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
Updated April 2009 Reprogramming. Increased by $75,000. Partnership Framework: Scale up - improved
and standardized integration of HIV services into MCH and improved and standardized models of follow up
care and referrals. These activities will be implemented through various APHIA partners.
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+More emphasis on decentralization of HIV care and treatment as well as TB services through capacity
building and task shifting, male involvement through targeted couple counseling
+Greater involvement of HIV+ mentor mothers and quality improvement through standards based
management and recognition
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS
This activity supports key attributions in human capacity development through the training of health care
service providers on PMTCT and other HIV prevention and care topics in order to equip them with
knowledge and skills to provide quality PMTCT services. These service providers include doctors, nurses,
clinical officers, nutrition officers and health record clerks. The activity will also support hiring of health
workers and other key staffs to fill critical gaps in service delivery.
COP 2008
The only change to the program since approval in the 2007 COP are 1) geographic coverage has been
expanded to include public and faith based health facilities in 11 districts; and 2) the provision of a
comprehensive ANC package of care to improve the quality of PMTCT services has been added.
The targets and funding levels have also been changed in order to provide for a complete ANC profile, birth
planning, HIV testing and counseling in ANC and delivery units, ARV and OI prophylaxis, HAART for eligible
women, and counseling on maternal and infant nutrition and improved obstetric care. APHIA II Nyanza will
use a family-centered prevention and care approach, including the expansion of couple counseling and
testing. Wrap around activities with the PMI, family planning and safe motherhood, TB and nutrition
programs will be undertaken in this year.
1. LIST OF RELATED ACTIVITIES
This activity relates to counseling and testing, abstinence/be faithful, condoms and other prevention,
palliative care, TB/HIV and ARV services.
2. ACTIVITY DESCRIPTION
USAID's APHIA Nyanza project implemented by EngenderHealth began its support to PMTCT services in
Nyanza Province in FY 2006. In FY 2009 this activity will continue the expansion of PMTCT services in 20
public sector and 80 faith-based health facilities across nine districts in Nyanza Province. In these health
facilities technical assistance will be provided to increase management and technical capacity of staff, and
improve quality and utilization of services. This activity aims to reach 31,094 (91%) of 34,146 pregnant
women with counseling and testing, to provide ARV prophylaxis to 4383 (93%) of the 4714 expected HIV+
mothers and early infant diagnosis of HIV to 50% of exposed infants. To improve the technical capacity of
health staff, 200 will receive training in PMTCT based on the national guidelines. In the fifteen districts,
counseling and testing will be provided to 31094 pregnant women, antiretroviral prophylaxis to 4383 HIV+
women, 2141 of whom will receive AZT/NVP, 877 will receive HAART and 1315 will receive single dose
nevirapine only. Early infant diagnosis will be provided to 2,141 exposed babies. Service delivery will
continue to incorporate best practices including op-out testing with same day results, maximally effective
combination prophylaxis regimens, partner testing and appropriate referral linkages to support post natal
follow up of HIV+ mothers and exposed infants. To maximize continuum of care, care and treatment
services will be provided in MCH clinics through decentralization and task shifting. The project will examine
ways to improve infant feeding and compliance to treatment. Priority will be given to provision of integrated
services ensuring establishment of treatment services in MCH, effective linkages to treatment, care and
support, as well as to family planning and reproductive health services. This will ensure that pregnant
women receive comprehensive HIV care including OI prevention and treatment especially for TB. Support to
infrastructure development, procurement of medical equipment and improved data collation will enhance
service delivery. Behavior change communication (BCC) and mentor mothers strategies will focus on
stigma reduction to increase utilization of services, psychosocial support, promotion of ante natal care
services and facility based deliveries.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will work in collaboration with other partners in Nyanza province to improve geographical
coverage for PMTCT services and strengthen service delivery. It will contribute 2.4% of the overall PMTCT
targets in 2009. This will enhance MCH service quality and encouraging rural women in underserved
communities to attend ante natal care services. Referrals and linkages to care and treatment for pregnant
women and infants, and referrals for partner testing will increase opportunities to provide comprehensive
family care and treatment.
4. LINKS TO OTHER ACTIVITIES
This activity relates to activities in counseling and testing, abstinence/be faithful, to reduce stigma and
encourage women and families to know their status. It also relates to condoms and other prevention,
palliative care, TB/HIV and ARV services encouraging healthier behaviors in HIV prevention in care and
treatment settings.
5. POPULATIONS BEING TARGETED
This APHIA Nyanza activity targets adults of reproductive health age, pregnant women, family planning
clients, infants, and HIV positive pregnant women. BCC activities will involve community leaders and
community based organizations to increase demand for services amongst community members. Strategies
to improve quality of services will target faith-based and public health doctors, nurses, mid wives and other
health care workers such as clinical officers and public health officers in both public and faith based
facilities.
6. KEY LEGISLATIVE ISSUES ADDRESSED
Activity Narrative: The behavior change communication activities for STI and HIV prevention will promote gender equity
through partnering with women's organizations in the design and implementation of community activities.
The activity will address male norms and behavior including multiple sexual partners through community
interventions, as well as stigma and discrimination.
7. EMPHASIS AREAS
This APHIA II Nyanza activity has emphasis on gender by addressing male norms and behaviors and
increasing women's access and equity in HIV programs, quality improvement through training and
supportive supervision, task shifting to allow more cadres of staff to offer services, wrap around program
with the PMI, family planning and safe motherhood, child survival and nutrition programs.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14777
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14777 8734.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $650,000
International Nyanza
Development
8734 8734.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $466,880
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
* TB
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $89,400
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
+ All Voluntary Medical Male Circumcision (VMMC) activities described in the FY08 Narrative are now
incorporated in their own narrative in FY09
+ Specific AB messages will target both adult men and women with the aim to reduce multiple concurrent
partners
+ This activity will incorporate $150,000 for HIV Free Generation activities targeting youth
The only changes to the program since approval in the 2007 COP are:
• Geographic coverage has been revised to include Kuria, Gucha and Masaba districts
• $100,000 of this AB activity is programmed with funds from the $7million FY08 plus-up for the Youth
Prevention Initiative
• The KARHP methodology will be rolled out in collaboration with the Ministry of Education, Ministry of
Health and Ministry of Gender, Sports, Culture and Social Services at approximately $250,000
• Peer education activities will be rolled out with the Kenya Girl Guides Association
• AB funds totaling $23,000 will contribute to the sensitization of teachers as a worksite population linking
with additional OP and OHPS funds for a $150,000 activity to reach 750 teachers and train 20
This activity relates to activities in Counseling and Testing (#8760), OHPS, Voluntary Medical Male
Circumcision and Condoms and Other Prevention (#8942).
The APHIA II Nyanza project implemented by EngenderHealth initiated support to AB activities in Nyanza
Province in FY 2006. In 2009, $150,000 of this activity is programmed for the Youth Prevention Initiative.
This activity will continue to equip youth with skills to cope with peer pressure and help them develop
positive norms and values to make appropriate and safe choices in relationships. It will target youth both in
and out of school expanding abstinence-based programs for youth through child-to-child programs in
Nyanza Province. Building on the KARHP model, the project will work closely with the Ministry of Education,
Ministry of Health and Ministry of Culture, Sports, Gender and Social Services. In schools, 122 teachers will
be trained in adolescent development, gender issues, and HIV information and facilitation skills. They will
train 2,000 secondary student peer educators and primary student peer educators who will then implement
a child-to-child school program targeting primary school children. Further, 100 youth advocates will be
trained to implement youth-to-family activities, a significant innovation in the community in FY 2009 aimed at
reaching out-of-school youth. The program will promote abstinence and responsible decision making,
including promotion of counseling and testing to youth out of school to reduce the risk of contracting
HIV/AIDS. These abstinence and behavior change activities will reach 100,000 in-school youth in urban and
rural settings. Further, 1000 youth magnet theatre members from 100 theatre troupes will be trained or re-
trained in abstinence and being faithful messages aimed at reaching out-of-school youth. Much of this work
with theatre groups will be interlinked with the peer educators in religious institutions, a continuing program
from the 2008 COP. These activities will reach 50,000 out-of-school youth. This project will work in close
collaboration with the National AIDS and STI Control Programme of the Ministry of Health and the Ministry
of Youth Services, ensuring that activities meet the Government of Kenya priorities and guidelines. In
Nyanza Province this activity will be planned, implemented and monitored in partnership with the District
Health Management Teams, District Education Officers, schoolteachers, employers, community leaders and
youth. This will create a continuum of youth-focused activities in the education, health and community
sectors and forge effective linkages aimed at guiding youth toward practicing safer behaviors. The program
will promote abstinence and responsible decision making, including promotion of counseling and testing to
youth out of school to reduce the risk of contracting HIV/AIDS. These abstinence and behavior change
activities will reach in-school youth and out-of-school youth in urban and rural settings. This activity includes
the involvement of church leaders and church-based youth groups to establish and reinforce norms that
reduce youth risk, vulnerability and stigma. The project will utilize magnet theatre approaches and
community radio to reach the general population with HIV prevention messages, including male
circumcision. Community media messages targeting men and encouraging abstinence and safer behavior
will be implemented through work site activities and linkages with faith-based community groups, churches
and mosques.
In this geographical area AB will contribute substantively to the Kenya 5-Year Strategy for primary
prevention which puts youth first to protect them from infection. The child-to-child program provides
significant support to the strategy targeting pre-adolescents and their families with appropriate messages.
Activities in the general population will include a special focus on reaching men.
This activity relates to activities in counseling and testing (#8760), voluntary medical male circumcision,
OHPS and Other Prevention (#8942). This will expand prevention opportunities for youth and provide
appropriate support for risk reduction.
This activity targets girls, boys, and primary school students through peer education activities. Youth-to-
family activities will target adults and out-of-school youth. Community outreach activities will target
community leaders, rural communities, religious leaders and teachers, community-based organizations and
faith-based organizations. This activity will reach 176,029 individuals with AB messages and train 1,222.
This APHIA II Nyanza activity will address male norms and behaviors, reducing violence and coercion
through peer family programs aimed at changing social norms.
This activity primarily emphasizes community mobilization/participation through peer education with a minor
Activity Narrative: emphasis on training of youth, teachers and community leaders as detailed in the activity description in
Section 1 above.
Continuing Activity: 14778
14778 8989.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $1,800,000
8989 8989.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $1,265,000
* Addressing male norms and behaviors
Workplace Programs
Table 3.3.02:
+ Clients of sex workers will be targeted with specific interventions that focus on consistent condom use and
knowing of status
+ Specific prevention messaging targeting women, men and discordant couples will be incorporated into CT
interventions. Specific messages will be developed for each target group.
+ This activity will incorporate $150,000 for HIV Free Generation activities focusing on youth
+ All male circumcision activities described in the FY08 narrative are now incorporated in their own narrative
in FY09 under voluntary medical male circumcision.
•Geographic coverage has been revised to include Kuria , Gucha, and Masaba
•An additional prevention component focusing on Male Circumcision (MC) was integrated with FY07 plus-up
funds. In FY 08 an additional $800,000 is provided for MC activities in the Northern districts of Nyanza
province.
•$50,000 of this OP activity is programmed with funds from the $7 million FY08 plus-up for the Youth
•OP funds totaling $29,000 will contribute to the sensitization of teachers as a worksite population linking
with AB and OPHS funds for a $150,000 activity to reach 750 teachers and train 20 more.
•APHIA II Nyanza will work with police, uniformed services, women, opinion leaders and others on issues of
gender-based violence
This activity relates to activities in Counseling and Testing (#8760), Abstinence and Be Faithful Programs
(#8989), Prevention of Mother-to-Child Transmission (#8734), Palliative Care: TB/HIV (#9059) and
HIV/AIDS Treatment: ARV Services (#8774).
In 2009, APHIA II Nyanza will reach 1,000,000 individuals, 10,000 people will be trained and condoms will
be distributed through 619 outlets. The USAID APHIA II Nyanza project implemented by EngenderHealth
initiated support to condom promotion and other prevention activities in Nyanza Province in FY 2006. In
2009, this activity will continue to promote the use of condoms in high-risk encounters and support STI
prevention and management in Nyanza Province but with a new focus on prevention strategies for HIV-
positive persons. In 50 public and faith-based health facilities, 300 health workers will be trained to promote
HIV prevention in care and treatment settings. Strengthening and expansion of STI management will
include training of health service providers in syndromic management of STIs with appropriate strategies for
condom promotion through the MCH, VCT, PMTCT and HIV treatment services. Utilizing the Ministry of
Health's Community Strategy, 200 community resource persons (CORPS) especially from women's groups
will be trained to promote health behaviors including faithfulness to their partner, knowing one's HIV status,
using condoms and seeking health care for management of STI's. This activity will include a component of
stigma reduction. In order to reach men, 100 peer educators at informal worksites including beach
communities will be trained in HIV-prevention behaviors. The CORPS and peer educators will implement an
HIV prevention program to reach 200,000 individuals in the community through community outreach and
promotional activities. Community-based organizations and faith-based groups will help to train 200 youth
advocates to use various BCC strategies including community radio and magnet theatre to deliver ABC
messages to 40,000 youth out of school. This activity must include adequate support to the primary sub-
recipient for prevention activities, PATH.
This APHIA II Nyanza project will contribute to the Kenya Five-Year Strategy that focuses on HIV prevention
targeting high-risk groups. It will support access to condoms for those at risk for transmitting or becoming
infected with HIV. In 2009, it includes a focus on prevention for HIV-positive individuals.
This activity relates to activities in counseling and testing (#8760), Abstinence/be faithful (#8989) to promote
healthy behaviors amongst youth and reduce stigma by encouraging individuals to know their HIV status. It
also relates to PMTCT (#8734), Palliative Care: TB/HIV (#9059) and ARV services (#8774) expanding HIV
prevention in care and treatment settings.
This activity targets youth, men and women living in rural communities. It targets FP clients and people
living with HIV/AIDS through clinical and community interventions. Training activities target public and faith-
based health care workers. Community outreach activities will target community-based organizations, faith-
based organizations, community leaders, religious leaders and out-of-school youth.
The behavior change communication activities for STI and HIV prevention will promote gender equity
This APHIA II Nyanza activity has a major emphasis on community mobilization/ participation with minor
emphases on training, IEC and local organization capacity development.
Continuing Activity: 14779
14779 8942.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $1,500,000
8942 8942.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $935,000
Table 3.3.03:
Updated April 2009 Reprogramming. Increased by $1,000,000. Partnership Framework: APHIA II Nyanza
is currently providing MC service in 12 facilities, but have indicated need to expand to reach 30 facilities in
the 3 districts they are operating in.
+ the activity description has been expanded to include more information on activities.
This activity relates to activities in abstinence/be faithful (#8989), condoms and other prevention (#8942),
counseling and testing, and adult care and treatment (#9059).
The USAID APHIA II Nyanza project implemented by EngenderHealth initiated support to Male
Circumcision services in Nyanza Province in FY 2008. In FY 2009 this activity will continue to expand the
geographical coverage of this service to increase access to Male Circumcision (MC) services. A total of 15
new MC procedure sites will be established in public health facilities and 5 new MC procedure sites in faith
based health facilities. Training in MC clinical skills will be provided for 100 health care workers. As a result
3,000 individuals will undergo Voluntary Medical Male Circumcision (VMMC). Counseling and Testing will
be an integral part of VMMC. Priority will be given to provision of integrated services ensuring effective
linkages to treatment, care and support, as well as to family planning and reproductive health services.
Activities will focus on decentralization of MC services resulting in initiation of services and follow up sites in
health centers. This will involve purchase of equipments, furniture, consumables and other items like patient
gowns. VMMC in clinical settings will require support for logistics, creation and renovation of space,
supportive supervision, ongoing clinical mentoring and monitoring and mainstreaming VMMC reporting.
This activity will also incorporate preventive messaging at health facilities targeting VMMC clients and their
families. It will involve the concept of AB and will promote the use of condoms in high-risk encounters and
support STI prevention and management in Nyanza Province. Behavior change communication (BCC)
strategies will focus on stigma reduction to increase utilization of services, psychosocial support and
promotion of MC services. Linked to condoms and other preventions component, there will be capacity
building and strengthening of 1,630 community health workers, and sensitization meetings with 1,200
women groups, 800 Village Health Committees around 24 health facilities in 5 districts to increase
knowledge and health benefits on Male Circumcision (MC). In worksites, there will be capacity building of
2000 Workplace Motivators and Peer Educators; men and women in formal and informal workplaces
through training on health benefits of male circumcision. They will be reached with BCC information and
education to promote the involvement of other workers and surrounding communities in decision making
with regard to MC uptake. Community Theatre approach will be employed and will entail capacity building
of theatre groups in 7 districts on the use of Magnet Theatre to provoke discussions and dialogue amongst
youth and community on the benefits of MC and promote its uptake. The established 100 Magnet theatre
groups with a membership of over 2500 will be sensitized on the benefits of MC they will develop skits and
reach out to other youths through sporting events and other interpersonal communication channels. Health
Action Days, which are integrated community outreach activities will be used to reach the most
disadvantaged members of the communities as a means of expanding and promoting MC. Through
Community Radio program, radio spots with appropriate BCC messages will be aired and interactive
programs that bring in experts to debate the importance of MC while creating awareness and provoking
communities to action will e facilitated to reach a large percentage of youth, men and women in 4 districts.
Through the schools program APHIA II Nyanza will sensitize 100 teachers and 5000 peer educators in
schools to facilitate discussions within existing health clubs and raise awareness on the benefits of MC.
Similarly, 100 FBO based youth leaders in supported churches/mosques will be facilitated to promote ABY
and MC messages to adolescents and young adults in 4 districts will continue. There will be continued
advocacy with community structures such as the Luo Council of elders and other option leaders to increase
acceptability of MC as a prevention strategy.
This APHIA II Nyanza project will contribute to the Male Circumcision policy that envisages adoption of MC
as one of the HIV prevention strategies. It will provide this service to 3,000 individuals in Nyanza province
prioritizing adolescents and young adults.
This activity relates to activities in Abstinence/be faithful (#8989) and condoms and other prevention
(#8942) to promote health behaviors.
This activity targets adolescents and adults living in both rural and small urban settings. It targets unmarried
as well as married males, those who are HIV negative. Training activities target public and private based
health care workers and other health workers, but with emphasis on public HCWs. Community activities will
target community based organizations, faith based organizations, community leaders and religious leaders.
The activity will promote prevention by encouraging males to adopt healthy behavior.
This APHIA II Nyanza activity has a major emphasis on training, quality assurance, and supportive
supervision. It also has a major emphasis on community sensitization.
Table 3.3.07:
ACTIVITY UNCHANGED FROM COP 2008
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS: this activity supports key cross-cutting
attributions in human capacity development through its training program for health workers ($50,000)
The APHIA II Nyanza HBHC activities relate to Pediatric and adult HIV/AIDS Treatment Services,
Counseling and Testing), Other Prevention, TB/HIV Care activities, PMTCT and Strategic Information.
USAID's APHIA II Nyanza project implemented by EngenderHealth began its support of basic health care
support services in Nyanza Province in FY 2006 and continued this in FY 2007 and FY 2008. In FY 2009
this activity will continue to provide basic health care support services to 47,000 PLWHA in 150 public
sector and faith-based health facilities and communities across fifteen districts in Nyanza Province. During
the COP 2009 period this activity will also continue to provide basic health care support services to 17,000
PLWHA in 25 communities across six districts in Nyanza Province out of the targeted 47,000 HIV infected
persons. The 1,000 CHWs who were trained in home-based care, nutrition, prevention, social and spiritual
support, and end-of-life care will continue to provide on-going support services. These will include basic
counseling, adherence counseling, and nutritional support and basic care packages. The project will
continue to work with the 25 CBOs to enroll PLWHA who are ready into support groups and networks which
will be linked to the national networks of people living with HIV/AIDS. Linkages between health facilities and
the community-based activities will be strengthened to ensure effective continuum of care, follow-up, and
effective referrals. The CHWs will the pregnant caregivers to the health facility for PMTCT services and will
follow-up on them and encourage them to join the HIV+ mother support groups. The households with HIV+
mothers will receive ITNs and water guard for water purification. The project will continue to work with the
CHWs to provide messages on prevention and VCT services in the rural communities 640 home based care
workers will be trained in nutrition, prevention, social and spiritual support, and end-of-life care. The quality
and availability of palliative services will also be increased in the community by engaging with community
support groups around the various comprehensive care centres. Linkages between health facilities and
community -based activities will be strengthened for effective care, follow up and tracking of referrals. Both
health care workers and community and home based care volunteer workers will be trained on effective
referral. This activity will work with community leaders and community based organizations to establish
linkages to other sectors to improve the livelihood of people living with HIV/AIDS. This will include
microfinance and agricultural organizations to enhance business skills and agricultural skills.
This activity will help to optimize the quality of life for 47,000 PLWHA in Nyanza province and provide critical
support to families affected by HIV/AIDS.
This activity relates activities relate to Pediatric and adult HIV/AIDS Treatment Services, Counseling and
Testing, Other Prevention, OVC, TB/HIV Care activities, AB, PMTCT and Strategic Information through the
formation of effective referral networks for HIV prevention, treatment care and support services.
This APHIA Nyanza activity targets adults of reproductive health age, people affected by HIV/AIDS and
people living with HIV/AIDS. Linkages to other sectors including agricultural programs and microfinance will
involve community leaders and community based organizations. Strategies to improve quality of services
will target faith-based and public health doctors, nurses, mid wives and other health care workers such as
clinical officers and public health officers in both public and faith based facilities.
This activity addresses stigma and discrimination by encouraging community support for people living with
HIV/AIDS.
The main Emphasis Areas for these activities will be workplace HIV prevention; care and treatment
programs that target both adults and children, as well as Health Related Wraparound Programs addressing
Family Planning and Safe Motherhood needs of adults.
Continuing Activity: 14780
14780 8928.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $900,000
8928 8928.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $350,000
Estimated amount of funding that is planned for Human Capacity Development $50,000
Table 3.3.08:
The narrative has been split to reflect adult and pediatric care and support and treatment. References to
targets have been updated including emphasis areas and budgets.
This activity supports key cross-cutting attributions in human capacity development through its training
program for health workers ($250,000).
This activity relates to activities in counseling and testing, PMTCT, orphans and vulnerable children,
TB/HIV, adult care and support and Pediatric HIV care and treatment.
The APHIA II Nyanza project implemented by EngenderHealth initiated support to ART services in Nyanza
Province in FY2006 and continued in FY2007 and FY2008. This activity will continue in FY2009 to expand
adult HIV care and treatment services in 15 districts of Nyanza province. Working in 58 public sector, 2 local
sugar company worksites and 20 faith based facilities, HIV treatment will be provided to 8,000 newly
initiating individuals. At the end of this COP 2009 period, 18,000 HIV infected adults will have ever received
ART, while 15,000 will be actively receiving ART. Activities will focus on decentralization of HIV care and
treatment services resulting in initiation of services and follow up sites in health centers, and inclusion of a
broad cadre of health staff to provide adherence counseling and support. To improve the technical capacity
of health staff, 150 will receive training in Adult ART and facilitative supervision. Infrastructure improvement,
logistics strengthening, procurement of supplies and dissemination of materials such as standard treatment
protocols, guidelines and pamphlets to address adherence will form part of the support. The project will
support networking and establishment of laboratory services to new health centers and facilitate provision of
laboratory equipment and reagents including CD4 count facilities in collaboration with other partners. The
project will computerize large (more than 250 patients) Comprehensive Care Centers to improve on drug
management and patient follow up. The network model of care will be incorporated to strengthen linkages to
MCH, PMTCT, TB, and STI services to expand opportunities for ART. A behavior change communication
program will be established in the rural communities surrounding the health facilities to address stigma
reduction; encourage utilization of treatment services; treatment compliance as part of psychosocial
support; and prevention of HIV among HIV positive individuals. Because the issue of stigma and
discrimination is still high amongst health workers in Kenya this activity whilst conducting clinical training will
also train workers on stigma and discrimination using a curriculum specifically produced for this purpose.
This activity will expand ART services in Nyanza Province providing treatment to 8,000 individuals newly
initiating ART, and increase availability of skilled health workers to provide care and treatment. It will enable
service providers to identify and refer the large numbers of HIV infected patients who are potential
candidates for ART. This activity will increase access to quality treatment services particularly among the
underserved. It also contributes to Kenya's 5-year strategy emphases of developing effective linkages
between prevention, care and treatment services within an integrated network.
This activity targets rural community members, people living with HIV/AIDS, HIV positive infants, and
children, HIV affected families, OVCs and caregivers. It also targets health care providers in public and faith
based facilities, other health care workers and other MOH staff based in Nyanza Province.
This activity will help to reduce stigma associated with HIV status and increase gender equity by expanding
the availability of comprehensive care.
Continuing Activity: 14785
14785 8774.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $3,050,000
8774 8774.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $1,400,000
Estimated amount of funding that is planned for Human Capacity Development $250,000
Table 3.3.09:
ACTIVITY UNCHANGED FROM COP 2008:
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS:
program for health workers ($10,000)
The APHIA II Nyanza PDCS activities relate to Pediatric and Adult HIV/AIDS Care and Treatment Service,
Counseling and Testing (#8760), Other Prevention (#8942), OVC (#9071), TB/HIV Care activities (#9059),
AB (#8989), PMTCT (#8734) and Strategic Information (#8859).
USAID's APHIA II Nyanza project implemented by EngenderHealth began its support to basic health care
support services in Nyanza Province in FY 2006 and continued in FY 2007 and FY 2008. In FY 2009 this
activity will continue to provide basic health care support services to 5,000 children living with HIV/AIDS in
150 public sector and faith-based health facilities and communities across fifteen districts in Nyanza
Province. In the rural communities 640 home based care workers will be trained in nutrition, prevention,
social and spiritual support, and end-of-life care. The quality and availability of palliative services will be
increased in the community by engaging with pediatric community support groups around comprehensive
care centers. Linkages between health facilities and the community-based activities will be strengthened for
effective care, follow-up, and tracking of referrals. Both health care workers and community and home
based care volunteer workers will be trained on effective referral. This activity will work with community
leaders and community based organizations to establish linkages to other sectors to improve the livelihood
of people living with HIV/AIDS. This will include microfinance and agricultural organizations to enhance
business skills and agricultural skills.
This activity will help to optimize the quality of life for 5,000 children infected with HIV in Nyanza province
and provide critical support to families affected by HIV/AIDS.
The APHIA II Nyanza PDCS activities relate to Pediatric and Adult HIV/AIDS Care and Treatment Services,
This APHIA II Nyanza activity targets adults of reproductive health age, people affected by HIV/AIDS and
Estimated amount of funding that is planned for Human Capacity Development $10,000
Table 3.3.10:
program for health workers ($30,000).
This activity relates to activities in counseling and testing (#8760), PMTCT (#8734), orphans and vulnerable
children (#9071), TB/HIV (#9059), Pediatric HIV Care and Adult HIV care and Treatment services.
Province in FY 2006 and continued in FY 2007 and FY 2008. This activity will continue in FY 2009 to
expand Pediatric HIV care and treatment services in 15 districts of Nyanza province. Working in 58 public
sector, 2 local sugar company worksites and 20 faith based facilities, HIV treatment will be provided to a
1,000 HIV infected children (including 177 new patients), which brings the total ever treated to 1,200.
Activities will focus on decentralization of pediatric HIV care and treatment services resulting in initiation of
services and follow up sites in health centers, and inclusion of a broad cadre of health staff to provide
adherence counseling and psychosocial support. To improve the technical capacity of health staff, 150 will
receive training in Pediatric antiretroviral treatment (ART) and facilitative supervision. To improve the quality
of life of children on treatment, 200 health care workers will receive training in pediatric psychosocial
counseling. Infrastructure improvement, logistics strengthening, procurement of supplies and dissemination
of materials such as standard treatment protocols, guidelines and pamphlets to address adherence will form
part of the support. The project will support networking and establishment of laboratory services to new
health centers and facilitate provision of laboratory equipments and reagents including CD4 percent and
CD4 count for facilities in collaboration with other partners. The project will computerize large (more than
250 patients) Comprehensive Care Centers to improve on drug management and patient follow up. The
network model of care will be incorporated to strengthen linkages to MCH and PMTCT services to expand
opportunities for Pediatric ART. A behavior change communication program will be established in the rural
communities surrounding the health facilities to address stigma reduction; encourage utilization of treatment
services; treatment compliance as part of psychosocial support; and prevention of HIV among HIV positive
individuals. Because the issue of stigma and discrimination is still high amongst health workers in Kenya
this activity whilst conducting clinical training will also train workers on stigma and discrimination using a
curriculum specifically produced for this purpose.
This activity will expand Pediatric ART services in Nyanza Province providing treatment to 1,200 children
and increase availability of skilled health workers to provide care and treatment. It will enable service
providers to identify and refer HIV infected children who are potential candidates for ART. This activity will
increase access to quality treatment services particularly among the underserved. It also contributes to
Kenya's 5-year strategy emphases of developing effective linkages between prevention, care and treatment
services within an integrated network.
children (#9071), TB/HIV (#9059), Pediatric HIV Care (#___) and Adult HIV care and Treatment services
(#__, #___).
Estimated amount of funding that is planned for Human Capacity Development $30,000
Table 3.3.11:
This activity relates to activities in Counseling and Testing, Condoms and Other Prevention, PMTCT,
Pediatric Care and Treatment, and Adult care and Treatment.
The APHIA II Nyanza project implemented by EngenderHealth began its support to TB/HIV palliative care
services in Nyanza Province in FY 2006 and continued in FY 2007 and FY 2008. In FY 2009 this activity will
continue the expansion of TB/HIV services that emphasizes HIV counseling and testing for all TB patients in
50 public sector and 20 faith-based health facilities across 12 districts in Nyanza Province. In the
communities this activity will encourage utilization of health facilities for TB screening and treatment through
a BCC strategy supported by community based and faith-based organizations. This activity will train 200
CHWs to introduce/strengthen community DOTS and encourage stigma reduction in rural communities. An
active contact tracing program will be established linking the health facility, the CHWs and home based care
providers. In the health facilities technical assistance will be provided to increase management and
technical capacity of staff, and improve quality and utilization of clinical and laboratory services. This will
ensure quality screening and clinical monitoring of patients, treatment for TB and referral for HIV testing.
This activity aims to train 200 health workers, including MOH laboratory personnel on DLTLD guidelines and
reporting procedures; quality laboratory services procedures and comprehensive HIV/TB management. It
will provide treatment to 750 HIV-infected TB patients, and provide HIV counseling and testing to 1,500 TB
infected patients. It prioritizes the screening of all HIV-infected persons, linking HIV-infected TB suspects to
TB diagnosis and TB treatment using DOTS, and linking all HIV-infected TB patients to HIV care and
treatment including ARV and cotrimoxazole therapy. This will strengthen referral linkages between the
community, VCT sites, PMTCT sites, CCCs and TB clinics.
This activity supports one of the high priorities of the Emergency Plan by improving geographical coverage
of services that address TB among persons living with HIV/AIDS, and total of 750 HIV-infected patients will
receive TB treatment. Referrals and linkages to treatment care and support for HIV-infected TB patients will
be strengthened.
This activity relates to activities in Counseling and Testing, Condoms and Other Prevention , PMTCT,
This APHIA Nyanza activity targets adults of reproductive health age, pregnant women, people living with
HIV/AIDS and rural communities to increase access to TB/HIV services. BCC activities will involve
community leaders, religious leaders, faith-based and community based organizations to reduce stigma and
improve health seeking behavior. Strategies to improve quality of services will target faith-based and public
health doctors, nurses, mid wives, laboratory workers and other health care workers such as clinical officers
and public health officers in both public and faith based facilities.
This activity addresses stigma and discrimination by enhancing community support for PLWHAs and
increasing gender equity in HIV/AIDS programs through increasing opportunity for comprehensive health
care.
Continuing Activity: 14781
14781 9059.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $300,000
9059 9059.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $300,000
Table 3.3.12:
+Prime partner EngenderHealth has been competitively selected to implement the activity.
+Activity will expand its coverage and initiate OVC activities in 3 key districts, namely, Siaya, Nyando and
Bondo to facilitate the provision of integrated USG support in these districts that already have on-going
treatment programs.
+Working with trained community health workers the activity will strengthen home based care and other
support interventions suitable for the children's well being and development.
+Linkages to food support; vocational training; educational opportunities; income generating activities;
health services and pediatric HIV services; will be strengthened through appropriate community
organizations.
+The activity will work in close collaboration with relevant community groups and government departments
to form networks that will address health improvement, capacity building and food support, vocational and
micro-business training for family income support.
+The activity will place an emphasis on the HIV counseling and testing of children with a focus on provider-
initiated home and community-based testing as an entry for care and support services to children. Using the
opt-out approach; this activity will test 90% of OVC enrolled; targeting approximately 81,900 with testing and
counseling. Of those tested, approximately 6,550 will be identified as HIV-exposed or infected and enrolled
into facility-based HIV care and treatment services to receive cotrimoxazole (CTX), evaluation for ART
eligibility and other basic HIV care services.
+In 2009, the activity will support the referral of particularly vulnerable OVC to the Nutrition and HIV/AIDS
Program and ensure that an increased number of OVC requiring food and nutritional services will be
reached with food supplements procured through the NHP.
+ In 2009, the activity will be used to support the development of OVC standards for Kenya and in
supporting quality improvement approaches for monitoring and improving the quality of OVC programs at
the provincial level.
+In 2009, the activity will also focus on establishing appropriate linkages with PMI and ensure that OVC
being supported are also able to benefit from mosquito nets procured by PMI.
+ In FY09, the activity will also focus on integrating prevention activities. The activity will link with prevention
programs to support male circumcision and counseling and testing for OVC as well as prevention with
positives for adolescents.
This activity will support key cross cutting attributions of the budget amounting to $195,000 towards
Economic Strengthening through the support of income generating activities to support increased
household food security. The activity will also attribute a portion of its budget to supporting educational
activities targeting OVC enrolled in the program in the amount of $ 325,000. A further budget amount of $
65,000 will be attributed to provision of safe water guards for households looking after OVC.
This activity relates to activities in TB/HIV (#9059), Palliative Care: basic health care and support (#8928),
ARV services (#8774), and counseling and testing (#8760).
APHIA Nyanza project implemented by Engender Health initiated support to OVC in Nyanza Province in FY
2006. It addresses OVC needs adopting the Kenya PEPFAR strategy of addressing seven essential
elements of OVC support. These essential services include: Nutrition, Education, Health, Protection,
Psychosocial support, Basic Material needs and Livelihood Capacity Building. This activity will continue to
employ a broad range of strategies and activities to build the capacity of communities, families and orphans
to meet their needs, and to build the capacity of community-based partners to deliver sustainable high
quality OVC interventions. The APHIA Nyanza project will serve 91,000 orphans and vulnerable children
and provide training to 8,190 caregivers. Working with trained community health workers the project will
implement home based care and other support interventions suitable for the children's well being and
development. Household members will be trained in palliative care for HIV+ children. Linkages to food
support; vocational training; educational opportunities; income generating activities; will be strengthened
through appropriate community organizations. The project will also build linkages to pediatric HIV services
and other relevant health services.
This activity will reach 91,000 OVC and train 8,190 caregivers in Nyanza province. It will augment the ability
of communities to provide comprehensive services including basic medical and nursing care, counseling
and psychological support, relief for social needs and prevention of HIV. It will strengthen the capacities of
families and communities to make informed decisions on who needs what care and how best to provide it.
The project will work in close collaboration with relevant community groups and government departments to
form networks that will address health improvement, capacity building and food support, vocational and
This activity is linked to APHIA II Nyanza activities in TB/HIV (#9059), Palliative Care: basic health care and
support (#8928), ARV services (#8774), and counseling and testing (#8760).
This activity will address individuals infected and affected by HIV/AIDS by targeting caregivers of OVC.
OVC - especially the girl child, as well as building the capacity of other community based and faith based
organizations by working closely with community and religious leaders in the delivery of care to OVC in
each community.
This activity will address issues in increasing gender equity in HIV/AIDS programs as well as wrap around
services in food and education.
Activity Narrative: 7. EMPHASIS AREAS
Major emphasis area is in development of local organization capacity and minor emphasis in
network/linkages/referral, community mobilization and training.
Continuing Activity: 14782
14782 9071.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $6,150,000
9071 9071.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $4,400,000
* Increasing women's access to income and productive resources
Estimated amount of funding that is planned for Economic Strengthening $195,000
Estimated amount of funding that is planned for Education $325,000
Estimated amount of funding that is planned for Water $65,000
Table 3.3.13:
+ Target population will be expanded to include testing for OVC
+ APHIA II Nyanza will expand counseling 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 CT and testing of family members of the infected individuals receiving care and
treatment within the facility and other outreaches like moonlight VCT as well as institutionalizing testing and
counseling in health care settings. PITC services will be scaled up.
+ HBCT services will be provided in Homa Bay district.
+ This activity will also provide support at the provincial and district levels for the annual national HIV testing
campaigns.
+ this activity will expand the VCT services within health facilities to provide outreach services including
door to door counseling and testing services
+ APHIA II Nyanza will also provide VCT to men interested in circumcision. This will be supported by
behavior change communication activities, targeting community leaders and youth.
This activity relates to activities in Abstinence/Be faithful, condoms and other prevention, palliative Care:
TB/HIV and ARV services.
The USAID APHIA II Nyanza project implemented by EngenderHealth initiated support to counseling and
testing services in Nyanza Province in FY 2006 and continued in FY 2007 and FY2008. In FY 2009 this
activity will continue to expand the geographical coverage of this service to increase access for couples and
families. Through this activity 50,000 individuals will be counseled and Tested through 50 sites and 200
providers trained. A total of 15 new VCT sites will be established in public health facilities and 30 new VCT
sites in faith based health facilities. Training in VCT and PITC will be provided for 200 counselors and health
care workers respectively. Additionally training in Door to Door Counseling and Couple Counseling will be
done for 150 counselors and health care workers. As a result 51,000 individuals will be counseled and
tested and referred to care, treatment and other services as required. Increasing access to antiretroviral
therapy dictates that CT efforts quickly transform to accommodate active case finding through provider
initiated testing, PITC, in clinical settings, in addition to the more passive client initiated testing (CIT). A total
of 180 mobile VCT service sessions will be conducted. As a way to capture populations at risk 30 moonlight
VCT sessions will be conducted. Home based testing and door to door testing for 20,000 clients will be
undertaken. Existing integrated VCT sites are particularly well placed to support these efforts; they will be
strengthened to support PITC efforts e.g. supporting start up activities, providing testing for partners and
other family members of index patients, and providing ongoing counseling. Testing in clinical settings will
require support for logistics, creation and renovation of space especially at inpatient facilities, supportive
supervision, ongoing monitoring, and mainstream CT reporting. Existing supported VCT sites already serve
a large population of young people aged 24 and younger. In addition to existing dedicated youth VCT
services, counselors at general VCT sites will be trained to work with young people. Targeted outreaches to
youth centers and tertiary institutions, will also reach young people. Experiences with comprehensive
counseling services at existing youth VCT centers including alcohol and substance abuse prevention
counseling; gender based violence prevention and counseling, pregnancy prevention/FP; STI prevention,
diagnosis and treatment; and referral to addiction treatment services; will be documented and used to scale
up these efforts at existing general VCT sites. Outreach services, health action days, will require effective
supervision, sessional staff, supplies, data collection and other logistics. BCC strategies supported by
CBOs, FBOs, churches and mosques will encourage people to know their HIV status, and develop
discordant couples support groups.
This APHIA II Nyanza project will contribute to the Kenya 5-Year Strategy that focuses on increasing access
to counseling and testing clinical services. It will provide this service to 15,000 individuals in Nyanza
province prioritizing youth, couples and families.
This activity relates to activities in Abstinence/be faithful and condoms and other prevention to promote
health behaviors and reduce stigma by encouraging individuals to know their HIV status. It also relates to
Palliative Care: TB/HIV and ARV services strengthening linkages between prevention, care and treatment
settings.
This activity targets youth and adults living in rural communities. It targets discordant couples and people
living with HIV/AIDS through clinical and community interventions. Training activities target public and
private based health care workers and other health workers. Community outreach activities will target
community based organizations, faith based organizations, community leaders and religious leaders. At-risk
populations will also be targeted with these services like commercial sex workers, discordant couples,
injecting drug users, street youth, truck drivers, migrant workers, out-of-school youth and partners/clients of
CSWs.
The activity will address stigma and discrimination by encouraging people to know their status. The
behavior change communication activities for HIV prevention will promote gender equity through partnering
with women's organizations in the design and implementation of community activities.
This APHIA II Nyanza activity has a major emphasis on training and minor emphasis in quality assurance,
quality improvement and supportive supervision and development of network/linkages/referral systems. It
Activity Narrative: has a minor on emphasis community mobilization/participation as well.
Continuing Activity: 14783
14783 12482.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $800,000
12482 12482.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $200,000
Table 3.3.14:
+ Jointly with program and MOH technical staff strengthen integration, linkages and/or referral systems
between facility-based and community-based monitoring and reporting systems especially with regard to
enrollment and retention of HIV+ clients on care and support (PMTCT, CT, TB, OVC and ART)
+ Increasingly, shift focus to quality of prevention care and treatment through planned and regular analysis,
feedback and use of data on quality indicators at facility/community, district and provincial data review
meetings.
+ Support MOH/PMO/PHRIO in strengthening HMIS functions especially on overall reporting rates, records
keeping, structured supportive supervision using M&E focused supervisory checklists, data use and hiring
of 19 data clerks to reduce increased data management burden on health care workers in the province.
+ Support the District Children Offices to strengthen the OVC M&E system to improve on data capture and
reporting
+ Conduct basic program evaluations (process evaluations, assessments, program reviews and some
outcome level evaluations) in prevention, care and treatment programs to document implementation and
short-term effectiveness of programs.
SECONDARY BUDGET ATTRIBUTIONS
This activity supports key cross-cutting attributions in human capacity development through training of GOK
and USG partner personnel in HMIS, M&E and Surveillance both at national and regional level.
The only changes since approval in 2007 COP are:
+expansion to 2 new districts and one municipality, support to provincial medical records office and the new
districts to computerize HMIS at the district level, support to about 20 ART sites with more than 250 clients
to computerize their systems to improve data management, drugs management and patient follow-up,
overall provincial reporting target and plan to conduct mid term evaluation. This activity also includes the
development of data quality improvement plan, training data point persons on DQA tools and
implementation of regular data quality audits at sampled health facilities and community level programs.
This activity is related to the strategic information activities to be carried out by University of North
Carolina/MEASURE Evaluation (#7098), NASCOP (#7002) and TE/TBD (#9220).
USAID'S APHIA II NYANZA project implemented by ENGENDERHEALTH began its service delivery
activities in Nyanza province in FY 2006. In FY 2007 this activity will strengthen the provincial and district
level Health Management Information Systems (HMIS) currently in use in Nyanza province MOH health
facilities, and Community Based Program Activity Reporting (COBPAR) currently being rolled out at
Constituency AIDS Control Committees (CACCS) levels by NACC through 3 key components. Component
1: Support APHIA II NYANZA/ENGENDERHEALTH and MOH program data collection processes for
performance reporting needs (quarterly, semi-annual, annual). This component will support a participatory,
coordinated and efficient data collection, analysis, use and provision of information to track achievement of
APHIA II NYANZA/ENGENDERHEALTH and MOH's district level Annual Operation Plan II objectives, and
inform decisions at the local, district and provincial levels, using standardized M&E/HMIS tools approved by
the MOH. Component 2: Strengthen community and facility based reporting systems being rolled out by
NACC and NASCOP. The component will support APHIA II NYANZA/ENGENDERHEALTH and MOH to
measure progress towards its contribution to the overall country's Emergency plan, National Health Sector
Strategic Plan II and Kenya National HIV/AIDS Strategic Plan goals and results frameworks. Specific
activities will include building capacity of 186 local organisations and facilities to collect, report, analyse, and
use both routine facility and non-facility data for planning and program improvement. Component 3: Take
lead role in coordinating M&E activities in the province to meet the information needs of USAID/Kenya, the
Emergency Plan, MOH, NACC and other stakeholders, in line with the "three ones" principle. APHIA II
NYANZA/ENGENDERHEALTH Nyanza will organize district-level consensus building forums on M&E
issues, distribute standardized data collection and reporting tools, conduct regular data quality assurance
processes at all data generation points, train 200 facility based and community based data point staff on the
new data collection/reporting tools and data use for improving program performance, and hold provincial
level quarterly and annual stakeholders' information dissemination meetings. APHIA II
Nyanza/ENGENDERHEALTH will be held accountable for tangible results, especially in increased use of
harmonized data collection and reporting tools at health facilities developed by MOH, increased data use in
planning and at dissemination workshops to various stakeholders, increased supportive-supervisory visits
and routine data quality assessments at all data collection points by M&E/HMIS officers, and improved
coordination of M&E activities in Nyanza province. These efforts should result into demonstrated evidence
in increased national level reporting by up to 80% from health facilities to NASCOP national database.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA.
The activity builds on the FY 2006 activities that support the national M&E systems as well as contributing
to the Emergency Plan's training outputs. In overall, the activity will provide technical assistance to forty
local organizations/health facilities in strategic information in addition to supporting the training of 110 SI
and program managers in M&E/HMIS, reporting and data use for program management
This activity is related to the strategic information activity to be carried out by University of North
Carolina/MEASURE Evaluation (#7098), where MEASURE Evaluation will be supporting NACC in rolling
out COBPAR system for community level reporting. It is also related to the strategic information to be
carried out by NASCOP (#7002), where NASCOP will be rolling out Form 726, Form 727 and program
specific client registers for data collection and reporting at health facilities. It is also related to SI TE/TBD
(#9220) that will attempt to investigate the causes for low reporting rate by health facilities and recommend
strategies for achieving 100% reporting level by health facilities.
5. POPULATIONS BEING TARGETED.
Activity Narrative: This activity targets host government and other health care workers like M&E and HMIS officers responsible
for data collection, analysis, reporting and use at both health facilities and community level. Program
managers are as well targeted for orientation on the role M&E program management.
6.EMPHASIS AREAS
The major emphasis area is Health Management Information Systems (HMIS) and minor areas include
Monitoring, evaluation, or reporting (or program level data collection) and Other SI Activities.
Continuing Activity: 14786
14786 8859.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $400,000
8859 8859.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $145,000
Estimated amount of funding that is planned for Human Capacity Development $180,000
Table 3.3.17:
1.LIST OF RELATED ACTIVITIES
This activity is related to the strategic information activities to be carried out by Macro International /APHIA
II Evaluation (#####), NASCOP (#####) and KDOD (####).
2.ACTIVITY DESCRIPTION
APHIA II Nyanza/EngenderHealth will help to strengthen the District Health Management Information
System by building the capacity of service providers and health records information officers to prepare and
submit timely and accurate reports. This will include training of 65 MOH officers in Nyanza Province to
improve the utilization of registers and other reporting tools both in clinical services and prevention services.
As an increasing number of clients receive male circumcision services in health facilities and counseling
and testing for the prevention of HIV/AIDS, the project will support the districts to collate this information
accurately in order to track the progress of the male circumcision initiatives. The project will work with the he
project will conduct regular data quality assurance processes at all data generation points, and provide
technical mentoring as required. APHIA II Nyanza/EngenderHealth will be held accountable for tangible
results, especially in increased use of harmonized data collection and reporting tools at health facilities
developed by MOH, increased data use in planning and at dissemination workshops to various
stakeholders, increased supportive-supervisory visits and routine data quality assessments at all data
collection points by M&E/HMIS officers, and improved coordination of M&E activities in Nyanza province. In
total the project will support 15 health facilities in improving the data collection and reporting processes.
These efforts should result into demonstrated evidence in increased national level reporting by up to 60%
from health facilities to NASCOP national database.
Continuing Activity: 14787
14787 12496.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $100,000
12496 12496.07 U.S. Agency for Engender Health 4915 4915.07 APHIA II - $100,000
Estimated amount of funding that is planned for Human Capacity Development $25,000
1. ACTIVITY DESCRIPTION
In 2009 APHIA II Nyanza will continue to strengthen the dissemination of key Government of Kenya (GOK)
policies and guidelines, developed at national level, to the district level. In addition APHIA II Nyanza will
continue to support provincial and district health systems strengthening by convening consultative meetings
and various stakeholders' forums.
In addition, APHIA II Nyanza will continue to strengthen the institutional capacity of various local partners at
grassroots level using very participatory methodologies. This will include institutional strengthening for 15
organizations. APHIA will also build the management and supervisory capacity of District Health
Management Boards (DHMTs) to effectively carry out their roles. All persons trained under APHIA will also
be equipped with skills for stigma mitigation. The prevention peer educators and community health workers
will engage the community on dialogue on stigma with the aim of enabling people to identify stigma in their
community and work towards stigma reduction, other approaches to be utilized will include community
theatre and outreaches.
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 and building the capacity of local APHIA implementing partners.
3. LINKS TO OTHER ACTIVITIES
This activity will link to other APHIA II Nyanza activities, particularly in AB and OP.
4. POPULATIONS BEING TARGETED
This activity will target all population of Nyanza province including youth, women, and men.
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 ¾
of the districts in the province served by the implementer.
Continuing Activity: 16334
16334 16334.08 U.S. Agency for Engender Health 6944 4915.08 APHIA II - $100,000
Table 3.3.18:
