Project Keneya, whose primary goal is to create a sustainable local response to HIV/AIDS through strengthened prevention and care services, was designed as a response to the needs of OVC, their families and caregivers, and PLWHA in northern Côte dIvoire, severely impacted by 10 years of political crisis and instability. . Keneya works in close collaboration with CBOs, networks, and social centers in targeted areas. S, and services delivered include: abstinence/be faithful prevention; adult care and support, OVC care and support, and HIV counseling and testing. Project Keneya also intends to build the capacity of CBO staff and l social workers, through regular training and mentorship.Keneya will increase cost efficiency through a family centered approach to care using a OVCs as entry points to the entire family.Keneyas transition strategy is to build the managerial and programmatic l capacity of Centre SAS in Bouaké, Notre Grenier in Bouna, and another NGO TBD in Korhogo.Key national and local stakeholders will be actively involved in the implementation and monitoring of the project. . Along with involved CBOs, best practices and lessons learned will be documented and shared.Vehicles: Through COP11:3 No vehicle will be purchased with COP12 funds. Through life of the project 5 vehicles will be purchased.

Under Project Keneya, EGPAF will support community-based care for people infected or affected by HIV (PLWHA). Trained community health workers (CHWs) at Keneyas sub-partners are responsible for providing care and support services to PLWHA enrolled in treatment centers in the Keneya coverage area . To avoid duplication and overlapping of adult care and support with HAI and other donors like Global Fund and World Bank, EGPAF will conduct coordination meetings with partners in Keneya area, as well as PNPEC, PNN, and PNOEV, to update the mapping and define areas of intervention. In Vallée du Bandama, Keneya support in priority sites complements EGPAFs Djidja project.Services provided, tailored to needs assessed, include: psychosocial and spiritual support, nutritional assessment and counseling, treatment adherence support, prevention of OIs, referral to ANC or OB-GYN for screening for cervical and uterine cancer, PwP, and palliative care, among others. Retention in care will be strongly emphasized.

During home visits, CHWs will make appropriate referrals, including: active linkages to clinical PMTCT and care and treatment services (including TB); linkages for PLWHA to support groups; linkages for any OVC identified during home visits to OVC services supported under Keneya; and linkages based on nutritional assessments of adults and children living with HIV to social centers for nutritional support.

To ensure quality services, EGPAF will conduct regular supportive supervision visits to its sub-grantees, social centers, and CHWs. Through the use of internal and external assessments, EGPAF will work with stakeholders in the community to monitor, evaluate, and improve program quality. Development, training, and use of SOPs and job aides at all levels will encourage a culture of quality assurance. EGPAF will work closely and with CDC, the MOH, and other relevant stakeholders to ensure that quality improvement is a top priority.

Condoms and WASH sanitation services (hand washing, environmental hygiene, and water purification tablets) will be made available to PLWHA. EGPAF will train CHWs to educate and monitor beneficiaries on the proper use of condoms and water purification tablets during home visits. CHWs will also be trained on stock management, identification, and distribution strategies to beneficiaries. Keneya staff will work closely with other partners, and particularly health centers, to avoid duplication of efforts.

The package of home-based palliative care services provided to PLWHA include nutritional assessments and appropriate referrals of adults and children living with HIV to community centers for nutritional support according to PNN guidance. Cooking demonstrations will be available to individuals based on nutritional assessment results. Keneya will also support economic strengthening through care and support of OVC and families for family empowerment.

The technical capacity of CHWs will be reinforced through training in PwP, adult care and support, and quality improvement. Counselors will be trained in PwP in collaboration with PNPEC, the health districts, and URC.

A sizeable portion of Keneyas scope is focused on OVC services, to be provided in covered regions. The goal of these activities is to contribute to the overall wellbeing of 9,500 OVC and their families and caregivers, including some OVC of sex workers. This goal is in line with national OVC goals as outlined by PNOEV. Keneya will assist community counselors to provide adequate responses building on the principle of one OVC, one intervention, ensuring consistency with national guidelines.

Working with sub-partners and social centers, EGPAF will use a 3-pronged family approach to effectively offer care and support to OVC: 1) OVC identification; 2) needs assessments using the Child Status Index; and 3) needs-based provision of services to OVC and families or caregivers.

Community counselors and social workers, trained and offered technical assistance under Keneya, will provide these services according to the specific needs of each child and family, who are involved in the response.

In order to successfully implement the project, EGPAF will support training and capacity building of relevant individuals, as well as the reproduction and dissemination of necessary communication materials. In collaboration with CDC and PNOEV, training in OVC care and support and the completion of OVC data collection tools will be organized. Coaching for quality assurance will be conducted in collaboration with the PNOEV and URC.

EGPAF is committed to aligning OVC support services with the seven services, defined in national policy as well as actual need for OVC and families:1.Psychosocial support2.Healthcare referrals3.Food and other nutrition services (interventions focused on assuring regular and continuous food access in quantity and quality)4.Economic strengthening services (implementing activities to reinforce long-term welfare of OVC and families)5.Education and vocational training (interventions focused on apprenticeship opportunities for OVC not in school, support for catch-up classes for OVC who have missed coursework, and school visits to check on educational and social progress)6.Shelter and caregiving (facilitation of access to safe and protective shelter and the promotion of a safe and supportive home environment)7.Legal aid and protection services for OVC rights.

EGPAF will organize an Ariel Camp to gather children from the covered regions for them to stay for 4 days, share experiences, and encourage team building skills while emphasizing peer support.To ensure high quality monitoring and evaluation of OVC activities, EGPAF will: ensure alignment of the projects M&E system with existing national M&E frameworks, including what is currently in place at social centers; routinely collect data on identified performance measures and train personnel on collection and reporting of data; maximize stakeholder involvement and promote data use for program improvement through quarterly data reviews; and ensure data quality through partner trainings on indicator definitions and SOPs.

EGPAF will conduct regular supportive supervision visits at its sub-partners in collaboration with social centers. EGPAF will work collaboratively with CDC, the MOH, local networks, other USG-funded implementing partners, and appropriate national institutions on QA/QI activities.

Community health workers and social workers will make appropriate referrals of OVC to child health centers to ensure linkages with maternal and child

Messages on abstinence and being faithful (AB) will preferably target young people aged 16-24 not in school, in youth associations, including young girls aged 16-19 years (and those who are permanent or temporary vendors in markets or bus stations. Among factors associated with high vulnerability, inconsistent use of condoms linked to poor negotiation skills and lack of knowledge about STIs are repeatedly reported as the most important (EIS, Aboudy, et al, 2009). The targeted population will be identified through youth community groups and also around markets, bus stations, and truck stations not covered by PSI/PSAMAO project to avoid duplication. The target population represents roughly 860,316 (38%) of the total population of youth in the coverage area. HIV-negative couples, women identified through PMTCT and VCT services are also targeted.AB interventions under EGPAFs Project Djidja will also target HIV-negative couples identified in PMTCT and VCT.EGPAF will work to ensure that age, gender, and culturally-appropriate materials are used for each specific target audience.Keneya AB activities will focus principally on educational AB outreach sessions hosted by 65 peer educators (PEs). A team of two PEs will lead three small weekly group education sessions (10 people) in the communities of Bouaké, Botro, Katiola, Korhogo, Boundiali, and Ferkessédougou, for a monthly average of 390 small group sessions. Themes, messages, and materials tailored to the targeted clients will be used. Community leaders and heads of associations will be involved in community mobilization activities and selection of PEs on the basis of predetermined criteria. Keneya will reproduce various awareness materials and distribute them to PEs.Keneya will support ongoing activities of at least six HIV prevention clubs at community VCT centers, where age- and culturally-appropriate messaging and discussions about AB occur. Working with two main sub-partners, Keneya will design and implement community AB educational outreach sessions, including media presentations, leaflets, posters, image boxes and sensitization messaging, led by PEs trained in BCC and with involvement of community and religious leaders and other relevant stakeholders.. Special focus will be put on negotiation techniques for females regarding abstinence and fidelity for HIV prevention. The HIV prevention clubs established at community VCT centers will be gender-specific to allow for open communication, and emphasis (in both the male and female support groups) will be placed on addressing issues related to sexual violence, inequity and equality of rights. Additionally, community sensitization on gender issues, including stigmatization and sexual violence, will be part of community outreach activities. Victims of gender-based violence will be referred to VCT centers for HIV testing. PEs will make appropriate client referrals, including active linkages to PMTCT services for pregnant women and family planning services for women with unmet family planning needs. During community outreach campaigns, PEs may also promote uptake of maternal and child health and/or family planning services, VCT services, or STI treatment, as appropriate.EGPAF will evaluate the effectiveness of the interventions in close collaboration with CDC and other key national and local stakeholders.

Keneyas target populations for voluntary HIV testing and counseling (VCT) activities are families and sexual partners of index subjects , AB program clients, women ages 30-34, and partners of women identified in PMTCT settings in the traditionally underserved areas surrounding Bouaké, Botro, Katiola, Ferkessédougou, and Korhogo. The HIV prevalence is 3.6% in central Côte d'Ivoire and 3.2% in the north.

EGPAFs family-centered approach reaches families of index subjects??? and the partners of 50% of PLWHA followed by Keneya, women using PMTCT services, OVC and their families, and PLWHA identified in community VCT centers. A repartition of families will be done to facilitate support by VCT counselors. This synergy of action will help to offer complementary services to these families that will include counseling advice and referrals to health centers for medical care follow-up.VCT will target participants in AB educational sessions who express a desire to be tested; trade professions (carpenters, blacksmiths, mechanics, barbers, hairdressers) and students in schools and universities will be referred to VCT centers for testing. Additionally, community counselors will receive technical assistance and supplies to conduct VCT activities at community centers. They will be supervised for compliance with national HIV rapid test algorithms and management of biomedical waste.

VCT funding amounts to 16% of total funding requested. Keneya closely links VTC activities with OVC and adult care and support and AB prevention activities, because referrals and linkages between activities are active and ongoing. In community VCT centers, active referrals of HIV-positive individuals are made to care and treatment (C&T) and PMTCT services supported by EGPAFs Project Djidja. HIV-positive individuals will also be enrolled in Keneyas palliative care program component. Active referrals of HIV-negative individuals will also be made to the prevention clubs..Age- and culturally-appropriate AB messages will be delivered in both the home-based and community VCT centers by community counselors and social workers.The bidirectional referral system will be analyzed each month to assess its functionality, and it will be strengthened as necessary to ensure complementarity of activities focused on AB prevention, counseling, testing, and treatment for better monitoring of people referred to C&T sites. At health centers around the VCT coverage area, counselors will make weekly visits to check the effectiveness of the management of referred patients, where they can get the counter-reference sheet. and thus ensure proper functionality of bidirectional referral system. This process involves key stakeholders (health workers, community workers) in providing services primarily to all people testing positive. For remote sites, monitoring will be done over the phone. All this information will be documented.

To ensure high quality monitoring and evaluation of VCT activities, EGPAF will: ensure alignment of the projects M&E system with existing national M&E frameworks, including what is currently in place at community VCT centers; routinely collect data on identified performance measures and train appropriate personnel on collection and reporting of activity data; maximize stakeholder involvement and promote data use for program improvement through quarterly data reviews; and ensure data quality through partner trainings on indicator definitions and SOPs.