This is an annual program statement (APS) that was planned in FY 2009. It has been designed and is being posted by end of FY 2009. The purpose is to increase the number of Mozambican organizations directly receiving USG resources and to encourage innovation and local responses.

The over-arching objective of the APS is to improve the continuum of prevention, care, and treatment at the community level by strengthening Mozambican civil society to play a more meaningful and sustainable role in response to HIV. It is open to a range of activities and innovation as there are many approaches that can be taken.

The geographic focus of the intervention is in the southern region: Maputo City, Maputo Province, Gaza and Inhambane, prioritizing catchment areas of treatment facilities. The APS will prioritize care and support of PLHIV and OVC, meaningful involvement of PLHIV and OVC, strengthening referral systems and networks, and ensuring coordinated and community-based prevention, care and support, and capacity-building activities. The target population includes PLHIV, OVC, as well as people in the general population.

The number of partners will depend on the quality of proposals. USG expects a 1-2 cooperative agreements, to be awarded in mid 2010. Projects are expected to last four years, pending availability of future funding.

The partners will coordinate activities closely with other partners such as the awardee of the General Population Prevention RFA, the Academy for Educational Development Capable Partners (AED CAP) program, small grantees and partners focused on strengthening civil society.

This program will contribute to Partnership Framework Goal 1, Objective 1.1, as it will include appropriate community-based prevention interventions for the general population in the highest-prevalence provinces; and Goal 5, Objectives 5.1, 5.2, 5.4, 5.5, as it will ensure community-based care and support for people living with or affected by HIV. The APS is aimed at local responses and local implementing partners, which will lead to a more sustainable response to HIV.

The contribution to health systems strengthening is the having the active participation of communities and civil society in strengthening the continuum of prevention and care and link it to treatment facilities.

This APS emphasizes viable economic strenghthening activities targeting PLHIV households which can protect and grow the vulnerable household's assets. Food and nutrition activities will focus on service delivery and may include training for HBC workers and Home Vistors, enhancing their capacity to carry out nutritional assessment and counseling as well as make effective referrals. The partner will also be able to link with Population Services International (PSI) to ensure access to safe water systems and hand washing soap for promotion of safe hygiene practices.

This program addresses cost-efficiency by prioritizing direct funding to Mozambican organizations. The program will focus on the southern region in order to consolidate the approach and lessons learned rather than starting in a vast geographical area. Coordination with other partners and government institutions is a pre-requisite of project design.

This program will address gender by promoting linkages between community prevention programs for women and clinical services (e.g. gender-based violence), implementing activities that address and respond to harmful gender and cultural norms, and building the capacity of gender focal points at district and provincial level on gender awareness, gender and HIV/AIDS, prevention of gender-based violence and constructive male engagement. Partners must address gender as an integral part of their programs and be in line with the Ministry of Health's Strategy for the Inclusion of Gender Equity in the Health Sector, released in January 2009.

The monitoring and evaluation (M&E) plan will include systems to collect and report on next generation indicators on a semi-annual and annual basis, as well as other project-related indicators, both qualitative and quantitative. At least one evaluation is required. An M&E plan must be submitted for USG approval soon after signing the award.

The APS currently has FY 2009 OHSS funds and reprogrammed FY 2008 and FY 2009 funds from HVAB, HVOP, HKID, and HBHC. In FY 2010, no additional OHSS funds are planned since FY 2009

OHSS funds will be able to carry over any capacity-building activities for year one; however, amounts are planned in the other budget codes.

Illustrative activities will reduce household food insecurity, improve nutritional status of PLHIV and support economic strengthening for members of HIV-affected vulnerable households. Beneficiaries will be identified by referral from lead clinical partners in Maputo City, Maputo, Gaza and Inhambane provinces.

Activities will improve nutritional status of PLHIV and improve linkages for nutritional support for OVC by implementing best practices for livelihood and food security support for vulnerable HIV-affected households. Partner will explore establishing consumer cooperatives to sell quality food commodities in small quantities at fair prices to poor families in urban/peri-urban communities, and promote permaculture

gardening to improve food security among HIV-affected households.

Meaningful involvement of PLHIV and OVC (individuals and organizations) will increase awareness of issues of HIV-related stigma and discrimination, girls' and women's vulnerability to transactional and intergenerational sex, and inheritance and property rights.

Economic strengthening interventions will minimize vulnerability of HIV-affected households through market driven viable interventions. These may include creating livelihood opportunities for older OVC and their families through job placement, training and/or creation of viable microenterprises using a multisectoral approach for training in entrepreneurship, business planning, linkages to credit sources, and identify mentors to start or expand small businesses.

By linking with Population Services International, activities will support interventions which include health promotion messages (positive prevention, partner reduction), family planning, child survival, malaria, tuberculosis prevention and treatment, cotrimoxazole prophylaxis, etc. The partner will make referrals as necessary to health facilities to ensure access to long lasting insecticide treated nets provided by the President's Malaria Initiative.

Before implementation USG will work closely with the partner to establish indicators, as well as baseline data and targets for each indicator.

Illustrative activities this APS aim to reduce household food insecurity, improve nutritional status of PLHIV and support viable economic strengthening activities that increase and/or protect members of vulnerable HIV-affected households. For effective targeting, beneficiaries for this activity will be identified by referral from lead clinical partners in Maputo City and Province, Gaza and Inhambane.

Partner will improve nutritional status of PLHIV and OVC by identifying and implementing best practices for livelihood assistance and longer-term food security support for vulnerable HIV-affected households. Partner will also explore establishing consumer cooperatives to sell quality food commodities in small quantities at fair prices to poor families in urban/peri-urban communities, and promote permaculture gardening to improve household food security for beneficiaries.

Meaningful involvement of PLHIV and OVC (individuals and organizations) will increase awareness of

issues of HIV-related stigma and discrimination, girls' and women's vulnerability to transactional and intergenerational sex, and inheritance and property rights.

Economic strengthening interventions will minimize vulnerability of HIV-affected households through market driven approaches. Activities may include creating livelihood opportunities for older OVC and their families through job placement, training and/or creation of viable microenterprises using a multisectoral approach for training in entrepreneurship, business planning, linkages to credit sources, idenifying mentors to start or expand small businesses.

Linkages with Population Services International will promote health messages (prevention with positives, partner reduction), family planning, child survival, malaria, TB prevention and treatment, cotrimoxazole prophylaxis, etc. Partners will make referrals as necessary to health facilities to ensure access to long lasting insecticide-treated nets provided by the President's Malaria Initiative.

USG will work closely with the partner to establish final indicators, baseline data and targets for each indicator.

This APS solicits applications for epidemiologically-responsive and contextually appropriate prevention interventions reaching beneficiaries at the individual, couple, family, institutional, community, and social levels. Programs will support operationalization of priorities outlined in the National Strategy for Accelerated Prevention of HIV infection and will target key drivers including concurrent partnerships, low risk perception, low knowledge of sero-status, and low condom use with non-regular partners. Community mobilization interventions will address structural factors, including attitudes towards gender roles and responsibilities, that influence these drivers. Programs will benefit adults aged 20-49, and youth aged 15-19, especially OVC, in high prevalence areas, especially the provinces of Maputo City, Maputo, and Gaza.

The APS will solicit applications from organizations to implement prevention activities, with strong emphasis on reduction of multiple concurrent partnerships and condom use with non-regular partners. Programs will go beyond 'awareness raising' to focus on building risk perception to change individual behavior and risk norms around the key drivers mentioned above. This APS will mainly support behavioral and structural interventions, conducted at community and/or institutional levels (eg workplace, school based) to prevent HIV infections. It will support a mix of media and interpersonal communication

approaches that are known to be effective and that are tailored to reach adults and young people with prevention programs that address delay of sexual debut, and multiple concurrent partnerships, and the normative factors that affect each. The APS will also support prevention interventions that focus on discordant couples to encourage mutual disclosure and faithfulness that protect the negative partner and limit HIV transmission outside the couple.

With a view to sustainability and Mozambicanization, the APS will support capacity building for smaller local NGO/CBOs, local leaders and community agents of change to address risky norms, for public institutions, at district and provincial levels, to coordinate and lead a strategic and effective prevention response.