The project goal is to reduce morbidity and mortality caused by malaria and waterborne diseases amongst vulnerable groups affected by HIV by increasing the use of long-lasting insecticide treated nets (LLIN) and safe water systems (SWS). With extensive experience in HIV malaria and diarrheal disease prevention and nationwide logistics system, Population Services International (PSI) will provide the commodities packaged in a Basic Care Kit that is part of the basic care package provided by HIV treatment and care partners. USG clinical partners implement in all provinces in Mozambique. Specific provinces for distribution will be determined by the partner in consultation with the DPS; the DPS will select provinces to prioritize. The Kit will be available to all PEPFAR implementing partners providing services to the targeted vulnerable groups: OVC, pregnant women, and PLHIV. Under this activity PSI will support the delivery of the Kit to community and clinical partners and provide training in information, education and communication (IEC) to partners distributing the Kit, so that the Kit is distributed to the target population in conjunction with appropriate health messages.

The Kit includes the following health items: 1) 10 generic condoms 2) 3 bottles of Certeza brand water purifier. 3) 3 bars of hand soap. The Kit also includes a durable illustrative booklet addressing the following topics: i) use of LLIN for malaria prevention; ii) use of SWS for diarrhea prevention; iii) proper hygiene; iv) HIV counseling and testing; v) tuberculosis (TB) treatment and prevention; vi) nutrition; vii) Cotrimoxazole prophylaxis; viii) pain & symptom management; ix) male circumcision; x) multiple concurrent partnerships; xi) family planning, and; xii) positive prevention. Key messages for the Kit have been selected in collaboration with the MOH. Beneficiaries will receive SWS for a 12-month period. The inclusion of soap in the Kit provides an increased emphasis on safe hygiene practices. Although soap is only included in the initial Kit, community-based Home Visitors will have many opportunities to monitor and reinforce safe hygiene practices in the home. Pending approval from the MOH, Kits targeting OVC households will include Sprinkles which is a simple, cost-effective way to prevent iron deficiency anaemia in children, which affects 75% of children under 5 in Mozambique.

PSI's current international nongovernmental organization (INGO) partners will continue to receive training on correct usage of LLIN and SWS. The last page of the durable booklet provided in the Kit will remain in the home of the beneficiary. The last pages of the booklet allows for the Home Visitor to note the date and topic that was discussed during a particular visit, which will provide useful information about the quality of messaging of Home Visitors during supervisions.

PSI will use Tracking Surveys (TRaC) which routinely collect data from cross sections of at risk populations to identify current knowledge beliefs, product ownership and use rates. This information is used to develop a consumer profile which then informs the design and evaluation of communication campaigns aimed at decreasing barriers to use of health promotion products such as LLIN, soap and SWS.

The Kit is one part of the Basic Care Package of services provided by PEPFAR clinical partners. The Basic Care Package also includes information on family planning, STI/OI treatment, CTXp, IPT, CD4, counseling and testing, TB screening, syphilis rapid tests, and effective two-way, referrals between different level facilities. In FY 2010 clinical partners will provide support to non-ART sites to increase coverage of clinical and preventive services. Distribution of refill commodities for the Kits will be piloted at non-ART sites to facilitate access to the Kit for beneficiaries.

LLIN are no longer included in the Kit. Through the Presidential Malaria Initiative PSI will support targeted distribution of LLIN to pregnant women through public health facilities and universal coverage campaigns. PSI also supports the distribution of SWS for cholera prevention through the public sector, facilitating coordination of activities with the USG. PSI will also continue to provide technical assistance to the MOH in the production of IEC materials for PMTCT and MCH programs.

Kits targeting PLHIV who have registered at a USG-supported health facility will be distributed according to geographic priorities defined by the Provincial Directorate of Health. The Kit includes the following health items: 1) 10 generic condoms 2) 3 bottles of Certeza brand water purifier. 3) 3 bars of hand soap.

Kits will continue to be delivered by USG-supported facility-based partners with delivery of key health messages on safe water, hygiene and malaria prevention provided while patients wait to receive services. Specific topics addressed in kit through a durable illustrative booklet include: i) use of LLIN for malaria prevention; ii) use of SWS for diarrhea prevention; iii) proper hygiene; iv) HIV counseling and testing; v) tuberculosis (TB) treatment and prevention; vi) nutrition; vii) cotrimoxazole prophylaxis; viii) pain & symptom management; ix) male circumcision; x) multiple concurrent partnerships; xi) family planning, and; xii) positive prevention. Key messages for the Kit have been selected in collaboration with the Ministry of Health.

Patients receiving anti-retrovirals should be linked to a partner providing community based care and support. During each Home Visit, a volunteer will review one of the 12 key health messages in the durable pamphlet provided at the first visit. As appropriate, the home visitor volunteer will counsel and refer PLHIV for family planning, OI/STI treatment, testing and other essential health and social services.

Kits targeting caregivers of households with orphans and vulnerable children (OVC) under the age of five

will be distributed through USG community-based implementing partners according to geographic priorities defined by the Provincial Directorate of Health. The Kit includes the following health items: 1) 10 generic condoms 2) 3 bottles of Certeza brand water purifier. 3) 3 bars of hand soap. The Kit also includes a durable illustrative booklet addressing the following topics: i) use of LLIN for malaria prevention; ii) use of SWS for diarrhea prevention; iii) proper hygiene; iv) HIV counseling and testing; v) tuberculosis (TB) treatment and prevention; vi) nutrition; vii) Cotrimoxazole prophylaxis; viii) pain & symptom management; ix) male circumcision; x) multiple concurrent partnerships; xi) family planning, and; xii) positive prevention. . Key messages for the Kit have been selected in collaboration with the Ministry of Health.

During each home visit, volunteers will review one of the 12 key health messages included in the pamphlet which is provided at the first home visit. As appropriate, the home visitor volunteer will counsel and refer the orphan or vulnerable child for family planning, opportunistic infections/sexually transmitted infections (OI/STI treatment, testing and other essential health and social services.

A new component of this activity is Sprinkles, a sachet containing a blend of micronutrients for the prevention and treatment of iron deficiency anemia, which affects 75% of children under five in Mozambique. The packet can be sprinkled onto foods prepared in the home. The distribution channel for Sprinkles will be determined in collaboration with the MOH and delivered by community care partners who are the primary channel for distribution of these Kits.