1. ACTIVITY DESCRIPTION

Community Housing Foundation will support the Kenya Food and Nutrition Network (KEFAN) to build the

organizational and technical capacity of health care providers and community health workers to support

counseling on infant and young child nutrition, and to build support groups of HIV positive mothers to

strengthen exclusive breastfeeding as an important strategy in PMTCT. KEFAN will train 120 health care

providers (HCP) in lactation management and infant and young child nutrition, and will form support groups

from mothers who are HIV positive who have passed through a PMTCT program and have already

disclosed their status. Such identified mothers will provide support both at facility and community levels. IEC

materials on infant and young child feeding will be developed/adopted and used to pass the correct

information on to both health workers and the mothers concerning appropriate feeding options from birth, at

6 weeks when early infant diagnosis is done, and at 6 months when weaning starts. This project will be

piloted first in 2 districts, Nyando and Kisumu. The key activities of KEFAN will be to develop the

organizational and technical capacity of local HCP to provide nutrition guidance and counseling and

supportive supervision and mother support groups to provide actual support on how to operationalize

exclusive breastfeeding for 6 months, and to demonstrate correct infant attachment and positioning during

breastfeeding. Funds granted through CHF will be used to provide a standard package including training of

HCP and some incentives for mothers used in the support groups both at facility level and the community

level. All mothers testing HIV positive who do not meet AFASS criteria will be encouraged to do exclusive

breastfeeding for 6 months, in line with the WHO latest consensus statement. This activity will be critical

especially following early infant diagnosis at 6 weeks or first contact where currently there is confusion on

the correct information to give when a child of a positive mother tests negative. Nutrition guidelines will be

used to pass the right information. Capacity building activities will include both strengthening of

administrative operations and strengthening community linkages and technical capacity. Documentation of

how many mothers practiced exclusive breastfeeding for 6 months will be encouraged.

2. CONTRIBUTIONS TO OVERALL PROGRAM AREA

These activities will contribute to the establishment of nutrition/ exclusive breastfeeding support groups for

mothers with HIV, strengthened human resource capacity to deliver infant and young child nutrition

counseling and strengthened mother to mother breastfeeding support groups. This partner has a key role in

building the organizational and technical capacity of local organizations so that these activities can be

sustained over the long term.

3. LINKS TO OTHER ACTIVITIES

In addition to building the capacity of HCP and communities in the pilot districts, an important aspect of the

KEFAN's activities is to support development of community linkages and support groups for sustainability of

the program.

4. POPULATIONS BEING TARGETED

The primary target population is HIV- infected mothers and their exposed infants, including HIV-infected

children. KEFAN will reach out to mothers testing positive in the antenatal or postnatal period, and to infants

receiving EID at 6 weeks or first contact, and at 6 months when complementary feeding starts. The activity

will also target training and capacity building of health care workers, mainly doctors, clinical officers,

nutritionists and nurses. The activity also aims to include community-based health care providers and

mothers living positively with HIV.

5. EMPHASIS AREAS / 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. Stigma will be avoided by encouraging

all mothers, HIV positive or negative, to practice exclusive breastfeeding for 6 months.

This activity includes emphasis in the areas of local organization capacity development, development of

community support networks, logistics, human resources, and supportive supervision.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

The only changes to the program since approval in the 2007 COP are:

• The target population has been revised (or expanded) to include specific targeting of couples;

• Other changes include: 1) program quality will be strengthened by ensuring program comprehensiveness;

2) wherever possible, evidence-based programs and approaches will be adopted;

• FY 2007 PLUS UP ADDITIONS: 1) This plus-up will support expanded activities implemented by sub-

grantees under the CHF umbrella funding mechanism as detailed in the 07 COP. Selected PLWHA

organizations and PLWHA networks will roll out prevention activities among Positives through providing

intensified education among members of PLWHA groups and their partners. Linkages will be established

with support groups set up in care and treatment centers as well as those within VCT localities and

communities. A close linkage will be established with counseling and testing services to ensure that HIV-

positive individuals have their partners tested and educated/counseled regularly on sexual risk reduction

(PWP $250,000).

2) Prevention activities will be scaled up through implementation of the Families Matter! intervention by

selected local organizations including faith-based organizations and community organizations for parents in

the general youth population. Parents' skills in communicating HIV prevention with their children will be

enhanced through a curriculum-based training (General Population youth $100,000).

3)Education on gender based violence will also be integrated to existing prevention programs to reduce the

risk and incidence of sexual violence, particularly among adolescent girls and young women. (GBV

$200,000).

• $300,000 of this activity is programmed with funds from the $7 million FY 2008 plus up for the Healthy

Youth Programs Initiative.

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 326,000 individuals will be reached with community outreach programs that promote abstinence

and/or Be Faithful. 2,000 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 an intensive review of their curricula-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.. 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 , 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 326,000

young people in various parts of the country, include young men in the Kisumu area. 2,000 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.

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.

Activity Narrative: 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.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS

This activity requires early funding: $100,000

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in Blood Safety implemented by National Blood Transfusion Service (NBTS)

(#) American Association of Blood Banks (AABB) (#), Internews (#), and APHIA II HC&M (#).

2. ACTIVITY DESCRIPTION

Cooperative Housing Foundation (CHF) will build organizational capacity and provide sub grants to NGOs,

FBOs, and CBOs, resulting in the dissemination of messages for HIV prevention through abstinence,

faithfulness in sexual relationships and where appropriate condom use (ABC). Blood donor mobilizers will

be trained to deliver "healthy life style/ donors love life and safe blood donation" messages to 480,000

potential blood donors aged 16 - 65 years. It is estimated that only one in four potential blood donors

approached actually become blood donors. This implies that to obtain 120,000 blood units in 2006, about

480,000 persons may have heard a pre-donation talk. This activity aims to ensure that HIV prevention ABC

and healthy living messages are given at all pre-donation talks through the development of appropriate

messages and training of blood donor mobilizers in the use of ABC/ healthy living messages for HIV

prevention. This will promote awareness of HIV prevention strategies even for persons who do not donate

blood. 100 blood donor mobilizers will be trained and IEC material produced for this activity. 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 ABC

messages for HIV prevention, training, improvement of community mobilization activities, and referral for

counseling and testing whenever appropriate. This activity will expand existing blood safety programs by

(Bloodlink Foundation (BLF) add new sub partners Africa Society of Blood Transfusion, Kenya Chapter

(AfSBT) and Kenya Red Cross Society (KRCS), and continue to place emphasis in HIV prevention through

provision of safe blood. 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. CHF has supported Bloodlink Foundation to mobilize blood

donors in work places for the last three years with good results. Capacity building activities have included

both strengthening of administrative operations (such as planning and accounting) and technical capacity

(specific ability to implement blood donor work place mobilization programs). This activity includes support

to the following sub-recipients for activities integral to the program: Bloodlink Foundation $180,000; Kenya

Red Cross Society $40,000; Africa Society for Blood Transfusion $100,000. This activity will enable KRCS

and BLF under guidance from CHF to deliver abstinence, be faithful and condom use (ABC) messages for

HIV prevention in blood donor mobilization settings. CHF already works with local organizations to

strengthen implementation of their abstinence curriculum. Two of the sub partners are non governmental

organizations that support the National Blood Transfusion Service (NBTS) in the mobilization of voluntary

nonremunerated blood donors. Specifically, KRCS is mandated to mobilize blood donors from high schools

and colleges, and BLF in work places. A new activity for BLF will be the acquisition of a mobile blood

collection unit to facilitate blood donation sessions in work places. 25,000 employees will be educated about

safer blood donation. AfSBT will work with NBTS and AABB to support and mentor 20 hospital transfusion

committees (HTC) at eight provincial hospitals, two referral hospitals and ten high blood use district

hospitals. Through advocacy with hospital management boards, HTC will be appointed, trained, and

quarterly meetings facilitated for each of the 20 hospitals. The HTCs will serve to review number of

transfusions and sources of blood, determine indications for transfusion, investigate transfusion reactions,

benefits and outcomes, and monitor blood storage and administration conditions and review policies and

procedures regularly. Additionally AfSBT will support NBTS and AABB in dissemination and monitoring of

the implementation of the recently introduced National Standards on Blood Transfusion.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

The blood Safety program aims to increase its contribution towards averting new HIV/AIDS infections in

Kenya. This will be achieved through delivery of ABC messages during mobilization of blood donors

amongst high school students, out-of school youth and workers to encourage abstinence and secondary

abstinence until marriage; increase faithfulness in monogamous relationships among both youth and the

general population; promote HIV testing to encourage abstinence and fidelity. This activity will train 100

individuals to provide HIV/AIDS programs that promote abstinence and/or being faithful. In addition 480,000

individuals will be reached with HIV/AIDS prevention/ blood mobilization programs that will promote

abstinence and/or being faithful. BLF will mobilize blood donors in work places alleviating blood shortage in

the school holiday months. BLF will further its activities of strengthening private public partnerships (PPP) to

mobilize additional resources for the NBTS. Functional HTC will enhance appropriate blood utilization and

minimize unnecessary transfusions. These activities are consistent with the Kenya 5-Year Strategy which

focuses on HIV prevention. 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. The ABC activities will be linked to

other HIV prevention activities including VCT campaigns and volunteer blood donor mobilization for the

prevention of HIV transmission through blood transfusions.

5. POPULATIONS BEING TARGETED

Training institutions such as schools, universities and colleges; CBOS, FBOs and work places form the

main populations that will be reached with ABC messages. Among the 15-24 year olds, the goal is to

increase their knowledge on abstinence and secondary abstinence options and to reach them with

messages about fidelity and expanded/strengthened "A" and "B" activities. In the younger adults the goal is

to increase the practice of abstinence until marriage among unmarried youth and to decrease infidelity and

other harmful behaviors among both youth and adults. Among parents, teachers, community leaders, and

leaders of corporates, the goal is to create a supportive environment for the practice of proven HIV

prevention strategies. Health providers will be trained on appropriate blood use.

Activity Narrative: 6. EMPHASIS AREAS

Major emphasis in this program is local organization capacity development, training and equipping potential

blood donors with relevant life skills for HIV prevention and supportive supervision.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

The only changes to the program since approval in the 2007 COP are:

+ Target populations have been revised (or expanded) to include discordant couples;

+ Organizational and program management capacity will be strengthened to ensure partner organizations

have sound systems for management of program funds and implementation;

+ FY 2007 PLUS UP ADDITIONS: This plus up will support expanded activities targeting prevention with

positives for sub-grantees funded under the CHF umbrella funding mechanism as described in the 2007

COP narrative. CHF will work with a technical agency and consultants to develop materials, adaptations

and translations, guidelines and scripts for use in PWP interventions. CHF will also support stakeholder

meetings and trainings to facilitate the process of developing materials and interventions and rolling these

out to identified communities. Training sessions will be supported as a capacity building process for

PLWHA organizations and networks. CHF will support a rapid roll-out of PWP activities and help monitor

program quality through a well-defined M&E system. Intensive education and counselor for partner testing

and disclosure will be supported to improve PWP among PLWHA in selected groups. Interventions for

targeted groups such as discordant couples will be supported for accelerating prevention. This activity will

also ensure the integration of PWP activities across other program areas to ensure a comprehensive and

rapid implementation of PWP activities. (PWP $250,000).

+ $500,000 of this activity is programmed with funds from the $7 million FY 2008 plus up for the Healthy

Youth Programs Initiative.

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 85,000 individuals will be reached with behavioral interventions and

490 people will be trained in delivering HIV prevention services for high risk populations. 1,126 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 2007 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 2008. 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 sugar belt region in south Nyanza. 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 85,000 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. 490 people will be trained to provide OP services and 1,126 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

Activity Narrative: 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.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

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 4,875 people (including 450

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).

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in Counseling and Testing (#6875) and TB/HIV (#7001).

2. ACTIVITY DESCRIPTION

The Community Housing Foundation will support TB/HIV services for patients in 30 sites. TB screening for

3250 HIV patients and HIV screening for 3100 TB patients will be offered as a standard of care. It is

estimated that 1500 patients will be HIV/TB co-infected. 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 in 2004 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 2008 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 2008 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. The two organizations will also support expanded and strengthened delivery of

integrated HIV and TB services, including strengthened referral systems and building capacity of health

workers to provide integrated HIV and TB services.

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.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

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 5,000 orphans

and vulnerable children (OVC) and train 500 caregivers to provide OVC care. It will provide primary direct

support to 4,000 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

2008, 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 5,000 OVC with access to

essential services, train 500 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 OVC 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.

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

Other changes:

+ the Cooperative Agreement between CDC and Community Housing Foundation ends at the end of FY 07.

In FY 08 this will be advertised again and re-competed. However, in order to ensure continuity, a one year

extension for CHF has been requested by CDC Kenya and granted. For the remaining duration CHF will not

start new activities. It will maintain the activities and sub-partners that it has had in FY 07. It is anticipated

that the new partner will be on board in FY 08. As such some of partners that have traditionally been

supported through CHF will henceforth be supported through this new mechanism. Notably, the Uniformed

Services Project which hitherto was funded through CHF will be moved to the new organization. This

included support to the Kenya Prison service, the Kenya Police, the Administration Police, the National

Youth Service and the Kenya Wildlife Service.

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 2008 CHF will consolidate the expansion of CT activities. This will result in an increase of

CT outlets supported by CHF to 70 through which 200,000 individuals will receive CT services. Apart from

providing the standard individual VCT services, CHF sub-partners will promote Mobile and Home Based

CT, Provider-Initiated HIV testing and counseling (PITC), couple counseling and testing, and ensure that

discordant couples are provided with support and care. CHF will train an additional 200 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 8% of the total USG target for Kenya in FY 2007. 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.

6. 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.

Activity Narrative: THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED REFERE

N/A (exempt)

N/A (exempt)

THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

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 five sub-grantees: Kenya Pediatric

Association (KPA), Kenya Association for Prevention of TB and Lung Disease (KAPTLD), Kenya Episcopal

Conference/Kenya Catholic Secretariat (KEC/KCS), Christian Health Association of Kenya (CHAK) and the

Organization of African Instituted Churches of Kenya (OAIC) in systems 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 5-year National Pediatric HIV Strategic plan,

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 initiating 10,000 infected children on ARVs by the end of FY 2007. The second sub-grantee,

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. The

third sub-grantee, the KEC-KCS 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. The three local faith-based organizations,

namely KEC/KCS, CHAK and OAIC 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.

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

Activity Narrative: 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.