Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 342
Country/Region: Kenya
Year: 2009
Main Partner: To Be Determined
Main Partner Program: NA
Organizational Type: Implementing Agency
Funding Agency: USAID
Total Funding: $0

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

1. ACTIVITY DESCRIPTION AND EMPHASIS AREAS

This activity is a follow on to activities carried out by the POLICY project in FY 2006 which contributed

indirect results to the Palliative care area through activities with the Networks such as the Network of

People Living with HIV/AIDS in Kenya (NEPHAK) and the National Muslim Council of Kenya (NMCK).

Various problems impinge on service delivery in this area and include the following: a) Ineffective referral

linkages particularly between home and communities to institutional services compounded by weak

capacities amongst community groups and People Living with HIV/AIDS networks; and b) Gender

imbalances that lead to barriers to accessing care and treatment for women and girls because of i) their

vulnerability to HIV/AIDS due to poverty and low social status compounded by harmful traditional customs

and ii) the burden of care predominantly falling on women that sees them expend enormous costs in time,

energy and resources caring for sick parents, orphans and vulnerable children (OVC), running households

etc. This activity will seek to expand access to community based non-clinical palliative care and strengthen

the referral network for opportunistic infections (OIs) and tuberculosis (TB) treatment services. The activity

will train 680 individuals and establish 150 service outlets which will provide HIV-related palliative care and

reach 6,000 individuals with HIV related palliative care. This will be achieved through: strengthening the

capacity of People Living with HIV/AIDS (PLWHA), faith-based organizations (FBOs), teachers and people

with disabilities networks to provide palliative care in their communities through training and mentoring;

providing community-based care and support and linking adults and children to antiretroviral therapy

(ARVs), opportunistic infections (OIs) and tuberculosis (TB) treatment; providing technical assistance to

strengthen the traditional community structures to target the vulnerable and hard to reach women in HIV

prevention care and treatment; and, providing technical assistance to build the capacity of community

institutions in gender equity in home and community based care focusing on social transformation for

increased male involvement.

The main emphasis area for this program is development of network/linkages/referral systems and a minor

emphasis on local organization capacity development.

2. CONTRIBUTIONS TO OVERALL PROGRAM AREA

This activity will contribute 2.4% to the overall target area of number of individuals provided with community-

based HIV-related palliative care by working with PLWHA and FBO networks.

3. LINKS TO OTHER ACTIVITIES

This activity relates to activities in System Strengthening and Policy Analysis and Orphans and Vulnerable

Children. This activity links to HPI's activities in: the program areas of Systems Strengthening and Policy

Analysis, that seek to enhance the capacity of local institutions and PLWHA networks; of OVC, working to

create a supportive social and policy environment for OVC and care givers to access basic services.

4. POPULATIONS BEING TARGETED

These activities target OVC, PLWHA and caregivers of OVC and PLWHA.

5. KEY LEGISLATIVE ISSUES ADDRESSED

The key legislative issue addressed is gender.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08:

Funding for Care: TB/HIV (HVTB): $0

ACTIVITY UNCHANGED FROM COP 2008

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

+ Prime partner is a TBD because Health Policy Initiative (HPI) Task Order 1 with Constella Futures has

reached its ceiling and therefore since the Health Policy Initiative mechanism is an IQC a new country task

order process will be issued for competitive selection of a partner to implement the activities.

1. ACTIVITY DESCRIPTION

TB remains a major cause of morbidity and mortality among the productive age groups and particularly

amongst HIV positive populations. Plus up funds were provided in FY07 for advocacy work particularly

amongst nascent networks of People Living with HIV and AIDS to be better advocates on TB/HIV issues at

the national level resulting in increased awareness of TB/HIV.

In Kenya it is appreciated that chronic coughers tend to be late in seeking diagnosis and treatment of their

coughs thus helping in the spread of TB. There is need therefore to address this knowledge gap with an

Advocacy, communication and social mobilization strategy. This will be done by working with the National

AIDS and STI Control Program (NASCOP), the National Leprosy and Tuberculosis Program (NLTP) and

other NGOs and FBOs to develop an appropriate comprehensive Advocacy, Communication and Social

Mobilization strategy and framework for action on TB. This strategy will also address an appropriate

communication strategy to disseminate TB/HIV interventions to the communities.

In addition to the above activities HPI will assist to implement the new TB/HIV guidelines facilitating the

process of dissemination of these guidelines.

2. CONTRIBUTIONS TO OVERALL PROGRAM AREA

This activity will contribute to TB/HIV advocacy in expanding access to prevention, care and treatment

services for the two diseases, especially during this time when more resistant TB variants are emerging in

many countries. This funding will enable the Health Policy Initiative to support nascent networks of people

living with HIV/ AIDS to be better advocates on TB/HIV issues at national level. The main outcome of these

activities will be increased awareness of TB/HIV at the national level.

3. LINKS TO OTHER ACTIVITIES

This activity links to USAID-OHPS-HPI-TBD an activity that will continue building the capacity of PLWA

networks in various areas including advocacy for continued access to treatment, prevention and care and

support services; USAID-HBHC-HPI-TBD an activity that seeks to develop and disseminate a national non-

clinical palliative care policy and guideline; and USAID-HKID-HPI-TBD an activity working on building the

capacity of indigenous organizations to care for OVCs and also training experts on psychosocial support for

OVCs.

4. POPULATIONS BEING TARGETED

This activity will target: People living with HIV/AIDS via working with Networks of people living with HIV and

AIDS; the general population via working on the Advocacy, Communication and Social Mobilization

strategy.

5. EMPHASIS AREAS / KEY LEGISLATIVE ISSUES ADDRESSED

The emphasis area for this activity is local organization capacity building working to build the capacity of not

only networks of PLWAs on TB/HIV issues but also assisting the national TB program in developing a

comprehensive advocacy, communication and social mobilization strategy on TB.

New/Continuing Activity: Continuing Activity

Continuing Activity: 15010

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

15010 12454.08 U.S. Agency for To Be Determined 7007 342.08 Health Policy

International Initiative

Development

12454 12454.07 U.S. Agency for The Futures 4286 342.07 Health Policy $50,000

International Group Initiative

Development International

Emphasis Areas

Health-related Wraparound Programs

* TB

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.12:

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

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:

+ Prime partner will be competitively selected to implement the activity

+Activity will support expansion of services to address gender-based violence (GBV).

SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS

This activity will contribute $ 640,000 of its total budget towards human capacity development by building

the capacity of the department of children services in developing policies that safe guard the rights of the

OVC.

COP 2008

1. LIST OF RELATED ACTIVITIES

This activity relates to activities in Systems Strengthening and Policy Analysis (#7040), Palliative Care:

Basic Health Care and Support (#8863, #8867, #8928, #8929, #8931, #8934, #8936), TB/HIV (#9059,

#9062, #9065, #9066, #9068, #9069, #9072), CT (#8760, #8776, #8777, #8778, #8781, #8782, #8976) and

OP (#8874, #8927, #8930, #8932, #8937, #8942, #9040).

2. ACTIVITY DESCRIPTION

Various issues beleaguer OVC support in Kenya today and include the following: the government has a

National OVC response plan but it is yet to be operationalized; the Ministry of Home Affairs has taken on

increased responsibilities in mainstreaming OVC issues into its cores functions but lacks the requisite

technical and management capacity to deliver effectively; the need to build the capacity of communities and

PLWHA groups to promote women and OVC's access to services and property ownership; the need to link

OVC to available support like bursaries, psychosocial support and counseling services. This activity will

serve to ameliorate the above problems and result in creating a supportive social and policy environment for

OVC and caregivers to access basic services. This will be achieved through: providing technical assistance

to strengthen government systems and structures to enact OVC legislation and responsive laws and

support policy dialogue and advocacy on the protection of children's rights with the HIV/AIDS and OVC

networks; strengthening the technical and management capacity of the Ministry of Home Affairs (Children's

Department) to co-ordinate OVC policy implementation including monitoring and supervision; providing

technical assistance to strengthen legal and traditional community structures to promote OVC and women

access to essential services and property ownership under the Women Property Ownership and Inheritance

Rights (WPOIR) initiative; providing technical assistance and training to Kenya Network of Positive

Teachers (KENEPOTE), Parents-Teachers Associations (PTA) and caregivers to improve OVC access to

education and strengthen related psychosocial support; and, train and build the capacity of indigenous

CBOs/NGOs to scale-up and/or initiate new and sustainable programs on OVC psychological support

through small grants programs. In FY 09 activities will expand to include working with the Sexual Offences

Bill Task Force to address protection issues of OVC (both legal and physical). This will be done through

training of local community organizations, health providers, local religious leaders, prosecutors, magistrates

and local law enforcement officers. The Task Force will be strengthened to be able to disseminate the Bill

up to the grassroots.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

It is anticipated that in FY 2009 this activity will contribute to the indirect target of over 50,000

affected/infected OVC. This will be done through the dissemination and roll out of Sexual Offences Bill,

OVC Policy, dialogue and advocacy to community based, non-government and faith based organizations,

policy makers, community leaders, religious groups and various HIV/AIDS and OVC networks.

4. LINKS TO OTHER ACTIVITIES

This activity links to HPI's activities in: Systems Strengthening and Policy Analysis (#7040), that seek to

enhance the capacity of local institutions and PLWHA networks; Palliative care (#8863, #8867, #8928,

#8929, #8931, #8934, #8936) that expand access to community based non-clinical palliative care and

strengthen referral networks to OIs and TB medical treatment services; Counseling and Testing (#8760,

#8776, #8777, #8778, #8781, #8782, #8976) that enhances CT amongst people with disabilities (differently-

abled persons) and other prevention (#8874, #8927, #8930, #8932, #8937, #8942, #9040) that promotes

HIV/AIDS prevention amongst positives through other behavior change messages beyond abstinence and

being faithful by providing technical assistance to PLWHA networks to develop their own behavior change

messages.

5. POPULATIONS BEING TARGETED

This activity targets policy makers, community and religious leaders and Country coordinating mechanism.

It also targets people affected by HIV/AIDS and specifically orphans and vulnerable children and also

caregivers of OVC, widows and widowers.

6. KEY LEGISLATIVE ISSUES ADDRESSED

This activity addresses issues related to gender increasing women's legal rights and access to services.

7. EMPHASIS AREAS

The main emphasis area for this activity is capacity of local organizations specifically the Children's

department in the Ministry of Gender, Children and Social Development and minor emphasis is community

mobilization/participation serving to increase the participation of PLWHA groups in caring for OVC.

New/Continuing Activity: Continuing Activity

Continuing Activity: 15011

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

15011 5104.08 U.S. Agency for To Be Determined 7007 342.08 Health Policy

International Initiative

Development

7041 5104.07 U.S. Agency for The Futures 4286 342.07 Health Policy $1,300,000

International Group Initiative

Development International

5104 5104.06 U.S. Agency for The Futures 3232 342.06 POLICY Project $394,000

International Group

Development International

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

* Increasing women's legal rights

* Reducing violence and coercion

Health-related Wraparound Programs

* Child Survival Activities

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.13:

Funding for Health Systems Strengthening (OHSS): $0

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:

+ Support for the formulation and implementation of the health sector financing strategy

+ Support to the Ministries of Health to help in the decentralization of health services

+ Support the Ministries of Health efforts to enhance their program and fiscal management efforts

COP 2008

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

• Prime partner is a TBD because Health Policy Initiative Task Order 1 with Constella Futures has reached

its ceiling and therefore since the mechanism is an IQC a new country task order process will be issued for

competitive selection of a partner to implement the activities.

• HPI will work to review, update and disseminate existing and the following new key policy and guidelines:

- the Gender Based Violence (GBV) advocacy strategy aimed at increasing awareness on GBV and reduce

women's vulnerability to HIV and AIDS; ART to incorporate emerging concerns relating to among others

2nd and 3rd line treatment, food and drug interaction, pediatric treatment and continuing education for

medical staff; and, RH/HIV integration policy that seeks to increase service uptake and promote

comprehensive service delivery.

• HPI will also work to implement the sexual offences act via enhancing the capacity of staff in the health

and justice sectors to correctly interpret and implement the act in the interest of the client.

• HPI will establish and strengthen four new PLHIV networks. These networks will be active in policy

advocacy seeking to enhance access to treatment, prevention, care and support services. These networks

will include the following: - tertiary and higher education staff infected and affected by HIV and AIDS;

Positive Health Care Workers Networks; Informal sector networks; and African Women of Faith Network.

• HPI will develop and strengthen an integrated policy process management system. This system will aim at

enhancing the facilitation, management, coordination and implementation roles of the government in the

policy process. This task will involve the establishment of a policy data base in the Ministry of Planning and

National Development and also a policy process management system and database at the Ministry of

Health.

• HPI will also develop and implement a strategic planning guide and costing framework for hospitals with

comprehensive care centers that aims at promoting evidence- based planning and management, better

articulation of priority interventions and better resource mobilization techniques for sustainability.

• HPI will also work with the informal sector assisting in the development of workplace HIV/AIDS policy.

1. LINKS TO RELATED ACTIVITIES

This activity relates to activities in Strategic Information (#9012), Palliative Care: Basic Health Care and

Support (#8823), Orphans and Vulnerable Children (#7041) and other System Strengthening activities

including (#8693).

2. ACTIVITY DESCRIPTION

In this program area, the Health Policy Initiative (HPI) will work in several distinct but related components,

as described below. 1) While Kenya continues to expand its HIV/AIDS care and support services, the

capacity of existing institutions and particularly the networks of people living with HIV/AIDS (PLWHA) are

fragmented, with poorly coordinated multi-sectoral responses, limited capacity to develop and implement

policies and programs for advocacy of stigma reduction; weak institutional structures for PLWHA networks

with high staff turnover; insufficient attention to gender, poverty and human rights issues; ineffective

leadership for community action; and limited engagement by PLWHA in the policy process. HPI will work in

this area to strengthen local institutions and networks such as the Kenya Network of Positive Teachers and

Educators (KENEPOTE), NEPHAK, a Muslim organization, UDPK, KENERELA, and KETAM for policy and

program implementation. HPI will also work closely with a TBD partner in this program area to develop

support groups for medical professionals living with HIV/AIDS. 2) In the policy arena, several issues have

been identified for support, including the need to disseminate user-friendly national policies to PLWHA and

other target groups; the lack of policies that pay attention to orphans and vulnerable children, food security

and safety nets; operational policy barriers that impede access to HIV treatment care and support; lack of

an appropriate index on stigma and discrimination activities; and an inadequate exchequer allocation to

HIV/AIDS due to lack of advocacy within the Medium Term Expenditure Framework (MTEF) process that

would provide increased allocations for HIV/AIDS. HPI will work on policy development, advocacy and

implementation, and also work to build the Government of Kenya's capacity to mobilize resources for

HIV/AIDS. Specifically, HPI will provide technical assistance to the National AIDS Control Council (NACC)

and the National AIDS, STI Control Program (NASCOP) to review, update and disseminate existing policies

to PLWHA networks and target groups. HPI will further provide technical assistance to NACC and Ministry

of Planning and National Development to mainstream HIV/AIDS into the MTEF budgeting and planning

process, as well as other areas of assistance that will be identified in close consultation with NACC. 3)

There is an identified need to increase the participation in the Sector Wide Approach to health programming

to include networks of faith based organizations (Inter-religious Consortium) and the private sector (Kenya

Private Sector Advisory Network); to strengthen the GFATM's country coordinating mechanism (CCM) and

AIDS-Interagency Coordinating Committee (AIDS-ICC) in accordance with the governance manual; and the

need to increase contributions by civil society organizations and other grass root level stakeholders in the

Joint AIDS Program Review (JAPR), all of which affect the MTEF planning and budgeting. In FY 2007, HPI

will continue to offer technical assistance to strengthen Global Fund activities by strengthening Civil Society

member organizations of the CCM. HPI will convene and facilitate FBOs, NGOs and private providers

involved in the planning and budgeting process, and provide technical assistance to NACC to promote the

participation by CSOs and other stakeholders at the grass-root level in the JAPR process. 4) In the stigma

and discrimination arena, HPI will field test the "USAID Interagency Working Group on Stigma &

Discrimination Indicators" questionnaire on measuring HIV/AIDS related stigma and discrimination. 5) In FY

2007, as part of PEPFAR's support to public private partnerships, HPI will also work closely with the Nairobi

Women's Hospital (NWH) Board of Directors to strengthen its capacity as a decision-making body, and to

help expand a vital resource, NWH's Gender Violence and Recovery Center (GVRC), to other parts of

Kenya. The GVRC offers counseling, treatment and support for women battling rape and gender violence.

Currently, GVRCs are located in Nairobi and Nyanza only. These activities will result in 4,000 individuals

trained in community mobilization, 150 individuals trained in institutional capacity building and also policy

development; and 1,800 individuals trained in stigma and discrimination reduction. In addition 15

Activity Narrative: organizations will benefit from institutional capacity building and 20 organizations' receive help in HIV-

related policy development.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

System Strengthening activities under HPI contribute directly to building the management and leadership

abilities of indigenous organizations, fortifying the GFATM management structure, and to creating an active

and engaged policy environment surrounding issues of HIV/AIDS.

4. LINKS TO OTHER ACTIVITIES

This activity links to HPI's activities in palliative care that expands access to community based non-clinical

palliative care and strengthens referral networks to OIs and TB medical treatment services; orphans and

vulnerable children working to create a supportive social and policy environment for OVC and care givers to

access basic services; counseling and testing that enhances CT among differently-abled persons; and other

prevention that promotes HIV/AIDS prevention amongst positives through other behavior change messages

beyond abstinence and being faithful by providing technical assistance to PLWHA networks to develop their

own behavior change messages.

5. POPULATIONS BEING TARGETED

This activity will target People Living with HIV/AIDS, HIV/AIDS affected families, caregivers of OVC and

PLWHA, host country government workers including policy makers, teachers, NACC staff and other MoH

staff including NASCOP. In addition the activities will target CBOs, FBOs, NGOs, and the CCM for the

GFATM.

6. KEY LEGISLATIVE ISSUES ADDRESSED

HPI's activities will address issues related to gender, as well as stigma and discrimination.

7. EMPHASIS AREAS

Emphasis areas include local organization capacity building, policy and guidelines, and community

mobilization and participation. The Health Policy Initiative (HPI) Kenya office has been a key partner in

PEPFAR/Kenya's groundbreaking work in supporting networks of People Living with HIV/AIDS (PLWHA). In

addition to support for a single inclusive national network, HPI has provided critical organizational and

capacity building support to networks of HIV-positive educators, religious leaders, persons with disabilities,

and Muslim women. These networks are increasingly proving their effectiveness in elevating the level of

policy dialogue between providers and recipients of services as well as holding providers, donors and the

host government accountable for results and transparency. ($50,000) On a separate project, HPI will also

work closely with National AIDS Control Council (NACC) to continue strengthening its ability to coordinate

AIDS programming in Kenya. Funds will also assist with costs of relocation and establishment of more user-

friendly offices for NACC ($200,000).

New/Continuing Activity: Continuing Activity

Continuing Activity: 15012

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

15012 7040.08 U.S. Agency for To Be Determined 7007 342.08 Health Policy

International Initiative

Development

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

* Increasing women's legal rights

* Reducing violence and coercion

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.18:

Subpartners Total: $0
National AIDS Control Council, Kenya: NA