1. LIST OF RELATED ACTIVITIES The COGRI Lea Toto Home Based Care activities will relate to HIV/AIDS treatment services (#6862), counseling and testing (#6860), and orphans and vulnerable children (#6861).

2. ACTIVITY DESCRIPTION The goal of the Lea Toto Project is to mitigate the impact of HIV/AIDS and decrease the risk of HIV transmission through the provision of a comprehensive home based care package. The project was started in September 1999, and implement programs in selected slums in Nairobi in Kangemi, Kariobangi, Kibera, Kawangware. In FY 2007, Children of God Relief Institute/Lea Toto Project will provide high quality facility and home based care and other support services to 12,000 family members and 4,200 children. In addition, 800 care givers will be trained in home based care services.

The facility-based activities will include strengthening of facilities that are already serving as network referral centers for pediatric HIV care, payment of laboratory services for HIV related tests, OI prophylaxis (cotrimoxazole, fluconazole) and strengthening pharmaceutical management. Lea Toto will also strengthen the ability of targeted local communities to prioritize needs of HIV+ children and their families and carry out activities to meet these needs.

In the community, the Lea Toto Project will work with trained community workers at the activity sites and provide or facilitate access to a range of services for families and OVC caregivers. It is anticipated that these services will include training around OVC support; anti-retroviral treatment education; vocational and micro-business training for family income support and psycho-social support, including succession planning. Other program activities include nutritional support, micro-finance and empowering of caregivers through the self help groups. Group therapy sessions will include life skills training, disclosure meetings, support group meetings and follow up counseling sessions. Life skills training sessions which are held with adults and children aged between 7 and 16 years address issues related to drug adherence basic hygiene and nutrition. The activity will also improve the organizational capacity of the Lea Toto program to deliver high quality care and counseling and other support services for HIV+ children and their families.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will contribute to the Kenya 5-year strategy by increasing the number of people receiving HIV/AIDS care and support. Specifically, 12,000 family members and 4,200 children will be provided with HIV-related palliative care, 800 trained to provide palliative care and 6 service outlets will provide care. This activity will contribute to increasing the number of HIV positive children receiving medical care, and accounts for 2% of all persons in care for this program area.

4. LINKS TO OTHER ACTIVITIES The COGRI Lea Toto Home Based Care activities will relate to HIV/AIDS treatment services (#6862), counseling and testing (#6860), and orphans and vulnerable children (#6861). As vulnerable children are identified, they will go through counseling and testing and will be enrolled as appropriate to care and treatment activities.

5. POPULATIONS BEING TARGETED This activity will target people affected by HIV/AIDS including Caregivers, HIV positive infants and children, OVCs and PLWHAs. The activity will also target comunity and religious leaders as well as community volunteers. Community health care workers will be targeted for training and groups/organizations that will be worked through include Community-based organizations, faith-based organizations and NGOs in Nairobi.

6. KEY LEGISLATIVE ISSUES ADDRESSED By meeting the needs of vulnerable children and their care providers, stigma and discrimination will decrease and allow children to return to school and parents/providers improve in health and earn income to contribute to the family's welfare. Gender issues will also be addressed to increase women's access to income and productive resources.

7. EMPHASIS AREA The main area of emphasis will be Community Mobilization/Participation as Lea Toto strengthens the ability of targeted local communities to prioritize needs of HIV+ children

and their families and carry out activities to meet these needs. Minor emphasis will be in training of care providers and providing IEC in Life Skills Training.

COGRI/Lea Toto Project will use these additional Plus Up funds to intensify provider-initiated DCT in health care settings, seeking to enhance HIV testing among children presenting with TB symptoms across their network of 6 sites. Other activities supported will include inensified TB case finding among household contacts of confirmed TB cases, as well as community-level contact tracing of TB suspects. HIV positive children and family members identified via these activities will be offered ART treatment in the Lea Toto network of clinics. This will complement the current DCT program that has intensified testing in facilities where both TB and ART services are provided. An additional 100 TB/HIV infected children will be identified and treated with these resources.

Table 3.3.07:

1. LIST OF RELATED ACTIVITIES The COGRI orphans and vulnerable children activities will relate to HIV/AIDS treatment services (#6862), counseling and testing (#6860), HBHC (#6863).

2. ACTIVITY DESCRIPTION Children of God Relief Institute/Lea Toto Project will provide care and support services to 3,333 orphans and vulnerable children (OVC) with high quality home based care and other support services. This activity is a continuation of the project which was started in September 1999, and implemented in selected slums in Nairobi in Kangemi, Kariobangi, Kibera, Kawangware. Lea Toto Project will work with trained community workers at the activity sites and will provide or facilitate access to a range of services for families and OVC caregivers. It is anticipated that these services will include training around OVC support; anti-retroviral treatment education; vocational and micro-business training for family income support and psycho-social support, including succession planning. Other program activities include nutritional support, micro-finance and empowering of caregivers through the self help groups. This activity will strive to strengthen the ability of targeted local communities to prioritize needs of HIV+ children and their families and carry out activities to meet these needs.

Lea Toto Project will work with trained community workers at the activity sites and will provide or facilitate access to a range of services for families and OVC caregivers. It is anticipated that these services will include training around OVC support; anti-retroviral treatment education; vocational and micro-business training for family income support and psycho-social support, including succession planning. Other program activities include nutritional support, micro-finance and empowering of caregivers through the self help groups. Lea Toto will also strengthen the ability of targeted local communities to prioritize needs of HIV+ children and their families and carry out activities to meet these needs. The goal of the Lea Toto Project is to mitigate the impact of HIV/AIDS and decrease the risk of HIV transmission through the provision of a comprehensive home based care package. Some of the activities include group therapy sessions include life skills training, disclosure meetings, support group meetings and follow up counseling sessions. Life skills training sessions which are held with adults and children aged between 7 and 16 years address issues related to drug adherence basic hygiene and nutrition. The activity will also improve the organizational capacity of the Lea Toto program to deliver high quality care and counseling and other support services for HIV+ children and their families. Other program activities include nutritional support, microfinance and empowering of caregivers through the self help groups.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will contribute to the Kenya 5-year strategy, will increase the number of OVCs receiving HIV/AIDS care and support, and will reach 3,333 OVC with comprehensive quality services and train 833 caregivers.

4. LINKS TO OTHER ACTIVITIES This activity is linked to ARV treatment (#6862), counseling and testing services (#6860) and palliative care (#6863) implemented by COGRI and also linked to other USG CT programs managing test kits procurement and distribution.

5. POPULATIONS BEING TARGETED This activity targets orphans and vulnerable children, caregivers of OVC, community leaders as well as Community-based and Faith-based organizations.

6. KEY LEGISLATIVE ISSUES ADDRESSED The key legislative issues being addressed is stigma and discrimination through enhanced medical and psychological well being, and demonstrated improved quality of life. This activity also addresses the wrap around issue of food.

7. EMPHASIS AREAS Major emphasis area is Community Mobilization and Participation and a minor emphasis in Training.

1. LIST OF RELATED ACTIVITIES The COGRI/Lea Toto counseling and testing activities will relate to COGRI/Lea Toto HIV/AIDS treatment services (#6862),COGRI-Lea Toto orphans and vulnerable children (#6861), COGRI Lea Toto palliative care: HBCS (#6863).

2. ACTIVITY DESCRIPTION Children of God Relief Institute/Lea Toto Project will provide counseling and testing services to 4,500 children and at least 2,800 adults in 5 existing Voluntary Counseling and Testing centers situated within the project sites in the selected slums of Nairobi. In addition, 15 VCT counselors will be trained. The activity will also improve the organizational capacity of the Lea Toto program to deliver high quality care and counseling services for HIV+ children and their families. Referrals for VCT services which are mainly through CHWs, caregivers, community leaders and other institutions within the Program area will be strengthened. Program Counselors and Community Based Counselors (CBCs) will carry out continuous dissemination of prevention information both during Voluntary Counseling and Testing and in any other counseling and / or group therapy session organized by the project. These group therapy sessions include life skills training, disclosure meetings, support group meetings and follow up counseling sessions.

The project was started in September 1999, and the first phase was implemented for 2 years in Kangemi.The goal of the Lea Toto Project is to mitigate the impact of HIV/AIDS and decrease the risk of HIV transmission through the provision of a comprehensive HIV/AIDS services.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will contribute to the Kenya 5-year strategy and increase the number of people counseled and tested for HIV/AIDS by training 15 VCT counselors and testing 2,800 children and 4,500 adults.

4. LINKS TO OTHER ACTIVITIES The COGRI/Lea Toto counseling and testing activities will relate to related COGRI Lea Toto activities in HIV/AIDS treatment services (#6862), orphans and vulnerable children (#6861), HBHC (#6863). This activity is also linked to other USG CT program on CT promotion and procurement of test kits.

5. POPULATIONS BEING TARGETED Targeted population include the General population (men and women), Families affected by HIV/AIDS including HIV positive infants and children, care givers, community health workers.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity will work to reduce stigma and address discrimination faced by individuals infected or affected by HIV/AIDS. This activity will address issues on disclosure of ones status to partner and family members.

7. EMPHASIS AREAS Training of VCT counselors to enhance their ability to provide quality HIV/AIDS services that are responsive to the clients' needs is the major emphasis area while community mobilization and participation are the minor emphasis areas.

1. LIST OF RELATED ACTIVITIES This activity relates to activities in Palliative Care: Basic Health Care and Support (#6863), Counseling and Testing (#6860), and Orphans and Vulnerable Children (#6861).

2. ACTIVITY DESCRIPTION The Children of God Relief Institute (COGRI)/Lea Toto Project will expand established programs in targeted slums in Nairobi to reach at least 1000 individuals with antiretroviral therapy (300 will initiate treatment) and 50 health care workers will be trained in the provision of antiretroviral therapy. These activities will include strengthening of facilities that are already serving as network referral centers. Activities will include procurement of laboratory services and strengthening rational pharmaceutical management. COGRI will track numbers of children served and will report nationally and through the Emergency Plan.

The goal of the Lea Toto Project is to mitigate the impact of HIV/AIDS and decrease the risk of HIV transmission through the provision of a comprehensive care and treatment package. The project was started in September 1999, and implements programs in selected slums in Nairobi in Kangemi, Kariobangi, Kibera, Kawangware.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will contribute to the Kenya 5-year strategy and increase the number of children on antiretroviral therapy, responds to OGAC objectives of increasing the number of children on ART. Specifically, the activity will reach at least 1,000 children with antiretroviral therapy (300 will initiate treatment) and 50 health care workers will be trained in the provision of antiretroviral therapy.

4. LINKS TO OTHER ACTIVITIES COGRI's activities are closely coordinated with its program in other areas, namely ARV home based care (#6863), counseling and testing (#6860), and orphans and vulnerable children (#6861).

5. POPULATIONS BEING TARGETED This activity will target people affected by HIV/AIDS including caregivers, HIV positive infants and children, OVC and PLWHAs. Community health care workers will be targeted for training. Groups and organizations identified include community-based organizations, faith-based organizations and NGOs in Nairobi.

6. KEY LEGISLATIVE ISSUES ADDRESSED Stigma and discrimination is the key legislative issue addressed through this activity.

7. EMPHASIS AREA The main area of emphasis will be Training of care providers. Minor emphasis will be in community mobilization/participation as Lea Toto strengthens the ability of targeted local communities to prioritize needs of HIV+ children and their families and carry out activities to meet these needs and strengthening networks and referrals.