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
Funding is requested to continue support for the position of Senior HIV/AIDS Prevention Advisor, created in
FY06. The Advisor focuses primarily on prevention of sexual transmission will also work closely with and
mentor the Senior Technical Advisor managing Safe Injection and PMTCT. The advisor has a leadership
role in ensuring the USG program implements an innovative, effective and balanced prevention program.
The Advisor oversees expansion of the prevention program, ensuring that best practices, lessons learned
and operational and epidemiological research results are applied in the design and refinement of the
Emergency Plan prevention activities. The Advisor plays a technical leadership role in design, management
of implementation and evaluation of prevention programs to reduce sexual transmission. The Advisor
coordinates USAID prevention programs with those of other USG partners and implementing partners, the
Government of Namibia, other development partners, and other sectoral teams within USAID/Namibia. The
Advisor provides technical support to local implementing partners and remains current in the developments
in the field of prevention, particularly prevention of sexual transmission.
Funding for this position is split between the AB and Condoms and other prevention program areas.
This activity is a continuation of a program of activities initiated under the FY07 COP (ref: FY074442.08)
and supports the OGAC global initiative on gender. Harmful male norms and behaviors and a lack of
positive, societal and family roles for boys and men were identified by USG/Namibia implementing partners
during the development of the FY07 COP and for follow-on activities under the FY08 COP as some of the
leading challenges in dealing with long-term behavior change in Namibia. Specific issues include
widespread prevalence of intimate partner violence, sexual assault, and child abuse throughout the country
as well as widespread abuse of alcohol which fuels violence and sexual coercion. Masculine norms support
and perpetuate male infidelity, transactional sex and cross generational sex and between older men and
younger girls is common. Lower rates of male participation in HIV/AIDS care and treatment services,
especially in PMTCT, C&T and ART, mean that men do not receive much needed services. The Namibia
National Medium Term Plan (MTPIII) 2004-2009 acknowledges these challenges and includes interventions
targeting gender inequality and violence and alcohol abuse.
In FY07, the Ministry of Health and Social Service (MOHSS), Ministry of Gender Equity and Child Welfare
(MGECW), Ministry of Safety and Security (MOSS), and Ministry of Defense (MOD) formed a Men and
HIV/AIDS steering committee, and took a leadership role in the mainstreaming of gender throughout their
sectors and for USG-supported clinical, community-based and media-driven interventions. This signaled a
strong start for the Men and HIV/AIDS initiative, and a unique opportunity for inter-ministerial ownership and
engagement in a movement which will influence in a sustainable manner deeply rooted Namibian male
norms and behaviors impacting HIV/AIDS. The Men and HIV/AIDS initiative in Namibia has three
components: a national strategy that employs an intensive and coordinated approach to addressing male
norms and behaviors that can increase HIV/STI risk; the provision of technical assistance (TA) to
implementing partners applying evidence-based approaches to integrate into existing programs and to
develop innovative programs; and an evaluation component that investigates the effect of gender
mainstreaming programming on self-reported behaviors. EngenderHealth (Engender) and Instituto
Promundo (IP) will facilitate the first two components; PATH the evaluation component. An interagency
USG gender task force in Namibia supports and coordinates all of these activities and the program receive
valuable support from the OGAC gender team.
The Men and HIV/AIDS technical approach is based on the evidence-based best practice program, Men as
Partners (MAP), developed and tested by Engender in sub-Saharan Africa and the Indian subcontinent.
MAP employs group and community education, and service delivery and advocacy approaches to promote
the constructive role men can play in preventing HIV, and improving care and treatment if they understand
the importance of gender equity issues and safe health practices via behavior modeling in their families and
communities. MAP programmatic approaches have been evaluated and have shown an increase in men
accessing services, supporting their partners' health choices, increased condom use and decrease in
reported STI symptoms.
To date, the Men and HIV/AIDS initiative has had a strong start. In collaboration with the inter-Ministerial
task force, Engender and IP developed a TA support plan and have initiated gender mainstreaming capacity
building activities within prevention, care and treatment activities with more than 30 PEPFAR-implementing
partners. Several partners were designated as key in-country resources in different areas (information,
education, communication (IEC) development, group education, training, and service delivery). The partners
are diverse, including FBOs and CBOs, and these partners engage many different groups of men, including
young men, religious leaders, teachers and soldiers. In addition, PATH has finalized the evaluation protocol
and is initiating the baseline study.
With FY07 re-programmed and plus up funds, additional monies were allocated to support a number of Men
and HIV/AIDS activities: to the MOHSS for a national Men and HIV/AIDS conference, to the MOD and
MOSS for mainstreaming gender throughout the uniformed services peer education programs; and to the
Ministry of Information and Broadcasting (MIB) to weave supporting messages throughout its national
HIV/AIDS mass media campaign, Take Control. Engender/IP received additional country funding for TA and
to hire a gender expert to coordinate the initiative in country.
In FY08, USG will strengthen and expand the Men and HIV/AIDS initiative. Engender and IP will continue to
focus on the providing TA to in-country partners. One of the USG's top priorities in strategic planning and
TA for implementation will be assisting partners to make choices based on optimizing the feasibility and
effectiveness of interventions and their potential for sustainability and scale-up. Another priority will be
strengthening the national and regional networks to discuss challenges and lessons learned in gender
mainstreaming. The initiative will support selected networks to implement joint activities at the local and
regional levels to advocate for male involvement in HIV. As feasible, these will be linked to global events
that focus on issues related to gender and HIV and AIDS: e.g., 16 days of activism, Father's Day, and World
AIDS Day.
Issues and behaviors to be targeted in FY08 include alcohol use and abuse, multiple concurrent partners,
transactional sex, condom use, and male violence. Building on partnerships with private and public sector
organizations, the initiative will continue to mobilize social capital to focus on the issue of male involvement
in HIV. This year, a specific focus will be on identifying ways that additional private sector organizations can
be mobilized to work with the network of partners already involved in Namibia's Men and HIV/AIDS
initiative. In addition, advocacy work will be continued with the government to ensure that male engagement
principles and approaches are integrated into government initiatives related to HIV/AIDS.
Overall during FY 2008-09, the USG/Namibia will ensure that a male engagement lens is applied to all
aspects of programming from program design and implementation to monitoring and evaluation. Technical
assistance will focus on further building the capacity of in-country partners including those listed above to
serve as resources through ongoing mentoring and supervision to ensure that male engagement is
mainstreamed into existing HIV and AIDS prevention, care, and treatment programs. Ongoing supervision
and monitoring will be provided in a variety of ways: through joint program design, implementation, and
training; in-country field visits and discussions on ways to address challenges, and feedback through email
and phone discussions with a core group of partners and in-country resources. One key area of focus will
be TA related to Behavior Change Communication (BCC) (activity 12342.08) with the aim of making sure
that partners not only effectively transfer knowledge to men about risky behaviors and safer behaviors, but
that the men are equipped to change their behaviors and are supported to do so by environmental factors.
BCC TA to USG partners will take the form of mentoring and on-the-job learning, and will be aimed at
Activity Narrative: strengthening the overall quality of their BCC programming, including design, implementation, quality
assurance and monitoring and evaluation (activity 16501.08). Another key area will be addressing alcohol
use and its relationship to unsafe health practices, and the Men and HIV/AIDS initiative will drawn on TA
and support from the comprehensive alcohol program (activity 17057.08).
The initiative will reinforce existing mass media activities such as the Take Control campaign by working
closely with Nawa Life Trust (NLT), which has been the key IEC partner during FY 2007 under the Men and
HIV/AIDS initiative and has ensured that all materials that are developed are consistent with the Take
Control campaigns. Gender partners will incorporate the Take Control guide packs developed by NLT into
gender mainstreaming activities (activity 5690.08, 4048.08).
The Men and HIV/AIDS quality assurance plan is designed to remain effective and relevant if needs evolve.
Each project staff person will be responsible for working with, following up and providing feedback to a small
group of in-country partners. This allows the provision quality, timely feedback and TA to a large group of
PEPFAR partners. The staff person seconded to this project during FY08 will continue to play a key role in
making sure that quality assurance and supervision at the country level and on the project team is strong.
This staffer will receive continued supervisory and on-the-job support to ensure that the PEPFAR partners
are getting the assistance they require for impacting male norms and behaviors.
The misuse of alcohol has a widespread negative impact on public health in Namibia. One local study
conducted in 2005 by the Ministry of Health and Social Services (MOHSS) and the Khomas Region Police
indicated that 56% of adult Namibians in Khomas use alcohol, 30% abuse alcohol over weekends, 20-25%
of road accidents involve intoxicated people, and on-the-job fatalities linked to drugs and alcohol account for
15%-30% of all accidents. According to the same study, ccessibility to alcohol is high - there are more
liquor outlets compared to other types of businesses in most towns, and "shebeens" (informal drinking bars)
supply alcohol to customers on a 24 hour basis, as well as illegally to minors. A KAP study of some
communities in Namibia found being drunk was positively associated with having multiple partners (NLT,
2006). Thus, the MOHSS believes that alcohol plays a major role in the disinhibition of risky behaviors and
failure to adhere to HIV/TB treatment. Within the region, sexual risk-taking behaviors associated with
alcohol use are highly prevalent in many of the countries severely affected by HIV/AIDS. For example, in a
recent longitudinal population study in Rakai, Uganda alcohol use was shown to be associated with a
relative risk of 1.67 for men and 1.40 for women for HIV acquisition. A recent study conducted by the
University of Boston found that heavy consumption of alcohol speeds up the onset of AIDS in those infected
by HIV.
There are no outpatient alcohol addiction treatment services in Namibia other than a few Alcoholic
Anonymous chapters in Windhoek, and there is only one inpatient addiction treatment center in the country.
Consistent anecdotal evidence from implementing partners and service providers within the MOHSS cite
the lack of alcohol treatment services as a great barrier to long term impact of advocacy and sensitization
efforts. Catholic Health Services conducted a study in 2005 which indicated that 41% of patients receiving
ARVs at St. Mary's Hospital in Rehoboth who defaulted did so on account alcohol. In FY07, Management
Sciences for Health will implement adherence monitoring which will determine factors associated with poor
adherence and default, including the influence of alcohol consumption.
In 2004, the MOHSS launched the Coalition on Responsible Drinking (CORD) with the mandate to ensure
increased awareness on the effects of alcohol. Member organizations include Ministry of Information and
Broadcasting (MIB), Ministry of Gender Equality and Child Welfare (MGECW), the Namibian Chamber of
Commerce and Industry, Namibian Breweries, the Namibian Broadcasting Company, various NGOs, the
Namibian Shebeen Association, and the Windhoek City Police. Since inception, CORD has developed a
mass media alcohol awareness campaign, held sensitization meetings with industry captains, and drafted a
National Substance Abuse Policy. USG partners with CORD and supports its alcohol efforts. COP07 funds
were allocated to support an alcohol knowledge, attitudes and practices assessment; CORD's alcohol
awareness campaigns; technical assistance in integrating alcohol prevention into prevention with positives
(PwP) efforts; and to mainstream alcohol prevention programming within the Ministry of Safety and Security
(MOSS) and Ministry of Defense (MOD) programs.
During FY08, USG will substantially expand its support to MOHSS and CORD to mainstream responses to
alcohol misuse at a national level throughout USG's programs. USG will strengthen the capacity of a
Namibian organization(s) to support CORD's advocacy and policy efforts, which will likely include advocacy
with the Namibian Shebeen Association, regulatory reform, and national alcohol policies. In addition, this
partner will provide technical assistance to USG's service delivery and community outreach partners to
strengthen their technical capacity to integrate alcohol responses into existing programs. This Namibian
partner(s) is TBD; CORD and USG will determine the technical assistance needs and partner selection
based on several factors, including sustainable capacity to provide support over time.
A possible alcohol mainstreaming approach that might be developed with CORD and OGAC is an evidence-
based approach to engaging population opinion leaders (POL). Using a methodology developed and tested
by the Academy for Educational Development, this intervention identifies, enlisted and trains opinion
leaders to encourage safer norms and behaviors within their social networks. This methodology is effective
in identifying and targeting influential leaders and their networks, and might be combined with another
potential best practice: a venue-based intervention to conduct outreach to bar owners, managers and
personnel, who then target patrons in drinking venues as peer educators. These peer educators provide risk
reduction information related to alcohol and sexual risk behaviors, teach proper, consistent condom use and
provide condoms to bar patrons, and refer them to a range of services within the prevention, care and
treatment continuum, including STI services. This approach uses a diffusion of innovation theoretical model
by the Sahwira Intervention Program, which is being evaluated in Harare, Zimbabwe.
Within clinical settings, USG will adapt brief interventions (BI) alcohol counseling and referral techniques.
These are time-limited patient centered counseling strategies that focus on changing patient behavior and
increasing patient compliance with treatment medications. BI are used in outreach and primary care settings
to change at-risk alcohol use patterns. Properly integrated into existing programs, the technique enhances
current HIV prevention efforts and promotes treatment compliance to HIV medications. The Capacity
Project will pilot the use of BI for alcohol in clinical settings (ref: Capacity Activity 4737.08).
FY07 funds are set aside to support MOHSS' development of an alcohol strategic plan. In FY08, the
MOHSS, with assistance from the USG will create a comprehensive alcohol addiction treatment roadmap,
in support of the National Substance Abuse Policy, which will include: a) treatment responsive aligned to
severity of addiction (in descending order of severity: rehabilitation center, hospital based addiction
treatment, outpatient treatment models). The roadmap will define MOHSS' response to building long term
capacity in addiction treatment, which might include pre-service capacity building (establishment of
addiction treatment subunit with the Department of Psychology/Basic Sciences at the University of Namibia
(UNAM); out of country post graduate training in South Africa, UCT) as well as in-service capacity building
responses. The ability to provide sustainable addiction treatment in Namibia might require an evaluation of
provider cadre responsibilities and task shifting.
USG will continue to support CORD's alcohol awareness mass campaigns, building on USG's investment
made in FY07. The mass media will reinforce all of the advocacy and alcohol mainstreaming initiatives
within clinical and community settings, lending scale and credibility to the national initiative. Nawa Life Trust
will continue to provide technical assistance to CORD in FY08 (ref: NLT 4048.08).
MOHSS and USG will design and pilot an outpatient alcohol addiction treatment program targeted to
patients on TB/ART treatment. Three models of treatment have been shown to be effective in treating
alcohol dependence: Twelve Step Facilitation (based on the Minnesota model and AA principles);
Activity Narrative: Motivational Enhancement Therapy (also known as Motivational Interviewing); and Cognitive Behavioral
approaches that include relapse prevention training. After treatment, treatment gains tend to be better
maintained if the person becomes actively involved in AA or other recovery support groups and develops
family and peer relationships that are supportive of recovery. MOHSS and USG will work closely with
OGAC to design, implement and evaluation the pilot, learn from the experiences of other countries, and
source expert TA from either the US (i.e. a university with addiction treatment services such as Columbia
University) or from within the region (South African Research Council, Alcohol and Drug Abuse Research
Unit; and university-based outpatient treatment services).
In summary, funding components for the comprehensive integrated alcohol program are as follows: 1)
Support to strengthen the capacity of a Namibian NGO to provide policy & advocacy support, TA to
PEPFAR clinical and communications partners to mainstream alcohol into programs: $100,000 (17061.08);
2) pilot addiction treatment program: $215,000 in HVOP, HTXS, systems strengthening ref: 17061.08). The
following are programs that will integrate alcohol programming into existing clinical and communications
programs with support from the Namibian TA organization. The International Training and Education Center
on HIV/AIDS (I-TECH) (4489.08 ) will integrate appropriate approaches into provider curricula, the Capacity
Project (4737.08) will ensure mainstreaming into regional supervision/case management and VCT
programs, and PHDC (16501.08) will coordinating TA in behavior change communications techniques.
Other USG supported programs that will receive alcohol mainstreaming TA include AED's workplace and
classroom programs (8500.08), PACT-supported community programs (6470.08), the national rollout of the
PwP program, SMA's MARPs outreach (3831.08), MOD and MOSS programs, and service delivery
programs. Additionally, NLT will continue to provide TA to CORD and MIB in support of its alcohol
awareness campaigns (4048.08). This activity's coverage will be national in scope.
FY06 but with a change in mechanism from a Fellow to a USPSC resulting in an eventual cost savings to
the USG. The Advisor focuses primarily on prevention of sexual transmission but will also work closely with
the Senior Technical Advisor for Treatment and Care managing Safe Injection and PMTCT and provide
technical support to all USG agency partners, implementing partners and initiatives involved in the
programmatic areas impacting prevention of sexual transmission. The advisor has a leadership role in
ensuring the USG program implements an innovative, effective and balanced prevention program. The
Advisor oversees expansion of the prevention program, ensuring that best practices, lessons learned and
operational and epidemiological research results are applied in the design and refinement of the Emergency
Plan prevention activities. The Advisor plays a technical leadership role in design, management of
implementation and evaluation of prevention programs to reduce sexual transmission. The Advisor
coordinates prevention programs with those of other USG partners and implementing partners, the
Advisor provides technical guidance to local implementing partners and remains current in the
developments in the field of prevention, particularly prevention of sexual transmission. Funding for this
position is split between the HVAB and HVOP.
Funding is requested for a Community Care Advisor to ensure on a long term basis that the USG care
portfolio can improve interventions at a facility, community, and caregiver level. To work with all USG care
partners to ensure that USG Namibia implementing partners are providing a full preventative care package
and that they are meeting the new guidelines for what constitutes a palliative care service. The Community
Care Advisor will be provided with Namibia specific care orientation by the Care Consultant (former RHAP
care advisor) who will provide technical assistance on a continuing basis to all USG partners. A recent
USG Staffing for results exercise revealed a critical need for an in-country USG person to focus on
community care, lend support to the existing USG OVC Advisor, and also monitor nutrition, TB, and
palliative care interventions and their integration at a community, facility, and caregiver level across the
USG portfolio. ($241,000 funding requested)
In addition to the care technical advisor, funding is requested to receive technical assistance from a Care
Consultant that has worked with the USG in Namibia for several years in her previous role as the Regional
Palliative Care Advisor based in South Africa. The consultant will build on care activities negotiated by the
USG with the Directorate of Primary Health Care, the Directorate of Special Programs, and respective USG
implementing partners, as well as the Clinton Foundation and Global Fund. This type of short term
technical support to the USG program and current USG care implementing partners is critical to ensure that
advances made in IMAI, Nutrition, and palliative care support are continued with FY 07 funding while the
USG is recruiting the Community Care advisor. ($75,000 funding requested)
This is a new activity. Namibia is the first PEPFAR focus country to complete draft OVC service standards
for use by programs. These service standards are now being used to assist the OVC partners with refining
their activities so a measurable difference in the lives of children served can be tracked. Service standards
are tied to country-agreed upon outcomes. The service standards include standards on the seven PEPFAR
core services and will link to the Ministry of Gender Equality and Child Welfare's (MGECW) OVC database.
Namibia is pioneering the process for establishing and applying service standards to improve quality
programming. Namibia has also offered south-to-south assistance to other countries regarding OVC service
standards.
This activity will assist Namibia's OVC program to refine and apply the OVC standards among USG OVC
partners, Namibia will continue to work with the MGECW to incorporate the standards in the regions and
develop the data fields to be collected for the OVC database. This FY 2007 program was under multiple
OVC partners and, in FY 2008, will gain a strategic focus as an individual activity since Namibia is
becoming a "center of excellence" for implementing quality service standards for OVC programs.
This activity has five components:
1. Address needs to revise the OVC standards. Present revisions to the OVC Permanent Task Force (PTF).
Work with partners to update other forums such as the Regional AIDS Coordination committees (RACOCs),
regional and constituency forums. The standards should be considered a living document to be revised
periodically based on involving key stakeholders who were not at original workshops including those with
experience with children on the street and children with disabilities
2. Communicate standards at grassroots or implementation level, including to staff, volunteers and children.
Undertake internal process to use and adapt standards to each organization and work with implementing
partners to update programs to comply with standards. Along with this, the activity will help identify barriers
and possible solutions for implementing and practicing the standards and documenting changes after a
year.
3. In FY 2007, case studies were conducted with the partners below looking at two types of service delivery
points: after school programs and provision of health service support through community health worker
home visits. The FY 2008 program will strengthen and maintain networking and relationship-building to
improve service delivery using peer reviews, collaboratives, exchange visits to other organizations and
technical assistance from local partners. The focus will be to develop local expertise within each activity's
area of work:
The Church Alliance for Orphans (CAFO) will mobilize the community and work with parents; the Katutura
Youth Enterprise Center (KAYEC) will provide-after-school classes in the north-central region; PACT and
LifelineChildline will ensure ethical child participation; Catholic AIDS Action (CAA) will do home-visits and
Philippi Trust will offer after-school programs.
4. Hold workshop on meaningful child participation, including training and support towards understanding,
adapting, and implementing policy within each organization with a focus on how to properly involve children
in planning, implementation and review.
5. Assess the application of the OVC service standards to OVC programs, addressing how service
standards have enabled programs to determine and provide good care for the greatest number of OVC.
Findings from the case studies done in FY 2007 can be used to inform the tools used in this process
evaluation.
In this continuing activity, funding is requested to cover technical assistance provided by the Regional OVC
Technical Advisor and other expert personnel to Namibia's HIV/AIDS Program in the areas of OVC and
Human Capacity Development (6471.08). Assistance will be provided to the USG Namibia team and
implementing partners not only through on-site assistance but along through continuing contact via
telephone and email.
The Advisors will work with the USAID/Namibia OVC Technical Advisor to strengthen OVC programming in
Namibia and will provide assistance based on experiences elsewhere in the southern African region.
In this continuing activity, funding is requested for assistance provided by the USAID OVC Technical
Advisor based in Namibia. This Advisor assists with planning, management, implementation, and
evaluation of OVC programs and activities. He represents the USG at a multisectoral level through
membership in the National OVC Permanent Task Force. The advisor works in close collaboration with
other USAID sectors to identify leveraging opportunities, maintains close contact with USG care partners,
UNICEF, and the Global Fund, and serves as the key liasion with the Ministry of Gender Equality and Child
Welfare on OVC matters. He works closely with the MOHSS, MOE, MHAI, and MOSS, and provides on-
site support, guidance, and follow up on a $7-8 Million OVC portfolio.
He raises awareness of challenges faced by implementing partners to GRN counterparts, and works closely
with the MGECW Permanent Secretary to tackle higher level policy and operational issues bottlenecking
implementation of OVC direct services. This in-country Advisor will work closely with the Regional OVC
Advisor CASU to strengthen HIV/AIDS programming for OVC in Namibia and will liaise directly with
ministerial and implementing partners to share best practices.
Namibia is hard hit by an HIV/AIDS epidemic with a current prevalence rate of 19.9% among pregnant
women based on sentinel surveillance data from 2006. Namibia has a successful HIV treatment program
reaching about 36934 patients as of June 2007. However, there is still a huge unmet need for HIV services,
and linkages of treatment to prevention and care programs. To effectively access HIV/AIDS services,
counseling and testing services are central to establishing an entry point to HIV/AIDS prevention, care and
treatment.
To better deliver these services, and keep up with new developments, a dedicated specialist will need to
support the program. A recent Staffing for Results exercise conducted by the USG revealed a critical need
to have a Counseling and Testing Specialist. This position was endorsed by an interagency team that met
an agreed that the current breadth of programs for counseling and testing required more attention to quality
and improvement at a service delivery level. This specialist will work closely with CDC's Counseling and
Testing Advisor to streamline USG support in counseling and testing, ensure that MOHSS guidelines are
followed by all implementing partners, and lend critical attention to improving quality, scale, and coverage of
activities. The C&T specialist will be directly responsible for a $5million portfolio, and is essential to
ensuring that all activities are closely monitored and implemented by faith based partners. The CT
Specialist will focus on improving a referral system to ensure that HIV+ patients and clients are linked to
care and treatment services, both at a community and facility level.
This position in critical to ensure that overall CT efforts will be coordinated with the Ministry, as well as other
development partners such as the Global Fund.
The Senior Advisor on Care and Treatment provides leadership for USAID programs in the areas of
PMTCT, ART, Injection Safety and other areas as necessary to assist the HIV/AIDS team in planning,
implementation, management, monitoring and evaluation of the care and treatment portfolio. The Advisor
works in close collaboration with other USG agencies to identify crosscutting themes, liaises with
development partners and stakeholders, and serves as the primary contact for these service areas with the
Ministry of Health and Social Services (MoHSS). The Advisor is responsible for planning care and
treatment program activities with Cooperating Agency partners and other local implementing partners and
ensuring that the program remains appropriate to Namibia, reflects the needs of Namibians, and that
activities encourage broad community-based participation in decision making. The Advisor ensures
alignment of program activities with MoHSS and O/GAC guidance and ensures timely submission of
program and financial reports from care and treatment partners. USAID will continue to use the services of
the advisor in 2008.
Funding is requested for a full time Capacity Building/Systems Strenghtening Advisor (USPSC):
This position is ongoing and was requested and approved under the FY 07 COP. There was a delay in
recruiting for the position due to a strategic review of the previously proposed mechanism which revealed
that a change from a Global Health Fellow position to a USPSC would provide better and more
comprehensive partner management support and that the USPSC mechanism would have the requisite
authorities required to manage direct funded cooperative agreements with implementing partners. However,
the USPSC mechanism required a more complex approval process under U.S. Department of State rules
and regulations. In addition, planning and guidance from Washington regarding the USAID/Namibia
mission's transition to an all PEPFAR mission during 2008 also resulted in recruitment delays.
The System Strengthening and Capacity Building (SSCB) Advisor/USPSC will serve as a key advisor on
HIV/AIDS systems strengthening and human and organizational capacity development working with
implementing partners and GRN ministries and offices. The Advisor will have overall leadership and
management responsibilities for expanding and directing systems strengthening and capacity building
initiatives for the benefit of USG/Namibia. The Advisor will be located at USAID/Namibia which currently
manages 41 local and international partners of which 5 are receiving direct funding plus a Strategic
Objective Agreement with the National Planning Commission and Ministry of Health and Social Services. It
is planned that under the guidance of the Advisor more local partners will acquire the organizational and
financial capacity to qualify for direct funding.
In addition to serving as a key advisor and manager of PEPFAR funded capacity building programs, the
incumbent will support Namibia's efforts to manage the following key capacity building partners. The advisor
will serve as Cognizant Technical Officer (CTO) managing directly the following key capacity building
partners - Pact, Inc. and Health Systems 20/20, and the BCC capacity-building new award.
USAID's operations costs outside of direct cost for human resources is approximately $100,521 (17 x 5,913)
for IRM Tax costs, payable to USAID
Noted April 22, 2008: USAID's operations costs outside of direct cost for human resources is approximately
$100,521 (17 x 5,913) for IRM tax costs, payable to USAID.
O/GAC/USAID M&S reprogramming request to reduce programmatic budget to allow for additional USAID
M&S costs.
This activity relates to USAID/HVAB/HVOP (8041.08 and 8011.08), USAID/HBHC (17442.08), USAID/HKID
(8016.08), USAID/HVCT (17578.08), Potentia/HTXS (8017.08), GHFP/HVSI (8012.08), USAID/OHPS
(8013.08). The USAID staff in Namibia manages a comprehensive program in all 13 regions of Namibia,
including support to the Namibia TB control program through Child Survival and Health funding from
USAID/W, the program is being implemented by 17 international partners and 31 local partners. Staffing
includes: an HIV/AIDS Office/Director (US direct-hire), Deputy Director for management and programs (US
direct-hire), a technical advisor for capacity building and systems strengthening (USPSC), and 1 new
(USPSC) position is proposed for community care including support to an expanding OVC program.
Contracted personnel include: a technical advisor for treatment and care (Potentia), a technical advisor
(Fellow) for monitoring and evaluation (GHFP), a technical advisor for prevention (GHFP) converting to a
USPSC position for FY 08, and Locally Employed Staff (LES) consisting of: 1 technical advisor for OVC, 1
program development specialist providing program management support, 1 program assistant, 1 budget
and M&E specialist, 1 administrative assistant, a financial analyst, an HR and procurement specialist, a
GSO/maintenance supervisor, 1 executive assistant to EXO and HR, 1 warehouse/storekeeper, 2 driver
positions, and 1 logistics clerk/driver, 1 proposed C&T specialist, 1 proposed administrative assistant, 1
proposed program assistants . The salaries and benefits of technical and programmatic staff are assigned
to the appropriate program area within the Emergency Plan categories, but for the most part their local
support costs are included under this activity. The HIV/AIDS Director is 10% assigned to C&T, and 90% to
management and staffing. The Deputy Director is 10% assigned to HBHC and 10% to HVTB and 80% to
management and staffing. Operations costs outside of human resources include information technology;
telecommunications; accounting, photocopying and materials production; printing of reports and other
documents; office consumables; utilities; office rent and maintenance, furniture and equipment; security;
staff training; field, conference and meeting and travel; and other daily operations costs. A major
accomplishment to date is to have identified and funded 31 local Namibian organizations including 15 FBO
organizations. The financial analyst, and HR/procurement specialist liaise with the Acquisition and
Assistance regional office in Pretoria/South Africa and with USAID-Washington and provide financial and/or
management assistance to counterparts in these Namibian organizations receiving either direct USG
funding under Cooperative Agreements or through sub-grants. This activity leverages resources with the
European Commission and GTZ which provide technical assistance to increase the capacity of the Office of
the Prime Minister to support the public sector with managing the impact of HIV/AIDS. This activity also
leverages UNICEF funds which provide technical assistance to the Ministry of Gender Equality and Child
Welfare for OVC and the Global Fund which provides co-funding to 10 of USAID's local partners. It also
provides technical officers in community care, counseling and testing, PMTCT, ARV drug procurement and
ART in the MoHSS Directorate of Primary Health Care and Directorate of Special Programs (HIV/AIDS, TB
and malaria).
