Faith-based Catholic Care

The activity is closely linked to the USG food aid program from dollar resources and food commodities provided under Title II of Public Law 480 of the Agriculture Trade Development Act of 1954, as amended (PL 480 Title II).

Catholic Relief Services (CRS) combines PL 480 Title II and Emergency Plan resources to support OVC. In FY 2007, CRS used these resources to work with Medical Missionaries of Mary, Organization for Social Services for AIDS (OSSA) and the Missionaries of Charity (MOC) to provide support to OVC in 17 urban communities in Addis Ababa, Afar, Amhara, Dire Dawa, Gambella, Oromiya, SNNPR, Somali and Tigray Regions. In addition, CRS used Title II resources to work with the OSSA to provide support to 200 OVC in Dire Dawa and Harari and Emergency Plan resources to work with the Ethiopian Catholic Church Social and Development Co-ordination Branch Office of Adigrat in the Tigray region. In COP 2008, CRS used both resource categories to work with these partners to provide PL 480 Title II to an estimated 12,100 OVC and supplement this with PEPFAR financial support for living costs, shelter, school fees and supplies, and medical care as needed. Local partners will undertake community mobilization and stigma reduction interventions within host communities and provide counseling and psychosocial support to OVC.

In COP 2008, CRS continued to strengthen links between its Track 1 AB youth activity, in Dire Dawa, Oromiya and Tigray Regions, and its OVC work. CRS will also strengthen the capacity of Counseling and Testing (CT) centers, OVC counselors and Catholic Church pastoral leaders to respond to the diverse needs of OVC. Over the last two years, CRS has supported OSSA and ECC-SDCOA-Mekelle to strengthen their community mobilization, counseling, nutrition, water, sanitation and hygiene and livelihoods support program components. Under COP 2008, CRS will involve three more partners in their OVC programming, Alem Tena Catholic Church, Ethiopian Catholic Church Social and Development Coordination Office of Harar (ECC-SDCOH) and Progress Integrated Community Development Organization (PICDO). These partners have previously received CRS private funds. CRS will develop cross-learning opportunities between these organizations and those working on rural livelihoods, agri-business and nutrition activities. Wrap around funds for the business and livelihoods strengthening will be requested from USAID's Assets and Livelihoods Transition (ALT) program.

CRS will provide support to 12,100 children, providing them with care based on individual needs. The majority of these children will receive supplementary food and/or medical support through MOC's program for the dying and destitute or psychosocial and/or educational support where other direct support is not required. The remaining children will be supported with a holistic package of services such as shelter and care, protection, healthcare, psychosocial support and education. The program will leverage CRS private funds and USAID Assets and Livelihoods Transition (ALT) program food and livelihoods support for OVC.

In partnership with other PEPFAR Ethiopia OVC partners, CRS will work with the new PEPFAR APS recipients to coordinate activities to achieve the most efficient use of resources for OVC in the highest HIV/AIDS prevalence areas. This includes harmonization on indicators, reporting, and OVC standards of care in line with Government of Ethiopia national guidelines, policies, OGAC OVC Program Guidance, as well as achieving quality assurance in OVC programming as described in the draft Standards of Service for Quality OVC Programs in Ethiopia. Data from the EDHS 2005 and the results of USG Ethiopia mapping will be used to identify geographic priority areas to increase services in areas of highest prevalence to OVC. CRS will link MOC with the PC3 OVC Food Support activity (103967) and the FANTA technical expertise (10571) to facilitate their access and use of Ready to Use Foods (RUTF). CRS will also liaise with the DAI Urban Agriculture Program for HIV/AIDS affected Women and Children (10486), supporting partners to access resources where feasible and/or sharing technical expertise and learning.

CRS' exit strategy states that "all the organizations through which CRS/Ethiopia implements its PEPFAR funded projects have alternative sources of funding. Similarly, CRS' partner organizations are well established and network with other funding agencies and cooperating sponsors of the USG. This broad base of donors and networking with other agencies allows the organizations to source alternative funding if required. Additionally, CRS supports organizations to better understand and work within the USG regulations and to access US government funding directly.

CRS continues to work with partners to improve their strategic planning, data quality and reporting systems. During FY 2008, CRS built on the current strategic planning exercise with OSSA to further strengthen OSSA's capabilities to program strategically. The program run by MOC is targeted at the provision of immediate care for the dying and destitute and does not differentiate children orphaned or made vulnerable due to HIV/AIDS and those from other causes. For this reason many of the homes struggle to collect the data required for PEPFAR and it is anticipated that the number of homes receiving PEPFAR funding during FY 2008 will therefore decrease.

Narrative:

Care and support for PLWHAPLWHAA

ACTIVITY UNCHANGED FROM FY2008

This is a continuous wrap around activity continuing with the same activities as is described in COP 2008.

COP 08 NARRATIVE:

This is a continuing activity which began in FY05. The activity is closely linked to the USG food aid program from dollar resources and food commodities provided under Title II of Public Law 480 of the Agriculture Trade Development Act of 1954, as amended (PL 480 Title II).

In FY 2006 Catholic Relief Services (CRS) combined PL 480 Title II and PEPFAR Ethiopia resources for care and support for PLWHAA. CRS leveraged 9,442 metric tons (MT) of food, worth $5,642,590, from Title II resources. CRS used both resources to work with the Organization for Social Services for AIDS (OSSA) and Missionaries of Charity to provide support to approximately 35,000 PLWHAA in 18 urban communities in Addis Ababa, Afar, Amhara, Dire Dawa, Gambella, Oromia, SNNPR, Somali, and Tigray regions. CRS also used Title II resources to work with Medical Missionaries of Mary (MMM) and OSSA to provide support to 100 PLWHAA in Dire Dawa and Harari and PEPFAR resources to work with the Ethiopian Catholic Church's Social and Development Coordination Branch Office of Adigrat Mekelle in Mekelle. This work included both home-based care (HBC) and support, and institutional-based medical care for opportunistic infections and end-of-life care.

The locations of hospices that provide support for HIV-positive orphans, medical and end-of-life care are the Asco Children's Home/Hospice and Sidist Kilo in Addis Ababa; Dubti in the Afar region; the Debre Markos Hospice and Debre Markos Children's Home/Hospice in the Amhara region; Dire Dawa in Dire Dawa Council; Gambella in Gambella region; Bale, Jimma and Kibre Mengist in the Oromia region; Awassa, and Sodo in the SNNPR; Jijiga in Somali; and Mekelle, Alamata, Adwa in the Tigray region. Outreach work providing HBC was associated with these hospices. Additional HBC programs were present in Addis Ababa and Nazareth.

In FY 2008, CRS will continue to use its resources to work with the abovementioned partners in collaboration with the Ethiopian Catholic Church's Social and Development Coordination Branch Office (ECC-SDCOA) of Adigrat Mekelle to address basic care and support needs of 26,000 PLWHAA and their family membersboth in the community and through the hospices and two homes for HIV-positive orphans.

All hospices are located in high-prevalence and highly populated urban areas within the health network model. This provides a unique opportunity for linking beneficiaries with facility-level ART, PMTCT, and chronic HIV care services. Many of the hospices are also TB treatment centers, and during FY 2008, CRS will work to strengthen the counseling and referral of PLWHAA for TB testing and TB patients for HIV testing as well as the post-test counseling follow-up. This will build on work initiated in FY 2007

CRS and other PEPFAR Ethiopia implementing partners will provide nutrition support, hygiene education, counseling, psychosocial, spiritual and medical care, and preventive care including cotrimoxazole prophylaxis as needed by PLWHAA both in their homes and through the hospices. Additional educational and life-skills support will be given to children living with HIV/AIDS. HBC programming partners will undertake stigma-reduction interventions (information, education and communications) within host communities and provide counseling and psychosocial support to asymptomatic and symptomatic PLWHAA.

During FY 2006 and 07 CRS has been supporting OSSA and ECC-SDCOA-Mekelle to strengthen their community mobilization; positive living, disclosure and ART adherence counseling; and nutrition, water, sanitation and hygiene and livelihoods support program components. To facilitate this CRS will involve three more partners in programming, Alem Tena Catholic Church, Ethiopian Catholic Church Social and Development Coordination Office of Harar (ECC-SDCOH) and Progress Integrated Community Development Organization (PICDO). These partners have previously been programming using CRS private funds. Cross-learning opportunities have been developed between these organizations and those working on rural livelihoods, agri-business and nutrition activities.

During FY 2007, CRS will provide support to OSSA to carry out a strategic planning exercise and develop its skills as learning organization through identification and documentation of best practice between the branch offices. FY 2008 intervention will build on this process and further strengthen OSSA's capabilities to program strategically.

The program conforms with the PEPFAR Ethiopia five-year-strategy of focusing on the community as the key actor in the health network for care and promoting a set of palliative care interventions appropriate to participating communities. Strong referral linkages exist between many community-based care and support programs, hospices, and facilities. CRS will strengthen these by identifying and referring adults and children in Missionary of Charity shelters for voluntary counseling and testing (VCT) and other diagnostics necessary for the provision of HIV/AIDS care and treatment services. Special emphasis will be given to enabling HIV-positive children to access quality HIV/AIDS care and treatment services. In 2007, this activity will continue to strengthen these linkages and collaboration with other PEPFAR Ethiopia partners for treatment, high-quality clinical care.

CRS continues to work with partners to improve their data quality and reporting systems. The program run by Missionaries of Charity is designed to provide immediate care for the dying and destitute and does not have a confidential, patient-centered, monitoring system. For this reason many of the homes struggle to collect the data required for PEPFAR and it is anticipated that the number of homes receiving PEPFAR in FY 2008 will therefore decrease.

COP 2009 NARRATIVE

Faith-based Catholic Care

The activity is closely linked to the USG food aid program from dollar resources and food commodities provided under Title II of Public Law 480 of the Agriculture Trade Development Act of 1954, as amended (PL 480 Title II).

Catholic Relief Services (CRS) combines PL 480 Title II and Emergency Plan resources to support OVC. In FY 2007, CRS used these resources to work with Medical Missionaries of Mary, Organization for Social Services for AIDS (OSSA) and the Missionaries of Charity (MOC) to provide support to OVC in 17 urban communities in Addis Ababa, Afar, Amhara, Dire Dawa, Gambella, Oromiya, SNNPR, Somali and Tigray Regions. In addition, CRS used Title II resources to work with the OSSA to provide support to 200 OVC in Dire Dawa and Harari and Emergency Plan resources to work with the Ethiopian Catholic Church Social and Development Co-ordination Branch Office of Adigrat in the Tigray region. In COP 2008, CRS used both resource categories to work with these partners to provide PL 480 Title II to an estimated 12,100 OVC and supplement this with PEPFAR financial support for living costs, shelter, school fees and supplies, and medical care as needed. Local partners will undertake community mobilization and stigma reduction interventions within host communities and provide counseling and psychosocial support to OVC.

In COP 2008, CRS continued to strengthen links between its Track 1 AB youth activity, in Dire Dawa, Oromiya and Tigray Regions, and its OVC work. CRS will also strengthen the capacity of Counseling and Testing (CT) centers, OVC counselors and Catholic Church pastoral leaders to respond to the diverse needs of OVC. Over the last two years, CRS has supported OSSA and ECC-SDCOA-Mekelle to strengthen their community mobilization, counseling, nutrition, water, sanitation and hygiene and livelihoods support program components. Under COP 2008, CRS will involve three more partners in their OVC programming, Alem Tena Catholic Church, Ethiopian Catholic Church Social and Development Coordination Office of Harar (ECC-SDCOH) and Progress Integrated Community Development Organization (PICDO). These partners have previously received CRS private funds. CRS will develop cross-learning opportunities between these organizations and those working on rural livelihoods, agri-business and nutrition activities. Wrap around funds for the business and livelihoods strengthening will be requested from USAID's Assets and Livelihoods Transition (ALT) program.

CRS will provide support to 12,100 children, providing them with care based on individual needs. The majority of these children will receive supplementary food and/or medical support through MOC's program for the dying and destitute or psychosocial and/or educational support where other direct support is not required. The remaining children will be supported with a holistic package of services such as shelter and care, protection, healthcare, psychosocial support and education. The program will leverage CRS private funds and USAID Assets and Livelihoods Transition (ALT) program food and livelihoods support for OVC.

In partnership with other PEPFAR Ethiopia OVC partners, CRS will work with the new PEPFAR APS recipients to coordinate activities to achieve the most efficient use of resources for OVC in the highest HIV/AIDS prevalence areas. This includes harmonization on indicators, reporting, and OVC standards of care in line with Government of Ethiopia national guidelines, policies, OGAC OVC Program Guidance, as well as achieving quality assurance in OVC programming as described in the Standard Service Delivery Guidlines for Orphans and Vulnerable Children's Care and support Programs in Ethiopia (2010). Data from the EDHS 2005 and the results of USG Ethiopia mapping will be used to identify geographic priority areas to increase services in areas of highest prevalence to OVC. CRS will link MOC with the PC3 OVC Food Support activity (103967) and the FANTA technical expertise (10571) to facilitate their access and use of Ready to Use Foods (RUTF). CRS will also liaise with the DAI Urban Agriculture Program for HIV/AIDS affected Women and Children (10486), supporting partners to access resources where feasible and/or sharing technical expertise and learning.

CRS' exit strategy states that "all the organizations through which CRS/Ethiopia implements its PEPFAR funded projects have alternative sources of funding. Similarly, CRS' partner organizations are well established and network with other funding agencies and cooperating sponsors of the USG. This broad base of donors and networking with other agencies allows the organizations to source alternative funding if required. Additionally, CRS supports organizations to better understand and work within the USG regulations and to access US government funding directly.

CRS continues to work with partners to improve their strategic planning, data quality and reporting systems. During FY 2008, CRS built on the current strategic planning exercise with OSSA to further strengthen OSSA's capabilities to program strategically. The program run by MOC is targeted at the provision of immediate care for the dying and destitute and does not differentiate children orphaned or made vulnerable due to HIV/AIDS and those from other causes. For this reason many of the homes struggle to collect the data required for PEPFAR and it is anticipated that the number of homes receiving PEPFAR funding during FY 2008 will therefore decrease.