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: 2008 2009
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
(1) HIV and malaria in pregnancy component reprogrammed to JHPIEGO in FY08; no new funding for FY09
(2) Central level support component to be reprogrammed for implementation in FY09
-- Acticity unchanged from FY08 --
This activity is composed of two distinct pieces: the first focusing on HIV and malaria in pregnancy
[$135,000], and the second focusing on central-level support for PMTCT policy development, including
mother support groups and integration with child health [$203,000].
HIV and malaria in pregnancy
It is well-known that malaria and HIV are devastating global health problems. Less is known about the
interaction of the diseases or treatment choices for co-infected individuals; however, the current information
reveals a very serious public health problem given the wide geographic overlap of the diseases in sub-
Saharan Africa. HIV and malaria are highly endemic in Mozambique. HIV prevalence is 16.2%, and more
than 90% of the population is exposed to malaria. Malaria is the largest single cause of mortality in
hospitals: it is responsible for over 40% of outpatient visits and for 30% of recorded hospital deaths. The
population is thus not only at severe risk of ill-effects of each disease, but for co-infection by both of them.
Pregnant women are especially vulnerable to these diseases. Malaria during pregnancy increases the risk
of maternal anemia, spontaneous abortion, still birth, low birth weight, and neonatal death. It is responsible
for the death of approximately 10,000 African women and 200,000 infants each year.
This activity, which is new in the PMTCT program area, represents initial steps for strengthening the
linkages between HIV and malaria prevention, diagnosis and treatment services. Experience from this
activity can be used to create the foundation for improved linkages between HIV and malaria components.
Objectives: A) Strengthen the linkages between HIV and malaria prevention, diagnosis and treatment
services; B) Improve coordination of PMTCT and malaria mitigation activities
Main Activities will be: A) Complete HIV and malaria health services assessment, including documentation
of current malaria and HIV prevention, diagnosis and treatment services conducted in PMTCT settings in
selected provinces, with additional focus on linkages between services; B) Complete analysis of
assessment findings, develop and disseminate recommendations; C) Develop updated service delivery
guidelines for malaria, HIV/AIDS, and reproductive health; D) Based upon results of assessment, create
plan for next steps for development/adaptation and pilot test of materials and recommendations for
strengthening of linkages between malaria and HIV prevention, diagnosis and treatment services.
The activity described so far will provide a foundation for future revision of training materials and service
delivery guidelines beyond the PMTCT setting, with latest evidence relating to the interaction between HIV
& Malaria.
Central-level PMTCT support
This is a new activity designed to strengthen national PMTCT leadership and guidance by creating
opportunities with a TBD partner with central-level influence and experience in Mozambique, such as
UNICEF or other potential applicants. The TBD partner will be in a unique position to influence MOH policy
at central level, including finalization of outstanding PMTCT norms and standards, as well as a systematic
approach to integrating PMTCT and child health (IMCI) activities, thereby creating a stronger link between
PMTCT and child survival efforts.
Key activities will include A) Support for central-level finalization and dissemination of PMTCT norms and
standards; B) Support coordination of PMTCT and child health integration, including IMCI; C) Collaborate
with I-TECH in development and implementation of mother support groups for PMTCT. Coordination
between stakeholders started in FY07 with planning for a support group assessment activity, and FY08
activities will include development of a standard model, pilot phase, and implementation.
New/Continuing Activity: Continuing Activity
Continuing Activity: 19729
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
19729 19729.08 HHS/Centers for JHPIEGO 8784 8784.08 $135,000
Disease Control &
Prevention
Table 3.3.01:
ACTIVITY UNCHANGED FROM FY2008 - NO NEW FUNDING IN FY09
Randomized, controlled trials have now confirmed that male circumcision (MC) reduces the likelihood of
female to male HIV transmission by approximately 60%. MC is, however, only partially protective; men will
need to take other steps, such as abstinence, partner reduction and/or condom use, in order to protect
themselves and their partners against HIV infection.
While MC is a promising intervention that could potentially prevent millions of new HIV infections, it is
important to keep in mind that it is a surgical procedure; and as such, it has risks and benefits. Safe MC
services require well-trained healthcare providers, appropriate infection prevention and control practices,
and sufficient equipment and supplies. In addition to the surgical procedure, other essential elements of MC
services that must be taken into account include informed consent, post-operative care and risk reduction
counseling including the promotion of abstinence, partner reduction being faithful, and a minimum package
of other male reproductive health services, such as sexually transmitted infections (STI) treatment, condom
distribution, and HIV counseling and testing.
Since late 2006, JHPIEGO, a partner of the Forte Saúde Project (funded by USAID), has been working in
close partnership with USAID, CDC, WHO, UNAIDS, PSI, among others, to provide technical guidance to
the Ministry of Health (MOH) and the National AIDS Commission (NAC) to plan and prepare a situational
assessment to identify the MOH capacity for expanding safe MC services for prevention of HIV
transmission.
This proposed activity will build upon the current work and the results of the situational assessment, and
while a new activity under A&B, is linked to MC funding under C&OP and CT. The purpose is to provide
technical assistance to the MOH and NAC to develop and implement a comprehensive educational package
to promote other important HIV prevention strategies such as abstinence and be faithful (A&B).
Objectives of this activity will be to: (a) promote A&B as a key complementary strategy for MC for HIV
prevention; (b) develop and implement a comprehensive educational package to promote A&B; and (c) train
counselors on the new educational package for individual and group counseling.
Main activities will be to:
(a) Develop, field-test, and finalize a comprehensive educational package for individual and group
counseling for use consultation rooms, waiting rooms and at the community level.
(b) Train 50 counselors on MC and on how to use the educational package.
(c) Support and monitor the implementation of the activities at the selected sites (up to 6 sites) where an
expected 30,000 clients or individuals will be counseled in A&B as a complementary strategy for MC.
Continuing Activity: 15684
15684 15684.08 HHS/Centers for JHPIEGO 8784 8784.08 $370,000
Table 3.3.02:
This RFA was developed to ensure continuation of support for activities that began under the University
Technical Assistance Program (UTAP) Cooperative Agreement (CoAg) to support a broad range and
expansion of prevention and care services and activities in Mozambique. Working with the Ministry of
Health (MOH) and other local partners, the agreement is designed to build on and strengthen multiple
PEPFAR activity service areas, specifically counseling and testing, infection prevention and control
(including tuberculosis), male circumcision, cervical cancer prevention, gender issues, human capacity
development, prevention of mother-to-child transmission, malaria and other linkages areas. Within this RFA,
the specific Infection Prevention and Control area activities where Fiscal Year (FY) 09 funding is being
requested include: Infection Prevention and Control (IPC) and improvement of waste management systems
at major US goverment supported hospitals where Anti-Retroviral Treatment (ART) services are provided.
MOH, with technical assistance from JHPIEGO, has been implementing a nationwide Standards-Based
Management and Recognition approach (SBM-R) to improve Infection Prevention and Control (IPC)
practice from 2004-2008 in major USG supported hospitals providing ART services and serving as referral
units for HIV/AIDS services throughout the country. Using the SBM-R approach, health staff across different
services areas including ART, PMTCT, CT, laboratories, blood banks etc. identify and correct IPC activities
to increase safety and prevent HIV transmission for both patients and health providers. In many instances,
hospital teams have been able to also mobilize additional provincial level MOH resources to support and
further strengthen IPC efforts in their facilities, thus leveraging support already provided by PEPFAR. The
program has been expanded from 6 hospitals in 2004 to 43 hospitals in 2008.
In 2009, the objective is to continue to support the MOH efforts through a TBD partner, in further
consolidation of the IPC program and expansion to a total of 53 hospitals throughout the country.
Also this effort will continue to support the improvement of waste management systems (procurement and
installation of hospital incinerators, training and supervision of waste separation and safe disposal, in
particular for ART sites with larger number of patients and thus large amounts of contaminated waste)
started in 2006. By 2008, six hospitals have improved their waste management system and health staff
have already been trained and supervised on the operation and maintenance of the system. In 2009,
additional hospitals will be included in the program. MOH has already selected two hospitals from the
northern region of the country. The improvement of the waste management system will reduce the risk of
HIV medical transmission and will contribute to safe and high quality of services being available at those
selected hospitals.
Activities will:
(a) Strengthen and institutionalize the IPC program in hospitals;
(b) Utilize the surveillance system created to measure the impact of the improved IPC program;
(c) Decrease the risk of medical transmission of HIV/AIDS; and
(d) Improve waste management systems in new hospitals
Main activities proposed include:
1. Conduct Training of Trainers (TOT) in IPC for 20 new IPC trainees for the 10 new facilities;
2. Conduct three SBM-R training courses for 80 new health workers;
3. Conduct IPC training for 100 health workers;
4. Support and monitor IPC activities in 53 hospitals;
5. Support external assessment to verify hospitals' compliance with the IPC standards conducted in
hospitals
6. Monitor the surveillance system to measure the impact of the improved IPC practices;
7. Procurement and installation of incinerators in up to two new hospitals;
8. Train hospital staff to operate and maintain each system; and
9. Monitor operation of systems to ensure proper functioning.
Product/Deliverables
- One TOT course on IPC activities
- Four courses on SBM-R for new health workers
- Five courses on IPC activities
- 15 Supervision visits to verify hospital compliance with IPC standards
- Two trainings for health staff responsible for the waste management system
- Two incinerators installed in hospitals selected
New/Continuing Activity: New Activity
Continuing Activity:
15775 5177.08 HHS/Centers for JHPIEGO 8784 8784.08 $900,000
8516 5177.07 HHS/Centers for JHPIEGO 4870 3566.07 UTAP $720,900
5177 5177.06 HHS/Centers for JHPIEGO 3566 3566.06 UTAP $825,000
Emphasis Areas
Workplace Programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $400,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.05:
Since 2004, the MOH, with TA from JHPIEGO, has been implementing a Standards-Based Management
and Recognition approach (SBM-R) to improve IPC practices in hospitals. A comprehensive set of
performance standards were developed covering 9 direct services: sterilization, operating rooms, TB,
emergency departments, inpatient services (medical, surgical, and pediatric wards), dental department,
blood bank, clinical laboratories, and post-mortem care; and 5 support services: administration, health
education, kitchen, laundry and waste management. Using the standards, workers identify and correct
performance gaps, mobilizing resources for Infection Prevention and Control (IPC). The program expanded
from 6 hospitals in 2004 to 13 in 2005, to 23 in 2006, and to 33 (including the Military Hospital in Maputo) in
2007. Compliance with standards ranged from 12 to 45% at baseline and from 52 to 93% in the latest
internal assessments of 2007.
The purpose of activities proposed for 2008 is to continue the support to the MOH for the expansion to a
total of 43 hospitals, and institutionalization of the IPC efforts in health facilities throughout the country.
Key objectives of this activity are to (a) strengthen, expand, and institutionalize the IPC initiative in hospitals;
(b) create a simple surveillance system to measure the impact of the improved IPC practices; and (c)
decrease the risk of medical transmission of HIV/AIDS and of nosocomial TB.
Main activities are to assist the MOH IPC program to:
(a) Develop a system to estimate, order and control the IPC materials and supplies
(b) Conduct one Training of Trainers (TOT) in IPC for 20 new IPC trainers for the 10 new facilities
(c) Conduct three IPC training courses for 100 healthcare workers
(d) Conduct SBM-R training for 90 healthcare workers already involved in IPC activities
(e) Support and monitor IPC training activities in 43 hospitals
(f) Support recognition activities for high performing hospitals in IPC
(g) Develop a simple surveillance system to measure the impact of the improved IPC practices
Continuing Activity: 15775
Program Budget Code: 06 - IDUP Biomedical Prevention: Injecting and non-Injecting Drug Use
Total Planned Funding for Program Budget Code: $0
Program Budget Code: 07 - CIRC Biomedical Prevention: Male Circumcision
Total Planned Funding for Program Budget Code: $2,000,000
Table 3.3.07:
Ongoing HIV transmission in sub Saharan Africa necessitates vigorous prevention efforts, which is why the
compelling evidence of effectiveness of male circumcision (MC) as an HIV prevention intervention has been
met with great excitement. Three randomized clinical trials conducted in Kenya, South Africa and Uganda
demonstrated that circumcision of HIV uninfected men provided between 50-60% protection against HIV
acquisition. Thus, this intervention is being considered for implementation and scale-up in communities with
high rates of HIV infection and low rates of circumcision of men globally.
In Mozambique, the Ministry of Health (MOH) recently granted approval for a MC demonstration project in
four sites, including one military facility. In FY09, JHPIEGO will work with the MOH, NAC, CDC, DOD and
other key partners to develop new communication tools and materials, services, and prevention messages
for MC. Objectives will be to: develop materials on MC informed consent, post-operative care, and risk
reduction counseling; train supervisors, trainers, and counselors on MC in each of the four sites; implement
safe MC services in selected sites; support and monitor the implementation of the activities at the selected
sites; provide technical assistance to the MOH, NAC, and stakeholders to identify and work with men at
higher risk to contract HIV and design effective prevention strategies; design a strategy to promote MC
among non-infected men; and implement a QA/M&E system for MC efforts as part of the overall strategy to
support a safe, effective, and scalable approach to expansion of MC services in Mozambique. Outcomes
will include increased number of skilled providers providing safe MC, strengthened health care facilities to
provide safe MC services, and increased demand for and access to safe MC services.
Male circumcision services will not be a stand alone intervention, but part of a comprehensive prevention
strategy, which incudes: the provision of HIV testing and counseling services; treatment for STIs; the
promotion of safer sex practices; the provision of male and female condoms and promotion of their correct
and consistent use; and linkages and referrals to prevention interventions and other social support services.
An additional emphasis will be on appropriate counseling of men and their sexual partners to prevent them
from developing a false sense of security and engaging in high-risk behaviors that could undermine the
partial protection provided by male circumcision. Appropriate communication tools and messages will
highlight accurate information regarding the protective effect of male circumcision, need for continued use of
other preventive behaviors (e.g. condom use), risks and benefits of the procedure, appropriate post-
operative wound management and the need to abstain from sex until certified complete incision healing.
The provision of accurate information regarding these important facts will be needed in order to achieve
successful and safe scale-up of male circumcision.
As part of FY09 funding, JHPIEGO partner will also develop and implement quality assurance measures
and an M&E system for MC efforts as part of the overall strategy to support a safe, effective, and scalable
approach to expansion of MC services in Mozambique. Additionally, adverse events and post-operative
complications will be monitored and tracked. To assist with future scale-up of male circumcision throughout
the country, JHPIEGO will regularly share M&E reports and lessons learned MOH, NAC, CDC, DOD and
other partners.
effectiveness of male circumcision (MC) as an HIV prevention intervention has been met with great
excitement. Three randomized clinical trials conducted in Kenya, South Africa and Uganda demonstrated
that MC of HIV uninfected men provided between 50-60% protection against HIV acquisition. Thus, this
intervention is being considered for implementation and scale-up globally in communities with high rates of
HIV infection and low rates of circumcision of men.
In Mozambique, USG partners have provided technical guidance to the Ministry of Health (MOH) and the
National AIDS Council (NAC) since late 2006 to plan and prepare a situational assessment for overall minor
surgical capacity, including the expansion of safe MC services for prevention of HIV transmission.
In preparation for future expansion, the WHO and UNAIDS developed toolkit, guidelines and the training
materials needed to train or re-train surgical providers on how to perform MC following the standradized
procedures have been translated to Portuguese using FY08 funds. With this accomplished, adaptation
could take place as soon as the assessment is completed and MOH approves preparation of pilot sites.
Activities in FY09 will build upon this ongoing work and the results of the situational assessment. The TBD
partner will work with the MOH, NAC, CDC and other key partners to: 1) develop or identify communication
tools and materials; 2) initiate safe MC services in four to five selected pilot sites; 3) develop systems to
support quality assurance and monitoring of MC service delivery; and 4) provide capacity building and
technical assistance to governmental bodies.
Based on the findings from situational assessment as well as available literature, appropriate
communication tools and educational materials will be developed with other USG partners and the technical
working group. The TBD partner will ensure that key messages provide accurate information regarding
protective effect of MC, need for continued use of other preventive behaviors (e.g. condom use), risks and
benefits of procedure, appropriate post-operative wound management and need to abstain from sex until
certified complete incision healing. Educational material will be reviewed by technical working groups for
linguistic and cultural appropriateness. Provider educational materials will also be identified that provide
similar information on the procedure as well as detailed information of operative and post-operative care.
Safe MC service provision for HIV-negative men requires appropriate site preparation and training of
providers on how to safely perform this surgical technique as well as how to monitor patients post
operatively is necessary to minimize complications. Partner activities will include:
Introductory meetings and onsite orientation workshops;
Site strengthening in preparation for service delivery;
South-to-south exchanges to support training of trainers;
Provider training for teams in each region (south, central and north), with follow-on counseling-specific
training as necessary; and
Onsite supportive supervision at select sites within each region where MC services are delivered.
partial protection provided by male circumcision.
As part of FY09 funding, the TBD partner will also develop and implement quality assurance measures and
an M&E system for MC efforts as part of the overall strategy to support a safe, effective, and scalable
approach to expansion of MC services in Mozambique. Potential outcomes will include increased number
of skilled providers providing safe MC, strengthened health care facilities to provide safe MC services, and
increased demand for and access to safe MC services. Additionally, adverse events and post-operative
the country, the TBD partner will regularly share M&E reports and lessons learned MOH and NAC.
Finally, the partner funded to conduct this activity will continue technical assistance and capacity building for
MOH, NAC, and stakeholders in the area of MC. The proposed funding will support a series of workshops
and capacity building events that will assist to (a) continuously update government staff and stakeholders
on progress of MC activities in-country as well as internationally/regionally; (b) ensure that data from the
assessment are shared with all relevant government entities and stakeholders, and that a participatory
process is in place to ensure a constructive debate around the results, recommendations and joint planning
for the development of the intervention plan and package; (c) support translation of key MC documents to
Portuguese; (d) support the in-country MC working group, chaired by MOH staff, with participation from
NAC and other stakeholders (including WHO, UNAIDS, UNICEF, and USG and its partners) as needed and
(e) develop appropriate MC policy, as needed.
Gender
* Addressing male norms and behaviors
Various activities related to technical support of MISAU, MMAS and CNCS in systems strengthening
(coordination and referral systems, materials development, M&E, supervision tools, policy development
etc). Includes support of OMM care, support and training
This is a new activity.
Gender-based violence (GBV) is an urgent public health problem worldwide, particularly in the context of
the HIV/AIDS epidemic. WHO (2002) reports that between 10 and 69% of women experience physical
abuse at the hands of a male partner at least once in their lives. When combined with a woman's increased
vulnerability to sexually-transmitted diseases including HIV in any given heterosexual encounter, violence
and other gender-related norms guiding male and female behavior greatly exacerbate the situation.
Since 2006, JHPIEGO has been providing technical assistance to the MOH to update and disseminate PEP
guidelines for HIV occupational exposures; and it is now expanding these guidelines to other vulnerable
groups such as victims of gender-based violence. Particularly in countries such as Mozambique, with an
estimated HIV prevalence of 16.2% and with the main mode of transmission being heterosexual
intercourse, and where women suffer a generally lower status of development than men, gender-based
violence and gender norms that influence women's vulnerability to HIV must be incorporated into the
context of existing HIV programs.
The purpose of this activity is to support the MOH to rapidly address the needs of gender-based violence
clients within the health care service delivery system and to ensure linkages between different levels of
interventions.
Objectives:
1. Provide support to the MOH to expand the concept of gender "mainstreaming" into health care service
delivery, through integration of gender-based violence components into existing HIV programs and
strengthening linkages to services for victims of gender-based violence
Measurable Outcomes:
• Assessment conducted of availability, suitability and coverage of local programs to which victims of gender
-based violence can be referred
• Findings of assessment and corresponding recommendations for strengthening of programs for victims of
gender-based violence disseminated
Main Activities:
• Conduct assessment to determine availability, suitability and coverage of local programs to which victims
of gender-based violence can be referred, and to determine culturally appropriate and relevant interventions
and messages to address gender issues (in Maputo City, Zambezia and Sofala provinces)
This activity sheet is also linked to activity sheets 8587, 8631 and 8637.
This activity is a continuation of South-to-South collaboration with Brazilian experts to support and provide
short-term technical assistance (TA) to the Mozambican National STI (Sexually Transmitted Infections) and
HIV/AIDS Program.
A technical expert for HIV/STI training from Brazil will provide short-term technical assistance for the
validation of the STI training roll-out to HIV/AIDS treatment service sites. In addition, the Brazilian expert will
assist the Ministry of Health (MoH) STI/HIV/AIDS program staff and staff from the MoH training institutes to
review of HIV/STI pre-service training materials, to ensure that HIV counseling and testing, partner
notification and STI treatment for HIV-positive clients are incorporated in pre-service training curricula.
Continuing Activity: 13206
13206 8570.08 HHS/Centers for JHPIEGO 8784 8784.08 $100,000
8570 8570.07 HHS/Centers for To Be Determined 4879 3640.07 TBD
Disease Control & Cooperative
Prevention Agreement
Table 3.3.08:
FY08: This program area is comprised of two separate components: Continuation of support for ART site
infrastructure (supported by FY06 Plus Up funds and FY07 funds) and support for a new gender activity.
ART Site Infrastructure: $950,000
One of the major barriers identified by the hospitals to improving infection prevention and control practices
to decrease the medical transmission of blood borne diseases, such as HIV/AIDS, is the lack of adequate
proper instrument processing and infectious waste disposal. Proper isolation systems to prevent nosocomial
transmission of Tuberculosis (TB) are also needed. Lack of appropriate equipment and inadequate physical
structure are among the main causes of these gaps in most of the hospitals. Since 2006, JHPIEGO has
been providing technical assistance to improve sterilization systems and waste management in
USGsupported
ART treatment sites, including provision of incinerators.
The purpose of the program area is to continue to support the improvement of instrument processing,
proper isolation systems, and waste management in USG-supported ART treatment sites, to be selected in
coordination with the Ministry of Health and USG.
These activities are continuing and will be complementary to those occurring in FY07.
Objectives are to: (a) Implement instrument processing and sterilization systems in treatment sites; (b)
implement waste management through provision of incinerators in treatment sites; and (c) improve isolation
measures to minimize nosocomial TB infection among HIV infected patients and healthcare workers
Main Activities will be to: (1) Support and improve central sterilization units in at least two selected USG
supported ART facilities, including provision of equipment and rehabilitation; (2) Select and purchase
incinerators for up to four USG supported ART sites; and (3) Design plans for the rehabilitation of isolation
units for infectious TB patients (Maputo, Sofala and Zambezia provinces).
Gender: $97,000
The purpose of this program area is to support the MOH to rapidly incorporate and address the needs of
gender-based violence clients within the health care service delivery system and to ensure linkages
between different levels of interventions.
Key objective of this activity is to provide support to the MOH to expand the concept of gender
"mainstreaming" into health care service delivery, through integration of gender-based violence components
into existing HIV programs and strengthening linkages to services for victims of gender-based violence,
beginning with the review, and updating of current policy and materials.
Main Activities will be to: (1) Conduct a desk review of current policy and materials to determine
appropriateness and coverage of issues relating to identification of, and support and referral for, victims of
gender-based violence; (2) Disseminate and utilize findings in desk review, create recommendations for
updating of policy and guidelines; and (3) Update service delivery guidelines for HIV accordingly, to
Activity Narrative: incorporate gender-based violence issues.
FY07 Narrative: This activity is linked to Activity 8593 in ARV Treatment Services. Proposed funding would
cover some activities initiated in FY06 and currently supported through a sub-agreement of EGPAF with
Vanderbilt University as well as new activities described below.
Zambezia province is the most populated of Mozambique's 11 provinces and also has the most number of
PLWHAs (est: 211,703). The provincial staff working in Zambezia are also said to face one of the biggest
challenges in delivering quality health services owing to deficient infrastructure and human resources even
by Mozambican standards.
The USG, with its new provinicial focus strategy, will identify one or two implementing treatment partners to
support ongoing ARV treatment activities in Zambezia at 3 existing facilities and to expand services to 6
new sites, thereby reaching 1040 persons on ARV in 9 sites total. Support to these sites will include
infrastructure development through renovation of treatment sites, recruitment and training of staff in the
provision of quality HIV care and treatments service, and provision of clinical advisors for supervision and
mentoring of clinic staff. In addition to offering ARV treatment services, the partner(s) will support training
and human capacity development and also assist in improving the health information system and routine
program monitoring at the MoH Provincial Health Office.
In addition to site-level support for ARV service delivery, funding will be provided for pre-service training of
nurses, medical technicians, laboratory assistants and pharmacy assistants in Zambezia Province to build
human capacity necessary for the scale up of ARV treatment and related HIV services in the province. The
partner(s) will also be expected to develop formal links with community-based groups in Zambezia to
provide adherence and psychosocial support. Finally, communication radios will be procured to improve
communication between provincial and district hospitals with smaller health centres that provide follow up
care for patients receiving care and treatment services and that function as down referral sites.
Continuing Activity: 13208
13208 8547.08 HHS/Centers for JHPIEGO 8784 8784.08 $1,047,000
8547 8547.07 HHS/Centers for To Be Determined 4879 3640.07 TBD
Table 3.3.09:
Continuing Activity: (No new funds for FY09)
JHPIEGO is working with the MoH since May 2008 in the area of Infection Control with the objective to
decrease the transmission of TB to patients, health care workers and the community.
The activities that have been implemented are:
1. A consultant has been indentified to work as a focal person for I Control.
2. Undergoing development of 5-year national plan for TB Infection Control in health care settings.
3. A protocol and tool to conduct a national rapid assessment on IC for TB in selected facilities have been
developed
4. A rapid assessment has been conducted in Machava General Hospital, Infulene Psychiatric Hospital. A
draft report and of recommendations regarding the possibility to move the TB reference hospital from
Machava to Infulene have been produced.
5. A chapter on Infection Control measures for the MOH Manual on Management of the MDR- TB has bee
written
6. Working with FHI to improve the translated version of the Infection Control Guidelines which will be soon
submitted adoption.
7. Collaboration with MoH and CDC to conduct the first training on Infection Control as pilot and ToT to
representatives of all the 11 provinces.
Continuing Activity: 15774
15774 15774.08 HHS/Centers for JHPIEGO 8784 8784.08 $450,000
Health-related Wraparound Programs
* TB
Table 3.3.12:
The prevention of TB nosocomial infection in Mozambique constitutes a challenge due to the high
prevalence of HIV and TB. Most of admitted patients are HIV-positive and are immuno- compromised and
therefore susceptible to Mycobacterium infection.
The Ministry of Health has requested the integration of the prevention of TB transmission in health care
settings as part of the national Infection Prevention and Control (IPC) plan with the aim to decrease the risk
of infection transmission of Infection to clients, providers and the community.
To better control TB nosocomial transmission in health care settings, there is need to adhere to three types
of preventive measures: administrative, environmental control and protection of health workers.
This activity is related to TB/HIV - ICAP, Vanderbilt University, CARE international and EGPAF, and has
several different components of continuing activities with emphasis on TB Infection Control. The goal of this
activity is to prevent the transmission of TB in health facilities. Activities will be implemented through a
Cooperative Agreement to a "To Be Determined" Partner. This TBD partner will support the Ministry of
Health to implement its TB Infection control plan in collaboration with other PEPFAR partners working in the
area of TB/HIV collaborative activities. FY2009 funding will support the following activities:
1. To support the development and implementation of infection control plan for each hospital.
2. Development of guidelines and protocols to help in recognition, separation, provision of services,
investigation for TB and referral of patients with suspect or confirmed TB disease.
3. Sensitization and training of all staff working in health facilities to understand the importance of Infection
Control and the risk of transmission to h.care workers and other staff .
4. Educate patients by providing them with basic information on TB (transmission, risks of transmission,
symptoms, diagnosis, treatment) and cough etiquette.
5. Support the improvement of natural ventilation and appropriate mechanical ventilation.
6. Support the implementation of voluntary counselling and testing for HIV and screening for TB to all staff.
7. Conduct regular supportive supervision and evaluation of the implementation of the infection control plan.
8. Assist the MoH in setting up a surveillance of nosocomial infections starting in provincial hospitals and
some district/rural hospitals.
The partner will be changed: TBD.
This activity sheet describes activities for a TBD partner to continue support and technical assistance for
Community Based CT. The major activity is to provide continuity to current partner's support for
implementation of this strategy newly accepted by the Ministry of Health to increase the number of
Mozambicans who know their HIV status.
The national CT expansion strategy has undergone major changes since 2005, which aside from greater
emphasis on expansion of Provider Initiated CT (PICT) in clinical settings, includes the "Counseling and
Testing in Health" (CTH) approach being introduced to include health promotion and prevention activities
aimed at increasing the number of people who access health services. This health promotion package
proposes continuation and expansion of HIV counseling and testing as well as the inclusion of Tuberculosis
(TB), Sexually Transmitted Infections (STIs) and hypertension screening and referrals where necessary,
counseling on malaria prevention, environmental health education, and sexual reproductive health
orientation - especially in relation to early pregnancy diagnosis and promotion of institutional delivery.
Partners have supported the MOH and National AIDS Council (NAC) in the establishment of the first
community-based CT (CCT) services in Mozambique since 2006. The Community CT strategy follows the
same approach of the facility-based CT in Health. The pilot program implemented with the support of
JHPIEGO in 2007 and 2008 took place in five provinces of Mozambique with strong support from
international and national NGOs, and Faith Based Organizations (FBOs) testing different models such as:
CT services delivered at non-traditional locations (e.g. churches and mosques); mobile CT teams providing
services at health facilities where CT services are not yet available on a daily basis; CT campaigns at
markets and other non-traditional locations; and home-based (door-to-door) CT services. A significant
result of this initiative is women and children accessing CT and being referred for treatment and care
through home-based CT. The expansion of CCT activities has been approved by the Minister of Health at
the end of 2007 ensuring direct MOH and NAC involvement, coordination, and quality assurance.
Efforts for FY09 increase the participation of national civil society organizations in the implementation of
Community based CT.
1. Increase the number of Mozambicans who know their HIV status
2. Expand community CT activities in terms of numbers of implementing NGOs and numbers of clients
served
A. Measurable Outcomes
• NGO staff and volunteers trained in community CT
• NGOs providing integrated community CT increased
• Number of individuals counseled and tested at the community level increased
• Number of individuals referred to care and treatment as a result of integrated community CT services
increased
Main activities
• Perform supportive supervision for community CT
• Monitor and evaluate expansion of community CT
• Provide sub-grants to approximately ten local NGOs for the implementation of community CT activities
• Support the MOH on the creation of minimum standards for CT in community settings
In addition to the activities mentioned above, technical assistance to the MOH will be continued to rapidly
identify and address the needs of gender-based violence clients within PMTCT and CT services using
Mozambique-specific screening tools and materials for the identification of women that access HIV testing
services and as a result are at risk of sexual and/or domestic violence. Objectives are to identify women that
access HIV testing services and as a result are at risk of sexual and/or domestic violence; and to propose
strategies to address these needs. A strategy to address gender-based violence clients within PMTCT and
CT services will be developed and implemented at 6 selected health facilities with up to 40 health care
workers trained on how to implement the screening tools and support women at risk of sexual and/or
domestic violence.
13207 8568.08 HHS/Centers for JHPIEGO 8784 8784.08 $1,405,000
8568 8568.07 HHS/Centers for To Be Determined 4879 3640.07 TBD
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Table 3.3.14:
ACTIVITY UNCHANGED FROM FYO8 BUT NARRATIVE HAS BEEN MODIFIED IN THE FOLLOWING
WAYS:
This is a continued activity to establish and enhance CT service provision in existing youth programs in
Mozambique through a TBD partner.
In many developing countries, youth encounter significant barriers to receiving sexual and reproductive
health (SRH) services and to obtaining effective, modern contraception and condoms to protect against
sexually transmitted infections (STIs), including HIV. According to UNAIDS, two-thirds of all young people
living with HIV/AIDS in the world live in sub-Saharan Africa. Young people frequently lack access to SRH
information or even services specifically addressed to them that emphasize STI/HIV prevention, as well as
the life skills needed to protect themselves. Social norms - such as gender imbalance, sexual exploitation,
alcohol use, and lack of sexual negotiation skills increase young people's vulnerability to HIV/AIDS. In many
areas of Mozambique, high HIV prevalence seems to be associated with a low median age at sexual debut
among female youth, low levels of condom use, a low level of of HIV knowledge and high levels of young
women engaged in intergenerational sexual relations. These risk factors underscore the need for integrated
and confidential family planning (FP)/SRH and Counseling and Testing (CT) for HIV services specifically
targeting vulnerable youth.
Scaling up CT services into existing FP/SRH youth health services can draw a range of clients that do not
access CT sites for the general population due to lack of information and access, fear of stigma, and
because they may as well perceive themselves as at "low risk" for HIV.
HIV CT is a good time for young people to think about other issues related to sexual behaviors, including
the prevention of other STIs and unintended pregnancy. Although a few counseling sessions are usually not
enough to affect long-term behavior change, HIV counseling can be a crucial first step. Comprehensive HIV
CT services and appropriate follow-up referrals have the potential to: increase general awareness of
HIV/AIDS; increase clients' understanding that they are vulnerable; encourage both HIV-positive and HIV-
negative youth to adopt safer behaviors, such as abstinence, faithfulness, and condom use as appropriate;
encourage HIV-positive youth to seek proper care and, when necessary and available, appropriate
treatment; reduce the likelihood of unintended pregnancy by providing information about contraception and
referrals as needed; encourage young people to seek other medical and support services, as needed; and
introduce other life skills, such as thinking critically and improving assertiveness. Additionally, youth friendly
CT services have proven successful in reaching more young men with prevention strategies, and
encouraging male involvement and access to FP/SRH services while increasing the predominantly female
clients' access to HIV testing and services.
The TBD partner will provide comprehensive CT services that are able to effectively attract young people,
meet their needs comfortably and responsively, and succeed in retaining these young clients for continuing
care. Basic components will include specially trained providers, privacy, confidentiality, and accessibility.
The intent is to increase access to affordable CT services and useful information while minimizing the
embarrassment of being seen at clinics, fear that confidentiality will not be honored, and concern that staff
members will be
hostile and judgmental.
Continuing Activity: 15931
15931 15931.08 HHS/Centers for To Be Determined 6412 3640.08 TBD
THIS ACTIVITY IS A CONTINUATION FROM FY2008 (Activity ID 15780.08). HOWEVER, FUNDING MAY
GO TO A NEW PARTNER TBD.
Federal University of Rio de Janeiro has been providing technical assistance (TA) for the Mozambican
Counseling and Testing (CT) Program since FY05. Main focus of activities has been in the strengthening of
CT program training and monitoring through the development and improvement of CT training materials and
supervision tools. This activity is a continuation of South-to-South collaboration with Brazilian experts to
support and provide TA to the Mozambican National Counseling and Testing Program.
FY2009 funds, administered through Brazilian Partner, TBD, will support a full time position for a Brazilian
HIV/AIDS, CT and training expert to provide technical assistance and build capacity within the Mozambican
National Counseling and Testing Program aiming at increased access to and improving quality of CT
services. The CT Program Support Officer will assist in all matters related to the development and
strengthening of the CT Program of the Ministry of Health in Mozambique. Specifically, the CT Program
Support Officer will work to strengthen MOH CT Program staff capacity to expand CT in the CT in Health
Units (UATS). The key objectives of this position are as follow:
Build the capacity and provide support to the MOH team responsible for managing and implementing CT
activities. This will be done in close collaboration with CDC to foster national counseling and testing goals
supported by the USG in Mozambique.
Provide technical assistance to ensure that CT activities are based on the latest relevant science and that
scientific knowledge is translated into programs guidelines and activities.
This RFA was developed to further advance activities that began under the University Technical Assistance
Program cooperative agreement to support a broad expansion of prevention, care and treatment services
and practices in hospitals and clinics in Mozambique. Working with the Ministry of Health and other local
partners, the agreement is designed to strengthen multiple PEPFAR activity service areas, specifically
counseling and testing, infection prevention and control, male circumcision, cervical cancer prevention,
gender issues, human capacity development, malaria, tuberculosis, laboratory biosafety, and anti-retroviral
treatment site infrastructure. Within this RFA, the specific Systems Strengthening area activities include:
workplace safety, gender isues, pre-service, training information systems, human resources for health
systems development and quality assurance.
The Training Department of the National Directorate for Human Resources on the MOH has been
implementing a nationwide quality assurance program for health training institutions starting in 2007. This
program consisted of several interventions: 1) Introduction of training information and monitoring systems at
pre-service institutions in FY08; 2) Introducing the Standards-Based Management and Recognition
approach (SBM-R) to improve teaching quality. This approach consists of 4 standards areas: classroom
and humanistic laboratory, institution management, practical rotation, and infrastructure. Using these
standards, training institution staff identify and correct performance gaps and mobilize resources for quality
improvements. One element of this overall approach was the successful piloting at the Central Hospital in
Maputo of in-ward training model (practical demonstration) for nurses. As a result of this pilot, resources,
tools, and equipment needed for practical demonstrations for students were put into place. 3) Previous year
funds were used to design a task analysis PHE for three cadres of health care providers: nurses (general
and maternal-child health) and clinical officers. There was an expert consultation in July regarding the
assessment tool proposed to capture information. The assessment will be conducted and results analyzed
before the end of calendar year 2008. 4) Developing tools for supervision and updating regulations for
training institutions have been underway for the last two years. Two PEPFAR partners have been involved
in the implementation of this plan through three Technical Advisors (who work closely with the Training
Department), technical assistance and funding for activities. 5) Adapting training materials for use by lower
level cadres of auxillary health care workers. 6) Per a reprogramming request, supporting the Human
Resources Dept at the MOH as they finalize the Human Resources for Health strategic plan and as they
present the plan to donors, international community and other Ministries in Mozambique
FY 09 activities will include:
Continued activities supporting the workplace safety in the form implementation of the workplace safety
program through training, supervision and dissemination activities. This would include standardizing the
use of PEP (post exposure prophylaxis).
Continued support of training information management system development through the expansion of the in
-service training information system using a web-based model and assessment and initial design of the
training information system for pre-service institutions . Funds would be used to support a comprehensive
assessment of needs and capacities at pre-service institutions in order to design a training information
system that captures the information identified as most important to institutions that prepare the majority of
the health care providers in Mozambique.
In FY 09, based on the results of in-ward training model (practical demonstration), this activity would be to
additional hospitals as the request of the Ministry of Health.
Based on the of the results of the task analysis for nurses and clinical officers, FY 09 funds will be used to
revise the curriculums of the cadres identified as priority cadres including recommendations around
teaching approaches, teaching aids and needed equipment.
Based on the results of FY 08 piloting of in-service training materials for auxillary health care workers, the
curriculum will be finalized and national roll-out of the training will occur as a result of support from FY 09
funds.
In FY 08, initial work was done on developing a system for providing PEP to victims of sexual violence in
Sofala province. This included development of training materials for health care providers. In FY 09, the
work will expand to include training a wider auidence, developing a suitable supervision model and
designing a recordkeeping system.
Using FY 08 funds, a two page summary document was developed from the HRH strategy that was used by
the President and Minister of Health in high level international meetings. Following this document
development, a 10-15 page summary document is being developed to explain the salient elements of the
HRH plan to donors and across Ministries the the GMZ. In FY 09, funds will be used to explore how the
HRH strategy can be operationalized and to engage with the Human Resources Dept and others at the
MOH on the usefulness of the current HRIS exploring options for resolving current problems with the HRIS
system.
Deliverables: expanded workplace safety system at the MOH; expanded in-service training information
system and design for pre-service training information system; expand in-ward training model to other
hospitals; HRIS assessed; pre-service curricula changes indentified and initial work on making changes
done; support for operationalizating the HRH strategy
Estimated amount of funding that is planned for Human Capacity Development $1,700,000
Table 3.3.18:
ISCISA is a higher level training institution that has provided health training courses for the Ministry of
Health since 2004. Graduates obtain bachelor degree in diverse health areas, such as General, Maternal,
Child Nursing, Administration and Hospital management, Psychology, Occupational Therapy and
Laboratory and Biomedical Technology. This training institution is regulated by the Ministry of Education
and abides by national health policy and World Health Organization principles. ISCISA shares a campus
with the Health Sciences Institute of Maputo, but has their own faculty and can provide accommodations for
students when necessary. In 2008, ISCISA recieved approval to run a 4-year public health course.
Beginning in 2009, this public health course will start with trainees from throughout the country who will be
admitted through a selection process. Curriculum for this course has been developed with support of Lisboa
Tropical Medicine and Hygiene Institute, WHO and UNICEF. There is an emphasis on field work with 58%
of the training focused on hands on learning where students will accomplish practical tasks. It is envisioned
that the graduates of this course will manage health programs and health services in the National Health
Service. Given that this program is in a start-up phase, it is not clear what specific support will be needed
although the ISCISA Director has officially requested PEPFAR support in general. Tentative areas for
support discussed include equipment, furniture, and training material. If individual scholarships are included
as part of the PEPFAR support, scholarships criteria developed by the USG would be used.
PEPFAR funds for 2009 will be available to develop new activities that are supported via a TBD partner with
the goal of supporting the implementation of the public health course in ISCISA. Specific activities to be
supported by PEPFAR are still under discussion with the course coordinator pending other sources of
support.
Product/Deliverables:
To be decided
Estimated amount of funding that is planned for Human Capacity Development $55,750
Estimated amount of funding that is planned for Education $55,750
Reprogramming August08: Support the use and distribution of the Ministry of Health's Human Resources
plan by summarizing the strategy, developing a document that can be distributed widely, printing that
document and supporting a 1 day workshop for donors, Ministry of Health and implementing partners.
All activities listed under TBD are being reprogrammed as is in this request except for the $258,151 to
support a training center.
The rapid expansion of the provision of ART and other HIV-related health services is creating a severe
strain on the health human resources situation of Mozambique. The Ministry of Health is trying to cope with
this situation by drastically increasing the production of some critical cadres of health personnel. Additional
support will be needed, however, to ensure: that these new workers acquire the necessary competencies to
perform upon graduation; that they are properly deployed and incorporated in the health system; and that
retention and support strategies, including the protection of the health workforce, are in place to enable their
effective and sustained performance.
The purpose of this program area is to support the MOH to rapidly and effectively expand, deploy, and
support its health workforce in order to provide HIV-related and other priority health services. The following
activities are being proposed to support the MOH in accomplishing this purpose:
1. Develop and support the implementation of a nation-wide training information system for pre-service
education to track the production and deployment of human resources. This will be based on the current
Training, Information and Monitoring System being implemented for in-service training
2. Strengthen pre-service education for laboratory technicians in coordination with the American Association
of Public Health Laboratories (AAPHL)
• Web-based training information system for pre-service education developed and tested in two provinces
• Pre-service training materials for laboratory technicians developed, including reference manual, trainer
notes, student learning materials and guidelines according to standards in coordination with the AAPHL
• Develop and test a web-based training information system for pre-service education
• Provide technical support regarding the training methodology of the pre-service curriculum for laboratory
technicians in coordination with the AAPHL, who will provide technical content for the curriculum materials
The following activities are continuing and will complement ongoing FY07 activities.
• Conduct assessment to compare competencies that nurses learned at the training institutions vs what they
currently perform at their workplace, and recommend most appropriate and cost-effective options for
nursing education
• Develop and implement in up to 13 sites a set of performance standards for nursing pre-service education
that can be adapted for different cadres
• Train teams of 5 members (teachers and clinical preceptors) from 13 teaching sites on the performance
improvement process
• Pilot a clinical teaching model where nursing students are closely supervised and mentored at the ward
level in provincial hospitals• Implement in-service training for ancillary workers
Activity Narrative: • Provide training and support to provincial staff in up to 13 sites for the implementation of the web-based
training and information system
• Develop master guidelines to guide the development and implementation of interventions to improve
preservice
training
Continuation of support for Gender plus up activities ($310,000)
These activities support the plus up activity around developing a system for providing PEP to women who
have been sexually abused in Sofala province. Specifically these activities focus on implementing PEP
guidelines, training of health care providers on how to serve the needs of gender based violence victims
and materials development.
Continuation of support for Male Circumcision ($50,000):
Activities proposed for continuation also include capacity building for the Ministry of Health (MOH), the
National AIDS Council (NAC), and stakeholders in the area of Male Circumcision. As described in other
sections of the COP08 (A&B, C&OP, CT and SI), a comprehensive intervention package will be developed
based on a situational assessment to identify the country's capacity for expanding safe MC services for
prevention of HIV transmission supported through USG FY06/07 funds.
The proposed funding will support a series of workshops and capacity building events that will assist to (a)
continuously up-date government staff and stakeholders on progress of MC activities in-country as well as
internationally/regionally; (b) ensure that data from the assessment are shared with all relevant government
entities and stakeholders, and that a participatory process is in place to ensure a constructive debate
around the results, recommendations and joint planning for the development of the intervention plan and
package; (c) support translation of key MC documents to Portuguese; and (d) support the in-country MC
working group, chaired by MOH staff, with participation from NAC and other stakeholders (including WHO,
UNAIDS, JHPIEGO, DCI, PSI, UNICEF, USG and others) as needed.
NEW Activity: ($258,151)
In an August 22nd meeting with HHS Secretary Leavitt, Mozambique's Minister of Health Garrido identified
the overall shortage of human resources as his number one operational constraint for improving health care
delivery. In their meeting it was proposed that a Lower Level Health Care Worker Training Center be
established in Mozambique to provide Portuguese-language instruction for participants from Lusophone
Africa. These health workers could be prepared through courses lasting only six months or less. Such
training could begin with basic technical skills that can serve in a variety of health care settings.
In initial discussions among USG officials following the meeting with the Minister of Health, an existing
facility was considered. On the outskirts of Maputo, there is a training center, the Centro Regional de
Desenvolvimento Sanitario (CRDS), which was developed by the Mozambican Ministry of Health and The
World Health Organization (WHO). The center has classrooms and recently renovated lodging and dining
facilities for participants. Few technical faculty are assigned to the facility; however, there are maintenance
staff. To date, this facility has been under-utilized but could be an ideal location for hosting training for local
Mozambicans and those from other African Lusophone countries. If the emphasis of training were on
gaining technical skills such as laboratory equipment repair, there would be a need to outfit the center with
needed equipment.
Identifying Portuguese-speaking trainers with the needed technical expertise would be important. Drawing
on expertise within each Lusophone country in Africa and partnering with Brazil to provide trainers and other
support for this center would strengthen the effectiveness and sustainability of the center. The proposed
next steps in exploring this idea are to:
1. Share concept paper with Ministry of Health officials in Mozambique.
2. Through a consensus process, revise the concept paper with MOH in Mozambique.
3. Conduct an asset mapping of resources (i.e., training expertise, training or conference center locations,
technical expertise) within each Lusophone country that could be drawn on in developing this training
endeavor.
4. Share concept paper with MOH in Brazil, Angola, Guinea Biseau and Cape Verde to gauge interest level.
Activity Narrative: 5. Assess training needs in participating Lusophone countries.
6. Develop an advisory entity consisting of representatives from key stakeholders.
Deliverables/benchmarks:
• Web-based information system for in-service training available at provincial sites
• Web-based training information management system for pre-service developed
• Training methodologies used in pre-service curriculum for laboratory technicians
• Nursing training institution assessment focusing on what nurses learn in pre-service and what they use in
practice
• Cost effective options for nursing education
• Performance standards for nursing pre-service
• Nursing faculty trained on performance improvement process
• Ward level clinical teaching model at provincial hospitals
• Master guidelines to guide development and implementation of interventions to improve pre-service
education.
Deliverables/benchmarks (gender)
• PEP guidelines implemented
• Health care providers trained around gender based violence
• Materials development.
Deliverables/benchmarks: (male circumcision)
• Assessment data widely shared
• Participatory process around data interpretation
• Translate materials
Deliverable/benchmark: (training center)
• Concept paper for a Lusophone training center
• Asset map of Lusophone countries
• Training needs of each participant country
• Advisory board of key stakeholders
Continuing Activity: 19730
19730 19730.08 HHS/Centers for JHPIEGO 8784 8784.08 $2,350,000
