PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
The key modification in COP 09 is the merging of Abstinence and Be faithful (AB) activities with the
Condoms and other Prevention (C&OP) program.
This activity relates to HIV counseling and testing (HCT), TB-HIV, and orphans and vulnerable children
(OVC) programming.
Society for Family Health's (SFH's) goal for sexual prevention activities is to contribute to a reduction in HIV
prevalence among youth aged 15-24 years and among most-at-risk populations (MARPs). SFH priority
target groups for COP 09 are: out-of-school youth, transport workers (TWs), uniformed service-men (USM),
brothel and non brothel based female sex workers (FSWs) and people living with HIV and AIDS (PLWHAs).
Other target groups include in-school youth, students of tertiary institutions, and workers reached through
workplace interventions. The key drivers of the HIV epidemic include soaring levels of commercial,
transactional and cross generational sex, multiple and concurrent partnerships, low risk perception, high
incidences of STIs, and skewed gender relations, power imbalances, and poverty.
In a Nigeria 2005 sentinel survey, youth aged 15 to 24 years were shown to have a higher than national
average HIV prevalence. Although the proportion of 15-19 year olds who have never had sex has risen,
many youth still engage in risky behavior. The 2007 Integrated Bio-Behavioral Surveillance Survey (IBBSS)
survey reveals that multiple partnerships were common among the armed forces (37.3%), police (29.4%)
and TWs (37.9%). Condom use at last sex with girlfriends was higher among the armed forces (64.7%) than
among police and TWs (45.4% and 45% respectively). The IBBSS also revealed that reported condom use
was very high among brothel- and non-brothel-based FSW in all commercial sex transactions; however,
their reported condom use with boyfriends was far lower.
In COP 09, SFH will continue its focus on addressing drivers of the HIV epidemic with interventions that
provide MARPs with information and skills needed to reduce their vulnerability through increased risk
perception, improved self efficacy, and negotiation skills for condom use. Societal factors, such as social
and cultural norms, practices, beliefs and laws that stigmatize and disempower certain female populations
and act as barriers to essential HIV prevention messages, will be addressed through agenda setting,
advocacy, and community mobilization and sensitization. At community level, strategies will facilitate the
enhancement of communities' willingness and readiness for change, the induction of social norms that
reinforce risk avoidance, and empowerment of communities' effort to prevent HIV. SFH has worked in 181
sites and 537 communities of male and female high risk groups to date.
SFH will implement a minimum package prevention services for AB and C&OP programming that includes
communication strategies, peer education plus (PEP) models, the Voice for Humanity approach, community
awareness and outreach, and a school-based approach for AR, and the PEP model, specific population
awareness campaigns, and community outreach for C&OP programming. SFH will continue its
programming in all 32 sites covered in COP08. SFH will train 12,484 persons who will reach 196,591
persons with AB messages, of which 112,400 persons will be reached with abstinence only messages. An
additional 1,656 persons will be trained to reach 131,061 persons with condom related interventions.
The PEP model is an evidence-based, cost effective and scalable approach to HIV programming. This 12-
month intervention package targets specific at-risk groups, including female sex workers, out-of-school
youth, uniformed servicemen, and transport workers. The PEP model is centered on peer education and
integrates other elements (such as the formation and nurturing of community-based organizations [CBOs])
into a single unified program. The ‘Plus' in the model refers to a non-peer approach that includes a mix of
drama, information, education and communication (IEC) material distribution, work with influencers and
gatekeepers, provision of HIV counseling and testing (HCT) services, and linkages to treatment sites for
STIs, TB and other HIV related service. In COP 09, SFH will maintain most of the community level activities
in COP 08. Within the AB program area, the key messages are delay in sexual debut, secondary
abstinence, and mutual fidelity.
The Voice for Humanity (VFH) BCC approach addresses the uniqueness of typical rural settings in which
access to modern information technology (print, electronic and internet access) is low, literacy levels -
including the knowledge of HIV prevention measures - are low, and learning occurs via oral tradition in
closely knit small groups often facilitated by community leaders. In such settings, new ideas are
disseminated in the form of story telling, folk songs and parables to aid comprehension. The BCC method
adopted by the VFH programme uses these channels to deliver messages using a solar powered digital
audio device in small group settings, with a community facilitator trained and able to respond to concerns
and make necessary clarifications. This helps to quickly clear misconceptions and facilitates learning. Pre-
recorded messages help ensure consistency of messages. One critical challenge faced by SFH programs
was its inability to reach female out-of-school youth (FOSY) between 15 and 23, particularly in rural areas.
Many have completed secondary school, some have only a primary education, while others are non-literate.
Although the majority are single, many in the northern regions are divorced and engage in transactional sex.
In line with the SFH strategy to increase and improve participation of FOSY in community HIV prevention
efforts, the VFH approach was piloted in Kano, Kaduna, Jos, and Bauchi in COP07 and scaled up to 10
states in COP08. SFH will continue to deploy community listening groups directly in the 10 selected states
in FY09. The VFH listening devices will be used to provide ABC messages to young girls primarily, and
other community members in Pidgin English and Hausa languages for wider reach. In COP09, 220 persons
will be trained to deploy these devices to reach about 11,000 male and female youth.
Community awareness and outreach activities targeting male social norms will continue to be implemented
among the general population to address continuing risky behaviors related to multiple and concurrent
sexual relationships. In COP09, SFH will train 64 persons to deploy customized flip charts to reach 25,600
men and women in the general population with mutual fidelity messages through interpersonal
communication (IPC) strategies. The target population will also be reached with community drama/road-
shows, IEC distribution, and HCT outreach. A national mass media campaign will be aired to provide AB
messages in a reinforcing and complementary manner.
To sustain the abstinence program in Nigeria, SFH will continue its in-school youth program that provides
young people with information, skills, and services to reduce their vulnerability and risk. This is conducted
Activity Narrative: through the National Youth Service Scheme (NYSC) HIV program. NYSC corps members will be trained as
peer educator trainers (PETs) to reach students of secondary schools with abstinence messages. Trained
PETs conduct interactive forums and special events (e.g., dance dramas) and distribute IEC materials
among targeted in-school youth. SFH will continue its work in 12 selected tertiary institutions from COP08
using a non-curriculum based peer led intervention. SFH will expand its activities within the selected
institutions in COP09 and continue to support anti-AIDS clubs to conduct outreach programs as part of a
comprehensive prevention package to address risk reduction, knowledge of HIV status, gender related
violence and rape, and trans-generational and transactional sex. Reinforcing this intervention will be special
events (shows, drama, seminars), IEC material, campus radio jingles, print media, and HCT outreach.
Within the C&OP components, key messages are partner reduction (concurrent and/or serial), consistent
condom use, and prompt treatment of all STIs. The PEP model will be used to provide information and
model behavior skills for the adoption of safer sexual practices relevant to consistent condom use, mutual
fidelity, partner reduction, knowledge of HIV status, and prompt and complete treatment of all STIs and TB.
SFH will maintain its program of engaging with the Nigerian prisons to provide prevention messages, HCT
and referrals for prison staff and inmates for care and treatment. A baseline assessment of sexual and
reproductive health knowledge and behavior will be completed in FY08. Peer education activities will
continue among prison staffs and inmates. Through the sexual prevention program, SFH will continue to
provide linkages to HCT, STI, TB and other HIV related services. Clients will be referred to identified USG,
Global Fund, and Government of Nigeria treatment and care sites, as well as support groups for
psychosocial support.
Under the specific population awareness campaign, SFH will utilize the Priorities for Local AIDS Control
Efforts, (PLACE) approach to identify potentially high transmission areas and specific venues for effective
AIDS prevention programs activities. In COP 08, PLACE was implemented in 10 states and will be
maintained in COP09, with expansion to more sites within the same states. This component will continue to
target street based sex workers and their clients with messages on partner reduction, reduction in alcohol
consumption, condom use, and knowledge of HIV status. SFH will engage individuals and groups in IPC
campaigns, distribute IEC materials, and sponsor special events (ladies night, shows) to reach target
populations with condom related messages. Through PLACE, SFH ensures easy product accessibility and
availability at high risk sites. Moonlight HCT services will continue to be provided at specific sites.
Prevention activities among PLWHAs will continue in FY09 in accordance with national guidelines for
secondary prevention among discordant couples, prevention of re-infection, prevention of opportunistic
infections and provision of basic care kits. In COP09, SFH will identify and select 2 new support groups per
SFH region. In each support group, 2 PLWHAs will be trained as IPC facilitators to continue monthly IPC
sessions using the new IPC guide at support group meetings to reach 6,400 persons. IPC facilitators will
also conduct community mobilization activities aimed at stigma and discrimination reduction around SFH
intervention sites. SFH will continue to provide IEC materials and condoms to the PLWHAs.
Community outreach will include condom distribution and promotion through social marketing. It will also
include education on HIV and condom use through pamphlets, brochures and other promotional material
available at the community level. This intervention will make condoms available at all times to those who
need it. It will also seek to improve coverage and quality of coverage, access and equity of access to men
and women for male and female condoms
In addition to the minimum package, SFH will continue to prioritize increasing faith-based organization
(FBO) capacity to participate as full partners in HIV prevention efforts by engaging with umbrella bodies of
selected Christian and Islamic groups to develop faith based responses and implementation of strategic
plans. In COP08, SFH engaged 4 FBO partners to reach youth and married couples with AB messages.
FBO activities will continue with program implementation in 2 select states per health zone. Religious
leaders will be trained to integrate HIV messages into their sermons and 120 youth within the congregation
will be trained as peer educators to facilitate peer education sessions. Other interventions will include HCT
outreach, IEC material distribution, and special events (e.g., youth and couple conferences).
Program evaluation will utilize participatory monitoring and evaluation and other intervention specific
evaluations to inform program design. Focus group discussions and semi-structured interviews will be used
for the baseline study and program monitoring.
SFH's program specifically focuses on gender by increasing female youth involvement and participation in
community HIV prevention programs, and through the VFH strategy. Another component of the gender
strategy includes messages on alcohol and substance abuse reduction as associated with gender based
violence and risky behavior. Referrals will be provided for women to access reproductive health services,
income generating activities and social support systems. For women to achieve greater control over their
protection from HIV and unintended pregnancy, SFH will market and distribute female condoms as a dual
protection method. The female condom project funded by Oxfam Novib will be piloted in 3 states in COP 09
(Lagos, Edo and Delta). SFH will collaborate with UNDP and GoN to increase demand, access and
availability of female condoms.
Target Population
This activity targets both street-based and brothel-based FSWs and their clients, transport workers,
uniformed servicemen, male and female in-school and out-of-school youths, gatekeepers and religious
authority figures in the community and PLWHAs.
Links to other activities
This component is linked to HCT, policy and systems strengthening, orphans and vulnerable children
programming, and TB-HIV. SFH will continue to reinforce partner reduction messages, promote HIV
counseling, and testing, create awareness about the links between TB and HIV and referral to ARV
services.
Key legislative Issues
This activity will address gender equity in programming through interventions targeting young girls.
Activity Narrative: Interventions will also address male norms and behaviors that put both men and women at risk as well as
stigma and discrimination against PLWHA.
Emphasis areas
This activity places major emphasis on community mobilization and participation, capacity building for
community based organizations while minor emphasis is placed on workplace programs
New/Continuing Activity: Continuing Activity
Continuing Activity: 13096
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13096 5316.08 U.S. Agency for Society for Family 6390 3682.08 USAID Track $6,747,340
International Health-Nigeria 2.0 SFH
Development
6733 5316.07 U.S. Agency for Society for Family 4179 3682.07 CIHPAC $2,074,108
International Health-Nigeria
5316 5316.06 U.S. Agency for Society for Family 3682 3682.06 CIHPAC $1,690,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Military Populations
Workplace Programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $162,187
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.02:
Condoms and other Prevention (C&OP) program. This activity relates to HIV counseling and testing (HCT),
TB-HIV, and orphans and vulnerable children (OVC) programming.
through the National Youth Service Scheme (NYSC) HIV program. NYSC corps members will be trained as
Activity Narrative: among targeted in-school youth. SFH will continue its work in 12 selected tertiary institutions from COP08
Interventions will also address male norms and behaviors that put both men and women at risk as well as
Activity Narrative: Emphasis areas
Continuing Activity: 13097
13097 5372.08 U.S. Agency for Society for Family 6390 3682.08 USAID Track $3,871,500
6735 5372.07 U.S. Agency for Society for Family 4179 3682.07 CIHPAC $926,714
5372 5372.06 U.S. Agency for Society for Family 3682 3682.06 CIHPAC $616,545
Table 3.3.03:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
This activity relates to Abstinence and Be Faithful, Condom and other Prevention and Counseling and
Testing. Tuberculosis remains a serious public health challenge in Nigeria and in the last four years there
has been an increase in Nigeria's TB incidence and a corresponding increase in drug resistant TB. HIV is
known to increase the burden of tuberculosis. It is estimated that TB is the leading cause of deaths among
PLWHAs and responsible for 14-54% of HIV/AIDS related deaths globally. In Nigeria the prevalence of HIV
among TB patients is 19.1% (Nigeria National Sentinel Survey 2001). As part of the social mobilization
efforts for TB control activities in Nigeria, SFH will continue to support TB awareness creation initiatives
through the development of mass media and mid-mass media campaigns. In COP09 SFH will continue to
produce and air radio jingles and TV campaigns in four languages to create awareness on the need for
early TB diagnosis, prevention, control and management among HIV persons and the general population.
This activity will support the National Tuberculosis/Leprosy Control program which has funding through the
Global Fund to air 13 TV slots per quarter on National Network Television.
In COP09 SFH will complement the mass media activities using interpersonal communication activities and
mid-mass media such as mobile drama shows (road shows). SFH will train 64 persons as interpersonal
counselors (IPC) to reach most at risk populations (MARPs) with TB-HIV messages. Additional drama
scripts will be developed to create awareness on the links between TB and HIV with opportunities for
questions and interactions at the end of each drama show. SFH will reach 6,400 persons in high risk
communities through TB/HIV focused road shows and IPC sessions. SFH will continue to use the
customized flip charts that will be deployed by the trained IPC conductors for outreaches on TB prevention
and management. Flip charts targeting clinic settings may also be designed and produced in support of
other USAID partners working in clinical settings. Relevant IEC materials will be produced and distributed to
target populations. This component is linked to peer education activities among high risk persons in sexual
prevention program area.
In COP09 SFH will continue to integrate TB prevention activities to the HCT service provision at the
community level. SFH will continue to train existing HCT counselors on early identification of TB symptoms
of clients for referrals to TB-DOTS centres and other USG and Government of Nigeria (GoN) sites were TB
diagnosis and management services are being provided. These activities will increase knowledge about
TB/HIV and create an enabling environment for TB-HIV management targeted at community, religious
leaders, and political/local government officials. In COP09, SFH will ensure implementation of the "Three
I's" at all levels of its activities and engagements by promoting screening for early TB diagnosis particularly
during HCT outreaches, improving responses to treatment and reducing spread of TB to others through
interpersonal communication activities. In addition HIV positive persons will be encouraged to adopt
preventive treatment. TB control efforts will be promoted among vulnerable groups including PLWHAs and
community members.
The activities will be ultimately linked to treatment, care, and support services that are being directly
implemented by USG implementing partners and the GoN. This activity will support advocacy and social
mobilizations programs that will be conducted at the community level.
This activity targets PLWHAs, TB clients and MARPs at the community level. The program will seek to
relate TB to HIV transmission and prevention. This program will provide linkages to other HIV and
reproductive health related services for all clients. The program will specifically focus on increasing female
participation at community outreach programs and referrals to other HIV related services. The program will
emphasize on community mobilization and participation and development of policy and guidelines for the
control of TB.
Continuing Activity: 13098
13098 12364.08 U.S. Agency for Society for Family 6390 3682.08 USAID Track $200,000
12364 12364.07 U.S. Agency for Society for Family 4179 3682.07 CIHPAC $0
Health-related Wraparound Programs
* TB
Table 3.3.12:
This component is linked to Condom and other Prevention, Counseling, and Testing and basic home based
care and support.
Society for Family Health (SFH) will continue to support PEPFAR partners to provide palliative care and
support to HIV vulnerable children and their families in the Nigeria PEPFAR states. SFH will continue the
distribution of developed Basic Care Kit (BCK) for distribution to select USG partners as chosen by USAID
for their involvement in OVC programming and in communities where SFH conducts prevention and care
outreach services. In COP 06 SFH distributed 45,000 basic care kits (BCK) and in COP 07, 100,000 units
of BCK were distributed. An additional 125, 000 units were budgeted for in COP 08. In COP 09 SFH will
distribute another 100,000 BCK to OVC partners for community OVC programming. Subsequent to the
initial distribution of 100, 000 BCK, SFH will continue to provide product replenishment in the form of
WaterGuard over the period of the grant.
The negative synergistic relationship between HIV and malaria is well documented: HIV infection increases
the risk and severity of malaria while malaria, in turn, increases the rate of HIV progression with far reaching
consequences, particularly for HIV+ pregnant women. The Nigerian environment is one in which malaria
thrives, responsible for more deaths in the country than any other disease. In addition, the Nigerian water
and sanitation infrastructure continues to be unreliable and suffers from disrepair and inadequate reach;
42% of the population continues to lack access to safe water sources (NDHS 2004). At least 27% of the
rural population obtains water from unsanitary wells; 16% from rivers; and 6% from vendors. Given these
environmental factors, it is especially critical for HIV+ individuals to take a proactive and holistic approach to
their health management.
HIV vulnerable children, whether HIV+ themselves or in an HIV affected household (i.e. with an HIV+
person or orphaned by of HIV), are particularly vulnerable to HIV and its sweeping effects. Without proper,
holistic care that addresses their particular variety of health, education, social and developmental needs,
HIV vulnerable children will not receive the necessary knowledge, tools or encouragement to improve their
well-being.
To provide HIV vulnerable children and their families a broader health management vision, each BCK is
constructed to promote healthy behaviour practices with respect to three major areas: malaria prevention
and management, diarrhoeal disease prevention, and improved basic sanitation and hygiene practices. Kit
components include: one long-lasting insecticide treated net (LLIN); one safe water storage vessel with
spigot (std. 20 litre bucket with lid); one bottle of WaterGuard point-of-use water treatment product; hand
soap; and a combination of relevant IEC materials.
SFH will leverage its relationships with PLWHA support groups to support IPs in the sensitization of health
care workers, and PLWHA support group facilitators and members. SFH will utilize its expertise in
behaviour change communications to develop a variety of culturally/regionally appropriate IEC materials
emphasizing positive behavioural decisions and healthcare products pertinent to HIV vulnerable children
and their families. In addition, SFH will train IP staff, facility staff (i.e. project implementers), and project
beneficiaries on the management of BCK. SFH expects to train 700 persons over the course of the project.
To support the PEPFAR partners in their ongoing care and support activities, SFH will develop and produce
targeted mid- mass media campaigns to create community support for OVCs in Nigeria. Evaluation of the
uptake and appropriate use of the BCKs will be conducted among recipients of the commodity,
implementers and trainers and the general population as a whole.
This activity targets HIV vulnerable children and their families and HIV+/- pregnant women. To address and
mitigate the issue of BCK stigma, 8% of the 100,000 kits are requested to be set aside for alternative
vulnerable groups and relevant facility-level project implementers in order to diversify the initial beneficiary
base, promote project receptiveness, and increase appropriate use of all BCK components among
beneficiaries who might otherwise be discouraged due to the fear of stigma surrounding the bucket. In
addition, SFH will produce different color variants of the buckets in order to reduce the current levels of
sigma associated with the blue buckets.
The emphasis areas are gender and health related wrap around. The activity targets vulnerable children
and women with a need to improve access to quality treatment, care and support services. This activity will
address access to products/commodities for malaria and safe water. This program area also addresses the
rights of women and children to gender based violence, coercion and physical and emotional abuse. Stigma
and discrimination will be addressed through training of healthcare providers on use of the kits and via
community awareness and mobilization programs, IEC development and distribution to address OVC
issues.
Through the community programs and mid-mass media campaigns i.e. the use of mobile rigs to perform
road shows and targeted community drama on OVC programming at selected IP sites, there will be
increased awareness about OVC programs across the country and this will lead to improved access of
target populations to OVC and other HIV related services, in USG and GoN sites across the country.
Continuing Activity: 13099
13099 6497.08 U.S. Agency for Society for Family 6390 3682.08 USAID Track $2,000,000
6737 6497.07 U.S. Agency for Society for Family 4179 3682.07 CIHPAC $2,086,674
6497 6497.06 U.S. Agency for Society for Family 3682 3682.06 CIHPAC $1,060,000
* Increasing women's access to income and productive resources
* Increasing women's legal rights
* Child Survival Activities
* Malaria (PMI)
* Safe Motherhood
Estimated amount of funding that is planned for Water $224,000
Table 3.3.13:
SFH recognizes that HIV Counseling and Testing (HCT) is an entry point for HIV/AIDS prevention and
impact mitigation as well as care and treatment services. HCT also serves as a platform for linkage to
reproductive health initiatives as it has been recognized that awareness creation does not necessarily
translate (significantly) to HCT uptake in Nigeria. The National HIV/AIDS and Reproductive Health Survey
(NARHS), 2005, shows that although awareness of HIV in Nigeria is high at 98%, only 11% of females and
10% of males had taken an HIV test (NARHS, 2005). However, 43% of respondents in this survey
expressed the desire to have an HIV test. In COP09, SFH will therefore build strongly on the concerted
efforts by the Government of Nigeria (GON) and development partners to improve access and provide
services towards increasing the number of persons who know their HIV status. SFH will build on efforts in
the previous COP years to increase the outreach activities among the MARPs. SFH will work with sites and
organizations to identify potential additional resources (from the GON, other donors, Global Fund, etc.) to
provide commodities and increase uptake of HCT services in all points of service.
Building on the efforts and achievements of 2008, SFH will maintain 32 Civil Society organization (CSO)
partners located within 16 SFH regions. SFH has 16 regional offices, each with three behavior change
coordinators; one person is designated as service delivery team leader. The service delivery staff leads a
team of no less than 6 trained counselors, derived across SFH partners (faith and community based
organizations (FBO/CBO and CSO), support groups, and volunteer corps. Effort will be focused on using
trained counselors to provide HCT services and referrals. These services will be targeted at most at risks
persons (MARPS) and the general populations. However, all HCT counselors will be provided with updated
materials and technical assistance on couple and youth counseling initiatives. In COP09, focus will be on
improving linkages and promoting access to services for those who test positive. An estimated target of
2,500 persons will benefit within the project period.
SFH will continue demand creation for HCT through community mobilization activities among most at risk
persons (MARPs) and the general population. This service will be consolidated in the 27 scaled-up states
from 2008 across the country.
The MARP communities include female sex workers (FSW), transport workers (TW), uniformed service men
(USM) and out-of-school youths (male and female). However in COP09, concerted efforts will be put in
place to increase outreaches to both brothel and non-brothel based female sex workers. Through the
PLACE project, SFH will provide "moonlight" mobile services that target non-brothel based female sex
workers and their patrons at identified red-light districts in 10 states. SFH will continue to provide community
outreach services to its brothel based FSW across the 27 intervention states.
SFH will continue intervention programs targeted at the hard to reach populations, with concerted efforts
targeting the prison inmates and staff. This activity will be in collaboration with the Prisons Services. In
COP08, SFH implemented interventions programs in 16 prisons across the country. However in COP09,
SFH will scale-up intervention activities to 16 new prison facilities in SFH regions (i.e., 16 states of Nigeria).
Other target populations include the paramilitary sector comprising of officers of the Customs and
Immigration Services, police force, prisons and inmates. SFH will continue to collaborate with the Armed
Forces Programme for AIDS Control (AFPAC) in provision of quarterly mobile service to USMs.
SFH will continue to use the non-cold chain dependent rapid test kits. In 2008, the GON approved a change
in the national HIV testing algorithm from parallel to serial testing; SFH will adopt the change using
Determine as first test. At the communities, SFH will conduct mapping of referral sites for confirmatory
testing and comprehensive treatment and support services for clients who test HIV positive. SFH will
provide additional links for all its clients to TB, family planning and STI services funded by the GON, USG
and Global Fund. For the prisons intervention, SFH will collaborate with other USG implementing partners
to provide mobile treatment, care and support services to inmates who test HIV positive.
Through the AB program area, SFH collaborates with FBO partners. Through this partnership, SFH will
continue to provide mobile HCT targeted at the youths, couples and host communities. SFH will provide
technical assistance to FBO, CSO and CBO partners to create, implement and sustain mobile services.
Clients/couples who test negative will be counseled and assisted to develop risk reduction plans; all
sexually active clients will be duly informed on correct and consistent use of condoms for all sexual acts to
prevent HIV infection. Condom demonstration will be conducted during community outreaches. SFH will
distribute sample condoms to sexually active clients and PLWHAs as required and clients will be
encouraged to purchase the socially marketed condoms for subsequent use. Clients/couples who test
positive will be counseled and assisted to develop a risk reduction plan on positive prevention or living.
Clients who test HIV positive will be counseled on disclosure to partner(s), referrals and partner referral,
assisted to identify sources of support and condom use to prevent HIV transmission and re-infection.
Female clients will also be provided with female condoms for dual protection purpose and women will be
trained on its use. SFH will also distribute WaterGuard and long lasting insecticide treated nets (LLIN) for
the prevention of diarrhea and malaria to clients and PLWHAs. These products will be provided at an
affordable cost to all clients.
Rapid Test Kits will be provided by the Supply Chain Management System through the USG. Test kits will
be stored centrally at the headquarters of SFH in Abuja and distributed quarterly along existing supply
chains to the regional offices. Adequate storage and transport conditions will be ensured to maintain test
kits quality and integrity. SFH has implemented a system to track essential data for adequate test kits
management. SFH will continue to support the harmonization of the logistics tracking system led by the
Federal Government of Nigeria with regard to the Logistics Management Information System (LMIS).
Monitoring and Evaluation
Quality assurance (QA) measures for testing will involve collecting dried blood samples (DBS) from every
tenth client. The DBS cards will be submitted to University College Hospital (UCH), Ibadan for retesting and
Activity Narrative: confirmation. Services of medical laboratory scientists will be engaged as required to provide oversight on
QA measures and on waste management. QA for counselors will involve supervisory visits to prevent
counselor burn-out and identify training needs of counselors. Trained counselors will hold monthly and
quarterly meetings at regional and zonal levels respectively to share experiences and deliberate on
replicable best practice models for providing quality HCT services. In 2008 SFH conducted a client exit
survey in 5 states to evaluate quality of counseling service provided by SFH counselors. This survey will be
scaled up to 10 states across the country. To ensure quality of service client exit forms will be distributed to
every tenth client to assess counseling services.
All mobile units will use the National HCT data collection tools to assist in monitoring and evaluation of
these activities. Population Services International (PSI), an affiliate of Society for Family Health will continue
to provide oversight functions and share international best practices from their East African HCT programs.
PSI has a wealth of experience with the New Start HCT program in Kenya, Zimbabwe and has successfully
integrated TB screening, family planning and other services into their program.
Link To Other Activities
This activity is linked to Abstinence and Be faithful, Condoms and other Prevention, OVC, Strategic
information and Care and Support.
The emphasis areas in this component are gender, workplace, health-related programs and military
populations.
Populations Targeted
This activity will provide services targeted at individual clients and couples at the community level. The
program area will provide an opportunity for couples to know their HIV status and make joint decisions on
their future to prevent HIV infection and re-infection. Couples counseling will reduce stigma and
discrimination against women infected and affected by HIV and AIDS. HCT will increase access to
reproductive health and HIV related services for women, discordant and concordant positive couples via
referrals. Female clients will have increased access to income generating programs and legal aid services.
There will be linkages to TB DOTS centers for clients with suspected TB infections for diagnosis and
treatment. All referrals services will be provided at USG and GON funded sites across the country. Sexually
active clients will be assisted to develop risk reduction plans and counseled on mutual fidelity and
consistent and correct condom use. Female condoms will be distributed to female clients as a dual
protection method.
HCT services will be provided at workplace and military programs targeted at men to address negative male
behaviors; counseling will be focused on partner reduction, mutual fidelity and consistent and correct
condom use among male clients.
Health-related Wraparound Programs (Child Survival Activities, Family Planning, Malaria (PMI), Safe
Motherhood, TB): through this program clients will be referred to USG and GON sites that provide
reproductive health and HIV related services. During outreaches SFH will distribute and social market
WaterGuard and long-lasting insecticide treated nets for the prevention of diarrhea and malaria respectively
amongst women and children under 5 years old and PLWHAs.
Continuing Activity: 13100
13100 5423.08 U.S. Agency for Society for Family 6390 3682.08 USAID Track $300,000
6736 5423.07 U.S. Agency for Society for Family 4179 3682.07 CIHPAC $0
5423 5423.06 U.S. Agency for Society for Family 3682 3682.06 CIHPAC $16,000
* Family Planning
Table 3.3.14:
This component is linked to Abstinence and Be Faithful, TB/HIV, Condom and Other Prevention,
Counseling and Testing, OVC, Strategic Information, Care and Support , and HIV/TB program areas. In
Nigeria, HIV & AIDS-related stigma is unacceptably high and poses a challenge to national HIV/AIDS
control efforts. However, evaluation of SFH interventions showed that people who had been exposed to
SFH's programs were less likely to stigmatize persons living with HIV/AIDS. In addition, young men
reported that parents and religious leaders increasingly supported condom use by sexually active youths
while still encouraging abstinence among youths. SFH engagement with religious leaders and other
gatekeepers using the successful Zip Up abstinence campaign was instrumental in eliciting support for HIV
prevention initiatives among gatekeepers in Nigeria.
In FY06, SFH sensitized the two major Islamic groups, the Jama'atul Nasir Islam (JNI) and the Ansar Ud
Deen Society of Nigeria (ADSN), on HIV prevention and stigma reduction programming, as well as to
conduct training of trainers for Implementing Committee Members (ICM). SFH also engaged with the
Redeemed Christian Church of God (RCCG) at the national level by facilitating the development of its HIV
strategic plan in preparation for the implementation of youth focused prevention programs. FY07 saw the
addition of Living Faith Foundation and NASFAT to SFH's FBO initiative. In FY08, 2 FBO partners were
supported technically to develop and produce their HIV/AIDS policies and implementation plan. In COP09,
SFH will continue the implementation of FBO strategic plans under the Abstinence and Be Faithful program
area. SFH will continue to train religious leaders to provide Abstinence and Be Faithful messages during
sermons and religious events; youth leaders will also be trained as peer educators to provide abstinence
messages to the youths within the organizations and host communities. In addition, in the COP09 year,
SFH will support 2 new FBOs to develop and produce their national HIV/AIDS policies. In FY08, a FBO
manual was developed to guide FBO program implementation targeted at the youths and married couples
for Abstinence and Be Faithful programs. In COP08, SFH trained FBO staff members on HIV counseling
and testing; In COP09, SFH will provide technical assistance and support to trained counselors to develop
and implement an HCT outreach program for the individual FBO communities.
In COP09, SFH will continue to promote the meaningful participation of FBOs in both National Agency for
the Control of AIDS (NACA) and State Agencies for the Control of AIDS (SACA) programs to ensure
effective FBO contribution to National, State, and Community response to HIV. Other areas of continuous
engagement with FBOs in COP09 will be in HIV prevention, care, and support, including stigma reduction.
In addition, SFH will continue to strengthen the capacity of FBOs in leadership development and program
management through organizational capacity development workshops. As part of the workplace initiatives
in COP09, through funding and technical assistance, SFH will support the implementation of the national
workplace policy in twelve selected companies.
In FY07, 21 civil society organizations (CSO) were engaged through participatory capacity building
processes which enabled SFH to identify program management gaps in these organizations. In FY08, SFH
identified and selected 32 new CSO partners to implement community prevention programs in 32 new sites
across the SFH regional states. In COP09, SFH will continue community interventions with the existing 32
CSO partners. SFH will build CSO capacity on community mobilization and sensitization, program
implementation, evaluation and financial management. CSO partners will also be provided technical
assistance and support to access funds for HIV programming from other local and international donors. In
COP09, SFH will continue to support national level civil society networks to enable these networks conduct
state-level step-down training and to implement HIV prevention and basic care and support activities. SFH
will continue to support capacity building of program persons in HIV program management, gender
mainstreaming, proposal writing, grant management, policy development, and the establishment of
management information systems for program tracking and evaluation. CSO capacity will be strengthened
to implement comprehensive programs in FY09. SFH has plans for 3 program and finance officers to
undergo capacity building in project management and implementation in COP09.
At the community level, SFH will continue to provide participatory organizational capacity development for
over 32 community-based organizations in high risk sites and will train 2 persons per organization in
community mobilization for stigma reduction and HIV program planning and management. Capacity building
programs for CBO partners will also focus on provision of HIV services for referrals, treatment care, and
support services. At the state and local government levels, SFH will provide technical support to strengthen
16 SACA and LACA groups in community level interventions targeted at most at-risk populations. SFH will
also support in the development of community program strategies, work-plans and budgets. At the
community level, SFH will train 3,128 persons from support group, youth, and FBO communities to carry out
community outreaches and advocacy that will address stigma and discrimination against PLWHAs. In
COP09, SFH will work with physically challenged groups to reach them with HIV prevention messages.
SFH will build their capacity on program implementation and management. The physically challenged
groups will also have their capacity built on Behavior Change Communication material development.
SFH will continue to support GoN to promote and position the "Heart to Heart" brand as the national HIV
counseling and testing brand. SFH will achieve this through national mass media campaigns on radio and
television, as well as print media approach. This campaign will lead to an increase in demand for HCT
nationally and provide easy access to care and support services. In addition, SFH will also support the
dissemination and implementation of the newly reviewed Behavior Change Communication Strategy
developed by NACA at the state level. SFH will continue to provide support for a director within NACA in
FY09. Funding from the HVABC program area will be used by SFH to continue to support the National
Agency for the Control of AIDS (NACA) and National Prevention Technical Working Group (NPTWG) in the
development and dissemination of the national prevention ABC guidelines. SFH will also support the
National Tuberculosis/Leprosy Control program through the development of mass media campaigns that
will promote TB prevention and control nationally via radio and TV campaigns. SFH will also train peer
educators at the community level to create awareness and provide referrals to located DOTS sites in SFH
states.
Activities in this program area will provide the enabling environment and strategic direction for other
interventions especially among the FBOs. This component is linked to HVAB, HVCT, HVOP, TBHIV, and
Activity Narrative: HKID program areas. Specific targets include religious and community leaders, civil society organizations,
and faith-based organizations. Dialogue and collaboration with GoN remains essential in the light of the
principles of the "three ones".
This activity will increase gender equity in programming through advocacy with other FBO leaders and will
address issue of stigma and discrimination against PLWHA. SFH will engage with women's groups within
the FBO leadership and ensure that women groups are equitably represented in all training and leadership
activities conducted amongst FBO groups. At the national level, SFH will continue to give funding and
technical support for sensitization workshops to educate gatekeepers on the relationship between gender
violence and spread of HIV. This activity places major emphasis on local organization capacity
development while the minor emphasis areas are community mobilization and participation, training, and
development of network/linkages and referral systems.
Continuing Activity: 13101
13101 5299.08 U.S. Agency for Society for Family 6390 3682.08 USAID Track $490,000
6732 5299.07 U.S. Agency for Society for Family 4179 3682.07 CIHPAC $0
5299 5299.06 U.S. Agency for Society for Family 3682 3682.06 CIHPAC $41,000
Estimated amount of funding that is planned for Human Capacity Development $17,500
Table 3.3.18:
