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 $112,500. 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:
+ Splitting of APHIA II Nairobi and Central to APHIA II Nairobi and APHIA II Central. Targets and Budgets
have been split to reflect this change.
+ 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
+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
care workers and other key staffs to fill critical gaps in service delivery
1. LIST OF RELATED ACTIVITIES
This activity will relate to the ARV services (APHIA II Central), Orphans and Vulnerable Children (APHIA II
Central), Palliative Care: TB/HIV (APHIA II Central), Palliative Care: Basic Health Care and Support (APHIA
II Central) and Condoms and Other Prevention (APHIA II Central).
2. ACTIVITY DESCRIPTION
Pathfinder International (PI) supports facilities to provide comprehensive antenatal package for all pregnant
women including screening, prevention and treatment for any infections (such as sexually transmitted
infections and malaria), nutrition support, prophylactic ARVS, counseling on safe infant feeding, counseling
and HIV testing of women and their partners. APHIA II Central will build on this work in Central province.
APHIA II Central will continue to support established support groups that are formed around PMTCT sites
by mothers who have benefited from the project services and scale up the mother to mother support
services to enhance adherence to ART and infant feeding practices. In addition, referral linkages will be
established within facilities where APHIA II Central is providing antiretroviral therapy, through which HIV
positive clients are assessed and put on treatment where necessary. Decentralization of and task shifting in
treatment and care services including TB services will be supported to improve access in lower level health
services. Quality improvement through standards based management and recognition will be introduced
and supported in all supported sites. The number of HIV positive women and children on treatment is
increasing steadily through these networks. Laboratory networks will also be established that will greatly
improve ART uptake as well as early infant diagnosis. In 2009, APHIA II Central will consolidate these
activities and provide HIV counseling and testing to 41,927 (93%) of 44,886 pregnant women and 8385
spouses in the geographic area of coverage. Antiretroviral prophylaxis will be provided to 1708 (93%) out of
1829 HIV-positive women identified. Of the positive women, 854 will receive AZT/NVP, 342 HAART and
512 single dose nevirapine only for prophylaxis. 854 exposed infant will receive PCR for early infant
diagnosis. At the community level lay counselors will be trained to strengthen the delivery of PMTCT
services and to provide continued support for the HIV-positive women and their families. The project will
train community health workers to provide community components of PMTCT services. In order to improve
the quality of care, 30 health supervisors will learn management skills, including utilization of data for
decision making. In 2009, this project will use its experience to consolidate progress in existing facilities,
expand to others within the province, up to 146 facilities and continue to strengthen District Health
Management Teams, and referral networks for PMTCT-plus activities. Pathfinder will train 123 health
workers in PMTCT and comprehensive HIV management for HIV-positive mothers and their families, 60 on
early infant diagnosis, 60 on infant and young child feeding and 15 on couple counseling and testing. Efforts
will be made to increase early infant diagnosis in order to identify infants that require HIV care and
treatment and offer more appropriate advice on infant feeding choices. More efficacious regimens for
PMTCT will be introduced and scaled up in all the sites offering services. Linkages to FP/RH will be made
as well as to laboratory services in order to offer a more comprehensive package of care. Capacity for
service providers to provide couple HIV Counseling and testing within PMTCT sites will be supported with
2009 funds. Many women accessing HIV counseling and testing at PMTCT sites do not know their partner's
HIV status. The program will strengthen innovative approaches to increase the number of men accessing
HIV testing services, thereby enabling discordant couples to know their HIV status -an important HIV
prevention strategy among couples. The program will reach at least 8385 couples.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute to 3.2% of the overall 2009 Emergency Plan PMTCT targets for Kenya.
Community participation and male involvement will significantly contribute to PEPFAR goals for primary
prevention, access to care and treatment, and support of those affected and infected. Technical assistance
to the Ministry of health facilities will contribute to improvement of the quality of services including GOK led
regional meetings.
4. LINKS TO OTHER ACTIVITES
Linkages to HIV care and treatment services will be strengthened, to ensure immediate appropriate care for
the woman and exposed infants, and family members as well and thus optimize utilization of
complementary services created through Emergency Plan funding. This activity will relate to the ARV
services (APHIA II Central), OVC care (APHIA II Central), TB/HIV services (APHIA II Central), HBHC
(APHIA II Central) and STP services (APHIA II Central) funded under the APHIA II Central.
5. POPULATIONS BEING TARGETED
This activity targets adults, pregnant women, HIV-positive pregnant women, HIV affected families, and HIV-
positive infants. Health care providers including Doctors, Nurses and Other Health care workers will be
Activity Narrative: targeted for training on PMTCT using the national NASCOP PMTCT CDC/WHO based curriculum.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity will address gender equity in HIV/AIDS programs through improved PMTCT service delivery at
ante-natal clinics and maternity units and male involvement. Community health workers and mentor
mothers will conduct community mobilization activities that will help increase service uptake as well as
address issues of stigma and discrimination at community level.
7. EMPHASIS AREAS
This activity includes emphasis on human capacity development through training, supportive supervision
and task shifting, support to strategic information, linkage to family planning, safe motherhood, TB and
nutrition programs as well as Quality Assurance, Community Mobilization/Participation and Development of
Network/Linkages/ Referral systems
New/Continuing Activity: Continuing Activity
Continuing Activity: 14957
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14957 8729.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $425,000
International International Central
Development
8729 8729.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $850,000
International International Central / Nairobi
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
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 $123,066
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
+ Specific AB messages will target both adult men and women with the aim to reduce multiple concurrent
partners
+ This activity will incorporate $200,000 for HIV Free Generation activities targeting youth
COP 2008
The only changes to the program since approval in the 2007 COP:
• $200,000 of this activity supports the Youth Prevention Initiative programmed with funds from the $7
million FY 08 plus up;
• Peer education activities will be rolled out with the Kenya Girl Guides Association;
• The target population has been expanded to include teachers at the worksite: $45,000 in AB funds will go
toward this activity complemented by allocations in OP and OHPS totaling $300,000 to reach 1,200
teachers and train 40 more;
• In response to the Ministry of Education's request the KARHP methodology will be continued at the level
of approximately $225,000 targeting teachers and in-school youth;
• $150,000 will expand support in HIV prevention and supportive services to victims of gender-based
violence in Nairobi and Central province through the Nairobi Womens Hospital and other facilities.
This activity relates to activities in Counseling and Testing (#8976), Palliative Care: TB/HIV (#9072), and
Prevention of Mother-to-Child Transmission (#8729).
$200,000 of this activity supports the HIV Free Generation activities. In FY 2009, Pathfinder and its
prevention partners, including PSI, will target 275,337 youth and adults with community outreach HIV/AIDS
prevention programs that promote abstinence and/or being faithful. Peer education, informal and formal
worksite interventions, community outreach by PLWA, mobile VCT and life skills education for youth will all
serve as a means through which messages will be conveyed. An in-school program for 10 to15 year olds
will emphasize creation of support systems for students to focus on long-term goals, self-esteem and life
skills. Emphasis will be on delayed sexual debut, and secondary abstinence will be encouraged for those
youth who are already sexually active. APHIA II community-level partner capacity for undertaking
prevention and behavior change activities will also be strengthened, so that messages can be conveyed
widely through implementing partners undertaking home and community support activities as well. It is
expected that 1,912 persons will be trained to provide HIV/AIDS prevention programs that promote
abstinence and/or being faithful. Additional project partners to be trained in Other Behavior Change will also
contribute to AB message dissemination. There will be a component of Prevention with Positives whereby
the Project will work through PLWHA Support Groups linked to the Comprehensive Care Centers in Central
province. This activity will provide support to patient support groups and post-test clubs in VCT Centers to
ensure abstinence by HIV-infected persons. This will empower 5 people in each of the 15 patient support
groups to become peer and advocacy leaders in prevention at the community level and will reach 30,000
PLWAs. APHIA II Central will expand their work with the Kenya Girl Guides Association. $100,000 will
expand support in HIV prevention and supportive services to victims of gender-based violence in Central
province through the Nairobi Women's Hospital and other facilities. This activity will reach 20,000 youth.
$100,000 will be used to reach high risk out-of-school youth including street children with AB messages.
This activity will reach 70,000 youth.
This activity will contribute significantly to the overall Emergency Plan AB Prevention targets for Kenya.
Integrating prevention into all community outreach for treatment and care, with special emphasis on men
and youth, will significantly contribute to PEPFAR goals for primary prevention and the Kenya Five-Year
strategy for HIV/AIDS.
4. LINKS TO OTHER ACTIVITIES
Support to AB Prevention will be one component of a package of integrated support at health facility and
community levels in the region, holistically addressing HIV prevention, treatment and care. This activity
relates to activities in Counseling and Testing (#8976), Palliative Care: TB/HIV (#9072), and PMTCT
(#8729) through referrals and networking.
The activity targets youth with messages about abstinence and both adults and youth with messages
advocating faithfulness to one partner. Special emphasis will be placed on reaching men through outreach
by PLWAs and involvement of community leaders, by couples counseling in PMTCT and through worksite
interventions. Implementing partner counterparts from NGOs, CBOs, FBOs and schools will be targeted for
training to implement prevention programs.
This activity will be consistent with national strategies for HIV prevention promoting abstinence, delay of
sexual debut including secondary abstinence, fidelity, partner reduction and related community and social
norms.
There will be a major emphasis on capacity building of implementing partners, community-owned resource
persons and other community level implementing partners. Community involvement in the design and
implementation of activities will play an integral part in ensuring the success of these interventions.
Continuing Activity: 14958
14958 8731.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $1,150,000
8731 8731.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $850,000
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 $100,000 for HIV Free Generation activities focusing on youth.
+ This activity will target police, uniformed services, women, opinion leaders, and others on issues of
gender-based violence.
The only changes to the program since approval in the 2007 COP are:
•$100,000 of this OP activity is programmed with funds from the $7million FY08 plus-up for the Youth
Prevention Initiative.
•OP funds totaling $58,500 will contribute to the sensitization of teachers as a worksite population linking
with AB and OPHS funds for a $150,000 activity to reach 1,500 teachers and train 40 more.
•APHIA II Nairobi/Central will work with select health facilities, police, uniformed services, opinion leaders
and others on issues of gender-based violence.
•The OP activity will include Prevention with Positives (PwP) activities working through PLWA support
groups linked to the Comprehensive care Centers.
•APHIA II Nairobi/Central will also expand their activities with CSWs and MSMs.
•APHIA II Nairobi/Central will continue work with select health facilities, police, uniformed services, opinion
leaders and others on issues of gender-based violence.
This activity is linked to Palliative Care: Basic Health Care and Support (#8936), Counseling and Testing
(#8976), and Palliative Care: TB/HIV (#9072).
In 2009, APHIA II Central will reach 276,423 individuals, train 821 people and distribute condoms through
248 outlets. This activity will strengthen HIV prevention programs through other behavior change
approaches (i.e. all behavior change approaches that do not focus on abstinence and being faithful) under
the APHIA II Central Province Project. In FY 2009, Pathfinder and its prevention partners, including PSI, will
target youth and adults with behavior change messages that are appropriately adapted to different target
groups. Peer education, informal and formal worksite interventions, community outreach by PLWA, mobile
VCT, life skills education for youth, high-risk outreach and transport corridor activities will all serve as
means through which messages will be conveyed. In particular, the project will capitalize on PSI's
experience in targeting informal worksites, market places, and "hot zones" where high-risk behavior is
common. Street theater, interactive games, PLWA testimonials, outreach sessions and community
mobilization will be used to convey messages that include consistent and correct use of condoms, knowing
one's status and knowing your partner's status. APHIA II community level partner capacity for undertaking
prevention and behavior change activities will also be strengthened, such that messages can be conveyed
widely through implementing partners and undertaking home and community support activities.
This activity will contribute significantly to the overall 2009 PEPFAR OP targets for Kenya. By specifically
focusing on men and youth, this activity will significantly contribute to PEPFAR goals for primary prevention
through the integration of prevention into all community outreach for treatment and care.
Support to Prevention/Other Behavior Change will be one component of a package of integrated support at
health facility and community levels in the region, holistically addressing HIV prevention, treatment and
care. It is specifically linked to palliative care, basic health care (#8936), counseling and testing (#8976),
and palliative care, TB/HIV (#9072).
This activity targets both adults and youth, with additional emphasis on worksites to reach men as well as
high-risk groups and persons frequenting/working in "hot spots". It will target special populations such as
bar maids to improve their HIV risk awareness, their rights as bar maids and how they can protect
themselves from acquiring HIV infection. Implementing-Partner counterparts from NGOs, CBOs, FBOs and
schools will be targeted for training to implement prevention programs.
This activity will be consistent with national policies regarding other prevention and will specifically address
gender to improve gender equity in HIV programming as well as address male norms and behavior that
often hinder uptake of prevention activities.
This activity includes major emphasis on worksites and minor emphases implementing-partner capacity
building, linkages with other sectors and initiatives and training. APHIA II Central will expand their activities
to target high-risk youth by training peer educators. The activity will focus on HIV prevention with male and
female sex workers to promote alternatives to commercial sex work as well as protective barriers to prevent
HIV transmission, both with commercial partners and steady boyfriends/girlfriends and husbands/wives. In
addition they will use $100,000 to expand support in HIV prevention and supportive services to 20,000
victims of gender-based violence in central province through the Nairobi Womens Hospital and outreach
centers and train 20 health workers and community participants.
Continuing Activity: 14959
14959 8874.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $600,000
8874 8874.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $1,050,000
Table 3.3.03:
ACTIVITY UNCHANGED FROM COP 2008
This activity supports key cross-cutting attributions in human capacity development through its training
program for health workers ($20,000).
This activity will be linked to PMTCT, VCT (APHIA II Central), Adult Care and Treatment services (APHIA II
Central), OVC Care (APHIA II Central), TB/HIV services (APHIA II Central).
This activity relates to the strengthening and expansion of HIV adult care services as well as care and
support for PLHIV and families affected by HIV & AIDS under the APHIA II Central Project. In FY09, APHIA
II Central will target 42 sites in support of adult care and treatment services and 50 Implementing Partners
(IP) working in community home based palliative care. The support will include Ministry of Health
supervision, progress review meetings and strengthening of quality assurance, especially with regard to
integrating HIV with RH/FP and TB services and HMIS. At new and ongoing sites, service providers will
receive training in adult HIV care management including prevention and treatment of OI, HIV adherence
counseling, HIV nutritional assessment and counseling, couple counseling and prevention with positives
(PWP) will be given more attention in order to curb the tide of new infections. Treatment at the CCCs will be
expanded to link and network with other entry points such as the out patient departments, inpatient
departments, PMTCT, VCT centers. APHIA II Central will continue to strengthen linkages with community
services which include patient empowerment on adherence through treatment literacy, strengthened
support mechanisms (PTC/support groups, counseling, IGA and legal aid), community based defaulter
tracing, home nursing care, prevention and strengthened referral linkages to the health facilities. APHIA II
Central will also provide more empowering support to people living with HIV by providing more opportunities
for Greater Involvement of PLHIV (GIPA) and making the participation of PLHIV more meaningful and
sustainable. Efforts will be made to decentralize services so that patients get treatment where they are
presenting for care. It is expected that 23,000 adult clients will be receiving palliative care at the end of this
reporting period in the 42 health facilities, and 5,000 of these will be targeted for home and community
support services. The project will continue to support clinical staff, continuous medical education,
mentorship, on site technical assistance, furniture and equipment at health facilities and grantees (Catholic
Medical Mission Board, CHAK etc) to strengthen provision of HIV services. A total of 120 service providers
will be trained in provision of care and support, 60 in HIV adherence counseling and 60 in nutritional
management in PLHIV.
These service providers will also be targeted for periodic orientation on home and community services to
strengthen linkages and between the facilities and community sites, and to ensure support for HCS at
facility level Palliative care (basic) will include a comprehensive package of community home-based care
consisting of home nursing, clinical care, nutrition, STI/HIV prevention, education, psychosocial and spiritual
support. PI will continue with treatment literacy training via support groups to enhance adherence, establish
paralegal clinics, facilitate VHC quarterly meetings and enhance links to income generating activities
notably training and facilitating PLHIV on IGA. PI will scale up IGA, VSL and food security through working
with the MOA and K_REP Development Agency. The number of adults trained in palliative care will be
2,500. This will include CHW refreshers, treatment literacy, couple counseling, community defaulter tracing,
and home nursing care and prevention techniques. The project will also put emphasis on continuous
medical education for service providers and continuous community education for IPs personnel. Formation
of support groups and working with post-test club members will be enhanced. Cotrimoxazole prophylaxis
and where indicated, fluconaze prophylaxis will be the basic standard of care for HIV infected people within
the facility and community. APHIA II Central will work with local implementing partners including established
NGOs, CBOs, and FBOs. APHIA II Central will strengthen the technical and institutional capacity of partners
and build collaborative working relationships with a variety of stakeholders to encourage effective, efficient
programming Elaborate plans will be put in place to improve on data collection and record keeping. Gender
and youth issues will be addressed. PLHIV will be involved to ensure expansion and high quality of care
and support programming. To promote GIPA, PLHIV will be recruited through implementing partners such
as KENWA, African Wildlife Foundation ,KENAPOTE WEHMIS, SWAK and Maragua Positive Voices and
Community Health Workers, in improving the quality of services but also in combating the serious issue of
stigma as well as encouraging prevention with positives.
This activity will contribute significantly to the overall 2009 Emergency Plan Palliative Care targets for
Kenya.
BCC teams such as drama groups, Advocates and CHWs will play an important role in community
mobilization, sensitization, literacy training and advocacy for enhanced for an increase in the uptake of
services. Linkages to clinical services will be established through a two-way referral system and will include
PMTCT, ART, OVC, TB testing and other basic health services. Clinical supervisors and other health care
providers and CORPs will reinforce clinic to community referrals by being kept up-to-date on local resources
for psychosocial, economic, legal and food security support. APHIA II Central will link with local partners
such as K-Rep, to address economic insecurity through microfinance and business skills training.
Implementing partners will collaborate with local programs and agencies to address food insecurity and
nutrition needs. . APHIA II Central will continue to expand its close working relationship with FBOs because
of their comprehensive community support programs addressing a wide range of needs for those
households made vulnerable by HIV and AIDS.
This activity targets people and families affected by HIV & AIDS. Local implementing partners will be
targeted for training and capacity building. Health care providers, religious leaders and the administration
officials will be targeted for sensitization and training related to home-based care. Community Health
Activity Narrative: Workers and caregivers will be trained and receive periodic refresher training. They will also continue to
receive HBC supplies, uniforms gumboots, bicycles and bags. IEC materials on child CT will be developed,
produced and distributed.
This activity will address issues of gender equity, gender based violence and greater involvement of 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: 14967
14967 8755.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $385,000
8755 8755.07 U.S. Agency for Pathfinder 4926 4926.07 Kenya Heartland $0
International International Coffee
Development Project/APHIA
Nairobi-Central
Estimated amount of funding that is planned for Human Capacity Development $20,000
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.
program for health workers ($150,000).
This activity will specifically be linked to other APHIA II Central supported activities in PMTCT (APHIA II
Central), OVC (APHIA II Central) and TB/HIV (APHIA II Central), home based care and other prevention
activities (APHIA II Central) ensuring successful referral of individuals that require ART care and support.
This activity relates to support to be provided to strengthen and expand ART services in Central Province
under the APHIA II Central Province Project. In FY09, Pathfinder International (PI), the lead partner and its
partners will target 35 sites in Central Province for support to ARV services, GOK, FBO and private
organizations. These sites include 15 Year 1 and 2 sites; the remainder will be new to the project.
Additional sites will be specified in coordinated planning with district and provincial counterparts as well as
the USG, for a total of 35 service outlets providing ART by the end of the period. Support at ongoing and
new sites will enable Ministry of Health supervision and progress review meetings as well as strengthen
quality assurance, especially with regard to integrating HIV services, integrating HIV with RH/FP and TB
services and HMIS. At the new sites 150 service providers will receive training in adult HIV care including
PEP. Emphasis will be laid on the integrated Management of Adult Illness in support of lower level facilities
to establish Comprehensive care services. Prevention with positives will be given more attention in order to
curb the tide of new infections. Treatment at the CCC will be expanded to link and network other entry
points such as the out patient departments, inpatient department community services, PMTCT and VCT
centers. Efforts will be made to decentralize services so that patients get treatment where they present for
care. Laboratory costs are often a hindrance to uptake of services and efforts will be made to facilitate
laboratory networks that improve uptake of ARV services. The laboratory will get equipment for basic tests
that support CCC services. It is expected that 1000 clients will be newly initiated on ART with 3,600 ever
received ART and 3,000 as currently on ART. Nyeri Provincial General Hospital will be supported to
establish and strengthen a Gender Violence recovery Centre as service providers will continue being
trained on GBV. Small renovations/ upgrades of infrastructure and furniture procurement will be carried out
with focus on adult HIV services. Psychosocial support groups will be supported at facility level to improve
community linkages, adherence to ART and stigma reduction among the PLWHA. APHIA II Central will also
support both paper based and electronic versions of record keeping at the CCC in line with the NASCOP
guidelines.
This activity will contribute significantly to the overall 2009 Emergency Plan ART targets for Kenya by
ensuring that all adults who require treatment are getting it.
Coordination will take place with other USG partners supporting ART services in Central, including
Columbia University, among others. Support to ART services will be one component of a package of
integrated support at health facility and community levels in the region, holistically addressing HIV
prevention, treatment and care. This activity will specifically be linked to other APHIA II Nairobi and Central
supported activities in PMTCT, OVC and TB/HIV, home based care and other prevention activities ensuring
successful referral of individuals that require ART care and support.
This activity targets HIV+ adults. Health care providers including Doctors, Nurses and Other Health care
workers will be targeted for training using national curricula.
This activity will address issues of expanding access and decentralization of services.
Continuing Activity: 14965
14965 8765.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $1,950,000
8765 8765.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $2,610,000
Estimated amount of funding that is planned for Human Capacity Development $150,000
Table 3.3.09:
+ APHIA II Nairobi/Central has been separated into two mechanisms; APHIA II Nairobi and APHIA II
Central. Provincial targets have also been updated appropriately.
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS:
This activity supports key cross-cutting attributions in Economic Strengthening by linking care-givers of HIV
positive children to microfinance opportunities with K-REP Development Agency.
This activity will be linked to PMTCT, VCT (APHIA II Central), ARV services (APHIA II Central), OVC Care
(APHIA II Central), TB/HIV services (APHIA II Central)
2. ACTIVITY DESCRIPTION:
This activity relates to strengthening and expansion of pediatric treatment, care and support services as well
as care and support for families with children affected by HIV & AIDS under the APHIA II Central Project. In
FY09, APHIA II Central will target 20 sites for support in pediatric care & support. Support will include
facilitation of MOH supervision and progress review meetings as well as strengthening of quality assurance,
especially with regard to integrating HIV services with TB services, psychosocial support and HMIS. Service
providers will be trained in pediatric HIV care management including prevention and treatment of OI, HIV
adherence counseling, HIV nutritional assessment and counseling, pediatric psychosocial support including
play therapy. Treatment at the CCCs will be expanded to link and network with other entry points such as
the out-patient departments, in-patient departments, pediatric psychosocial services, and PMTCT. APHIA II
Central will continue to strengthen linkages with community services in order to empower families with
children living with HIV (CLHIV) and make their participation in the program more meaningful and
sustainable. Efforts will be made to strengthen and scale up early infant diagnosis through training of
service providers and support for transportation of dry blood spot (DBS) samples for DNA Polymerase
Chain Reaction (PCR). The care and support package will also include aggressive patient empowerment
on adherence for older children and caregiver/parent empowerment on adherence for younger children,
strengthened support mechanisms (support groups, IGA for families, advocacy and legal aid), home nursing
care, community based defaulter tracing, nutritional support, specialized counseling and strengthened
continuum of care from health facility to the community level, including strong linkages with PMTCT services
for prevention. Other community BCC activities will include formation of Kids clubs, adolescent support
groups and working with adolescent post-test club members will be enhanced, fun days for children, peer
education, dialogue forums, sporting activities and edutainment for youth. Caregivers/parents of CLHIV will
be given special attention and will be empowered through formation of support groups, treatment literacy,
and support for IGA and PSS sessions to bolster their coping mechanisms. Efforts will be made to
decentralize services so that patients get treatment where they are presenting for care. It is expected that
2,500 pediatric clients will be receiving OI prophylaxis at the end of this reporting period in the 20 health
facilities, while 2,650 children will be targeted for home and community support. The project will continue to
support clinical staff, continuous medical education, mentorship, on site technical assistance, furniture and
equipment at health facilities and grantees to strengthen provision of HIV services. 150 service providers
will be trained in pediatric care and support including pediatric psychosocial support and play therapy.
facility level. Palliative care for pediatrics will include a comprehensive package of community home-based
care consisting of home nursing, clinical care, nutrition, education, OVC care, paralegal support and
protection, psychosocial and spiritual support. This will be implemented through 50 IPs and 20 service
delivery sites and will reach 2,650 pediatrics. A total number of 100 care givers with children living with HIV
will be trained in nutritional support, formation of support groups, counseling and PSS. PI will continue with
treatment literacy training via support groups to enhance adherence, establish paralegal clinics, facilitate
VHC quarterly meetings and enhance links to income generating activities notably training and facilitating
caregivers on IGA. PI will scale up IGA, VSL and food security through working with the MOA and K_REP
Development Agency. Cotrimoxazole prophylaxis and where indicated, fluconazole prophylaxis will be the
basic standard of care for HIV infected children within the community and at facilities. APHIA II Central will
work with local implementing partners including established NGOs, CBOs, and FBOs. APHIA II Central will
strengthen the technical and institutional capacity of partners and build collaborative working relationships
with a variety of stakeholders to encourage effective, efficient programming Elaborate plans will be put in
place to improve on data collection and record keeping. CHWs will be updated on child counseling and
testing, and ensure referral linkages are established with health facilities providing CT. Other care and
support services for the pediatric are mostly provided in the community and are included within services for
OVC. Linkages will be strengthened between the community and the facility where the facility will be
supported by APHIA II Central to provide a basic care package inclusive of; Nutritional counseling of
caregivers, safe water provision, and pain management. OI treatment, insecticide treated mosquitoes and
clinical support.
Linkages to clinical services will be established through a two-way referral system and will include PMTCT,
ART, OVC, TB testing and other basic health services. Clinical supervisors and other health care providers
will reinforce clinic to community referrals by being kept up-to-date on local resources for psychosocial,
economic, legal and food security support. APHIA II Central will link with local partners such as K-Rep, to
address economic insecurity through microfinance and business skills training. Implementing partners will
collaborate with local programs and agencies to address food insecurity and nutrition needs. APHIA II
Central will continue to expand its close working relationship with FBOs because of their comprehensive
community support programs addressing a wide range of needs for those households made vulnerable by
HIV and AIDS. Children living with HIV will be linked to pediatric CCs and other facilities that provide care,
legal aid and specialized services as need arises.
Activity Narrative: 5. POPULATIONS BEING TARGETED:
Workers and caregivers will be trained and receive periodic refresher training. They will also continue to
This activity will address issues of expanding access to and training in home-based care following the GOK
guidelines and curriculum. The activity will also address decentralization of services to widen the catchment
areas for patients requiring the services. It will address gender equity, gender based violence and greater
involvement of people living with HIV/AIDS.
Estimated amount of funding that is planned for Economic Strengthening $10,000
Table 3.3.10:
Central), OVC (APHIA II Central) and TB/HIV (APHIA II Central), Pediatric Care and Treatment (APHIA II
Central), and Adult Care and Treatment (APHIA II Central), ensuring successful referral of individuals that
require ART care and support
This activity relates to support to be provided to strengthen and expand pediatric antiretroviral treatment
(ART) services in Central Provinces under the APHIA II Central Province Project. In FY09, Pathfinder
International (PI), the lead partner and its partners will target twenty sites in Central Province for support to
Pediatric ARV services, GOK, FBO and private organizations. These sites include 10 Year 1 and 2 sites;
the remainder will be new to the project. Additional sites will be specified in coordinated planning with
district and provincial counterparts as well as the USG, for a total of 20 service outlets providing ART by the
end of the period. Support at ongoing and new sites will enable MOH supervision and progress review
meetings as well as strengthen quality assurance, especially with regard to integrating HIV services,
integrating HIV with RH/FP and TB services and HMIS. At new sites, service providers will receive training
in pediatric HIV care. A subcontractor will be used to train 15 TOT in pediatric ART addressing the TOT gap
in Central province, as well as have additional trainings for 150 service providers. Emphasis will be laid on
the Pediatric ART training in support of lower level facilities to establish Comprehensive care services for
children. Efforts will be made to introduce and scale up early infant diagnosis as well as scale up pediatric
care and treatment. PMTCT will be given more attention in order to curb the tide of new infections.
Treatment at the CCC will be expanded to link and network other entry points such as the pediatric out
patient departments, pediatric inpatient departments, community services, MCH and PMTCT centers.
Efforts will be made to decentralize services so that patients get treatment where they are presenting for
that support CCC services. It is expected that 100 clients will be newly initiated on ART with 200 being
currently on ART at the end of the reporting period. This will bring the total ever treated to 240. Small
renovations/ upgrades of infrastructure and furniture procurement will be carried out with focus on pediatric
HIV services. Child psychosocial support will be directed towards providers involved both in child counseling
and testing as well as treatment. Kids clubs and adolescents psychosocial support groups will be supported
at facility level to improve community linkages, adherence to ART and stigma reduction among the infected
children. APHIA II Central will also support both paper based and electronic versions of record keeping at
the CCC in line with the NASCOP guidelines.
This activity will contribute significantly to the overall 2009 Emergency Plan ART targets for Kenya. It will
also ensure that more children are identified through early infant diagnosis and through other means in
order to increase the number of children on care and treatment.
integrated support at health facility and community levels in the region, holistically addressing pediatric HIV
successful referral of children that require ART care and support.
This activity targets HIV positive children. Health care providers including Doctors, Nurses and Other
Health care workers will be targeted for training using national curricula.
6. EMPHASIS AREAS
Table 3.3.11:
+ Splitting of APHIA II Nairobi/Central to APHIA II Nairobi and APHIA II Central. Targets and budgets have
been split to reflect this change.
program that targets all cadres of health workers using the national curriculum ($20,000).
This activity will be linked to Adult HIV care and treatment services (APHIA II Central), Pediatric HIV Care
and Treatment services (APHIA II Central), HIV counseling and Testing (CT) Services (APHIA II Central)
and national DLTLD services
This activity relates to support for strengthening and expanding palliative care in clinical settings for
addressing TB and HIV. Pathfinder International (PI), which is the lead partner in APHIA II Central, will
develop and implement new interventions, expand and integrate service delivery in COP 2009 period in
sites targeted under the APHIA II Nairobi/Central Project, and add new ones. In 2009, 35 sites in Central
will be supported in the provision of TB/HIV services. Through these sites, 500 HIV-infected clients
attending HIV care and treatment services will receive treatment for TB and 1,000 patients attending the TB
clinic will be tested for HIV. Emphasis will be on filling gaps in service delivery and linking to community
based services and 3,250 patients will get intensified TB screening through community and clinical
programs. TB prevention, treatment and care programs will be strengthened and effective linkages made
between TB and HIV services. Service quality and supervision at all levels of facility care and referral will be
improved. Drug supply management, case management, records systems, supervision and community-
based adherence/follow-up will be strengthened. All health facilities targeted by the project will provide OI
treatment, including TB, cotrimoxazole prophylaxis, and nutritional support. APHIA II Central will work to
expand diagnostic and DOTS case management capacity. According to GOK policy, all HIV+ patients will
be screened for TB, and all TB patients tested for HIV.
Malteser International, a PI partner, will provide guidance for training of nurses and CHWs, annual refresher
training on TB/HIV/AIDS care and education and basic training on clinical observation and case
management. In 2009, 100 health workers will be trained to provide treatment for TB to HIV infected
individuals and case surveillance and management of MDR TB. PI will ensure that cotrimoxazole
prophylaxis, de-worming, intermittent treatment for malaria, and ITNs are provided at all HIV care sites in
collaboration with KEMSA and PSI. Lab staff will be trained to be more responsive to the needs of TB
patients. In 2009 PI will continue to support ART provision in TB clinics in an effort to decentralize and treat
patients where they are presenting for care, as outlined in the MOH decentralization strategy.
This activity will contribute significantly to the overall 2009 Emergency Plan HIV Care and Support - TB/HIV
targets for Kenya.
Clinic-based palliative care is one component in a comprehensive treatment and care approach under
APHIA II, such that clients will benefit from long term ART as appropriate and linkages to community
services. Linkages will also be made with the DLTLD and VCT sites.
This activity targets clients at ante-natal clinics, VCT sites, in-patients and clients of DTC, TB-ward patients
and clients of home and community support services who are referred for clinical care by community health
workers. Health care providers including Doctors, Nurses and Other Health care workers will be targeted
for training using national curricula.
Continuing Activity: 14962
14962 9072.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $250,000
9072 9072.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $400,000
Table 3.3.12:
+ 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; the activity will test 90% of OVC enrolled; targeting approximately 43,200 with testing and
counseling. Of those tested, approximately 3,400 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 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 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.
+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.
This activity will support key cross cutting attributions of the budget amounting to $ 102,000 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 ($ 170,000) to supporting
educational activities targeting OVC enrolled in the program. A further $ 34,000 will be attributed to
provision of safe water guards for households looking after OVC.
This activity relates to counseling and testing (#8976), ARV Services (#8765) and palliative care: Basic
Health Care and Support (#8936).
This activity relates to expanded support to be provided to OVC. Once competitively identified, the lead
partner in APHIA II Central will partner with other NGOs/CBOs to provide integrated, age-appropriate
services to build resilience of children infected with and affected by HIV/AIDS. Emphasis will be placed on
development of healthy and supportive home and community environments where OVC and
guardians/families have access to psychosocial support, education, health and nutrition services, economic
livelihood support, shelter and protection from exploitation and abuse. Institutional capacity and technical
expertise of implementing partners will be strengthened. OVC support will be integrated with and linked to
the project's home and community support. Village Health Committees and implementing partners will
identify OVC, who are often in the same households as those individuals receiving home-based care and
support.
It is anticipated that in FY 2009 a total of 48,000 OVC in Central Province will be reached. Training of
individuals in caring for OVC will cover 4,320 caregivers. The activity will identify implementing partners that
will be supported to provide care and support for OVC. This will contribute to the overall 2009 emergency
Plan OVC targets for Kenya.
This activity will be linked with other APHIA II activities in the areas of counseling and testing (#8976), ARV
Services (#8765) and Palliative Care: Basic Health Care and Support (#8936) in Central Province.
This activity targets orphans and vulnerable children, caregivers, Community Health Workers, guardians
and educators involved with OVC. Capacity building efforts with the local communities will focus on the
community and religious leaders as well as partnering with other community and faith based groups that
exist in the area.
Issues addressed are stigma and discrimination and the wrap around services in food and education.
This activity includes major emphasis in the development of the local organization and minor emphasis in
the areas of community mobilization and participation.
Continuing Activity: 14963
14963 9056.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $1,650,000
9056 9056.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $2,700,000
* Increasing women's access to income and productive resources
* Reducing violence and coercion
Estimated amount of funding that is planned for Economic Strengthening $102,000
Estimated amount of funding that is planned for Education $170,000
Estimated amount of funding that is planned for Water $34,000
Table 3.3.13:
+ APHIA II Central will expand counseling services within the province and include outreach services
provided through existing and new CT sites that are integrated within health facilities. The CT services will
include, PITC, home testing, and door to door testing of family members of the infected individuals receiving
care and treatment within the facility.
+ APHIA II Central will also support the annual national HIV testing campaigns with a focus on Central
Province.
+ geographic coverage has been revised and expanded to include additional districts in the Nairobi and
Central Province
+ target population will be expanded to include OVCs
+ APHIA II Nairobi and Central will expand counseling and testing services within the province and include
outreach services provided through existing and new VCT sites that are integrated within health facilities.
The CT services will include door to door VCT and testing of family members of the infected individuals
receiving care and treatment within the facility.
This activity relates to activities in HIV/AIDS treatment services, abstinence and be faithful, OVC, HBHC,
TB/HIV care activities, other prevention, PMCT and strategic information.
This activity relates to support to be provided to increase VCT coverage while taking account of the need to
emphasize PITC as well. New VCT sites may be needed, for example, in large companies where
employees lack easy access. Mobile VCT will complement fixed sites. The MVCT will be conducted at least
once a month in every district and this will be supported through APHIA II Central, Youth friendly services
will be emphasized. Where possible, VCT will be integrated with facility and community level treatment and
social support services for individuals testing positive and with prevention activities for discordant couples
and individuals testing negative. HCW will be trained in VCT, Couple counseling and testing and provider
initiated counseling and testing (PITC). APHIA II Central will support counselor supervision meetings at the
district level and supervision of counselors. PITC will be scaled up in support of the National AIDS and STI
Control Program. Year 1 will see expansion and strengthening of PITC in imperative site facilities, PMTCT
and blood transfusion sites and in district hospitals and health centers with laboratory capacity. In Central
Province, the ICAP Project is addressing PITC in district and sub district hospitals; therefore, APHIA will
focus on bringing PITC to lower level partner facilities as well as VCT at all levels. A subcontractor will train
counselors from target facilities and work with GOK and NGO counterparts to ensure supervision.
Individuals who test positive will be systematically referred to CCC and higher levels for comprehensive
testing and linkages to community services. Pathfinder will liaise with NASCOP to ensure HIV test kit
supply. It is anticipated that in FY09, 100,000 will be tested in Central in an additional 20 sites and existing
59 sites. In FY09, 250 people in Central will be trained in counseling and testing, including training as
counselors, supervisors and in PITC. APHIA II Central will undertake to train PMTCT, VCT and TB/VCT
counselors in couple counseling and assist to support PMTCT sites in couple counseling by: printing and
initiating use of partner invitation cards: express services for couples in ANC ; extended maternity hours to
increase male testing and support counselors in high volume sites. To bolster pediatric ART: Counselors
and service providers will be trained in child psychosocial support. Counselors will be supported to facilitate
pediatric fun days. Child psychosocial support will be directed towards providers involved both in child
counseling and testing as well as treatment. APHIA II Central will introduce door to door CT in one of the
districts in Central province other than Thika. Update on CHW on child counseling and testing and
establishment of referral linkages will be provided for sites providing child CT. APHIA II Central will
reproduce or develop IEC materials on child CT.
This activity will contribute significantly to the overall 2009 Emergency Plan Counseling & Testing targets for
Kenya. Integrating promotion of VCT into all community outreach for treatment and care will significantly
contribute to PEPFAR goals for primary prevention.
Support to counseling and testing will be a linchpin activity in APHIA II Central resulting in increased
numbers of individuals accessing care, treatment and support and in strengthening prevention efforts. This
activity will specifically be linked to ARV services (APHIA II Central), TB/HIV (APHIA II Central) and
palliative care basic health care (APHIA II Central)
This activity targets a wide range of population groups, including, for PITC, those receiving other clinical
services, and for VCT, the general population, with emphasis on sexually active individuals, youth, OVCs
and high risk groups such as bar workers, matatu and boda-boda, and other transport workers and couples.
Health service providers will be targeted for training.
This activity will address the GOK HIV Testing policy and guidelines and legislation related to protection of
human rights and confidentiality. It will address gender issues to ensure that women who are
disproportionately affected by HIV are identified and linked with care and treatment programs. Couples in
discordant relationships will also benefit from knowing their status so that they can make informed decisions
in their sexual relationships.
This activity includes major emphasis on training to build capacity of Counseling &Testing providers and
CHWs. The activity emphasizes VCT as a major prevention strategy. Implementing Partners, Community
Own Resource Persons and other community level implementing partners are key to its success.
Continuing Activity: 14964
14964 8976.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $750,000
8976 8976.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $500,000
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 data clerks to reduce increased data management burden on health care workers in the province.
+ Development and implementation of data quality improvement plan by all supported health facilities and
community based programs.
+ 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.
+ One operations research activity will be designed, implemented and analyzed with a view to improving
project activities.
SECONDARY CROSS CUTTING 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 change to the program since approval in the 2007 COP is:
+ the planned development of improved tools and models for collecting, analyzing and disseminating
HIV/AIDS behavioral and health monitoring information including health facility surveys, plan to conduct
operations research that will illuminate areas of data management requiring strengthening and
development. This activity also includes the development of data quality improvement plan, training data
point persons on DQA tools and implementation of regular data quality audits at sampled health facilities
and community level programs. Targets and funding levels have also changed.
1.LIST OF RELATED ACTIVITIES
This activity is related to the strategic information activities to be carried out by University of North
Carolina/MEASURE Evaluation (#7098), NASCOP (#7002), and TE/TBD (#9220).
2.ACTIVITY DESCRIPTION
This activity will strengthen the provincial and district level Health Management Information Systems
(HMIS) currently in use by MOH at health facilities and Community Based Program Activity Reporting
(COBPAR) currently being rolled out at Constituency AIDS Control Committees (CACCS) levels by NACC
through 3 key components. Component 1: Support APHIA II NAIROBI-CENTRAL/PATHFINDER
INTERNATIONAL and MOH program data collection processes for performance reporting needs (quarterly,
semi-annual, annual). This component will support a participatory, coordinated and efficient data collection,
analysis, use and provision of information to track achievement of APHIA II NAIROBI-
CENTRAL/PATHFINDER INTERNATIONAL and MOH's district level Annual Operation Plan II objectives,
and inform decisions at the local, district and provincial levels, using standardized M&E/HMIS tools
approved by the MOH. Component 2: Strengthen community and facility based reporting systems being
rolled out by NACC and NASCOP. The component will support APHIA II NAIROBI-
CENTRAL/PATHFINDER INTERNATIONAL and MOH to measure progress towards its contribution to the
overall country's Emergency plan, National Health Sector Strategic Plan II and Kenya National HIV/AIDS
Strategic Plan goals and results frameworks. Specific activities will include building capacity of the 83 local
organisations and facilities to collect, report, analyse, and use both routine facility and non-facility data for
planning and program improvement. Component 3: Take lead role in coordinating M&E activities in the
province to meet the information needs of USAID/Kenya, the Emergency Plan, MOH, NACC and other
stakeholders, in line with the "three ones" principle. APHIA II NAIROBI-CENTRAL/PATHFINDER
INTERNATIONAL will organize district-level consensus building forums on M&E issues, distribute
standardized data collection and reporting tools, conduct regular data quality assurance processes at all
data generation points, train 100 facility and community based data point staff on the new data
collection/reporting tools and data use for improving program performance, and hold provincial level
quarterly and annual stakeholders' information dissemination meetings. APHIA II Nairobi-Central/Pathfinder
International will be held accountable for tangible results, especially in increased use of harmonized data
collection and reporting tools at health facilities developed by MOH, increased data use in planning and at
dissemination workshops to various stakeholders, increased supportive-supervisory visits and routine data
quality assessments at all data collection points by M&E/HMIS officers, and improved coordination of M&E
activities in Nairobi/Central provinces. These efforts should result into demonstrated evidence in increased
national level reporting by up to 60% from health facilities to NASCOP national database
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 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.
Activity Narrative: 5.POPULATIONS BEING TARGETED
This activity targets host government workers and other health care workers like M&E and HMIS officers
responsible for data collection, analysis, reporting and use at both health facilities and community level.
Program managers are as well targeted for orientation on the role M&E program management.
6.EMPHASIS AREAS
The major emphasis area is Health Management Information Systems (HMIS) and minor areas include
Monitoring, evaluation, or reporting (or program level data collection) and Other SI Activities.
Continuing Activity: 14966
14966 8870.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $275,000
8870 8870.07 U.S. Agency for Pathfinder 4917 4917.07 APHIA II - $140,000
Estimated amount of funding that is planned for Human Capacity Development $153,000
Table 3.3.17:
ACTIVITY UNCHANGED FROM COP 2008.
1. ACTIVITY DESCRIPTION
In 2009 APHIA II Central 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 Central will
continue to support provincial and district health systems strengthening by convening consultative meetings
and various stakeholders' forums.
In addition, APHIA II Central 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 Central activities, particularly in AB and OP.
4. POPULATIONS BEING TARGETED
This activity will target all population of Central 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: 16326
16326 16326.08 U.S. Agency for Pathfinder 6987 4917.08 APHIA II - $100,000
Table 3.3.18:
