Pact supports several PFIP goals and objectives. One of PACT's key goals is to develop human capacityin Swaziland's NGOs, CBOs, and FBOs to promote the establishment and strengthening of viable andsustainable civil society organizations. Pact develops the capacity of partners to deliver HIV serviceswhich include HIV Counseling and Testing, home and facility-based care and support, ARV Treatment,and TB/HIV. Pact also develops the capacity of partners to deliver HIV prevention messages thatpromote positive behavior change through one-on-one and group based activities. Pact will develop thecapacity of partners to deliver quality OVC services which include food and nutrition, education support,PSS, protection and legal support, economic strengthening, shelter and care, and health care. Pactprovides extensive assistance to partner organizations in developing comprehensive program designdocuments that accurately reflect planned activities and clearly articulate defined goals and objectives.Pact supports teamwork between program and finance units and conducts organizational capacityassessments. A resource mobilization course provides information on strategies for diversifying theirfunding base for sustainability. Pact partners work in all four regions. Since HIV is affecting the generalpopulation, the targeting of HIV prevention is also generalized, with specific partners targeting specificgroups. Pact partners target PLHIV for positive prevention, clinical care, ART, TB/HIV and support care.Impact mitigation activities target OVCs and caregivers. Pact will mentor CANGO to become a local UGMthat will provide support to partners. Pact's strategic information support is provided through staff andinstitutional M&E capacity and M&E systems strengthening.

Global Fund / Programmatic Engagement Questions

1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does thismechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Neither3. What activities does this partner undertake to support global fund implementation or governance?

Recipient(s) of ApproximateBudget Code Brief Description of ActivitiesSupport BudgetPact will develop a program of technicalassistance to enhance civil society'sinvolvement and success in the GlobalNERCHA/civilOHSS 0 Fund. Pact will work closely with keysocietystakeholders to design and implement aTA program to address the capacityneeds of civil society organizations

including proposal writing, programplanning, monitoring and evaluation andfinancial management. Pact will continueto support NERCHA'S GMU.

Pact partners will provide a range of facility and community based clinical and support care services.These services will include clinical, psychological, food and nutritional support, spiritual, social andprevention services. The primary emphasis for these activities is comprehensive direct service deliveryfor improved quality of life for PLHIV, TB-infected individuals, and training of caregivers and counselors.

Strategic Area Budget Code Planned Amount

Pact partners will scale-up existing care and support services to improve the lives of vulnerable childrenaffected by HIV & AIDS. Partners will deliver services for vulnerable children across all seven serviceareas based on the needs of vulnerable children, their families, and communities. Service areas includeaccess to basic education, health care services, targeted food and nutritional support, protection andlegal aid, shelter and care, psychosocial support, and economic strengthening as well as the training andsupport of caregivers. TechnoServe will provide technical support to OVC partners to improve thesocio-economic status of households with vulnerable children. Pact will build the capacity of partners tosupport family units/primary caregivers and strengthen community structures. Pact will coordinatetechnical assistance through the following: strengthening capacity of local organizations; strengtheningmonitoring and QA systems; and advocating for sound strategies, policies, and programs that benefitvulnerable children. Pact will share impact mitigation lessons and strategies across partners and withinthe region through meetings, workshops, and visits. Pact participates in the national network forums andcoordinates an Impact Mitigation Technical Working Group. Pact capacity building efforts will ensure thatprograms reflect sound practices; are evidence-based; remain sensitive to the dynamics of the SwazilandHIV epidemic; and work to meet the needs of OVCs in a measurable way. Pact will support the NCCU infinalizing the development of the OVC quality service standards. Pact will work with two partners pilotingthe WORTH model to improve the socio-economic status of women through micro-finance savings andlendings. Pact will conduct training in Gender Mainstreaming to continue to build the technical andinstitutional strength of partners working in prevention and HTC. As part of the training Pact willcollaborate with gender experts in the region to explore and share innovative approaches to genderprogramming. Pact will strengthen the capacity of SWAGAA to provide technical support to otherpartners in responding to issues of GBV.

Strategic Area Budget Code Planned Amount

Pact will continue to prioritize capacity development of local organizations to integrate TB/HIV screeningin their programs for early detection and treatment of TB resulting to improved care and treatmentservices. This intervention supports the national strategic focus of early identification of TB so thatreferrals for treatment are made in a timely manner. Capacity development of partners will continue tofocus on TB/HIV co-infection, TB screening, referrals for treatment, and guidelines to prevent the spreadof TB. Pact will work in partnership with the National TB Program and URC to support partners providingTB/HIV interventions in communities by providing IEC materials, complete the national registers, andreport data to the national M&E system. Pact's partner TB/HIV programming emphasizes mobilizationactivities for awareness, testing, and treatment to promote early detection and diagnosis of TB in thecommunities. Activities include sputum collection and testing at TB diagnostic centers, collecting TB testresults and giving them to clients, and providing treatment adherence support within a community setting.Pact's primary goal is to provide necessary technical support while building the institutional capacity ofpartners to increase their effectiveness and capacity to achieve expanded, quality services andstrengthening the management of financial and human resources. Pact will continue to build the technicaland institutional strength of partners that will be working in the TB/HIV technical area.

Strategic Area Budget Code Planned Amount

Pact will support the care and support partners to systematically integrate pediatric care and supportactivities. Pact will build the technical and institutional strength of partners that will be working in PediatricCare and Support for effective management of acute malnutrition, early detection and treatment of OIs,and creation of effective relevant referrals for further care and support as. HIV exposed infants will bemonitored through regular DBS, and home visits to assess homestead situation. Nutritional supplementswill be provided as necessary.

Strategic Area Budget Code Planned Amount

Pact's Strategic Information support to partners is provided through two broad areas: staff andinstitutional M&E capacity and M&E systems strengthening, with the overall aim of generating programimprovement decision support information. Pact will provide training on MER, data quality management,data analysis, and database development for MER and program staff. Pact will continue to assist eachpartner in developing results frameworks that tracks success against both PEPFAR program and

organizational indicators. Pact will assist partners in the development of MER plans and data qualitymanagement plans. Pact provides additional MER systems strengthening assistance to all partners in thefollowing areas: review and development of effective data collection, analysis, and reporting tools; settingrealistic and achievable targets; establishing and strengthening data quality management systems;conducting internal data quality audits; and verifying and validating partner and sub-partner datasubmissions. The primary emphasis areas for these activities are training and one-on-one mentoring andTA. Pact will conduct data quality assessments aimed at meeting quality requirements for reporting tointernal and external audiences including PEPFAR. These assessments will enable Pact and partners toidentify and strengthen the data management processes that are critical in ensuring high quality data.Pact will work with each partner to undertake and document findings from their programs data qualityassessment and develop mitigation plans to address system gaps identified. Pact will providecomprehensive mentoring MER support to a UGM partner. Pact will conduct an assessment of theUGM's MER capacity, which will provide benchmark information on the status of human capacity andsystems development, as well as processes for generating, managing, and using program data fordecision making.

Strategic Area Budget Code Planned Amount

Pact carries out organizational capacity and technical assessments to develop individualized andcrosscutting plans for tailored interventions for each partner. Primary emphasis areas are one-on-onementoring, TA, and grant and financial management support. Interventions aim to strengthen andinstitutionalize organizational systems and processes and improve quality and standards of servicesdelivery. Activities target local partner staff member who work directly on program implementation andmonitoring as well as senior management. Pact will ensure adherence and compliance of Partners toUSAID rules and regulations through grants management workshops. Pact will conduct MCAT(Management Capacity Re-assessments) for all existing partners. The findings from reassessments willassist Pact in developing specific grants and financial management TA for each partner. Technicalre-assessments analyze key gaps in technical programming and are used to develop tailored plans fortargeted interventions. All local Partners receive direct one-on-one TA to strengthen the design ofprograms to improve quality of service delivery, address gaps, and identify opportunities for scale-up.Pact will support its grantees to mainstream gender in all their HIV/AIDS focus areas by conductinggender assessments and developing strategies to address the gaps identified. Pact will continue to workwith the identified UGM partner to transfer skills required for managing a UGM and mentoringimplementing partners. Pact will develop a program of technical assistance to enhance civil society's

involvement and success in the Global Fund program in Swaziland. Pact will work closely with thePEPFAR team, the CCM, NERCHA (and/or other principal recipients) and key stakeholders to designand implement technical assistance program that will address the capacity needs of civil societyorganizations including such areas as proposal writing, program planning, monitoring and evaluation andfinancial management.

Strategic Area Budget Code Planned Amount

Programming will support the National Strategic Framework prevention objectives of behavior change(including a workplace focus). Many activities link to HCT, which the NSF recognizes as a key strategy inprevention. Pact will support partners to implement prevention activities which support the attainment ofthe NSF, Partnership Framework, and SBCC strategy. Activities will address the drivers of the HIVepidemic in Swaziland: rates of partner change, prevalence of concurrent partners, sexual mixingpatterns, sexual practices and condom use, age of sexual debut, and levels of sexual and physical abuseespecially for women and girls. Pact partners' prevention activities focus on appropriate messaging forsocial and behavior change in target populations. Social behavior change communication will be directedat specific behavioral outcomes including correct and consistent condom use, delayed sexual debut,fewer partners/reduction of MCPs, and issues of abuse and violence. Pact partners implement activitiesin schools, churches, community centers, and households. Approaches include community volunteersand peer educators to conduct age-appropriate activities, working with religious leaders to reachcongregations with value-based prevention strategies, promoting HIV counseling and testing, and the useof other preventive services, road shows, and radio programming. All partners implementing HIVprevention activities will mainstream gender in their prevention activities to address some of theunderlying gender norms and behaviors that influence further spread of HIV. Pact will strengthen andsupport the linkages of HIV prevention programs with MC programs. Sexaul prevention activities willsupport pre and post MC interventions. To ensure consistent, coherent and comprehensive HIVprogramming across all partners, and to be in line with the NSF, PF, and NSBCC, all partnersimplementing prevention activities will take part in the Pact Partners Prevention Technical Working Group(PPPTWG).

Strategic Area Budget Code Planned Amount

HIV testing and counseling (HTC) has been identified as the entry point for HIV prevention, treatment,and care and support. It is a key strategy to empower individuals at a personal level to make informed

choices and decisions in seeking appropriate health care. Pact will build the technical and institutionalstrength of partners to increase testing opportunities and enable people who test positive to seekappropriate care and prevent transmission. HIV testing and counseling services to be supported will beboth provider and client initiated. Pact will also ensure that partners scale up HTC services by increasingthe number of both free-standing and provider initiated testing and counseling sites nationwide, targetingboth key and rural populations, improving the ratio of male to female counselors and development ofprograms aimed at increasing couple/partner testing and counseling and disclosure of some services tolay counselors. Pact's partners provide HTC services from mobile sites, linking clients to treatment andcare services including referrals for CD4 counts and referrals to support groups. HTC activities areutilized for personalized HIV prevention education to clients through pre- and post-test counselingsessions. Pact will strengthen the HTC partners' capacity to mainstream gender in HTC and addressunderlying gender norms and behaviors and gender based violence issues that influence further spreadof HIV. Partners will also forms strategic partnerships with MC providers to facilitate easy referrals andlinkages of HTC to MC.

Strategic Area Budget Code Planned Amount

To strengthen programming in this area, partners will focus on reduction of new infections amongstsexually active individuals and also target high risk sexual populations such as commercial sex workers,truck drivers, uniformed forces, and mobile populations. This will entail dissemination of information oncorrect and consistent use of condoms in preventing sexual transmission of HIV, as well as systematicand continuous condom distribution. Partners will work with other stakeholders to ensure constant supplyof condoms for distribution to sites. Partners will educate, demonstrate, and distribute condoms tosexually active adults. This intervention will increase: the availability and use of male and femalecondoms; the proportion of sexually active persons who use condoms consistently; and the number ofnew condom outlets per region. The primary emphasis for these activities is direct reach, servicedelivery, and training. Prevention activities will also be implemented to support the attainment of the NSF,Partnership Framework, and SBCC Strategy. All partners will mainstream gender in their preventionactivities to address some of the underlying gender norms and behaviors that influence further spread ofHIV. Pact will strengthen and support the linkages of HIV prevention programs with MC programs.Prevention activities will support pre and post MC interventions, and will continue to encourage the use ofcondoms before and after MC. Pact will work with traditional authorities to address the male norms andbehaviors that influence further spread of HIV. Traditional authorities include a "women regiment" whoare recognized as the cultural gate keepers in the country. Khulisa Umtfwana is an organizationestablished by the Queen Mother to protect the traditional ways of raising children in communities. The

program will address young people on gender norms and behaviors and GBV issues that are entrenchedin the Swazi culture which have a direct impact on the spread of HIV. Partners will use communitydialogues as the main tool to initiate discussions and develop strategies for positive cultural influences ongender and HIV.

Strategic Area Budget Code Planned Amount

Pact partners will support and provide ARV treatment at the local level to support the MOH'sdecentralized ART strategy. Partners will provide services which include HIV Counseling and Testing,CD4 count monitoring, ART initiation including Pre-ART counseling, ART treatment (act as a refill/outreach site to an ART centre), managing opportunistic infections, TB screening, TB treatment, andadherence support. Partners will be supported by the MOH with the supply of test kits, drugs andmedication for treatment activities. Pact's partners will build on PEPFAR-funded activities to strengthentreatment services through specialized training that will improve and expand quality of care, as well assupport grassroots initiatives for positive living treatment adherence.

Strategic Area Budget Code Planned Amount

Pediatric treatment will include routine assessment and treatment of OIs through the two partners. CD4will be monitored every 3 months or more often if it seems that the symptoms are increasing.Cotrimoxazole will be initiated at different CD4 levels depending on the age and size of the child.Education is done every step of the way and in the presence of the child's care taker. The children will begiven special attention along with their care-givers to teach how to take the medicine, when to ask forhelp, etc. Nutritional supplements will be given as needed.