PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
SUMMARY
The Connect Project, implemented by Population Services International (PSI), aims to increase private
sector engagement in PMTCT through demonstration of pilot private sector service delivery models. In
FY08, key activities will include providing PMTCT services at three private sector hospitals, improving the
quality of services, increasing the client flow at PMTCT services through innovative demand creation
activities, involving the male partners of pregnant women to support safe disclosure and the involvement of
fathers in follow-up, mobilizing local resources to support PMTCT program activities, and building the
capacity of private hospitals and NGOs to provide high quality services and linkages with care and
treatment for HIV-positive parents. The primary target population is 500 pregnant women and their male
partners. Targets under this program area will be achieved by using both GHAI and Child Survival funds to
achieve results.
BACKGROUND
The Connect project has been implemented by Population Services International (PSI) since October 2006,
in partnership with the Federation of Indian Chambers of Commerce and Industry (FICCI), Y.R, Gaitonde
Centre for AIDS Research and Educations (YRG CARE) and the Karnataka Health Promotion Trust
(KHPT). The project aims to increase private sector engagement in HIV/AIDS through workplace
interventions and the development of public-private partnerships for a continuum of prevention to care
services. The main strategies include mobilizing companies for workplace interventions, developing private
models of service delivery in counseling and testing (CT) and PMTCT, and provision of technical assistance
to government on mainstreaming HIV/AIDS in the private sector. The geographical focus is Karnataka,
coastal Andhra Pradesh and selected port towns (Mumbai, Vashi, Mangalore, Tuticorin, Chennai and Vizag)
in the USG focus states. The International Labor Organization (ILO) provides technical support to the
project.
ACTIVITIES AND EXPECTED RESULTS
Under the national program in India, PMTCT is referred to as PPTCT or Prevention of Parent to Child
Transmission, to mitigate any stigma associated with the mother/woman as a vector of the infection. The
PMTCT component under the Connect project is implemented through two model PMTCT sites established
within the private sector hospitals in Chennai (Tamil Nadu) and Vizag (Andhra Pradesh). The activities are
led by YRGCARE (Y.R. Gaitonde Center for AIDS Research and Education) which is supported and
managed by PSI. The focus in FY08 will be on assessing sites in two other high prevalence states to study
the feasibility of expanding the model, in addition to further strengthening service delivery, improving its
quality and mobilizing resources for PMTCT services.
ACTIVITY 1: Demonstrate High-Quality Models of Service Delivery in the Private Sector
Connect project will continue to provide high quality PMTCT services to two centers that started operating in
FY07, and will expand to a third site. Starting in October 2007, a mystery client study will be carried out at
the PMTCT centers to assess the current levels of adherence to standard quality protocols in accordance
with the national guidelines. Based on the gaps identified by the mystery client studies, specific training
programs will be designed for the counselors and case management workers at the PMTCT centers. The
capacity building plan for FY08 includes training 10 counselors and case management workers in
implementing standard quality protocols in accordance with the national guidelines, with an emphasis on
quality assurance for PMTCT services and data quality assurance. The activity's aim is that at least 70% of
the standard protocols are followed at the PMTCT centers. Quality assurance will include ensuring the
complete package of elements of PMTCT is provided, including community mobilization, partner counseling,
ARV prophylaxis for the mother-baby pair, counseling on safe disclosure, safe elective surgeries and
linkages with the government ARV centers for follow-up for the mother (and positive baby) for ARV and OI
treatment. The Connect project will follow the national protocols for promoting exclusive breastfeeding;
however it will leverage infant food wherever appropriate as part of an informed choice package.
ACTIVITY 2: Demand Creation for PMTCT Services
Demand creation activities will continue at the community level through identification and motivation of
pregnant women to access PMTCT services. In FY08, training of private ANC providers will be conducted to
increase their knowledge of the national PMTCT program, approved medication regimens, and counseling
techniques to motivate them to refer clients for PMTCT services. Regular meetings will be conducted under
the aegis of the Indian Medical Association and Federation of Obstetric and Gynecological societies of India
to mobilize local private practitioners. Outreach activities by the YRG Care team will reach women through
NGOs working with women's groups, women's clubs and women's self help groups. Regular stakeholders'
meetings with community influencers will be conducted with NGOs to motivate them to promote demand for
PMTCT services. Innovative communication materials in the form of brochures, flip charts, pamphlets,
posters and newsletters will be developed to address the benefits of PMTCT. In FY08, around 1800 women
will be counseled and tested at the private PMTCT centers, and around 150 mother-baby pairs will receive
the complete package of PMTCT services. Testing of other younger children from previous pregnancies will
also be encouraged.
ACTIVITY 3: Involvement of Male Partners in Utilization of PMTCT Services
In FY08 specific interventions will be conducted in the community to target male partners through the
PMTCT intervention. All pregnant women accessing services at the PMTCT centers will be motivated to
bring their partners for HIV testing. Partner testing and counseling for safe disclosure will be strongly
encouraged as also referral to community-based organizations to mitigate possible negative effects of
disclosure and increase community support. Counselors will be trained in motivating women to bring their
male partners for HIV CT. Male partners will also be reached to motivate them to access PMTCT services
as a couple. Communication material will be developed emphasizing the need for male partner participation
in the PMTCT component. Around 100 male partners will be counseled and tested at the PMTCT centers.
ACTIVITY 4: Raising Resources for Sustainability of PMTCT.
In FY08, the project will focus on leveraging resources for nutritional support, the cost of elective caesarian
section, salary for human resources, and the training and research cost. Local donors like Rotary and the
Lions Clubs will be targeted to raise funds for the elective caesarian section for HIV-positive mothers, which
are currently subsidized service at the private sector hospitals. Partner hospitals will be motivated to
assume the cost of salaries for the human resources dedicated to PMTCT services.
The long-term goal is to demonstrate the success of this model to the National AIDS Control Organization
Activity Narrative: (NACO) and incorporate it under the national program. A public-private partnership Community Advisory
Board will be established in each project site. The Community Advisory Board will consist of representatives
from local NGOs, SACS, local PLHA networks, partner hospitals and the community. These community
advisory boards will provide guidance in overall program implementation and most critically ensure
leveraging of resources from different stakeholders in society. The Connect project will aim to increase the
engagement of the private sector (through corporate social responsibility) and the NGO/CBO sector to build
the long term sustainability.
ACTIVITY 5: Referral Linkages for Care and Treatment of HIV Positive Parents
Connect will conduct an assessment of the care and treatment facilities in the three project sites to assess
the quality of services at these centers. An intensive network will be mapped out of government and private
(NGO) service providers to which HIV-positive clients can be referred for care, support and treatment
(ncluding ART). Referred clients will be tracked through a card system monitored through field and
community outreach. This activity plans to refer 150 HIV positive clients to care and treatment services.
ACTIVITY 6: Capacity Building of Local NGOs and the SACS
Connect will design and conduct training programs for local NGOs and the State AIDS Control Societies
(SACS) to build their institutional capacity to manage and monitor private sector PMTCT models.
Operational guidelines and standard operating procedures at the PMTCT centers will be shared with the
SACS to assist in strengthening the quality of services in public sector PMTCT centers. The operational
guidelines will include the steps to set up a private sector PMTCT model that provides a range of
comprehensive services going from community mobilization to follow-up of mother-baby pair with ARV/OI
treatment services; a training plan; and monitoring protocols to measure services, client satisfaction and
data quality. The training programs will use a mixed methodology that has classroom sessions followed by
on-site technical assistance and field visits to the PMTCT center. This activity will aim at training 20
individuals from different NGOs in PMTCT protocols.
In FY08, the Connect project activities implemented by Population Services International (PSI) in this
program area will focus primarily on formal and informal workers in two industrial sectors, such as
plantations and construction. PSI's earlier experience with port workers in the informal sector showed the
need based on a behavioral baseline study, to include A and B messages as appropriate prevention
strategies for this group. PSI aims to transition out of direct implementation and so Connect will focus on
building the capacity of NGOs and partner companies to implement workplace interventions (WPI) to
promote appropriate A and B messages and mutual fidelity. In collaboration with NGOs and CBOs, a
capacity building plan to build local capacity to implement workplace interventions as well as provide
community outreach will be put in place with linkages to counseling and testing (CT) and TB diagnostic
services. Documentation, dissemination and resource mobilization will also be important activities in FY08.
The completion of an industrial assessment study is expected to provide information on the prioritization of
the geographical clusters and port towns in order to demonstrate different workplace intervention (WPI)
models.
in partnership with the Federation of Indian Chambers of Commerce and Industry (FICCI), Y.R,Gaitonde
(KHPT). The International Labor Organization (ILO) is providing technical support to the project. The project
aims to increase private sector engagement in HIV/AIDS through workplace interventions and the
development of public-private partnerships in continuum of prevention to care services. The main strategies
include mobilizing companies for workplace interventions, developing private models of service delivery in
CT and PMTCT and provision of technical assistance to the government on mainstreaming HIV/AIDS in the
private sector. Currently, the geographical focus is Karnataka, coastal Andhra Pradesh and selected port
towns (Mumbai, Vashi, Mangalore, Tuticorin, Chennai and Vizag) in the USG focus states.
ACTIVITY 1: Reaching the Organized Workforce
Connect will continue to implement the ILO model at workplaces in selected geographical industrial areas
with vulnerable populations, including mobile, formal and informal workers. In FY08, the implementation of
this model will be scaled up to reach nearly 10,000 formal workers in industries. Based on the baseline
study of sexual behavior in these sectors expected to be completed in FY07, efforts will be made to address
behavior change through specific communication tools, peer education and capacity building of key peers.
Abstinence and Be Faithful messages will continue to be integrated in the training of trainers and peer
educator training modules. Workplace communication materials like posters, leaflets and pamphlets, based
on triggers and barriers to adopting abstinence and being faithful will be developed for workers in the
industrial sector who are vulnerable to high-risk behaviors. ‘Master' trainers and peer educators will be
trained to promote A and B messages and to foster social norms that promote risk reduction.
PSI aims to involve partner companies in mobilizing their own resources to implement WPI. Some
companies have asked for customized workplace interventions that focus on the overarching health and
well being of their workers. The customized package will include life skills trainings, A and B messages, risk
assessments for personal health including HIV/AIDS, TB and hypertension and referrals for CT. Efforts will
be made to ensure equitable access to gender-appropriate prevention messages and services by women
and men. Advocacy programs to address male norms will be included in the customized intervention
package. Women workers from the informal sector who are employed as casual labourers and on daily
wages are vulnerable to exploitation due to livelihood insecurity and have inadequate or no access to
information and health care services. These women will be especially targeted to improve their knowledge
and accessibility to services
ACTIVITY 2: Reaching Informal Workers in At-Risk Industrial Sectors and Ports
An initial assessment showed that certain industries like plantations and mining have a large informal
workforce vulnerable to high-risk behaviors. In FY08, Connect will continue to reach these informal workers
(or those in other sectors) with a high intensity model that combines targeted behavior change
communication with outreach activities. Interpersonal Communicators (IPC) will conduct interactive one-to-
one and one-to-group sessions and promote A and B messages. Communication materials like flip charts
and interactive games will be developed based on the triggers and barriers among informal workers to
adopting A and B. Connect will also use drama shows, street play and magic shows to target informal
workers with messages promoting A and B.
PSI will continue to reach high risk informal workers at port towns through IPC and simultaneously mobilize
resources from industries and local NGOs to take over the direct implementation of these activities in a
gradual manner. Women in the unorganized sector are particularly vulnerable to exploitation and risk for
HIV/STI. The communication and outreach activities will specifically work on strategies for women that will
promote negotiation and be faithful messages as well as encourage personal risk assessments and quality
health seeking behaviors.
ACTIVITY 3: Capacity Building of Local NGOs.
Connect will continue to experiment and implement various models for workplace interventions with the
formal and informal sectors. As part of technical assistance and capacity building to mobilize other sources
of funding for prevention activities, NGOs will be identified and trained to implement these models. In
addition, capacity building of the Karnataka and Andhra Pradesh State AIDS Control Societies to
mainstream HIV/AIDS at the workplaces is planned in FY08 through placement of a Workplace Coordinator
in each of these organizations.
ACTIVITY 4: Documentation and Dissemination
Connect will continue to document the reasons for the success and failure of different models of workplace
Activity Narrative: interventions (WPI), lessons learned and challenges faced. Simple operational guidelines for
implementation of WPI models will be developed. Reports and guidelines will be released electronically so
that they can be easily and widely disseminated. The information will be disseminated to NGOs, SACS,
NACO, USAID, partner companies, employers' associations and other key stakeholders
ACTIVITY 5: Resource Mobilization from the Private Sector
A key focus area in FY08 will be on raising resources for on the ground communication activities to promote
A and B messages among formal and informal workers in port towns and with those most-at-risk in the
industrial sector. The Connect team will mobilize resources by targeting: a) large, established companies
with foundations or other corporate social responsibility (CSR) programs that include HIV/AIDS
programming; b) companies whose leadership is particularly enlightened about the issue; and c) groups of
companies and government ministries. The Connect team will reach these segments of companies in close
collaboration with influential industrial leaders, business associations, the CSR forum, and employers'
associations.
The Connect project, implemented by Population Services International (PSI) will continue to reach formal
and informal workers in industries in sectors and geographical clusters including port towns through
different interventions. Depending on the perceived risk and behaviors of the workforce, communication
messages will focus on consistent condom usage, prompt treatment and referral for STI and utilization of
CT services. A large section of the workforce in sectors like plantation, construction and mining comprises
casual and daily wage workers who are basically seasonal short-stay migrants. In FY08, Connect will work
with populations vulnerable to high-risk behavior among these workforces through prevention interventions.
Those at risk will be provided skills to motivate consistent condom usage. Peer educators and outreach
activities will promote information about and increased use of services. In the port towns, Connect will target
female sex workers (FSW) to build and strengthen their ability to negotiate condom use with male clients
and facilitate treatment of STI. Connect will actively seek to mobilize corporate resources, with the aim of
reducing its direct involvement in the implementation of these interventions and transitioning them to
NGO/CBOs. Connect will also increase its technical assistance to the local SACS on reaching out to
workforce populations with prevention messages and on demand creation for various HIV services,
especially counseling and testing (CT).
The Connect Project has been implemented by PSI since October 2006, in partnership with the Federation
of Indian Chambers of Commerce and Industry (FICCI), Y.R, Gaitonde Centre for AIDS Research and
Educations (YRG CARE) and the Karnataka Health Promotion Trust (KHPT). The International Labor
Organization (ILO) provides technical support to the project.
Connect aims to increase private sector engagement in HIV/AIDS through workplace interventions and
development of public-private partnerships in a continuum of prevention to care services. The main
strategies include mobilizing companies for workplace interventions, developing private models of service
delivery in CT and PMTCT and provision of technical assistance to government on mainstreaming
HIV/AIDS in the private sector. Currently, the geographical focus is Karnataka, which is a high prevalence
state with all 29 districts classified as high burden districts; coastal Andhra Pradesh, the state with the
highest HIV infections in the country; and selected port towns (Mumbai, Vashi, Mangalore, Tuticorin,
Chennai and Vizag) in the USG focus states.
The project will leverage HIV-related services for the target populations through other PSI projects that
promote social marketing of condoms, voluntary CT and STI treatment and, with the comprehensive
Samastha project, referrals and linkages to palliative care, TB treatment, and HIV prevention. The third
phase of the National AIDS Control Program (NACP-3) identifies short-stay migrants as a bridge population
that needs to be reached to reduce HIV in India. Thus the strategy of targeting the workforce, especially
those employed as daily wage workers in the informal sector is consistent with the national HIV prevention
strategy. Coverage will be expanded to include the FSW population around port towns through interventions
designed to increase condom usage as well as STI treatment and referrals. Close to 80,000 workers will be
reached with condoms and prevention messages through these activities.
ACTIVITY 1: Address High Risk Behaviors to Reduce Vulnerability of Workers and Sex Workers
In FY08, Connect will continue to reach workers in the formal and informal sector through workplace
interventions. Interpersonal communications will reach out to the target groups with messages on consistent
and correct condom use and prompt treatment of STI. In geographical locations which have industries that
have a workforce that is vulnerable to HIV, such as the construction and mining sectors, in particular those
in the informal sector, efforts will be made to identify persons with high-risk behaviors, using risk
assessment tools and focus group discussions to ascertain risk behaviors. FSW in the vicinity of the
workplace and around the port towns where PSI implements prevention programs will also be reached.
Connect will leverage the USG-supported Samastha project, which works with FSW in industrial districts of
rural areas like Bellary in Karnataka, to target sex workers with prevention messages and other care
components including referrals and linkages to palliative care, and TB treatment. The project will also
leverage STI treatment facilities made possible under a grant by the Bill and Melinda Gates Foundation to
UM. Effective treatment of STI will reduce the risk and vulnerability of FSW to HIV infection. The project will
aim to increase accessibility of VCT services with focus on counseling for safe disclosure, as well as partner
counseling and testing.
ACTIVITY 2: Increase Access to Condoms
Connect will continue to promote condom outlets in the port locations in the USG focus states and at
various points of service including CT centers, PMTCT centers and STI treatment centers. Peer educators,
who will be trained at the various workplace interventions using the ILO model, will be encouraged to
distribute condoms at the workplace. Condom demonstrations using penis models and innovative activities
to promote condom usage will be held to improve visibility and debunk myths related to condom use.
ACTIVITY 3: Capacity Building of Local NGOs and State AIDS Control Societies (SACS).
The Connect project will continue to implement models of workplace interventions and to engage the private
sectors in mobilizing resources. In FY08, NGOs will be identified and trained to implement these models as
a strategy for long-term transition and sustainability. The capacity- building plan will include training NGO
staff and interpersonal communicators on improving awareness on condom usage and tailoring messages
related to condom use across various target populations in the organized and unorganized sectors. The
curriculum will include identifying risk behaviors, assessing self efficacy and promoting risk reduction. The
training will include skills in using street theatre and other innovative games to demonstrate safer sex
practices and increase motivation for safer behaviors. PSI will place a Workplace Coordinator at the SACS
in Karnataka and Andhra Pradesh to build the capacity of the SACS to plan and implement workplace
interventions. The Coordinator will leverage the targeted interventions with FSW, STI services and linkages
with care and treatment from the SACS.
Activity Narrative:
ACTIVITY 4: Reaching Vulnerable Women in the Work-force
In FY08, Connect will continue to target vulnerable women working as informal workers in port towns and
industrial sectors with messages on condom use and utilization of CT services through interpersonal
communicators (IPC). IPC will use different gender-specific themes like negotiation skills, barriers to health-
seeking behavior and condom use in communication materials like games, flipcharts and story boards to
promote these messages. Women working as formal workers in vulnerable industries like mining and
construction sectors will be reached through a workplace model that utilizes a cascading approach of
training Master Trainers or Peers who in turn train and reach other peers in the industry. Through this
model, 10,000 women will be reached through messages pertaining to condom use and utilization of CT
services. Linkages and partnerships will be developed with women's clubs, women's self help groups and
local NGOs working with women to promote negotiation skills, improved health seeking behaviors for STI
treatment, utilization of CT and correct condom use.
ACTIVITY 5: Resource Mobilization for Sustainability
The Connect project aims to increase resources from the private sector in addressing HIV/AIDS at the
workplace. In FY08, Connect will mobilize resources from industries that have been assessed for increased
risk and vulnerability for HIV/ AIDS, including the informal sector, whih is associated with seasonal
migration, limited access to information and services. Industries will be motivated to commit resources for
workplace programs and to reach out to larger vulnerable communities at risk through corporate social
responsibility approaches. Connect will also provide technical assistance to the SACS to address improved
condom and other preventive methods including treatment of STI, through promotion of social marketing of
condoms and social franchising of STI services.
In FY08, the Connect project, implemented by Population Services International (PSI), will continue to
provide high quality services through nine counseling and testing (CT) clinics, reaching out to women and
couples, ensuring greater involvement of people living with HIV/AIDS (PLHA) and mobilizing local
resources. The main emphasis areas of these activities will be training, services with approaches to ensure
high quality, resource mobilization from the private sector for sustainability and increased private sector
engagement in HIV/AIDS. CT clinics will continue to target high-risk individuals in the 18-34 age group.
The Connect Project has been implemented by Population Services International (PSI) since October 2006,
interventions and the development of public-private partnerships for the continuum of prevention to care
models of service delivery in CT and PMTCT and provision of technical assistance to government on
mainstreaming HIV/AIDS in the private sector. Currently, the geographical focus is Karnataka, coastal
Andhra Pradesh and selected port towns (Mumbai, Vashi, Mangalore, Tuticorin, Chennai and Vizag) in the
USG focus states. The International Labor Organization (ILO) is providing technical support to the project.
The Connect project continues to operate nine Saadhan clinics established under the USAID-supported
Operation Lighthouse project and aims to continue supporting them by mobilizing resources from the private
sector.
Low quality of counseling services, inadequate trained personnel including counselors, weak Management
Information Systems (MIS) and poor accessibility of CT services by MARPs have been some of the
challenges in the public sector CT centers. Under the third phase of the National AIDS Control Plan (NACP-
3), over 4900 integrated counseling and testing centers (ICTC) will be established in the country as part of
the scale-up of HIV services. In addition, the national program is looking at private sector involvement in
service delivery to expand coverage. The Connect project will provide counseling and testing services
through five static and four mobile CT centers in the USG focus states. These centers provide high-quality
pre and post test counseling, confidential high quality HIV testing, STI treatment and referrals to HIV/AIDS
care and support organizations. Connect will increase mobilization of resources from the public-private
sectors for high quality services including CT services.
ACTIVITY 1: Providing High Quality CT Services
Connect will continue to provide high-quality CT services at nine CT centers. Mystery client studies to
assess the level of adherence to standard quality protocols will help determine the capacity building plan for
strengthening the quality of services at all clinics. The training will be aimed at building the capacity of
counselors to provide quality services including quality control and quality assurance for HIV testing and
counseling in accordance with the national protocols. This includes following standard operating procedures
in key areas like inventory management, testing protocols, counseling and disclosure, infection control,
record keeping and analysis of data for improving service delivery. In FY08, it is expected that at least 85%
of standard protocols will be followed at all CT clinics. About 8,000 high risk individuals will receive high
quality CT services.
ACTIVITY 2: Reaching Out to Women and Couples
The Connect project has provided CT services to women and couples since October 2006. In FY08, these
activities will be further strengthened through engagement of male partners. Individual male clients
accessing CT services will also be motivated to refer their partners for HIV counseling and testing and safe
disclosure. Trained counselors and laboratory technicians from Connect-supported CT centers will expand
coverage of services to women at the intervention sites of NGOs working with vulnerable women's groups,
women's clubs and women's self-help groups. Interpersonal communicators will conduct interactive one-to-
one and one-to-group sessions with women and couples with the objectives of motivating them to access
CT services, debunking myths on testing and assuring confidentiality as part of the high quality services.
New communication materials like games, flipcharts; pamphlets for targeting women and couples will be
designed to motivate them to access CT services. Women in particular will be counseled to address safe
disclosure and motivate their partners to be tested. Supportive counseling will address the potential
negative consequences of testing like abandonment. Community-based supportive counseling will also be
leveraged through USG-supported prevention, care and treatment programs in the USG focus states.
ACTIVITY 3: Ensuring Greater Involvement of PLHA in CT Services
Linkages were established in October 2006 with the local HIV Positive networks in Karnataka and Andhra
Pradesh and the national level network, the Indian Network for Positive People (INP+) to ensure the greater
involvement of people living with HIV/AIDS (PLHA). Sub activities include: a) recruitment of an HIV-positive
peer counselor at PSI-operated CT centers to counsel all HIV- positive clients after the post-test counseling
to reinforce positive living, facilitate case management and facilitate the access of PLHAs to care and
treatment facilities; b) facilitate the strategy of ‘Services under one roof' at all seven CT center to make all
medical services available to PLHA at one site (‘under one roof') free of cost on a particular day.
PSI will continue to act as a catalyst to mobilize the available resources (health care providers, counselors,
nutrition support, leveraging services from charity) to provide important medical services to PLHA once a
month. The positive networks, partner companies and NGOs will be mobilized to motivate HIV-positive
clients to use these services. Medicines for opportunistic infections will be leveraged from the
pharmaceutical companies; the snacks and food for the PLHA will be leveraged from the local hotel
industries. In FY08, about 500 PLHA will receive services through this innovative approach to improve
access.
Activity Narrative: ACTIVITY 4: Increase Use of HIV/AIDS Care and Treatment Services
Case management and post test clubs were initiated in FY06 to increase referrals for care and treatment
services. These activities will continue in FY08. About 1000 positive clients will be referred for care and
treatment services and will be tracked using cards and follow-up through outreach. In addition, new
activities will be initiated in FY08 to ensure effective referrals of all positive clients from CT clinics. This
includes training and capacity building of partner NGOs for tracking cases and follow-up; providing quality
care and support services from health care providers, and training in case management approach for the
government and private TB services to ensure effective referrals for TB services. Twenty medical and
paramedical staff from different organizations implementing care and treatment projects will be trained
under this initiative. About 150 positive clients are expected to be referred for TB services.
ACTIVITY 5: Mobilizing Local Resources for Sustainability of Services.
The Connect project will mobilize resources by targeting large, established companies that have
foundations or other corporate social responsibility (CSR) initiatives which include HIV/AIDS programming,
companies whose leadership is particularly enlightened about the issue of HIV/AIDS, and groups of
business associations, the government and civil society organizations. These groups will be encouraged
and empowered to pool resources and design or support prevention to care activities. In addition, initiatives
can be customized of an initiative to meet an organization's needs. In mid 2007, one of the mobile CT
clinics in Vashi was supported by a partnership with the private sector tyre company, Apollo Tyres. Apollo
provides STI treatment services at the CT clinic with support for a specialized STI medical provider, three
outreach workers and the supply of STI drugs. In FY08, the Connect project will continue to offer companies
a ready platform to fulfill their CSR responsibilities with a menu of ‘on ground' initiatives. The test kits for CT
clinics will be leveraged from the local State AIDS Control Society (SACS) or from the manufacturers.
In FY08, the Connect project, implemented by Population Services International (PSI) will aim at sustained
capacity building of institutions and stakeholders, like the State AIDS Control Societies (SACS) in Karnataka
and Andhra Pradesh, employers' organizations, labor unions, and private and public sector companies, in
developing policy and programs on HIV/AIDS and TB. The program will mobilize increased involvement of
the corporate sector in HIV/AIDS programs. Activities will also include supporting the local SACS and the
National AIDS Control Organization (NACO) in policy development, institutional capacity building for
implementing workplace programs, proposal development, financial management, human resource
management and documentation.
The Connect project has been implemented by PSI since October 2006, in partnership with the Federation
of Indian Chambers of Commerce and Industry (FICCI), Y.R. Gaitonde Centre for AIDS Research and
Educations (YRG CARE) and the Karnataka Health Promotion Trust (KHPT). The ILO provides technical
support to the project. Connect aims to increase private sector engagement in HIV/AIDS through workplace
models of service delivery in counseling and testing (CT) and PMTCT and technical assistance to the
government on mainstreaming HIV/AIDS in the private sector. The geographical focus is Karnataka, coastal
USG focus states.
The third National AIDS Control Plan (NACP-3) outlines a strategy to leverage the strengths of the private
sector to become an active partner in the national response. Potential areas for private sector participation
include activities to support vulnerable and infected populations, mobile CT, behavior change
communication through outreach, and other innovations such as smart cards for ARV adherence. Private
sector engagement at the district level and innovative demand-side financing mechanisms like vouchers for
HIV services have been identified as key activities. In August 2007, NACO invited Connect to provide
technical assistance (TA) for better understanding of models that Connect is developing in the private sector
and to identify areas that can be replicated by the government.
ACTIVITY 1: Technical Assistance to NACO and the SAS to Build the Private Sector Response to HIV/AIDS
Connect will continue to build the capacity of the SACS to design and implement workplace intervention
(WPI) models. The project will support a Workplace Coordinator at the SACS in Karnataka and Andhra
Pradesh to plan and implement various WPI models for mainstreaming HIV/AIDS in various sectors
(government, private sector and civil society) as envisaged under NACP-3. Connect aims to transition the
models developed to SACS so the SACS can continue implementation in existing companies and enroll
new ones. At the national level, operational guidelines for implementing workplace interventions and
engagement of the private sector through corporate social responsibility initiatives will be developed in
response to corporate and state needs. Models developed through the project will be documented and
disseminated for the benefit of other SACS, NGOs and USG partners in Maharashtra, Tamil Nadu,
Karnataka and Andhra Pradesh.
ACTIVITY 2: Institutional Capacity Building of Employers' Organizations
In FY08 the formal partnerships/collaborations established with employers' organizations like the Karnataka
Employers Association, will continue to facilitate the implementation of WPI in Karnataka, especially around
the industrial areas of Peenya in Bangalore and Bellary district in northern Karnataka (which has an HIV
prevalence rate of over 1%). Through this collaboration, senior management of member organizations will
be directly engaged through a series of capacity building initiatives to: a) motivate businesses to get
involved in HIV/AIDS; and b) provide technical assistance to employers' organizations to formulate and
issue policy guidelines to member organizations. Employers' organizations will be encouraged to include
messages on HIV/AIDS and TB in their regular communications with member companies. By FY08, the
capacity of at least five employers' organizations will be built in motivating companies to design and
implement HIV/AIDS and TB workplace programs and policies.
ACTIVITY 3: Partnership with Labor Unions to Reach Informal Workers
Partnerships established with labor unions in FY07 will expand through engagement with labor unions at the
district level in Karnataka and coastal Andhra Pradesh. Unions will be provided training on HIV/AIDS and
TB using the training material produced by Connect, adapted from materials developed by the ILO and
other agencies. In August 2007, five national trade unions released a Joint Policy statement based on the
ILO's "Code of Practice and the World of Work" that urged all affiliates and members to recognize HIV/AIDS
as a workplace issue and give it the highest priority. The ILO will provide technical support to Connect to
implement two pilot projects that will reach 1000 informal workers. The capacity of labor unions to develop
future proposals to seek small grants from SACS will be developed. .
ACTIVITY 4: Strengthening Capacity of Private Companies for HIV/AIDS Programs
a) Developing Workplace HIV/AIDS and TB Policies in Private Companies
In FY08 the project will continue to enroll private sector companies to support WPI. Connect's strategy is to
ensure that private sector companies contribute to their workplace programs. TA will be provided to partner
companies to help them form committees on HIV/AIDS and TB. Attempts will also be made to integrate
HIV/AIDS and TB in existing committees on other health/social issues. Using the ILO's cascade model to
reach the workforce across all management tiers, Connect will train master trainers and peer trainers within
the companies, so that HIV/AIDS programs are internalized; and mentor the master trainers in training peer
educators. Over 120 trainers from 60 companies will be trained in HIV/AIDS and TB to create awareness
amongst co-workers and families. Partner companies will be supported to develop workplace HIV/AIDS and
TB policy. The project will establish linkages with already existing HIV/AIDS community services such as CT
and STI clinics. Connect will assist companies to develop monitoring and evaluation systems to monitor and
track the progress of WPI programs.
b) Mobilizing Resources from the Private Sector for Service Delivery
Connect will mobilize resources by targeting large, established companies with foundations or other
corporate social responsibility (CSR) initiatives that include HIV/AIDS programming, companies whose
leadership is particularly enlightened about HIV/AIDS and groups of business associations, government and
Activity Narrative: civil society organizations to encourage them to pool resources and design or support prevention to care
activities. Initiatives will be customized to meet an organization's needs. In mid-2007, one of the mobile CT
clinics in Vashi in Maharashtra was partially supported by a partnership with the private sector tyre
company, Apollo Tyres, to provide STI treatment services. In FY08, Connect will offer companies a ready
platform to fulfill their CSR responsibilities with a menu of ‘on ground' initiatives. Test kits for CT clinics will
be leveraged from the local SACS or directly from the manufacturers.
ACTIVITY 5: Mainstream HIV/AIDS and TB Programs into Public Sector Companies
Connect will work with the state departments of Health, Labor, and Transport and establish relationships
with other key state government departments to reach out to large public sector enterprises. Sensitization
programs will be organized for senior management of public sector companies. Connect will assist in
building institutional mechanisms to develop and monitor HIV/AIDS activities in those departments. With the
involvement of senior management, trainings will be conducted for the public sector workers on HIV/AIDS
and TB. Policy development guidelines will be made available and assistance provided to draft policy
statements. The project will develop and implement at least five WPI in public sector enterprises across
Karnataka and coastal Andhra Pradesh in FY08.
ACTIVITY 6: Reduction of Stigma and Discrimination at Workplaces
Connect works in the formal and informal sector as with populations vulnerable to exploitation that have
poor access to information and services. Connect will include initiatives to address women in the workforce
especially in the unorganized sector. Activities will sensitize their employers, overcome barriers to testing
and maintain confidentiality will be introduced. Information on empowerment and entitlements will be
provided to HIV-positive women employees. The project will leverage involvement of PLHA from other USG
-supported programs in Karnataka and Andhra Pradesh to expand the Greater Involvement of People Living
with AIDS (GIPA) in the workplace intervention activities, such as in Project Advisory Committees,
workplace training programs, and in mobilizing corporate through events at state and district levels. Specific
trainings will be organized to train members of positive networks in Karnataka and Andhra Pradesh for
advocacy at the workplace. Stigma and discrimination at the workplace is a barrier for testing and
disclosure. Interpersonal communication through peer education will specifically address these issues as
part of demand generation for CT and improved access to care and treatment services.