CMMB will work with faith based mission facilities to provide PMTCT services through capacity building, staff training, and improved logistics supply of consumable items. These facilities are based througout the country- thus support provided is nation wide. During 2007, these facilities will provide HIV counseling and testing to pregnant women attending ANC and Maternity clinics and will provide ARV prophylaxis to the HIV + women. The program targets to provide HIV CT to 57,771 pregnant women, and provide ARV prophylaxis to 5,033 HIV + women. The program will also stregthen the use of the more efficacious PMTCT ARV regimen and will target to provide combination AZT and single dose Nevirapine to2,500 HIV + pregnant women, while providing HAART to all the eligible HIV + women. The program will also support Early Infant HIV diagnosis and will target to reach 3,000 HIV exposed infants with this intervention.

Targets

Target Target Value Not Applicable Number of service outlets providing the minimum package of 70
PMTCT services according to national and international standards Number of pregnant women who received HIV counseling and 5,033
testing for PMTCT and received their test results Number of HIV-infected pregnant women who received 57,771
antiretroviral prophylaxis for PMTCT in a PMTCT setting Number of health workers trained in the provision of PMTCT 60
services according to national and international standards

Table 3.3.01:

1. LIST OF RELATED ACTIVITIES This activity relates to activities in Counseling and Testing (#6875), Condoms and Other Prevention (#6872), Orphans and Vulnerable Children (#6874). It also relates to Abstinence / Be Faithful (#6843).

2. ACTIVITY DESCRIPTION A total of 250,000 individuals will be reached with community outreach programs that promote abstinence and/or Be Faithful, of which 80,000 will be reached with Abstinence-only education. 2,500 individuals will be trained to implement these programs through over fifteen programs. CHF will continue to provide sub-award grants to organizations and build their organizational and technical capacity to deliver quality AB programs. Specific activities to be carried out by sub-grantees will include curriculum-based programs, theatre, community outreach targeting in and out of school youth in communities with abstinence education and life skills. CHF works with community and faith-based organizations to strengthen implementation of their abstinence curriculum in their church-sponsored schools. These curricula are used in programs such as the African Inland Church Ministries' "Why Wait" program, the Baptist AIDS Response Agency (BARA) "True Love Waits" and the "True Love Stays" a fidelity program and the programs of the Kenya Episcopal Conference (KEC-Catholic Secretariat). The KEC program also works through a twinning relationship with the American Health Alliance through De Paul University to develop a strong monitoring and evaluation system. CHF will continue to support new emerging partners identified collaboratively with CDC/Kenya, culminating in increased sub-award grants to partners implementing AB programs under the new COP. CHF will work towards strengthening each partner organization's capacity progressively towards independent sustainability. Subgrantees will receive advanced training on grant writing and will be linked to other funding sources, with a view to "graduating" some partners from the LPATH program to make room for new, emerging partners. CHF will also facilitate networking among the sub-grantees to share lessons learned. CHF will promote implementation of best practices, evidence based interventions and will provide supportive supervision for continuous quality improvement. CHF will continue to support behavioral interventions for the Nyanza Reproductive Health Society's "young men's prevention project" for young men enrolling in the Kisumu male circumcision project (please note: the circumcision component is not PEPFAR supported). Significant changes in FY 2007 include support to the Kenya uniformed services recruits, an activity previously supported through KEMRI. This activity also includes estimated support to the following sub recipients for activities integral to the program, including CHF management costs:

African Inland Mission: $100,000 Apostles of Jesus AIDS Ministries: $60,000 Baptist AIDS Response Agency: $100,000 Vuma: $60,000 Community Research for Education and Development: $70,000 Eastlands Pastors Pentecostal Fellowship: $40,000 Gethsemane Children of God: $8,000 Kenya Assemblies of God: $30,000 Kenya Episcopal Conference: $100,000 Nomadic Community Trust: $30,000 Nyanza Reproductive Health: $100,000 Nyarami I: $7,000 Soy: $35,000 Upendo: $10,000 Uniformed Services: $250,000 New Partners: TBD

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA The activities supported by CHF in this program area will work to prevent HIV infection among 250,000 young people in various parts of the country, include young men in the Kisumu area. 2,500 people will also be trained to deliver AB programs. These activities are consistent with the Kenya 5-Year Strategy which focuses on HIV prevention in youth.

4. LINKS TO OTHER ACTIVITIES These interventions for young people, will link to interventions funded by CHF under OP

activity (#6872), CT activity (#6875), OVC activity (#6874) and American Health Alliance Twinning activity (#6843). Young sexually active people eligible for condoms and other prevention interventions will be served by OP activities and referred to CT services. OVC programs will also incorporate AB activities. The Kenya Catholic Secretariat project will receive additional support from the Twinning in strengthening its M&E system.

5. POPULATIONS BEING TARGETED The general population, including adult men and women of reproductive age are targeted with AB messages. Children and youth, including boys and girls in primary and secondary schools and their teachers are targeted. More at-risk groups including out-of-school youth are also a key target. These activities will continue targeting parents to help ensure that a supportive adult environment is promoted for a comprehensive youth prevention approach. Other supportive adults to be included in interventions include teachers, community and religious leaders and program managers. Most project involve volunteers in many activities including peer-based approaches and these serve mainly rural communities. The capacity building focuses on CBOs, FBOs, and local NGOs.

6. KEY LEGISLATIVE ISSUES ADDRESSED This project will focus on changing male norms and behaviors through the provision of HIV prevention services targeted to young men. It also addresses increasing gender equity in HIV/AIDS programs. Twinning is also addressed through partnership with the American Health Alliance/De Paul University.

7. EMPHASIS AREAS The primary focus of CHF is capacity building support to these local organization which includes conducting preliminary partner assessment, training and organizational set ups. This is followed on by providing Quality Assurance, Quality Improvement and Supportive Supervision to funded projects. The partners mainly undertake community mobilization / participation and related activities. Other activities include provision of information, education and communication including curriculum based AB interventions and training. Training is conducted at various levels; by CHF to its partners as well by partners to their project implementation staff and community members. These activities entail a minor emphasis of the project. Human resources also are a minor emphasis with both CHF and its partners employing staff to run these programs.

1. LIST OF RELATED ACTIVITIES This activity links to the NBTS Track 1 cooperative agreement for blood safety activity (#7011) and the AABB Track 1 cooperative agreement for blood safety activity(#6840).

2. ACTIVITY DESCRIPTION This activity relates to the prevention of HIV transmission through blood transfusion. Community Housing Foundation (CHF) will support Bloodlink Foundation to work with the National Blood Transfusion Service (NBTS) in the mobilization of voluntary non-remunerated blood donors in the workplace within corporate organizations. This activity will increase the supply of safe blood to the NBTS, increase the proportion of repeat donors and develop private-public partnerships that will enhance the sustainability of the blood safety program in Kenya. Equally important will be the expansion of the out-of-school donor pool from the current 20% to 30 % by the year 2008. Bloodlink Foundation will assist the NBTS to collect 14,000 additional units of blood through the continuation of established partnerships with 150 corporate partnerships in Nairobi, Mombasa, Nakuru, Kisumu and Eldoret. (Please note: targets for units of blood collected are reported under NBTS's activity #7011.) At least two key personnel will be trained in each corporate organization to mobilize donors within their organizations. A training curriculum was developed for these trainings in 2005. 25,000 employees will be educated about safer blood donation. To enhance the sustainability of Kenya's blood program corporate organizations will be encouraged to take up blood safety programs as part of their social responsibility projects thus promoting public-private partnerships in the area of blood safety. Bloodlink Foundation in partnership with a leading local tele-communications company initiated the highly successful Safaricom blood drives conducted in major towns during school holiday months. This activity will be continued in FY 2007 to help boost national blood supplies. Significant changes from 2006 to 2007 for this activity include expansion to an additional 30 military barracks in Nairobi, Thika, Nanyuki, Nakuru, Mombasa, Isiolo and Eldoret through which 30,000 adults will be reached. Activities will also aim to increase repeat donors in partner organizations by 50%. Currently there are less than 20% repeat donors within the NBTS. Bloodlink will work with the NBTS to support donor clubs in partner organizations.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will contribute to the prevention of medical transmission of HIV through blood transfusion by increasing the supply of blood from volunteer blood donors. These persons have a lower prevalence of transfusion transmissible infections than family replacement donors. All blood will be collected, processed and distributed by the NBTS. Other organizations that will be involved in donor recruitment for the NBTS are the Kenya Red Cross and Hope Worldwide.

4. LINKS TO OTHER ACTIVITIES This activity links to the NBTS Track 1 cooperative agreement for blood safety activity (#7011) and the AABB Track 1 cooperative agreement for blood safety activity(#6840). Please note: because NBTS will actually be collecting the blood from donors mobilized by CHF, targets for units of blood collected are reported under NBTS activity #7011.

5. POPULATIONS TARGETED This activity will target adults in the workplace as well as private businesses that can contribute to the sustainability of blood safety activities in Kenya.

6. EMPHASIS AREAS Major emphasis for this activity is the workplace at which volunteer blood donors will be recruited. Minor emphases are community mobilization, information/education/communication, and local organization capacity development.This activity will also promote private-public sector partnerships.

1. LIST OF RELATED ACTIVITIES This activity relates to activities in Abstinence and Be Faithful Programs (#6876), Counseling and Testing (#6875), and Orphans and Vulnerable Children (#6874).

2. ACTIVITY DESCRIPTION The primary implementing partner in this activity, Community Housing Foundation (CHF), is implementing a capacity building and grants management program, supporting numerous local organizations to implement various interventions. CHF will work with local organizations to implement HIV prevention activities among high risk youth and adults. A total of 90,000 individuals will be reached with behavioral interventions and 450 people will be trained in delivering HIV prevention services for high risk populations. 200 condom outlets will be established. These activities will contribute to the result of increased access to HIV/AIDS prevention services for high risk and underserved population. CHF will continue supporting local groups currently receiving FY 2006 funds by building both their organizational and technical capacity to enhance service delivery for OP, culminating in the disbursement of sub-award grants to carry out targeted OP activities. CHF will assist its sub-grantees to develop appropriate tools and strategies for Monitoring and Evaluation and the use of scientific and evidence based approaches in Behavior Change Communication (BCC) to enhance partners output. CHF will strengthen its partner interventions by ensuring there is an adequate focus on Positive Prevention. It will help partners employ appropriate approaches to focus on preventing sexual transmission among individuals with HIV. To help both with prevention as well as reduce stigma and discrimination, these programs will promote leadership by PLWAs in Positive Prevention through groups such as the Movement of Men Against AIDS. Networking and information sharing among partner organization will be strengthened. CHF will continue to support behavioral interventions for the Nyanza Reproductive Health Society in implementing a pilot "young men's prevention project" for young men enrolling in the Kisumu male circumcision project. Moreover, CHF will work collaboratively with CDC to identify additional emerging partners to engage with during FY 2007. CHF will continue to support behavioral interventions for the Nyanza Reproductive Health Society in implementing a pilot "young men's prevention project" for young men enrolling in the Kisumu male circumcision project. It will also provide workplace interventions for sugar plantation workers, including migrant workers and sex workers with their partners within the sugarbelt region in south Nyanza. A significant change in FY 2007 will be support to the Uniformed services programs including the National Youth Service, the Kenya Wildlife Service and the Kenya Police service departments, previously supported through KEMRI. This activity also includes support to the following sub recipients for activities integral to the program, with CHF management costs included: Community Research and Education Development $70,000 Merlin $70,000 Movement of Men Against AIDS in Kenya $70,000 Nomadic Community Trust $40,000 Soy $35,000 Nyanza Reproductive Health $100,000 Uniformed Services $550,000 New partners - TBD $200,000

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA The activities supported by CHF in this program area will work to prevent HIV infection among 90,000 high risk individuals, including commercial sex workers and their partners, sugar plantation workers, migrant workers, out of school youth and discordant couples. PLWAs will help provide leadership on Positive Prevention. Young men in the Kisumu area enrolling for the UNIM male circumcision will be targeted as well as boda boda and matatu operators. 450 people will be trained to provide OP services and 200 condom outlets will be established. These activities are consistent with the Kenya Five-Year Strategy which focuses on HIV prevention in youth.

4. LINKS TO OTHER ACTIVITIES This activity is linked to CHF activities in the areas of AB (#6876); and CT (#6875), Orphans and Vulnerable Children (#6874). Sub-grantees will segment their target populations and link younger youth and OVCs to AB activities. Counseling and testing will be widely advocated and people will be referred to CT services.

5. POPULATIONS BEING TARGETED Young adults, especially young men, will be targeted by these activities. In addition, commercial sex workers and their clients will be targeted in both Nairobi and in the sugar plantations in Nyanza Province. People living with HIV/AIDS will be targeted, not only to receive services, but also to be involved in community outreach promoting Positive Prevention. These interventions for high risk youth, especially young people, will link to the partner faithfulness interventions, including advocacy for partner reduction. Teenage men who may have begun sexual activity can be targeted for voluntary counseling and testing (VCT), messages of faithfulness to one partner, and rapid treatment of STI. Individuals and groups involved in high risk sexual behavior will also be educated about the benefits and means of achieving faithfulness including reduction of sexual partners and other prevention strategies such as correct, consistent condom use, rapid treatment of STI and VCT, as well as reporting for VCT. Such young men can also be asked to refer their female sexual partners, who by definition are sexually active, high risk individuals, for counseling and treatment. PLWAs and their sex partners will be encouraged to seek screening and treatment for STIs, care and ART treatment. This activity will also train community, program, and religious leaders as well as local organizations including CBOs, FBOs and local NGOs. Activities will largely focus on serving rural communities.

6. KEY LEGISLATIVE ISSUES ADDRESSED Gender issues will be addressed. These include increasing gender equity, addressing male norms and reducing violence/coercion. The focus on Positive prevention programming will also address stigma and discrimination. The projects targeting commercial sex workers will work to assist young women to find alternate forms of employment and income.

7. EMPHASIS AREAS The primary focus of CHF continues to be support to local organizations' capacity development as well as provide Quality assurance, Quality Improvement and Supportive Supervision. CHF will help sub-grantees train their staff and volunteers in the interventions, and will assist in capacity building of the local groups. This will enable groups provide services that relate to community mobilization / participation, provision of information, education and communication and the development of networks, referrals and linkages. Human resources both for CHF and for sub-grantees are an additional minor emphasis area.

1. LIST OF RELATED ACTIVITIES This activity relates to activities in ARV Services (#6869), Counseling and Testing (#6875), TB/HIV (#6871) and PMTCT (#6949).

2. ACTIVITY DESCRIPTION Cooperative Housing Foundation (CHF) will build organizational capacity and provide sub grants to NGOs, FBOs, and CBOs, resulting in the provision of palliative care services for 14,000 people (including 2000 children) in 25 facilities and programs; in addition to training 300 individuals to provide HIV-related palliative care services. The key activities of the primary partner will be to develop capacity of local organizations and provide supportive supervision. Funds granted through CHF to sub partners will be used to provide a standard package of palliative care services, including support for health care worker salaries in accordance with Emergency Plan guidance, training, infrastructure improvement, community mobilization activities, support for laboratory evaluation, prevention and treatment of opportunistic infections, and expanded access to safe water and malaria prevention interventions. This activity will expand existing programs, add new sub partners, and continue to place emphasis on providing services for children. The primary implementing partner in this activity, CHF, has over 50 years of experience in building the capacity of local and indigenous organizations in numerous countries, and in providing sub-grants to local organizations.

By March 2006, CHF was supporting 4 organizations, whose combined activities were providing palliative care services for more than 2500 individuals with HIV. Capacity building activities have included both strengthening of administrative operations (such as planning and accounting) and technical capacity (specific ability to implement care programs).

This activity includes support to the following sub-recipients for activities integral to the program: Merlin $130,000 AID Village Infectious Disease Clinics $20,000; Christian Missionary Fellowship $30,000; Nomadic Communities Trust $40,000; Community of St. Egidio $30,000; VIHDA $20,000; Kenyan Pallative Care Association $30,000 Services supported by the various sub-partners vary widely. For example, AID Village Infectious Diseases and Christian Missionary Fellowship both support services for rural, primarily Masaai populations, the Hospice Association provides end of life pain management and care for people with HIV/AIDS and HIV associated cancers, Community of St. Egidio serves very remote populations and Vihda provides services that specifically target children.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA These activities will contribute to the expansion of palliative care services for people with HIV, strengthened human resource capacity to deliver care for HIV, and a strengthened referral network for these services. This partner has a key role in building capacity of local organizations so that these activities can be sustained over the long term.

4. LINKS TO OTHER ACTIVITIES In addition to building the capacity of sub-grant recipients, an important aspect of CHF's activities is to support development of linkages between the organizations they support to implement a variety of HIV prevention and treatment activities. For example, linkages that have been established during capacity building trainings have led to improved referrals/linkages of patients from VCT - Nyarami, a sub partner of CHF (#6875), Palliative care: TB/HIV (#6871), ARV services (#6869), and PMTCT (#6949).

5. POPULATIONS BEING TARGETED The primary target populations are people with HIV, including HIV-infected children. Some sub-partners reach remote populations who are otherwise unable to access care services, for example, the Maasai populations served by AID Village Infectious Diseases and Christian Missionary Fellowship. the activity will also target to work with public health care workers, mainly doctors, nurses, pharmacists and laboratory workers. The activity also

targets to include community-based and faith-based organizations and NGOs in the area.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity addresses legislative issues related to stigma and discrimination through involvement of PLWAs in service provision and community sensitization activities.

7. EMPHASIS AREAS This activity includes emphasis in the areas of local organization capacity development, commodity procurement, development of networks, logistics, human resources, and quality assurance and supportive supervision (the last 5 through sub-grants).

1. LIST OF RELATED ACTIVITIES This activity relates to activities in CT (#6875) and TB/HIV (#7001).

2. ACTIVITY DESCRIPTION This activity supports a public-private partnership (PPP) between Kenya's National Leprosy and TB Program (NLTP) and the Kenya Association for Prevention of TB and Lung Disease (KAPTLD) for collaborative TB/HIV activities. KAPTLD is an affiliate of the International Union Against TB and Lung Disease (IUATLD), a group of chest physicians in private practice in Nairobi and major urban centers in Kenya. More than 75% of Kenya doctors and half of the national health facilities reside in the private sector, and this PPP seeks to promote good clinical practice in TB/HIV services provided by those physicians. The partnership was established last year with support from the Emergency Plan, and since the signing of an MOU with NLTP in 2006, KAPTLD has begun TB/HIV activities in Nairobi, Mombasa, Nakuru, Eldoret, Kisumu and other urban sites in Kenya. KAPTLD will use FY 2007 funds to support administrative operations in Nairobi, provide support supervision to private practitioners, establish a TB/HIV resource center, and train staff - nurses, clinical officers and doctors - in order to strengthen capacity in the private sector. The funds will also support the printing and distribution of monitoring and evaluation tools. KAPTLD will invest FY 2007 funds into the following key TB/HIV activities: testing TB patients/suspects for HIV, screening HIV-infected persons for TB, providing co-infected patients with additional care (cotrimoxazole, ART), providing risk reduction counseling and psycho-social support, training health workers to deliver TB/HIV services, supporting infrastructure, and supporting procurement of commodities (such as HIV test kits and drugs). Private diagnostic TB and HIV laboratories will be supported, through collaboration with CDC's Laboratory Program, the National Public Health Laboratory Services (NPHLS) and the NLTP to ensure that national standards are achieved and maintained. In addition, KAPTLD, in collaboration with the NLTP, will strengthen reporting and patient tracking systems to ensure that standard TB and HIV care outcomes are accurately reported and factored into the national database.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA These activities will result in strengthened delivery of integrated HIV and TB services in the private sector, including strengthened patient tracking systems between the pubic and private practitioners, improved diagnostics and treatment of TB among HIV-positive patients and of HIV in TB patients, strengthened capacity of private health workers to provide integrated HIV and TB services and strengthened systems capacity for program monitoring and evaluation and management of commodities.

4. LINKS TO OTHER ACTIVITIES These activities will be linked to ongoing VCT, PMTCT, STI and ARV treatment services in both the private and public settings. These activities will be coordinated by the NLTP and NASCOP (#7001) and will result in strengthened delivery of integrated HIV and TB services, including strengthened referral systems, improved diagnosis and treatment of TB among HIV-positive patients and of HIV in TB patients, strengthened capacity of health workers in private practice to provide integrated HIV and TB services and strengthened systems capacity for program monitoring and evaluation and management of commodities.

5. POPULATIONS BEING TARGETTED These activities target TB suspects (adults and children) from whom 15% of all notified TB patients will be derived. The TB suspects will be seen at private outlets in the major urban settings in Kenya. The other populations targeted are HIV+ persons identified from VCT, PMTCT, STI, and ARV clinics and PLWHA organizations - deliberate action will be taken to intensify TB screening and TB case finding among PLWHA

6. KEY LEGISLATIVE ISSUES ADDRESSED Diagnostic HIV testing for all TB patients will be on an "opt out" principle. Guidelines on HIV testing based on consent, confidentiality and counseling will be observed as standard practice. Increased availability of CT in clinical settings and increased access to HIV-related care for TB patients will help reduce stigma and discrimination.

7. EMPHASIS AREAS Emphasis areas include commodity procurement, development of

network/linkages/referral systems, IEC, infrastructure, local organization capacity development, and training.

"Plus-up funds will be used to expand existing COP 07 activities for this partner. Specifically, they'll be allocated to 2 partners already providing palliative care to HIV patients to support intenstified and integrated HIV/TB services, particularly intenstified case finding for TB and HIV testing among TB patients. 2. ACTIVITY DESCRIPTION This activity supports a public-private partnership (PPP) between Kenya's National Leprosy and TB Program (NLTP) and the Kenya Association for Prevention of TB and Lung Disease (KAPTLD) for collaborative TB/HIV activities. KAPTLD is an affiliate of the International Union Against TB and Lung Disease (IUATLD), a group of chest physicians in private practice in Nairobi and major urban centers in Kenya. More than 75% of Kenya doctors and half of the national health facilities reside in the private sector, and this PPP seeks to promote good clinical practice in TB/HIV services provided by those physicians.

" The partnership was established last year with support from the Emergency Plan, and since the signing of an MOU with NLTP in 2006, KAPTLD has begun TB/HIV activities in Nairobi, Mombasa, Nakuru, Eldoret, Kisumu and other urban sites in Kenya.KAPTLD will use FY 2007 funds to support administrative operations in Nairobi, provide support supervision to private practitioners, establish a TB/HIV resource center, and train staff - nurses, clinical officers and doctors - in order to strengthen capacity in the private sector. The funds will also support the printing and distribution of monitoring and evaluation tools. KAPTLD will invest FY 2007 funds into the following key TB/HIV activities: testing TB patients/suspects for HIV, screening HIV-infected persons for TB, providing co-infected patients with additional care (cotrimoxazole, ART), providing risk reduction counseling and psycho-social support, training health workers to deliver TB/HIV services, supporting infrastructure, and supporting procurement of commodities (such as HIV test kits and drugs). Private diagnostic TB and HIV laboratories will be supported, through collaboration with CDC's Laboratory Program, the National Public Health Laboratory Services (NPHLS) and the NLTP to ensure that national standards are achieved and maintained. In addition, KAPTLD, in collaboration with the NLTP, will strengthen reporting and patient tracking systems to ensure that standard TB and HIV care outcomes are accurately reported and factored into the national database. In addition, CHF will build organizational capacity and give sub grants to Merlin ($ 50,000) and Community of St. Egidio ($50,000) to intensify screening and treatment for TB among HIV patients and HIV among TB patients. It is estimated that 500 patients will be HIV/TB co-infected. The two organizations will also support expanded and strengthened delivery of integrated HIV and TB services, including strengthened referral systems and building capacity of 25 health workers to provide integrated HIV and TB services

1. LIST OF RELATED ACTIVITIES This activity relates to activities in Abstinence/Be Faithful (#6876), Condoms and Other Prevention (#6872), Counseling and Testing (#6875), Palliative Care: Basic Health Care Support (#6870), Palliative Care: TB/HIV (#6871), Treatment: ARV services (#6869) and Other/Policy Analysis and Systems Strengthening (#6873).

2. ACTIVITY DESCRIPTION Cooperative Housing Foundation (CHF) will work with sub-grantees to provide services to 4,000 orphans and vulnerable children (OVC) and train 1,000 caregivers to provide OVC care. It will provide primary direct support to 3,000 OVC and 1,000 supplemental support. CHF was awarded a cooperative agreement with CDC in late FY 2004 to work with local Non-Governmental Organizations (NGOs), Community Based Organizations (CBOs) and Faith Based Organizations (FBOs) in Nyanza and other regions in Kenya to build their capacity to implement community-based HIV services. In FY 2006, CHF partnered with three local NGO partners to provide critical services to OVC including: Gethsemane Garden of Hope for Africa, which provides a comprehensive package that includes education, shelter, nutritional support, care and support, and support to OVC caretakers; Our Lady of Perpetual Support for People Living with HIV/AIDS (OLPS), which provides education and clothing, while linking OVC to other critical services; and Narok Integrated Development Project, which provides material support, school fees, and nutritional support. In addition, CHF continues to respond to new applicants seeking to support work with orphans and vulnerable children. In FY 2007, CHF will expand its scope of activities to include suitable organizations that have on-going programs for OVC. CHF will continue supporting new partners who will be selected through close collaboration with CDC. These may include Homeless Children International, St. Stephens Children's program, Adventist Care and Support program, African Brotherhood Church ministries, Redeemed Gospel church Ministries, Garissa Children's Home, Kiserian Children's program among others. These are potential partners who have expressed interest to CDC for consideration to support their on-going programs. An important element in this program is strengthening HIV prevention education among OVC to equip them with life skills that would reduce their vulnerability to the risk of HIV infection. Caregivers will be trained to strengthen the family support system and strong linkages will be established between PLWHAs, HIV-infected children and health care services, including ensuring that children and their parents or caregivers and other family members affected access appropriate care and treatment. These programs will work closely with care and treatment partners to ensure that HIV-infected children receive appropriate psychosocial support and that they have a consistent caregiver to assure adherence to treatment. The scope of the current programs will be expanded to ensure that they provide a package of essential services that qualify as primary direct support. All programs will work in close collaboration with the District Children's Department and will follow guidelines provided by the parent ministry, alongside PEPFAR guidelines.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA Through partnerships with local sub-partners supported, CHF will provide 4,000 OVC with access to essential services, train 1,000 caregivers, and build the capacity of local, community and faith-based organizations to meet the needs of OVC in their communities. CHF mainstreams the development of referral mechanisms and linkages among all partner organizations within a geographic region, ensuring that served OVC link with appropriate services, even if the individual NGO partner does not provide them.

4. LINKS TO OTHER ACTIVITIES The OVCs and the community will be referred to VCT centers in the health facilities where the activities are taking place. CHF will work with the organizations undertaking home and community support in the same areas. CHF is also funded under the home and community service category. This activity is linked to CHF activities in the following program areas: CHF CT (#6875); AB (#6876); OP (#6872); Policy Analysis and Systems Strengthening (#6873) and ART (#6869).

5. POPULATIONS BEING TARGETED This activity targets orphans and vulnerable children, older OVC, widows/widowers, HIV+ children, HIV/AIDS affected families and People Living with HIV/AIDS.

6. KEY LEGISLATIVE ISSUES ADDRESSED

This activity helps increasing gender equity in HIV/AIDS programs by ensuring the girl children have equal access to services, and disaggregating data on girl children. It also addresses the wrap around issues of food and education.

7. EMPHASIS AREAS There are six minor emphasis areas in local organization capacity development, human resources, quality assurance, development of network linkages/referral system, community mobilization/participation and training.

1. LIST OF RELATED ACTIVITIES This activity is related to Cooperative Housing Foundation activities in AB (#6876), OP (#6872), ARV treatment (#6869), OVC (#6874), and TB/HIV (#6871).

2. ACTIVITY DESCRIPTION Through the President's Emergency Fund, Community Housing Foundation (CHF) already supports 37 local partners implementing a wide range of HIV prevention and care activities mainly in remote and hard to reach parts of Kenya. In FY 2006, through reprogramming, CHF included in their domain a component of the uniformed services project (USP), which was previously supported through the KEMRI cooperative agreement. In FY 2007 CHF plans further to expand activities and broaden its geographical coverage. The planned expansion will result in an increase of CT outlets supported by CHF to 56 through which 130,000 individuals will receive CT services. Apart from providing the standard individual VCT services, CHF sub-partners will promote couple counseling and testing, and ensure that discordant couples are provided with support and care. CHF will train an additional 65 counselors to provide CT in both medical and non-medical setting during the plan period. CHF was awarded a cooperative agreement with CDC in late FY 2004 to work with local Non-Governmental Organizations (NGOs), Community Based Organizations (CBOs) and Faith Based Organizations (FBOs) in Kenya, building their capacities in implementing CT activities for prevention and care. The network model approach in programming and financing adopted by CHF has greatly enhanced linkages among the complementary activities implemented by these sub-partners, especially between CT and care services supported through the President's Emergency Fund. In order to further expand availability of CT services, CHF will consider supporting up-coming NGOs which have unique and innovative programs or those who work in hard-to-reach areas. The targeted partners will collectively cover a wide geographical area and provide confidential CT services in varying settings that will meet the unique needs of many segments of the population. CHF has over 50 years of experience in building the capacity of local and indigenous organizations in numerous countries, and in providing sub-grants to local organizations. Under the terms of the current cooperative agreement with CDC, CHF has done well in responding to the national aspiration of increasing access to quality HIV prevention and care services in Kenya. Besides building the capacity of the local sub-partners in CT program implementation, CHF will continue to provide sub-grants and to build their overall management capacity. Training in proposal writing, which will enable sub-grantees to compete independently for USG and donor funds, will be emphasized. CHF will promote compliance with prescribed national standards for CT service delivery and continuous quality improvement at all sites through a program of support supervision conducted jointly with the Ministry of Health.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA Through partnership with local sub-partners supported with FY 2007 funds CHF will provide CT to 120,000 Kenyans. Majority of those testing positive will be linked to care services within and beyond the network of HIV/AIDS services initiated by CHF through President's Emergency fund. CHF's effort in CT is expected to contribute approximately 15% of the total USG target for Kenya in FY2007. A number of CHF sub-partners will provide CT through multiple approaches including fixed and Mobile VCT, CT in medical settings and CT within home Based Care Programs, thereby improving equity in access to HIV prevention and care services since many rural communities that are currently underserved will have better access. Overall, CHF's activities will contribute to the result of increased access to CT among underserved and high risk populations and enhanced capacity to implement HIV/AIDS interventions by local sub-partners.

4. LINKS TO OTHER ACTIVITIES The CHF supported CT activities will focus on enhancing links to other Emergency Plan funded care and treatment activities intended to better serve geographical areas where linkage to care for those testing HIV positive are still weak. CHF CT activity is closely linked to CHF activities in AB (#6876), condoms and other prevention (#6872), ARV treatment/services (#6869), TB/HIV (#6871) and Orphans and Vulnerable Children (#6874).

5. POPULATIONS BEING TARGETED This activity targets predominantly rural populations falling largely within remote parts of Kenya. In these areas the entire population will be reached including adults and youth.

For this to be achieved the partners will have to work closely with community leaders. Innovative programs for promoting CT amongst commercial sex workers and the youth are an integral part of the planned activities. New sites will include facilities operated by Community or Faith-Based Organizations and non-profit organizations serving nomads and other hard to reach population groups.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity will increase gender equity in access to HIV/AIDS services, particularly for the nomadic communities in northern Kenya.

7. EMPHASIS AREAS This activity includes major emphasis on local capacity building, human resource development and minor emphasis on improvement of infrastructure for CT service provision. CHF will focus mainly on building the capacity of local organizations to implement high quality HIV/AIDS interventions responsive to the needs of target communities. The training component of the planned activities will result into increased human resource capacity to provide both diagnostic and voluntary counseling and testing at grassroots level. In settings where infrastructure for CT service provision is underdeveloped or lacking, resources will be committed for minor alterations, improvements and furnishings to create decent CT service outlets.

1. LIST OF RELATED ACTIVITIES This activity relates to activities in Palliative Care (#6942), Counseling and Testing (#6941), TB/HIV (#6944), and PMTCT (#6949).

2. ACTIVITY DESCRIPTION Cooperative Housing Foundation (CHF) will build organizational capacity and provide sub-grants to NGOs, FBOs, and CBOs, resulting in the provision of antiretroviral treatment to 4,000 HIV-infected people in nine health care facilities, including 100 children. 300 health care providers will be trained to provide antiretroviral therapy. The key activities of the primary partner will be to develop capacity of local organizations and provide supportive supervision. Funds granted through CHF to sub-partners will be used to provide a standard package of ARV treatment including support for health care worker salaries in accordance with Emergency Plan guidance, training, infrastructure improvement (for example, through renovation of clinic spaces), community mobilization activities, support for laboratory evaluation, and adherence counseling and monitoring. ARVs are supplied to the sites through distribution system of the Mission for Essential Drugs and Supplies (MEDS) and the Kenya Medical Supplies Agency (KEMSA). This activity will expand existing programs and continue to place emphasis on providing treatment for children. The primary implementing partner in this activity, CHF, has over 50 years of experience in building the capacity of local and indigenous organizations in numerous countries, and in providing sub-grants to local organizations.

By March 2006, CHF was supporting four organizations, whose combined activities were providing ARVs to approximately 2,000 individuals with advanced HIV. Capacity building activities have included both strengthening of administrative operations (such as planning and accounting) and technical capacity (specific ability to implement care programs). Sub-partners funded through CHF will support HIV treatment in three districts in Nyanza Province, and remote areas of Rift Valley and Eastern Provinces. This activity includes support to the following sub-recipients for activities integral to the program:

Merlin $230,000; AID Village Infectious Disease Clinics $190,000; Christian Missionary Fellowship $150,000; Kenya Pediatric Association $280,000; Community of St. Egidio $280,000; VIHDA $100,000; Kenyan Pallative Care Association $40,000.

One of the partners funded through CHF is the Kenya Pediatric Association. This local professional organization is providing national classroom, practical training, and mentorship related to pediatric treatment, and is strengthening networks for pediatric HIV treatment (for example, through an e-mail list-serve and national meetings).

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA These activities will contribute to the expansion of ARV treatment for clinically qualified HIV-positive patients, strengthened human resource capacity to deliver ARV treatment, and a strengthened referral network for provision of ART. This partner has a key role in building capacity of local organizations so that these activities can be sustained over the long term.

4. LINKS TO OTHER ACTIVITIES This activity relates to activities in Palliative Care (#6942 and CHF sub-partners), Counseling and Testing (#6941and CHF sub-partners), TB/HIV (#6944 and CHF sub-partners).

5. POPULATIONS BEING TARGETED The primary target populations for these activities are people with HIV, including HIV-infected children. While HIV-infected children are targeted by most partners, the activities of the Kenya Pediatric Association are specifically critical to the scaling of treatment for children in Kenya. Some sub-partners reach remote populations who are otherwise unable to access treatment services, for example, the Maasai populations served by AID Village Infectious Diseases and Christian Missionary Fellowship.

6. KEY LEGISLATIVE ISSUES ADDRESSED This activity addresses legislative issues related to stigma and discrimination through involvement of PLWAs in service provision and community sensitization activities.

7. EMPHASIS AREAS This activity includes major emphasis in the area of local organization capacity development, and minor emphases in commodity procurement, human resources, logistics, development of linkages and quality assurance and supportive supervision through sub-grants.

1. LIST OF RELATED ACTIVITIES This activity is linked to activities in HTXS (#6945), MTCT (#6949), HVCT (#6941), HVTB (#7001), HVAB (#6876), HVOP (#6872) and HKID (#6874).

2. ACTIVITY DESCRIPTION In FY 07, the Cooperative Housing Foundation (CHF) will support three sub-grantees: Kenya Pediatric Association, Kenya Episcopal Conference, and Kenya Association for Prevention of TB and Lung Disease in system strengthening and policy issues.

The Kenya Pediatric Association (KPA) is a body of pediatricians that works in policy development, training and mentorship of health providers. KPA is actively involved in the training of health workers on comprehensive pediatric HIV care and treatment, and is working on a mentorship program to scale up pediatric ARVs.

With PEPFAR support, KPA will increase the capacity of 200 health facilities and 360 health care providers to provide pediatric HIV care and treatment. The association will play a key role in the dissemination of national guidelines and curricula to health workers. KPA will work closely with the National AIDS and STI Control Program (NASCOP) to develop guidelines for diagnostic testing and counseling (DTC) in children and to train 360 health workers in pediatric DTC. Stigma is a major hindrance to the linkage to care and treatment of HIV infected adults and children. KPA will develop strategies for reducing stigma and discrimination among health workers and target 360 health providers for training on stigma reduction. CHF support will help to achieve the national target of intiating 10,000 infected children on ARVs by the end of FY 2007.

In the second component, CHF will work with the Kenya Episcopal Conference-Catholic Secretariat (KEC-CS) which is responsible for coordinating and facilitating programs of the Catholic Church. In FY 2007, the KEC-CS will develop a policy on how to effectively respond to the epidemic, maximize services, lobby government and advocate for the rights of the infected. KEC-CS will also develop a workplace policy for staff infected or affected by HIV/AIDS. CHF support will further strengthen the capacity of KEC-CS by training 150 members in HIV/AIDS-related policy development, capacity building, grants management and program monitoring and evaluation.

The third component is CHF support to the Kenya Association for Prevention of TB and Lung Disease (KAPTLD). KAPTLD is an affiliate of the International Union against TB and Lung Disease (IUATLD) initiated by chest physicians in private practice in Kenya. The National Leprosy and TB Program (NLTP) and U.S. Government agencies recognize the private medical practice as a resource that is still underutilized for TB/HIV work. To promote both public-private partnership and good clinical practice, NLTP and KAPTLD have established a strong partnership with Emergency Plan support. In FY 2006, KAPTLD began TB/HIV activities in Nairobi, Mombasa, Nakuru, Eldoret, Kisumu and other towns across Kenya. In FY 2007, CHF will support KAPTLD administrative operations, supervision of private practitioners, establishment of a TB/HIV resource center and printing and distribution of TB/HIV reporting tools, guidelines and curricula. KAPTLD will train 300 health workers to deliver TB/HIV services. Private TB and HIV laboratories will be supported, through collaboration with CDC's Laboratory Program, the National Public Health Laboratory Services (NPHLS) and the NLTP to ensure that national standards are achieved and maintained. In collaboration with the NLTP, KAPTLD will strengthen reporting and patient tracking systems to ensure that standard TB and HIV care outcomes are accurately reported and integrated in the national data base.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA CHF support to the KPA will facilitate the scale up pediatric HIV care and treatment through capacity building, on-site mentorship, HIV stigma reduction, pediatric DTC guidelines and dissemination of guidelines and job-aids. The second component of this activity will strengthen linkages across and among religious groups working in HIV/AIDS. CHF support to KEC-Catholic Secretariat will facilitate the development of HIV policies that will guide the HIV/AIDS activities religious groups working in HIV/AIDS. The third component of this activity will strengthen the delivery of integrated HIV and TB services in the private sector to ensure that TB/HIV services are in line with national guidelines and good clinical practice.

4. LINKS TO OTHER ACTIVITIES This activity will strengthen the capacity of health facilities and health workers to provide comprehensive pediatric HIV/AIDS services to children affected and infected with HIV/AIDS. The activity will also strengthen the capacity of the religious and the private practice medical sectors to contribute in the provision of high quality TB/HIV services.

5. POPULATIONS BEING TARGETED CHF support to the KPA will target children, private and public health care providers (doctors, clinical officers, nurses, laboratory technicians, pharmacists, nutritionists and counselors) and other MOH staff. Support to the KEC-CS will target faith-based organizations, religious leaders and people living with HIV/AIDS. The activities of the KAPTLD will target TB suspects, HIV+ persons, and private and public health care providers and other health workers.

6. KEY LEGISLATIVE ISSUES ADDRESSED CHF support to the KPA , KEC-CS and KAPTLD will address stigma and discrimination of HIV/TB infected adults and children in the health care setting, among health workers and religious groups working in HIV/AIDS.

7. EMPHASIS AREA The primary focus of CHF support to the three sub recipients is to build local organization capacity. CHF support will enhance the association's capacity to develop policies and guidelines to support HIV testing of children in clinical settings and to address stigma and discrimination of HIV infected persons. CHF will provide relevant training to the three sub recipients to enhance their capacity to achieve their goals.

This additional support will expand the scope of current activities in the current 07 COP. Three local faith-based organizations the Christian Health Association of Kenya (CHAK), the Organization of African Instituted Churches of Kenya (OAIC)and the Kenya Episcopal Conference/Kenya Catholic Secretariat (KEC/KCS) will have their organizational capacities strengthened through the CHF umbrella funding mechanism. They will receive funding to strengthen their HIV/AIDS desks to promote continued provision of high-quality HIV/AIDS services and treatment by mission hospitals (KEC and CHAK) and a comprehensive church-sponsored HIV/AIDS community interventions including prevention, OVC support, home-based care programs and VCT (KEC, CHAK and OAIC). Funds will also be used to better equip KEC and CHAK to effectively carry foward policy dialogue with the Government of Kenya (particularly the Ministry of Health) with an ultimate goal of restoring direct GoK support for health care provision at mission hospitals and health facilities. OAIC support is directed through $50,000 from previously unallocated funds. CHF will also work with KEC to implement policy for youth prevention programming throughout their national network.