1. Goals & Objectives under the Award

CSDS is an indigenous capacity building institution, contracted to disburse and monitor grants to a network of local organizations, and the NGO Coordinating Committee while strengthening their financial and administrative management (including governance) capacity. Under the current contract with USAID, support to the NGOs include the development of financial and accounting systems to ensure these systems are compatible with the project budgeting procedures and generally accepted accounting principles, capacity building, and, monitoring and evaluation of the NGOs' targets. CSDS will continue to provide technical assistance to enable the NGOs to expand HIV/AIDS services while simultaneously enhancing their capacity through formal workshops, monthly on-site visits/training and mentoring. Partner organizations will be assisted in strengthening all aspects of their Human Resources policies and practices; improving their internal management and administrative systems and practices; developing the skills of NGO staff in areas of project management and administration, including conflict management; ensuring that each NGO has the governance structure appropriate to meet its objectives, and ensuring that the governance function is clearly understood and operationalized.

The contract will also disburse and manage sub-grants and provide training, technical assistance, and equipment/technology needed to strengthen financial management and control systems of the USAID-supported NGOs/FBOs, as well as Public-Private Partnerships, and other special projects selected by USAID/Guyana. This assistance should result in the strengthening of the financial management and administrative capacity of USAID partner organizations.

2. Geographic Coverage CSDS will be supporting the USAID-supported NGOs/FBOs who are implementing project activities across Guyana, except in Regions # 1 and 9, under the technical guidance of GHARP II.

3. Key Issues In-spite of the reported reduction in the prevalence of HIV/AIDS in Guyana, much more work is needed to address matters of behavioural change, stigma and discrimination and to provide the necessary care, support and treatment for persons who are infected and affected by HIV/AIDS. These NGOs/FBOs, while willing to serve their communities, lack some of the fundamental skills to efficiently manage their organizations and effectively manage U.S. Government funds. CSDS, the Grants Manager, will continue to work with the NGOs/FBOs to further strengthen their management capacities in areas of financial management, project management, administrative management with focus on governance, organizational development and developing human resources policies and practices, and monitoring and evaluation.

4. Strategy towards costs efficiency CSDS being the only organization of its kind in Guyana is now fully equipped to carry-out its mandate. The organization over the past two years has built the foundation upon which the systems and procedures of the NGOs/FBOs can be further developed. Currently, each of the nineteen (19) NGOs/FBOs have computerized accounting systems, eight (8) with Administrative Operational Procedures Manuals, nine (9) have operationalized human resources polices along with human resources manuals, the monitoring & evaluation database is currently being tested at six (6) NGOs with a view to implementing in FY 10. All the NGOs/FBOs are legally registered with at least twelve (12) having documented constitutions. The mechanisms are in place to enable further development of policies and the operationalization of good-governance within each NGO/FBO. CSDS will review its organization structure and determine the level-of-effort needed proportional to the budget, as well as continue the work from the templates and manuals developed over the past two years.

5.0 Monitoring & Evaluation As in FY 2009, CSDS will have responsibility for monitoring the NGOs/FBOs targets and ensuring the quality of data maintained. In keeping with guidance from the Office of the Global AIDS Coordinator, CSDS will continue to utilize standardized data collection forms for each program area, which were developed by the Guyana HIV/AIDS Reduction and Prevention (GHARP) Project in the coming year Achievements reported by NGOs/FBOs will be compiled in one database, and compared to program area targets. Quarterly data quality assurance reviews will be conducted for each NGO/FBO, in order to monitor the utilization of the monitoring system and the accuracy of the data collected. CSDS will monitor and report on progress against the total program area targets and those individually set by the NGOs/FBOs, in their annual Monitoring and Evaluation Plan. CSDS will also prepare semi-annual and annual reports and achievements for submission to USAID for PEPFAR reporting.

For FY2010 CSDS will continue to provide financial and administrative assistance to a core of nineteen NGOs, and the Guyana Business Coalition on HIV/AIDS, through on-site coaching and mentoring. This Agency works in collaboration with the GHARP 11 project which provides technical assistance in all programmatic and technical aspects of the project to the NGOs/FBOs, in the areas of Orphans & Vulnerable Children, Condoms & Other Prevention, Abstinence/Be Faithful, Home-Based Care, and Counselling & Testing, within the USAID HIV/AIDS strategy. Hence CSDS is the key agent in building the financial and administrative capacity of the NGOs.

More specifically, the tasks of CSDS will include: 1. Conduct monthly financial liquidation; 2. In collaboration with GHARP 11, conduct NGO yearly work-planning sessions; 3. Conduct yearly financial training; 4. Review and develop customized constitutions and guidelines for NGO boards, and train members on final constitution; 5. Develop management plans and scopes of work for each NGO position; 6. Develop NGO guidelines for sub-contracting; and 7. Respond to NGO requests for on-site support.

In terms of program implementation by the NGOs/FBOs, CSDS in FY10, will introduce "cost sharing," whereby the NGOs/FBOs will be required to make contributions of a certain percentage-level, to the program budget. In FY 10, the NGOs/FBOs will fund 5% of their approved program budget, while USAID will fund 95%.

The NGOs/FBOs will be encouraged to share resources and collaborate where practicable.

In FY 10, nine (9) key NGO/FBO partners will receive financial support from CSDS to continue to reach PLWHA and their families in their communities. These NGOs are Hope for All, the Guyana Responsible Parenthood Association, Lifeline Counseling Services, Love and Faith (Agape), Comforting Hearts, FACT, Hope Foundation, and Linden Care Foundation. To date, palliative care services have been provided to over 900 PLWHA and their families in seven regions, with 68 community health care providers/volunteers and nurse supervisors trained in community home-based care (HBC). Under this program, one of our USAID-supported NGOs, Hope for All in Region 2, occupies an office within the public hospital where a volunteer is on call to receive referrals of PLWHA from the doctors. This method, of an NGO working on site along side the formal health care team has strengthened the referral system and has greatly reduced the delay in a client's access to Home Based Care Services and support. All NGOs work closely with the MOH Regional home-based care nurse supervisors, supported by the GFATM, who refer patients identified as positive to the NGOS to ensure a continuum of care. Once a referral is received the client is registered into the program and arrangements are made to do home visits, or, if the client is sick to do home care. In the home, an assessment of the needs of both the client and family is conducted by the nurse supervisor attached to Hope for All. Based on that assessment, a plan of care is drafted by the nurse supervisor, and is communicated to the volunteer(s) assigned to the case. This process is used for all NGOs involved in HBC activities.

The package of care provided includes:

1.) Clinical care accompaniment, nutritional and hygiene counseling, adherence support, hospital visits to coordinate discharge planning, grief

and bereavement counseling, provision of care packages, and basic nursing care in the home;

2.) Prevention education for family members, testing of family members and encouraging family members to be a source of support;

3.) Psychosocial support (Clients are invited to eventually join the NGO support groups once they have adjusted and accepted their diagnosis);

4.) Referral to a religious organization that is sensitive to HIV/AIDS issues;

5.) Linkages to social services such as welfare and legal services; and facilitating access to micro-enterprise initiatives and vocational skills

training.

The program is also helping people living with HIV/AIDS (PLHA) access small loans provided through a micro financing program. These PLHA have been unable to receive loans through traditional means because of their economic status. The loans enable PLHA to expand their small businesses and support their families. As of July 2009, more than 100 loans had been completed with a cumulative value of US$51,000. These were disbursed to HIV-positive entrepreneurs with businesses in diverse fields such as poultry, livestock, lawn maintenance, sanitation, graphic design, craft production, and internet café services.

FY 10 will see the continuation of financial and administrative assistance to eight (8) NGO/FBO partners to implement comprehensive OVC programs. Linden Care Foundation (LCF), one of the key NGO partners, is currently providing care and support services to two hundred and thirteen (213) children who are reached through referrals from schools, members of the community and health care centres, the HBC and VCT programs. Services offered to OVC include psychosocial counseling( individual counseling with OVC as well as parent/guardian counseling), homework supervision, medical referrals, nutritional assessment and counseling, adherence support, referring caregivers to social and legal services, access to micro-enterprise initiatives and vocational skills training for older youth, age appropriate prevention education and encouraging testing for family members. Community facilitators from LCF, trained through the program, conduct visits to homes and schools to follow-up on the progress of the child. LCF has also been able to leverage resources from international and local agencies to construct a 'drop in' centre for OVC, obtain raw materials for food and the acquisition of multi-vitamins, and, other medications for pain management and the treatment of opportunistic infections. With support from UNICEF and 'Every Child Guyana' LCF also manages a mini-pharmacy. Support from the World Bank has enabled the organization to provide nutritious meals for one hundred and twenty four OVC four days weekly, as well as the Linden Diaspora provides nutritional support through its program "Adopt-A-Child. Other local private sector enterprises such as the Telecommunications and Telegraph Company, Mings Products and Services, U Mobile among others, have been aiding the program.

The capacity building organization will continue to provide financial assistance to a regional distribution of twenty (20) NGOs/FBOs to initiate interpersonal and community dialogue, provide information, and mobilize communities to access Counseling and Testing Services, including counseling and testing through PMTCT ANC clinics.

In FY 10, the following seven (7) NGO/FBO partners and the Guyana Business Coalition on HIV/AIDS will be supported to deliver counseling and testing: Comforting Hearts, the Guyana Responsible Parenthood Association, Hope for All, Hope Foundation, Lifeline Counseling Services, Linden Care Foundation and Youth Challenge Guyana. Of those seven, there are five fixed sites and two mobile units located at the Guyana Responsible Parenthood Association and Youth Challenge Guyana. The NGOs/FBOs have been reaching high risk populations with C&T services through their walk-in service and community outreach activities, utilizing both interpersonal and multi-media intervention. Appropriate AB education has been integrated into their risk reduction counseling, and, prevention programs for high risk populations follow the ABC guidance. Persons who are tested positive through counseling and testing are referred to treatment services, home and community based programs. Emphasis is placed on male access and MARP. The NGOs are also an integral part of the MOH yearly National Day of Testing. As of July 2008, 15,962 persons were counseled and tested.

In FY 10, the NGOs/FBOs will continue to expand counseling and testing services in key communities, particularly targeting the rural and hinterland communities. Couples counseling will also continue to be emphasized in FY 10 in an effort to increase the number of males who access C&T, reduce transmission between sero-discordant couples, and encourage faithfulness in concordant negative couples.

The Government of Guyana, donors and civil society have recognized that in order to scale up the HIV response and achieve Guyana's goals, non-governmental and faith-based organizations have become important partners in the national response. While the NGOs are essential to extending the delivery of HIV/AIDS prevention, care and support services throughout the country, many of them have demonstrated inadequate capacity to rapidly scale up services as a result of their limited administrative management and financial capacity. In addition, as the number of NGOs grows, it becomes increasingly necessary to identify a sustainable cost effective solution to institutional capacity building. This requires the transfer of the capacity building mandate to a local entity which can work with the NGOs in the field and maintain regular, even daily contact, to respond to emergency needs and monitor progress. This agency would also fill the gaps in the institutional memory created by the high turnover of key staff in these local NGOs. Hence, Community Support & Development Services (CSDS) Inc, an indigenous capacity building organization, was awarded the contract in May 2007 to meet the emerging needs of the NGOs. CSDS is contracted to disburse and monitor small grants to a network of USAID-supported non-governmental organizations (NGOs), faith-based organizations (FBOs), and the NGO Coordinating Committee, while strengthening their financial and administrative management (including governance) capacity. CSDS will provide continue to provide technical assistance through local consultants and a local Accounting Firm to enable the NGOs to immediately expand HIV/AIDS services while simultaneously enhancing their capacity. Assistance will be provided in a targeted manner, focusing on direct management, onsite training and mentoring and other direct support, and when warranted, other formal training in the form of workshops to ensure long-term organizational sustainability.

Thus, under the Other/Policy Analysis and System Strengthening program area, CSDS will continue to build the capacity of twenty (20) USAID-supported NGOs to fulfill critical governance and administrative tasks:

1. Review and develop customized constitutions and guidelines for NGO boards;

a. Train NGOs and their boards on final constitution

2. Update NGO Coordinating Committee Constitution;

a. Train board on final constitution

b. Participate in coordinating committees to oversee process

3. Develop customized staffing and volunteer policies for NGOs;

a. Develop management plans

b. Develop scopes of work for each position;

4. Develop conflict of interest policies;

5. Develop NGO guidelines for sub-contracting; and

6. Respond to NGO requests for on-site support.

CSDS will continue to sub-contract a local Accounting Firm to provide oversight to its financial management of the NGOs through the review of financial systems and practices and the conduct of audits, thereby ensuring continuous quality improvement and quality assurance.

Programming responding to yellow-lit activities- Guyana PEPFAR Interagency team has adopted OGAC Prevention Technical Working Group recommendations for the sexual prevention portfolio.

The capacity building organization will sub-contract eight NGOs, including the M.A.R.C.H. (Modeling and Reinforcement to Combat HIV/AIDS) behavior change communication project, and three FBOs, to deliver A and B messages to youth and adults. These organizations currently work with in and out of school youth, youth groups in churches, as well as communities, focusing on awareness, knowledge and applied prevention activities. Activities include sensitization sessions with youth, adults/parents and religious leaders; a peer education program using local materials and manuals; a structured in-school and out-of-school youth program at select schools; edutainment through the performing arts; IEC radio and television programs; and, the distribution of IEC materials. Messages are age-appropriate and are geared to encourage primary and secondary abstinence, the development of skills for practicing abstinence, 'be faithful' in sexually active adults, adolescents and older youth, and, the reduction of stigma and discrimination. The target audience is also informed about the risk associated with cross generational sex, alcohol and drug use, thus encouraging behavior that will reduce the risk of infection. As of March 09, over forty thousand persons were reached with A and B messages.

Programming responding to yellow-lit activities- Guyana PEPFAR Interagency team has adopted OGAC Prevention Technical Working Group recommendations for the sexual prevention portfolio.

CSDS will disburse funds, manage and strengthen the financial systems to the following twelve (12) NGOs working with MARP in Guyana's highest HIV/AIDS affected regions. These NGOs are Hope for All, Artistes in Direct Support, the Guyana Responsible Parenthood Association, Youth Challenge Guyana, Love and Faith (Agape), FACT, Hope Foundation, Linden Care Foundation, the United Bricklayers, Guybow, Merundoi and the Guyana Business Coalition on HIV and AIDS. The Ministry of Health and the USAID-supported NGOs are working collaboratively and directing efforts at risk elimination and risk reduction among this population.

Female sex workers and MSM are also being reached with combined targeted outreach and referrals to friendly clinical care and treatment sites. This program is implemented in Regions Four and Six and will be expanding to Regions Two, Three, Seven, Eight and Ten. The NGOs currently work with street-based and brothel based commercial sex workers and their clients as well as men-who-have sex with men. Interventions include HIV/STI prevention education including information on assessing, reducing and eliminating one's risk of infection through behavior change, as well as substance abuse. These are conducted through one-on-one interaction by outreach workers and peer education training. Outreach workers and peer educators (FCSW/MSM) also facilitate access to screening and treatment for HIV and other STI, assistance for care and treatment referrals, as well as access to affordable condoms. In FY 10, significant expansion of these programs, together with interventions to reduce the risk among miners and loggers, and youth who are transitioning into sexual activity will remain a priority.

The Modeling and Reinforcement to Combat HIV and AIDS (MARCH) serial drama project, supported by USAID will continue to focus on condom use, stigma and discrimination, alcohol and drug reduction, negotiation and assertiveness skills and access to HIV related services. These issues will be addressed in the listening and discussion groups, as well as two15-minute episodes aired twice weekly on the FM and medium wave channels with two weekend omnibus editions. Reinforcement activities focus on sexually active groups with the aim of sharing information on protective measures. Reinforcement activities to the target groups include listening and discussion groups (LDGs), street theatre, and community mobilization activities in conjunction with MOH, the private sector, and the NGO/FBO. The MARCH project will continue to receive technical assistance and oversight by CDC Guyana.