Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 3680
Country/Region: Mozambique
Year: 2008
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: USAID
Total Funding: $1,980,000

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $200,000

This is a continuing activity under COP08, with the following update. The emphasis in this activity is on

providing technical assistance and support to the RESP for behavior change communication activities and

materials in support of PMTCT. With increased resources, JHU will have the opportunity to expand

provincial level support, as appropriate, to Nampula Province, the target province for USG activities under

COP08, in addition to continuing their support to prior year focus provinces of Sofala and Zambezia.

The below narrative from FY2007 has not been updated.

This activity is related to JHU/HCP activities C&OP 8648; AB 8645; HTXS 9165; and OPHS 8646. These

activities taken together form a major initiative for providing technical assistance to the MOH/RESP (health

education unit) and the CNCS (National AIDS Council) and implementation of communication strategies in

support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces.

JHU/CCP is also expected to serve as a resource and support to other Ministries such as the Ministry of

Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as well as the

NGO community and other USG PEPFAR agencies. With regards to PMTCT, a communication strategy

and IEC materials have been developed and are awaiting MOH approval. JHU/CCP will need to determine

the status of the PMTCT communication strategy and IEC materials, and work with the MOH and all

PMTCT partners to respond to their needs in implementing the strategy. This may include, but is not limited

to, organizing consultation meetings at national and provincial levels, reproducing IEC materials and

assisting the MOH to distribute them through their normal channels, carrying out formative research and

development of additional materials to fill identified gaps, planning and working with partners for community

mobilization, developing mass media programming. Given the broad portfolio assigned to JHUCCP for the

communication activity, it is expected that opportunities will be found for integrating promotion of PMTCT

services and destigmatization of use of those services in other program area activities.

The primary emphasis area is IEC, referring to the need for materials and educational activities for the

promotion of PMTCT in the community and patient/client education in the health facilities. Job aides and

other materials will improve quality of services delivered. Better understanding on the part of clients, staff

and community members will help reduce stigma and discrimination.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $800,000

This is a continuing activity under COP08. JHU/HCP has phased out the activity with the University of

Eduardo Mondlane (COP06) and will be starting the expanded communication activity in September 2007.

In addition to Maputo-based technical staff, JHU/HCP will have technical advisors in Sofala and Zambezia

provinces. With the $200,000 increase in COP08, JHU/HCP will extend intensified activities to Nampula

province.

The FY2007 reprogramming narrative below has not been changed.

This activity is related to JHU/HCP communication activities OHPS 8646; HVOP 8648; PMTCT 9162; and

HTXS 9165. These activities taken together form a major initiative for providing technical assistance to the

MOH/RESP and the CNCS and implementation of commmunication strategies in support of all program

areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/HCP should phase

out of prior year UEM programming, and devote attention to AB normative change, focusing on priority

behaviors of reducing multiple concurrent partners, cross-generational and transactional sex. JHU/HCP is

being asked to work with the MOH, CNCS, PEPFAR partners, USG agencies and other stakeholders to

develop and implement large scale behavior change interventions. This may include, but is not limited to,

organizing consultation meetings at national and provincial levels; developing and coordinating media

strategies in print and electronic media (for example, a script with characters on radio programming, in

comic books, on television, billboards); carrying out formative research, planning and working with partners

for community mobilization, developing mass media programming. Given the broad portfolio assigned to

JHU/HCP for the communication activity, it is expected that opportunities will be found for integrating AB

messages in other program area activities. It is expected that JHU/HCP will assist other partners to

leverage funding for AB behavior change from CNCS, and will provide the technical assistance required for

large scale activities requiring the participation of a multitude of partners including private sector

businesses, the public sector, advertising and graphic arts agencies, etc.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $313,000

This is a continuing activity. With the addition of$90,600, JHU/HCP will be able to initiate some activities in

Nampula, the third focus province. In its second year of the activity, JHU/HCP, working in partnership with

the MOH and the National AIDS Council and other USG partners, will use COP08 funding to continue to

address priority adult behaviors including cross-generational sex, multiple, concurrent partnerships, and

transactional sex at national and provincial levels.

The FY2007 narrative below has not been updated.

These activities taken together form a major initiative for providing technical assistance to the MOH/RESP

(health education unit) and the CNCS (National AIDS Council) and implementation of communication

strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala

Provinces. JHU/CCP is also expected to serve as a resource and support to other Ministries such as the

Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as

well as the NGO community and other USG PEPFAR agencies.

This activity is conceptualized as a large scale media activity with local community mobilization components

to effect real behavior change and to create a supportive environment for addressing the HIV/AIDS

epidemic in Mozambique. While implementation of communication activities is important, attention to

building capacity in Mozambique to design, carry out, implement and sustain behavior change is paramount

to success in slowing down the HIV/AIDS epidemic. It is anticipated that this activity will focus largely on

populations affected in a general epidemic with PSI focusing more on the most at risk populations, and FDC

focusing more on traditional and cultural practices affecting HIV transmission.

JHU/HCP has worked with the MOH and the CNCS to finalize a national communication strategy which has

now been approved and is being rolled out to the provincial nucleos. This Condoms and Other Prevention

activity will provide the necessary expertise for implementation of the strategy and effective use of the

media to accelerate change. Components of this activity include:

1. Municipal and local leaders: mobilization of local political leaders to promote and model ABC behaviors

and to reduce stigma;

2. Technical assistance to the Health Education Unit of the MOH (RESP) for promotion of free condoms and

better distribution. This TA will include a condom assessment with three objectives: a) to engage the MOH

in identifying barriers and opportunities for distribution of free condoms in all services, but especially

reaching at risk groups (STI, FP, TARV, PMTCT and MCH services, discordant couples); b) to engage the

MOH and CNCS in identifying better ways of promoting use of these free condoms and assuring that no

opportunity is missed in providing ample supplies with appropriate counseling and education to staff and

clients within the health care system; c) to inform the development of condom distribution and promotion

policies and procedures within the MOH and planning of condom promotion BCC interventions under the

egis of the National Communication strategy.

3. Technical assistance to the CNCS for large scale implementation of the national communication strategy

4. Media campaigns and leadership supporting the presidential initiative: The Ministers of Defense and

Interior as well as high rank commanders from both ministries will record (video and audio) appropriate

prevention messages to be transmitted in military bases and police squadrons [military $150,000; police

$50,000]

5. Mozambique appropriate media and community activities directed towards older youth and young

couples establishing families, with the purpose of addressing living a healthy life together, either as couple

without HIV, a discordant couple or a positive couple.

6. Mozambique appropriate media and community activities reinforcing uptake of all HIV/AIDS services:

prevention, care and treatment.

7. Mozambiqiue appropriate media and community activities addressing the role that alcohol plays in risky

behavior and shifting norms around acceptable behaviors for men and women with regards to alcohol.

Indirect target estimates 50,000 individuals to be reached; 100 individuals trained are the municipal and

local leaders. It is expected that more accurate targets will be developed when JHU/CCP provides a

proposal and workplan for the activity.

Add to existing narrative: JHU/HCP should focus efforts on priority behaviors: multiple concurrent

partnerships, transactional sex and cross-generational sex. Emphasis also should be placed on adult

behaviors.

Funding for Care: Adult Care and Support (HBHC): $150,000

This is a new activity in COP 08.

Linked closely with the JHU HTXS activity this activity is intended to support the partners, provincial medical

department and provincial "nucleos" (provincial level organization of the National AIDS Council) in the focus

provinces (Nampula, Sofala, Zambezia) in implementation of the communication strategy related to home-

based care. Funding in HBC allows for integrated and effective behavior change communication activities

targeted to PLWHA and caregivers, their families and friends and the community at large. Reduction of

stigma as well as identifying and addressing communication needs of HBC clients and their families is an

important component of this program. Because this is a behavior change communication activity, HBC

targets are not applicable and have not been set.

Funding for Care: TB/HIV (HVTB): $100,000

This is a continuing activity in COP08.

It is expected that the main development and testing of IEC materials for TB/HIV activities will take place

with FY07 funding. Additional funding at a reduced level is provided in COP08 in order to complete the

behavior change communication package for TB/HIV services, with partners providing TB/HIV services in

addition to those providing HBHC and with relevant community organizations such as faith based

organizations and groups of PLWHA. No emphasis areas or target populations have been selected because

this activity is intended to develop materials and behavior change strategies for use in TB/HIV programs in

facilities and in the community.

The narrative below from FY2007 has not been updated. These activities taken together form a major

initiative for providing technical assistance to the MOH/RESP (health education unit) and the CNCS

(National AIDS Council) and implementation of communication strategies in support of all program areas at

national and provincial levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to

serve as a resource and support to other Ministries such as the Ministry of Defense, Ministry of the Interior,

Ministry of Education and Ministry of Women and Children as well as the NGO community and other USG

PEPFAR agencies. With regards to HTXS, JHU will work with the MOH, CNCS and other partners to

standardize, develop and produce according to the identified needs, IEC materials for TB/HIV activities such

as TB education for PLWHAs, support for HIV testing of TB patients, need for TB treatment adherence.

Because this activity is focused on IEC materials, targets are not applicable.

Funding for Treatment: Adult Treatment (HTXS): $97,000

This is a continuing activity under COP08.

It is expected that the main development and testing of IEC materials for treatment adherence and pediatric

AIDS activities will take place with FY07 funding. Additional funding at a reduced level is provided in

COP08 in order to support to the provincial "nucleos" (national aids council provincial level organizations)

and partners for roll out of communication programs to implement the treatment adherence strategies. No

emphasis areas or target populations have been selected because this activity is intended to develop

materials and behavior change strategies for use in treatment programs in facilities and in communities.

The FY2007 narrative below has not been updated.

Plus-up: Plus-up funding will incorporate pediatric AIDS in the JHU/HCP HTXS activity. JHU/HCP will

support the MOH to adapt/develop and disseminate IEC materials on care for the HIV exposed adn infected

child including OVC, targeting communities, caregivers. Specific topics to include nutrition and infant

feeding, cotrimoxazole and INH prophylaxis, ART and adherence to treatment, disclosure, and infection

prevention and control. Because this activity is focused on IEC materials, targets are not applicable.

Original COP: This activity is related to JHU/HCP communication activities C&OP 8648; HVAB 8645;

MTCT 9162; and OHPS 8646. These activities taken together form a major initiative for providing technical

assistance to the MOH/RESP (health education unit) and the CNCS (National AIDS Council) and

implementation of communication strategies in support of all program areas at national and provincial

levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and

support to other Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and

Ministry of Women and Children as well as the NGO community and other USG PEPFAR agencies. With

regards to treatment services, JHUCCP is being asked to work with the MOH, CNCS, PEPFAR treatment

partners, USG agencies and other stakeholders to develop an effective community behavior change

strategy to promote treatment adherence, treatment literacy and increased uptake of treatment services.

The focus of these efforts should be in Zambezia and Sofala provinces where the treatment services will be

greatly expanded in COP07. The MOH has set ambitious targets for people on treatment and is expanding

sites and services rapidly. People must be able to overcome stigma and use those services and follow their

treatment regimens correctly. Caregivers, support groups in the community, friends, neighbors and

workplace colleagues also need to be able to assist the person on treatment and provide reinforcement for

desired behavior change. This may include, but is not limited to, organizing consultation meetings at

national and provincial levels, reproducing IEC materials and assisting the MOH to distribute them through

their normal channels, carrying out formative research and development of additional materials to fill

identified gaps, planning and working with partners for community mobilization, developing mass media

programming. Given the broad portfolio assigned to JHUCCP for the communication activity, it is expected

that opportunities will be found for integrating promotion of TARV services and destigmatization of use of

those services in other program area activities. In this context, JHUCCP must work closely with and be

responsive to the MOH and treatment partners in Zambezia and Sofala.

Funding for Health Systems Strengthening (OHSS): $320,000

This is a continuing activity under COP08. The funding increase is intended for the additional production of

materials and manuals needed to increase capacity for behavior change communication programs related

to priority behaviors in transmission of HIV/AIDS. This will not change targets from the levels indicated in

FY07.

The FY2007 narrative below has not been updated.

This activity is related to JHU/HCP communication activities C&OP 8648; AB 8645; PMTCT 9162; and

HTXS 9165. These activities taken together form a major initiative for providing technical assistance to the

MOH/RESP (health education unit) and the CNCS (National AIDS Council) and implementation of

communication strategies in support of all program areas at national and provincial levels, especially

Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and support to other

Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of

Women and Children as well as the NGO community and other USG PEPFAR agencies.

This activity is conceptualized as a large scale media activity with local community mobilization components

to effect real behavior change and to create a supportive environment for addressing the HIV/AIDS

epidemic in Mozambique. While implementation of communication activities is important, attention to

building capacity in Mozambique to design, carry out, implement and sustain behavior change is paramount

to success in slowing down the HIV/AIDS epidemic.

JHU/CCP has worked with the MOH and the CNCS to finalize a national communication strategy which has

now been approved and is being rolled out to the provincial nucleos. This activity will provide the necessary

expertise for implementation of the strategy and effective use of the media to accelerate change. It will also

provide the coordination and framework for bringing together the various programatic area activities to

assure economies of scale, harmonization of messages, appropriate Mozambican approaches and

ownership by the responsible central and provincial level authorities. Technical assistance to the MOH

Health Education Unit(RESP) and to the CNCS will be key to the success of this activity. JHUCCP will

need to explore the structures required to provide leadership to the communication initiative. This may take

the form of a national commission or forum which brings together stakeholders (public sector, private sector,

civil society) to oversee the roll out of the communication strategy, or it may take the form of smaller

regional or provincial groups. Leadership and coordination with the donor community will also be important.

Sustainability and planning for an exit should be considered from the beginning.

Components of this activity include:

1. Municipal and local leaders: mobilization of local political leaders to promote and model ABC behaviors

and to reduce stigma;

2. Technical assistance to the Health Education Unit of the MOH (RESP) for promotion of free condoms and

better distribution

3. Technical assistance to the CNCS for large scale implementation of the national communication strategy

4. Media campaigns and leadership supporting the presidential initiative

5. Mozambique appropriate media and community activities directed towards older youth and young

couples establishing families, with the purpose of addressing living a healthy life together, either as couple

without HIV, a discordant couple or a positive couple.

6. Mozambique appropriate media and community activities reinforcing uptake of all HIV/AIDS services:

prevention, care and treatment.

7. Mozambique appropriate media and community activities addressing the role that alcohol plays in risky

behavior and shifting norms around acceptable behaviors for men and women with regards to alcohol

8. Mozambique appropriate media and community activities directed towards AB norms

9. Mozambique appropriate media and community activities which involve health workers as community

members as well as providers of care

10. Building capacity in both public and private sectors to plan and carry out BCC activities to reduce

incidence of HIV/AIDS

Products will include a collection of IEC materials produced in all areas; documentation from a leadership

structure for the communication initiative (terms of reference, minutes, correspondence)

Deliverables/benchmarks

• Large scale media and community education campaigns

• Collection of IEC materials

• Documentation from a leadership structure for the communication