PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2007 2008 2009
THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED
REFERENCES TO TARGETS AND BUDGETS
The only change to the program since approval in the 2007 COP are 1) geographic coverage has been
expanded to include public and faith based health facilities in 11 districts and 2) the provision of a
comprehensive ANC package of care to improve the quality of PMTCT services has been added.
The targets and funding levels have also been changed in order to provide for a complete ANC profile, birth
planning, HIV testing and counseling in ANC and delivery units, ARV and OI prophylaxis, HAART for eligible
women, and counseling on maternal and infant nutrition and improved obstetric care. APHIA II Nyanza will
use a family-centered prevention and care approach, including the expansion of couple counseling and
testing. Wrap around activities with the PMI, family planning and safe motherhood, TB and nutrition
programs will be undertaken in this year.
1. LIST OF RELATED ACTIVITIES
This activity relates to counseling and testing (#8760), abstinence/be faithful (#8989), condoms and other
prevention (#8942), palliative care (#8928), TB/HIV (#9059)) and ARV services (#8774).
2. ACTIVITY DESCRIPTION
USAID's APHIA Nyanza project implemented by EngenderHealth began its support to PMTCT services in
Nyanza Province in FY 2006. In FY 2007 this activity will continue the expansion of PMTCT services in 60
public sector and faith-based health facilities across nine districts in Nyanza Province. In these health
facilities technical assistance will be provided to increase management and technical capacity of staff, and
improve quality and utilization of services. This activity aims to reach 80% of ANC clients, with counseling
and testing, to provide ARV prophylaxis to 90% of the expected HIV+ mothers and early infant diagnosis to
50% of exposed infants. To improve the technical capacity of health staff, 250 will receive training in
PMTCT based on the national guidelines. In the eleven districts, counseling and testing will be provided to
28,965 pregnant women, antiretroviral prophylaxis to 4932 HIV+ women, 2466 of whom will receive the
more efficacious regimen, 986 will receive HAART and 1480 will receive single dose nevirapine. Early infant
diagnosis will be provided to 2,466 exposed babies. Service delivery will continue to incorporate best
practices including op-out testing with same day results, maximally effective combination prophylaxis
regimens, referral for partner testing and appropriate referral linkages to support post natal follow up of
HIV+ mothers and exposed infants. The project will examine ways to improve infant feeding and compliance
to treatment. Priority will be given to provision of integrated services ensuring effective linkages to
treatment, care and support, as well as to family planning and reproductive health services. This will ensure
that pregnant women receive comprehensive HIV care including OI prevention and treatment especially for
TB. Support to infrastructure development, procurement of medical equipment and improved data collation
will enhance service delivery. Behavior change communication (BCC) strategies will focus on stigma
reduction to increase utilization of services, psychosocial support, promotion of ante natal care services and
facility based deliveries.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will work in collaboration with other partners in Nyanza province to improve geographical
coverage for PMTCT services and strengthen service delivery. It will contribute 2.4% of the overall PMTCT
targets in 2008. This will enhance MCH service quality and encouraging rural women in underserved
communities to attend ante natal care services. Referrals and linkages to care and treatment for pregnant
women and infants, and referrals for partner testing will increase opportunities to provide comprehensive
family care and treatment.
4. LINKS TO OTHER ACTIVITIES
This activity relates to activities in counseling and testing (#8760), abstinence/be faithful (#8989), to reduce
stigma and encourage women and families to know their status. It also relates to condoms and other
prevention (#8942), palliative care (#8928), TB/HIV (#9059) and ARV services (#8774) encouraging
healthier behaviors in HIV prevention in care and treatment settings.
5. POPULATIONS BEING TARGETED
This APHIA Nyanza activity targets adults of reproductive health age, pregnant women, family planning
clients, infants, and HIV positive pregnant women. BCC activities will involve community leaders and
community based organizations to increase demand for services amongst community members. Strategies
to improve quality of services will target faith-based and public health doctors, nurses, mid wives and other
health care workers such as clinical officers and public health officers in both public and faith based
facilities.
6. KEY LEGISLATIVE ISSUES ADDRESSED
The behavior change communication activities for STI and HIV prevention will promote gender equity
through partnering with women's organizations in the design and implementation of community activities.
The activity will address male norms and behavior including multiple sexual partners through community
interventions, as well as stigma and discrimination.
7. EMPHASIS AREAS
This APHIA II Nyanza activity has emphasis on gender by addressing male norms and behaviors and
increasing women's access and equity in HIV programs, quality improvement through training and
supportive supervision, task shifting to allow more cadres of staff to offer services, wrap around program
with the PMI, family planning and safe motherhood, child survival and nutrition programs.
REFERENCES TO TARGETS AND BUDGETS.
The only changes to the program since approval in the 2007 COP are:
• geographic coverage has been revised to include Kuria, Gucha and Masaba districts
• $100,000 of this AB activity is programmed with funds from the $7million FY08 plus-up for the Youth
Prevention Initiative
• the KARHP methodology will be rolled out in collaboration with the Ministry of Education, Ministry of Health
and Ministry of Gender, Sports, Culture and Social Services at approximately $250,000
• peer education activities will be rolled out with the Kenya Girl Guides Association
• AB funds totaling $23,000 will contribute to the sensitization of teachers as a worksite population linking
with additional OP and OHPS funds for a $150,000 activity to reach 750 teachers and train 20
1. LIST OF RELATED ACTIVITIES This activity relates to activities in Counseling and Testing (#8760),
OHPS (####) and Condoms and Other Prevention (#8942).
The APHIA II Nyanza project implemented by EngenderHealth initiated support to AB activities in Nyanza
Province in FY 2006. $100,000 of this activity is programmed with funds from the $7 million FY 08 plus up
for the Youth Prevention Initiative. This activity will continue to equip youth with skills to cope with peer
pressure and help them develop positive norms and values to make appropriate and safe choices in
relationships. It will target youth both in and out of school expanding abstinence-based programs for youth
through child-to-child programs in Nyanza Province. Building on the KARHP model, the project will work
closely with the Ministry of Education, Ministry of Health and Ministry of Culture, Sports, Gender and Social
Services. In schools, 100 teachers will be trained in adolescent development, gender issues, and HIV
information and facilitation skills. They will train 900 secondary student peer educators and 1700 primary
student peer educators who will then implement a child-to-child school program targeting primary school
children. Further, 150 youth advocates will be trained to implement youth-to-family activities, a significant
innovation in the community in FY 2008 aimed at reaching out-of-school youth. The program will promote
abstinence and responsible decision making, including promotion of counseling and testing to youth out of
school to reduce the risk of contracting HIV/AIDS. These abstinence and behavior change activities will
reach 250,000 in-school youth in urban and rural settings. Further, 150 youth magnet theatre members from
100 theatre troupes will be trained or re-trained in abstinence and being faithful messages aimed at
reaching out-of-school youth. Much of this work with theatre groups will be interlinked with the peer
educators in religious institutions, a continuing program from the 2007 COP. These activities will reach
250,000 out-of-school youth. This project will work in close collaboration with the National AIDS and STI
Control Programme of the Ministry of Health, ensuring that activities meet the Government of Kenya
priorities and guidelines. In Nyanza Province this activity will be planned, implemented and monitored in
partnership with the District Health Management Teams, District Education Officers, schoolteachers,
employers, community leaders and youth. This will create a continuum of youth-focused activities in the
education, health and community sectors and forge effective linkages aimed at guiding youth toward
practicing safer behaviors. The program will promote abstinence and responsible decision making, including
promotion of counseling and testing to youth out of school to reduce the risk of contracting HIV/AIDS. These
abstinence and behavior change activities will reach in-school youth and out-of-school youth in urban and
rural settings. This activity includes the involvement of church leaders and church-based youth groups to
establish and reinforce norms that reduce youth risk, vulnerability and stigma. The project will utilize magnet
theatre approaches and community radio to reach the general population with HIV prevention messages,
including male circumcision. Community media messages targeting men and encouraging abstinence and
safer behavior will be implemented through work site activities and linkages with faith-based community
groups, churches and mosques. At least $825,000 will be required for PATH to implement prevention
activities.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA In this geographical area AB will contribute
substantively to the Kenya 5-Year Strategy for primary prevention which puts youth first to protect them
from infection. The child-to-child program provides significant support to the strategy targeting pre-
adolescents and their families with appropriate messages. Activities in the general population will include a
special focus on reaching men.
4. LINKS TO OTHER ACTIVITIES This activity relates to activities in counseling and testing (#8760), OHPS
(XXXX) and Other Prevention (#8942). This will expand prevention opportunities for youth and provide
appropriate support for risk reduction.
5. POPULATIONS BEING TARGETED This activity targets girls, boys, and primary school students through
peer education activities. Youth-to-family activities will target adults and out-of-school youth. Community
outreach activities will target community leaders, rural communities, religious leaders and teachers,
community-based organizations and faith-based organizations.
6. KEY LEGISLATIVE ISSUES ADDRESSED This APHIA II Nyanza activity will address male norms and
behaviors, reducing violence and coercion through peer family programs aimed at changing social norms.
7. EMPHASIS AREAS This activity primarily emphasizes community mobilization/participation through peer
education with a minor emphasis on training of youth, teachers and community leaders as detailed in the
activity description in Section 1 above.
+ geographic coverage has been revised to include Kuria , Gucha, and Masaba
+ an additional prevention component focusing on Male Circumcision (MC) was integrated with FY07 plus-
up funds. In FY 08 an additional $800,000 is provided for MC activities in the Northern districts of Nyanza
province.
+ $50,000 of this OP activity is programmed with funds from the $7 million FY08 plus-up for the Youth
+ OP funds totaling $29,000 will contribute to the sensitization of teachers as a worksite population linking
with AB and OPHS funds for a $150,000 activity to reach 750 teachers and train 20 more.
+ APHIA II Nyanza will work with police, uniformed services, women, opinion leaders and others on issues
of gender-based violence
This activity relates to activities in Counseling and Testing (#8760), Abstinence and Be Faithful Programs
(#8989), Prevention of Mother-to-Child Transmission (#8734), Palliative Care: TB/HIV (#9059) and
HIV/AIDS Treatment: ARV Services (#8774).
In FY08, APHIA II Nyanza will reach 400,000 individuals, 2,000 people will be trained and condoms will be
distributed through 100 outlets. The USAID APHIA II Nyanza project implemented by EngenderHealth
initiated support to condom promotion and other prevention activities in Nyanza Province in FY 2006. In FY
2007, this activity will continue to promote the use of condoms in high-risk encounters and support STI
prevention and management in Nyanza Province but with a new focus on prevention strategies for HIV-
positive persons. In 50 public and faith-based health facilities, 300 health workers will be trained to promote
HIV prevention in care and treatment settings. Strengthening and expansion of STI management will
include training of health service providers in syndromic management of STIs with appropriate strategies for
condom promotion through the MCH, VCT, PMTCT and HIV treatment services. Utilizing the Ministry of
Health's Community Strategy, 200 community resource persons (CORPS) especially from women's groups
will be trained to promote health behaviors including faithfulness to their partner, knowing one's HIV status,
using condoms and seeking health care for management of STI's. This activity will include a component of
stigma reduction. In order to reach men, 100 peer educators at informal worksites including beach
communities will be trained in HIV-prevention behaviors. The CORPS and peer educators will implement an
HIV prevention program to reach 200,000 individuals in the community through community outreach and
promotional activities. Community-based organizations and faith-based groups will help to train 200 youth
advocates to use various BCC strategies including community radio and magnet theatre to deliver ABC
messages to 40,000 youth out of school. This activity must include adequate support to the primary sub-
recipient for prevention activities, PATH.
This APHIA II Nyanza project will contribute to the Kenya Five-Year Strategy that focuses on HIV prevention
targeting high-risk groups. It will support access to condoms for those at risk for transmitting or becoming
infected with HIV. In FY 2007, it includes a focus on prevention for HIV-positive individuals.
This activity relates to activities in counseling and testing (#8760), Abstinence/be faithful (#8989) to promote
healthy behaviors amongst youth and reduce stigma by encouraging individuals to know their HIV status. It
also relates to PMTCT (#8734), Palliative Care: TB/HIV (#9059) and ARV services (#8774) expanding HIV
prevention in care and treatment settings.
This activity targets youth, men and women living in rural communities. It targets FP clients and people
living with HIV/AIDS through clinical and community interventions. Training activities target public and faith-
based health care workers. Community outreach activities will target community-based organizations, faith-
based organizations, community leaders, religious leaders and out-of-school youth.
This APHIA II Nyanza activity has a major emphasis on community mobilization/ participation with minor
emphases on training, IEC and local organization capacity development.
The APHIA II Nyanza HBHC activities relate to HIV/AIDS Treatment Services (#8774), Counseling and
Testing (#8760), Other Prevention (#8942), OVC (#9071), TB/HIV Care activities (#9059), AB (#8989),
PMTCT (#8734) and Strategic Information (#8859).
USAID's APHIA II Nyanza project implemented by EngenderHealth began its support to basic health care
support services in Nyanza Province in FY 2006. In FY 2008 this activity will continue to provide basic
health care support services to 20,000 PLWHA in 130 public sector and faith-based health facilities and
communities across six districts in Nyanza Province. In total 500 facility-based and home-based care
workers (CHWs) will be trained in nutrition, prevention, social and spiritual support, and end-of-life care.
Training for health workers will target the management of opportunistic infections and other HIV/AIDS-
related complications. Linkages between health facilities and the community-based activities will be
strengthened for effective care, follow-up, and tracking of referrals. Both health care workers and
community and home-based care volunteer workers will be trained on effective referral. This activity will
work with community leaders and community based organizations to establish linkages to other sectors to
improve the livelihood of people living with HIV/AIDS. This will include microfinance and agricultural
organizations to enhance business skills and agricultural skills.
This activity will help to optimize the quality of life for 20,000 PLWHA in Nyanza province and provide critical
support to families affected by HIV/AIDS. A total of 500 facility-based health workers and CHWs will be
trained in palliative care to improve quality of services.
This activity relates to activities in counseling and testing (#8760), condoms and other prevention (#8942)
and PMTCT (#8734), TB/HIV Care activities (#9059), and ARV Services (#8774) through the formation of
effective referral networks for HIV prevention, treatment care and support services.
This APHIA Nyanza activity targets adults of reproductive health age, people affected by HIV/AIDS and
people living with HIV/AIDS. Linkages to other sectors including agricultural programs and microfinance will
involve community leaders and community based organizations. Strategies to improve quality of services
will target faith-based and public health doctors, nurses, mid wives and other health care workers such as
clinical officers and public health officers in both public and faith based facilities.
This activity addresses stigma and discrimination by encouraging community support for people living with
HIV/AIDS.
This APHIA II Nyanza activity has a major emphasis on training, with minor emphases on community
mobilization/participation and development of networks and referral systems.
Condoms and Other Prevention (#8942), PMTCT (#8734), Palliative care: Basic health care and support
(#8928), and ARV services (#8774).
2. ACTIVITY DESCRIPTION USAID's APHIA Nyanza project implemented by EngenderHealth began its
support to TB/HIV palliative care services in Nyanza Province in FY 2006. In FY 2008 this activity will
continue the expansion of TB/HIV services emphasizing HIV counseling and testing for all TB patients in 15
public sector and faith-based health facilities across five districts in Nyanza Province. The districts targeted
for expanded TB/HIV services are Homa- Bay, Rachuonyo, Gucha, Nyamira, Kuria and parts of Migori
District. Intensified TB screening for 11000 HIV patients and HIV screening for 2000 TB suspects/patients
will be offered as a standard of care in all the facilities; approximately 1000 TB patients will be identified as
being infected with both TB and HIVIn the communities this activity will encourage utilization of health
facilities for TB screening and treatment through a BCC strategy supported by community and faith-based
organizations. This activity will train 90 CHWs to introduce/strengthen community DOTS and encourage
stigma reduction in rural communities. An active contact-tracing program will be established linking the
health facility, the CHWs and home based care providers. In the health facilities technical assistance will be
provided to increase management and technical capacity of staff, and improve quality and utilization of
clinical and laboratory services. This will ensure quality screening and clinical monitoring of patients,
treatment for TB and referral for HIV testing. This activity aims to train 100 health workers, including MOH
laboratory personnel on NLTP guidelines and reporting procedures; quality laboratory services procedures
and comprehensive HIV/TB management. It will provide treatment to 1,000 HIV-infected TB patients. It
prioritizes the screening of all HIV-infected persons, linking HIV-infected TB suspects to TB diagnosis and
TB treatment using DOTS, and linking all HIV-infected TB patients to HIV care and treatment including ARV
and cotrimoxazole therapy. This will strengthen referral linkages between the community, VCT sites,
PMTCT sites, CCCs and TB clinics.
This activity supports one of the priorities of the Emergency Plan by improving geographical coverage of
services that address TB among persons living with HIV/AIDS, and total of 2,000 HIV-infected patients will
receive TB treatment. Referrals and linkages to treatment care and support for HIV-infected TB patients will
be strengthened.
This activity relates to activities in Counseling and Testing (#8760), Condoms and Other Prevention
(#8942), PMTCT (#8734), Palliative care: Basic health care and support (#8928), and ARV services (#8774)
through the formation of effective referral networks for HIV prevention, treatment, care and support services.
This APHIA Nyanza activity targets adults of reproductive health age, pregnant women, people living with
HIV/AIDS and rural communities to increase access to TB/HIV services. BCC activities will involve
community leaders, religious leaders, faith-based and community based organizations to reduce stigma and
improve health-seeking behavior. Strategies to improve quality of services will target faith-based and public
health doctors, nurses, midwives, laboratory workers and other health care workers such as clinical officers
and public health officers in both public and faith based facilities.
This activity addresses stigma and discrimination by enhancing community support for PLWHA and
increasing gender equity in HIV/AIDS programs through increasing opportunity for comprehensive health
care.
This APHIA II Nyanza activities have a major emphasis on community mobilization/participation and quality
assurance, quality improvement and supportive supervision. It has a minor emphasis on training.
This activity relates to activities in TB/HIV (#9059), Palliative Care: basic health care and support (#8928),
ARV services (#8774), and counseling and testing (#8760).
APHIA Nyanza project implemented by EngenderHealth initiated support to OVC in Nyanza Province in FY
2006. It addresses OVC needs adopting the Kenya PEPFAR strategy of addressing seven essential
elements of OVC support. These essential services include: Nutrition, Education, Health, Protection,
Psychosocial support, Basic Material needs and Livelihood Capacity Building. This activity will continue to
employ a broad range of strategies and activities to build the capacity of communities, families and orphans
to meet their needs, and to build the capacity of community-based partners to deliver sustainable high
quality OVC interventions. The APHIA Nyanza project will serve 55,000 orphans and vulnerable children
and provide training to 5,500 caregivers. Working with trained community health workers the project will
implement home based care and other support interventions suitable for the children's well being and
development. A total of 1,100 household members will be trained in palliative care for HIV+ children.
Linkages to food support; vocational training; educational opportunities; income generating activities; will be
strengthened through appropriate community organizations. The project will also build linkages to pediatric
HIV services and other relevant health services.
This activity will reach 55,000 OVC and train 5,500 caregivers in Nyanza province. It will augment the ability
of communities to provide comprehensive services including basic medical and nursing care, counseling
and psychological support, relief for social needs and prevention of HIV. It will strengthen the capacities of
families and communities to make informed decisions on who needs what care and how best to provide it.
The project will work in close collaboration with relevant community groups and government departments to
form networks that will address health improvement, capacity building and food support, vocational and
micro-business training for family income support.
This activity is linked to APHIA II Nyanza activities in TB/HIV (#9059), Palliative Care: basic health care and
support (#8928), ARV services (#8774), and counseling and testing (#8760).
This activity will address individuals infected and affected by HIV/AIDS by targeting caregivers of OVC.
OVC - especially the girl child, as well as building the capacity of other community based and faith based
organizations by working closely with community and religious leaders in the delivery of care to OVC in
each community.
This activity will address issues in increasing gender equity in HIV/AIDS programs as well as wrap around
services in food and education.
Major emphasis area is in development of local organization capacity and minor emphasis in
network/linkages/referral, community mobilization and training.
+ this activity will expand the VCT services within health facilities to provide outreach services including
door to door counseling and testing services
+ APHIA II Nyanza will also provide VCT to men interested in circumcision. This will be supported by
behavior change communication activities, targeting community leaders and youth.
1.LIST OF RELATED ACTIVITIES
This activity relates to activities in abstinence/be faithful (#8989), condoms and other prevention (#8942),
palliative Care: TB/HIV (#9059) and ARV services (#8774).
2.ACTIVITY DESCRIPTION
In 2008, this activity will provide CT services to 50,000 individuals through 35 outlets and train 100
providers in PITC, VCT and HBCT. The USAID APHIA II Nyanza project implemented by EngenderHealth
initiated support to counseling and testing services in Nyanza Province in FY 2006. In FY 2007 this activity
will continue to expand the geographical coverage of this service to increase access for couples and
families. In A total of 25 new CT sites will be established in public and faith based health facilities. Training
in VCT and DCT will be provided for 80 counselors and health care workers respectively. As a result 15,000
individuals will be counseled and tested and referred to care, treatment and other services as required.
Increasing access to antiretroviral therapy dictates that CT efforts quickly transform to accommodate active
case finding through provider initiated testing, PIT, in clinical settings, in addition to the more passive client
initiated testing, CIT. Existing integrated VCT sites are particularly well placed to support these efforts; they
will be strengthened to support DTC efforts e.g. supporting start up activities, providing testing for partners
and other family members of index patients, and providing ongoing counseling. Testing in clinical settings
will require support for logistics, creation and renovation of space especially at inpatient facilities, supportive
supervision, ongoing monitoring, and mainstream CT reporting. Existing supported VCT sites already serve
a large population of young people aged 24 and younger. In addition to existing dedicated youth VCT
services, counselors at general VCT sites will be trained to work with young people. Targeted outreaches to
youth centers and tertiary institutions, will also reach young people. Experiences with comprehensive
counseling services at existing youth VCT centers including alcohol and substance abuse prevention
counseling; gender based violence prevention and counseling, pregnancy prevention/FP; STI prevention,
diagnosis and treatment; and referral to addiction treatment services; will be documented and used to scale
up these efforts at existing general VCT sites. Outreach services, health action days, will require effective
supervision, sessional staff, supplies, data collection and other logistics. BCC strategies supported by
CBOs, FBOs, churches and mosques will encourage people to know their HIV status, and develop
discordant couples support groups.
3.CONTRIBUTIONS TO OVERALL PROGRAM AREA
This APHIA II Nyanza project will contribute to the Kenya 5-Year Strategy that focuses on increasing
access to counseling and testing clinical services. It will provide this service to 15,000 individuals in Nyanza
province prioritizing youth, couples and families.
4.LINKS TO OTHER ACTIVITIES
This activity relates to activities in Abstinence/be faithful (#8989) and condoms and other prevention
(#8942) to promote health behaviors and reduce stigma by encouraging individuals to know their HIV
status. It also relates to Palliative Care: TB/HIV (#9059) and ARV services (#8774) strengthening linkages
between prevention, care and treatment settings.
5.POPULATIONS BEING TARGETED
This activity targets youth and adults living in rural communities. It targets discordant couples and people
living with HIV/AIDS through clinical and community interventions. Training activities target public and
private based health care workers and other health workers. Community outreach activities will target
community based organizations, faith based organizations, community leaders and religious leaders. At-risk
populations will also be targeted with these services like commercial sex workers, discordant couples,
injecting drug users, street youth, truck drivers, migrant workers, out-of-school youth and partners/clients of
CSWs.
6.KEY LEGISLATIVE ISSUES ADDRESSED
The activity will address stigma and discrimination by encouraging people to know their status. The
behavior change communication activities for HIV prevention will promote gender equity through partnering
with women's organizations in the design and implementation of community activities.
7.EMPHASIS AREAS
This APHIA II Nyanza activity has a major emphasis on training and minor emphasis in quality assurance,
quality improvement and supportive supervision and development of network/linkages/referral systems. It
has a minor on emphasis community mobilization/participation as well.
N/A (exempt)
THIS IS AN ONGOING ACTIVITY AND THE NARRATIVE IS UNCHANGED EXCEPT FOR CHANGES IN
TARGETS AND FUNDING LEVEL.
+expansion to 2 new districts and one municipality, support to provincial medical records office and the new
districts to computerize HMIS at the district level, support to about 20 ART sites with more than 250 clients
to computerize their systems to improve data management, drugs management and patient follow-up,
overall provincial reporting target and plan to conduct mid term evaluation. This activity also includes the
development of data quality improvement plan, training data point persons on DQA tools and
implementation of regular data quality audits at sampled health facilities and community level programs.
This activity is related to the strategic information activities to be carried out by University of North
Carolina/MEASURE Evaluation (#7098), NASCOP (#7002) and TE/TBD (#9220).
USAID'S APHIA II NYANZA project implemented by ENGENDERHEALTH began its service delivery
activities in Nyanza province in FY 2006. In FY 2007 this activity will strengthen the provincial and district
level Health Management Information Systems (HMIS) currently in use in Nyanza province MOH health
facilities, and Community Based Program Activity Reporting (COBPAR) currently being rolled out at
Constituency AIDS Control Committees (CACCS) levels by NACC through 3 key components. Component
1: Support APHIA II NYANZA/ENGENDERHEALTH and MOH program data collection processes for
performance reporting needs (quarterly, semi-annual, annual). This component will support a participatory,
coordinated and efficient data collection, analysis, use and provision of information to track achievement of
APHIA II NYANZA/ENGENDERHEALTH and MOH's district level Annual Operation Plan II objectives, and
inform decisions at the local, district and provincial levels, using standardized M&E/HMIS tools approved by
the MOH. Component 2: Strengthen community and facility based reporting systems being rolled out by
NACC and NASCOP. The component will support APHIA II NYANZA/ENGENDERHEALTH and MOH to
measure progress towards its contribution to the overall country's Emergency plan, National Health Sector
Strategic Plan II and Kenya National HIV/AIDS Strategic Plan goals and results frameworks. Specific
activities will include building capacity of 186 local organisations and facilities to collect, report, analyse, and
use both routine facility and non-facility data for planning and program improvement. Component 3: Take
lead role in coordinating M&E activities in the province to meet the information needs of USAID/Kenya, the
Emergency Plan, MOH, NACC and other stakeholders, in line with the "three ones" principle. APHIA II
NYANZA/ENGENDERHEALTH Nyanza will organize district-level consensus building forums on M&E
issues, distribute standardized data collection and reporting tools, conduct regular data quality assurance
processes at all data generation points, train 200 facility based and community based data point staff on the
new data collection/reporting tools and data use for improving program performance, and hold provincial
level quarterly and annual stakeholders' information dissemination meetings. APHIA II
Nyanza/ENGENDERHEALTH will be held accountable for tangible results, especially in increased use of
harmonized data collection and reporting tools at health facilities developed by MOH, increased data use in
planning and at dissemination workshops to various stakeholders, increased supportive-supervisory visits
and routine data quality assessments at all data collection points by M&E/HMIS officers, and improved
coordination of M&E activities in Nyanza province. These efforts should result into demonstrated evidence
in increased national level reporting by up to 80% from health facilities to NASCOP national database.
3.CONTRIBUTIONS TO OVERALL PROGRAM AREA.
The activity builds on the FY 2006 activities that support the national M&E systems as well as contributing
to the Emergency Plan's training outputs. In overall, the activity will provide technical assistance to forty
local organizations/health facilities in strategic information in addition to supporting the training of 110 SI
and program managers in M&E/HMIS, reporting and data use for program management
This activity is related to the strategic information activity to be carried out by University of North
Carolina/MEASURE Evaluation (#7098), where MEASURE Evaluation will be supporting NACC in rolling
out COBPAR system for community level reporting. It is also related to the strategic information to be
carried out by NASCOP (#7002), where NASCOP will be rolling out Form 726, Form 727 and program
specific client registers for data collection and reporting at health facilities. It is also related to SI TE/TBD
(#9220) that will attempt to investigate the causes for low reporting rate by health facilities and recommend
strategies for achieving 100% reporting level by health facilities.
5.POPULATIONS BEING TARGETED.
This activity targets host government and other health care workers like M&E and HMIS officers
responsible for data collection, analysis, reporting and use at both health facilities and community level.
Program managers are as well targeted for orientation on the role M&E program management.
6.EMPHASIS AREAS
The major emphasis area is Health Management Information Systems (HMIS) and minor areas include
Monitoring, evaluation, or reporting (or program level data collection) and Other SI Activities.
THIS IS AN ONGOING ACTIVITY.
The narrative is unchanged except for updated references to targets and budgets.
APHIA II Nyanza/EngenderHealth will help to strengthen the District Health Management Information
System by building the capacity of service providers and health records information officers to prepare and
submit timely and accurate reports. This will include training of 65 MOH officers in Nyanza Province to
improve the utilization of registers and other reporting tools both in clinical services and prevention services.
As an increasing number of clients receive male circumcision services in health facilities and counseling
and testing for the prevention of HIV/AIDS, the project will support the districts to collate this information
accurately in order to track the progress of the male circumcision initiatives. The project will work with the he
project will conduct regular data quality assurance processes at all data generation points, and provide
technical mentoring as required. APHIA II Nyanza/EngenderHealth will be held accountable for tangible
results, especially in increased use of harmonized data collection and reporting tools at health facilities
developed by MOH, increased data use in planning and at dissemination workshops to various
stakeholders, increased supportive-supervisory visits and routine data quality assessments at all data
collection points by M&E/HMIS officers, and improved coordination of M&E activities in Nyanza province. In
total the project will support 15 health facilities in improving the data collection and reporting processes.
These efforts should result into demonstrated evidence in increased national level reporting by up to 60%
from health facilities to NASCOP national database.
THIS IS A NEW ACTIVITY.
1. ACTIVITY DESCRIPTION
USAID APHIA II Nyanza began activities in Nyanza in FY 2006. In FY 2008 APHIA II Nyanza will work to
strengthen the dissemination of key Government of Kenya (GOK) policies and guidelines, developed at
national level, to the district level. In FY 2008 this will include working with the Ministry of Education and
other stakeholders to sensitize teachers about HIV/AIDS prevention and the AIDS policy for the education
sector.
In addition APHIA II Nyanza will support provincial and district health systems strengthening by convening
consultative meetings and various stakeholders' forums. The activity will target to reach at least six of the
twelve districts in the province and train at least 60 individuals on HIV-related policy development.
2. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to strengthening Government of Kenya systems on policy, planning and
budgeting. This will be done by enhancing dissemination and understanding of key government policies
and guidelines, which will be developed or reviewed nationally, out to the districts through provincial
channels.
3. LINKS TO OTHER ACTIVITIES
This activity will link to other APHIA II Nyanza activities, particularly in AB and OP as well as USAID-OHPS-
HPI-TBD-2008 that will be developing and reviewing key policies and guidelines nationally.
4. POPULATIONS BEING TARGETED
This activity will target teachers through activities guided by the Ministry of Education particularly as regards
the dissemination of the AIDS policy for the education sector.
5. EMPHASIS AREAS / KEY LEGISLATIVE ISSUES ADDRESSED
The main emphasis area for this activity will be local organization capacity building via serving to enhance
the management and coordination capacity of district and provincial health management teams in at least
half of the districts in the province served by the implementer.
