Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 5785
Country/Region: India
Year: 2008
Main Partner: FHI 360
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $2,028,105

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $87,600

SUMMARY

The Samarth project will continue supporting demonstration programs on AB interventions among most-at-

risk children and youth and will use these lessons to provide technical assistance to USG partners.

Additionally, it will develop best practices for mainstreaming AB interventions for youth and children into the

programs of government ministries.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

technical assistance (TA), capacity building and institutional strengthening of government (the National

AIDS Control Organization [NACO] and the State AIDS Control Societies [SACS]) and civil society. In

addition, the Global Fund's Country Coordinating Mechanism (CCM) Secretariat will be provided with TA to

strengthen its leadership and governance. FHI implements the Samarth project in partnership with the

Christian Medical Association of India (CMAI, which has over 300 faith-based hospitals as members), the

Indian Network of Positive People (INP+), and Solidarity and Action Against the HIV Infection in India

(SAATHII, an NGO with a mandate to build capacity of civil society). The Samarth project extends needs-

based capacity-building assistance to government and non-government stakeholders as well as to USG

partners. Since FY07, Samarth has supported NACO with human and technical assistance in key program

areas like counseling and testing (CT), OVC, ARV, strategic information and policy and systems

strengthening. Samarth also implements 4 demonstration projects in New Delhi to showcase best practices

in Abstinence and Be Faithful (AB) programming, OVC and palliative care for injecting drug users.

ACTIVITIES AND EXPECTED RESULTS

This activity is an ongoing project funded under PEPFAR in FY07. With FY08 funding, the project will

continue to improve the capacity of its partners in demonstration projects to implement AB programs and

will provide TA on AB programs to USG partners.

ACTIVITY 1: Implementing Abstinence and Be Faithful Programs in Demonstration Projects

Samarth will continue supporting four demonstration projects to develop best practices in AB interventions

among most-at-risk-children in urban slums, street youth and vulnerable local communities in Delhi. The

local communities include traditional sex workers, rag-pickers and the snake-charmers community. Children

from these communities are often school drop-outs. The outreach activities include mobilizing children to

attend non-formal education, life skills education and skills development to promote livelihood security.

These activities will prevent children and youth from engaging in high-risk behaviors.

The demonstration projects will also develop best practices of mainstreaming programs for vulnerable

children and youth into the various ministries such as the Ministry of Women and Child Development,

Ministry of Youth and Sports and Ministry of Social Justice and Empowerment. Activities include

development of guidelines and capacity-building of ministry staff to implement mainstreaming activities. The

Life Skills Education Toolkit developed by Samarth using FY07 funds has been approved by NACO for

adaptation and replication by the Government of India as part of the national mainstreaming program. About

2400 youth will be reached through the demonstration projects; this includes 300 OVC, aged 10-14, who

are currently being reached through the community-based OVC project.

ACTIVITY 2: Technical Assistance (TA) to USG Partners on AB Programs

Samarth will provide TA to USG partners implementing AB programs in integrating AB approach into

existing communication strategies, and with BCC materials for youth and mobile populations. TA will also be

provided to USG partners to document success stories and lessons learned in AB interventions.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $43,800

SUMMARY

Under this program area the Samarth project, implemented by Family Health International (FHI) will support

demonstration projects in Delhi to reach out to injecting drug users(IDU), most-at-risk children, street youth

and local vulnerable communities with messages on safe sex including abstinence, increasing condom use

and promoting STI treatment. Samarth will also provide technical assistance (TA) to USG partners in

designing positive prevention programs in the four focus states.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

TA, capacity building and institutional strengthening of government (the National AIDS Control Organization

[NACO] and the State AIDS Control Societies [SACS]), and civil society. In addition, the Global Fund will be

provided TA to strengthen the leadership and governance of its India Country Coordinating Mechanism

(CCM) Secretariat. FHI implements Samarth in partnership with the Christian Medical Association of India

(CMAI, which has over 300 faith-based hospitals as members), the Indian Network of Positive People

(INP+), and Solidarity and Action Against the HIV Infection in India (SAATHII, an NGO with a mandate to

build capacity of civil society). Samarth extends needs-based capacity building assistance to government

and non-government stakeholders as well as to USG partners. Since FY07, Samarth has supported NACO

with human and technical support in key program areas like counseling and testing (CT), OVC, ARV,

strategic information and policy and systems strengthening. Samarth also implements four demonstration

projects in New Delhi to showcase best practices in Abstinence and Be Faithful programs, OVC and

palliative care for IDU.

ACTIVITIES AND EXPECTED RESULTS:

With FY08 funding, FHI will continue to improve the capacity of the four demonstration partners to

implement HIV prevention programs for most-at-risk populations (MARPs) including PLHAs with a focus on

safe sex practices.

ACTIVITY 1: Support to Demonstration Projects on Prevention in Delhi.

The Samarth project will continue to support four demonstration projects in Delhi to promote safe sex

including condom use among IDU, most-at-risk children, street youth and local vulnerable communities in

Delhi. The local communities include traditional sex workers, rag-pickers and the snake-charmers

community. These populations will be targeted through outreach activities such as interpersonal

communication, counseling, street plays and exhibitions. Most-at-risk children in the age group of 14-17

years will be particularly targeted for linkages with activities promoting AB messages and strategies for

delaying sexual debut. Some in this target group are sexually active and will be specifically reached through

peer educators and counseled for consistent and correct condom use, partner reduction and motivated for

testing.

ACTIVITY 2: Technical Assistance (TA) on Positive Prevention for USG Partners

Samarth through its partner the Indian Network of Positive People (INP+) will provide TA to the state and

district PLHA networks to reinforce prevention education and to develop risk-reduction strategies for PLHA

and their partners. INP+ will conduct training on positive prevention and share training materials and

information on lessons learned with state and district-level PLHA networks. Additionally, advocacy with

SACS will be carried out to promote integrating positive prevention into the existing training curricula for

healthcare professionals and counselors.

Funding for Care: Adult Care and Support (HBHC): $131,400

SUMMARY

In FY08, the Samarth project will provide technical assistance (TA) to the National AIDS Control

Organization (NACO), the State AIDS Control Societies (SACS) and USG partners in developing strategies

on the continuum of care, including guidelines for implementation. Hands-on training of health care

providers will be carried out in the four USG focus states on the minimum package of palliative care as

defined by USG/India

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006. The

project will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through TA,

capacity building and institutional strengthening of government (NACO, the SACS), and civil society. In

addition, the Global Fund will be provided specific TA to strengthen the leadership and governance of its

India Country Coordinating Mechanism (CCM) Secretariat. FHI implements Samarth in partnership with the

Christian Medical Association of India (CMAI, which has over 300 faith-based hospitals as members), the

Indian Network of Positive People (INP+), and Solidarity and Action Against the HIV Infection in India

(SAATHII, an NGO with a mandate to build capacity of civil society). Samarth extends needs-based

capacity building assistance to government and non-government stakeholders as well as to USG partners.

Since FY07, Samarth has provided NACO with human and technical support in key program areas like

counseling and testing (CT), OVC, ARV, strategic information and policy and systems strengthening.

Samarth also implements four demonstration projects in New Delhi to showcase best practices in

Abstinence and Be Faithful programs, OVC and palliative care for injecting drug users (IDU).

ACTIVITIES AND EXPECTED RESULTS

This activity continues a Samarth intervention funded under PEPFAR in FY07. With FY08 funding Samarth

will continue to partner with CMAI to use CMAI's learning sites to improve the capacity of USG partners to

scale-up quality facility and home-based palliative care. FHI will also continue to provide TA to strengthen

national/state HIV palliative care programs.

ACTIVITY 1: TA to NACO, SACS and USG Partners on Palliative Care Services

Samarth will provide TA to NACO, SACS and USG partners in developing strategies and operational plans

for implementing the continuum of care services for PLHA and their families. USG/India has defined the

palliative care package which includes activities on clinical/medical, psychological, and spiritual care, and

socioeconomic and legal support. Samarth will also provide TA to develop common minimum quality

standards, checklists, and a training curriculum for HIV palliative care services. Samarth will identify a team

of consultants with expertise in palliative care to work with the palliative care specialists of NACO, SACS

and USG partners in supporting the TA needs.

SAATHII, a sub-partner of the Samarth project, will document the best practices on palliative care services

including the network model of integrating prevention, care and treatment services and will disseminate this

information to NACO, SACS and USG partners.

ACTIVITY 2: Support Demonstration Center on Palliative Care for IDU

Samarth will support a residential care home for providing palliative care to IDU and PLHA. Services will

include in-patient and out-patient facilities for treatment of opportunistic infections, counseling and referral

services for ARV treatment. TB diagnosis and treatment will be provided to HIV-positive people through the

TB-DOTS center co-located on the premises. The best practices in palliative care for IDU will be

documented and disseminated to government agencies and USG partners.

ACTIVITY 3: On-site Training in Palliative Care for Health Care Providers and Caregivers

In FY06, four faith-based hospitals were developed by CMAI, a sub-partner of Samarth, as learning sites for

HIV palliative care, in the USG focus states of Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. In

FY08, these sites will provide onsite training to health care providers and the caregivers in four USG states

in providing quality palliative care, based on the minimum package defined by USG/India. The health care

providers (HCP) will include medical officers, nurses and palliative care outreach workers. A "caregiver" is

defined as a family member of the HIV-positive person. CMAI will update the existing training modules on

palliative care to ensure that quality training is provided to the HCP. The training will cover topics in clinical

care such as prevention and treatment for opportunistic infections, ART referrals and adherence;

psychological care such as counseling, support for disclosure and bereavement care; nutritional care such

as dietary counseling and food supplementation; and social support. The training institutions will conduct

follow-up training periodically based on needs.

Funding for Care: TB/HIV (HVTB): $21,900

SUMMARY

The focus of this activity is training health care providers on HIV/TB treatment and care services, specifically

related to cross-referrals for TB/HIV. This activity will take place in the USG focus states at the four learning

sites on palliative care developed by the Samarth project in FY06.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

technical assistance(TA), capacity building and institutional strengthening of government (the National AIDS

Control Organization [NACO] and the State AIDS Control Societies [SACS]), and civil society. In addition,

the Global Fund will be provided specific TA to strengthen the leadership and governance of its India

Country Coordinating Mechanism (CCM) Secretariat. FHI implements this project in partnership with the

Christian Medical Association of India (CMAI, which has over 300 faith-based hospitals as members), the

Indian Network of Positive People (INP+), and Solidarity and Action Against the HIV Infection in India

(SAATHII, an NGO with a mandate to build capacity of civil society). Samarth extends needs-based

capacity building assistance to government and non-government stakeholders as well as to USG partners.

Since FY07, Samarth has supported NACO with human and technical support in key program areas like

counseling and testing (CT), OVC, ARV, strategic information and policy and systems strengthening.

Samarth also implements four demonstration projects in New Delhi to showcase best practices in

Abstinence and Be Faithful programs, OVC and palliative care for injecting drug users (IDU).

ACTIVITIES AND EXPECTED RESULTS

ACTIVITY 1: Training of Health Care Providers on TB/HIV

In FY06, four faith-based hospitals were developed as learning sites for HIV palliative care in the USG

priority states of Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. In FY08, these sites will

provide onsite training to health care providers and caregivers in four USG states on providing TB

diagnostic and treatment services to HIV-positive people and HIV services to TB patients. The curriculum

will be developed based on national guidelines on HIV/TB programs.

ACTIVITY 2: HIV/TB Services in Demonstration Projects in Delhi

In FY08, Samarth will continue to provide TB treatment and/or referral services to HIV infected IDU and

children in the demonstration programs. The staff of the demonstration programs will be trained on active

TB case finding and screening PLHA for signs and symptoms of TB, referral for diagnosis, and initiation and

completion of DOTS. The project staff will provide adherence counseling to the TB clients during home and

clinic follow-up visits and work closely with the DOTS center to ensure completion of the course of anti-

tubercular treatment.

Funding for Care: Orphans and Vulnerable Children (HKID): $175,200

SUMMARY

The focus of this activity is to provide technical assistance (TA) to the National AIDS Control Organization

(NACO), State AIDS Control Societies (SACS) and USG partners in developing and expanding quality

orphans and vulnerable children (OVC) programs in the public and private sectors. Specifically, TA will be

provided to operationalize OVC strategies including developing capacity-building plans for NGOs. The

Samarth project will continue to support demonstration programs on OVC to serve as learning sites and

transfer best practices.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

TA, capacity building and institutional strengthening of government (NACO, the SACS), and civil society. In

addition, the Global Fund will be provided specific TA to strengthen the leadership and governance of its

India Country Coordinating Mechanism (CCM) Secretariat. FHI implements the Samarth project in

partnership with the Christian Medical Association of India (CMAI, which has over 300 faith-based hospitals

as members), the Indian Network of Positive People (INP+), and Solidarity and Action Against the HIV

Infection in India (SAATHII, an NGO with a mandate to build capacity of civil society). Samarth extends

needs-based capacity building assistance to government and non-government stakeholders as well as to

USG partners. Since FY07, Samarth has supported NACO with human and technical support in key

program areas like counseling and testing (CT), OVC, ARV, strategic information and policy and systems

strengthening. Samarth also implements four demonstration projects in New Delhi to showcase best

practices in Abstinence and Be faithful programs, OVC and alliative care for injecting drug users (IDU).

ACTIVITIES AND EXPECTED RESULTS

FHI as a member of the National Task Force Committee for children affected by HIV/AIDS assisted NACO

and the Ministry of Women and Child Development, Government of India, in developing national policies on

addressing OVC issues in India. In FY07, the Samarth project provided TA to NACO for developing the

national operational guidelines on OVC.

ACTIVITY 1: Support to OVC Demonstration Program

With FY08 funds, Samarth project will continue to support a demonstration program on OVC in Delhi. The

capacity of NGO staff working on OVC programs will be built in participatory training skills in order to

transfer the best practices of the OVC program to the SACS and NGOs in USG focus states. The

demonstration center will provide onsite experiential training and mentoring support to NGOs, SACS and

USG partners in caring for OVC through life skills education (LSE), counseling, medical care, nutritional

support and non-formal education. The demonstration site has an exemplary way of tracking uniquely

identifiable OVC children through individual tracking sheets across the six PEPFAR core OVC intervention

areas. This monitoring tool will be shared with other USG partners and SACS to assist in ensuring a

comprehensive range of services and referrals for the child.

ACTIVITY 3: TA to NACO, SACS and USG Partners in OVC Programming

In FY07, TA was provided to NACO in developing the national operational guidelines for programs with

children infected and affected by HIV/AIDS. In FY08, Samarth will provide technical support to NACO,

SACS, and USG partners to use the national guidelines to scale up OVC programs in India. Technical

support will be provided through theme-based workshops, trainings, site visits and sharing of tools and

guidelines. Areas of technical support will include child counseling and behavior change communication,

with an emphasis on AB prevention messages, child participation, LSE, community mobilization for care

and support, and establishing linkages for medical, psychosocial, and economic support. Toolkits and

guidelines developed by Samarth on LSE, child-counseling and child detoxification will be shared with

NACO, SACS and USG partners.

SAATHII, a sub-partner of the Samarth project, will document the lessons learned and best practices of the

USG-supported OVC programs and disseminate this information through publications and workshops for

SACS and non-government partners.

ACTIVITY 4: Wrap-around Support for OVC Programs

In FY08, Samarth will develop guidelines for leveraging services such as nutrition, education and household

economic strengthening for children infected and affected by HIV/AIDS from government, and private and

non-governmental agencies. TA will be provided to NACO, SACS and USG partners on operationalizing

such wrap-around services for OVC.

Funding for Testing: HIV Testing and Counseling (HVCT): $21,900

SUMMARY

The focus of this activity is to provide technical assistance (TA) in operationalizing the guidelines on quality

standards in counseling and testing (CT) at the national and state level. TA will also be provided to USG

agencies in developing and operationalizing strategies for various CT models in the private sector. .

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

TA, capacity building and institutional strengthening of government (the National AIDS Control Organization

[NACO] and the State AIDS Control Societies [SACS]), and civil society. In addition, the Global Fund will be

provided TA to strengthen the leadership and governance of its India Country Coordinating Mechanism

(CCM) Secretariat. FHI implements the Samarth project in partnership with the Christian Medical

Association of India (CMAI, which has over 300 faith-based hospitals as members), the Indian Network of

Positive People (INP+), and Solidarity and Action against the HIV Infection in India (SAATHII, an NGO with

a mandate to build capacity of civil society). Samarth extends needs-based capacity building assistance to

government and non-government stakeholders as well as to USG partners. Since FY07, Samarth has

supported NACO with human and technical support in key program areas like CT, OVC, ARV, strategic

information and policy and systems strengthening. Samarth also implements four demonstration projects in

New Delhi to showcase best practices in Abstinence and Be Faithful programs, OVC and palliative care for

intravenous drug users. .

ACTIVITIES AND EXPECTED RESULTS

This activity continues the Samarth intervention funded in FY07. With FY08 funding FHI will continue to

partner with the Christian Medical Association of India (CMAI) and Solidarity and Action against the HIV

Infection in India (SAATHII), to improve the capacity of NACO, SACS, USG partners and local organizations

in the provision of quality CT services and improved coverage of most-at-risk populations (MARPs).

ACTIVITY 1: TA to NACO and SACS on Quality CT Services

TA will be provided to NACO and SACS to standardize the quality and consistency of counseling services

and to strengthen the national counseling curricula, including training in post-test counseling, confidentiality,

and family counseling. TA will also be provided to NACO and SACS in developing strategies for improving

coverage of MARPs, development and/or adaptation of technical standard operating procedures (SOPs)

and development of a quality assurance (QA)/quality improvement (QI) framework. In addition, Samarth will

assist NACO in developing and implementing the guidelines on provider-initiated counseling and testing

services.

ACTIVITY 2: TA to USG partners on Quality Counseling and Testing

TA will be provided to USG partners to develop strategies for expanding different models of CT in the

private sector, including stand-alone centers, mobile and community-based services, and laboratory-based

services. These will be implemented by NGOs, private hospitals, laboratories and CBOs. Samarth will also

provide TA to USG partners in developing common minimum quality standards, checklists, and training

curricula for CT services in the private sector.

SAATHII, a sub-partner of the Samarth project, will document the best practices of the various models of CT

including integrated CT programs for MARPs, CT services in private hospitals and clinic settings and mobile

CT services. With regard to CT services for women, efforts will be made to document gender-specific issues

such as counseling for safe disclosure, addressing fears of abandonment and the community-based

supportive mechanisms to address these issues.

ACTIVITY 3: Wrap-around Support for CT Programs

In FY08, Samarth project will continue to support the four demonstration projects to implement CT activities

for the most-at-risk children, youth and MARPs in the local communities. The demonstration projects will

provide CT services to the target population by leveraging additional funds from private donors for purchase

of rapid HIV kits for testing, costs for conducting HIV testing camps and the provision of counseling services

(pre-test, post-test and follow-up). Samarth will also leverage test kits and human resources from the Delhi

SACS.

Funding for Treatment: Adult Treatment (HTXS): $21,900

SUMMARY

The focus of this activity is on strengthening the quality of ARV programs in public and private sectors

through trainings and local organization capacity building. Technical assistance (TA) will also be provided to

develop strategies for scaling up pediatric ARV treatment services. Training on ARV services will be carried

out for health care providers in USG focus states. The target population for technical assistance includes

the National AIDS Control Organization (NACO), USG partners and health care providers (HCP) in the

private sector.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

TA, capacity building and institutional strengthening of government [NACO and the State AIDS Control

Societies (SACS)], and civil society. In addition, the Global Fund will be provided specific TA to strengthen

the leadership and governance of the GFATM India Country Coordinating Mechanism (CCM) Secretariat.

FHI implements this project in partnership with the Christian Medical Association of India (CMAI, which has

over 300 faith-based hospitals as members), the Indian Network of Positive People (INP+), and Solidarity

and Action Against the HIV Infection in India (SAATHII, an NGO with a mandate to build capacity of civil

society). Samarth extends needs-based capacity building assistance to government and non-government

stakeholders as well as to USG partners. Since FY07, Samarth has supported NACO with human and

technical support in key program areas like counseling and testing (CT), OVC, ARV, strategic information,

and policy and systems strengthening. Samarth also implements four demonstration projects in New Delhi

to showcase best practices in Abstinence and Be Faithful programming, OVC and palliative care for

injecting drug users.

ACTIVITIES AND EXPECTED RESULTS

This activity continues the Samarth intervention funded under PEPFAR in FY07. With FY08 funding,

Samarth in partnership with the Christian Medical Association of India (CMAI) and the Indian Network for

People Living with HIV/AIDS (INP+) will enhance the capacity of NACO, USG partners and HCP to improve

the coverage and quality of ART services for people living with HIV/AIDS (PLHA).

ACTIVITY 1: TA to NACO on ARV Services

Samarth and its sub-partner CMAI will collaborate with the World Health Organization, CDC, the Indian

Medical Association (IMA) and the Clinton Foundation to provide TA to NACO. The team will review and

update the existing national operational guidelines and standards on HIV/AIDS. These include guidelines

on ARV and opportunistic infection (OI) management, including second-line treatment, ARV treatment for

IDU with hepatitis B/C co-infection and pediatric ARV. This will involve field-testing the ARV operational

guidelines and providing periodic feedback. TA will also be provided to NACO on the strategies to increase

access to ARV services for girls and women including pregnant women who are HIV-positive. INP+ through

its state networks will document the availability and accessibility of ARV drugs in USG priority states and

prepare a status report for NACO.

ACTIVITY 2: TA to USG Partners on Pediatric ARV services

Samarth will provide technical support to USG partners in developing strategies for establishing linkages

between the orphans and vulnerable children (OVC) programs and the ART centers for pediatric treatment

and care. Specifically, TA will be provided on establishing referral mechanisms including follow-up for

adherence.

ACTIVITY 3: Training of Health Care Providers (HCP) in the Private Sector on ARV

Samarth and its sub-partner CMAI will collaborate with the Clinton Foundation to assist USG partners in

developing capacity building plans for training HCP on ARV treatment. The curriculum will be based on the

national ART guidelines. Hands-on experience in ARV treatment will be provided in response to the

expressed need of HCP.

Funding for Strategic Information (HVSI): $538,905

SUMMARY

The strategic information (SI) program area will focus on providing technical assistance (TA) at national,

state, and district levels to strengthen data collection, analysis, and use of data for program planning.

Specifically, the Samarth project will provide TA in analyzing and disseminating HIV/AIDS behavioral and

biological surveillance and monitoring information; developing and disseminating best practices to improve

program efficiency and effectiveness; planning/evaluating national prevention, care and treatment efforts;

and supporting human capacity development through trainings. The target population includes the National

AIDS Control Organization (NACO), State AIDS Control Societies (SACS) and USG partners. Targets under

this program area will be achieved by using both GHAI and Child Survival funds to achieve results.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

TA, capacity building and institutional strengthening of government (NACO, the SACS) and civil society. In

addition, the Global Fund will be provided specific TA to strengthen the leadership and governance of its

India Country Coordinating Mechanism (CCM) Secretariat. FHI implements Samarth in partnership with the

Christian Medical Association of India (CMAI, which has over 300 faith-based hospitals as members), the

Indian Network of Positive People (INP+), and Solidarity and Action Against the HIV Infection in India

(SAATHII, an NGO with a mandate to build capacity of civil society). Samarth extends needs-based

capacity building assistance to government and non-government stakeholders as well as to USG partners.

Since FY07, Samarth has supported NACO with human and technical support in key program areas like

counseling and testing (CT), OVC, ARV, SI and policy and systems strengthening. Samarth also

implements four demonstration projects in New Delhi to showcase best practices in Abstinence and Be

Faithful programs, OVC and palliative care for injecting drug users.

ACTIVITIES AND EXPECTED RESULTS

Strategic Information is an ongoing focus program area under the Samarth project, supported with PEPFAR

funds. NACO has requested Samarth to provide ongoing mentorship to epidemiologists at the national and

state level on HIV/AIDS surveillance, data quality and use of monitoring data for programming.

ACTIVITY 1: TA to NACO and SACS on Improving Monitoring and Evaluation (M&E) and the National HIV

Surveillance System

Samarth will support 14 epidemiologists to provide ongoing support to NACO and SACS in strengthening

M&E and HIV surveillance systems. The specific roles of the epidemiologists include strengthening state

HIV surveillance system, program data collection (prevention, palliative care, CT, PMTCT and ART)

monitoring and supervision of data quality, analyzing data from the computerized management information

system (CMIS) and supporting SACS to analyze and use data to plan interventions in their states.

ACTIVITY 2: TA to USG Partners on PEPFAR MIS and Reporting

In FY08, the Samarth project will conduct workshops and provide ongoing TA to all USG partners on

integrating PEPFAR indicators into their existing reporting systems and collecting and reporting gender-

disaggregated information on key indicators. TA will also be provided to USG partners for ensuring data

quality and data accuracy through sharing best practices in data collection and management developed by

FHI.

ACTIVITY 3: TA to USG Partners on Behavioral Surveillance Surveys (BSS) and Integrated Biological and

Behavioral Assessments (IBBA)

Samarth will provide ongoing technical assistance to USG partners in planning and implementing BSS and

IBBA surveys. Samarth project is a member of the technical working groups (TWG) for these surveys

conducted by USG partners. As a TWG member, Samarth will contribute to designing the sample protocols

including those for sampling, data collection tools and analysis.

Activity 5: TA on Documentation and Dissemination of Best Practices

SAATHII, a sub-partner of the Samarth project, will document and disseminate the best practices of USG-

supported programs including successful models of private-public partnership, and case studies of industry

champions and of people living with HIV/AIDS. These will be disseminated through the Samarth project

website and print media. SAATHII will conduct workshops on documentation and dissemination of best

practices for SACS and USG partners. SAATHII will provide TA to develop a one-stop online resource

center on the gender dimensions of HIV/AIDS.

Funding for Health Systems Strengthening (OHSS): $985,500

SUMMARY

This activity will enhance the capacity of National AIDS Control Organization (NACO), State AIDS Control

Societies (SACS) and USG partners in program and technical skills in the areas of prevention of mother to

child transmission (PMTCT), counseling and testing (CT), antiretroviral treatment and monitoring and

evaluation. The Samarth project will also provide technical assistance to strengthen the functioning of

India's Country Coordinating Mechanism (CCM) for the Global Fund for TB, AIDS and Malaria,

mainstreaming HIV/AIDS programs in government ministries and implementing the principles of Greater

Involvement of People Living with HIV/AIDS (GIPA). In addition, consultants will be provided to the SACS

and District AIDS Prevention and Control Units (DAPCUs) to assist in the HIV/AIDS planning,

implementation and monitoring and evaluation activities of the state.

BACKGROUND

The Samarth project has been implemented by Family Health International (FHI) since October 2006.

Samarth will directly contribute to implementing quality HIV/AIDS prevention, care and treatment through

technical assistance (TA), capacity building and institutional strengthening of government (NACO and the

SACS), and civil society. In addition, the Global Fund will be provided specific TA to strengthen the

leadership and governance of the CCM Secretariat. FHI implements this project in partnership with the

Christian Medical Association of India (CMAI, which has over 300 faith-based hospitals as members), the

Indian Network of Positive People (INP+), and Solidarity and Action Against the HIV Infection in India

(SAATHII, an NGO with a mandate to build the capacity of civil society). Samarth extends needs-based

capacity building assistance to government and non-government stakeholders as well as to USG partners.

Since FY07, Samarth has provided human and technical support to NACO in key program areas like CT,

OVC, ARV, SI and policy and systems strengthening. Samarth also implements four demonstration projects

in New Delhi to showcase best practices in AB, OVC and Palliative care for injecting drug users (IDU).

ACTIVITIES AND EXPECTED RESULTS

Policy and system strengthening is an ongoing core initiative under Samarth project. This will be the major

focus of the FY08 program and will directly contribute to the implementation of the third phase of the

National AIDS Control Program (NACP-3) and the USG HIV/AIDS strategy for India. With FY08 funding FHI

will continue to partner with INP+, CMAI, and SAATHII to provide TA to NACO, SACS, DAPCU and USG

partners in technical and program areas.

ACTIVITY 1: TA to NACO, SACS and USG Partners for Program and Institutional Strengthening

As part of USG's support to NACO, Samarth will build the capacity of 30 senior program managers of

NACO engaged in PMTCT, ARV, CT and monitoring and evaluation activities. Specifically, the program

management skills and technical knowledge of these staff will developed by arranging or sponsoring them

to attend appropriate training programs, including conferences and workshops. Samarth will also provide

continuous mentoring support through a team of consultants.

INP+, a major sub-partner to Samarth, will continue to provide TA to NACO, SACS and USG partners to

strengthen the operationalization of GIPA strategies at the national, state, and district levels by sharing tools

and mentoring the staff. In addition, with support from SAATHII, another sub-partner of Samarth, best

practices for integrating gender into HIV prevention, care and treatment programs for sex workers that are

implemented by the Samastha project (a USG partner) will be documented and disseminated through

publication of reports and workshops..

ACTIVITY 2: TA for Mainstreaming and Institutional Strengthening of Government of India Ministries and

the Global Fund CCM

Samarth will provide TA to key government ministries such as the Ministries of Women and Child

Development, Health and Family Welfare, Social Justice and Empowerment and Youth Affairs and Sports to

mainstream HIV/AIDS into their programs. These activities include advocacy workshops with government

officials, development of HIV/AIDS mainstreaming guidelines, and support for implementation and

monitoring and evaluation (M&E) of the mainstreaming activities.

Samarth will provide TA for strengthening the functioning of the Global Fund CCM Secretariat through

placement of a staff member as a financial and program management advisor, to ensure transparency and

wider representation for Global Fund proposals; development of quality proposals to mobilize additional

funding; improved program management and development of an integrated M&E system. INP+, as Vice

Chair of the Global Fund CCM in India, will work with the CCM to ensure greater participation of civil society

and PLHA, especially women, in the CCM.

ACTIVITY 3: Institutional Strengthening of SACS and the DAPCUs

This activity will focus on providing needs-based capacity-building assistance to SACS and the DAPCUs for

program planning, implementation, monitoring and evaluation and sustainability. As part of USG's technical

support to the national program, Samarth will lead a team of consultants in the USG focus states to develop

and finalize the State Implementation Plans under NACP-3. Consultants will also be placed at SACS to

provide ongoing technical support for strengthening administrative, program and financial management

systems and developing strategies and operational plans for scaling-up HIV prevention, care and treatment

activities.

TA will also be provided on establishing procurement systems to access commodity needs, ensure

adequate drug supply, procure and purchase supplies, drugs and equipments. With support from SAATHII,

TA will be provided on gender mainstreaming through documentation and dissemination of tools and best

practices at the state and district level.

In FY07, FHI played a key role in the development of terms of reference for Technical Support Units that are

to be established for providing TA to the SACS. With FY07 funds, Samarth will support the establishment of

the TSU in the states of Uttar Pradesh and the adjoining Uttarakhand State. Using FY08 funds, ongoing

Activity Narrative: technical support will be provided for the TSU to plan and implement technical assistance and capacity-

building programs for the Uttar Pradesh and Uttarakand State AIDS societies.

ACTIVITY 4: Capacity Building of NGOs by Demonstration Project Partners

The Samarth project will build the capacity of the four demonstration partners implementing model

programs on street children, OVC and palliative care in Delhi, in training skills including planning and

implementing experiential learning programs. These partners will provide onsite experiential training and

mentoring to NGOs identified by SACS and USG partners.

ACTIVITY 5: Capacity Building of PLHA Networks in Policy Development

INP+ will continue to develop the leadership skills of PLHA members as champions for advocacy on GIPA,

treatment, stigma and discrimination, and positive prevention. PLHAs, will be trained to actively participate

in policy development. Case studies highlighting positive and inspiring experiences of PLHA will be

documented and disseminated.

ACTIVITY 6: Training of Health Care Providers to Address HIV/AIDS Stigma and Discrimination

CMAI, a sub-partner of Samarth, will train private health care providers on stigma and discrimination issues

related to HIV/AIDS. Specifically, providers will be trained to provide quality HIV management services, and

respect patients' rights to confidentiality and the need for obtaining informed consent before HIV testing.

CMAI will update the existing training modules on stigma and discrimination and tailor them to the needs of

the health care providers. CMAI will carry out follow-up exercises by conducting focus group discussions

with the health care providers to assess the effectiveness of the training program. Based on their needs,

CMAI will conduct refresher training programs on stigma and discrimination related to HIV/AIDS issues.

Subpartners Total: $1,156,000
Sahara Michael's Care Home: $41,000
Christian Medical Association of India: $91,000
Indian Network for People Living with HIV/AIDS: $54,000
Salaam Balak Trust: $41,000
Women's Action Group: $41,000
Young Women's Christian Association: $41,000
Solidarity and Action Against The HIV Infection in India: $97,000
National AIDS Control Organisation: $750,000
Cross Cutting Budget Categories and Known Amounts Total: $7,400
Food and Nutrition: Commodities $5,000
Food and Nutrition: Commodities $2,400