Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 655
Country/Region: Ethiopia
Year: 2008
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: HHS/CDC
Total Funding: $5,773,750

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $975,000

I. MARCH Technical Assistance:

Johns Hopkins University-Bloomberg School of Public Health/Center for Communication Programs (CCP)

provides technical support for all partners implementing Modeling and Reinforcement to Combat HIV/AIDS

(MARCH), including the National Defense Force of Ethiopia (NDFE), Addis Ababa University (AAU), and the

Federal Police Commission (FPC). CCP began providing technical assistance (which now includes financial

management for AAU and FPC) to these CDC partners in FY06 to facilitate the MARCH project among

these three key audiences. Intensive HIV-prevention activities among the military, police, and university

students are critical for these at-risk populations, which are highly mobile groups frequently away from

home.

Targeted interventions to most-at-risk subgroups are essential to stem the spread of the epidemic.

Sustained success of these programs is therefore a crucial aspect of the national response. There are two

main components to the MARCH program: entertainment as a vehicle for education and interpersonal

reinforcement at the community level. Printed serialized dramas (PSD) portray role models evolving towards

positive behaviors. PSD are published every two weeks and are distributed among the target populations.

Discussions are held every two weeks, while informal discussions among peers continue throughout. Peer

discussions explore issues raised by the PSD and give individuals community support for behavior change.

In FY07, CCP continued work with CDC Ethiopia and CDC Atlanta to provide technical assistance (TA) and

guidance to the partners in the areas of: planning and designing projects; monitoring activities; organizing

trainings; and assisting with materials production, including both modeling and reinforcement materials and

activities. CCP provided training to the creative team and program staff for the three MARCH partners. The

training resulted in the development of high-quality, research-based, information-education-communication

(IEC) and behavior-change communication (BCC) materials on relevant HIV/AIDS topics. CCP provided TA

to partners on monitoring and evaluation of reinforcement activities; and data collection and dissemination.

CCP also conducted site-level support and training, and helped AAU develop and implement its certificate

curriculum program through a collaborative TA relationship with AfriComNet.

In FY08, CCP will continue to build the capacity of all three MARCH partners through ongoing training, TA,

and staffing, with particular emphasis on program and materials development and implementation. NDFE

will, with CCP support, continue expansion and decentralization of its MARCH intervention to three new

commands with both PSD and reinforcement activities. NDFE will also conduct outcome evaluations in the

two NDFE commands where MARCH has been implemented for more than three years. CCP will build

upon its activities with AAU to conduct a feasibility study exploring the potential to expand MARCH to new

youth audiences, and may subsequently expand to additional universities in Jimma and Mekele. Activities

with the FPC will focus on consolidation of progress to date, with an emphasis on building capacity. This will

include ongoing technical assistance to the FPC's public relations and television programming.

Activities with all three partners will include strengthened capacity-building in program management,

development of PSD, and reinforcement activities with the aim of institutionalizing MARCH program

management and implementation within all three partners. CCP will foster new linkages between MARCH

activities and partners and male-norms interventions and HIV/AIDS services such as the University of

California at San Diego's mobile voluntary counseling and testing services.

There are no targets for MARCH technical assistance with this activity, as it is assistance toward the targets

reported with AAU, FPC and NDFE activities.

II. Technical Assistance to Produce Information-Education-Communication and Behavior-Change

Communication (IEC/BCC) Material Production:

In FY06, three documentary films on HIV/AIDS were developed and produced by CDC, and in FY07, CCP

produced a variety of IEC/BCC print materials designed to strengthen quality of care at service sites through

coordination of major PEPFAR partners operating at all levels. In FY08, CCP will continue to duplicate and

distribute these three documentary films (and accompanying discussion materials) and print materials.

In addition, CCP will develop and produce materials for service providers, communities, and individuals

promoting Other Prevention (OP) strategies, help providers identify gender-based violence, train providers

on utilization of counseling and educational aids, and monitor and evaluate utilization of materials. CCP will

also develop and implement communication activities to address prevention-for-positives messaging.

Among other audiences, materials will target young people and married couples (including discordant

couples and those with concurrent partners), and will highlight themes such as gender norms and

masculinity, transactional sex, and sexual networks. These materials will address PEPFAR wraparound

areas (and respond to feedback from Wegen AIDS Talkline callers) with greater integration of HIV

prevention and other health topics, including reproductive health and family planning. Whenever possible,

CCP will involve local partners in the development of materials so as to ensure ongoing in-country capacity

building in IEC/BCC.

CCP will strengthen links with other prevention partners to ensure broad distribution and use of these

communication materials. All materials will be disseminated and reinforced through expanded outreach and

community mobilization activities, such as HIV-related trainings, seminars, and discussion groups, peer-

education sessions, mini classes, and panel discussions to be conducted by CCP at national and selected

regional sites and by partners nationwide. These activities will be implemented in close collaboration with

national and regional HAPCO through establishment of national and regional IEC/BCC working groups.

The communication materials reaching the targets will be comprehensive; targets reached will be reflected

under Other Prevention activity 10387.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $1,300,000

Added 10/15/08 with August 2008 Reprogramming:

This funding will be used to incorporate behavior change and life skills programming into "School Net", a

state-of-the-art ICT initiative established by the Ethiopian government. Approximately 8, 498 computers in

214 high schools in 11 regions all linked to the internet via VSAT and broadband technology. These groups

are among the Most at risk populations.

Currently 864,733 students are available in 706 high schools in the country. At an average class size of

around 60 students, 458 schools (509,980 students) have access to Plasma-TV, with the remaining schools

to receive equipment soon. 2978 television programs are ready for use by the Educational Media Agency

using terrestrial and VSAT satellite networks (Education Statistics Annual Abstract 1997 E.C, (2004/2005),

Ministry of Education, 2005). These technologies provide tremendous potential to reach students and

teachers throughout the nation. The Educational Mass Media Agency officially requested ARC to develop

HIV/AIDS prevention messages to broadcast between programs throughout the day free of charge. Part of

this funding will also be used to provide technical assistance to university partners in the production,

development and mounting of billboards in different regions.

---------

I. National AIDS Resource Center (ARC) - Abstinence and Be Faithful

This project is designed to expand access to AB (abstinence and be faithful-focused HIV/AIDS prevention

by enhancing the relevance of the activities carried out by the Johns Hopkins Bloomberg School of Public

Health/Center for Communication Programs (CCP) in support of the AIDS Resource Center (ARC), and by

building the capacity of partners and the HIV/AIDS Program Coordinating Office (HAPCO) to implement HIV

-prevention communication activities.

CCP/ARC will promote AB prevention strategies through two interrelated activity areas. First, CCP/ARC will

continue to provide accessible, current, and accurate information on AB strategies and service uptake to

governmental and nongovernmental partners, journalists and media professionals, healthcare providers,

researchers, and the general public through its national and regional resource centers. In FY08, CCP/ARC

will focus on maintaining and strengthening its premier, virtual-information center and library for HIV/AIDS

information resources. Particular areas of emphasis will be improved quality of library and IT services, such

as increasing the library's capacity to serve an increasingly tech-savvy public. Other areas of emphasis

include a major overhaul of the library's collection, and expansion of the library's resource-monitoring and

retention strategy. CCP/ARC will also work to establish defined areas in the resource center that can serve

populations with special needs (e.g. introducing audio booths and software for the visually impaired).

CCP/ARC will also systematize outreach activities by leveraging its existing resources. Outreach activities

will be targeted to the general public and special audiences such as youth aged 15-24, students, health

professionals and other individuals working in HIV/AIDS in Ethiopia. These activities will include a regular

schedule of single-session, drop-in, information-education-communication and behavior-change

communication (IEC/BCC) activities (e.g., classes, panel discussions, lunchtime presentations, and/or

discussion groups) pertaining to HIV/AIDS. CCP/ARC will also encourage groups and organizations in the

wider Addis Ababa region to use ARC space to conduct their own trainings and peer-education sessions.

As part of its second activity area, CCP/ARC will work to strengthen the expanded Wegen Talkline's

capacity to respond to escalating demand and to provide accurate and valid information, referral, and

counseling services on non-AB focused prevention. This will be done by hiring additional counselors fluent

in key local languages. The Wegen Talkline currently receives more than 6,000 calls per day. In FY08, the

Talkline's hours will be extended to allow for service seven days a week. CCP/ARC's current system for

monitoring the Talkline and analyzing Talkline data will be streamlined to allow for easier tracking of

behavioral trends and appropriate development of IEC/BCC materials. CCP/ARC will compile and analyze

hotline data to recommend a mechanism for feedback and dissemination of data for program improvement

and monitoring. ARC will also produce a newsletter highlighting findings of Talkline monitoring and a

monthly article on top issues addressed by Wegen counselors. These materials will be distributed to the

general population and to partner organizations to help them in the development of their own activities.

CCP/ARC will also continue to build the capacity of its own staff to retain hotline counselors.

II. Support to Regional AIDS Resource Centers (ARC)

In each region, the ARC has been integrated into the regional HAPCO, where staff receive orientation,

training, and ongoing technical support from CCP/ARC. The regional HAPCO is responsible for

management, funding, procuring equipment and supplying necessary operational materials. In FY07, CCP

provided support to the regional ARC, enabling it to provide access to accurate and up-to-date information

on HIV/AIDS, sexually transmitted infections (STI), and tuberculosis (TB) in the regions through activities

including:

1) Support for HIV/AIDS-related projects and activities of regional HAPCO, regional health bureaus (RHB),

and PEPFAR Ethiopia implementing partners

2) Support for development of culturally appropriate IEC/BCC materials specific to regional populations,

including mass media, print materials, and/or interpersonal communication tools and trainings

3) Piloting of IEC/BCC outreach activities at Bahir Dar, Mekele, and Nazaret ARC, including providing and

hosting HIV/AIDS-related trainings for local groups, expanded outreach for IEC/BCC programs, and drop-in

sensitizations and classes

4) Expansion of information-dissemination activities by facilitating outreach and distribution planning in the

regions

5) Promotion of other ARC functions, such as the Wegen AIDS Talkline in the regions

6) Provision of Internet access through high-speed computer terminals for users to research current health

and HIV/AIDS-related issues

In FY08, CCP/ARC will build upon this progress through:

1) Establishing five additional regional or zonal ARC, with clear linkages to existing local services

2) Providing ongoing training and technical assistance to seven existing regional ARC, HAPCO, and RHB in

monitoring, information technology, and materials distribution

3) Strengthening information technology capacity of all regional ARC

4) Collaboration with regional HAPCO to develop or adapt IEC/BCC materials for use at the regional level.

These materials will be culturally and linguistically tailored to the regions, and will cover a wide range of

Activity Narrative: HIV/AIDS-related topics.

5) Expansion of outreach activities to three additional regional ARC. These outreach activities may include:

providing trainings for local groups; encouraging regional HIV/AIDS groups to use ARC space to conduct

their own trainings and activities; expanding reinforcement and outreach activities for CCP/ARC's existing

BCC programming, such as the Betengna Radio Diaries or the HIV/AIDS Services Communication Initiative;

and providing a regular schedule of single-session, drop-in IEC/BCC activities (such as classes, panel

discussions, or discussion groups) pertaining to HIV/AIDS.

6) Establishing monitoring and evaluation systems at all regional ARC through staff training, implementing

outcome-evaluation protocols for user services modeled on those developed for the national ARC in FY06,

and conducting an impact evaluation of selected services at national and regional ARC.

III. Support to HAPCO for World AIDS Day

World AIDS Day (WAD) is marked every year in Ethiopia, providing an opportunity to commemorate and

publicly share successes and achievements in the battle against HIV/AIDS, and recognizing its global and

national impact. CCP/ARC, supported by PEPFAR Ethiopia, serves as an active member of the World AIDS

Day Campaign, providing technical and financial support to conduct the campaign. This includes developing

messages and producing campaign materials (posters, flyers, t-shirts, banners, billboards, press kits, press

alerts, web pages, video and radio PSAs, documentaries, and feature stories). In FY07, CCP/ARC assisted

the Federal HAPCO with coordination of all of PEPFAR Ethiopia's implementing partners for WAD, and

gave direct technical assistance in special-events management to Federal HAPCO to conduct an effective

campaign.

In FY08, CCD/ARC will give direct technical and financial assistance to HAPCO to conduct an effective

campaign throughout the year, employing a multimedia approach. CCP/ARC will expand and increase its

World AIDS Day activities at both the national and regional levels, including nationally-broadcast mass

media (televised panel discussions, TV spots, and radio spots); extensive outreach events through the

regional ARC; and production of regionally-specific World AIDS Day promotional materials. CCP/ARC will

also work to involve parliamentarians and government ministries in advocacy and communication activities

for WAD. These activities will be in addition to CCP/ARC's continued coordination of PEPFAR Ethiopia's

implementing partners for WAD.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $828,750

MARCH and IEC/BCC Materials Production Technical Assistance

I. MARCH Technical Assistance:

Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP) provides

technical support for all partners implementing Modeling and Reinforcement to Combat HIV/AIDS

(MARCH), including the National Defense Force of Ethiopia (NDFE), Addis Ababa University (AAU), and the

Federal Police Commission (FPC). CCP began providing technical assistance (which now includes financial

management for AAU and FPC) to these CDC partners in FY06 to facilitate the MARCH project among

these three key audiences. Intensive HIV-prevention activities among the military, police, and university

students are critical for these at-risk populations, which are highly mobile groups frequently away from

home.

Targeted interventions to most-at-risk subgroups are essential to stem the spread of the epidemic.

Sustained success of these programs is therefore a crucial aspect of the national response. There are two

main components to the MARCH program: entertainment as a vehicle for education (serialized printed

dramas portraying role models evolving towards positive behaviors), and interpersonal reinforcement at the

community level. Printed serial dramas published every two weeks are distributed among the target

populations and discussions are held every two weeks, while informal discussions among peers continue

throughout. Peer discussions explore issues raised by the serial dramas and give individuals community

support for behavior change.

In FY07, CCP continued work with CDC Ethiopia and CDC Atlanta to provide technical assistance (TA) and

guidance to the partners in the areas of planning and designing projects, monitoring activities, organizing

trainings, and assisting with materials production, including both modeling and reinforcement materials and

activities. CCP provided training to the creative team and program staff for the three MARCH partners. The

training resulted in the development of high-quality, research-based, information, education, and

communication (IEC) and behavior change communication (BCC) materials on relevant HIV/AIDS topics.

CCP also: provided TA to partners on monitoring and evaluation of reinforcement activities and data

collection and dissemination; conducted site-level support and training; and helped AAU develop and

implement its certificate curriculum program through a collaborative TA relationship with AfriComNet.

In FY08, CCP will continue to build the capacity of all three MARCH partners through ongoing training, TA,

and staffing, with particular emphasis on program and materials development and implementation. NDFE

will, with CCP support, continue expansion and decentralization of its MARCH intervention to three new

commands, with both print serial dramas and reinforcement activities, as well as conduct outcome

evaluation in the two NDFE commands where MARCH has been implemented for more than three years.

CCP will build upon its activities with AAU to conduct a feasibility study exploring the potential to expand

MARCH to new youth audiences, and may subsequently expand to new universities in Jimma and Mekele.

Activities with the FPC will focus on consolidation of progress to date, with an emphasis on building

capacity. This will include ongoing TA to the FPC's public relations and television programming.

There are no TA targets for MARCH with this activity, as it is assistance toward the targets reported with

AAU, FPC and NDFE activities.

II. Information, education, and communication and behavior change communication (IEC/BCC) Material

Production TA:

In FY07, CCP produced a variety of IEC/BCC print materials designed to strengthen quality of care at

service sites by coordinating major PEPFAR partners operating at all levels. In FY08, CCP will continue to

duplicate and distribute these three documentary films (and accompanying discussion materials) and print

materials.

In addition, CCP will: develop and produce materials for service providers promoting Other Prevention (OP)

strategies; help providers identify gender-based violence; train providers on use of counseling and

educational aids; and monitor and evaluate use of materials. CCP will also develop and implement

communication activities to address prevention-for-positives messaging. Materials will target young people

and married couples (including discordant couples and those with concurrent partners), and will highlight

themes such as gender norms and masculinity, transactional sex, and sexual networks. These materials will

address PEPFAR wraparound areas with greater integration of HIV prevention and other health topics.

Whenever possible, CCP will involve local partners in the development of materials.

CCP will strengthen links with other prevention partners to ensure broad distribution and use of these

materials. All materials will be disseminated and reinforced through expanded outreach and community

mobilization activities such as trainings, seminars and discussions groups, peer-education sessions, mini

classes, and panel discussions to be conducted by CCP at national and selected regional sites and by

partners nationwide. These activities will be implemented in close collaboration with national and regional

HIV/AIDS Prevention and Control Offices (HAPCO) through establishment of national and regional

IEC/BCC working groups.

Through these IEC/BCC materials, 15,000 individuals will be reached with a comprehensive ABC message

and 300 individuals will be trained with these IEC/BCC materials to encourage use and effectiveness.

III. People Living with HIV (PLWH) Betengna Radio Diaries:

This cross-cutting activity prioritizes involving PLWH in programs. It primarily addresses stigma reduction

and prevention strategies such as abstinence, condom use, and prevention for HIV-positives. HIV thrives in

a climate where PLWH face blame, discrimination, and stigma. Effective HIV/AIDS care and prevention

depends on social change, which instead of socially isolating infected people, allows their voices to be

heard within their communities and beyond. In Ethiopia, research reveals high levels of stigma and low

perceptions of risk. Evidence in other sub-Saharan countries shows that personal acquaintance with

someone with HIV/ AIDS is a major influence in adoption of safer behavior, and that people respond to

personal stories and make behavioral decisions more on emotional than on rational grounds.

The Betengna radio program features short, intimate accounts of daily life narrated by real people, followed

by a feature that delves more intensely into issues discussed in the diarist's interview. A PLWH radio diarist

creates a personal relationship with thousands of people simultaneously as s/he relates his/her daily

struggle. Audiences hear how very like themselves HIV-positive people are. Gradually, listeners develop a

Activity Narrative: relationship with the diarist, and share in their trials and challenges. During broadcasts, Betengna links

listeners with the nearest health service centers for health issues discussed and refers listeners to the

Wegen AIDS Talkline. In FY07, CCP expanded the Betengna program to the Amhara, Oromiya, and Tigray

regions to broaden their scope. To reach people who do not have radio access, or who are outside the

coverage, CCP produced and distributed the diaries in audiocassette form for 460 discussion groups and

for approximately 400 health-center and health-post waiting rooms. A discussion group guide used during

these discussions refers participants to the nearest available health services. In FY07, CCP also conducted

an impact evaluation of the radio diaries program.

In FY08, CCP will expand upon its progress in this area by: developing a new website; creating audio

listening stations at the national AIDS Resource Center; and developing and broadcasting new radio diaries

and promotional materials for the Afar and Somali regions, where culturally specific HIV/AIDS

communication materials and radio transmission in local languages is very limited and stigma is high.

Betengna will also train new radio producers and diarists to produce a new set of diaries. Betengna will also

launch broadcasts and discussions in high school radio clubs and university anti-AIDS clubs to encourage

young people to address stigma, discrimination, and prevention issues among their cohorts.

Expanded monitoring and strategic information services will be a priority in FY08, with CCP establishing

streamlined systems for gathering escalating feedback related to the program from Wegen AIDS Talkline

callers, the website, letters from listeners, and from Betengna's special call-in line. CCP will also produce a

20-minute audio special highlighting the program's impact on diarists and listeners.

Through the PLWH radio diaries, CCP will reach 15,000 listeners through comprehensive ABC activities

and community outreach. 25 individuals will be trained to promote HIV/AIDS prevention through other

behavior change beyond abstinence and/or being faithful through the radio diaries.

IV. Secondment of Staff:

A prevention advisor will be seconded to the Federal HAPCO, and a behavior-change communication

advisor will be seconded to the Health Extension and Education Center (HEEC) to ensure integration of the

support being rendered to the overall HIV-prevention system.

V. Strategic communication planning and evaluation (SCOPE) tool:

CCP will provide technical assistance for health education centers to develop a SCOPE tool for Ethiopia.

SCOPE will help to better utilize scientific data such as antenatal care prevalence, Demography and Health

Survey, Behavioral Surveillance Survey, and other HIV/AIDS data for program planning and evaluation.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $950,000

Additional narrative: 10/7/08

This funding will be used to strengthen and scale up the existing media activities of JHU-CCP. It is very

well know that the media plays crucial roles in HIV/AIDS prevention, care and treatment. The role of mass

media among other things includes; raising public awareness, clearing misconceptions, giving accurate

information, fostering open discussion, helping to reduce stigma and discrimination, improving HIV/AIDS

service seeking behavior, promotes services like PMTCT, ART, HCT and mobilizing the community at large.

JHU/CCP/ARC through a media professionals association called EVMPA (Ethiopian Volunteer Media

Professionals against AIDS) will implement this activity. The members of this NGO include private and

public media (both electronics and print) including community radio. The major role of the organization is

advocacy, capacity building to media professionals including leadership, some targeted interventions like

youth, TB/HIV and technical assistance to journalists having a library. This is an agency which access most

of the media and owned by the media professional having HIV/AIDS as its top agenda. EVMPA is already

working with different local and international partners to contribute in the fight against HIV/AIDS. In addition,

AIDS Resource Center is supplementing technical assistance providing different IEC/BCC materials both in

print and electronic form

The objective of the project is to enhance the role of mass media both public and private (print and

electronic) to 1) raise the public awareness and clear misconceptions through promotion of positive values

the community has on Abstinence and Fidelity 2)Sensitize media managers to enhance the media coverage

3) mobilize the community; 4) reduce stigma and discrimination; 5) promote services like STIs, TB, CT and

ART 6) Promote treatment adherence through innovative programs and 7) promotes positive living

8) Build the capacity of media in the area of HIV/AIDS prevention, care and treatment to enhance their

contribution for public awareness.

The program mainly target public and private media professionals (media managers, journalists and editors)

of both print and electronic media. Involvement of the educational media will be also emphasized.

Support to National and Regional AIDS Resource Centers - Reaching Youth and MARPs

I. National AIDS Resource Center (ARC) - Other Prevention

This project is designed to expand access to non-AB-focused (abstinence and be faithful) HIV/AIDS

prevention by enhancing the relevance of the activities carried out by the Johns Hopkins Bloomberg School

of Public Health/Center for Communication Programs (CCP) in support of the AIDS Resource Center

(ARC), and by building the capacity of partners and the HIV/AIDS Program Coordinating Office (HAPCO) to

implement HIV-prevention communication activities.

CCP/ARC will promote non-AB prevention strategies through two interrelated activity areas. First, CCP/ARC

will continue to provide accessible, current, and accurate information on non-AB strategies (including

condom use, sexually transmitted infections, and counseling and testing) and service uptake to

governmental and nongovernmental partners, journalists and media professionals, healthcare providers,

researchers, and the general public through its national and regional resource centers. In FY08, CCP/ARC

will focus on maintaining and strengthening its premier virtual information center and library for HIV/AIDS

information resources. Particular areas of emphasis will be improved quality of library and information

technology services, such as increasing the library's capacity to serve an increasingly tech-savvy public.

Other areas of emphasis include a major overhaul of the library's collections and expansion of the library's

resource-monitoring and retention strategy. CCP/ARC will also work to establish defined areas in the

resource center that can service populations with special needs (e.g., introducing audio booths and

software for the visually impaired).

CCP/ARC will also systematize outreach activities by leveraging its existing resources. Outreach activities

will be targeted to the general public and special audiences such as youth aged 15-24, students, health

professionals and other individuals working in HIV and AIDS in Ethiopia. These activities will include a

regular schedule of single-session, drop-in information, education, and communication and behavior change

communication (IEC/BCC) activities (such as classes, panel discussions, lunchtime presentations, and/or

discussion groups) pertaining to HIV/AIDS. CCP/ARC will also encourage groups and organizations in the

wider Addis Ababa region to use ARC space to conduct their own trainings and peer education sessions.

As part of its second activity area, CCP/ARC will work to strengthen the expanded Wegen Talkline's

capacity to respond to escalating demand and to provide accurate and valid information, referral, and

counseling services on non-AB focused prevention, by hiring additional counselors fluent in key local

languages. The Wegen Talkline currently receives more than 6,000 calls per day. In FY08, the Talkline's

hours will be extended to allow for service seven days a week. CCP/ARC's current system for monitoring

the Talkline and analyzing Talkline data will be streamlined to allow for easier tracking of behavioral trends

and appropriate development of IEC/BCC materials. CCP/ARC will compile and analyze hotline data to

recommend a mechanism for feedback and dissemination of data for program improvement and monitoring.

ARC will also produce a newsletter highlighting findings of Talkline monitoring and a monthly article on top

issues addressed by Wegen counselors. These materials will be distributed to the general population and to

partner organizations to help them in the development of their own activities. CCP/ARC will also continue to

build the capacity of its own staff to retain hotline counselors.

II. Support to Regional AIDS Resource Centers (ARC)

In each region, the ARC has been integrated into the regional HAPCO, where staff receives orientation,

training, and ongoing technical support from CCP/ARC. The regional HAPCO is responsible for

management, funding, equipment procurement, and supplying necessary operational materials. In FY07,

CCP provided support to the regional ARC, enabling them to provide access to accurate and up-to-date

information on HIV/AIDS, sexually transmitted infections, and tuberculosis in the regions through activities

including:

1) Support for HIV/AIDS-related projects and activities of regional HAPCO, regional health bureaus (RHB),

and PEPFAR Ethiopia's implementing partners

2) Support for development of culturally appropriate IEC/BCC materials specific to the regional populations,

including mass media, print materials, and/or interpersonal communication tools and trainings

3) Piloting of IEC/BCC outreach activities at Bahir Dar, Mekele, and Nazaret ARC, including providing and

Activity Narrative: hosting HIV/AIDS-related trainings for local groups, expanded outreach for IEC/BCC programs, and drop-in

sensitizations and classes

4) Expansion of information-dissemination activities by facilitating outreach and distribution planning in

regions

5) Promotion of other ARC functions, such as the Wegen AIDS Talkline in the regions

6) Provision of Internet access through high-speed computer terminals for users to research current health-

and HIV/AIDS-related issues

In FY08, CCP/ARC will build on this progress by:

1) Establishing five additional regional or zonal ARCs, with clear linkages to existing local services

2) Providing ongoing training and technical assistance in monitoring, information technology, and materials

distribution to seven existing regional ARC, HAPCO, and RHB

3) Strengthening of information technology capacity of all regional ARC

4) Collaboration with regional HAPCO to develop or adapt IEC/BCC materials for use at the regional level.

These materials will be culturally and linguistically tailored to the regions, and will cover a wide range of

HIV/AIDS-related topics.

5) Expansion of outreach activities launched in three regions under FY07 to three additional regional ARC.

These outreach activities may include provision of trainings for local groups; encouragement of regional

HIV/AIDS groups to use ARC space to conduct their own trainings and activities; expansion of

reinforcement and outreach activities for CCP/ARC's existing BCC programming, such as the Betengna

Radio Diaries or the HIV and AIDS Services Communication Initiative; and provision of a regular schedule

of single-session, drop-in IEC/BCC activities (such as classes, panel discussions, or discussion groups)

pertaining to HIV/AIDS.

6) Establishment of monitoring and evaluation systems at all regional ARC through staff training,

implementation of outcome evaluation protocols for user services modeled on those developed for the

national ARC in FY06, and an impact evaluation of selected services at national and regional ARC

III. Support to HAPCO for World AIDS Day

World AIDS Day (WAD) is marked every year in Ethiopia, providing an opportunity to commemorate and

publicly share successes and achievements in the battle against HIV and AIDS, and recognizing its global

and national impact. CCP/ARC, supported by PEPFAR Ethiopia, serves as an active member of the World

AIDS Day Campaign, providing technical and financial support to conduct the campaign, developing

messages and producing campaign materials (posters, flyers, t-shirts, banners, billboards, press kits, press

alerts, web pages, video and radio PSAs, documentaries, and feature stories). In FY07, CCP/ARC assisted

the Federal HAPCO with coordination of all of PEPFAR Ethiopia's implementing partners for WAD, and

gave direct technical assistance in special events management to Federal HAPCO to conduct an effective

campaign.

Funding for Prevention: HIV Testing and Counseling (HVCT): $160,000

Creating Demand for Counseling and Testing through Promotional Activities

In view of expanding HIV counseling and testing (HCT) service availability, it is important that public

demand and utilization continue to increase. Since its inception, the Johns Hopkins University/Center for

Communication Programs AIDS Resource Center (CCP\ARC) has not only empowered people to access

voluntary counseling and testing (VCT), but also targeted service providers to provide quality VCT services.

For example, CCP/ARC produced print and multimedia materials encouraging use of VCT and distributed

VCT communication materials to service providers. CCP/ARC also conducted two national VCT Day

promotion campaigns in collaboration with partners. CCP/ARC played a major role in establishing the

annual National HCT Day on the eve of the Ethiopian New Year. As more people and organizations observe

HCT Day, use of services and efforts to improve quality will increase.

In FY08, CCP/ARC plans to continue promotion via two approaches:

1) Implementation of HCT Day 2008 with local and international partners, in both Addis Ababa and in all of

the regions.

2) Development of a long term HIV counseling and testing BCC campaign aimed at increasing quality and

uptake of services.

3) Creation of synergy between its HCT promotion activities and those of the Millennium AIDS Campaign

through shared messaging, images, sponsorship, or events

4) Closely work with HAPCO to harmonize with the Ethiopian government's HIV/AIDS social mobilization

strategy

CCP/ARC will continue support to HAPCO and partners for HCT Day 2008 by producing campaign

materials (posters, flyers, radio/TV spots, and newspaper ads), creating web pages, organizing and

coordinating media coverage, and facilitating and providing information through its Wegen Talkline and

Warmline for service providers. CCP/ARC will support HCT Day activities at both the national and regional

levels.

CCP/ARC will support HAPCO in the development of VCT promotion strategy.

In addition to these HCT Day activities, CCP/ARC will also continue its ongoing HCT promotion campaign,

with a particular focus on three pilot regions, in which CCP/ARC is also launching expanding outreach

activities through its regional satellites. This longer-term campaign, which will likely target different

audiences than HCT Day activities (including youth and residents in rural areas) will serve as an important

entry point in HIV prevention and early access to treatment, care and support. CCP/ARC will promote both

VCT and provider-initiated counseling and testing to create demand and reduce stigma against people living

with HIV/AIDS. The campaign will use traditional and modern channels to develop region-specific promotion

messages, support annual HIV-testing campaigns, lead development of an HCT communications strategy;

and support development of national HIV counseling and testing themes and logos. This campaign will

complement other CCP/ARC activities, including the Betengna Radio Diaries program and other prevention

activities carried out through CCP/ARC's website, as well as materials distribution and outreach at the

regional ARCs. These new mass media and community mobilization activities will be complemented by

training for journalists and other partners in HCT reporting and communication. This expanded HCT

campaign will be supported through the addition of key staff.

The increase budget in FY08 by 100% from the level of FY07 is justified, in that the initial budget (FY07)

was low, to increase the coverage all forms of HCT promotion to all regions.

Funding for Treatment: Adult Treatment (HTXS): $720,000

User Support Center for ART Service Outlets

Under this ongoing activity, Johns Hopkins Bloomberg School of Public Health\Center for Communication

Programs' AIDS Resource Center (CCP\ARC) designed and developed the call-center system, which

provides services to ART service sites and hospitals throughout Ethiopia. In FY07, CCP/ARC launched a

system that will provide call-center services to 131 ART hospitals and 493 health centers selected to

provide ART services. Based on commercial "call center" software, it allows hospitals, clinics, or other

service facilities to access technical support by telephone or e-mail. The system routes the request to the

appropriate organization/person for resolution. In addition to providing an efficient means for service

providers to receive support, this system allows PEPFAR Ethiopia to track accurately issues that arise

during rapid scale-up processes and use this information to improve ART service delivery. The main

objective of the support center is to provide quick response to problems encountered by healthcare

providers. This system would benefit the health sector by improving access to information, reducing cost of

transporting healthcare providers for workshop and trainings, and reduce patient costs by avoiding

unnecessary referrals. The call center addresses an urgent need of treatment and care providers by

providing immediate responses to problems and constraints encountered while providing ART services. In

FY07, the call center was upgraded in terms of hardware, software, and human resources to accommodate

all PEPFAR-supported ART hospitals, as well as all health centers selected for ART provision. This activity

also supported website development for knowledge and information sharing, as well as piloting

teleconferencing technology using existing infrastructure among service outlets and the call center.

In FY08, CCP/ARC will continue to support the development of the provider call center with enhanced

logistics and management, as well as expansion to additional hospitals and health centers. As access to

HIV/AIDS services grows in Ethiopia, there will likely be an increased need for psychosocial support and

burnout prevention among clinicians and counselors working with people living with HIV/AIDS (PLWH) and

their caregivers. CCP/ARC has already seen this issue among its hotline counselors. In order to respond to

this challenge, CCP/ARC will explore local needs in this area and programmatic strategies that have been

used with success elsewhere and develop a framework for psychosocial support that can be shared with

partners working in service provision.

To date, CCP/ARC has helped to install dial-up Internet connectivity at 39 hospitals in three regions. At the

request of the HIV/AIDS Prevention and Control Office (HAPCO), CCP/ARC will now support hospitals by

overseeing the introduction of Internet connectivity at 100 hospitals nationwide, a move which will allow for

more effective data collection on HIV/AIDS services, as well potential for enhanced information exchange

with, and support to, providers working in HIV/AIDS services. This will also support capacity building at the

regional level, through deepened collaboration between regional HIV/AIDS Prevention and Control Offices,

hospitals, and regional AIDS Resource Centers.

Funding for Treatment: Adult Treatment (HTXS): $600,000

Public Awareness on ART

The Johns Hopkins University—Center for Communications Programs' (JHU-CCP) AIDS Resource Centers

(ARC), together with other ART-implementing partners, will undertake national and regional public

awareness activities. With the scale-up of ART services in Ethiopia, and rapid decentralization of the

national program, it is critical to generate awareness among both the general public and high-risk groups in

order to enhance and optimize uptake of services.

In FY07, in concert with the Federal HIV/AIDS Prevention and Control Office's (HAPCO) Millennium AIDS

campaigns, print media about ART have been produced and successfully disseminated. The print materials

were distributed to all regions to enhance the public's awareness level.

In FY08, public-awareness activities will be consolidated and scaled up to a greater degree to enhance

demand for ART services, as well as to increase ART service uptake, with particular emphasis on rural

settings. This will contribute immensely to national and regional efforts to prevent the expansion of the

epidemic from urban and semi-urban areas to rural areas, where 85% of the Ethiopian population resides.

In addition to ART for adults, there will be an increased focus on promoting pediatric ART, allowing for a

more holistic communication initiative that truly reflects the treatment options now available in Ethiopia.

Experience gained in generating general awareness about HIV and AIDS in major cities across the country

will be used to organize campaigns and events (e.g., workshops, symposia) to generate awareness about

the ART program. The scale-up of service expansion will require a concomitant increase in awareness

among providers and clients across the country and—most important—among the rural population. Along

with the expansion of ART, intensive work will be done to increase the use of HIV/AIDS services. In

collaboration with the ARC and others, JHU-CCP will continue to develop materials to meet regional needs,

taking cultural and language differences into consideration. In support of this, 2-3 of the most popular ART

promotion materials will be adapted for use in the regions, including translating them into local languages.

JHU-CCP will also develop new tools to support community conversation around ART, including a

documentary video and an accompanying discussion guide. In addition, there are plans to continue work to

reach low-literacy audiences in rural and urban areas by printing and distributing "speaking books" that

address a variety of HIV/AIDS treatment themes. ART communication will also play a larger role in both the

national and regional ARC's user-driven services.

The activity will be linked with different USG and non-USG partners, particularly those working in different

regions of the country. It will involve local organizations with proven experience of developing and

disseminating awareness generation activities, including mass media campaigns. They will collaborate with

the US universities and other implementing partners to organize and implement public awareness

campaigns on ART. Awareness campaigns will involve national and local media, mini-media, and other

forms of promotional activities, and will be conducted using various local languages. MOH and HAPCO will

be actively supported to lead activities related to this project in order to build the country's capacity to meet

immediate implementation needs, as well as to sustain the activities in the long term. This will be done in

collaboration with the Community Planning Project and other partners on the ground, and will build

leadership capacity at various levels, including community leaders and associations for people living with

HIV/AIDS, to support activities enhancing ART access and uptake. Technical support will strengthen ART

program activities in hospitals and assist treatment-adherence initiatives. The activities outlined above will

enhance demand and increase effective uptake of the fast-expanding ART services in urban and rural

settings.

Funding for Health Systems Strengthening (OHSS): $240,000

IT and Clearinghouse Systems Strengthening

This project is designed to expand access to HIV/AIDS information and services by strengthening the

collaboration between the Johns Hopkins Bloomberg School of Public Health/Center for Communication

Programs (CCP) and the AIDS Resource Center (ARC). CCP/ARC will strengthen existing information

systems through building capacity of its partners and national and regional HIV/AIDS Prevention and

Control Offices (HAPCO) to conduct HIV/AIDS programming. This activity has three interrelated

components.

The first focuses on strengthening and maintaining the quality of a multi-target interactive website and

increasing its popularity as part of CCP/ARC's premier virtual information center for HIV/AIDS resources,

including access to online databases and satellite websites. The main CCP/ARC website serves the

national and regional HAPCO by posting policies and guidelines, data, and information, education and

communication and behavior-change communication (IEC/BCC) materials focused on international and

Ethiopia-specific HIV/AIDS issues. The website aims to increase information provision through the ARC on

specific programmatic and thematic areas such as ART, voluntary counseling and testing (VCT), and

PMTCT.

The ARC website (www.etharc.org) is the nation's first comprehensive on-line resource on HIV/AIDS,

sexually transmitted infections (STI), and tuberculosis (TB). It provides stakeholders, policy makers,

university students, teachers, and the general public with the latest HIV-prevention news, events, resources,

and information. The website also provides access to the ARC database for organizations, funding,

materials, conference calendars, PEPFAR-Ethiopia Training Information Management System (TIMS)

summary reports, news, and employment vacancies. These databases, in particular the organization

information and conference calendars, provide a useful means by which to coordinate and network the

different HIV/AIDS organizations and activities in the country. The news, vacancy, conference, and events

databases are updated every week.

The AIDS in Ethiopia Online Database is one of the most popular, interactive online database applications

with useful information on AIDS epidemic in Ethiopia. It presents the trend of HIV/AIDS in Ethiopia from

1982-2008 with charts, indicators, and publications. The people living with HIV (PLWH) website is also a

very useful resource, with resources for living positively and testimonies of HIV-positive people. Regional

HAPCO websites of Amhara, Tigray, and Oromiya are also hosted on the ARC website, enabling regions to

disseminate region-specific information.

In February 2004, a usability study of the Ethiopia ARC website was conducted using focus groups and

featuring structured tasks and moderated discussions. The results of the usability study led to the design

and introduction of new revisions and enhancements to the website. Since its inception, the website has

experienced rapid, steady growth in the amount of traffic. Every year there has been a 100% growth in the

amount of traffic the website receives. In 2006, for example, the website had more than 2.4 million hits from

all over the world. Currently, the CCP/ARC is conducting another survey to improve the use of the website.

ARC website traffic has grown considerably since the introduction of a downloadable format for the

Betengna Radio Diaries, a program by and about PLWH. Betengna Radio Diaries is currently the most

accessed resource in ARC website, followed by the AIDS in Ethiopia Online Database.

In FY08, CCP/ARC will create two new websites, for the Betengna Radio Diaries program and national

HAPCO, and add additional Amharic content to the existing websites. Content on all websites will be

updated to ensure that it is current and user-friendly. CCP/ARC will also work to establish defined areas in

the resource center that can serve populations with special needs (e.g., introducing audio booths and

software for the visually impaired).

The second component is ongoing information technology support to the national and regional HAPCO,

including Internet and e-mail access, system administration and maintenance, and basic information

technology trainings. In FY08, CCP/ARC will improve the quality of services that ARC offers by updating

computing hardware and software and purchasing additional audiovisual materials to support the public's

extended use of BCC materials, such as the Betengna Radio Diaries. Technical assistance and support to

national and regional HAPCO will also be ongoing.

The third component aims to strengthen the ARC clearinghouse function by providing HIV/AIDS, VCT,

PMTCT, ART, STI and TB materials (print, electronic, and audiovisual) to all PEPFAR Ethiopia supported

sites, as well as nongovernmental organizations working in HIV/AIDS.

In FY08, CCP/ARC will also focus on strengthening materials acquisition, retention, and distribution to

partners in both Addis Ababa and the regions. The ARC will also implement a targeted mail-out delivery of

IEC/BCC materials through postal services and provide on-site materials delivery when appropriate. The

ARC will not be limited to development and production, but will also adapt and reprint/reproduce IEC/BCC

materials produced by other partner organizations. This will allow it to sufficiently expand outreach service

and distribution coverage of those materials throughout the country. Regional resource centers will serve as

conduits to distribute materials at district and zonal levels.