1. Goals and objectives: The mechanism goal is to develop and reinforce capacities among indigenous sub-grant local organizations (LO) to improve HIV services to individuals in underserved areas of Kenya. The project objectives include increasing capacity of LO to expand quality HIV services including abstinence and be faithful interventions and HIV testing and counseling and to provide people living with HIV access to palliative care, high quality ART services, and support. The mechanism also assists LO provide support to OVCs. The objectives are in line with Kenyas Partnership Framework and GHI.

2. Cost-efficiency strategy: The mechanism improves local partners efficiency in program, financial management, and capacity in M&E, through assistance with development of policies, procedures and strategic plans. Trainings are conducted on policy, procedure, strategic planning and sustainability. Site visits are conducted to provide mentorship and guidance in developing these institutional documents.

3. Transition to country partners: One of the key outputs of this mechanism is to help the sub-partners be able to apply and access and manage funds on their own for future and continuing programs. CRS works with 16 indigenous partners with an aim of building their capacity to be able to in future carry on with the activities.

4. Vehicle information: Five vehicles were purchased with FY1 funds for monthly mentoring and monitoring visits by two technical teams visiting different regions/partners at the same time. During the organization and technical capacity assessments, it came out clearly that a number of partners need vehicles to facilitate their work.

This activity supports GHI/LLC.

Catholic Relief Society (CRS) SAIDIA Project will support partnerships with local grantees to provide 3,000 OVC in FY12 and 6,000 OVC in FY13 with access to essential services in Nairobi, Central, and Eastern Provinces. CRS will train 200 caregivers and build the capacity of local, community, and/or faith-based organizations to meet the needs of OVC in their communities. CRS will support the partners to provide critical services to OVC which include a comprehensive package for education, shelter, nutritional support, psychosocial care and support, and support to OVC caretakers while linking OVC to other critical services and economic strengthening activities.

CRS will target all OVC aged between 0 and 18 years and will provide 6 plus 1 services and report on at least 3 services that they provide to the OVC based on individual need. By March 2011, CRS had achieved the following: 3,840 OVC served; 2,536 of OVC received primary direct support (PDS); 1,304 of OVC were provided with Supplemental Direct Support (SDS); and 100 providers/caretakers trained in caring for OVC.

CRS continues to experience challenges in areas of capacity building, partner linkages and networking to the local partners. In the next two years CRS will focus on strengthening HIV prevention education among OVC to equip them with life skills that will reduce their vulnerability to HIV infection. CRS will start to implement OVC interventions that are evidence-based in order to achieve their two year goals.

They will also train the local organizations to strengthen the family support system and help them to establish strong linkages between PLWHAs and HIV-infected children with health care services, including ensuring that children and their parents or caregivers and other family members affected access appropriate care and treatment. CRS will work closely to link OVC with care and treatment partners to ensure that HIV-infected children receive appropriate psychosocial support and that they have a consistent caregiver to assure adherence to treatment.

CRS will continue to work closely with District Children's Department and will follow guidelines provided by the Ministry of Gender, Children, and Social Development, alongside PEPFAR guidelines. CRS will support the local partners to establish partnerships and networks among other NGOs in order to strengthen their collective voice, build a unified approach, improve coordination, and share knowledge.

CRS will embrace community and family centered approaches (such as the cash transfer program) that are preferred to institutional approaches and they will explore livelihoods OVC programming approaches. There is limited information regarding current OVC programming by CRS supported partners. CRS will undertake an OVC situation and gap analysis for its CBOs to document best practices and lessons learned for OVC to help the CBOs to explore new program approaches. CRS will also develop an OVC advocacy curriculum and provide training to CBOs and other OVC stakeholders. CRS will work with the local organizations to engage and advocate for OVC issues with key stakeholders in the Kenyan HIV/AIDS response, including donors.

CRS will work with the local partners to improve M&E systems based on rapid capacity and gaps analysis of the OVC activities they support. The program will also capture age specific services that are offered to OVC aged between 0 and 18 years.

SAIDIAs activities focus on strengthening institutional capacity building for indigenous organizations to improve HIV treatment, care and support services to marginalized people in underserved areas of Kenya. Participatory Development Consultancy was commissioned to provide technical support to the fifteen indigenous organizations supported by the SAIDIA Agencies project to develop and/or review governance systems, financial guidelines, programs management, human resource policies and strategic plans in order to not only facilitate the implementation of the SAIDIA project but also enhance their capacity to independently bid for funds.

The process entails the following tasks: Review of capacity assessment reports for the fifteen indigenous organizations contracted by CRS in the SAIDIA project, training of board members from the fifteen indigenous organizations, workshops to train management team members on institutional guidelines/policies development, mentorship visits to the fifteen indigenous partner organizations to support them in developing individual institutional guideline and policies to ensure organizational growth, several trainings on proposal writing and presentations will be delivered.

PDC is also developing a guidance manual for good practice. This manual is part of a wider CDC/CRS indigenous organizations systems strengthening strategy which included capacity assessment of various organizations in Eastern, Central, Rift Valley and Nairobi provinces of Kenya.

Monitoring and evaluation are conducted through site visits which are conducted one to three times per quarter with every sub-grantee. Partners are contacted and dates are sent for the visit and objectives and activities of the visit are shared. Before the site visit starts previous trip reports to the partner are reviewed. During the trip there is a meeting with the partner staff to review the objectives and activities and any other issues that may need to be addressed are discussed. The site visit is conducted with the technical team from CRS occaisonally accompanied by CDC technical team, observing program activities and agency capacity. After the visit is complete a meeting is held with concerned project staff and management to review the visit, any issues that need immediate attention and any other recommendations that needs to be discussed. After the meeting a trip report is completed and shared with the partner.

CRS works in the following provinces and counties: Nairobi, Eastern (Machakos, Embu, Kituia and Makueni), and Central (Nyeri, Kirinyaga, Nyandarua, Maranga, and Kiambu) to implement HIV-prevention, abstinence and being faithful evidence-informed behavioral interventions (EBIs) among the following priority populations (targets): 10-14-year-olds (20,000), and parents of youth 9-12 years of age (9,654).

CRS and its partners will serve youth aged 10-14 with two EBIsHealthy Choices I (HC1) and Families Matter! Program (FMP).

FMP is an EBI for parents of preadolescents and promotes positive parenting practices, positive reinforcement, parental monitoring, and effective parent-child communication on sexual topics and sexual risk reduction. FMP seeks to delay onset of sexual debut by training parents to deliver primary prevention messages to their children. HC1 targets in-school youth and aims to delay sexual debut by providing knowledge and skills to negotiate abstinence, avoid negative peer pressure, avoid or handle risky situations, and to improve communication with a trusted adult.

For quality assurance, CRS has put in place for all sites the following: use of approved national curricula; emphasis of importance of fidelity to the respective curricula; use of trained and certified pair of gender balanced facilitators; trainings on EBIs are conducted by certified national trainers; observed practice of implementation is done soon after training; use of standardized, national data tools at every stage of EBI implementation; and regular field visits by trained program staff to check on delivery of EBIs and offer support supervision.

The proposed activities and EBIs are guided by the goal and objectives of the project. Targets for each of the interventions are laid out at the start of the project year which is tracked on a monthly basis through respective field reports. Results are analyzed on a quarterly basis. The targets are in line with the PEPFAR Next Generation Indicators (NGIs). Monitoring and evaluation will be conducted with EBI approved data capture / monitoring tools. Field staff will send reports on a monthly basis; these reports will be compiled into an overall report quarterly which will be submitted to CDC.

Target population: CRS Umbrella mechanism is mandated to build the capacity of local indigenous organizations to be able to implement high quality and cost effective HIV programs. The target population for these local organizations is mainly the general population in the three provinces of Kenya (Nairobi, Eastern and Central). These regions have a generalized epidemic and the coverage of HIV testing and counseling (HTC) programs are below 50% except in Nairobi Province.

HTC Approaches: CRS sub-partners utilize both client-initiated (CITC) and provider initiated (PITC) approaches. Sub-partners that have health facilities focus mainly on PITC in the OPD, TB clinics, Wards and ANC settings. Sub- partners that do not operate within health facilities utilizes mainly static, mobile and Home based counseling and testing.

Targets and achievements: In the past 12 months, CRS had a target of 100, 000 persons and surpassed its target. A total of 52 providers were trained in HTC using the national training curriculum. For COP 2012, CRS will target 77,000 with HTC services of which 20% will be tested as couples, and 10% will be children below the age of 15.

Testing algorithm: National algorithm

Referrals and linkages: In order to achieve effective referrals and linkages, CRS has established a referral directory at all the testing points to facilitate easy referrals by the providers. It has also made actual contacts to referring facility for discussions on complete referrals. Further to this, each partner keeps a referral log to track referrals. Phone calls and in the case of CHBCT, actual home visits done to confirm that client visited. And in the cases of community units, CHWs are utilized for follow up purposes. In order to monitor successful referrals, CRS came up with data collection tools for monitoring linkages, these indicators are reported on a monthly basis, to ensure that they are performed and tracked.

Promotional activities for HTC: CRS utilizes a number of strategies to promote HTC uptake. They include use of health talks at the facility level targeting inpatient and outpatient clients; community awareness and demand creation activities facilitated by Community Health Workers/Promoters; use of media campaigns (HTC video screening, IEC materials) targeting the general population, etc.

Quality management: Training and continuing education of HTC providers; HTC is conducted in accordance with the procedures outlined in the national HTC guidelines; HIV rapid kits are managed as per the guidelines; Functional HTC QA systems are in place as provided for in the national HTC guidelines; IQA- In-house lot testing of kits; participation in EQA- proficiency testing and finally conducting support supervisory visits.

Monitoring and evaluation: CRS Sub-partners uses all ministry of health tools to capture HTC data, both for couples and individual patients. These include HTC lab Register and Monthly summary tool (MOH 711). MOH approved HTC lab registers have been introduced at all HIV testing points except PMTCT.