The Kinshasa School of Public Health (KSPH), created in 1984 with funds from USAID, has five objectives: (1) train and educate undergraduate and postgraduate professionals in public health and health economics; (2) update and upgrade the knowledge and skills of Congolese health professionals as needed in order to address health management priorities; (3) enhance disease surveillance; (4) reinforce health operational research; and (5) gather, evaluate and publish health data on programs in the DRC. These objectives are achieved through training programs (MPH), research and community health service delivery. The school has been providing technical assistance to the Ministry of Health (MOH) programs and national universities. During the last five years, KSPH has implemented the project « Strengthening Infectious Diseases Control in DRC » which focused on HIV/AIDS, Malaria and tuberculosis control. This project was funded by CDC Atlanta under the cooperative agreement U62/CCU0233-43.

The goal of this project is to contribute to the reduction of HIV/AIDS and sexually transmitted infection transmission and to attenuate their impact in order to improve the well being of the Congolese people. This project pursues the following specific objectives: (1) to achieve primary prevention of HIV infection through activities such as expending confidential counseling and testing programs; (2) to strengthen the capacity of the country to collect and use surveillance data and manage national HIV/AIDS programs; (3) to strengthen laboratory support for surveillance, diagnosis, treatment, disease monitoring and HIV screening for blood safety; (4) to provide a support for the improvement of the nutritional status and food diet of PLWHA.

This project's activities are concentrated in USG-supported areas: Kinshasa, Bas Congo, Katanga, Sud Kivu, Kasai Oriental and Province Orientale; however, certain activities, such as the unified national monitoring and reporting system will have national impact

This projects targets youth, health workers, (clinicians and laboratory technicians) PLWHA, students, social workers, and MOH staff.

This project will reinforce the national health system by supporting the MOH's human capacity development, laboratories at the central and provincial levels, and providing technical assistance in strategic information and HIV M&E.

In terms of cross-cutting budgetary attributions, KSPH will focus on human resources for health, food and nutrition (policy, tools, etc), food and nutrition (commodities), and economic strengthening. Across several budget code areas, KSPH will dedicate $937,214.30 to human resources for health. Using Action Contre la Faim (ACF) as a subpartner, KSPH will dedicate $132,000 to food and nutrition (policy, tools, etc.), $463,000 to food and nutrition (commodities), and $70,000 to economic strengthening activities. These nutrition and economic strengthening activities are intended to ensure food security and proper nutrition for adult and pediatric PLWHAs and their families.

In terms of key issues, all of KSPH's activities will have ongoing periodic evaluations over the life of the program as well as an end-of-program evaluation. The ACF managed nutrition activities will provide increased access to income and productive resources to women in order to increase the food security of them and their families. Finally, in clinics where KSPH will provide pediatric care and treatment services, KSPH will leverage government-sponsored child survival services.

KSPH will strengthen the health system by providing training (pre-service and in-service) to DRC National Institutions/Programs staff at different levels (national, provincial, district) and providing technical and administrative assistance to National programs and institutions, local and international USG partners, and other donors. National programs and institutions will include the National Multi-Sector AIDS Control Program (PNMLS), the National AIDS Control Program (PNLS), the National Tuberculosis Program (PNT), the National Blood Safety Program (PNTS), the National Nutrition Program (PRONANUT), the national medical and nurse schools, and some national universities. Local and international USG partners include the Fondation Femme Plus (FFP) and youth associations involved in counseling and testing, sexual prevention, and abstinence-only prevention activities, and the US DoD. Other donors include Global Fund, Catholic Relief Services, the German Development Corporation (GTZ), CORDAID, AMO CONGO, the Clinton Foundation, the World Bank MAP project, and others.

Selected professionals in MOH programs will be provided with MPH-level training in public health. National programs and institutions will receive technical and administrative assistance to develop HIV- related policies, norms, and standard operating procedures. KSPH will provide technical and

administrative assistance to other donors as necessary for them to participate in contributing to the unified national monitoring and reporting system.

Each planned activity described in different sheets below includes outputs to be reached during the program period aligned with PEPFAR indicators. Quarterly reports will include these indicators, problems identified, and recommendations to resolve problems. These reports will be transmitted to CDC/DRC. A mixed team of KSPH staff, CDC/DRC and a CDC consultant will assess the progress being achieved through the project period.

NUTRITION AND FOOD SECURITY SUPPORT PROGRAM FOR PLWHA

In order to be consistent and in synergy with the activities of other participants and to respond to the growing needs in the fight against HIV/AIDS, the KSPH, ACF, PRONANUT and PNLS have therefore decided to become part of a nutrition and food security program targeting the most vulnerable PLWHA over 22 health zones of Kinshasa. The objective of this intervention is to improve the life conditions and longevity of PLWHA, as well as to ensure nutritional treatment for the most vulnerable HIV positive people. Activities are centred on three aspects: nutritional promotion, treatment through nutritional support, and food security activities.

Nutritional promotion activities aim at improving the diet of PLWHA by increasing access and utilization of nutritional centers. This includes a reference/referral sytem customized to each participant based on his/her individual health needs allowing him/her to seek target nutritional interventions at specified nutritional centers.

The KSPH in collaboration with ACF, PNLS and PRONANUT will take part in the development of local capacities, communities, local organisations and health authorities at a local and central level. The support to the Ministry of Health for the Reinforcement of the Nutritional Program enable the promotion of national politics for nutrition and the reinforcement of the nutritional surveillance of the country. At the local level, the nutritional teams of ACF will work together with the Provincial Health Inspection and the Central Offices of the Health Zones, and train the health personnel on malnutrition. These teams will implement targeted nutritional, food security and water and sanitation programs. Specifically, this intervention will consist of training of trainers, training of local partners and actors on detection and treatment of malnutrition, training on balanced food diet and nutritional support for PLWHA through a voucher system; and training and follow-up of PLWHA and affected persons (AP) who benefit from income generating activities (IGA).

STRENGTHENING YOUTH MOBILIZATION FOR COUNSELING AND TESTING

In the DRC, there are many youth associations which are active in HIV prevention activities. They promote abstinence and sexual behavior changes. Many young people are already sexually active. For them, it is important to promote the utilization of VCT services, which are becoming more available. This

project will collaborate with 12 community-based youth associations in Kinshasa, Kasai Oriental, Katanga, Sud Kivu, Bas Congo and Province Orientale. It will also strengthen the referral system to available nearest HIV services for HIV positive cases. Furthermore, peer recruiters from youth associations will be trained in ABC prevention, counseling and testing. This project will provide technical and administrative support to those youth associations. The direct beneficiaries will be young people.

NUTRITION AND FOOD SECURITY SUPPORT PROGRAM FOR PLWHA

In order to be consistent and in synergy with the activities of other participants and to respond to growing needs in the fight against HIV/AIDS, the KSPH, ACF, PRONANUT and PNLS have therefore decided to become part of a nutrition and food security program targeting children affected by and living with HIV/AIDS in over 22 health zones of Kinshasa. The objective of this intervention is to improve the life conditions and longevity of these children and their caretakers through nutritional treatment. Activities are centred on three aspects: nutritional promotion, treatment through nutritional support, and food security activities.

The KSPH in collaboration with ACF, PNLS and PRONANUT will take part in building local and central capacities targeting communities, local organisations and health authorities. The support to the Ministry of Health for the Reinforcement of the Nutritional Program enable the promotion of national politics for nutrition and the reinforcement of the nutritional surveillance in the country. At the local level, the nutritional teams of ACF will work together with the Provincial Health Inspection and the Central Offices of the Health Zones, and train the health personnel on malnutrition. These teams will also implement nutritional, food security and water and sanitation programs. This intervention will include a training of trainers, training of local partners, actors, and caretakers on detection and treatment of malnutrition, on balanced food diet and nutritional support for children living with HIV/AIDS and those exposed to the risk of HIV transmission (Mother To Child Transmission). Income generating activities will be provided for families with a child/children living with HIV/AIDS.

PROVIDING TECHNICAL ASSISTANCE FOR STRATEGIC INFORMATION ($ 294,194.1)

CISSIDA, the HIV Strategic Information Center, was developed by the KSPH during the last three years. This center is working closely with the M&E Unit of the PNMLS to assure quality data collection and analysis, and to ensure the data are used for evidence based programming. Within the framework of this project, CISSIDA will continue to provide technical assistance to the PNMLS for annual report elaboration and dissemination to NGOs as well as other key stakeholders. Collected HIV information will be shared with partners through its website. This activity includes support for logistics such as internet, office supplies, phone, fax, printing documents, and transport fees of documents, car fuel and maintenance.

OPERATIONS AND MAINTENANCE OF THE NATIONAL REPORTING SYSTEM FOR HIV/AIDS INDICATORS ($ 173,000) KSPH will be responsible for the maintenance and operation of the national reporting system which is currently being established by KSPH and other partners with PF08 funding. This activity will include trainings, some technical assistance from the collaborating institution in Haiti, equipment maintenance, hosting of the reporting website, software license, system development, replacement of IT equipment and purchase of some supplies such as back-up devices, CDs, ink cartridges, etc.

SHORT TERM TRAININGS IN M&E ($ 170,608.7) In the DRC, despite the existence of a national M&E framework, there are discrepancies in the collected information regarding the fight against HIV/AIDS. Consequently, the KSPH in collaboration with the PNMLS has developed a training manual in M&E targeting decision-makers and field workers who are conducting interventions. The KSPH in collaboration with PNMLS has organized two training sessions of M&E trainers. Furthermore, the trainings will also help in disseminating the existing tools related to M&E. This project will organize five training sessions through six provinces of the DRC during the coming year. Participants will come from the HIV/AIDS stakeholders and partners. Trainings will be conducted by the national experts from the M&E training pool.

POLICY ANALYSIS AND SYSTEM STRENGTHENING- INSTITUTIONAL CAPACITY BUILDING ($ 75,000)

The KSPH will continue to review current policies, norms and standards based on the performance evaluations conducted with donor agencies, voluntary agencies, and relevant Ministry of Health

programs. In collaboration with the appropriate Ministry of Health program (PNLS, PNMLS, PNT, PNTS, and PNSR), KSPH will provide technical assistance in updating policies, norms and standards based on current international scientific knowledge, understanding of the Congolese socio economic environment, results from program evaluations and the feasibility of implementing recommended policies, norms and standards. In addition, the KSPH will train in HIV-related policy development which will target 25 local organizations of the following categories: health sciences schools, MOH programs, and community-based organizations. Contractors will be recruited to perform these trainings.

MPH TRAINING ($ 40,000)

Many infectious diseases are prevalent in the DRC. TB, Malaria and HIV/AIDS are the leading causes of morbidity and mortality. In order to control those diseases, primary prevention case management strategies should be applied. These approaches require an adequate basic training in several areas such as medicine and public health. Over the past twenty years, the KSPH has developed curriculum for MPH training targeting health professionals devoted to the management of the 515 actually planned Health districts / health Zones. At this time, cumulative figures show that only 720 individuals have graduated from the KSPH, while the need stands at around 2060 Health professionals for the entire country, taking into account 5 personnel trained for each health district. The gap appears immense. Fortunately, new public health schools and departments are emerging in several universities throughout the country. KSPH proposes to provide five MPH scholarships.

PARTICIPATION AT INTERNATIONAL HIV/AIDS, TB, AND STI CONFERENCES ($ 20,000)

Support is provided to key decision makers to attend relevant international conferences for updating skills, knowledge and abilities and sharing the Congolese experience with international researchers.

SENSITIZATION ON THE PREVENTION OF SEXUAL TRANSMISSION (ABC PREVENTION)

The HIV/AIDS epidemic is still growing all over the country, despite the extended effort undertaken by the PNLS, the PNMLS and other stakeholders (NGOs, faithful-based organizations, etc.). There is a constant need to inform people about the spreading of the disease and its transmission routes, and also about several services being developed throughout the country. "Femmes-Plus" foundation has implemented a

hotline aimed at providing information on HIV/AIDS to callers. This call-center functions with counselors 24 hours per day, 7 days a week. The phone network is provided free of charge by local phone firms but administrative and maintenance costs need to be covered. Thus, this project will assist the ongoing effort by providing administrative and logistical support. The direct beneficiaries will be the overall population.

TRAINING OF HEALTH PROFESSIONALS ($ 102,645.5)

The previous KSPH project conducted a nationwide laboratory status assessment. The result revealed an insufficient number of provincial reference lab technicians. Additionally, the current technicians were not performing their duties at the required level. The same assessment also noticed a lack of HIV and TB topics in the curriculum of lab technician students at secondary and university levels. This project intends to train health professionals and undergraduate students in the diagnosis of HIV and opportunistic infections, STI and biological follow-up of PLWHA. Those trainings will be organized at the KSPH laboratory which is well equipped in addition to other provincial laboratories. These trainings will be organized in collaboration with the national AIDS control program (PNLS), the National Tuberculosis Control Program (PNT) and the national Blood safety Program (PNTS). They will be conducted by experts from the pool of local lab trainers during the program period. In addition these training will be held in national, provincial and General Hospital laboratories. Participants, including lab technicians and students, will be selected from all USG area of the DRC. In addition, mentorship CoAg will be concluded with an International Lab (Senegal or Cote d'Ivoire) in order to retrain local lab technicians. Lab technicians, nurses, physicians, midwives, social workers, non medical personnel, and students will be the direct beneficiaries.

PROVISION EQUIPMENTS, LABORATORY SUPPLIES AND MAINTENANCE TO THE NATIONAL LABORATORY NETWORK ($ 501,578.70)

In order to overcome equipments and laboratory supply shortage identified during the laboratory status assessment, this project will provide laboratory computer equipments, maintenance and other lab supplies to three provincial reference laboratories located in Sud Kivu, Kasai Oriental, and Province Orientale) and maintenance and lab supplies to the existing 3 laboratories in Kinshasa, Bas Congo and Katanga. These activities will be performed to complement other interventions involving the laboratory sector, notably those funded by Global funds and MAP/World Bank.