This is a new activity which relates to other activities in the USG AB program.

Nigeria's HIV epidemic may be classified as ‘generalized' but has marked unequal high prevalence among

different subgroups, thus displaying the characteristics of a concentrated epidemic, largely among most-at-

risk populations (MARPs). Youth aged 15 to 24 years in Nigeria have a higher than national average HIV

prevalence rates (ANC sentinel survey, 2005). Research shows a significant increase in the proportion of 15

-19 year olds who have never had sex; among males the proportion significantly increased from 77% to

83.0% and for females those who report never having had sex went from 73.0% to 80.1%. However, many

youth still engage in risky behavior and about a third of males and 10% of females reported having sex with

non-marital partners.

The Hope WorldWide Nigeria (HWWN) abstinence and be faithful (AB) program will target young people

and adolescents aged 10-18 years for abstinence skills access and learning, and other information that will

assist them in making healthy sexual choices to prevent HIV infection. Under this program, orphans and

vulnerable children (OVC) who fall within the age bracket will benefit by learning skills to prevent HIV and

other sexually transmitted infections (STIs) and have the opportunity to train as peer educators. This

program will enhance self esteem of the target audience and help them acquire life skills and reinforce the

values of abstaining from sex until marriage.

In COP09, the program will be implemented in six States in Nigeria namely, Federal Capital Territory-Abuja,

Cross River, Delta, Lagos, Osun and Oyo. This effort will be delivered in partnership through capacity

strengthening of the following implementing agencies (IAs): Initiative for People's Good Health (IPG- Ugep

Cross River State), Positive Development Foundation (PDF- Calabar, Cross River State), Neighborhood

Care Outreach (NCO- Calabar South, Cross River State), Integrated Development Initiative (IDI- Ikom,

Cross River State), Counseling for Youths And Teenagers On HIV/AIDS in Nigeria (COYATOHAN- Ojo,

Lagos), Living Hope Care (LIHOC- Ilesa, Osun state), Community of Women Living with HIV/AIDS (NCW+

Amuwo Odofin, Lagos), Positive Life Organization of Nigeria (PLON- Yaba, Lagos), and The International

Church of Christ (ICOC- Lagos, Delta & Oyo), as multiplier organizations.

ACTIVITY DESCRIPTION

The first phase of activities under this program involve capacity building of IAs to provide quality

comprehensive HIV prevention services to the target population. HWWN in COP09 will provide IAs with

training in utilizing the following prevention methodologies and skills: abstinence curriculum; improved

parenting; facilitation skills update; community mobilization; and Men As Partners methodology (MAP). The

existing abstinence curriculum addresses personal and character issues, dating and marriage, peer issues,

and social pressures. Gender-based violence, rape and abuse are also discussed over the intensive 8-hour

youth project. These participatory youth discussions follow discussion guides and are led by trained

facilitators. In view of the major role that parents play in the lives of young people, IA staff will be trained on

how to deliver parenting curriculum to create opportunities for parents and guardians to improve

communication with their children, and to create a supportive environment for young people to sustain

positive behavior. Each of the training sessions will hold for 5 days. Secondary audiences will include those

individuals whose behavior makes young people susceptible to sexual exploitation, such as adults in the

communities. Additionally, societal norms and practices can also make adolescents and young people

susceptible to sexual exploitation and HIV infection. The MAP methodology is designed to engage men in

discussion with a view to addressing issues of masculinity, gender and sexual/domestic violence. Training

on MAP methodology will be provided to IA staff to engage men in discussions in the communities during

implementation of program activities. The training will hold for 3 days.

Based on the assessment carried out and uniqueness of each community, IAs will implement activities

under the minimum package that better address the needs of their target population in their various

communities. As part of HWWN's effort to implement activities and ensure program sustainability in line with

PEPFAR principles, each of these IAs will conduct advocacy visits in their respective communities and

engage leaders in community dialogue, and small-group discussions will be organized to engage the target

population to assess risk levels and risk factors. This community awareness campaign will be followed by

training of peer educators among the target population, the formation of AIDS awareness clubs in schools,

and information dissemination activities in communities and churches to equip young people with

abstinence skills. It is expected that these peer educators will reach out to their peers to sustain the

messages delivered. OVCs between the ages 10 and 18 years under the ACCORD project will be reached

and given the opportunity to train as peer educators to reach their peers and counterparts with abstinence

information and skills. In COP09, 26 people will be trained as trainers of trainers (TOT); these people will be

selected from the IAs and Child Care Forum (CCF) under the ACCORD project. The TOTs will train 240

OVC as peer educators for a total of 266 peer educators trained. In order to serve those who might be

sexually active, messages on condoms will be provided to equip them with information and skills to avoid

infection with HIV or other STIs and/or unwanted pregnancies. With these 3 approaches (Community

Awareness Campaign, School Curricula Based approach and Condom Messaging) HWWN with partners

will reach 10,961 individuals (4,748 males and 6,213 females) and 1,312 parents/adults making a total of

12,273 people (5,332 males and 6,941 females) in this reporting year.

To create an environment supportive of the messages and sustenance of positive behavior by young

people, advocacy visits will be carried out to parents, principals and other community leaders to give

support to peer education clubs formed to sustain the program effort. Parents will be engaged in small

group discussions on faithfulness and impediments to conjugal fidelity, and how these affect children's

behavior. Balanced ABC messages will be provided to strengthen faithfulness in marriages and thereby

provide an enabling environment for young people to model their protective behaviors. Implementing

agencies will apply the MAP methodology to address gender issues that surround domestic violence,

masculinity, and coerced sex. 43 MAP workshops will be organized in this reporting year.

16 seminars will be organized to create opportunities for children to express how they feel about their

communication with their parents and caregivers. Also, different fora will be organized for games that

involve both children and parent/caregivers in a supportive atmosphere to explore improved

Activity Narrative: communications between parents and their children. Improved communication at home will assist

adolescents to sustain positive behaviors, thereby preventing new infections among the target audience.

Information Education Communication (IEC) materials will be distributed to reinforce messages.

HIV testing will be promoted in schools, churches and during support group sessions for parents and

caregivers through voluntary HIV counseling and testing (HCT) campaigns to encourage knowledge of

status, abstinence and fidelity. Individuals within the most-at-risk populations (MARPs) will be identified and

referred to existing health centers for counseling and testing, and those testing positive will then be referred

for treatment and care. International Church of Christ (ICOC), a multiplier organization, will be supported in

the establishment of resource centres in Lagos and Ibadan, where youth and adults will be mobilized to

utilize the facilities. At the centre, information on HIV and adolescent health will continue to be provided and

IEC materials developed and produced under the AB program.

CONTRIBUTIONS TO OVERALL PROGRAM AREA

AB activities provided in Cross River, Delta, Lagos, FCT, Osun and Oyo States will contribute considerably

to the overall Emergency Plan prevention targets for Nigeria and to a strengthened populace with behaviors

that impact positively on their communities and in a reduction in gender-based violence. Child Care forums

(CCFs), Community Development Associations (CDAs), Parent-Teachers Association (PTAs) and other

groups will be mobilized to create a more supportive normative environment for the practice of abstinence

and fidelity.

LINKS TO OTHER ACTIVITIES

HWWN's AB activities related to HCT will be realized in collaboration with government-owned health

centers and other programs that provide HIV testing to complement the effort of campaign. Vulnerable

individuals will be referred to these centres for counseling and testing. AB activities will work together with

the OVC program to provide curriculum-based abstinence skills to OVC at camps and Kids Clubs, and at

the same time empower caregivers with parenting skills to better communicate with their children, especially

on sexual and reproductive health issues.

POPULATIONS BEING TARGETED

The primary target audiences under this program are adolescent boys and girls aged 10-18 years, including

OVC of that age. Others are adult men and women (parents and caregivers).

KEY LEGISLATIVE ISSUES ADDRESSED

The program addresses stigma and discrimination and gender issues by addressing male norms and

behaviors to reduce violence and sexual coercion.

EMPHASIS AREAS

Program activities include a major emphasis on training in which a structured curriculum is used to deliver

abstinence and parenting skills to targeted audience by trained staff. These trained individuals will then step

down the acquired skills to their peers in their respective communities. The program has a minor emphasis

on development of networks, linkages, and referral systems and IEC development.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Reducing violence and coercion

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $52,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

ACTIVITY DESCRIPTION

This activity has two components; which are to strengthen local NGO capacity to respond to HIV/AIDS in

their communities and to provide quality comprehensive and compassionate care for Orphans and

Vulnerable Children (OVC).

In COP08, the Assistance and Care for Children Orphaned and at Risk (ACCORD program) commenced a

partnership to build the capacity of the following Civil Society Organizations/Faith Based Organizations

through organizational service delivery to provide care and support to OVC in 6 states in Nigeria, which

includes the following groups: Initiative for People's Good Health (IPG- Ugep Cross River State),

Neighborhood Care Outreach (NCO- Calabar South, Cross River State), Integrated Development Initiative

(IDI- Ikom, Cross River State), Counseling for Youths And Teenagers On HIV/AIDS in Nigeria

(COYATOHAN or COY- Ojo Lagos), Living Hope Care (LIHOC- Ilesa, Osun state), Community of Women

Living with HIV/AIDS (NCW+ Amuwo Odofin, Lagos), and Positive Life Organization of Nigeria (PLON-

Yaba, Lagos). The International Church of Christ (ICOC) is also part of this program as a multiplier

organization.

Building sustainable programs is essential to PEPFAR's success and continues to be a strong priority under

PEPFAR II. In accordance with the guiding principle of PEPFAR of building local and host-nation capacity to

provide quality services and sustain national programs, HWWN, under ACCORD, will build its own and its

partner's Organizational Capacity (OC) and Service Delivery (SD) Capacity with support from Management

Sciences for Health (MSH) and HOPE Worldwide Limited (HWW). In COP 08, MSH provided OCD on

Financial Management, Small Grants Administration, Project Management, Procurement and Store

Management. In COP 09 MSH will continue the OCD on Strategic and Sustainability Planning, Human

Resource Management, Leadership and Governance and Volunteer Engagement and Management. In

addition to these MSH will mentor, monitor and evaluate the IAs on their organizational development. HWW

International will provide SD to HWWN and its partner organizations on core service delivery issues such as

principles of child protection and child participation and will assist organizations in reviewing/developing

child protection policies.

In order to provide quality, comprehensive and compassionate care for AIDS Orphans and Vulnerable

Children (OVC), ICOC, the main multiplier organization, will be provided with specific training to provide

services to OVC. ICOC's work in COP08 covered Lagos and Oyo states. These organizations have already

received trainings on monitoring and evaluation and psychosocial support. In COP08, the ACCORD

program will reach 3,997 OVC.

In COP09, the program will scale up activities to Delta and the FCT, and will provide services to a

cumulative number of 6,832 OVC. Children will be identified within the church community with the help of

church members and by local community members in the other communities where the program will be

domiciled. All identified children will receive health and psychosocial support services. The three resource

centers established in Lagos (Surulere, Agege) and Ibadan (Mokola) by ICOC in COP08 will continue to run

and receive some level of strengthening from the AB program. Materials will be developed to teach children

life skills. Staff and volunteers of ICOC and the IAs who are directly working with the children, will also be

trained as trainer of trainers and will step down this training to all 10-18 year old OVC as peer health

educators.

Newly identified parents/caregivers will be constituted into already existing caregiver's forums while

additional ones will be established to accommodate new intakes. In COP09 a total of 1,312 caregivers will

be trained on memory book, succession planning and will writing. These sessions will be taught by trained

professionals from within and outside the organizations while training on parenting under the AB program

will be done for all caregivers. To deal with the issue of gender violence, male caregivers will be included

under the Men as Partners activities of the AB program as well.

In COP08 the ACCORD program established 7 kids clubs, this will continue operation while an additional 21

clubs will be established in the communities where ICOC/IAs operates namely- Shomolu/Mushin, Ikeja/ketu,

Ogba/Agege, Lagos Island, Ojo/Apapa, Oshodi/Isolo, Bariga, Yaba, Surulere, Calabar South, Ugep, Ikom,

the FCT and Delta state to accommodate new intakes. The clubs will serve as coordinating points where

OVC can receive the other core services. ACCORD will through her partners increase OVC enrolment in

school with the Universal Basic Education Scheme through partnerships with state ministries and local

education authorities. Short term direct assistance to subsidize school related costs such as books,

uniforms, exam registrations, school bags and sandals will be provided to 3,936 OVC based on a prior

assessment using the child status index (CSI). Support will also be solicited from the Communities to

provide Children heading household and/or older OVC with free vocational training. 256 OVC and 195

caregivers will receive training in trades such as hairdressing, computer and tailoring. Sequel to this, start

up grant/materials based on assessments conducted will be provided to some of them and the rest will be

referred for employment.

With support from the Society for Family Health (SFH), households with OVC less than 5 years old and HIV

positive children under the program will receive basic prevention kits comprising a bucket with spigot, LLITN

and water guard to assist in the prevention of malaria and diarrhoea. Children will also be referred to

primary health care facilities in their communities where drugs to treat minor ailments will be provided. The

resource centres established in COP 08 will retain the services of a volunteer doctor and counsellor so that

children and their caregivers can also access free consultations and drugs. As most of the identified

households are in rural communities, caregivers will receive training surrounding safe water storage, proper

hand washing techniques and hygiene while HIV related cases for both children and their caregivers will be

referred to the nearest ARV/PMTCT treatment centre. The ACCORD program will also continue to provide

assistance to families in critical need by paying their medical bills through the church benevolence

committee.

According to UNICEF report, 38% of children under five years are suffering from stunting and 29% of

Activity Narrative: children under five years old are underweight in Nigeria . Therapeutic and supplementary feeding of

malnourished children, based on assessments conducted following WHO guidelines, will be done in

partnership with the primary health care facilities where food demonstrations classes will also hold. The

feeding program will target 1968 children with priority given to infants of HIV positive mothers and under

fives. Linkages will also be made with the MARKETS' Family Nutritional Support Program (FNSP) which will

target the immediate nutritional needs of the most vulnerable children and address the long-term livelihood

support needs of OVC and their caregivers. The IAs especially will embark on fund raising activities to

access food stuffs from community members in other to provide vulnerable household food support.

The ability to prove age and nationality is vital to guaranteeing a child's rights. Article 7 of the Convention on

the Rights of the Child establishes the right of every child to a name and nationality, stipulating that boys

and girls should be registered immediately after birth. Yet in many countries, including in Nigeria, birth

registration is neither accessible nor affordable to large portions of the population, especially to people in

hard to reach areas. The program will pay advocacy visits to the National Population Commission, UNICEF,

Federal and State Ministry for Women Affairs to access free birth certificates for all children under the

program who have not been provided with one.

It is anticipated that 60% of the programs total beneficiaries will be girls and the remaining 40% boys.

As case manager organization, we will work closely with the state OVC desk officers and the OVC steering

committee to review the OVC situation analysis, monitor and evaluate OVC programs in the state and help

in the creation of a data base of all OVC serving organizations in Lagos and Cross River state. We will

strengthen networking and referral linkages among OVC serving organization by facilitating a quarterly

meeting of the representatives of the OVC serving organizations within the 2 states.

CONTRIBUTIONS TO OVERALL PROGRAM AREA:

This activity contributes to the USG's PEPFAR 5 year strategy of providing care to 400,000 OVC and is

consistent with the Nigerian National Plan of Action on OVC.

LINKS TO OTHER ACTIVITIES:

This activity leverages existing USAID funded Economic Growth programs to provide wrap-around

nutritional and income generating support for OVC identified in PEPFAR programs. This is an activity that

relates to other activities in the USG OVC portfolio. The program is also linked to the AB program as well.

POPULATION BEING TARGETED:

OVC and OVC caregivers are the direct targets, while the communities and support groups will indirectly

benefit.

EMPHASIS AREAS:

This activity has a major focus on Wrap-Arounds that will primarily provide nutrition and IGA support for

OVC. Local organization capacity development is another major emphasis area. Community mobilization

and participation, development of network/linkages/referral system, and information, education and

communication will also be addressed.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $500,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Estimated amount of funding that is planned for Food and Nutrition: Commodities $100,000

Economic Strengthening

Estimated amount of funding that is planned for Economic Strengthening $30,000

Education

Estimated amount of funding that is planned for Education $40,000

Water

Table 3.3.13: