ACTIVITY DESCRIPTION:

This activity also links to AIDSTAR's activities under OVC (16302.08) so as to encourage integration of AB

prevention activities with OVC programming. These activities will also be linked with the Project Search

(#7607.08) work in AB for data-informed program design.

Analysis of the current USG Nigeria AB portfolio conducted by the USG Nigeria Prevention Technical

Working Group (TWG), and reinforced by recommendations from previous technical assistance (TA)

assessments, highlights a number of programmatic gaps. The analysis also shows that a new

implementing partner is needed to achieve the level of community and social norm change required to

address the programmatic gaps at a sustainable level. In particular, a partner that could provide technical

expertise and capacity for implementation at a national level in a place as large, complex and challenging

as Nigeria is needed.

Based on these recommendations, the AIDS Support and Technical Resources (AIDSTAR) Indefinite

Quantity Contract (IQC) mechanism has been selected as a new potential partner under COP08 because

AIDSTAR contractors have demonstrated technical capacity in a range of technical areas related to

prevention, stigma and discrimination, gender, and program-related data collection and analysis. The

mechanism, when awarded, will work closely with the Prevention TWG to ensure that it is integrated within

the broader USG prevention portfolio. The final scope, including targets and activities, will be shared with

OGAC prior to award.

The Nigeria Prevention AB Task Order will particularly focus on AIDSTAR's ability to:

1) Expand coverage of epidemiologically appropriate, best-practice HIV prevention interventions that apply

balanced messaging to prevent sexual transmission across different settings through scaling up community

mobilization and individual behavior change initiatives;

2) Provide technical assistance and program implementation support in the specialized HIV/AIDS technical

areas of community-based HIV/AIDS services and monitoring and evaluation;

3) Document and disseminate successful innovative approaches and sustainable models, evidence-based

best practices and lessons learned, and new approaches, tools and methodologies in prevention

programming.

The TWG has determined two key programmatic gaps that will be addressed by AIDSTAR - activities to

prevent cross-generational and transactional sex and activities to address adults, especially men, with

partner reduction messaging. Further specific needs will be identified and defined as epidemiological data

becomes available for the TWG to make programmatic decisions. The secondary analysis of bio-behavioral

studies which will be undertaken by Project Search (#7607.08) during COP08 will also help inform

intervention design.

Activities around transactional sex will include skills-based HIV education for girls and young women and

broad-based community mobilization activities to engage ‘influencers' of youth - parents, teachers, religious

and community leaders - in order to create a more supportive normative environment for the practice of

abstinence and fidelity. Special program initiatives will also be deigned to address younger, out-of-school

adolescent girls who are at high risk owing to contextual factors, e.g., domestic workers and street vendors.

Activities to address adults, particularly men, will promote fidelity to one sexual partner, address male norms

and behaviors that put both men and women at risk, and increase personal risk perception. The activities

will include a mix of closely-linked and reinforcing interpersonal communication and mass media activities

that highlight the importance of mutual fidelity and avoidance of multiple and concurrent partners.

AIDSTAR will also be tasked with documenting and disseminating evidence-based best practices, lessons

learned and new approaches, tools and methodologies for prevention interventions in Nigeria, both of their

own design as well as those developed and used by IPs and other groups involved in sexual transmission

prevention. Of particular interest will be lessons learned and effective approaches for improving linkages

between clinical services and community based services, how to effectively scale up programming to reach

wider audiences without diminished quality, and effective methodologies for working on prevention actions

for risk groups, such as men-who-have-sex-with-men (MSM). AIDSTAR will be tasked with the collection

and dissemination of these tools and methodologies for improved programmatic use by IPs and other

interest groups.

CONTRIBUTIONS TO OVERALL PROGRAM AREA:

The explicit targets will be determined based upon the final level and combination of activities designed for

this proposal; however, a minimum package of prevention interventions will be provided per target in line

with the strategic prevention implementation design norm. As this is an IQC mechanism, the prime partner

and final targets will be vetted with OGAC and uploaded into COPRS after final award negotiations as is

USG/Nigeria's custom for TBD activities.

The programs and activities implemented will increase the reach of AB interventions into epidemiologically

important populations to better address gaps in coverage and to better address specific behaviors within

underserved populations.

This activity substantively contributes to Nigeria's 5-Year Strategy by developing and strengthening the

sexual prevention portfolio.

LINKS TO OTHER ACTIVITIES:

The AB activities implemented under the AIDSTAR IQC will achieve set prevention targets while also

providing clear linkages between their own activities and the wider prevention portfolio as implemented by

other IPs. The emphasis dissemination of best practices will also help develop the sustainability and

efficacy of the program.

POPULATIONS BEING TARGETED:

Populations targeted in these AB activities will include younger adolescent girls and their corresponding

figures-of-influence to better address issues around cross-generational and transactional sex, and adult

males. Other target populations include teachers and religious leaders.

EMPHASIS AREAS:

An emphasis will be placed on human capacity development and gender.

Activities that will address male norms and behaviors, increasing women's rights, reducing violence and

Activity Narrative: coercion, and stigma and discrimination will be addressed.

ACTIVITY DESCRIPTION:

This is a new activity and it links to AIDSTAR activities in AB prevention (3.3.02) to ensure that all OVC get

age-appropriate prevention messaging integrated into their general health care.

An analysis of the current USG Nigeria OVC portfolio, conducted by the USG Nigeria's Orphans and

Vulnerable Children (OVC) TWG and reinforced by recommendations from previous technical assistance

(TA) assessments, identified a number of key programmatic gaps: current paucity of indigenous partners to

take programs to scale; poor understanding of OVC definitions by implementing partners; inadequate

monitoring and supervision; weak referral networks between facility-based and community-based partners;

lack of coverage in high prevalence states; few programs addressing the needs of adolescent OVC,

particularly females; and little programming for young married girls in Northern Nigeria who have increased

vulnerability. In addition to these programmatic gaps, the analysis identified a number of contracting

constraints, as the current in-country capacity for making awards to new partners is limited by the current

capacity of indigenous, civil society organizations (CSOs) to respond to the USG solicitation and award

standards. The analysis also showed that to achieve community level service provision and comprehensive

services, a partner is needed with the technical expertise and implementation capacity to not only envision,

but have the ability to rapidly develop a large-scale effort in a country as large, complex and challenging as

Nigeria. Finally, the analysis noted that implementing partners should have the mandate and capacity to

engage local partners in its efforts to ensure that the program is implemented comprehensively at the

grassroots level.

Based on these recommendations, the AIDS Support and Technical Resources (AIDSTAR) Indefinite

Quantity Contract (IQC) mechanism has been selected as a new partner under COP08, due to the fact that

AIDSTAR contractors have demonstrated technical capacity in a range of technical areas related to care

and support addressing multifaceted needs of OVC and palliative care. These include pediatric home

based care, gender, stigma and discrimination, and program-related data collection and analysis. This

partner, when awarded, will work closely with the inter-agency OVC TWG and will be overseen by the

PEPFAR Nigeria Senior Management team to ensure that it is integrated within the broader USG OVC

portfolio. The scope of work will be developed in conjunction with the OVC TWG, and targets and specific

activities will be shared with O/GAC prior to award as is USG/Nigeria's practice for TBD activities.

The USG Nigeria team has discussed this request for task order proposal (RFTOP) with the AIDSTAR

Cognizant Technical Officer (CTO) who will approve the SOW prior to issuance and has determined that the

proposed activities fall within the scope of the IQC. The Nigeria OVC task order will use AIDSTAR to

provide:

1. Long-term in-country support for coordination and scale-up of HIV/AIDS activities in support of

USG/Nigeria OVC strategies.

2. Service delivery focusing on the multifaceted needs of OVC, including home-based care for infected

children, gender issues related to the vulnerability of female OVC and heads of household, and stigma and

discrimination. Specifically AIDSTAR contractors will:

a) Identify OVC: Activities will be designed to build provider understanding of who is eligible for OVC

services, and work with communities and clinical service providers to identify all children that are eligible for

services. The geographic area of focus for AIDSTAR activities will be in areas of Nigeria with HIV

prevalence at or above the national average that are underserved particularly in the Southeast, South-

South, North East and North West regions. Community-based and faith-based organizations in particular

will be targeted as sub-partners.

b) Develop a holistic OVC service model: AIDSTAR contractors will understand and establish the standard

level of care for each of the 6+1 services using standards and practices that have been developed with

USG support and GON collaboration. All OVC will receive at least 3 of these services, one of which must be

psychosocial support. These services will be delivered through a family-centered and community-based

model that reaches out to all children in a family infected/affected by HIV/AIDS.

c) Ensure a multi-program and multi-sectoral referral system: AIDSTAR contractors will collaborate and

form linkages/referrals between existing clinical and community-based partners within the geographical area

of focus. In some states, AIDSTAR contractors will serve as case managers which coordinate referrals for

OVC to ensure comprehensiveness of services. Wherever possible, community partners will engage with

and link to clinical service providers; refer clients for HCT, care, and treatment; accept client referrals; and

use this as a starting point to engage families in order to assist all children infected with or affected by

HIV/AIDS.

d) Address girls vulnerability issues: AIDSTAR contractors will focus activities in key Northern and

Southern states where increased vulnerabilities of female girls are common, and provide support for girls'

continuation in, or return to, school as well as improve outreach and linkages with HIV-related health

services, particularly outreach efforts by USG projects (ACQUIRE, ACCESS, and Pop Council).

3. Increased technical capacity of Nigerian decision-makers and personnel to design and implement

effective, evidence-based HIV/AIDS interventions. Specifically, AIDSTAR contractors will: a) link with State

Ministries of Women's Affairs (SMOWA) in focus states to build technical capacity so that they can roll out

national-level policies, strategies, guidelines, quality assurance, and data collection systems. b) provide

technical support to FMOWAs to plan, manage, monitor and evaluate OVC service provision. c) contribute

to OVC program M&E in collaboration with the USG SI team and PEPFAR IP tasked with overall M&E and

SI capacity building

4. Documentation and dissemination of successful innovative approaches and sustainable models,

evidence-based best practices and lessons learned, and new approaches, tools and methodologies in

HIV/AIDS OVC programming.

In COP 08, AIDSTAR will directly serve 14,400 OVC with services and train 3,600 care-givers on OVC care

and support services.

CONTRIBUTIONS TO OVERALL PROGRAM AREA:

This activity substantively contributes to the overall USG Nigeria's Five-Year Strategy and to the

implementation of Nigeria's National Plan of Action on OVC by developing and strengthening the

community based service delivery for affected children. The suggested targets are determined based on the

Activity Narrative: current estimated cost per targets for a minimum package of OVC interventions. As this is an IQC

mechanism, the prime partner and final targets will be vetted with O/GAC and uploaded into COPRS after

final award negotiations. The programs and activities implemented will increase the reach of OVC

underserved populations and geographic areas with fairly high HIV/AIDS prevalence in comparison with the

national average.

LINKS TO OTHER ACTIVITIES:

The activities implemented under the AIDSTAR IQC will achieve set targets for OVC served and caregivers

trained while also providing clear linkages between their own activities and the wider OVC portfolio as

implemented by other IPs. Strong linkages with the LMS project will be developed as LMS focuses on

institutional capacity building in the FMOWA, while AIDSTAR focuses on increasing technical capacity. The

emphasis on dissemination of best practices will also help develop the sustainability and efficacy of the

program.

POPULATIONS BEING TARGETED:

Populations targeted in these activities will include all OVC, with particular focus on the female adolescents

OVC in the Northern and Southern parts of Nigeria. Also targeted are community members, traditional

leaders, religious leaders, men and women who act as caregivers for OVC.

EMPHASIS AREAS:

Emphasis areas will include human capacity development.

The service delivery component of this award will have a key focus on community mobilization/participation

and local organization capacity development. Other emphasis areas are development of

network/linkages/referral system; information, education and communication and linkages with other sectors

and initiatives.

Targets:

Number of OVC reached with services: 14,400

Number of care-givers trained: 3,600