Summary

Save the Children had previously introduced CRS I-LIFE Consortium partners to the Hope Kit developed by

the JHU BRIDGE Project, to promote open discussion on issues of HIV and AIDS. The Hope Kit is currently

being used by the NGOs. I-LIFE staff have been trained by the BRIDGE Project and they have in turn

trained community members and groups. The Hope Kit is being incorporated and adopted by groups such

as village savings and loans groups, food distributors and during other meetings occurring in the

community. The target groups for these activities are adolescents, adults PLWHA, pregnant women, and

the general adult population.

Background

CRS basic I-LIFE, a consortium of seven NGOs co-lead by CRS and CARE, aims at reducing food

insecurity among vulnerable households in seven districts of Malawi. The other five NGOs include Africare,

Emmanuel International, SAVE the Children USA, The Salvation Army and World Vision International; each

NGO implements I-LIFE activities in a separate district. To effectively manage overall program coordination,

the co-leads have established an independently-housed Program Management Unit (PMU). I-LIFE is a title

II program, with complementary funds from OFDA to implement irrigation activities. The consortium has

established six technical working groups on agriculture/marketing, commodities, decentralization, HIV/AIDS,

health/ nutrition and M&E to provide sectoral guidance to consortium members. SAVE is the technical lead

on HIV/AIDS.

The program provides each targeted household with a holistic package of services that ultimately work to

protect, enhance and secure its food security status. With regard to HIV/AIDS, program beneficiaries

include households caring for the chronically ill. Existing networks of HBC volunteer services are utilized

where possible. As such, HBC volunteers are drawn upon to assist in identifying, registering, monitoring and

graduating beneficiaries. In so doing, they provide basic care, which include assistance in undertaking

household chores such as farming, cleaning homesteads, cooking and bathing chronically ill persons. They

also collaborate with I-LIFE extension workers to facilitate the participation of targeted chronically

households in other program components such as establishment and maintenance of home gardens,

membership in village savings and loan schemes along with participation in community based

organizations. I-LIFE's health and nutrition activities will be implemented through the care group model - a

community based health care provision strategy - that will also encompass key HIV/AIDS activities such as

positive living and promotion of HIV/AIDS messages.

Activity 1: Hope Kit Training and Distribution

In FY 2008, I-LIFE will use FY 2007 Emergency Plan funds to implement use of the Hope Kit as part of their

community outreach strategy for promoting HIV/AIDS prevention. It is expected that sub-partners will train a

total of 150 community members (e.g. HBC volunteers, PLWHA support groups, youth groups, village AIDS

committee members) in how to use the Hope Kit for HIV/AIDS prevention. Through these trained individuals

a further 1500 people are expected to be reached with abstinence and/or being faithful messages through

Hope Kit demonstrations during group meetings and community gatherings. Efforts will be made to integrate

these efforts into the care group model - a community based health care provision strategy.

Activity 2: Capacity Building

Save The Children US, as the I-LIFE technical lead organization for HIV/AIDS, will continue to enhance the

capacities of key project staff in partner organizations in how to ensure provision of quality HBC services

and mainstream HIV/AIDS in programs, as well as in the workplace. This will be accomplished through

trainings and regular provision of technical assistance.

HIV/AIDS Mainstreaming workshops conducted by the HIV/AIDS Technical Lead in FY 2006 and FY 2007

have focused on building skills of NGO staff to ensure that HIV/AIDS issues are addressed in all I-LIFE

activities including workplace programs targeting staff. A key strategy for achieving this is to include

technical staff from sectors outside of HIV/AIDS and health, in order to increase understanding of the

benefits of program integration. The development of annual action plans for HIV/AIDS mainstreaming and

sharing of achievements, challenges and lessons learned have been key activities in the workshops and will

continue to be so in the workshop conducted in FY 2008. The workshops also provide the opportunity to

address specific skills gaps in the area of mainstreaming identified by staff. A total of 30 I-LIFE staff from

the 7 implementing partners will be targeted for these activities.

Summary

I-LIFE, a consortium of seven NGOs co-lead by CRS and CARE, aims at reducing food insecurity among

vulnerable households in seven districts of Malawi. The other five NGOs include Africare, Emmanuel, Save

the Children, The Salvation Army, and World Vision; each NGO implements I-LIFE activities in a separate

district. To effectively manage overall program coordination, the co-leads have established an

independently-housed Program Management Unit (PMU). The consortium has established six technical

working groups on Agriculture/Marketing, Commodities, Decentralization, HIV/AIDS, Health and Nutrition,

and Monitoring and Evaluation to provide sectoral guidance to consortium members. SAVE is the technical

lead on HIV/AIDS.

Background

During FY 2006 and FY 2007, I-LIFE partners focused on improving the quality of palliative care as well as

scaling up of service provision to chronically ill people in the seven I-LIFE districts. This was achieved

through the training of both key HIV/AIDS partner project staff and the Home Based Care (HBC) volunteers

in different palliative care areas. The program trained 492 HBC volunteers in palliative care provision,

exceeding the set target of 50. The target was surpassed due to the overwhelming response by

communities in the mobilization of volunteers along with a change in the refresher training structure that

created room for additional training participants. The training resulted in the standardization of HBC

provision practices and expansion of services by the volunteers as well as an overall improvement in the

quality of care delivered.

492 trained volunteers provided palliative care to 1,682 (544 males and 1,138 females) chronically ill people

in the I-LIFE districts. This achievement was below the set target of 2,000 due to changes in the volunteer

work structure and volunteer drop-out. I-LIFE partners assigned 2 volunteers per village, resulting in a lower

volunteer to beneficiary ratio than the 1:40 proposed in the FY 2006 COP. The new structure was found to

be more cost-effective because volunteers do not cover long distances, which ultimately improved the

quality of service provision.

Activity 1: Service Delivery

I-LIFE will conduct refresher courses for a total of 175 volunteers and health staff. HBC kits will be provided

and/or replenished. The key elements of the quality care package of services to be delivered by I-LIFE

trained CHBC volunteers, include basic nursing and care e.g. bathing and feeding of patients; Management

of common health ailments through medical supplies provided in drug kits and referral to nearest health

facilities where necessary; Psycho-social care incl. counseling of both infected and affected individuals;

Promotion of VCT and linkage to PLWHA support groups; Provision of information on the dietary needs of

the chronically ill and PLWHA; Promotion of positive living through food diversification, establishing labor-

saving kitchen gardens, provision of information on nutrition and food processing demonstrations. In

addition to this, the CHBC package implemented by I-LIFE partners encourages formation of volunteer

support groups as part of caring for the caregivers and CHBC volunteers are supervised by Ministry of

Health staff. All CHBC activities are carried out in close collaboration with MOH staff as well as with other

stakeholders at district and community levels incl. NGOs, FBOs and CBOs. The program will also develop

strategies to ensure HIV-positive children are reached and linked to pediatric care and treatment.

Activity 2: Stigma Reduction

A key area of focus for I-LIFE in FY 2008 is overcoming the stigmatization of people living with HIV/AIDS.

This will be accomplished through partnerships with Johns Hopkins Bridge program that has effectively

utilized the Hope Kit to address stigmatization. This will include Bambo wa Chitsanzo (Model Father) roll out

- a complementary Hope Kit package that will be developed by Bridge. The consortium is also benefiting

from the effective network of local and international partners established by USG-supported Umoyo

program which has now ended. It is expected that sub-partners will provide 2,050 individuals with palliative

care.

Activity 3: Volunteer Support

With FY 2007 funds, I-LIFE will focus on ensuring the provision of quality services, by reducing the ratio of

volunteers to beneficiaries. This approach will also counter the high burn-out and drop-out rates of

volunteers.