1. LIST OF RELATED ACTIVITIES This activity relates to all PMTCT activities described in all APHIA II Partners in the FY 2007 Country Operational Plan (#8729, #8733, #8734, #8738, #8752, #8764).

2. ACTIVITY DESCRIPTION In COP 06, FHI/CRTU planned to conduct a formative assessment to identify opportunities and barriers to provision of FP as part of PMTCT, disseminate the findings to stakeholders and develop a training manual on provision of FP for HIV+ in collaboration with NASCOP, DRH and the National PMTCT Technical Working Group to train health workers in the provision of FP within the PMTCT context.

To move the COP 06 forward, the COP 07 activity will ensure that providers' skills are strengthened through roll out of the training materials developed under COP 06. In addition, IEC materials will be developed and used to educate clients on the importance of FP. Therefore, the COP 07 activity will provide technical assistance to the MOH (both NASCOP and DRH) to roll out the training materials to trainers and providers representing 60 sites in both the public sector and faith-based organizations in approximately 10 districts, develop and distribute IEC materials to educate PMTCT clients on FP.

A second component of the COP 07 activity will involve conducting a targeted evaluation of FP into PMTCT integration in order to generate strategic information about PMTCT best practices and inform scale up of FP-PMTCT integration. The evaluation will use the same "typical" PMTCT sites involved in the on-going (COP 06) PMTCT Best Practices project in order to build upon current efforts to disseminate these practices, evaluate how these typical PMTCT sites implement PMTCT best practices, gather strategic information about best practices for integrating FP into PMTCT, and inform scale up of integrated FP-PMTCT services.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA Integration of FP in PMCT will greatly enhance HIV prevention for both mother and child and therefore contribute to PEPFAR goals and targets in several ways. The FP approach into PMTCT program will result in reduced unwanted pregnancies. By improving the PMTCT program will directly result in reduced mother-to-child transmission.

4. LINKS TO OTHER ACTIVITIES This activity relates to all PMTCT activities described in all APHIA II Partners in the FY 2007 Country Operational Plan (#8729, #8733, #8734, #8738, #8752, #8764).

5. POPULATIONS BEING TARGETED This activity targets adults of reproductive health age, pregnant women, family planning clients, doctors, nurses and other health workers.

6. KEY LEGISLATAIVE ISSUES ADDRESSED By building upon current efforts to disseminate best practices to PMTCT sites using strategic information on integrated FP-PMTCT services these efforts, focusing on FP clients, will reduce transmission and therefore increase gender equity in programming and stigma reduction.

7. EMPHASIS AREAS This activity includes major emphasis on strategic information generation, and minor areas in quality assurance, quality improvement and supportive supervision, needs assessment, targeted evaluation and information, education and communication.

1. LIST OF RELATED ACTIVITIES As the target population is at risk for sexual activity which may not be possible to abstain from, the activity is linked to OP interventions as well. This activity is also related to Condoms and Other Prevention (#6887).

2. ACTIVITY DESCRIPTION In FY 2006, FHI/CRTU will collaborate with "I Choose Life" (ICL) to reach youth in special groups with ABC messages in a balanced way. ICL will increase the total number of trained student peer educators to 400 (including those already trained in FY 2005) and reach 25,000 students with AB messages. Ongoing life skills training and small behavior change communication (BCC) groups need to be further refined and expanded to ensure additional students are equipped with personal values, attitudes and life skills to prevent HIV infection and unintended pregnancy.

Specifically, FHI/CRTU and ICL through FY 2007 propose to strengthen life skills training, particularly to address gender equity issues, train an additional 400 student peer educators and expand the intervention to cover all campuses of University of Nairobi plus an additional university campus, reaching 25,000 students. The activity will generate strategic information in order to identify the appropriate channels to reach youth with essential prevention and health messages. The activity will also incorporate information about family planning (FP) into the ongoing peer education and BCC program since recent research shows that youth (1) still confuse ABC concepts with the need for dual protection and (2) need more information about contraceptive methods. Adding FP to the ongoing on-campus program will address needs expressed by students, and will also strengthen linkages between the peer educator network, campus organizations and the student health service. Radio will be used to reach students with vital health and ABC prevention messages that resonate with university youth by engaging students fully in the pre-production research and script writing. FHI will also actively seek opportunities to collaborate with the School of Journalism, as well as campus theatre groups and other student clubs and organizations on the production of the radio series. FHI and ICL will partner with local FM radio stations to produce and broadcast ABC messages and programs as part of their social responsibility program targeted at youth in institutions of higher learning. 20 producers will be trained to promote ABC messages as part of the activity.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA These activities will contribute to the 2007 prevention targets by targeting special youth groups, i.e. university students. Behavior change among university students is expected to have a multiplier effect as university students are viewed as "successful" role models by other youth. These activities are consistent with the Kenya Five-Year Strategy targeting young people as full partners in defining and delivering programs and messages.

4. LINKS TO OTHER ACTIVITIES As the target population is at risk for sexual activity which may not be possible to abstain from, the activity is linked to OP interventions as well. This activity is also related to Condoms and Other Prevention implemented by FHI/CRTU (#6887).

5. POPULATIONS BEING TARGETED This activity targets university students and out-of-school youth.

6. KEY LEGISLATIVE ISSUES ADDRESSED Key legislative issues include gender by addressing male norms and behaviors for university students that will result in reduced violence and coercion against female students. Other issues addressed include stigma and discrimination since it is key for effectiveness of peer educators who are volunteers.

7. EMPHASIS AREAS The major emphasis area for this activity is information, education and communication. Since FHI is also imparting skills to ICL to carry out these peer education prevention activities, local organization capacity development is a minor emphasis area. ICL uses a network of peer educators to disseminate prevention messages, making development of network/linkages/referral systems minor emphasis areas. Community mobilization and participation is also emphasized, since university students are also the main partners in the

design and implementation of the activity.

1. LIST OF RELATED ACTIVITIES This activity is related to Condoms and Other Prevention Activities (#8874) and Abstinence and Be Faithful Programs (#6889).

2. ACTIVITY DESCRIPTION Findings from the formative assessment (05 COP) and lessons learned from the pilot intervention (06 COP) need to be rolled out through additional communities in Nairobi and reach more housegirls with HIV prevention messages. Therefore, FHI/CRTU proposes in FY 2007 to continue to gather strategic information and identify lessons learned to support scale-up of the intervention. The activity will scale-up the intervention beyond Bahati Church to two additional faith-based institutions in Nairobi. 50 trained peer educators will reach an additional 500 housegirls with HIV and unwanted pregnancy prevention messages.

The 06 COP mass media campaign will be expanded to involve two additional radio stations which will air HIV and unintended pregnancy prevention messages to reach 10,000 housegirls as well as the communities in which they work to create awareness of the vulnerability of housegirls. CRTU will work with Kenyatta University (KU)'s Linguistics department to develop communications materials to be channeled through the local radio stations. In order to enhance the quality of the materials, CRTU will sub-contract a yet to-be-determined Communications Agency (possibly University of Nairobi's School of Journalism) to help design the messages. FHI and Kenyatta University will also explore opportunities to produce a documentary that sensitizes communities to the vulnerability of housegirls to HIV, unintended pregnancy and other negative health outcomes. FHI will also conduct an intervention assessment to generate strategic information that will enhance the design and implementation of interventions for housegirls.

Finally, FHI will provide technical assistance (TA) to five local faith-based organizations (FBOs) to design interventions to reach housegirls with prevention messages. Kenyatta University will be a sub-recipient ($135,000) to carry out these activities.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA These activities will contribute to the 2007 prevention targets by targeting special youth groups, i.e. housegirls. Reaching these hard-to-reach out-of-school youths is consistent with the Kenya Five-Year Strategy targeting young people as full partners in defining and delivering programs and messages.

4. LINKS TO OTHER ACTIVITIES This activity also relates to OP activities (#8874) and AB activities (#6889).

5. POPULATIONS BEING TARGETED This activity targets out-of-school youth (girls) and women working as housegirls/women, as well as religious leaders and volunteers working in faith-based organizations (FBOs).

6. KEY LEGISLATIVE ISSUES ADDRESSED Key legislative issues focus on gender, specifically on increasing gender equity in HIV/AIDS programs while also addressing male norms and behaviors.

7. EMPHASIS AREAS The major emphasis is on information, education and communication with minor emphases on training, community mobilization, and local organization capacity development.

1. LINKS TO OTHER ACTIVITIES This activity is a follow-up of COP 2006 activity #5096. The activity is also linked with the activities in COP 2006 ARV Services to be carried out by APHIA II-FHI/IMPACT (#5367) and the MSH/RPM+ activity (#4209) in the ARV Drugs program area.

2. ACTIVITY DESCRIPTION In COP 2006, FHI/CRTU planned to conduct an assessment of perceptions of fertility desires, contraceptive practices and pregnancy levels among women eligible for ART and modify existing curricula based on assessment findings & train 100 ART providers at least 2 sites. Lessons learned and training materials developed during COP06 need to be rolled out in order to increase the number of ART providers trained in FP service delivery and assess how well integration of FP and ARV provision addresses the fertility desires and FP needs of HIV+ women and couples.

Therefore, in COP 2007, FHI/CRTU proposes to: Provide technical assistance to the MOH, specifically NASCOP and DRH, to scale up training on integration of RH into HIV services for 100 ART providers at additional ART sites (especially within APHIA II sites); Build centers of excellence for training within CCCs for provision of FP and other RH services to women and couples; Generate strategic information on the effectiveness of the training in addressing the fertility desires and family planning needs of people living with HIV who are clients of ART programs. Specifically the information generated will expand the evidence base for understanding 1) how integrated services can meet HIV+ women's immediate needs when their demand for family planning is identified; and 2) how the services meet women's evolving needs over the long term as they adjust to the reality of their HIV status, move onto ART regimens, and experience the health benefits of ART; and Generate information on appropriate contraceptive methods for use by women on ART.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA This activity will provide additional information on the reproductive health needs of women on antiretroviral therapy, as well as important insights into sexual behavior in the era on ART. This information is necessary to inform future ART program implementation and HIV prevention in the era of treatment.

4. LINKS TO OTHER ACTIVITIES This activity is a follow-up of COP 2006 activity #5096. The activity is also linked with the activities in COP 2006 ARV Services to be carried out by APHIA II-FHI/IMPACT (#5367) and the MSH/RPM+ activity (#4209) in the ARV Treatment/ARV Drugs program area.

5. POPULATIONS BEING TARGETTED The main population targeted is HIV positive women and health workers.

6. KEY LEGISLATIVE ISSUES ADDRESSED Legislative issues addressed include gender, stigma and discrimination.

7. EMPHASIS AREAS The major emphasis area is dissemination and utilization of Information, Education, and Communication materials resulting from the findings of the assessment. Minor areas are needs assessment, training of health workers and a targeted evaluation.

1. LIST OF RELATED ACTIVITIES This activity is related to all other Strategic Information activities in COP 2007.

2. ACTIVITY DESCRIPTION FHI/CTRU in collaboration with the National AIDS and STI Control Program (NASCOP) and Kenyatta University (KU) received COP 2005 funds to train 4 Masters students in targeted evaluation and generation of strategic information (SI). In order to have widespread impact of HIV/AIDS programming in the country, COP 2006 funds were committed to support training of an additional 4 Masters and 2 PhD students in targeted evaluation; FHI will continue to work closely with NASCOP, KU and a representative of the SI ITT to select and train these additional students. Also, using information generated in COP 2005, a dissemination strategy will be developed and implemented to facilitate utilization of the students' findings in relevant PEPFAR program areas, namely HTXD, HVCT and MTCT. In COP 2007, FHI/CRTU, NASCOP and KU propose to undertake the following activities: Continue the collaborative selection and support approach used in COP 2006 to identify and train 6 additional Kenyatta University students in targeted evaluation and SI generation in order to increase the human resource base for HIV/AIDS targeted evaluation in Kenya. Prior to selection of the 6 students, a meeting will be held with NASCOP to identify priority strategic information and targeted evaluation areas that the students can potentially address through their theses. The students will then develop projects that: 1) are relevant to identified capacity gaps at NASCOP as well as other local HIV/AIDS service delivery organizations/institutions; and 2) will generate SI to feed into PEPFAR program areas and activities. Once students have identified the PEPFAR program area they plan to address, Interagency Technical Team (ITT) representatives for these areas will be integrally involved in the students' work through quarterly meetings in order to provide guidance for students' projects and regularly review their progress. In addition, 12 additional field-based HIV/AIDS program staff will be trained in targeted evaluation and SI generation activities using the approach that will be developed under COP 2006 for building targeted evaluation skills of staff working with other HIV/AIDS organization apart from NASCOP. The activity will also ensure dissemination and utilization of students COP 2006 targeted evaluation findings. The dissemination strategy to be used in COP 2007 will be developed by FHI and its partners under COP 2006 to ensure dissemination and utilization of the SI generated by this ongoing activity within the MOH and other key organizations involved in HIV/AIDS programming. Finally, FHI will conduct training on data use using the data-for-decision making strategy developed in COP 2006. In this process, 16 trainers and 320 service providers will be trained in data-for-decision making at the provincial and district levels through cascade trainings. In COP 2006, capacity building activities with NASCOP and its partners will involve identification of gaps in utilization of data for decision making and planning. This gap analysis and development of appropriate strategies to address the identified gaps conducted during COP 2006 will be carried out by one or two of the students in collaboration with FHI and its partners. FHI/CRTU will sub-contract ($250,000) Kenyatta University as their main sub-partner to accomplish these activities.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA Currently, there is limited local capacity to conduct targeted evaluations relevant to HIV/AIDS. An in cases where some capacity exist such as in national Universities, this capacity is disconnected to the mainstream HIV/AIDS activities being conducted by NASCOP and with support of the USG. This activity therefore builds on the FY 2006 activity that supported Kenyatta University and NASCOP to improve the national M&E systems as well as contributing to the Emergency Plan's training outputs.

4. LINKS TO OTHER ACTIVITIES This activity is related to the Strategic Information activity to be carried out by CPC-MEASURE (#6988) that provides technical assistance and capacity building at the National HIV/AIDS Control Council (NACC).

5. POPULATIONS BEING TARGETED The population targeted are University students and program managers at NASCOP.

6. EMPHASIS AREAS The major emphasis area addressed is capacity building; minor is M&E systems.