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
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
Based on the PEPFAR/India program review recommendations, FHI will reduce its support for AB-related
activities. National HIV prevalence data indicates a concentrated epidemic and thus a need for focused
efforts on high risk populations. The YWCA demonstration project among adolescent girls will therefore be
gradually phased out from Samarth.
FHI will, however, continue to provide limited support to vulnerable children who may need A and B
messages as appropriate through demonstration partners SBT and WAG/Chelsea.
FY08 NARRATIVE
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.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14113
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14113 11465.08 U.S. Agency for Family Health 6711 5785.08 Samarth $87,600
International International
Development
11465 11465.07 U.S. Agency for Family Health 5785 5785.07 $83,400
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $35,640
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Estimated amount of funding that is planned for Economic Strengthening $13,000
Education
Estimated amount of funding that is planned for Education $13,000
Water
Table 3.3.02:
ACTIVITY UNCHANGED FROM FY2008
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.
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.
Continuing Activity: 14114
14114 10937.08 U.S. Agency for Family Health 6711 5785.08 Samarth $43,800
10937 10937.07 U.S. Agency for Family Health 5785 5785.07 $85,000
Estimated amount of funding that is planned for Human Capacity Development $17,820
Estimated amount of funding that is planned for Education $8,000
Table 3.3.03:
NEW ACTIVITY NARRATIVE
four demonstration projects in Delhi. One of these projects targets injecting drug users (IDU) with
messages on safe sex, increasing condom use, promoting STI treatment, and positive prevention. This
continues the work undertaken for IDUs described in the Condoms and Other Prevention program area in
the FY08 COP.
(INP+), and Solidarity and Action Against the HIV Infection in India (SAATHII), an NGO with a mandate to
FHI will continue to improve the capacity of the demonstration partner to implement HIV prevention
programs for IDU populations including PLHAs with a focus on safe sex practices.
ACTIVITY 1: Support to Demonstration Projects on Prevention in Delhi
The Samarth project will continue will support the demonstration project in Delhi to promote safe sex
including condom use among IDU. The IDU population will be targeted through outreach activities such as
interpersonal communication, counseling, and positive prevention. PLHAs in the IDU population will be
linked with the Indian Network of Positive People (INP+) to reinforce prevention education and to develop
risk-reduction strategies. INP+ will conduct training on positive prevention and share training materials and
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.06:
UPDATE
During FY08, FHI partnered with the Christian Medical Association of India (CMAI) and Indian Network of
People Living with HIV/AIDS (INP+) to scale-up quality palliative care through facility- and home-based
care. The CMAI learning sites matured to function as training centers on select HIV/AIDS care and support
areas. CMAI conducted trainings for the health care workers of Community Care Centers (CCCs) in
collaboration with the Institute of Palliative Medicine, Medical College Calicut.
In FY09, activities 2 and 3 will continue as in FY08. The following modifications are proposed for activity 1.
ACTIVITY 1: TA to National AIDS Control Society (NACO), State AIDS Control Society (SACS) and USG
Partners on Palliative Care Services
In FY07, Samarth conducted a review of the four CMAI learning sites to identify the core areas of strength
and weaknesses. Based on this review, the Catherine Booth Hospital will be phased out from SAMARTH
Project while the other learning sites in Andhra Pradesh, Karnataka and Maharashtra will continue to
provide training and mentoring support to other health care facilities on specific HIV/AIDS care and support
service areas. The support for training of health care providers on palliative care will be extended to Uttar
Pradesh and Uttarakhand. CMAI will ensure increased HIV/AIDS care and support service coverage for
girls and women, including pregnant women, with HIV at the three learning sites. The training program will
also continue to emphasize women's access to care and use of gender-disaggregated data for improved
provision of services.
FY 2008 NARRATIVE
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
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
(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).
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
Activity Narrative: 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.
Continuing Activity: 14115
14115 11467.08 U.S. Agency for Family Health 6711 5785.08 Samarth $131,400
11467 11467.07 U.S. Agency for Family Health 5785 5785.07 $79,805
* Increasing women's access to income and productive resources
Estimated amount of funding that is planned for Human Capacity Development $31,720
Estimated amount of funding that is planned for Water $23,140
Table 3.3.08:
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.
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.
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.
Continuing Activity: 14247
14247 6597.08 U.S. Agency for Family Health 6711 5785.08 Samarth $21,900
10799 6597.07 U.S. Agency for Family Health 5596 3944.07 $79,200
6597 6597.06 U.S. Agency for Family Health 3944 3944.06 $115,000
Estimated amount of funding that is planned for Human Capacity Development $3,920
Estimated amount of funding that is planned for Water $2,860
Table 3.3.09:
During FY08, FHI sub-partner Christian Medical Association of India (CMAI) conducted training programs
for various stakeholders, including health care providers in the private medical sector (missionary hospital
settings). CMAI provided TA on pediatric treatment and supported development of strong HIV care and
treatment services within their member hospitals, with special focus on four hospitals (one in each of the
USG priority states of Maharashtra, Karnataka, Tamil Nadu and Andhra Pradesh). They provided support
to scale-up quality care for adults and pediatrics through facility- and home-based care. These CMAI
learning sites have matured to function as training centers on select HIV/AIDS care and support areas. The
Samarth project's pediatric care and treatment services reach infected children in 3 faith-based hospitals
operated by CMAI as well as infected children from the Delhi-based Chelsea project.
Pediatric treatment is a continuing activity from FY08. In the previous COP it was classified under the
palliative care narrative, which included services for adults and children. In FY09, the following modifications
are proposed (all other activities remain the same):
Will not be continued under Pediatric Care and Support (adult population focus)
ACTIVITY 3: On-site Training in HIV/AIDS Palliative Care for Health Care Providers and Caregivers
The on-site training for pediatric care and support will be decreased from four to three sites for FY09. In
FY07, Samarth conducted a review of the four CMAI learning sites to identify the core areas of strength and
weaknesses. Based on this review, the Catherine Booth Hospital will be phased out from SAMARTH
areas.
FY 2008 PALLIATIVE CARE NARRATIVE
Activity Narrative: ACTIVITY 3: On-site Training in Palliative Care for Health Care Providers and Caregivers
providers (HCP) will include medical officers, nurses and palliative care outreach workers. A "caregiver" is
Estimated amount of funding that is planned for Human Capacity Development $7,484
Table 3.3.10:
The pediatric ART treatment services are currently provided through the Clinton Foundation; this
arrangement with the Government of India is expected to end in 2009. Samarth will provide TA to the
national level GOI to strengthen logistics and inventory management to build institutional capacity for the
imminent supply chain management of pediatric ART.
The on-site training for pediatric treatment will be decreased from four to three sites for FY09. In FY07,
Samarth conducted a review of the four CMAI learning sites to identify the core areas of strength and
provide training and mentoring support to other health care facilities on specific HIV/AIDS treatment areas.
The following new activity will be undertaken in FY 2009:
ACTIVITY 4 (new - FY09): Support to NGOs for Identification of Pediatric Cases for ART
Samarth will build the capacity of the demonstration project in New Delhi to improve identification of infected
children among the rural slums and communities in Delhi where the project is operating.
Activity Narrative: ACTIVITY 2: Support Demonstration Center on Palliative Care for IDU
Estimated amount of funding that is planned for Human Capacity Development $10,336
Table 3.3.11:
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.
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
Since FY07, Samarth has supported NACO with human and technical support in key program areas like
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.
Continuing Activity: 14116
14116 11468.08 U.S. Agency for Family Health 6711 5785.08 Samarth $21,900
11468 11468.07 U.S. Agency for Family Health 5785 5785.07 $39,000
Table 3.3.12:
In FY08, FHI, along with the National OVC Task Force, finalized, printed, and disseminated the national
operational guidelines for children affected by HIV/AIDS. FHI initiated the process of operationalisation of
the guidelines through its three learning sites - one in Andhra Pradesh, Delhi (Women's Action Group
(WAG)/Chelsea) and Tamil Nadu. WAG/Chelsea continued to implement the OVC program providing
services directly and through linkages with emphasis on greater coverage of girls.
In FY09, Activities 1 and 3 will continue as in FY08. The following modifications are suggested for Activity
2.
ACTIVITY 2: TA to National AIDS Control Organization (NACO), State AIDS Control Societies (SACS) and
USG Partners in OVC Programming
FHI will facilitate the process of setting up coordination committees and mechanisms with different
stakeholders like SACS, District AIDS Prevention and Control Units (DAPCUs), ministries, departments,
non-governmental organizations (NGOs), civil society and private sector. The three sites working on OVC
will start functioning as learning sites and will provide training and mentoring support for scaling-up and
replication. In the three districts with learning sites, an OVC Trust will be set up to provide financial support
for health and educational needs that are not fulfilled through referral services. In the implementation of
national operational guidelines for OVC, linkages will be established with government and private sectors to
ensure adolescent girls and their mothers have access to income and productive resources.
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.
TA, capacity building and institutional strengthening of government (NACO, the SACS), and civil society. In
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).
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 2: 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
Activity Narrative: USG-supported OVC programs and disseminate this information through publications and workshops for
SACS and non-government partners.
ACTIVITY 3: 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.
Continuing Activity: 14245
14245 10944.08 U.S. Agency for Family Health 6711 5785.08 Samarth $175,200
10944 10944.07 U.S. Agency for Family Health 5596 3944.07 $198,000
* Increasing women's legal rights
Estimated amount of funding that is planned for Human Capacity Development $160,380
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $10,000
and Service Delivery
Estimated amount of funding that is planned for Economic Strengthening $10,000
Estimated amount of funding that is planned for Education $30,000
Estimated amount of funding that is planned for Water $20,000
Table 3.3.13:
In FY08, a national consultation was held to identify the gaps in the existing pediatric counseling imparted
through the Integrated Counseling and Testing Centers (ICTC), Community Care Centers (CCC),
Antiretroviral Therapy (ART) centers and by non-governmental organizations (NGOs). Based on the
consultation, a comprehensive training module for pediatric counseling was developed in close coordination
with the National AIDS Control Organization (NACO), UNICEF, Clinton Foundation, major NGOs and other
key stakeholders. The training module provides specific guidance to counselors on dealing with female
HIV/AIDS affected children.
In FY09, Activity 2 and 3 will continue as in FY08. The following modifications are suggested for Activity 1.
ACTIVITY 1: TA to NACO and State AIDS Control Societies (SACS) on Quality Counseling and Testing
Services
In FY09, FHI will continue with all the sub-activities mentioned in COP 08 under this activity. In addition,
Training of Trainers (TOTs) will be conducted in the USG priority states based on the comprehensive
training module for pediatric counseling developed during FY08.
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.
(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. .
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.
Continuing Activity: 14246
14246 10939.08 U.S. Agency for Family Health 6711 5785.08 Samarth $21,900
10939 10939.07 U.S. Agency for Family Health 5596 3944.07 $108,800
Estimated amount of funding that is planned for Human Capacity Development $4,455
Table 3.3.14:
In FY08, FHI provided support to Government of India for strengthening the HIV surveillance system.
Technical Assistance (TA) was also provided to National AIDS Control Organization (NACO) and State
AIDS Control Societies (SACS) through support of technical officers, including epidemiologists. FHI, in
collaboration with UNAIDS, CDC and WHO supported NACO in setting up a Strategic Information
Management System (SIMS) and expanding the system to include data from other strategic information
sources like Surveillance and National Family Health Survey (NFHS) along with Management Information
System (MIS).
In FY 09, Activities 2, 3 and 4 will continue as in FY08. The following modifications are proposed for Activity
1.
ACTIVITY 1: TA to NACO and SACS on Improving Monitoring and Evaluation (M&E), and the National HIV
Surveillance System
In FY09, FHI will provide need-based TA to strengthen the capacity of and support to epidemiologists and
strategic information staff at NACO, SACS and District AIDS Prevention and Control Units (DAPCUs) in the
roll-out and proper functioning of SIMS at the National, State and District levels. FHI will continue to play an
active role in the functioning of the M&E working group, consisting of bilateral and international
organizations. Technical assistance will be provided to Maharashtra and Mumbai AIDS Control Societies in
synergy with Technical Support Unit (TSU) on strengthening state sentinel surveillance system. Support
will be continued to Uttar Pradesh State AIDS Control Societies (UPSACS) and TSU in planning
interventions among high-risk groups and migrants based on the mapping data. FHI and its partners will
continue to collect gender-disaggregated service delivery data and use it to provide appropriate and high
quality services to women and children. The disaggregated data will be utilized by FHI for designing and
providing TA to NACO, SACS and USG partners. The strategy to use this data for appropriate HIV/AIDS
programs and policies will be an important component within the program area for FHI/SAMARTH.
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.
TA, capacity building and institutional strengthening of government (NACO, the SACS) and civil society. In
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.
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
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
Activity Narrative: 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 4: 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.
Continuing Activity: 14248
14248 14248.08 U.S. Agency for Family Health 6711 5785.08 Samarth $538,905
Estimated amount of funding that is planned for Human Capacity Development $196,020
Table 3.3.17:
In FY08, the FHI-led Samarth project focused on providing Technical Assistance (TA) at the national, state,
and district levels to improve the effectiveness of the response of government and civil society for evidence-
based HIV policy and programs in India through human capacity development and strengthening of capacity
of local organizations. Additionally, support was provided to Global Fund to Fight AIDS, Tuberculosis and
Malaria (GFATM) County Coordinating Mechanism (CCM) to strengthen the Secretariat in India by
facilitating the enhanced role of private sector and wider civil society participation and support for proposal
development. In FY09, technical and program officers which are supported at National AIDS Control
Organization (NACO) since FY07 will be trained as part of an approved mentoring plan as a long-term
strategy to build institutional capacity at NACO.
In FY09, Activities 1 through 4 will be modified in the following ways, while Activities 5 and 6 will continue as
in FY08.
ACTIVITY 1: TA to NACO, State AIDS Control Society (SACS) and USG Partners for Program and
Institutional Strengthening
FHI will scale-up the support for institutional strengthening of NACO including both short and long-term TA
support. The short-term support will cover activities like assessment of systems and programs,
development and/or strengthening of need-based protocols and guidelines, publications, organizing national
conference and activities related to human resource development. The long-term support will include
continued personnel support for the program and technical officers in NACO and their capacity building in
project management, monitoring and evaluation, research, quality improvement in care, support and
treatment, capacity building and institutional strengthening. Support will also be provided for National
Technical Support Unit (NTSU) for program and technical support personnel. In partnership with the WHO,
Samarth will pilot the Quality Assurance/Quality Improvement (QA/QI) systems for HIV/AIDS care in two
public hospital settings based on the experiences from its demonstration projects. As part of the national
Orphans and Vulnerable Children (OVC) task force, Samarth has led the development of the national OVC
guidelines in FY07 and will conduct a national workshop and two regional workshops to operationalize the
standard protocols with an emphasis on child counseling for HIV testing, disclosure and support. The
project will support the institutional capacity development of the Indian Network of People Living with
HIV/AIDS (INP+) to facilitate the formation of a Greater Involvement of People Living with HIV/AIDS (GIPA)
Task Force with members from NACO and select UN, donor, national and international agencies to
coordinate implementation of GIPA. INP+ will increase participation of women living with HIV/AIDS (WLHA)
into the existing networks, play active role in influencing policy to address issues of Women Living with
HIV/AIDS (WLHA) and for increasing their access to services. INP+ has created a National Women's
Forum (NWF) and state level women's forums which will be leveraged in different aspects of the technical
support. This will include strategies and activities towards implementation of GIPA at National, State and
District level. WLHA will also participate through providing positive testimonies to influence HIV/AIDS
policies and programs to become more gender sensitive. CMAI, based on the experience of
implementation of work-place policy in the hospital learning sites, will provide TA to USG partners, other
CMAI hospitals and private health care institution. Samarth will continue to support the Technical Support
Units (TSU) in Uttar Pradesh (UP) and Uttarakhand which provide the required TA to SACS for
implementing the NACP-3 at the state and district levels.
ACTIVITY 2: TA for Mainstreaming and Institutional Strengthening of Government of India Ministries and
the GFATM CCM
Samarth will enhance support for HIV/AIDS mainstreaming activities in coordination with NACO and UNDP
through establishment of an HIV/AIDS Cell in Ministry of Women and Child Development (MWCD) and
inclusion of PLHA as a target group for accessing Ministry of Social Justice and Empowerment (MSJE)
schemes. The project will support the India CCM for personnel, proposal development, strengthening
monitoring and evaluation and enhancing civil society participation in GFATM program. INP+ will ensure
greater involvement of WLHA for HIV mainstreaming and for TA to GFATM CCM secretariat.
ACTIVITY 3: Institutional strengthening of SACS and District AIDS Prevention and Control Units (DAPCUs)
As requested by NACO, Samarth will adopt 5 ‘A' category districts in UP to demonstrate an integrated
comprehensive response to HIV/AIDS at the district level in close collaboration with other district health
systems, Efforts will be made to identify and resolve challenges in implementation of Program
Implementation Plans and increased utilization of budgets. FHI along with its TA partners will facilitate
cross-learning from other SACS, particularly USG-supported SACS in Andhra Pradesh, Karnataka and
Tamil Nadu. Need-based support will also be provided for generating evidence for programming, district-
level planning and sensitizing private health care providers.
ACTIVITY 4: Capacity Building of NGOs by Demonstration Project Partners
The three demonstration projects will continue to provide on-site experiential training and mentoring to local
non-governmental organizations (NGOs) and community-based organizations (CBOs) on national and
PEPFAR priority program areas.
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
Activity Narrative: and District AIDS Prevention and Control Units (DAPCUs) to assist in the HIV/AIDS planning,
implementation and monitoring and evaluation activities of the state.
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
(SAATHII, an NGO with a mandate to build the capacity of civil society). Samarth extends needs-based
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).
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..
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
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.
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 Narrative: 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.
Continuing Activity: 14249
14249 6139.08 U.S. Agency for Family Health 6711 5785.08 Samarth $985,500
10798 6139.07 U.S. Agency for Family Health 5596 3944.07 $393,000
6139 6139.06 U.S. Agency for Family Health 3944 3944.06 $546,000
Estimated amount of funding that is planned for Human Capacity Development $1,039,262
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $12,150
Table 3.3.18:
