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, EMPHASIS AREAS AND BUDGETS.
1. LIST OF RELATED ACTIVITIES
This activity will relate to the ARV services (#8765), Orphans and Vulnerable Children (#9056), Palliative
Care: TB/HIV (#9072), Palliative Care: Basic Health Care and Support (#8936) and Condoms and Other
Prevention (#8874).
2. ACTIVITY DESCRIPTION
Pathfinder International (PI) supports facilities to provide comprehensive antenatal package for all pregnant
women including screening, prevention and treatment for any infections (such as sexually transmitted
infections and malaria), nutrition support, prophylactic ARVS, counseling on safe infant feeding, counseling
and HIV testing of women and their partners. APHIA II Nairobi/Central will build on this work in both Nairobi
and Central provinces. APHIA II Nairobi/Central will continue to support established support groups that are
formed around PMTCT sites by mothers who have benefited from the project services. In addition, referral
linkages will be established within facilities where APHIA II Nairobi/Central is providing antiretroviral
therapy, through which HIV positive clients are assessed and put on treatment where necessary. The
number of HIV positive women and children on treatment is increasing steadily through these networks.
Laboratory networks will also be established that will greatly improve ART uptake as well as early infant
diagnosis. In 2008, APHIA II Nairobi/Central will consolidate these activities and provide HIV counseling and
testing to 47,193 pregnant women and provide antiretroviral prophylaxis to 3772 HIV-positive women. Of
the positive women, 1886 will receive AZT, 754 HAART and 1132 single dose nevirapine for prophylaxis.
1886 exposed infant will receive PCR for early infant diagnosis. At the community level lay counselors will
be trained to strengthen the delivery of PMTCT services and to provide continued support for the HIV-
positive women and their families. The project will train community health workers to provide community
components of PMTCT services. In order to improve the quality of care, 500 health supervisors will learn
management skills, including utilization of data for decision making. In 2008, this project will use its
experience to consolidate progress in existing facilities, expand to others within the two provinces, up to 72
facilities and continue to strengthen District Health Management Teams, and referral networks for PMTCT-
plus activities. Pathfinder will train 180 health workers in PMTCT and comprehensive HIV management for
HIV-positive mothers and their families. Efforts will be made to increase early infant diagnosis in order to
identify infants that require HIV care and treatment and offer more appropriate advice on infant feeding
choices. More efficacious regimens for PMTCT will be introduced and scaled up in all the sites offering
services. Linkages to FP/RH will be made as well as to laboratory services in order to offer a more
comprehensive package of care. Capacity for service providers to provide couple HIV Counseling and
testing within PMTCT sites will be supported with 2008 funds. Many women accessing HIV counseling and
testing at PMTCT sites do not know their partner's HIV status. The program will strengthen innovative
approaches to increase the number of men accessing HIV testing services, thereby enabling discordant
couples to know their HIV status -an important HIV prevention strategy among couples. The program will
reach at least 10,000 couples and will be implemented in Nairobi and Central Province.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to 4% of the overall 2008 Emergency Plan PMTCT targets for Kenya. Community
participation and male involvement will significantly contribute to PEPFAR goals for primary prevention,
access to care and treatment, and support of those affected and infected. Technical assistance to the
Ministry of health facilities will contribute to improvement of the quality of services.
4. LINKS TO OTHER ACTIVITES
Linkages to HIV care and treatment services will be strengthened, to ensure immediate appropriate care for
the woman and exposed infants, and family members as well and thus optimize utilization of
complementary services created through Emergency Plan funding. This activity will relate to the ARV
services (#8765), OVC care (#9056), TB/HIV services (#9072), HBHC (#8936) and STP services (#8874)
funded under the APHIA II Nairobi/Central.
5. POPULATIONS BEING TARGETED
This activity targets adults, pregnant women, HIV-positive pregnant women, HIV affected families, and HIV-
positive infants. Health care providers including Doctors, Nurses and Other Health care workers will be
targeted for training on PMTCT using the national NASCOP PMTCT CDC/WHO based curriculum.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity will address gender equity in HIV/AIDS programs through improved PMTCT service delivery at
ante-natal clinics and maternity units. Community health workers will conduct community mobilization
activities that will help increase service uptake as well as address issues of stigma and discrimination at
community level.
7. EMPHASIS AREAS
This activity includes emphasis on human capacity development through training, supportive supervision
and task shifting, support to strategic information, linkage to family planning, safe motherhood, TB and
nutrition programs as well as Quality Assurance, Community Mobilization/Participation and Development of
Network/Linkages/Referral Systems.
REFERENCES TO TARGETS AND BUDGETS.
The only changes to the program since approval in the 2007 COP:
• $200,000 of this activity supports the Youth Prevention Initiative programmed with funds from the $7
million FY 08 plus up;
• Peer education activities will be rolled out with the Kenya Girl Guides Association;
• The target population has been expanded to include teachers at the worksite: $45,000 in AB funds will go
toward this activity complemented by allocations in OP and OHPS totaling $300,000 to reach 1,200
teachers and train 40 more;
• In response to the Ministry of Education's request the KARHP methodology will be continued at the level
of approximately $225,000 targeting teachers and in-school youth; and
• $150,000 will expand support in HIV prevention and supportive services to victims of gender-based
violence in Nairobi and Central province through the Nairobi Womens Hospital and other facilities.
This activity relates to activities in Counseling and Testing (#8976), Palliative Care: TB/HIV (#9072), and
Prevention of Mother-to-Child Transmission (#8729).
$200,000 of this activity supports the Youth Prevention Initiative programmed with funds from the $7 million
FY 08 plus up. In FY 2008, Pathfinder and its prevention partners, including PSI, will target 600,000 youth
and adults with community outreach HIV/AIDS prevention programs that promote abstinence and/or being
faithful. Peer education, informal and formal worksite interventions, community outreach by PLWA, mobile
VCT and life skills education for youth will all serve as a means through which messages will be conveyed.
An in-school program for 10 to15 year olds will emphasize creation of support systems for students to focus
on long-term goals, self-esteem and life skills. Emphasis will be on delayed sexual debut, and secondary
abstinence will be encouraged for those youth who are already sexually active. APHIA II community-level
partner capacity for undertaking prevention and behavior change activities will also be strengthened, so that
messages can be conveyed widely through implementing partners undertaking home and community
support activities as well. It is expected that 130,000 individuals will be reached with community outreach
HIV/AIDS prevention programs that promote abstinence and/or being faithful, while 500 persons will be
trained to provide HIV/AIDS prevention programs that promote abstinence and/or being faithful. Additional
project partners to be trained in Other Behavior Change will also contribute to AB message dissemination.
There will be a component of Prevention with Positives whereby the Project will work through PLWHA
Support Groups linked to the Comprehensive Care Centres in Nairobi and Central Provinces. $100,000 of
plus-up will provide support to patient support groups and post-test clubs in VCT Centres to ensure
abstinence by HIV-infected persons. This will empower 5 people in each of the 15 patient support groups to
become peer and advocacy leaders in prevention at the community level and will reach 30,000 PLWAs.
The PwP activity is additional to the narrative in the 2007 COP narrative for this prime partner. $200,000 of
plus-up funds will enable APHIA II Nairobi Central to expand their work with the Kenya Girl Guides
Association by training 2,500 Girl Guides to reach 350,000 in-school youth with abstinence and being
faithful messages. $150,000 will expand support in HIV prevention and supportive services to victims of
gender-based violence in Nairobi and Central province through the Nairobi Womens Hospital and other
facilities. This activity will reach 20,000 youth. $150,000 will be used to reach high risk out-of-school youth
including street children with AB messages. This activity will reach 70,000 youth.
This activity will contribute significantly to the overall 2007 Emergency Plan AB Prevention targets for
Kenya. Integrating prevention into all community outreach for treatment and care, with special emphasis on
men and youth, will significantly contribute to PEPFAR goals for primary prevention and the Kenya Five-
Year strategy for HIV/AIDS.
4. LINKS TO OTHER ACTIVITIES
Support to AB Prevention will be one component of a package of integrated support at health facility and
community levels in the region, holistically addressing HIV prevention, treatment and care. This activity
relates to activities in Counseling and Testing (#8976), Palliative Care: TB/HIV (#9072), and PMTCT
(#8729) through referrals and networking.
The activity targets youth with messages about abstinence and both adults and youth with messages
advocating faithfulness to one partner. Special emphasis will be placed on reaching men through outreach
by PLWAs and involvement of community leaders, by couples counseling in PMTCT and through worksite
interventions. Implementing partner counterparts from NGOs, CBOs, FBOs and schools will be targeted for
training to implement prevention programs.
This activity will be consistent with national strategies for HIV prevention promoting abstinence, delay of
sexual debut including secondary abstinence, fidelity, partner reduction and related community and social
norms.
There will be a major emphasis on capacity building of implementing partners, community-owned resource
persons and other community level implementing partners. Community involvement in the design and
implementation of activities will play an integral part in ensuring the success of these interventions.
The only changes to the program since approval in the 2007 COP are:
+ $100,000 of this OP activity is programmed with funds from the $7million FY08 plus-up for the Youth
Prevention Initiative
+ OP funds totaling $58,500 will contribute to the sensitization of teachers as a worksite population linking
with AB and OPHS funds for a $150,000 activity to reach 1,500 teachers and train 40 more.
+APHIA II Nairobi/Central will work with select health facilities, police, uniformed services, opinion leaders
and others on issues of gender-based violence.
+ The OP activity will include Prevention with Positives (PwP) activities working through PLWA support
groups linked to the Comprehensive care Centers
+ APHIA II Nairobi/Central will also expand their activities with CSWs and MSMs.
+ APHIA II Nairobi/Central will continue work with select health facilities, police, uniformed services, opinion
leaders and others on issues of gender-based violence.
This activity is linked to Palliative Care: Basic Health Care and Support (#8936), Counseling and Testing
(#8976), and Palliative Care: TB/HIV (#9072).
In FY 08, APHIA II Nairobi/Central will reach 350,000 individuals, train 1,000 people and distribute condoms
through 25 outlets. This activity will strengthen HIV prevention programs through other behavior change
approaches (i.e. all behavior change approaches that do not focus on abstinence and being faithful) under
the APHIA II Nairobi/Central Province Project. In FY 2007, Pathfinder and its prevention partners, including
PSI, will target youth and adults with behavior change messages that are appropriately adapted to different
target groups. Peer education, informal and formal worksite interventions, community outreach by PLWA,
mobile VCT, life skills education for youth, high-risk outreach and transport corridor activities will all serve as
means through which messages will be conveyed. In particular, the project will capitalize on PSI's
experience in targeting informal worksites, market places, and "hot zones" where high-risk behavior is
common. Street theater, interactive games, PLWA testimonials, outreach sessions and community
mobilization will be used to convey messages that include consistent and correct use of condoms, knowing
one's status and knowing your partner's status. APHIA II community level partner capacity for undertaking
prevention and behavior change activities will also be strengthened, such that messages can be conveyed
widely through implementing partners and undertaking home and community support activities. It is
expected that 74,000 individuals will be reached with community HIV/AIDS outreach prevention programs
that are focused on more than just abstinence and/or being faithful, while 275 persons will be trained in the
same. At the same time, 15 condom outlets will be installed to provide easy access.
This activity will contribute significantly to the overall 2007 PEPFAR OP targets for Kenya. By specifically
focusing on men and youth, this activity will significantly contribute to PEPFAR goals for primary prevention
through the integration of prevention into all community outreach for treatment and care.
Support to Prevention/Other Behavior Change will be one component of a package of integrated support at
health facility and community levels in the region, holistically addressing HIV prevention, treatment and
care. It is specifically linked to palliative care, basic health care (#8936), counseling and testing (#8976),
and palliative care, TB/HIV (#9072).
This activity targets both adults and youth, with additional emphasis on worksites to reach men as well as
high-risk groups and persons frequenting/working in "hot spots". It will target special populations such as
bar maids to improve their HIV risk awareness, their rights as bar maids and how they can protect
themselves from acquiring HIV infection. Implementing-Partner counterparts from NGOs, CBOs, FBOs and
schools will be targeted for training to implement prevention programs.
This activity will be consistent with national policies regarding other prevention and will specifically address
gender to improve gender equity in HIV programming as well as address male norms and behavior that
often hinder uptake of prevention activities.
This activity includes major emphasis on worksites and minor emphases implementing-partner capacity
building, linkages with other sectors and initiatives and training. With $150,000 in plus-up funding APHIA II
Nairobi/Central will expand their activities to target 100,000 high-risk youth by training 50 peer educators.
HIV prevention activities targeting glue-sniffing youth, a growing IDU population, and other alcohol and
susbstance abusers will be expanded in Nairobi and Central province. With $250,000 they will focus on HIV
prevention with 100,000 male and female sex workers to promote alternatives to commercial sex work as
well as protective barriers to prevent HIV transmission, both with commercial partners and steady
boyfriends/girlfriends and husbands/wives. To do this they will train 50 adults. In addition they will use
$100,000 to expand support in HIV prevention and supportive services to 20,000 victims of gender-based
violence in Nairobi and central province through the Nairobi Womens Hospital and outreach centers and
train 20 health workers and community participants.
The APHIA II Nairobi/Central HBHC activities will relate to HIV/AIDS treatment services (#8765),
Counseling and Testing (#8976), Other Prevention (#8874), OVC (#9056), TB/HIV care activities (#9072),
AB (#8731), PMTCT (#8729) and Strategic Information (#8870).
This activity relates to care and support for people and families affected by HIV/AIDS under the APHIA II
Nairobi/Central Province Project. In FY 2008, Pathfinder International (PI) and its partners will target 13,000
people with home and community based palliative care in Nairobi and Central Province. Palliative care
(basic) will include a comprehensive package of community home-based care consisting of home nursing,
clinical care, nutrition, STI/HIV prevention, education, OVC care, paralegal support and protection,
psychosocial and spiritual support and links to income generating activities. PI will work with local
implementing partners including established NGOs, CBOs, and FBOs. PI will strengthen the technical and
institutional capacity of partners and build collaborative working relationships with a variety of stakeholders
to encourage effective, efficient programming. Gender and youth issues will be addressed. PLWHA will be
involved to ensure expansion and high quality of care and support programming. To promote GIPA, PLWHA
will be recruited through implementing partners such as KENWA and others as CHWs, as they can be
particularly effective not only in improving the quality of services but also in combating the serious issue of
stigma.
This APHIA II Nairobi/Central activity will reach 13,000 clients and 200 individuals will be trained to provide
palliative care through 50 service outlets. This APHIA II Nairobi/Central activity responds to NACC's priority
areas #2 "Improve the quality of life of people infected and affected by HIV/AIDS" and #3 "Mitigation of socio
-economic impact". It is expected that the APHIA II- Nairobi/Central will adhere to GOK policies and
guidelines and participate in national-level HIV technical working groups.
Linkages to clinical services will be established through a two-way referral system and will include HIV/AIDS
treatment services (#8765), Counseling and Testing (#8976), Other Prevention (#8874), TB/HIV care
activities (#9072), AB (#8731) and PMTCT (#8729). Clinical supervisors and other health care providers will
reinforce clinic to community referrals by being kept up-to-date on local resources for psychosocial,
economic, legal and food security support. PI will link with local partners such as K-Rep to address
economic insecurity through microfinance and business skills training. Implementing partners will
collaborate with local programs and agencies to address food insecurity and nutrition needs.
This activity targets people and families affected by HIV/AIDS. Local implementing partners will be targeted
for training and capacity building. Health care providers will be targeted for sensitization and training related
to home-based care. CHWs and caregivers will be trained and receive periodic refresher training.
Groups/Organizations targeted include community-based and faith-based organizations.
6. KEY LEGISLATIVE ISSUES ADDRESSED This activity will address issues of stigma and discrimination
by improving the health and lives of the PLWAs, allowing them to provide increased care for their children
and potentially return to work.
This activity includes major emphasis on quality and expansion of home-based care, linkages between
community and formal health care sector, development and strengthening of networks and referral systems.
This activity will be linked to ARV services (APHIA II Nairobi/Central), Basic Health Care services (#8936),
CT Services (#8976) and other TB/HIV activities (#7001).
This activity relates to support for strengthening and expanding palliative care in clinical settings addressing
TB and HIV. Pathfinder International (PI), the lead partner in APHIA II Nairobi/Central will develop and
implement new interventions, expanding and integrating service delivery in Year 1 and Year 2 sites targeted
under the APHIA II Nairobi/Central Project and adding new ones. In 2008, 52 sites (17 in Central and 35 in
Nairobi) will be supported in provision of TB/HIV services. Through these sites, Intensified TB screening
for 6500 HIV patients and HIV screening for 3000 TB suspects/patients will be offered as a standard of care
in all the facilities; approximately 1500 TB patients will be identified as being infected with both TB and
HIV. Emphasis will be on filling gaps in service delivery and linking to community based services. TB
prevention, treatment and care programs will be strengthened and effective linkages made between TB and
HIV services. Service quality and supervision at all levels of facility care and referral will be improved. Drug
supply management, case management, records systems, supervision and community-based
adherence/follow-up will be strengthened. All health facilities targeted by the project will provide OI
treatment, including TB, cotrimoxazole prophylaxis, and nutritional support. APHIA II Nairobi/Central will
work to expand diagnostic and DOTS case management capacity. According to GOK policy, all HIV+
patients will be screened for TB, and all TB patients tested for HIV. Malteser International a PI partner, will
provide guidance for training of nurses and community health workers, annual refresher training on
TB/HIV/AIDS care and education and basic training on clinical observation and case management. In 2008,
200 health workers will be trained to provide treatment for TB to HIV infected individuals PI will ensure that
cotrimoxazole prophylaxis, de-worming, intermittent treatment for malaria, and ITNs are provided at all HIV
care sites in collaboration with KEMSA and PSI. Lab staff will be trained to be more responsive to the needs
of TB patients. In FY 2008 PI will pilot ART provision in TB clinics in an effort to decentralize and treat
patients where they are presenting for care pending successful piloting of this activity in 2007. In both
Nairobi and Central 1500 HIV infected people will be administered TB therapy, 200 health care workers will
be trained in TB/HIV services from a total of 20 sites.
This activity will result in 1500 persons accessing TB/HIV services in Nairobi and Central, as well as better
prevention and control of urban TB in Nairobi.
Clinic-based palliative care is one component in a comprehensive treatment and care approach under
APHIA II, such that clients will benefit from long term ART as appropriate and linkages to community
services. Linkages will also be made with the NLTP and VCT sites.
This activity targets in-patients and clients of DTC, TB-ward patients and clients of home and community
support services who are referred for clinical care by community health workers. Health care providers
including Doctors, Nurses and Other Health care workers will be targeted for training using national
curricula.
This activity will address stigma and discrimination against persons infected with HIV.
This activity includes major emphasis on Quality assurance and supportive supervision with additional focus
on training; development of networks/linkages/referral systems
This activity relates to counseling and testing (#8976), ARV Services (#8765) and palliative care: Basic
Health Care and Support (#8936).
This activity relates to expanded support to be provided to OVC. Pathfinder International (PI), the lead
partner in APHIA II Nairobi/Central, will partner with Christian Children's Fund (CCF) to provide integrated,
age-appropriate services to build resilience of children infected with and affected by HIV/AIDS. Emphasis
will be placed on development of healthy and supportive home and community environments where OVC
and guardians/families have access to psychosocial support, education, health and nutrition services,
economic livelihood support, shelter and protection from exploitation and abuse. Institutional capacity and
technical expertise of implementing partners will be strengthened. OVC support will be integrated with and
linked to the project's home and community support. Village Health Committees and implementing partners
will identify OVC, who are often in the same households as those individuals receiving home-based care
and support.
It is anticipated that in FY 2008 a total of 13,600 OVC in Nairobi and 20,000Central (total 33,600) will be
reached. Training of individuals in caring for OVC will cover 1,400 people in Nairobi and 2,100 in Central
(total caregivers 3,500). A total of 50 implementing partners (IP) (20 in Nairobi; 30 in Central) will be
supported to provide care and support for OVC. Caretaker support groups will include OVC needs (8 in
Nairobi and 12 in Central). This will contribute to the overall 2008 emergency Plan OVC targets for Kenya.
This activity will be linked with other Pathfinder International APHIA II activities in the areas of counseling
and testing (#8976), ARV Services (#8765) and Palliative Care: Basic Health Care and Support (#8936) in
both Central and Nairobi Provinces.
This activity targets orphans and vulnerable children, caregivers, Community Health Workers, guardians
and educators involved with OVC. Capacity building efforts with the local communities will focus on the
community and religious leaders as well as partnering with other community and faith based groups that
exist in the area.
Issues addressed are stigma and discrimination and the wrap around services in food and education.
This activity includes major emphasis in the development of the local organization and minor emphasis in
the areas of community mobilization and participation.
+ geographic coverage has been revised and expanded to include additional districts in the Nairobi and
Central Province
+ target population will be expanded to include OVCs
+ APHIA II Nairobi and Central will expand counseling and testing services within the province and include
outreach services provided through existing and new VCT sites that are integrated within health facilities.
The CT services will include door to door VCT and testing of family members of the infected individuals
receiving care and treatment within the facility.
This activity is related to activities in HIV/AIDS treatment services (#8765), abstinence and be faithful
(#8731), TB/HIV care (#9072), OVC (#9056), HBHC (#8936), other prevention (#8874), PMCT (#8729) and
strategic information (#8870)
In 2008, APHIA II Nairobi/Central will reach 200,000 individuals with counseling and testing services
including PITC, VCT, and HBCT through 75 outlets and 500 providers trained. This activity relates to
support to be provided to increase VCT coverage while taking account of the need to emphasize diagnostic
testing and counseling (DTC) as well. New VCT sites may be needed, for example, in large companies
where employees lack easy access. Mobile VCT will complement fixed sites. Youth friendly services will be
emphasized. Where possible, VCT will be integrated with facility and community level treatment and social
support services for individuals testing positive and with prevention activities for discordant couples and
individuals testing negative. DTC will be scaled up in support of the National AIDS and STI Control
Program. Year 1 will see expansion and strengthening of DTC in imperative site facilities, PMTCT and blood
transfusion sites and in district hospitals and health centers with laboratory capacity. A subcontractor will
train counselors from target facilities and work with GOK and NGO counterparts to ensure supervision.
Individuals who test positive will be systematically referred to CCC and higher levels for comprehensive
testing and linkages to community services. Pathfinder will liaise with NASCOP to ensure HIV test kit
supply. It is anticipated that in FY 2007, 31,900 people in Nairobi will be tested in 40 sites while 9,100 will
be tested in Central in 10 sites. In Nairobi in FY 2007, 86 people will be trained in counseling and testing
while Central will have 54 people trained as counselors.
This activity will contribute to COP 07 Counseling & Testing targets for Kenya. Integrating promotion of VCT
into all community outreach for treatment and care will significantly contribute to PEPFAR goals for primary
prevention.
Support to counseling and testing will be a linchpin activity in APHIA II resulting in increased numbers of
individuals accessing care, treatment and support and in strengthening prevention efforts. The APHIA II
Nairobi and Central Provinces activities will relate to HIV/AIDS treatment services (#8765), abstinence and
be faithful (#8731), TB/HIV care (#9072), OVC (#9056), HBHC (#8936), other prevention (#8874), PMCT
(#8729), and strategic information (#8870)
This activity targets a wide range of population groups, including, for DTC, those receiving other clinical
services, and for VCT, the general population, with emphasis on sexually active individuals, youth, and high
risk groups such as bar workers, matatu and other transport workers. Health service providers will be
targeted for training. All efforts are in coordination with the National AIDS control program staff. Community
based and faith based groups will also be targeted in the community mobilization of CT services.
This activity will address gender, stigma and discrimination through post test clubs and legislation related to
protection of human rights and confidentiality.
This activity includes major emphasis on capacity building of C&T providers and CHWs. The activity
emphasizes VCT as a major prevention strategy. IPs, CORPS and other community level implementing
partners are key to its success. Training is a major emphasis area and this activity will train 140 people to
implement CT activities. Minor emphasis is also in community mobilization.
N/A (exempt)
THIS IS AN ONGOING ACTIVITY.
The only change to the program since approval in the 2007 COP is
+ the planned development of improved tools and models for collecting, analyzing and disseminating
HIV/AIDS behavioral and health monitoring information including health facility surveys, plan to conduct
operations research that will illuminate areas of data management requiring strengthening and
development. 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. Targets and funding levels have also changed.
1.LIST OF RELATED ACTIVITIES
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).
2.ACTIVITY DESCRIPTION
This activity will strengthen the provincial and district level Health Management Information Systems
(HMIS) currently in use by MOH at 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 NAIROBI-CENTRAL/PATHFINDER
INTERNATIONAL 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 NAIROBI-
CENTRAL/PATHFINDER INTERNATIONAL 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 NAIROBI-
CENTRAL/PATHFINDER INTERNATIONAL 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 the 83 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 NAIROBI-CENTRAL/PATHFINDER
INTERNATIONAL 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 100 facility 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 Nairobi-Central/Pathfinder
International 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 Nairobi/Central provinces. These efforts should result into demonstrated evidence in increased
national level reporting by up to 60% 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.
4.LINKS TO OTHER ACTIVITIES
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 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 workers 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 A NEW ACTIVITY.
1. ACTIVITY DESCRIPTION
USAID APHIA II Central/Nairobi began activities in Central/Nairobi in FY 2006. In FY 2008 APHIA II
Central/Nairobi 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 Central/Nairobi will support provincial and district health
systems strengthening by convening consultative meetings and various stakeholders' forums. The activity
will target to reach at least four of the districts in Central and four of the districts in Nairobi and also train 100
individuals on HIV-related policy development from both provinces.
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 Central/Nairobi 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 provinces served by the implementer.
