NOTE: THIS ACTIVITY WAS FULLY FUNDED BY GHCS-USAID FUNDS IN COP 08. IN COP 09 IT IS

SPLIT FUNDED BETWEEN GHCS-USAID and GHCS-STATE. THE ACTIVITY HAS BEEN MODIFIED IN

THE FOLLOWING WAYS:

UPDATE

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.

FY08 NARRATIVE

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

Activity Narrative: 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

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

Activity Narrative: 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.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

* Increasing women's legal rights

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $243,778

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $2,850

and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.18: