Workplace Peer Education Program

ACTIVITY UNCHANGED FROM FY2008

The Private Sector Program (PSP) led by Abt Associates works with large workplaces and private clinics to

improve access to HIV prevention, care and treatment services for the general population and employees

and dependents. PSP focuses on developing abstinence, being faithful and correct and consistent condom

use (ABC) programs which reflect the needs and demands of private and parastatal business firms. The

project seeks to establish management and labor ownership of its workplace ABC activities and encourages

companies to share a significant part of ABC program costs. As of 2007, the project provided routine

support and supervision for 75 workplace sites in both AB only and ABC (10374) activities.

In workplaces, PSP conducts a rapid assessment of HIV services, knowledge and behavior. Based on the

assessment, the project conducts an orientation session with senior management to reach agreement on a

memorandum of understanding regarding activities and the contributions made by PSP and the company.

PSP trains a cadre of peer educators over a two-to-five-day period on ABC, TB, and HIV topics. Peer

educators also learn skills to support effective counseling and communication with family and community

members. Ideally the project trains one peer educator for every 20 to 30 workers. In turn, the peer

educators conduct eight to 16 sessions which focus on increasing knowledge and fostering behavioral

change. The sessions require 30 minutes to one hour of staff time which the company provides during

working hours. The monthly education sessions use peer interpersonal communication to teach positive

behaviors including correct consistent condom use, seeking sexually transmitted infection (STI) treatment,

and accessing counseling and testing services. Sessions also address stigma and self risk perception of

males engaging in cross-generational, coercive or transactional sex.

PSP sponsors "family days" to recognize the employer/employee commitment to workplace peer education.

The project engages PLWH associations to deliver messages on HIV prevention. The project also supports

companies to design and complete HIV/AIDS workplace policies and strengthens the capacity of company

health and anti-HIV committees. In 2006, PSP leveraged resources from the International Labor

Organization to expand HIV prevention programs in ten additional workplaces throughout the country.

In FY07, PSP prepared and enabled large Ethiopian companies to conduct peer education programs with

ABC and TB/HIV messages by providing training for peer educators, supportive supervision, and

consultation with company senior management. PSP integrated materials on ABC, cross-generational and

transactional sex, TB and HIV, gender norms and the current HIV burden on women. Utilizing cross-

generational sex study results, PSP developed three video spots focusing on male behaviors which will be

used in the program component on stigma and discrimination.

In FY08, PSP implementing partners will continue implementation of the peer education program in the

existing 75 medium to large workplaces. The project intends to propose some innovations in its peer

education program after completing a review of the 40 workplaces which have not yet begun to train peer

educators. Many of these 40 companies assert that their economic circumstances make them unable to

enter the longer-term commitment to an eight-month peer education program.

The PSP rapid review will assess the opportunity to offer a new option to companies that are reluctant to

embark on the eight-month peer education program. PSP will assess whether these companies would be

willing to participate in ABC and TB/HIV information sessions which compress key messages into a half-day

format delivered by professional educators.

If the target companies indicate an interest in the half-day event format, the project will seek opportunities to

connect these half-day sessions with PSP's mobile counseling and testing (CT) activities (ID 10375) in

order to give staff the opportunity to be counseled and tested. PSP experience in January and February

2007 during the Millennium AIDS campaign indicates that there is strong demand in workplaces for mobile

or external CT services.

PSP will test the acceptability of a half-day interpersonal communications (IPC) program of ABC and

TB/HIV messages with existing workplaces. If the results are positive, the project will look actively for

opportunities to implement the half-day program with agricultural, industrial, and service sector workplaces

along the four corridors where PSP is implementing mobile CT activities. This activity will focus on

identifying and targeting at-risk populations in the workforce.

PSP's existing intensive eight month workplace peer education and the possible new half-day IPC program

are expected to reinforce positive behavioral norms and build more accurate self perception of risk among

the most at risk population groups. PSP will provide peer educators with follow-up training and supportive

supervision to ensure the consistency of message delivery and support their motivation.

In workplace and private clinics, PSP provides technical assistance to support counseling on prevention for

positives which utilizes existing materials. PSP emphasizes prevention for urban males of high educational

and socioeconomic status based on Ethiopia Demographic and Health Survey (EDHS) data which indicates

that this group has a large number of sexual partners. Self-reported condom use among urban males is

48% (EDHS 2005) and there is opportunity for increased AB programming. This activity will collaborate with

HIV prevention partners to utilize or adapt pre-existing audio and print materials to address issues

surrounding male social norms and low self risk perception.

This workplace program involves sectors such as tourism, transportation, plantation and seasonal

agriculture which employ workers with a higher risk of HIV/AIDS infection. The modified half-day program

approach should permit allow more transportation, agriculture, and service sector employees to participate

in workplace communication activities. It will also enable PSP to reach out to new enterprises along the

major transportation corridors whose employees are at risk because of their contact with the mobile

Activity Narrative: population along the corridor. Family day events will support activities in several communities at risk.

This activity is implemented as an integrated element with the other Abt Associates PSP other prevention

(ID 10374) and TB/HIV (ID 10375) activities in the workplace, and will provide referrals for the PSP

workplace and mobile CT services (ID 10538).

The PSP program is complementary to AB programs implemented with public sector, government partners,

and affords significantly more reach for PEPFAR than would the public sector alone. PSP reaches the

employees and dependents in the general population through its workplace and private clinic programs. It

also reaches at risk populations through the workplace program by selecting a majority of its intervention

sites in companies whose employees are thought to have one or more risk factors. The target enterprises

include transportation companies, (trucking, airline, and railway) agricultural and floricultural enterprises,

tourism, and manufacturing. Through the workplace, PSP reaches men in their sexually active years who

also earn a regular income. At the management level, PSP reaches males of higher educational and

socioeconomic status who the EDHS indicates are at risk due to their high number of sexual partners and

low reported condom use.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16565

Continued Associated Activity Information

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

System ID System ID

16565 5605.08 U.S. Agency for Abt Associates 7471 645.08 Private Sector $370,000

International Program

Development

10376 5605.07 U.S. Agency for Abt Associates 5465 645.07 Private Sector $312,000

International Program

Development

5605 5605.06 U.S. Agency for Abt Associates 3767 645.06 Abt Private $260,000

International Sector

Development Partnership

Table 3.3.02:

Workplace Peer Education Program

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

This is a continuing activity. This activity is a comprehensive HIV prevention activity with both HVAB and

HVOP funding.

This activity remains similar to COP08 activities. Additional activities by the implementing partner will

include leveraging work in HVCT, HVTB and HXTS to train private clinics participating in TB/HIV and ART

service delivery to strengthen and standardize STI diagnosis and treatment in approximately 160 private

clinics in Addis Ababa, Amhara and Oromia.

FY 08 ACTIVITY NARRATIVE

This is a continuing activity. This activity is a comprehensive HIV-prevention activity with both HVAB and

HVOP funding.

Private Sector Program (PSP) reaches at-risk populations through the workplace program by selecting a

majority of its intervention sites in companies whose employees are thought to have one or more risk

factors. The target enterprises include transportation companies, (trucking, airline, and railway) agricultural

and floricultural enterprises, tourism, and manufacturing. Through the workplace, PSP reaches men in their

sexually active years who also earn a regular income. At the management level, PSP reaches males of

higher educational and socioeconomic status. The Ethiopian Demographic and Health Survey has indicated

that members of this group are at risk due to their high number of sexual partners and low reported condom

use.

PSP works with large workplaces and private clinics to improve access to HIV-prevention, care, and

treatment services for the general population, employees, and dependents. PSP focuses on developing

abstinence, being faithful, and correct and consistent condom use (ABC) programs which reflect the needs

and demands of private and parastatal business firms. The project seeks to establish management and

labor ownership of workplace ABC activities and encourages companies to share a significant part of ABC

program costs. As of 2007, the project provided technical assistance in interpersonal HIV-prevention

activities and clinical services in 75 large workplaces. A majority of workplaces have over 500 employees, of

which a subset has several thousand employees in several sectors of the economy including tourism,

transportation, and plantation and seasonal agriculture which employ workers with a higher risk of HIV/AIDS

infection. Many workplaces currently are located adjacent to major transportation corridors whose

employees are at risk because of their contact with the mobile population along the corridor.

In workplaces, PSP conducts a package of interpersonal and interactive HIV-prevention activities, as well

as clinical services strengthening. PSP works closely with company management to outline a package of

services per company requirements. This accentuates company interest and increases the leveraging of

private non-USG resources.

PSP trains a cadre of peer educators over a two- to five-day period on HIV prevention and tuberculosis

(TB)/HIV services. Peer educators also learn skills to support effective counseling and communication with

family and community members. Ideally the project trains one peer educator for every 20 to 30 workers. In

turn, the peer educators conduct eight to 16 structured sessions focused on increasing knowledge and

fostering risk-reduction. Sessions use peer interpersonal communication to teach positive behaviors,

including correct consistent condom use, seeking sexually transmitted infection (STI) treatment, accessing

HIV counseling and testing (CT) services, stigma, and self-risk perception of males engaging in cross-

generational, coercive or transactional sex. One major effort in FY07 was to increase participants'

knowledge of the HIV epidemic using recent Ethiopian Demographic and Health Survey (EDHS) and

antenatal care (ANC) information, specifically the estimated prevalence rates and the burden and

vulnerability on women.

PSP sponsors "Family Days" to recognize the employer/employee commitment to workplace peer education

and to address communities at risk. Family days engage associations for people living with HIV/AIDS

(PLWH) to deliver messages on HIV prevention. The project also supports companies to design and

complete HIV/AIDS workplace policies and strengthens the capacity of company health and anti-HIV

committees. In late 2006, PSP leveraged resources from the International Labor Organization to expand

standard HIV-prevention programs to additional workplaces throughout the country.

In FY07, PSP supported 75large Ethiopian companies train peer educators to reach individuals with

repeated HIV-prevention and risk-reduction sessions. PSP integrated materials on ABC, cross-generational

and transactional sex, TB and HIV, gender norms, and the current HIV burden on women for these

sessions. Using a FY05 cross-generational sex study, three video spots focusing on male behaviors were

used to initiate dialogue on stigma and discrimination.

In FY08, PSP will continue implementation of the peer education program in up to 75 large workplaces.

Several workplaces involved in FY05 will be graduated and provided minimal technical assistance to

facilitate more intensive interventions for recent entrants. The project will innovate peer-education activities

after completing a review of the 40 workplaces. PSP will provide several new options to facilitate access to

HIV-prevention activities among as many employees as possible. Specifically, PSP will implement frequent,

interactive HIV-prevention and CT events in parallel to modified peer-education sessions. This will be

coupled with the delivery of mobile HIV CT services to accommodate employees, family members, and

community members and their families.

PSP experience in January and February 2007 during the Millennium AIDS campaign indicates that there is

strong demand in workplaces for mobile or external CT services. The project will look actively for

opportunities to implement the half-day program with agricultural, industrial, and service sector workplaces

Activity Narrative: along the four corridors where PSP is implementing mobile CT activities. This activity will focus on

identifying and targeting at-risk populations in the workforce. PSP's intensive eight-month, workplace peer-

education and half-day interactive program seeks to reinforce positive behavioral norms and build more

accurate self-perception of risk among the most-at-risk population groups. PSP will provide peer educators

with follow-up training and supportive supervision to ensure the consistency of message delivery and

support their motivation.

To build up a knowledge based for workplace HIV-prevention programming, PSP will conduct a structured

internal evaluation to determine the effectiveness of the HIV-prevention program in FY08.

In workplace and private clinics, PSP provides technical assistance to support the integration of HIV-

prevention counseling and prevention with positives into workplace clinical settings using pre-existing

materials and leveraging other USG implementing partner's expertise.

PSP's expanding engagement with private clinics offers an opportunity to integrate HIV-prevention

counseling in private, voluntary, CT and TB clinics.

Each workplace program encourages the public distribution of condoms. To support sustainable

programming, PSP does not procure condoms but helps track expiry of condoms in workplaces.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16566

Continued Associated Activity Information

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

System ID System ID

16566 5603.08 U.S. Agency for Abt Associates 7471 645.08 Private Sector $180,000

International Program

Development

10374 5603.07 U.S. Agency for Abt Associates 5465 645.07 Private Sector $150,000

International Program

Development

5603 5603.06 U.S. Agency for Abt Associates 3767 645.06 Abt Private $90,000

International Sector

Development Partnership

Table 3.3.03:

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

This mechanism will conduct similar activities as described in COP08. Initiation of ART in private higher

clinics for adult and pediatric clients slowed based on ART drug management policies. Private higher

clinics have limited ability to manage ART drugs and capacity must be installed alongside establishment of

a policy framework to deliver public ART drugs through private health facilities. Despite delays the activity

has overcome policy issues and is now on track to expand to an initial 30 private higher clinics in Addis

Ababa in COP08 making ART services more affordable and accessible to those seeking therapy in the

private sector due to long queues and poor quality of health services in the public sector. This activity will

not be updated in COP09. Targets will be updated to reflect continued expansion from COP08 and COP09.

COP 08 Narrative:

The Private Sector Program (PSP) led by Abt Associates works with large workplaces and private clinics to

improve access to HIV prevention, care and treatment services for the general population and employees

and dependents.

As Ethiopia has increased the number of people on ART, hospital-bases services have become increasingly

congested. While hospitals which provide ART are overcrowded, the related services in those facilities such

as counseling and testing (CT), PMTCT and TB are frequently underutilized. This activity is designed to

assist in identifying and treating HIV-positive adults with specific focus on pregnant women in peri-urban

communities who are not served by other entry points to care. Despite greater access to HIV/AIDS services

in urban and peri-urban areas, efforts to prevent pediatric HIV infection have been hampered by low

PMTCT uptake, clients' perception of poor quality public sector ANC services, low utilization of antenatal

care (ANC) services, and lack of awareness of PMTCT and ART services.

Based on recommendations from the USG private sector technical assistance visit of August 2006,

PEPFAR Ethiopia expanded its approach to target private sector facilities which may identify HIV-positive

persons and link them to ART.

According to the Ethiopia Demographic and Health Survey (EDHS) 2005, approximately 11% of deliveries

in Addis Ababa occur in the private sector. Furthermore, 17% of all women (urban and rural) receive family

planning services from the private sector. It is likely that this number comes primarily from urban and peri-

urban areas. PSP will work in regional capitals and large towns such as Addis Ababa, Bahir Dar, Dessie,

and Nazareth to expand the ART health network through private clinics and pharmacies to identify and treat

those living with HIV/AIDS who do not attend public facilities.

This activity will build on linkages between health centers and hospitals supported in the FY07 activities.

The following activities are proposed:

1) Improve awareness of HIV services among pregnant women and address client perceptions of service

quality to increase uptake. The contractor will work with private sector providers to: strengthen their

awareness and involvement in HIV/AIDS care for pregnant women; increase counseling and testing for

adults and specifically pregnant women receiving CT; improve the quality of care and support for HIV-

positive women; strengthen referral linkages for HIV-positive adults specifically pregnant women; strengthen

the public-private partnerships to bring HIV-positive adults, specifically pregnant women into the ART

network; and integrate HIV/AIDS and TB services, specifically ART clinical management of stable patients

into private sector clinics in selected high client flow private facilities.

2) Ensure that private facilities which provide integrated TB and HIV services target pregnant women for

service. The contractor will prioritize assistance to facilities that reach this audience, such as antenatal care

and family planning providers.

3) Support outreach to raise community awareness of HIV/AIDS counseling and testing, care during and

after pregnancy, and of assisted delivery. Several pre-existing materials were developed with past PEPFAR

Ethiopia investments. Low-level mobilization, (i.e. road shows during market days) will be conducted where

mass media has little penetration.

4) The activity will prioritize identification and enrollment of pregnant women for ART in selected high-

volume private facilities.

5) This activity will improve data management, supportive supervision, quality assurance and stewardship in

the Regional Health Bureau (RHB) and District Health Offices' (DHO) interaction with the private sector. It

will accelerate rollout of PMTCT and ART in private facilities, and generate community demand for PMTCT

and ART services.

6) Work with the Ministry of Health and Regional Health Bureaus to revise national Public Private Mix

guidelines for HIV/AIDS services.

This activity is integrated with several Private Sector Program activities proposed for FY08 funding. The

activity will be implemented in full collaboration with US government implementing partners at Health Center

and Hospitals as well as Pharmacy specific expertise of RPM Plus.

It will also draw strategies, material, and tools from the following activities: IntraHealth International for

PMTCT/Health Centers and Communities (104615), JHPIEGO Qualitative Assessment of Women's

Attitudes related to PMTCT (10650), the ART treatment activities of US universities which provide technical

support for ART scale-up [Johns Hopkins University (10430) Columbia University (10436), and University of

Washington (10439)], Johns Hopkins University, Clinically Focused Record Systems (10598), Family Health

International ART Service Expansion at Health Center Level (10604), Johns Hopkins University, User

Support Center for ART Service Outlets (10606), US Centers for Disease Control and Prevention, Public

Awareness on ART (10623).

This initiative targets adults and HIV positive adults who utilize private sector pharmacies and health

facilities for care and treatment services or products. It will reach pregnant women and those planning

pregnancy by strengthening and PMTCT counseling services, training, and communication material within

those facilities.

PSP will build the capacity of the Regional Health Bureaus, District Health Offices and Town Health Offices

to supervise private sector providers through systems-oriented technical assistance and secondment.

The result of this activity is expected to build the private sector facilities' capacity for clinical services,

referral, reporting, internal quality assurance, and general management.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16569

Continued Associated Activity Information

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

System ID System ID

16569 6637.08 U.S. Agency for Abt Associates 7471 645.08 Private Sector $1,200,000

International Program

Development

10379 6637.07 U.S. Agency for Abt Associates 5465 645.07 Private Sector $1,000,000

International Program

Development

6637 6637.06 U.S. Agency for Abt Associates 3767 645.06 Abt Private $1,000,000

International Sector

Development Partnership

Emphasis Areas

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.09:

ACTIVITY UNCHANGED FROM FY2008

Activities remain similar to activities described in the COP08 narrative. External quality control will be

expanded to support additional private clinics in Addis Ababa, Amhara and Oromia alongside TB/HIV

activities. This activity narrative will not be d in COP09.

COP 08 NARRATIVES:

This is a continuing activity. This activity implements activities to support mobile HIV counseling and testing

(HCT), private sector HCT and workplace HCT.

The Private Sector Program (PSP) led by Abt Associates works with large workplaces and private clinics to

improve access to HIV prevention, care and treatment services for the general population and employees

and dependents. The project seeks to establish management and labor ownership of its workplace activities

and encourages companies to share a significant part of program costs.

In FY08 PSP and its local subcontractors will complement on-going efforts in workplaces and private clinics

with expanded high quality, mobile HCT services targeting adult populations in higher prevalence urban and

periurban areas. The project will also leverage activities under several existing PEPFAR programs providing

HIV prevention and facility-based counseling and testing (CT) and TB services.

Utilization and access of high quality, facility-based voluntary counseling and testing (VCT) services by at

risk populations remain problematic along major transportation corridors, Addis-Djibouti; Addis-Adigrat;

Addis-Metema; and Modjo-Dilla transport corridors. Private CT services, although promising, are not yet

sufficiently supervised to assure that they comply with national guidelines to provide quality laboratory

services, and comprehensive referrals. The activity will expand mobile CT services in parallel to expanding

long term facility-based CT services in workplaces and private for-profit clinics along the corridors.

Each component is described below. It is important to note that the intermittent nature of mobile CT services

poses a challenge to provide sustained improvements to CT services. In response to this, PSP is ensuring

that private for-profit clinics are identified and CT services are installed or strengthened in areas of mobile

CT. Furthermore, using basic subcontracting, PSP is working with large indigenous commercial and civil

society CT providers to support mobile CT services. These subcontracts are improving the capacity of these

partners to perform services and compete in future USG activities.

1) Support for Mobile CT Services:

During FY08, PSP will operate four low-cost mobile counseling and testing units along four transportation

corridors focusing on high prevalence and high demand areas. The mobile units will:

- Target adult populations, commercial sex workers, mobile workers, and other risk groups for CT in urban

and periurban areas.

- Employ highly visible promotion teams to prime demand and offer multi-day counseling and testing events

in high prevalence areas the ART health network.

- Receive training and supervision to assure that services meet national guidelines including quality

assurance/quality control, utilization of finger prick techniques with dried blood spots or parallel testing.

- Make comprehensive referrals for care and treatment which the program will follow-up to monitor success

in connecting seropositive individuals with appropriate care.

- Standardize reporting to appropriate levels of the Ministry of Health and conduct joint analysis with

Regional Health Bureaus and USG partners of client demographics and findings.

This activity will support targeted community mobilization to promote use of CT services along

transportation corridors, in markets, workplaces, public gatherings, and particularly in places identified as

sites where high risk populations live and work.

Each quarter, PSP will select four different groups of ten-to-twenty towns along the major transportation

corridors where the project will provide mobile CT services. Program staff will complement CT services with

targeted mobilization activities to increase uptake of such services among adult populations and MARPS.

By vigorously promoting the CT services, PSP will help to make the teams efficient and productive. The

program will target 15 tests per counselor per day on a five-day-per-week activity schedule. CT service

capacity ranges from 5-15 counselors per day depending on the findings of service demand assessments.

The mobile services will contribute to the national strategy to rapidly scale up CT services to reach

underserved and marginalized populations. Current services are predominantly based in static centers in

government health centers and hospitals. Ethiopia's July 2007 National CT guidelines clearly indicate the

need for outreach and mobile CT service delivery.

2) Support for CT Services in Private Health Clinics:

In FY08, PSP will work closely with Regional Health Bureaus and Town Health Offices to strengthen a

minimum of 200 private clinics with high client volume to provide CT services. PSP will also develop

innovative models to refer at-risk clients visiting pharmacies to appropriate TB or HIV clinical services. While

working with private health facilities, PSP will:

- Strengthen the capacity of Ethiopian NGO and private sector partners to provide CT and TB diagnosis and

treatment.

- Provide facilities with training, supervision, and assistance to improve service quality, productivity and

management to support better quality counseling and testing services.

- Promote extended VCT hours to facilitate access.

- Strengthen referral linkages to community and facility-based HIV/AIDS prevention, care and treatment

services.

Activity Narrative: By increasing the use of the private sector to provide CT services, this program will reduce the strain on the

already burdened public health providers and build the competence of local organizations to provide high

quality sustainable CT services where international organizations may now be filling that role.

3) Support for workplace CT services and referral

PSP will continue implementation in large (1000+ employees) and medium-sized companies (500+

employees) in seven regions to ensure improved access to counseling and testing. By September 2008,

this activity will operate in up to 75 workplaces and private health facilities across Ethiopia and will ensure

the presence or improved access to quality services, including counseling and testing.

As part of an integrated workplace program for HIV/AIDS prevention, care and treatment, PSP will continue

to support intensive workplace peer education program which supports greater uptake of TB and HIV

services. PSP promotes a "Know Your Status" interpersonal communication program to reinforce positive

behavioral norms. The peer education program will increase numbers of employees and dependants

choosing VCT and needing subsequent clinical care and treatment.

PSP will support CT services in the workplace by providing supportive supervision for those clinics which

offer on-site CT services or refer clients to external CT providers through provider-initiated counseling and

testing (PICT) or voucher programs. The project will also link workplaces whose employees fall into the high

risk groups with mobile CT services.

This activity will educate the workforce and families about basic facts and the importance of CT in 75

workplaces and will reach families and the surrounding community with similar messages during mass

educational events. The peer education component educates staff through eight modules on TB and

HIV/AIDS delivered in small group discussions during work time. This activity works with employers to

establish HIV policies to protect HIV-positive employees from stigma and discrimination.

PSP will work closely with Medical Association of Physicians in Private Practice (MAPPP) and other

professional associations in collaboration with Regional Health Bureaus to initiate and sustain private sector

CT services. This activity will focus on reaching most at risk populations along the four high risk corridors in

urban and periurban settings. It will increase access to quality, integrated HIV and TB services for urban

populations by engaging new private sector clinics in delivering services.

PSP targets most at risk populations by conducting thorough rapid assessments prior to deploying mobile

CT teams or selecting private sector clinics. The assessments gathers information on who the most at risk

populations are in a community, where they live or work, and what messages might persuade them to

accept CT services. The assessment identifies the most at risk groups in a community through key

informant interviews with regional health bureau (RHB) and district health office (DHO) staff as well as local

non-governmental and faith based organizations which provide care, treatment and support services. It also

uses focus group discussions and individual interviews with individuals from the risk groups to ascertain

where these groups can be reached with CT services and what messages might prompt them to seek CT.

PSP reaches at risk populations through the workplace program by selecting a majority of its intervention

sites in companies whose employees are thought to have one or more risk factors. The target enterprises

include transportation companies, (trucking, airline, and railway) agricultural and floricultural enterprises,

tourism, and manufacturing. Through the workplace, PSP reaches men in their sexually active years that

have disposable income. At the management level, PSP reaches males of higher educational and

socioeconomic status who the Ethiopia Demographic and Health Survey (EDHS) indicates are at risk due to

their high number of sexual partners and low reported condom use.

PSP will utilize national systems for implementation, M&E and intensive supportive supervision to

strengthen CT services in areas of operation.

Explanation of Targets

355 service outlets include 75 workplace clinics, 200 private sector clinics and 60 distinct

towns/communities where mobile CT services will be provided.

New/Continuing Activity: Continuing Activity

Continuing Activity: 16568

Continued Associated Activity Information

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

System ID System ID

16568 6452.08 U.S. Agency for Abt Associates 7471 645.08 Private Sector $1,627,031

International Program

Development

10538 6452.07 U.S. Agency for Abt Associates 5465 645.07 Private Sector $1,496,000

International Program

Development

6452 6452.06 U.S. Agency for Abt Associates 4066 4066.06 Population $1,300,000

International Services

Development International

Emphasis Areas

Workplace Programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14: