The goal of this program is HIV response to mineworker-sending communities of southern Mozambique. TEBA will implement HIV prevention, HBC and OVC activities. It contributes to Partnership Framework Goals 1, 2, 4 and 5, and is in line with the Global Health Initiative Governance goal. TEBA, a regional organization, will receive capacity building from International Office for Migration, a local financial firm, and the TEBA office in South Africa. In Maputo City, Maputo Province, Gaza, and Inhambane, beneficiaries include mineworkers, partners and families of mineworkers, and others in the communities. In FY12, TEBA will implement in Gaza province (select localities of Xai Xai, Chibuto, Chokwe and Bilene). TEBA coordinates with other actors in the same provinces, such as PACTO and TB-CARE to ensure activities are not duplicative (i.e. two partners are not providing the same services to same population/in same locality) and that referrals strengthened. TEBA will seek cost-efficiency through its reliance on Mozambican staff, and technical assistance from its South African office and the local office of International Organization of Migration (IOM). TEBA is expanding a pilot project that was funded by IOM in the past; economies of scale will be had as the project builds upon past experience. This activity has pipeline from COP09-11, attributed to TBD Community-Based Responses to HIV. The pipeline is sufficient to cover the nearly $6 million of this award; in COP12 only a small amount is added for Counseling and Testing, a budget area not previously included. TEBA has bought two vehicles ($66,544) and will purchase another in FY12 with pipeline funds (total 3). Cars are for project implementation (OVC, prevention, HBC, monitoring, etc.).

TEBA's HBC program will provide the following servies for PLHIV: symptom diagnosis and relief, psychological and spiritual support, referral for counselling and testing and ART, management (or referral for) of opportunistic infections including TB, malaria, and other complications; culturally-appropriate end-of-life care; social and material support such as nutrition support, water, sanitation and hygiene, and training and support for caregivers. "Change Agents" (HBC providers) will provide services through home visits, and will train and support family caregivers to sustain services. Women will increase their access to income and productive resources, as well as access to health activities and services, given that there is a large proportion of women in TEBA's communities (due to male migration to South Africa).

Meaningful involvement of PLHIV and OVC will increase awareness of issues of HIV-related stigma and discrimination, girls and womens vulnerability to transactional and intergenerational sex, and inheritance and property rights. Interventions will be tailored to mineworker-sending communities heavily affected by migration.

By linking with clinical partners, health facilities, and other partners in the same geographic areas (for example, referrals to counseling and testing, PMTCT, and ART services), TEBA will strengthen community-facility linkages.

TEBA will also implement a cross-border referral system for Mozambicans working in South African mines. TEBA provides HBC for mineworkers who are medically repatriated, as well as support for the family. TEBA will strengthen cross-border referral systems in this project, including the tracking of mineworkers who return to Mozambique unofficially, and those who default from treatment.

TEBA has pipeline from previous COP allocations, and thus will not need HBC funding in this COP.

TEBA staff and Change Agents will be trained on OVC services, child rights, and national standards, in collaboration with USAID and the Ministry of Women and Social Action. TEBA will also participate in an exchange visit to HACI and Reencontro, two Mozambican OVC organizations, to gain a better understanding of OVC services.

TEBA will provide family-centered OVC services, with its HBC program as an entry point. OVC services will include nutrition support, registration for poverty certificates, and life skills, as well as other services that will be identified during its capacity-building process in OVC. Appropriate activities benefiting girl OVCs, such as caretaker counselling on issues such as intergenerational sex and early marriage, girls' access to education, dissemination of child protection law, etc. will be identified as part of this process.

TEBA has pipeline from previous COP allocations, and thus will not need HKID funding in this COP.

OHSS funds will be used to build capacity of HBC caregivers and other community workers, as well as TEBA staff in financial management and other organizational areas. No amount is planned for COP 2012, since TEBA has OHSS pipeline.

TEBA will buy three vehicles as it is expanding in three new provinces. However the expansion and the car purchase will be phased over two years.

TEBA will implement epidemiologically-responsive and contextually appropriate prevention activities reaching beneficiaries at the individual, couple, family, institutional, community, and social levels in mineworker-sending areas of Southern Mozambique. The project 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 migration, which influence these drivers. Beneficiaries will be adults aged 20-49, and youth aged 15-19, including mineworkers, ex-mineworkers, partners and families of mineworkers in mineworker-sending communities of Gaza, Inhambane, Maputo City, and Maputo Province.

Prevention activities will have a strong emphasis on reduction of multiple concurrent partnerships and promotion of 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 project will mainly support behavioral and structural interventions, conducted at community level to prevent HIV infections. It will support a mix of media (community radio) and interpersonal communication approaches that are known to be effective and that are tailored to reach adults and young people (including miners, ex-miners, potential miners, and partners and families of miners) with prevention programs that address multiple concurrent partnerships, the importance of counselling and testing, risks associated with migration, alcohol, etc, and the normative factors that affect each. The partner 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. Change Agents will be trained in gender and GBV training as they inter-relate with migration and HIV.

By linking with clinical partners, health facilities, and other partners in the same geographic ares (for example, referrals to counseling and testing, PMTCT, and ART services), TEBA will strengthen community-facility linkages.

TEBA has pipeline from previous COP allocations, and thus will not need HVAB funding in this COP.

TEBA will receive HVCT funds for the first time through COP 12. As a partner serving a specific high risk group, allotting new funds to this existing partner falls within the PEPFAR Mozambique counseling and testing (CT) strategy of community based CT expansion for most-at-risk groups. TEBA has experience implementing community-based CT through past projects funded by other donors and will implement community-based counseling and testing, promotion and supervision in Gaza and Maputo provinces targeting mine workers, ex-mine workers, their partners and families, individuals residing in mine-sending communities, and partners of PLHIV.

Gazas HIV prevalence is 29.9% among women 15-49 years compared with 16.8% of men. 26% of women reported having had a test in the last 12 months compared with only 10% of men. Maputo provinces HIV prevalence is 20% for women and 19.5% for men. 24% of women reported having had a test in the last 12 months compared with 17% of men.

The project will mobilize communities to increase the demand and use of CT services and coordinate with care, support and treatment providers to establish a two-way referral system of clients and will complement TEBAs sexual transmission prevention activities. In addition to providing community-based CT , TEBA will reach in-transit miners with miner-specific HIV prevention messages and miner-friendly CT services at key transit points between the employment site in South Africa and their home community. CT will be part of a before you go home package of services that Mozambican miners will receive at the miner processing center at the Ressano Garcia border crossing. Planned HVCT trainings include but are not exclusive to: quality assurance and control, counseling and message delivery in non-judgmental ways, supply planning and forecasting, campaign coordination, linkages/continuum of care, gender and gender-based violence (especially due to disclosure) and treatment as prevention. These interventions will increase gender equity in CT-seeking behavior. Information about the gender-based violence law, child protection law, and other relevant information will be shared to miners en route, as well as migrant-sending communities.

TEBA will participate in planning, coordination and implementation of any provincial CT campaigns led by the Provincial Health Directorate and National AIDS Council Provincial Nucleus, likely in Gaza, one of the three Global Health Initiative focus provinces. All CT partners will benefit from Quality Assurance/Quality Improvement support to INS at the central level. The lead clinical partners in Maputo and Gaza provinces will receive funds to support EQA logistics for all CT partners, including TEBA.

TEBA is developing its Monitoring and Evaluation (M&E) plan, which will include PEPFAR and non-PEPFAR indicators. IOM is providing TA in M&E, including the baseline survey. There are zero targets for this activity as TEBAs COP 12 HVCT funds are not expected until the very end of FY12. Upon receiving these funds, the awardee will begin identification and training of their community change agents. CT will be included in the HIV prevention component of their training.

TEBA will implement epidemiologically-responsive and contextually appropriate prevention activities reaching beneficiaries at the individual, couple, family, institutional, community, and social levels in mineworker-sending areas of Southern Mozambique. The project 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 migration, which influence these drivers. Beneficiaries will be adults aged 20-49, and youth aged 15-19, including mineworkers, ex-mineworkers, partners and families of mineworkers in mineworker-sending communities of Gaza, Inhambane, Maputo City, and Maputo Province.

Prevention activities will have a strong emphasis on reduction of multiple concurrent partnerships and promotion of 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 project will mainly support behavioral and structural interventions, conducted at community level to prevent HIV infections. It will support a mix of media (community radio) and interpersonal communication approaches that are known to be effective and that are tailored to reach adults and young people (including miners, ex-miners, potential miners, and partners and families of miners) with prevention programs that address multiple concurrent partnerships, the importance of counselling and testing, risks associated with migration, alcohol, etc, and the normative factors that affect each. The partner 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. Change Agents will be trained in gender and GBV training as they inter-relate with migration and HIV.

By linking with clinical partners, health facilities, and other partners in the same geographic ares (for example, referrals to counseling and testing, PMTCT, and ART services), TEBA will strengthen community-facility linkages.

TEBA has pipeline from previous reprogramming funds, and thus will not need HVOP funding in this COP. AB and OP funds will be used to provide a comprehensive and appropriate prevention interventions to the different target populations.