Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 7792
Country/Region: Kenya
Year: 2008
Main Partner: Christian Reformed World Relief Committee
Main Partner Program: NA
Organizational Type: Unknown
Funding Agency: USAID
Total Funding: $0

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $0

THIS IS A NEW ACTIVITY.

1. LIST OF RELATED ACTIVITIES

CRWRC's activities in the program area of PMTCT are closely related to a great degree with CRWRC's

activities in the Counseling and Testing program area, since the health facilities providing PMTCT services

will also be providing counseling and testing services.

2. ACTIVITY DESCRIPTION

In partnership with three faith-based organizations in Kenya, namely; Western Region Christian Community

Services, an agency of the Anglican Church of Kenya, will implement the program in all eight districts of the

Western Province. KAMATAKIMO, which is also an agency of the Anglican Church, will target Kitui and

Mwingi districts in Eastern Province. Plateau Mission Hospital, an agency of the Reformed Church of East

Africa, will target Uasin Gishu district in Rift Valley Province. Christian Reformed World Relief Committee

(CRWRC) will equip 26 health facilities during FY 2008 to provide a minimum package of PMTCT services.

These health facilities will be selected based on a review of existing health facility assessment data and with

the intention of filling service gaps.

This program has the following components; firstly, the 26 service outlets will be refurbished and/or

equipped in ways that may include repair of roofing; reconnecting water; fixing gutters for rain water

collection; and acquisition of examination room tables, chairs, charts, scales, HIV/AIDS reference manuals,

posters, and other similar supplies. Refurbishing and equipping the facilities, along with retraining health

personnel are needed to assist many local health facilities to be able to provide the minimum package of

PMTCT services, including counseling and testing for pregnant women, ARV prophylaxis to prevent MTCT,

counseling and support for safe infant feeding practice, and family planning counseling or referral.

Secondly, certified trainers from the Ministry of Health and the Kenya Institute of Professional Counselors

will provide on-the-job training to 283 community-based health workers at the identified health facilities.

Training will be provided to them in their own districts and sub-locations using the National Guidelines for

CT training in Kenya. The counseling portion of the training will be done through an intensive five-day

training workshop. After the training, the health workers will receive ongoing supervision from district-level

Ministry of Health (MOH) officers.

This activity will target pregnant women and newborns residing in the poor, rural communities located near

the newly refurbished and equipped health facilities and encourage them to access the comprehensive

antenatal services, which will include counseling and testing for HIV and other PMTCT services. The

activity will also seek to educate men on the topic of PMTCT and encourage their participation at their

partners' prenatal check-ups. Men will be targeted through existing community groups such as local men's

groups in the barazas or through church groups like the Kenya Anglican Men's Association. The review of

existing KAP data and barrier analysis will inform the process of designing the behavior change activities

and messages related to PMTCT.

Thirdly, at least 530 pregnant women will be provided with counseling and testing services and will receive

their test results from health facilities operated directly by CRWRC's local partners. Of these, it is expected

that 100 will be provided with a complete course of antiretroviral prophylaxis - which may include the

following regiments; Nevirapine, Lamivudine, Azidothymidine or Zidovudine - these are provided to health

centers certified by the Ministry of Health. Another 520 will be referred to other health facilities that offer the

minimum package of PMTCT services. Community health workers will be trained to make these referrals.

These 283 community health workers will target women with the least knowledge of PMTCT and their male

partners at antenatal check-ups and during bi-weekly house-to-house visits.

3. CONTRIBUTIONS TO OVERALL PROGRAM

This activity will contribute toward the 5-year target of preventing 7 million new infections by preventing the

transmission of the virus from mother to child. By assisting 26 health facilities to upgrade their PMTCT

facilities and by providing critical training for 283 community health workers in the delivery of PMTCT

services, CRWRC and its partners will build local capacity in the area of referral and tracking of PMTCT

recipients for long-term prevention programs. Knowledge about mother to child transmission of HIV is very

low among rural and disadvantaged people in Kenya. Using behavior change communication to encourage

pregnant women and their sexual partners to be tested will create demand for the services in an area where

so far only a small percentage of pregnant women are using PMTCT services.

4. LINKS TO OTHER ACTIVITIES

A major priority will be for CRWRC and its partners to collaborate with other pre-existing HIV/AIDS service

providers in all three working areas so that the CRWRC NPI program can be linked to services offered by

these organizations. CRWRC and its partners have already begun this networking process by initiating

communication with PATH, Family Health International, and JHPIEGO, which are the three agencies

implementing APHIA II in the same provinces that CRWRC and its partners are targeting under the NPI

program. CRWRC and its partners will develop a system for tracking and following-up on referrals for

PMTCT.

5. POPULATIONS BEING TARGETED

In partnership with three faith-based organizations in Kenya, CRWRC will scale up PMTCT services in all

eight districts of the Western Province, Kitui and Mwingi districts in Eastern Province, and Uasin Gishu

district in Rift Valley Province.

Pregnant women aged 15-49 and their husbands or partners (males 15 and over) will be targeted by

community-based health workers during antenatal check-ups and bi-weekly house-to-house visits.

Pregnant women will be encouraged to seek counseling and testing for HIV within comprehensive antenatal

services. Husbands or partners will also receive counseling to allow their wife or partner to be tested for

HIV and will be sensitized on the need for the wife or partner to deliver her baby in a health facility.

Pregnant women who are HIV+ will be treated with a full course of ARV prophylaxis or referred to another

health facility where treatment can be obtained.

6. KEY LEGISLATIVE ISSUES ADDRESSED

Key legislative issues are included in the emphasis areas described in section 7 below.

Activity Narrative:

7. EMPHASIS AREAS

CRWRC and its partners will address gender in the PMTCT program area by addressing male norms and

behaviors regarding HIV counseling and testing and not preventing their female partners from accessing

other needed antenatal health services. CRWRC and its partners will also focus on human capacity

development through a five-day in-service training of clinic-based health workers in counseling and testing

for pregnant women. CRWRC and its partners will also work with health facility workers and community

health volunteers to develop a health worker and volunteer retention strategy that aims at enabling health

worker develop an action plan to recognize the roles played by volunteers in the program and enables

health workers to develop activities towards volunteer recognition. Other emphasis areas to be addressed

by this program area include CRWRC's on-going local organization capacity building of the three partner

organizations and coordination of the health management information system for tracking referrals of HIV+

pregnant women for ARV prophylaxis. This program area is funded through the New Partner Initiative.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $0

THIS IS A NEW ACTIVITY.

1. LIST OF RELATED ACTIVITIES

CRWRC's activities in the AB program area are closely liked with CRWRC's other activities in the

Counseling and Testing program area. Messages about the need for everyone to be tested will be built into

all the HIV prevention education and emphasized in the TOT for church and community leaders who will

promote testing in their congregations and communities. Opportunities for testing and counseling will be

available at awareness campaign events.

Education support, vocational training, and other assistance that CRWRC and its partners are providing to

adolescent girls (10-17) under the OVC program area is intended to reduce the vulnerability of female OVC

to coercive and transactional sex and thereby empower them to choose abstinence.

2. ACTIVITY DESCRIPTION

In partnership with three faith-based organizations in Kenya, Christian Reformed World Relief Committee

(CRWRC) will implement activities focused on promoting abstinence and being faithful. The three partners

namely; Western Region Christian Community Services, an agency of the Anglican Church of Kenya, will

implement the program in all eight districts of the Western Province. KAMATAKIMO, which is also an

agency of the Anglican Church, will target Kitui and Mwingi districts in Eastern Province. Plateau Mission

Hospital, an agency of the Reformed Church of East Africa, will target Uasin Gishu district in Rift Valley

Province. During FY 2008, CRWRC and its partners will reach 90,973 individuals through community

outreach that promotes HIV/AIDS prevention through abstinence and/or being faithful and train 1,420

individuals to promote HIV/AIDS prevention through abstinence and/or being faithful.

The 90,973 individuals shall be reached through outreach meetings directly organized by the 1,420

individuals within the following population groups: Firstly, out of the 1420 individuals trained using the

Choose life manual, 1,120 church and community leaders will use congregation and community based

meetings to reach at least 88,233 individuals through barazas, church and community group meetings such

as the "men who care groups" through which 2380 men and boys will be reached in 68 groups (as

described below). Through these meetings, church and community leaders will also address women's

legal rights namely where they can access reproductive health services in their communities. Secondly; the

three hundred peer educators trained by the training-of-trainers (TOTs) - 3 NPI program coordinators and at

least 3 field officers- will form peer groups by identifying other youth in their own networks. Three hundred

peer educators will be recruited and trained in FY 2008. A total of 1,260 youth will be participating in 60

youth to youth groups and an additional 1480 through youth to family and "writing on the walls" across all

three partner working areas.

CRWRC will use the Choose Life and Creating Positive Relationships training manuals in peer education

and support groups for youth. Using stories, illustrations, and discussion questions, these manuals guide

youth's understanding of sexuality and HIV/AIDS covering topics such as decision-making, peer pressure,

family life, body changes, STIs and HIV/AIDS, and AIDS in the home. Motivators like the abstinence pledge

card and "Writing on the Walls" activities will be used to encourage abstinence and fidelity.

Youth-to-Family (Y2F) groups will equip in-school youth to share information about HIV prevention and

treatment services with their families. Youth who have a strong understanding of the HIV/AIDS epidemic

and of gender will be identified through pre- and post-testing in the peer education groups. A total of 740

youth will be participating in 34 groups across all three working areas.

"Men Who Care" (MWC) groups will recruit men as positive role models for youth and will promote

accountability among older men to model abstinence, if unmarried, and fidelity, if married. A total of 2,380

boys and men will participate in 68 groups. The MWC groups will be set up under the supervision of the

trained church and community leaders in collaboration with program staff. The men will be recruited through

barazas and existing church groups such as the Kenya Anglican Men Association.

"Writing on the Walls" is an activity that will be used to engage young people in reflection on HIV, risk,

prevention, and abstinence options through theatre, wall painting, and essay writing. A total of 740 youth

will participate in 34 groups across all three working areas. This activity will be integrated in some places

with the Y2Y peer education and support groups. Church and community leaders will form accountability

partnerships with adolescents who make abstinence pledges through Writing on the Walls and pledge cards

during awareness campaigns.

In FY08, CRWRC and its partners will reach 88,233 people through awareness campaigns at churches,

schools, youth groups, women's groups and community forums. Campaigns will be organized and led by

the 1,120 trained church and community leaders. Some of the events will be separate for youth, men and

women, while others will be gender mixed. Awareness campaigns will address barriers to AB behaviors

through drama, youth competition days, youth and parent forums, lectures, and public events. Opportunities

for testing and counseling will be available at these events.

3. CONTRIBUTIONS TO OVERALL PROGRAM

This activity will contribute toward the 5-year target of preventing 7 million new infections by reducing the

sexual transmission of the virus in Kenya. CRWRC and its FBO partners will use behavior change

communication to promote abstinence (including "secondary abstinence") among unmarried youth and

faithfulness among married and sexually active adult couples. Some of the elements of the 5-year strategy

that are incorporated into the design of the CRWRC include reinforcing the role of parents (through Y2F);

challenging norms for male behavior (through MWC); and using behavior change strategies to promote

abstinence among youth (through Y2Y peer education and support groups and Writing on the Walls).

Because CRWRC's partners are agencies of the Anglican Church of Kenya and the Reformed Church of

East Africa, partner staff will contribute greatly to the promotion of healthy norms and behaviors as they

train local religious and other traditional leaders how to incorporate behavior change messages into their

sermons and public remarks.

4. LINKS TO OTHER ACTIVITIES

The AB interventions will draw upon lessons from existing ABY programs that CRWRC and its partners

Activity Narrative: have been implementing under the leadership of World Relief and Family Health International. CRWRC

has been using the Choose Life manual developed by World Relief as part of this other ongoing ABY

program. The manual for youth aged 10-24 years has been effectively used for both in- and out-of-school

youth in World Relief sites.

5. POPULATIONS BEING TARGETED

CRWRC is scaling up HIV prevention services in all eight districts of the Western Province, Kitui and Mwingi

districts in Eastern Province, and Uasin Gishu district in Rift Valley Province. Under the AB program area,

youth ages 10-24 years (men and women) are targeted, but there will be a concentration on girls 15-19 who

are out-of-school, widowed and divorced women, and married men.

Mobile populations who have been shown to exhibit higher prevalence of HIV than men who never sleep

away from home will also be targeted with faithfulness messages. The messages will be delivered through

"men who care" groups and other community forums that the trained church and community leaders will

address.

The populations targeted for participation in AB activities will be recruited by the 1,120 church and

community leaders who participate in TOT to learn how to mobilize groups. Men will be reached through

barazas and existing men's groups at churches. Potential peer educators will be identified by the church

and community leaders also. And other youth who will participate will be recruited by the peer educators.

6. KEY LEGISLATIVE ISSUES ADDRESSED

Key legislative issues are included in the emphasis areas described in section 7 below.

7. EMPHASIS AREAS

CRWRC and its partners will focus on abstinence and being faithful by addressing cross-cutting social

justice issues, like cross-generational sex, by addressing male norms and behavior issues. CRWRC and its

partners will also focus on increasing women's legal rights to empower women - married, divorced, and

widowed - to have access to reproductive health services in their communities. This will be done by

equipping church, community and NGO leaders with information regarding HIV/AIDS in order to address

these systemic issues as they arise in their communities. CRWRC and its partners will also focus on

human capacity development through in-service training of community volunteers including 300 peer

educators, 1,120 church leaders, community leaders and NGO leaders in the areas of HIV transmission and

prevention. CRWRC and its partners will also work with the community volunteers to develop a volunteer

retention strategy. Other emphasis areas to be addressed by this program area include CRWRC's on-going

local organization capacity building of the three partner organizations and coordination of the health

management information system for tracking beneficiaries reached by the AB activities. This program is

funded through the New Partner Initiative.

Funding for Care: Adult Care and Support (HBHC): $0

THIS IS A NEW ACTIVITY.

1. LIST OF RELATED ACTIVITIES

CRWRC and its partners will also initiate and expand social activities within the community, schools, and

churches (drama groups, choir, and poetry) that contain messages that reduce stigmatization of OVC and

PLWAs. At least 750 church and community leaders will be equipped as trainers-of-trainers (TOTs) on

stigma reduction using existing HIV/AIDS stigma reduction manuals and encouraged to include HIV/AIDS

messages in their sermons and public addresses. They, in turn, will train another 20,000 individuals in the

community to address HIV-related stigma and discrimination.

2. ACTIVITY DESCRIPTION

In partnership with three faith-based organizations in Kenya, namely; Western Region Christian Community

Services, an agency of the Anglican Church of Kenya, will implement the program in all eight districts of the

Western Province. KAMATAKIMO, which is also an agency of the Anglican Church, will target Kitui and

Mwingi districts in Eastern Province. Plateau Mission Hospital, an agency of the Reformed Church of East

Africa, will target Uasin Gishu district in Rift Valley Province. Christian Reformed World Relief Committee

(CRWRC) will improve the well-being of people living with HIV/AIDS and their families. A key strategy is to

link with local community-based health care programs and the district-level Ministry of Health to facilitate

access to home-based care for PLWAs in order to ensure improvement of the quality of these services over

time. During FY 2008, CRWRC and its partners will provide 3,300 individuals with HIV-related palliative

care and train 1,600 individuals to provide HIV-related home-based palliative care.

CRWRC and its partners will mobilize and train 1,600 individuals from community and church groups to

provide home-based care to PLWAs using the Training Home-Based Caregivers to Care for People Living

with HIV/AIDS at Home curriculum (developed by the National AIDS Control Council). CRWRC has already

received a list of certified HBC trainers at district level from NASCOP. CRWRC will have all three Program

Coordinators trained as certified trainers in the HBC curriculum.

Trained community mentors/volunteers will visit households weekly to problem-solve issues of health,

nutrition, and psychosocial care with caregivers; make referrals as needed to clinical care and other support

services; provide family-friendly information on disease transmission, prevention, treatment, and locally

available services; channel health and livelihood-supportive resources to families; and to develop PLWA

caregiver support groups which can provide both spiritual and psychosocial support.

In addition to these services, CRWRC and its partners will raise awareness about health care services

available to PLWAs through community forums, churches, community centers, and other gatherings.

3. CONTRIBUTIONS TO OVERALL PROGRAM

This activity will contribute toward the 5-year target of providing care to 10 million people infected or

affected by HIV/AIDS. In FY 2008, CRWRC and its partners will provide palliative care to 3,300 individuals

infected with HIV. During FY 2008, the emphasis will be on building local capacity for long-term

sustainability of palliative care by establishing community-based groups and training 1,600 volunteers to

provide these services. CRWRC's program builds on and expands the networks of informal caregivers by

providing them with training and support they require to be more effective.

4. LINKS TO OTHER ACTIVITIES

Home-based care (HBC) in Kenya is community-based, with most of the care provided by community

volunteers operating under the supervision of NGOs and CBOs. In addition to good nutrition, quality HBC

includes clinical care, nursing care, counseling and psycho-spiritual care, and social support. CRWRC and

its partners will use the national curriculum to train their volunteers to provide the multifaceted HBC

services. This will be done in close collaboration with NASCOP and other PEPFAR agencies like PATH

under APHIA II. In addition, CRWRC and its partners will link PLWAs where available, to one mobile clinic

per district through the Ministry of Health (MOH).

5. POPULATIONS BEING TARGETED

CRWRC and its partners will scale up care services for PLWAs in all eight districts of the Western Province,

Kitui and Mwingi districts in Eastern Province, and Uasin Gishu district in Rift Valley Province.

The program is targeting men and women living with HIV/AIDS aged 15-49. An inventory form has been

developed to enroll new PLWAs into the program and assess their care needs. The community level

committees and volunteers will identify the needy households and provide the needed care and support

based on the needs as highlighted during the inventory process.

6. KEY LEGISLATIVE ISSUES ADDRESSED

Key legislative issues are included in the emphasis areas described in section 7 below.

7. EMPHASIS AREAS

The program will address human capacity development through in-service training of health care workers,

community and religious leaders and caregivers to provide palliative care to individuals affected by

HIV/AIDS. Lessons on volunteer retention will also be drawn from the ongoing OVC and other development

programs. Other emphasis areas to be addressed by this program area include CRWRC's on-going local

organization capacity building of the three partner organizations and coordination of the health management

information system for tracking PLWAs reached with HBC. This program area is funded through the New

Partner Initiative.

Funding for Care: Orphans and Vulnerable Children (HKID): $0

THIS IS A NEW ACTIVITY.

1. LIST OF RELATED ACTIVITIES

CRWRC's activities in this program area are closely linked with its other activities under the Palliative Care

program area. In many cases the OVC identified to receive care will be residing in households where there

is also a person living with AIDS who is receiving palliative care.

2. ACTIVITY DESCRIPTION

In partnership with three faith-based organizations in Kenya, namely; Western Region Christian Community

Services, an agency of the Anglican Church of Kenya, will implement the program in all eight districts of the

Western Province. KAMATAKIMO, which is also an agency of the Anglican Church, will target Kitui and

Mwingi districts in Eastern Province. Plateau Mission Hospital, an agency of the Reformed Church of East

Africa, will target Uasin Gishu district in Rift Valley Province. Christian Reformed World Relief Committee

(CRWRC) will engage with church and community leaders to raise their awareness about the needs of OVC

in their communities and will provide training and assistance to them as they establish community

committees and recruit volunteers to respond to those needs. During FY 2008, CRWRC and its partners

will provide care to 6,100 OVC and train at least 1,200 caregivers to care for OVC.

Under this program, community committees will expand services to additional OVC. These committees

enable caregivers to form caregiver groups and ensure that they are getting the needed support from

community members and religious bodies. In FY 2008, the program plans to reach and support 6,100 OVC.

CRWRC and its partners will scale up their current OVC program by identifying 6,100 new OVC and their

caregivers. Caregivers will be trained using the Our Children manual (developed by World Relief), which is

effective for inspiring and mobilizing churches and communities and teaching the essential principles of

orphan care and support by portraying experiences and lessons learned by church members and

community volunteers involved in OVC care and support. A total of at least 1,200 caregivers will be trained

and supported to meet the needs of OVC in the program. The program will support OVC by linking them to

health facilities, providing them with home-based care, and empowering them with advocacy, education

about prevention, linkages to legal services, and providing access to nutritious food and skills in agriculture

(bio-intensive farming) and animal husbandry. The program will also mobilize church and community groups

to provide food contributions to OVC. Partners will mobilize OVC committees to source for relief food from

government and other agencies in their areas. An inventory of OVC in each community will be created

during the first two quarters of each year and home visit schedules will be developed for staff and

volunteers to visit OVC homes. Following the training, caregiver support groups will be initiated.

3. CONTRIBUTIONS TO OVERALL PROGRAM

This activity will contribute toward the 5-year target of providing care to 10 million people infected or

affected by HIV/AIDS. OVC care activities have been designed to enhance community ownership and build

local capacity for long-term sustainability of OVC care services. OVC are supported within family and

community structures as opposed to institutional care. There is an emphasis on strengthening the capacity

of families to cope with their problems and on increasing the support offered to these households by other

members of the community or church congregation.

4. LINKS TO OTHER ACTIVITIES

CRWRC and its partners are committed to work alongside the OVC National Steering Committee and the

Government of Kenya to bring comprehensive support to OVC to scale by working closely with the

children's department in all the three partner locations as is the case with the World Concern OVC program.

Partners will be encouraged to participate in monthly Children's Department meetings where applicable and

collaborate with the said departments in the marking of The Day of the African Child, World AIDS Day and

any other important events as advised by the Department.

5. POPULATIONS BEING TARGETED

CRWRC and its partners will scale up OVC care services in all eight districts of the Western Province, Kitui

and Mwingi districts in Eastern Province, and Uasin Gishu district in Rift Valley Province. And thus CRWRC

and its partners will reach 6,100 new OVC, up from 2,300 from the same partner sites in previous years

under the OVC program.

The program is targeting OVC aged 0 to 17 years (boys and girls), including child-headed households. An

inventory of OVC will be created by the community committees and the caregivers will provide the needed

care and support based on the needs as highlighted during the inventory process.

6. KEY LEGISLATIVE ISSUES ADDRESSED

Key legislative issues are included in the emphasis areas described in section 7 below.

7. EMPHASIS AREAS

The program will also focus on increasing women's access to income and productive resources through

some of the activities targeted at female youth. To ensure sustainability beyond the life of the project for

OVC in child-headed families, the program will coordinate with wraparound programs in economic

strengthening to channel funding to support vocational training and income generating activities for the 10-

17 year old children. The program will also train OVC and caregivers regarding children's rights so that

needy OVC can seek legal support to repossess property and assets. CRWRC and its partners will also

focus on human capacity development through in-service training of caregivers. Lessons on volunteer

retention will be drawn from the ongoing OVC and other development programs. Other emphasis areas to

be addressed by this program area include CRWRC's on-going local organization capacity building of the

three partner organizations and coordination of the health management information system for tracking

services provided to OVC. This program is funded through the New Partner Initiative.

Funding for Testing: HIV Testing and Counseling (HVCT): $0

THIS IS A NEW ACTIVITY.

1. LIST OF RELATED ACTIVITIES

CRWRC's activities in the program area of counseling and testing are closely related and overlap to a great

degree with CRWRC's activities in the PMTCT program area. The husbands and partners of pregnant

women who receive PMTCT services will be strongly encouraged to also be tested in order to know their

HIV status.

2. ACTIVITY DESCRIPTION.

In partnership with three faith-based organizations in Kenya, Christian Reformed World Relief Committee

(CRWRC) will equip 24 health facilities during FY 2008 to provide HIV counseling and testing services in 11

districts of Kenya. These health facilities will be selected based on a review of existing health facility

assessment data and with the intention of filling service gaps.

The selected health facilities will be refurbished and/or equipped in ways that may include purchasing of test

kits; repair of roofing; reconnecting water; fixing gutters for rain water collection; and acquisition of

examination room tables, chairs, charts, scales, HIV/AIDS reference manuals, posters, and other similar

supplies.

At least 26 health workers from these health facilities will be trained together at a central location by certified

Ministry of Health (MOH) trainers using Kenya's National Guidelines for CT training. After the training, the

health workers will receive ongoing supervision from district-level MOH officers.

An additional 410 religious and community-based volunteers will be trained to provide HIV counseling in the

communities. This training will be provided through a five-day intensive course offered by the Kenya

Institute of Professional Counselors. The role of volunteers will be to encourage people to be tested, to link

them to services, and to provide counseling follow-up to them after they have received their results. A

barrier analysis will be used to tailor the behavior change activities and messages to the men and women

most in need of being tested.

At least 4,500 individuals will receive counseling and testing from health facilities operated directly by

CRWRC's local partners. Another 2,250 individuals will be referred to other health facilities for counseling

and testing.

3. CONTRIBUTIONS TO OVERALL PROGRAM

CRWRC's activities in this program area will contribute toward the Emergency Plan 5-year objectives of

preventing 7 million new infections and providing care to 10 million who are infected with or affected by

HIV/AIDS. By being tested for HIV and receiving follow-up counseling, individuals who are HIV-positive will

be encouraged to adopt behaviors that will help them to prevent infecting others. They will also be linked to

treatment (if needed). Once an individual is identified as being HIV-positive, it will be possible to enroll that

person in a program to receive palliative care and to enroll children in their household in an OVC support

program. By filling service gaps through mobile VCT clinics and refurbishing and equipping existing health

facilities, CRWRC and its partners will improve access to HIV testing services to people living in remote

rural areas that are underserved.

4. LINKS TO OTHER ACTIVITIES

The program intends to establish linkages with the existing health facilities to facilitate provision of VCT as

well as provide new VCT services to those without access to health facilities through mobile clinics.

Additional referral linkages will be established with other HIV/AIDS services providers in the target area,

including facilities where ARV treatment can be accessed.

5. POPULATIONS BEING TARGETED

In partnership with three faith-based organizations in Kenya, CRWRC will scale up voluntary counseling and

testing services in all eight districts of the Western Province, Kitui and Mwingi districts in Eastern Province,

and Uasin Gishu district in Rift Valley Province.

Improved and expanded VCT services will be made available to all categories of the community

encompassing the male and female youth aged 15-24; women of reproductive age (aged 15-45); sexually

active adult couples (ages 25 and over); orphans and vulnerable children (ages 0-17); and families and

communities affected by HIV/AIDS. The religious and community-based volunteers who have been trained

to provide HIV counseling services will be instrumental in identifying people who do not know their HIV

status and encouraging them to be tested.

6. KEY LEGISLATIVE ISSUES ADDRESSED

Key legislative issues are included in the emphasis areas described in section 7 below.

7. EMPHASIS AREAS

CRWRC and its partners will address gender in the VCT program area by focusing on male norms and

behaviors regarding HIV counseling and testing. CRWRC and its partners will also focus on human

capacity development through in-service training of clinic-based health workers in counseling and testing for

men and women. CRWRC and its partners will also work with health facility workers and community health

volunteers to develop a health worker and volunteer retention strategy. Other emphasis areas to be

addressed by this program area include CRWRC's on-going local organization capacity building of the three

partner organizations and coordination of the local partners' health management information system for

tracking referrals of HIV+ men and women for ARV treatment. This program is funded by the New Partner

Initiative.