

sites. The platforms are a strong tool for coordinating local responses, and strategies in FY09 will develop non-monetary

incentives (training, access to computers) to help ensure utilization and maximize consistency of data collected.

3. Strengthen referral systems and improve quality and consistency of service delivery. A new partner is being added in FY09 to

coordinate harmonization of indicators of quality in all areas of OVC programming, to train all partners, and to help integrate QAI

procedures across OVC programs. The PNOEV will continue to develop its certification system for OVC training. All PEPFAR

ART and PMTCT service providers will continue to engage lay referral counselors at all sites dedicated to providing a

comprehensive package of HIV prevention interventions and effective referrals to community-based OVC and palliative-care

services. Efficiency of OVC care delivery will be improved by funding all OVC partners to cross-train their OVC community

caregivers to provide community- and home-based palliative care and support as well, and vice versa. PEPFAR also is

participating in national strategic planning to implement core competencies and incentives for community and lay counselors.

4. Further expand referral systems to improve geographic and targeted population coverage, including the contribution of AVSI, a

new partner beginning in October 2008, who will continue to work in areas of greatest need. In coordination with the PNOEV,

PEPFAR partners will continue to provide sub-grants and technical assistance to local NGO/CBO/FBOs throughout the country,

including in the underserved North and West. The PNOEV will continue its coordinating meetings to address gaps in regional

coverage and to limit duplication at the subpartner level, while a stronger focus on platforms in Abidjan will help reach OVC in

higher-prevalence urban and peri-urban areas.

5. PEPFAR partners will continue to work with the CEROS-EV to develop strategies for meeting the needs of especially

vulnerable children and youth. This includes links, co-planning, and advocacy with the Ministry for Technical and Vocational

Training and the private sector to address livelihood security and preparation for work among older OVC, as well as advocacy with

the Ministry of Youth to provide psychosocial support for older OVC (targeting ages 18-24). Partners will continue to develop and

implement strategies for nutritional support for younger children and will work to reduce the vulnerability of adolescent female

OVC through income generation, psychosocial support, HIV prevention, and linking with male-norms programs in AB. Social

workers and OVC caregivers will be trained in income-generating activities, based on a best-practices guide elaborated with FY08

funding, with implementation efforts prioritizing the development of IGA for female OVC caregivers.

All USG-funded partners will report to the PEPFAR strategic information team with quarterly program results and other requested

program data. To help build one national monitoring and evaluation system, all USG-funded partners will participate in quarterly SI

meetings and will implement decisions made during these meetings.

Table 3.3.13:

Funding for Testing: HIV Testing and Counseling (HVCT): $0

RIP+ (Réseau Ivoirien des Organisations de Personnes Vivant avec le VIH), a nationwide umbrella network

of PLWHAs organizations created in 1997, works to establish and protect the legal rights and improve the

quality of life of persons living with HIV/AIDS. Through fund raising, sub-granting, advocacy, and mentoring,

RIP+ seeks to strengthen the capacities of its 50 active affiliates to build national and local responses to the

HIV/AIDS pandemic. A partner of the Ministry for the Fight Against AIDS (MLS), Ministry of Health (MOH),

and Ministry of Family, Women, and Social Affairs, as well as many other technical ministries, RIP+

participates in the design and implementation of national policies and strategies as a member of various

technical working groups and committees.

In late 2006, RIP+ was awarded a three-year grant, one of three Ivorian organizations selected in the first

round of the New Partners Initiative (NPI). Through the NPI program, RIP+ is implementing Project SERVIR

in Côte d'Ivoire to achieve the following objectives: (1) build administrative capacity of PLWHA

organizations, (2) train the members of all PLWHA NGOs in positive HIV prevention, (3) implement positive-

prevention activities, (4) institutionalize a national HIV testing day, (5) provide care and support to newly

diagnosed PLWHA, and (6) provide home-based care and support to those in need.

RIP+ manages the project and provides sub-grants and organizational and technical capacity-building to its

affiliate organizations. Direct care and support, as well as CT promotion and services, are delivered by local

staff members of affiliate PLWHA organizations. Over three years, the project is expected to result in HIV

counseling and testing (CT) for at least 100,000 youths and adults through Cote d'Ivoire Testing Day and to

provide direct care and support services to at least 17,500 PLWHA nationwide.

With FY07 and FY08 NPI funds, RIP+ has collaborated with JHU/CCP, MLS, MOH, and other national key

stakeholders to develop, launch, and institutionalize a Côte d'Ivoire Testing Day (CITD). The first CITD is

planned for Dec. 15, 2008.

In FY09, RIP+ will build on its experience and on outreach activities of its affiliates to continue to strengthen

and expand the capacity of local PLWHAs organization to respond to HIV/AIDS in their communities,

including strengthening access to and uptake of CT as a critical component of prevention, care, and

treatment strategies. RIP+ has worked with a variety of partners (including RIP+ affiliates, local NGOs,

JHU/CCP, the District of Abidjan, PSI, Hope Worldwide, Alliance CI, Clinique de Confiance, and the private-

sector network CGECI) to mobilize communities and increase demand for CT, using innovative approaches

such as door-to-door, family-centered services provided by mobile units. At least 4,503 persons were

reached through community mobilization activities. These community mobilization efforts highlighted the

need to harmonize stakeholder understanding of scale-up to support a national testing day. RIP+ worked in

support of a new simplified algorithm allowing whole-blood, finger-prick rapid testing and promoted

understanding of home- and community-based service-delivery approaches. In FY09, the MLS and MOH

will spearhead the national testing day, and RIP+ will lead community mobilization efforts. RIP+ will ensure

that an effective, client-friendly national referral system is put in place to ensure a continuum of quality care

for PLWHA newly diagnosed during the second CITD (2009).

With FY09 NPI funds, RIP+ will provide logistical, technical, and financial support to PLWHA groups, NGOs,

and other HIV/ AIDS and civil-society groups to conduct community mobilization activities and to promote a

family-centered approach in clinical and community settings (including home- and community-based CT

services and couples counseling and testing). RIP+ will work through community-based organizations and

their communication networks (including partnerships with local radio stations) and community and religious

leaders to reinforce CT activities. These organizations will be trained in positive prevention, a rights-based

approach, the concept of greater involvement of persons with HIV/AIDS (GIPA), and reduction of stigma

and discrimination.

At each CT event during CITD, RIP+ will coordinate outreach adapted to the community involved. RIP+ has

experience in coordinating community counselors at CT sites and will replicate and adapt this model to

identify and empower community counselors providing CT services and ensure strong community links.

JHU/CCP and Alliance CI will continue to assist RIP+ by providing technical assistance to ensure training,

supervision, and quality of CT-related communication and community-mobilization activities.

RIP+ will advocate with decentralized governmental bodies (mayors, general councils) for additional

resource mobilization for community-based CT, in order to enhance community appropriation of this service.

RIP+ will ensure that its M&E system provides timely, accurate reports to national authorities and the USG

strategic information team. To help build a unified national M&E system, RIP+ will participate in quarterly SI

meetings and will implement decisions taken during these meetings.

New/Continuing Activity: Continuing Activity

Continuing Activity: 17082

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

17082 17082.08 U.S. Agency for Network of People 7078 7078.08 NPI RIP+ GHH- $0

International Living with A-00-07-00016-

Development HIV/AIDS 00

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Workplace Programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14:

Funding for Health Systems Strengthening (OHSS): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

- In response to an AED recommendation, RIP+ will seek CTO approval to purchase a new accounting

software called SAGE SAARI

- To ensure that an external evaluation of the program is conducted, RIP+ will take part in the EDS process

planned by the MLS in 2010. This evaluation will assess the SERVIR program's progress toward meeting its

indirect targets in CT community mobilization.

COMPLETE NARRATIVE

RIP+ (Réseau Ivoirien des Organisations de Personnes Vivant avec le VIH), a nationwide umbrella network

of PLWHAs organizations created in 1997, works to establish and protect the legal rights and improve the

quality of life of persons living with HIV/AIDS. Through fund raising, sub-granting, advocacy, and mentoring,

RIP+ seeks to strengthen the capacities of its 50 active affiliates to build national and local responses to the

HIV/AIDS pandemic. A partner of the Ministry for the Fight Against AIDS (MLS), Ministry of Health (MOH),

and Ministry of Family, Women, and Social Affairs, as well as many other technical ministries, RIP+

participates in the design and implementation of national policies and strategies as a member of various

technical working groups and committees.

In late 2006, RIP+ was awarded a three-year grant, one of three Ivorian organizations selected in the first

round of the New Partners Initiative (NPI). Through the NPI program, RIP+ is implementing Project SERVIR

in Côte d'Ivoire to achieve the following objectives: (1) build administrative capacity of PLWHA

organizations, (2) train the members of all PLWHA NGOs in positive HIV prevention, (3) implement positive-

prevention activities, (4) institutionalize a national HIV testing day, (5) provide care and support to newly

diagnosed PLWHA, and (6) provide home-based care and support to those in need.

RIP+ manages the project and provides sub-grants and organizational and technical capacity-building to its

affiliate organizations. Direct care and support, as well as CT promotion and services, are delivered by local

staff members of affiliate PLWHA organizations. Over three years, the project is expected to result in HIV

counseling and testing (CT) for at least 100,000 youths and adults through Cote d'Ivoire Testing Day and to

provide direct care and support services to at least 17,500 PLWHA nationwide.

With FY07 and FY08 NPI funds, RIP+ has collaborated with JHU/CCP, MLS, MOH, and other national key

stakeholders to develop, launch, and institutionalize a Côte d'Ivoire Testing Day (CITD). The first CITD is

planned for Dec. 15, 2008.

In FY09, in coordination with national authorities, key partners (including Alliance Cote d'Ivoire and

JHU/CCP, AED), and national stakeholders, RIP+ priorities include:

- Provide technical support and periodic supervision to its 31 sub-grantee organizations. In consultation

with local stakeholders, RIP+ will reactivate the existing Project Selection Committee.

- Promote and enforce the established Code of Conduct for all affiliate organizations. The code will enable

RIP+ affiliates to respond to the challenges of sustaining democratic and participatory institutional

procedures, while creating an enabling environment in which PLWHA can collectively determine their goals.

The code addresses themes such as values, transparency, good governance, accountability, and

partnership. RIP+ will reinforce the Code of Conduct by leading as a role model.

- Provide technical support and mentoring to its 31 affiliate NGO/CBO/FBOs, enabling them to contribute

to HIV prevention, care, and/or treatment services. RIP+ will provide technical support focused on

promoting good governance, developing effective advocacy skills, and building capacity in basic

bookkeeping, partnership building, resource mobilization, and monitoring and evaluation.

- Strengthen grantee capacity in organizational networking in order to develop, consolidate and sustain

achievements acquired.

- Develop lessons learned and recommendations for sustainability and quality services, focusing on

networking leveraging funds from local governments, the private sector, and diverse donors.

- Participate in local and international meetings, including the PEPFAR 2009 implementer meeting.

- Based on an AED recommendation, RIP+ will seek CTO approval to purchase a new accountancy

software called SAGE SAARI

- Participate in the EDS process planned by the MLS for 2010 to document that the SERVIR Program met

its indirect targets in CT community mobilization.

Technical capacity building training offered by RIP+ will target both sub-grant award winners and non-

winners to improve their capacity for the next grant round and improve the quality of ongoing activities. The

Small Grant Program will also complement the administrative and financial technical assistance received

from RIP+.

For the implementation of the small-grant projects, SERVIR is expected to generate at least 60 full-time jobs

for PLWHA, and indirectly involve 200 volunteers.

New/Continuing Activity: Continuing Activity

Continuing Activity: 17295

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

17295 17295.08 U.S. Agency for Network of People 7078 7078.08 NPI RIP+ GHH- $0

International Living with A-00-07-00016-

Development HIV/AIDS 00

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's legal rights

* Reducing violence and coercion

Workplace Programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.18: