This cooperative agreement was awarded in FY 09 but does not yet have a mechanism system ID. This mechanism is now being submitted in COP 10 as a continuing implementing mechanism with no mechanism system ID.

Through the Ungana project, Liverpool VCT and Care (LVCT) will provide technical assistance to and build the capacity building of local indigenous organizations to deliver high-quality HIV prevention care and treatment services to communities. This support is intended to strengthen the community and national-level response to the HIV/AIDS epidemic.

The Ungana project will be implemented through sub-grants identified in a competitive process. LVCT, in collaboration with CDC, will provide ongoing technical assistance to sub-partners for comprehensive HIV prevention interventions including to Most at Risk Populations (MARPs), counseling and testing service delivery, as well as activities to promote a safe blood supply.

By providing quality HIV counseling and testing services couple with efforts to reduce stigma, LVCT will contribute to the national population level target of 80% knowledge of HIV status by 2011. LVCT will promote efforts to ensure availability of safe blood by mobilizing and retaining safe donors from the community. LVCT will also adherence to safe transfusion practices policies at all health facilities.

LVCT will also build capacity of the sub-partners in organizational and financial management, and monitoring and evaluation.

Liverpool VCT and Care (LVCT) Umbrella will continue to work with the Kenyan ministries of health and the National AIDS and STI Control Program (NASCOP) at the national, provincial and district levels to support the provision of HIV testing and counseling services. This will include support to 50 health facilities in four provinces of Nyanza, Central, Eastern and Nairobi that had not previously been supported by PEPFAR/CDC/LVCT. LVCT will implement these activities directly and also through sub-grantees.

LVCT will support provider-initiated HIV testing and counseling (PITC) provided by all health workers as part of routine minimum package of care for all patients, family members and relatives regardless of their presenting signs and symptoms. This shall be in line with the Kenya National AIDS Strategic Plan for HIV AIDS (KNASP III) that aims to attain universal access to HIV testing and counseling by 2013. This mechanism will support HIV testing and counseling to an additional 160,000 patients, family members and relatives in 2010 program year making a total target for LVCT to 210,000. It will also support training of health 1500 healthcare workers on PITC, support staff salaries, continuous medical education, promotional meetings, national and regional coordination meetings, quality assurance activities, printing of recording and reporting tools, supplies and other relevant logistics.

LVCT will continue to ensure that at least 30% of all out patients and 80% of all patients admitted in the supported health facilities are provided HIV testing and counseling and received their results as per national guidelines. LVCT will work closely with NASCOP and the Ministry of Medical Services, medical superintendants and other relevant leadership to ensure that routine HIV testing and counseling is adequately supported. It will also work towards ensuring high level of quality through support to regular staff support supervision, mentorships, and external test validation and proficiency testing as per the Kenya national quality assurance strategy. Finally, LVCT will ensure effective referral and linkages between prevention, care and treatment depending are implemented.

This umbrella mechanism will continue to build organizational, financial and technical capacity of the local indigenous organizations to provide quality services while at the same time enabling their growth as organizations which are able to apply and compete and manage donor funds along side others. LVCT will support the sub grants to establish and strengthen health systems to foster successful implementation of developmental priorities at different levels. This will include integration and linkage of the heath services infrastructure and logistics, human resource development, health financing and advocacy and leadership. The sub grants will be supported to mobilize partnerships including people living with HIV, address gender issues, stigma and discrimination.

The ultimate goal is to achieve efficiency and effectiveness in delivery of their corporate vision and mission and purpose to communities they serve. Mentorship will be provided and include us will be placed on the smaller organizations that target peer led interventions such as sex workers and MSM.

Sub grants will be provided to local NGOs, FBOs and CBOS who will then be able to provide quality services in testing and counseling, blood safety, abstinence and being faithful, as well as condoms and other preventions, thus contributing to national targets as well. Twenty facilities will be strengthened to offer safe blood while at the same time establishing blood safety committees.

The sub grants will be supported to engage and get involved in and contribute to national policy issues as opportunities arise.

Liverpool VCT and Care (LVCT) will build the organizational and financial management capacity of local and indigenous organizations and provide supportive supervision. Funds granted through LVCT to sub partners will be used to disseminate a standard package of ABC messages for HIV prevention, improvement of community blood mobilization activities, and referral for counseling and testing whenever appropriate.

LVCT will build capacity of two local indigenous organizations: one will be involved in blood mobilization specifically in workplaces and colleges/universities while promoting public-private partnerships. This partner will target low risk donors who will be counseled to remain HIV negative and be regular blood donors.

The second partner will promote appropriate blood use by strengthening hospital transfusion practices. This will be done through dissemination of guidelines and formation of hospital transfusion committees (HTC). The HTC will sensitize health care workers on issues of blood safety and will discourage hospital-based family replacement donations since such blood is not tested in a quality assured manner.

These activities will lead to prevention of medical transmission of HIV through provision and proper use of safe blood.

Liverpool VCT and care will continue to support the implementation and scale up of a combination of evidence-based, cost-effective HIV prevention interventions for the general population and youth, provide technical support to improve the quality of HIV prevention interventions in Kenya, develop systems for quality assurance of these programs, and share experience, training, and lessons learned with the relevant Government of Kenya agencies.

LVCT will, directly or through sub grantees, support increasing access to combination HIV prevention services that incorporates behavioral, structural, and biomedical HIV-prevention interventions. LVCT will design and implement targeted HIV-prevention behavioral interventions. Adaptations of evidence-based behavioral interventions (e.g., interventions from the Diffusion of Behavioral Interventions project or Replicating Effective Programs project [www.effectiveinterventions.org and www.cdc.gov/hiv/topics/prev_prog/rep/index.htm]) are also encouraged. Behavioral interventions should focus on increasing condom use, reducing number of sexual partners and concurrent partnerships, and decreasing cross-generational sex. LVCT umbrella covers the general population and youth mainly out of school in Central, Eastern, Rift Valley and Nairobi regions and will reach 7000 adults and youth out of school with programs encouraging condom use and reducing number of partners and eliminating concurrent partners.

Quality assurance informed by central policy guidelines and standards will guide the implementation of this program. LVCT will also be required to develop a robust M&E plan to inform the prevention programs.