Through quality programs and services LifeLine/ChildLine (LLCL) seeks to improve the safety, health and resilience of children, youth, families and communities in Namibia. LLCL focuses on HIV counseling and testing (HCT) programs; and trainings which address behavior change, efficacy and gender equity related to HIV prevention, care and support. It more broadly addresses child health, safety, rights and resilience. LLCL advocates for zero tolerance of abuse against children and gender-based violence. The program is aligned with the GHI Strategy and Partnership Frameworks focus on social behavior change in HIV prevention, legal rights and protection for vulnerable persons, specifically children and women. LLCL targets communities in Kavango, Khomas, Hardap, Oshana and Ohangwena Regions. For HCT, LLCL targets vulnerable youth (16-30) and most at risk populations in Windhoek, Rundu and Oshikango. The latter will be reached through partnership with the SFH MARPs project. Sustainability efforts will target the diversification of donor funding, development of partnerships with private sector, designing public fundraising plans and responding to GRN and other tenders. Also, LLCL will pursue integration with GRN, where possible, for programs and staff to be absorbed into GRN structures. This strengthens program sustainability, aand contributes to the achievement of USG GHI strategy goal of transition. LLCL will rationalize its own premises, human resources and programs as well as building consortia with civil society organizations for the sharing of premises, human resources and programs, increasing cost-efficiency gains.

Outcome and output indicators are used to monitor the program. A baseline and endline assessment will be conducted.

No vehicle purchases are envisaged.

This is a new budget code which supports transition. Under this budget code, LifeLineChildLine (LLCL), a locally owned partner, will utilize COP13 funding to complete the following objectives: (1) Strengthen linkages to care and support for people living with HIV/AIDS (PLWHA) who are experiencing gender-based violence (GBV); and (2) Strengthen HIV care, treatment and support for GBV survivors.

This activity fits within the country strategy to both strengthen linkages and referral systems, and improve care services among adults, specifically women, who are experiencing GBV. These services are critical as they address gender inequality, a key driver in the HIV epidemic, as well as develop integrated strategies to change harmful gender norms.

This activity will implement programming at the facility and community level, covering two regions. This activity will engage both men and women, and promote GBV prevention and response as an avenue to increasing linkages and referral systemsas GBV serves as a barrier to accessing necessary care and treatment services.

More specifically, LLCL will provide outreach counseling services; address client referrals to clinical and community care following testing and Antiretroviral therapy initiation; ensure retention and follow-up; link clients to nutritional, income-generating, legal and spiritual services.

Additionally, to improve approaches and results aimed at integrating GBV into HIV prevention, care and treatment, LLCL will regularly monitor the quality of care and support services, through data collection and evaluation of activities. LLCL strategy to transition will occur over time by shifting their role toward government clinical facilities and PLWHA support groups by June 30, 2015.

In collaboration with other USG partners, including Project Hope, KAYEC and Positive Vibes, LLCL will address the needs of PLWHA subjected to GBV.

This narrative is linked to activities under HVCT, HVTB, HTXS and HVSI.Cross-cutting activities include: Gender and GBV and estimated funding is $270,000. No construction, rennovation, or motor vehicle envisaged.

The goal of the HKID work under the Strengthening HIV/AIDS Responses in Prevention and Protection (SHARPP) IM through Lifeline/ChildLine (LLCL) is to complement the governments child protection efforts to prevent/mitigate violence against children and build sustainable and cohesive systems that uphold the right to a safe and secure childhood. The program targets children under the age of 18 through the 116 HelpLine and Uitani Radio activities, primarily focusing on HIV education. In addition, community activities will take place in Kavango, Hardap and Khomas Regions. LLCL will continue to build on the Child Protection Program with the Ministry of Gender Equality and Child Welfare (MGECW). The Mission of LLCL is the social protection of orphans and vulnerable children.

Community Parenting Training will continue to be conducted for OVC caregivers, government and civil society to promote the identification of OVC, improved implementation of childrens rights, and provide referrals to health services.

SHARPP will implement an evidence-based child protection program in schools complementing the Ministry of Educations (MOE) life-skills curricula, targeting children at risk, and LLCL combination prevention targets vulnerable/at risk children, as well as, learners with leadership potential to act as agents of change. The intervention comprises small group sessions led by OVC to build self-efficacy and coping skills, prevent gender-based violence and transactional sex, and increase awareness of HIV prevention. Drop-in counseling and referrals into the safety net system is offered to children in need/at risk. SHARPP will also offer structured interventions at schools to respond to abuse and build capacity of teachers to use intervention tools.

The 116 ChildLine is a national free number to report/prevent child abuse and offers crisis counseling by phone and face-to-face as part of the national safety net targeting OVC. Referrals and case tracking from 116 calls are done with service providers. Online counseling and SMS counseling will continue, together with a generic counseling line for adults. Provision of counseling services to children and adolescents living with HIV will be pursued and LLCL will provide counseling services to Women and Child Protection Units (WACPU). Survivors are of rape are provided counseling support and referrals to post-exposure prophylaxis.

Discussions with MGECW and/or telecoms providers to fund the radio programs will take place, in line with the National Agenda for Children. A memorandum of understanding to recruit University of Namibia (UNAM) social work and psychology student interns to provide services for sustainability and to reduce counselor salary burden will be sought and group/family counseling will promote systemic approaches and increase efficient use of human resources.

The national child operated radio program (Uitani), covers protection topics and will continue to be produced and presented by children 8-14 years of age, including those children in the regions who participate in school programs.

Advocacy and government collaboration: LLCL will continue to participate in and support GRN agencies and national/regional fora to implement a national safety net and referral flow chart that incorporates service agreements and standard operating procedures.

The activities under this budget code are all aimed at sustainability and are part of a broader sustainability plan for Lifeline/Childline (LLCL).

Aligning with the transition and sustainability objectives of the GHI, organizational systems strengthening will be conducted to enable LLCL to be a sustainable indigenous civil society organization (CSO). Utilizing cost-share principles resources will be provided to strengthen the viability of the corporate wing of LLCL. This will support the GHI and Partnership Framework goal of building local capacity to sustain the HIV/AIDS response.

LLCL will offer training, technical assistance (TA) and other marketable services to CSO, government and the private sector at market prices. LLCL will also respond to the Government of Namibia (GRN) and private sector tenders, working on a consultancy basis within their scope of expertise.

Self-enhancement of LLCL in terms of capacity to strengthen its response to the market will be supported. Ongoing market research and marketing will be carried out to inform this process. LLCL will continue to provide capacity development opportunities to LLCL staff to enable them to fulfill their program activities at the highest quality.

The Training Team of LLCL follows a system to ensure continued quality. In addition to annual performance appraisals for the trainers, trainers are regularly monitored and supervised by the Training Manager and the Curriculum Specialist to ensure that training is of a consistently high quality. Planned and unplanned visits to workshops take place for this purpose. Written feedback is captured on a LLCL training standards sheet and a narrative report is also given to each trainer. One- on-one supervision is also provided. Regular monthly meetings conducted by the Training Manager and Curriculum Specialist encourage discussion of challenges faced in training each course and regarding necessary curriculum changes.

Monitoring and evaluation will be implemented based on the approved performance-monitoring plan that captures critical training indicators such as ability of trainers to transfer skills as well as transferability of developed training materials. Other training outcomes will be assessed using pre-post assessments as well as trainee evaluations.

The Strengthening HIV/AIDS Responses in Prevention and Protection (SHARPP) through Lifeline/Childline (LLCL) will carry out integrated and multi-level interventions under this budget code to: 1) Build skills and knowledge for young adolescents on age appropriate comprehensive/combination HIV/AIDS prevention; 2) Lay foundations for HIV risk perception, self-efficacy for HIV prevention and optimal uptake of biomedical prevention including medical male circumcision (MMC); and 3) Provide age-appropriate dosage of information relating to national campaigns on drivers of the HIV epidemic.

Complementary activities will be carried out with school children selected together with the Ministry of Education (MOE). Emphasis is on reaching vulnerable children and on obtaining a critical mass for behavior change for HIV prevention and gender-based violence (GBV).

Skilled counselors will offer small group interventions using drama, games, discussions and interpersonal communication tools. The program is evidence-based and complements MOE life skills curriculum. Sessions cover: 1) Building self-esteem and self-efficacy; 2) Reasons for and ways to delay sexual debut; 3) Gender inequality, GBV and child protection; 4) Exploring social and family norms; and 5) MMC and HIV testing and counseling awareness (with children, parents and teachers).

Immediate one-on-one counseling will be offered to children from the small groups who are experiencing difficulties. Such children may also be referred for Government of Namibia (GRN) and LLCL protection services described under HKID.

SHARPP will mobilize in-school youth to recognize and respond to GBV. This will be integrated in to HIV prevention social and behavior change communication (SBCC) activities.

The combination nature of the program is provided through access to national services offered under HKID and HVOP, including 116 helpline, HER (sexual and reproductive health information SMS service) and Uitani Radio.

SHARPP will work closely with MOE to build teacher capacity on combination prevention approaches to complement the life skills programs for sustainability. SHARPP will employ a catchment area approach, working in schools and in the surrounding community with parents, teachers and opinion leaders for effective saturation of messaging.

Through strong working relationships with HAART clinics, SHARPP will pilot specifically-tailored SBCC and adherence counseling packages to child and adolescent patients as well as their parents.

SHARPP will work through regional and constituency level coordinating groups to promote coordination in community based activities.

In order to ensure quality, small group sessions will be in line with minimum standards and curriculum developed by the C-Change IM. Regular supervisory support will be offered to facilitators using a supervisory checklist and through observation and spot checks of sessions. Debriefing sessions will be scheduled using activity, counseling and supervisory reports to inform coaching, mentoring and capacity building.

To reduce costs, improve integration and sustainability, youth groups and teachers will be identified and trained to gradually take over the program.

In order to strengthen evidence and inform programming SHARPP will conduct baseline and end-line assessments. Monitoring of activities using agreed-upon performance indicators will be carried out.

Target regions: Hardap, Kavango, Khomas, Oshana, and Ohangwena.

Under this budget code, HIV Counseling and Testing (HCT) services are provided through the Strengthening HIV/AIDS Responses in Prevention and Protection (SHARPP) from stand-alone sites in Rundu, Oshikango and Windhoek as part of the mixed model. The sites are non-clinical settings and use a client-initiated approach through voluntary counseling and testing, mobile and outreach services. Targets are geographically hard-to-reach populations, adolescents and youth 16 -30 years of age, men, couples and key populations in collaboration with the Strengthening HIV Prevention for MARP.

Targeted HCT community mobilization and promotion activities will continue to increase awareness on availability and benefits of HCT and linkages to other services. SHARPP will partner with the Strengthening HIV Prevention for MARP IM to complement their activities. Partnerships with Ministry of Education (MOE) and other specific non-governmental organizations (NGO) will also be formed to reach youth and adolescents in the education system. Collaboration will be sought with Ministry of Youth and several NGO to reach out-of-school youth in different settings. For couples and men, campaigns and testing days will be used, including making sites more male friendly. Outreach and mobile testing services will be provided to geographically hard-to-reach populations in line with MOHSS guidelines.

HCT is a critical gateway to combination prevention, treatment, care and support. Screening and referrals of HCT clients for STI, TB, alcohol abuse, voluntary medical male circumcision will continue. For HCT positive clients, bi-directional referrals to treatment and care services, existing post-test support clubs, family counseling to facilitate disclosure to children and partners will continue. The new MOHSS bi-directional referral strategy will be implemented to provide individual and group adherence counseling for clients referred from MOHSS and others. Partnerships will be formed with the African Palliative Care Association and Positive Vibes to complement the Positive Health Dignity and Prevention intervention for HIV positive clients and individuals in sero-discordant partnerships. For clients with negative results, risk reduction plans will be developed together with them. Generic counseling and support around barriers to prevention will be offered especially to repeat testers and GBV survivors. In line with combination prevention, HCT clients will be referred to SHARPP social behavior change communication (SBCC) sessions, where appropriate, while SBCC participants will be offered HCT services. Female and male condoms will be offered as part of HCT services. All referrals at the sites will be monitored, tracked and reported periodically.

Routine monitoring comprises a site-level client/patient register to record client information and a laboratory log to record test kit information and HIV test results for every test performed. Sites have standardized data collection and collation tools, reporting formats and electronic data bases. Retesting of 5% samples is done by the National Institute of Pathology. For counseling quality assurance, weekly sit-in supervision and debriefing sessions are done, a counseling of counselor safety net program is supported and client satisfaction questionnaires are used.

In line with the GHI strategy to increase acess to evidence-based combination prevention intervention the Strengthening HIV/AIDS Responses in Prevention and Protection (SHARPP) will carry out integrated social behavior change communication (SBCC) interventions to: 1) Address HIV risk perception and social/behavioural barriers to HIV prevention; 2) Promote uptake and adherence to biomedical prevention especially voluntary medical male circumcision (VMMC); 3) Provide Positive Health Dignity and Prevention (PHDP) links and information for people living with HIV (PLHIV); and Provide dosage relating to national campaigns on epidemic drivers

Beneficiaries will be segregated in to two groups: 1) The 15-24 year old; and 2) Adults 25-49 years old.

The 15-24 year old group will target vulnerable youth, including PLHIV, identified through schools, Ministry of Health and Social Service (MOHSS), youth programs, Ministry of Gender Equality and Child Welfare (MGECW) and Ministry of Youth. Beneficiaries are specifically vulnerable to alcohol/drug abuse, multiple concurrent partnerships, domestic violence and poor adherence in case of PLHIV. The program will provide information and skills to engage in safer and healthier sexual activity where appropriate. SHARPP will work with civil society organizations offering economic empowerment programmes (e.g. Junior Achievers, KAYEC, Project HOPE) and refer beneficiaries between programs. As a member of the Task Force on Teenage Pregnancy in the Kavango Region, Lifeline/ChildLine (LLCL) will design activities to address study recommendations.

The adults 25-49 years old group will comprise two sub-groups: 1) Those referred from LLCL HIV counseling and testing (HCT) programs, MOHSS, MGECW, where high HIV risk is identified and behavior change/counseling is advised; and 2) Those referred by parents, teachers and community members that interact with the learners reached through the HVAB budget code program. Working with the latter group reinforces messages given to the children in the AB program. SHARPP will offer a program for parents and teachers, based on sessions from our positive parenting and social behavior change communication curricula to address discipline, child abuse, gender norms and rights and effective communication for HIV and sexual and reproductive health.

SHARPP will use small group sessions in line with minimum standards developed by MOHSS with C-Change support. Participants will be given access to accurate sexual and reproductive health information through SMS services and calls to 116 ChildLine to prevent and report abuse.

Community sensitization and mobilization to recognize and respond to GBV and its relationship to HIV infection will underscore the SBCC work implemented under SHARPP in Hardap and Kavango Regions.

Adequate and effective supervision for facilitators will be conducted via observations and spot checks of sessions and applying a supervisory checklist. Debriefing sessions will use activity, counseling and supervisory reports to inform coaching and capacity building.

To reduce costs, improve integration and sustainability, teachers, youth and community leaders will be identified and trained to gradually take over the program with continued support from LLCL.