APRIL 2009: This activity was reprogrammed under Pact (6470.26984.09) when CAA did not pass its audit

to become a prime partner. In COP09 CAA remains a sub-partner to Pact (and Intrahealth for HVCT).

----------------------

Catholic AIDS Action (CAA), an indigenous Namibian organization, is receiving direct PEPFAR funding as a

prime partner for the first time this year. In previous years, they were a primary sub-partner under PACT to

build organizational and technical capacity.

CAA will target 2,830 OVC, ages 8-12, using the Adventure Unlimited curriculum (a ten session course) that

focuses primarily on abstinence. CAA will target 4,170 OVC, ages 13-25, with its Stepping Stones

curriculum (a fourteen session course) which is an AB focused curriculum (see CAA HKID). Both curricula

will cover not only basic information regarding HIV infection and transmission but, equally important, they

will address the co-factors that contribute to positive community health. Sessions will cover effective

communication skills, gender norms, the role of alcohol on increased risk for HIV infection, intimacy and

relationship skills, cultural norms and practices. These sessions are discussed as they relate to their impact

on HIV infection risk, the role of interpersonal "power" (violence and coercion) on relationships, and choices

regarding sexual activity. A revised Stepping Stones curriculum also includes components on preventing

trans-generational sexual activity and transactional sexual activity and the risks associated with multiple

concurrent partnerships.

CAA will conduct this intervention and routine follow-up activities through peer educators. CAA will train

150 new peer educators. CAA will continue to support and provide refresher training for 100 "senior" peer

educators from the previous FY who will also provide additional guidance and supervision to new peer

educators. Peer educators will also be trained to screen all participants for TB infection and make referrals

to local health centers. 280 local community leaders will be trained and sensitized to support CAA

prevention activities in their local area. Follow up activities will include collaboration with PEPFAR partner

Nawa Life Trust for community mobilization and media and collaboration with Engender Health/Respond for

male involvement activities. C-Change/AED will provide TA to CAA to better articulate a more precise

strategy in behavior change communication which will improve the prevention course implementation and

outcomes.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.02:

APRIL 2009: This activity was reprogrammed under Pact (4727.26986.09) when CAA did not pass its audit

to become a prime partner. In COP09 CAA remains a sub-partner to Pact (and Intrahealth for HVCT).

----------------------

Catholic AIDS Action (CAA), an indigenous Namibian organization, is receiving direct PEPFAR funding as a

prime partner for the first time this year. In previous years, they were a primary sub-partner under PACT to

build organizational and technical capacity.

CAA is the largest FBO network in Namibia, with a target of 2,000 volunteers for FY 2009 resources,

providing community based palliative care services for 7,500 adult and pediatric clients and their families.

Approximately 6,150 HIV+ clients are adults.

CAA provides an integrated family-centered program that involves the assessment of PLWHA, family

needs, provision of family-based health education, advocacy and referral, stigma reduction, counseling and

emotional support, spiritual care, practical care, emergency material assistance, and referrals to CAA

services for OVC (see CAA HKID, CAA HVTB, CAA HVAB, CAA HVCT, and CAA PDCS).

In FY09, a comprehensive prevention package will continue to be incorporated into HBHC services covering

education, referrals for VCT and PMTCT, mobilization for cotrimoxizole prophylaxis and isoniazid preventive

therapy, improved ART adherence, safe water, hygiene, malaria prevention and treatment, TB preliminary

screening and referrals, promotion of good nutrition practices for adults and children, promotion of child

immunizations, and referral for family planning services. If there are any challenges with access to either

cotrimoxizole or isoniazid treatment, CAA volunteers and staff can coordinate and communicate this directly

to local GRN health facilities.

Additionally, CAA will expand its nurse-supervised home based palliative care services from 7 regional

offices in FY08 to 10 regional offices in FY09. In collaboration with the African Palliative Care Association

(APCA) and the MoHSS, CAA will offer direct clinical services, including pain management, through

staff/volunteers supervised by trained nurses. CAA will continue to work with the MoHSS to develop and

strengthen referal mechanisms to and from the community and facility. Palliative care trained volunteers,

supervised by trained nurses, will improve the quality of life of people living with HIV through the prevention

and relief of suffering by means of early identification of HIV infection and opportunistic infections, and the

impeccable assessment and treatment of psychosocial, spiritual, and physical pain. Care will be provided

throughout the disease continuum from diagnosis to bereavement support for families and loved ones.

Program quality will be monitored through frequent supervision by CAA staff, monthly data collection, as

well as the APCA palliative care outcome scale. CAA is active in the Namibian Palliative Care Task Force

that advocates for increased access and quality of palliative care services, including access to opioids.

Early referral and retention in CAA home based palliative care programs will be achieved through an

extensive network of 2,000 community volunteers, the structure of over 300 parishes and missions, the

volunteer's constant community mobilization and education, and the CAA reputation for quality, caring

services.

Monitoring and evaluation begins with volunteer documenting service provision on individual forms, collating

this data with other volunteers from the same group (service site) and submitting data during monthly

supervision to the CAA Regional Coordinator. Data from individual volunteer groups are then assembled by

each regional office and submitted to the CAA Regional Manager. These Regional Managers then submit

data on a monthly basis to the CAA national office where the information is further checked and collated

and made available to Namibian governmental offices, donors, and for program monitoring and evaluation.

CAA M&E data are subjected to both internal and external audits.

Each volunteer group is provided with a small amount of funding for emergency assistance to the neediest

clients. The local community volunteer group is empowered to make decisions regarding the allocation of

this resource. It is frequently used for funeral and burial expenses, food, and shelter. Food security

remains a priority issue for the HBC volunteers and their clients. A national office staff member is charged

with providing capacity building and training for staff and volunteers in food and nutrition as well as the

development of small micro-enterprise activities to increase food security. The volunteers are the targets

for this intervention so that indirect beneficiaries include adult and pediatric HIV+ clients as well as OVC.

These projects assist volunteers and clients providing sustainability at a community level. In addition, the

poorest and most needy clients are provided with supplemental nutrition in the form of e-pap.

Activities targeting prevention with positives are being developed through collaboration and coordination

with other partner NGO's including Positive Vibes. Center-based and community based support groups

empower clients to protect their own health against infection with other strands of HIV as well as to prevent

the further spread of the virus to others.

During routine home visits, CAA volunteers remind families and caregivers of the importance of boiling

water, safe water storage, and basic hygiene to reduce the burden of diarrhea on the nutritional and health

status of HIV infected clients.

CAA volunteers also provide extensive community mobilization and education to decrease stigma and

discrimination and increase uptake of clinical services including VCT, PMTCT, ART and treatment for TB.

Regular monthly supervision and an annual retreat for staff and volunteers, as well as materials from the

southern African region on "caring for caregivers" will ensure HIV services for infected caregivers and

emotional and spiritual care for all volunteers to renew and sustain caregiver motivation.

CAA will also target HIV+ volunteers and provide those that need it, a small transport subsidy to ensure

accessibility to ARV treatment.

CAA will enhance the quality of its home based palliative care services by mainstreaming the involvement of

Activity Narrative: at least 500 men, male partners of existing home based palliative care volunteers and male community

leaders. With the technical assistance of Engender Health, a community workshop curriculum has been

developed to clarify how cultural values play a key role in determining attitudes and behaviors related to

gender and HIV infection. These workshops assist participants to redefine masculinity and develop new

models for healthier individuals, families and communities. The workshops help men understand how they

need to be involved in transforming culture to address key issues in HIV transmission and plan for greater

involvement of men in HIV prevention, care, and treatment.

Collaboration with the MoHSS and the Social Marketing Association, through Global Fund Resources, will

allow CAA staff and volunteers to distribute insecticide-treated nets for home based palliative care clients.

Home care kits are replenished to each volunteer on a monthly basis during supervision by CAA staff. In

some areas, GRN facilities provide both the kit and the replenished supplies. However this is not

consistent. PEPFAR funding is used to replenish non-pharmaceutical supplies such as skin lotion and

disinfectant. Other private donations from Action Medior (Germany) are used to replenish home care kits

with over-the-counter analgesics, multi-vitamin tablets, and protective equipment. Medical supplies and

equipment for the nurse supervisor are provided both through PEPFAR funding and private donations.

New/Continuing Activity: New Activity

Continuing Activity:

Program Budget Code: 09 - HTXS Treatment: Adult Treatment

Total Planned Funding for Program Budget Code: $18,318,500

Total Planned Funding for Program Budget Code: $0

Table 3.3.09:

APRIL 2009: This activity was reprogrammed under Pact (4727.26987.09) when CAA did not pass its audit

to become a prime partner. In COP09 CAA remains a sub-partner to Pact (and Intrahealth for HVCT).

----------------------

Catholic AIDS Action (CAA), an indigenous Namibian organization, is receiving direct PEPFAR funding as a

prime partner for the first time this year. In previous years, they were a primary sub-partner under PACT to

build organizational and technical capacity.

CAA is the largest FBO network in Namibia, with a target of 2000 volunteers for FY 2009 resources,

providing community based palliative care services for 7,500 adult and pediatric clients and their families.

Approximately 18% or 1,350 HIV+ clients are children.

CAA provides an integrated family-centered program that involves the assessment of PLWHA, family

needs, provision of family-based health education, advocacy and referral, stigma reduction, counseling and

emotional support, spiritual care, practical care, emergency material assistance, and referrals to CAA

services for OVC (see CAA HKID).

In FY09, a comprehensive prevention package will continue to be incorporated into pediatric home based

palliative care services covering education, referrals for VCT and PMTCT, mobilization for cotrimoxizole

prophylaxis and isoniazid preventive therapy, improved ART adherence, safe water, hygiene, malaria

prevention and treatment, TB preliminary screening and referrals, promotion of good nutrition practices for

adults and children, promotion of child immunizations. If there are any challenges regarding either

cotrimoxizole or isoniazid supplies, CAA volunteers will report this to CAA staff and coordinate and

communicate this directly to local GRN health facilities.

Additionally, CAA will expand its nurse-supervised home based palliative care services from 7 regional

offices in FY08 to 10 regional offices in FY09. In collaboration with the African Palliative Care Association

(APCA) and the MoHSS CAA will offer direct clinical services, including pain management, through

staff/volunteers supervised by trained nurses. Palliative care trained volunteers, supervised by trained

nurses improve the quality of life of children living with HIV through the prevention and relief of suffering by

means of early identification of HIV infection and opportunistic infections, impeccable assessment and

treatment of psychosocial, spiritual and physical pain. Care is provided throughout the disease continuum

from diagnosis to bereavement support for children and their families. Program quality is monitored through

the collection of basic statistical data as well as the APCA palliative care outcome scale. CAA is active in

the Namibian Palliative Care Task Force that advocates for increased access to palliative care services,

including access to opiods. CAA will continue to coordinate with the MoHSS to develop and strengthen

referal mechanisms to and from the community and facility. These referals are key for the clinical

monitoring of physical, cognitive, social, emotional, and behavioral growth and development as well as

facility based care and treatment when required.

CAA volunteers and staff, during regular visits of identified clients as well as during community mobilization,

reinforce the importance of pediatric HIV testing and counseling. This fosters early diagnosis and

treatment. Because volunteers are daily in the community, pregnant women can readily be identified and

referred for the range of PMTCT interventions.

During routine home visits, CAA volunteers remind families and caregivers of the importance of boiling

water, safe water storage, and basic hygiene education to reduce the burden of diarrhea on the nutritional

and health satus of HIV exposed and infected children. Beginning in FY07, and continuing in FY08 and

FY09, CAA has a designated national office staff person to build the capacity of regional staff and CAA

volunteers for improved nutritional assessments of HIV infected children. This includes body mass index

(BMI), mid-upper arm circumference (MUAC) measures, and building the capacity of staff and volunteers to

assess for nutrition related symptoms (appetite, nausea, thrush, and diarrhea) and provide education on the

importance of basic nutrition using locally available foodstuffs. Micronutrients are provided through a

separate donor (Action Medior of Germany). Targeted nutritional support (e-Pap) for children most-at-risk

following nutritional assessments is provided through PEPFAR resources and resources through the new

OGAC public-private partnership development.

Collaboration with the MoHSS and the Social Marketing Association, through Global Fund Resources, will

allow CAA staff and volunteers to distribute insecticide-treated nets for HIV infected children. Volunteers

are trained in the provision of psychosocial support for both children and their families and caregivers. CAA

will work with other NGO partners, such as Positive Vibes and Family Health International to further develop

and implement community based group support for children affected by HIV.

Monitoring and evaluation begins with volunteers documenting service provision on individual forms,

collating this data with other volunteer group members and submitting the data during monthly supervision

to the CAA regional coordinator. Data from regions are checked and collated by CAA regional managers

and then submitted to the national office in Windhoek where it is further collated and made available to

Namibian governmental offices, donors, and for program monitoring and evaluation.

Regular monthly supervision and an annual retreat for both staff and volunteers, as well as materials from

the southern African region on "caring for caregivers" ensures HIV services for infected caregivers and

emotional and spiritual care for all volunteers is renewed and sustained for continued caregiver motivation.

New/Continuing Activity: New Activity

Continuing Activity:

Program Budget Code: 11 - PDTX Treatment: Pediatric Treatment

Total Planned Funding for Program Budget Code: $3,097,509

Total Planned Funding for Program Budget Code: $0

Table 3.3.11:

APRIL 2009: This activity was reprogrammed under Pact (21260.26988.09) when CAA did not pass its

audit to become a prime partner. In COP09 CAA remains a sub-partner to Pact (and Intrahealth for HVCT).

----------------------

Catholic AIDS Action (CAA), an indigenous Namibian organization, is receiving direct PEPFAR funding as a

prime partner for the first time this year. In previous years, they worked under PACT as a sub-partner in

implementing this activity.

At the community level, CAA will provide TB education to over 40,000 individuals through community based

programs, emphasizing the difference between TB infection and TB disease, screening for symptoms of all

persons receiving other CAA services, providing referrals for clinicial sputum testing, and providing support

for Directly Observed Treatment Short-course (DOTS) adherence .

As part of its community based service provision, CAA will also train 100 staff members, 2,000 HBC

volunteers, and 250 peer educators in TB education, screening and referral. CAA staff and volunteers are

also trained to implement basic infection control strategies, amongst themselves and with family caregivers,

to prevent TB transmission. This includes simple environmental intervention (improving natural ventilation)

and proper cough hygiene

CAA will ensure that TB screening and referrals are integrated into all CAA programs, which include 7,500

home-based care clients, 16,500 orphans and vulnerable children (OVC), 7,000 A/AB prevention

participants, and 11,520 VCT clients. CAA estimates that 90% of these target populations will receive

screening and referral services.

Intensified community based TB-case identification will begin upon receipt of permission from the MoHSS to

initiate this process. In collaboration with the MoHSS, CAA will use simplified tools in picture format to help

community members screen, identify, and refer clients to available TB services for treatment. CAA is

working with the CDC and the MoHSS to develop an appropriate pictorial general population screening tool,

similar to that used in Rwanda, incorporating diagnostic questions such as: 1. Has the patient had a cough

for 3 weeks? 2. Has the patient had night sweats for >3 weeks? 3. Has the patient lost >3kg in the past 4

months? 4. Has the patient had fever for > 3 weeks? 5. Has the patient had recent contact with another

person with active TB? If the client answers "Yes" to any question, the patient is a TB suspect and will be

referred for sputum collection for acid fast bacilli smear and continue evaluation for TB per the TB control

program diagnostic algorithm for pulmonary TB. If the answer is "No" to question 1 but "Yes" to any other

question the patient is a TB suspect and is referred for continued evaluation for TB guided by clinical signs

and symptoms. If the answer is "No" to all of the questions the patient is not considered a TB suspect at

that time and repeat screening with the questionnaire will be performed in 3 to 6 months. Among PLWHA,

the following same questions above will be asked. However, unlike general population, PLWHA will be

rescreened at every contact with home based care volunteers. For clients identified as TB suspect through

screening, HBC volunteers will accompany the clients to health facilities where/when feasible, provide

referral slips which will be audited and arrange a return visit to the home to make sure the cleint went to a

medical facility.

During home care visits, volunteers routinely inquire if HIV clients without active TB disease have access to

isoniazid preventive therapy (IPT) and are properly adhering to the prescription. Any problems with this are

reported to CAA staff and CAA palliative care nurses for follow-up with local GRN facilities. CAA is also

currently tracking HBC clients who are on treatment for TB, including treatment adherence support. For

clients failing to respond appropriately to treatment, referrals can be made to the CAA palliative care nurse

and the client's GRN health facility to help prevent MDR TB. It is hoped that in the near future, with the

introduction of Integrated Management of Adult and Adolescent Illnesess (IMAI) and task shifting, CAA

nurses will be able to distribute both IPT and Cotrim directly to CAA HBC clients.

New/Continuing Activity: New Activity

Continuing Activity:

Program Budget Code: 13 - HKID Care: OVC

Total Planned Funding for Program Budget Code: $9,572,227

Total Planned Funding for Program Budget Code: $0

Program Area Narrative:

The USG Orphans and Vulnerable Children (OVC) program responds to the GRN National Strategy on HIV/AIDS to provide care

and support for OVC and the Ministry of Gender Equality and Child Welfare (MGECW)'s National Plan of Action for OVC (NPA:

2006-2010). The MGECW leads implementation of the action plan, and is the convener of the OVC Permanent Task Force

(PTF), which brings together key government ministries, development partners, and civil society partners for a coordinated

response. The MGECW currently has three directorates: Child Welfare; Gender Equality; and Community and Integrated Early

Childhood Development. The MGECW is restructuring in line with the National Policy on Decentralization and placing the

implementation and supervision of the function of child welfare and NPA implementation responsibilities into 13 regional councils.

To scale up a national OVC response, the NPA outlines five basic strategies for essential care and support to OVC most in need:

Rights and Protection; Education; Care and Support; Health; and Management and Networking of the program The target

population for USG programming as of 2008 is 250,000 OVC (this figure includes child-and-elderly-headed households), of which

155,000 are orphans who have lost one or both parents. Seventy-five percent of these orphans acquired their status as a result of

HIV/AIDS. In 10 to 15 years, these children will represent 25-50% of the economically active population in Namibia.

In FY08, USAID continued implementation of quality standards of care for OVC services through PEPFAR partners. Namibia

partners began working in collaboratives to foster cross-sharing of implementation best practices in areas such as after school

education, child protection, and psychosocial support. Standards for delivery of community care were also developed through

Pact support to the Ministry of Health and Social Services, placing increased emphasis on provision of care to OVC infected and

affected by HIV/AIDS. The MGECW remained a lead for improving quality of care at the service delivery level. Across all USG

implementing partners, only those children who received services that met or exceeded the minimum standards were recorded as

having received a service. Within the context of work with orphans and vulnerable children, quality was defined as the degree to

which the cluster of services provided to children, families and communities affected by HIV and AIDS maximized benefits and

minimized risks, such that children were able to grow and develop appropriately according to their community norms and cultural

context. Children, families and communities were also involved in decisions about the care and services they received.

The MGECW continued to improve the process of reporting progress obtained in their first ever annual national progress report,

with support from UNICEF and the USAID M&E Advisor. However, much work remains to be done in FY09 to ensure that all

USG OVC implementing partners are delivering quality care, reporting progress into a national OVC database, and providing

support such that all OVC eligible for social welfare grants from the Ministry can access them. The total number of OVC that

benefited from government social welfare grants in FY08 rose to 90,126, compared to 41,000 in 2006. Pact subgrantees, AED,

Project Hope, ORT, and CAFO contributed directly to this increase by supporting households and communities to apply for grants.

Pact supported 165 volunteers in regions where MGECW social workers were overloaded with processing applications, to create

an interim solution to the MGECW human resource crisis while vacant social work and community child care worker positions

were recruited and filled.

In FY08, Pact also supported the MGECW to develop policies, guidelines, and standards for residential care facilities where there

were no other alternatives for especially vulnerable children. Targeted assistance was provided to deinstitutionalize children and

reintegrate them back into community and family based placement settings. Additionally, a new Request for Application (RFA)

for child protection was released to strengthen the nexus of counseling, care, follow up support, and protection that could be

offered to OVC that have been raped or abused, or are victims of violence. Rights and protection training was provided to key

ministerial, law enforcement, and implementing partners, and the 15 existing Women and Child Protection Units in country will

continue to serve as a base of referral for counseling, psychosocial support, care, and protection in FY09.

In FY08, the MGECW, in collaboration with colleagues from Malawi at a Regional Interagency Task Team Meeting (RIATT) in

Tanzania, presented the findings of a joint UNICEF and USAID human resource capacity assessment/gap analysis. The formal

presentation and finalization of recommendations from the process allowed targeted technical support to be provided to the

MGECW in M&E, OVC, and human resource planning. The USG continued to help the MGECW in FY08 to implement key

recommendations from the analysis, which included: 1) strengthening coordination capacity of the OVC national Permanent Task

Force; 2) strengthening regional implementation capacity through collaboratives; 3) appointing senior advisors to the MGECW to

assist with OVC technical capacity and M&E; 4) providing regional technical support in HR planning; 5) advancing the recruitment

processes of social workers and child care workers (CCCW); 6) using NGO and CBO volunteers to assist social workers and

CCCW; 7) providing opportunities for leadership training and mentoring of senior staff; 8) assisting with staff restructuring to

accommodate decentralization, the M&E unit, the implementation of the national OVC database system, and the secretariat for

the PTF; and 9) funding bursaries to allow six students to pursue social work studies at UNAM.

Overall, the number of OVC directly served increased from 56,520 in FY07 to XXXXX in FY08, and each partner reinforced M&E

training to ensure that services were counted appropriately. FHI FABRIC transitioned its subgrantee, Church Alliance for Orphans,

to direct funding, and ORT/KAYEC trained 444 young OVC and caretakers in basic artisan skills that should enable them to enter

the formal or informal sector. Pact successfully provided OVC technical and M&E support to the MGECW, while continuing to

provide services to OVC via nine NGOs. Project Hope microcredit interventions improved caregivers' economic capacity,

particularly evident in the increased purchases (more assets, animals, clothing) for OVC, improved investments in homes (larger

houses with better quality walls), and reduced vulnerability (less selling off of assets, and shorter insufficient income periods).

In FY09 USG partners will continue to receive critical support from PACT to improve programmatic monitoring and evaluation, and

strengthen coordination and partnership with regional OVC forums via Pact and AED in collaboration with UNICEF. USG will

continue to staff two positions in the MGECW (OVC and M&E Advisor) based on the human resource assessment/gap analysis,

and provide regional technical support to address HR planning through the Southern African Human Capacity Development

Coalition. USG partners will continue to support OVC database development efforts at an implementation level and reinforce

country efforts to register, monitor, and track exactly what kinds of services are rendered in regions. The tool will actively serve as

a means for partners, donors, and the MGECW to leverage resources from one another and provide comprehensive services to

OVC. Pact will continue support to the Women & Child Protection Units in Namibia which have been established to assist victims

of sexual assault, work with victims of violence to launch appropriate investigations, and link with needed services, and involve

other stakeholders to expand rights and protection efforts by focusing on community mobilization for prevention of such violence

among women and children through improving the referral system and victim counseling and follow-up support.

In FY09, Project HOPE will continue to scale up services to especially vulnerable populations such as elderly caregivers and

orphan-headed households to improve access to economic strengthening opportunities in four regions (Oshana, Omusati,

Ohangwena, and Oshikoto). KAYEC Trust will provide older OVC and heads of households with vocational skills training, youth

development through leadership training and mentorship, and linking them youth to direct care, support, and treatment services.

AED will improve the monitoring and evaluation capacity of the Ministry of Education's school feeding unit in FY09 to include more

vulnerable schools with larger concentration of OVC, conduct basic anthropometric assessments, and gauge impact of improved

nutrition on learner performance. AED will also support the MOE on reinforcing the OVC fee exemption policy to increase the

number of schools and regions receiving refunds for OVC school fee exemption under the government supported Education

Development Fund. AED will also continue to implement the MOE OVC policy in the national education system and improve

school-level provision of care and support to children affected by HIV and AIDS. Teachers in the workplace and the Ministry of

Education will be targeted to ensure that schools are safe environments in which to learn and grow, rather than sites for sexual

assault, cross-generational, or transactional sex. (See Prevention AB.) Sub-grantees under Pact and Church Alliance for

Orphans will work together to facilitate community responses that build local capacity and sustain meaningful interventions to

meet the physical, economic, social and emotional needs of OVC. CAFO will be completely funded under the New Partners

Initiative as a direct prime in FY09, and Catholic AIDS Action will be a new prime partner graduating from capacity building

support of Pact. These local organizations will emphasize reducing the vulnerability of girls who are heading households or

victims of violence and abuse.

Strategic wrap-arounds will continue to be leveraged with the Global Fund and the private sector to provide OVC with nutritional

support and business apprenticeship opportunities. Coca Cola, Standard Bank, and other private companies have proposed

partnering with USG to "make the job candidates ready" for the jobs including supporting skills training and management. Namibia

Business Coalition on AIDS (NABCOA) and USG will lead an OVC nutrition initiative in partnership with NABCOA-member

businesses and Namibia Dairies. In cases where adequate nutritional support is not available, partners will work with local

communities to support food and nutrition for OVC. All USG-funded partners will register OVC and improve their access to social

welfare grants provided by the MGECW. Peace Corps will support 4 PCV's to implement OVC focused interventions and access

small grants for community projects on care and support and capacity building for OVC.

New support will be provided in FY09 to UNHCR for a refugee camp in Osire which hosts refugees from Angola, Burundi, DRC,

and Rwanda. Half of the camp population is under 17 years of age, and 35% under 11. Nominal support will assist 300

especially vulnerable orphaned children in need of care and support, and allow greater access to ART services, care, and

support.

Most USG-funded OVC efforts will improve NGO/CBO/FBO capacity to strengthen family/household, facility, and community

capacity to meet the needs of OVC. All OVC partners will work together to improve referral systems between community and

facility settings, and adopt holistic approaches to care and support for OVC, with special attention paid to those who have lost

more than one set of caregivers and/or who live in child-headed households. Community care volunteers will be mobilized to

support the needs of OVC as an extension of palliative care (before and after a parent's death). Trained counselors will provide

psychosocial support to build resilience, working to ensure full participation in local society (attending school and receiving all

available benefits and services), and will include OVC in prevention-education, income generation, vocational skills training, and

after-school clubs/activities. New partnerships will also be implemented to reduce gender-based violence, vulnerability, and

abuse of OVC. USAID linkages to UNICEF-programs will be strengthened with harmonized workplans in FY09, particularly given

the magnitude of PEPFAR resources in Namibia for OVC programs. A USG OVC Advisor will continue to strengthen coordination

and leveraging capacity of the program with other partners in country.

Table 3.3.13:

APRIL 2009: This activity was reprogrammed under Pact (6471.26989.09) when CAA did not pass its audit

to become a prime partner. In COP09 CAA remains a sub-partner to Pact (and Intrahealth for HVCT).

----------------------

Catholic Aids Action (CAA), an indigenous Namibian organization, is receiving PEPFAR funding as a prime

partner for the first time this year. In previous years they were a primary sub-partner under PACT to build

organizational and technical capacity.

CAA is one of Namibia's largest providers of community-based support to Orphans and Vulnerable Children

(OVC) and with FY 2009 PEPFAR funding, CAA's community volunteers will deliver quality services to

16,500 OVC, of whom 60% are girls. Supervised by fulltime staff, 2,000 community volunteers provide

psychosocial support, supervision and advocacy services. The volunteers themselves will be supported

through quality monthly supervision, routinely receive refresher training, and trained in preliminary TB

screening for all OVC to increase case finding (see CAA HVTB).

Of the 16,500 OVC receiving services, 70% (11,550) will receive at least three focused interventions from

shelter and care, protection, health care, psychosocial support, education and vocational training, or food

and nutrition. After-school programs that provide both psychosocial support and nutrition will target 1,380

OVC. All CAA key program staff are trained in male norms and will apply their knowledge and skills to their

support for young boys in after-school programs. CAA will continue encouraging girls to join soccer teams,

engaging them in sports rather than have them idle on the streets and vulnerable to sexual abuse.

CAA will also provide school uniforms and supplies to 7,000 of the most needy children it supports. CAA

will continue to focus on school access for girls to decrease teenage pregnancies and trans-generational

sex. The service represents not only a "material" intervention, but equally as important, it represents

volunteer and staff time and compassion, ensuring that these children are regularly attending school and

encouraging and motivating these children toward academic success.

Body mass index (BMI) and mid-upper arm circumference (MUAc) measurements as well as qualitative

information interviews of caretakers are used to assess the impact of supplemental feeding. Staff and

volunteers are trained to provide quality nutritional meals using locally available food stuffs. CAA will

continue to evaluate feeding centers for environmental compliance as per USAID guidelines.

CAA will provide 500 secondary school scholarships and six university scholarships to selected OVC in

"Saving Remnant," a program that receives additional support from private resources. CAA continues to

work through the PEPFAR Public/Private Partnership Coordinator in collaborating with Namibian private

sector donors to provide supplemental donations. Continuing programs include wrap around activities such

as nutrition and food assistance to OVC and the development of small-scale businesses for older girl OVC

and female care-givers.

CAA's Home Based Care volunteers (see CAA HBCS) will identify and refer OVC to CAA's OVC program

and other public health services.

Along with other USG partners, CAA will continue to implement and improve on minimum quality standards

for OVC services.

New/Continuing Activity: New Activity

Continuing Activity:

Table 3.3.13: