ACTIVITY UNCHANGED FROM FY2008

In COP 09, the NELA Consortium AIDS Initiatives in Nigeria (NECAIN) will provide HIV prevention

messages on abstinence and be faithful (AB) to 7,500 youth and couples (3,000 males and 4,500 females)

in 8 states in the 6 geopolitical zones of Nigeria; Osun in southwest, Adamawa and Borno in northeast,

Kebbi and Jigawa in northwest, Nasarawa in north-central, Edo in south-south, and Ebony in southeast.

5,625 (75%) of the targets will be youth, while 1875 (25%) will be couples (counted individually). HIV

prevention services will be provided at the community level through the consortium's 3 multiplier

organizations and their 24 local partners (including community-based, faith-based, and non-governmental

organizations [CBOs, FBOs, NGOs]).

The consortium is made up of the Network on Ethics/Human Rights Law, HIV/AIDS - Prevention, Support

and Care (NELA), the Federation of Muslim Women's Associations in Nigeria (FOMWAN), the Society for

Women on AIDS Africa Nigeria (SWAAN) and the Civil Society Network on HIV/AIDS in Nigeria (CiSHAN),

North Central Zone.

Understanding the pattern of sexual behavior among the target populations has been and will continue to be

the key to identifying the drivers of the HIV pandemic in project communities, and determining which

strategies will best address the needs identified. The 2005 HIV/AIDS sentinel survey showed that youth

aged 15 to 24 years have a higher than national average of HIV prevalence. A 2007 Nasarawa NGO Forum

report corroborated this and revealed a high prevalence of HIV among youths in Karu and Keffi Local

Government Areas (LGAs). The specific findings are as follows: 75% of in-school youth and 86% of out-of

school youths, aged 15-24 years have inadequate HIV prevention knowledge, about 48% of in-school girls

and 57% of in-school boys had unprotected sex at least once in the 6 months preceding the study, between

19 and 25% of girls reported having unprotected sex for fear of losing their boyfriends, 21% of girls 15-24

years reported having more than one sexual partner at the time of the study, and about 51% of young

couples believe HIV prevention messages should not target couples, while 24% of couples believe infidelity

exists among couples (Nasarawa NGO forum report November 2007).

The drivers of the epidemic among in-school-youths in the NECAIN project states, as indicated in reports

from LGAs and NGOs in NECAIN project states include early sexual debut among girls for fear of losing

their boyfriends, peer influence for both boys and girls, and trans-generational sex (especially between

students and their teachers to ensure success in examinations), and cultural norms that make it impossible

for parents to discuss sex with their children. An additional driver of the epidemic in Edo State is the

trafficking of persons for prostitution.

To address the drivers of the epidemic among in-school youth, NECAIN will scale up existing HIV

prevention education for behavior change with a focus on primary and secondary abstinence, and provide

information about correct and consistent use of condoms with the active involvement of young people, their

parents and guardians. Strategies that will be employed include a school-based approach (curricular and

non curricular based), peer education models using age peers, peer education plus models using sports

activities, drama and role models, and a ‘vulnerability issues' approach that provides training on essential

life skills. These strategies will be complemented with national mass media campaigns and information,

education, and communication (IEC) materials produced by the project. All activities that will be undertaken

for each strategy will stress the benefits of abstinence until marriage and mutual fidelity thereafter. The

project will also arrange educational seminars for parents in schools to provide information on abstinence

and emotional support for their children. Such seminars will also equip parents and guardians with the skills

to guide young people towards healthy and responsible decision-making and safer sex behavior.

The drivers of the epidemic among out-of-school youth are drug and alcohol abuse, cultism, and trans-

generational sex. An additional driver of the epidemic in Edo State is the trafficking of persons for sex work.

To address the drivers of the epidemic among out-of-school youth, NECAIN will continue to use the

following strategies: community awareness campaigns (interpersonal and focused small-group discussions,

rallies and community dialogues), peer education models (age-related, job-related, and social peers), the

peer education plus model (sports activities, use of role models, dance and drama), and focused attention

on vulnerability issues (including essential life skills training). Where indicated, NECAIN will refer out-of-

school youth to other implementing partners (IPs) and projects for access to economic empowerment

through income generating activities. These strategies will be complemented with national mass media

campaigns and IEC materials.

The drivers of the epidemic among couples include: low risk perception, multiple sexual partners, widow

inheritance practice, lack of women's decision-taking power on sexual issues, and continued risky behavior

of males in the general population. The 2003 NARHS reported that men and women in all geo-political

zones of Nigeria engage in extra marital sexual relationships. The lowest reported figures were those from

the northwest (1.8% of female and 5.8% of male respondents), while the highest reported percentages were

in the south-south region (20.9% of female and 34.2% of male respondents). The same study also reported

the prevalence of transactional sex among females and males across all the geopolitical zones; these

figures ranged from 2.8% of female and 2.9% of male respondents in the northwest and 15.3% of female

and 21.4% of male respondents in the south-south.

The strategies to be employed to reach couples will be multi-level, as this approach is needed to change

social behaviors. NECAIN will employ the following strategies to address the issue of multiple sexual

partners among couples: community awareness campaigns (rallies, focused small-group discussions,

interpersonal communications, and community dialogues), peer education models (age- and job-related

peers), and peer education plus model (use of role models), to be complemented with national mass media

campaigns and IEC materials developed by the project. All activities will be tailored to increase risk

perception among concurrent partners. NECAIN has in the past involved the community, and will continue

to involve the community and other stakeholders in constructing appropriate messages that will be tailored

to the pattern or types of sexual partnerships in communities.

Activity Narrative: To address the issues of gender inequality in taking decisions about sex, the project will employ a

‘vulnerability issues' strategy. Activities will include training in essential life skills and the referral of women

to other IPs that provide services for income generation and economic empowerment. NECAIN local

partners have already established linkages for these services.

The above strategies will be implemented through educational activities in churches and mosques. The

multipliers' networks and branches will facilitate educational programs with an emphasis on faithfulness in

marriage and the promotion of respectful images of men and women that are upstanding and faithful.

Educational activities will also include the use of role models at all levels. Activities will also promote being

faithful to spouses, discouraging coercion and alcohol abuse and cross-generational sex. These strategies

will be complemented with national mass media campaigns and IEC materials with messages that focus on

fidelity in marriage.

Religious leaders will be trained to conduct participatory workshops, deliver sermons, and provide peer

support and counseling to church members on mutual monogamy and HIV prevention. All faith based

activities will be integrated into existing male and female group activities in churches or mosques.

The project will continue to work with the 800 peer educators already trained on the project; 600 to work

with in- and out-of-school youth and 200 to work with couples. Each trained peer educator, both for in-

school or out-of-school youth and for couples, will recruit a cohort of peers to work with over time, and will

reach each of the cohorts with at least three AB strategies. The project has developed reporting formats that

will serve as a means of verification for counting individuals reached, and will continue to modify these as

needed to ensure accurate reporting of activities.

The project will work in collaboration with prevention programs that distribute condoms for the prevention

with positives (PWP) programs. A linkage has already been established with Society for Family Health

(SFH) for the distribution of condoms to clients on the project. The project has also established linkages

with organizations working in the area of HIV counseling and testing for clients reached with the various

prevention messages.

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

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

The Network on Ethics/Human Rights Law HIV/AIDS - Prevention, Support and Care (NELA), working in

concert with the Federation of Muslim Women's Associations in Nigeria (FOMWAN), the Society for Women

on AIDS Africa Nigeria (SWAAN) and the Civil Society Network on HIV/AIDS in Nigeria (CiSHAN),

comprises an indigenous NGO, with technical and financial management experience and leadership in the

development of community based organizational capacity for HIV/AIDS action. Working together, the NELA

program will provide expanded community level prevention, care and treatment services to people infected

and affected by HIV/AIDS including OVC and to reduce the rate of HIV transmission among youths, couples

and general population.

The program particularly aims to increase coverage and enhance the quality of civil society responses to

HIV/AIDS at community levels; prevent HIV transmission among young people and couples; improve the

quality of life of people living with HIV, their families and communities; and to provide comprehensive and

compassionate care and prevention services for AIDS orphans and vulnerable children.

ACTIVITY UNCHANGED FROM FY2008

NELA will continue to implement the Adult Care & Treatment aspect of the project as of COP 08. The

project will provide HBC services to PLHIV at the community level in 8 States of Nigeria through 8 CBOs.

Services that will be provided include:

•Basic Nursing care

•Promotion of client and household hygiene and disease prevention

•Treatment, prophylaxis and management of common opportunistic infections

•Prevention with positives

•Linkages and referrals of clients for services that they need, but which the project is not providing e.g.

PMTCT, ARVs, diagnosis and treatment of OIs, programs providing care for OVC, and programs providing

HIV prevention and HCT services especially for PWP, economic strengthening/skills acquisition for income

generation.

In COP 09, the NELA Consortium AIDS Initiatives in Nigeria (NECAIN) will continue to provide basic care

and support to 4000 PLHIV in 8 states - Osun, Borno, Kebbi, Adamawa, Nasarawa, Edo, Ebonyin and

Jigawa. The indirect targets include family and community members and health care workers that will be

reached with anti-stigma messages; the project is targeting 8, 000 PABA.

The consortium is made up of the Network on Ethics/Human Rights Law HIV/AIDS - Prevention, Support

and Care (NELA), the Federation of Muslim Women's Associations in Nigeria (FOMWAN), the Society for

Women on AIDS Africa Nigeria (SWAAN) and the Civil Society Network on HIV/AIDS in Nigeria (CiSHAN)

North Central Zone.

The NELA/PCO will continue to provide technical backstopping its 3 partners, the Multiplier Organizations

(MOs) whose capacity has already been built or enhanced to provide training and technical support to their

eight (8) local branches and networks (CBOs/NGOs/FBOs) that work at the community level. These local

partners have trained volunteers, and/or family members within the communities to provide basic care and

support services for PLHIV through home based care.

Service delivery will continue to promote active participation of PLHIV as a strategy for reducing stigma and

discrimination. This approach will continue to be promoted in collaboration with PLHIV support groups in the

focus states and project communities. The CBOs/FBOs/NGOs will be responsible for providing Home

Based Care; referrals and linkages to other care and support services that the project is not providing, but

which the clients need; and services that ensure reduction in Stigma and Discrimination at the community

level.

The NELA/PCO and the 3 MOs will monitor and provide on-going technical support to the

CBOs/FBOs/NGOs to ensure delivery of sustainable, high quality services. The MOs will support the

CBOs/FBOs/NGOs to develop/maintain relationships with existing service providers for

HBC/VCT/ARV/PMTCT/TB, and basic clinical care and laboratory support for opportunistic infections

including malaria and syndromic management of STI. Where the resources are not available,

CBOs/FBOs/NGOs will provide drugs and laboratory support for PLHIV. The CBOs/FBOs/NGOs will train

health care workers and community health workers as volunteers to participate in the provision of home

care to PLHIV.

Transport re-imbursements, HBC kits containing Soap, Hypochlorite solution (Bleach), Plastic sheet,

Condoms, Gauze and cotton wool, Bandages/adhesive tape, Gloves, Apron, Petroleum jelly, Scissor, nail

clippers, Waste disposal bags, Thermometer, Talcum powder, packets of ORS, paracetamol, Gentian violet,

Calamine lotion, Anti-malaria tablets, Multivitamins, Iron tablets, and 1% Hydrocortisone ointment will be

provided for the volunteers. The local organizations will provide each of their clients with a self care kit

containing ORS, ITN, water guard, water container, bleach, cotton wool, gloves, soap, calamine lotion,

Vaseline, GV, and methylated spirit

Activities to be carried out by the CBOs/NGOs/FBOs at community level include the following:

Basic nursing care using uniform patient management protocols and standards developed by NELA :

trained care givers will be provided with a care giver handbook and will be supervised by trained staff of the

CBOs/NGOs/FBOs and health care facility partners.

Promotion of client and household hygiene and disease prevention in the home: The project will supply

each client registered on the project with a minimum Basic Care package. The package will include ORS,

ITN, water guard, water container, cotton wool, gloves, soap, Vaseline, GV, IEC materials and methylated

spirit. The trained care givers will treat the conditions they are able to, but will refer cases they are unable to

handle to health facilities with which the CBO/NGO/FBO already has a working agreement. The

CBOs/NGOs/FBOs will pay for laboratory services and treatment for clients who are not able to pay; these

are identified through a checklist provided by the project.

Treatment, prophylaxis and management of common infections: The project will supply each client

registered on the project with a minimum Basic Care package. (The package will include ORS, ITN, water

guard, cotton wool, gloves, soap, Vaseline, GV, and methylated spirit. The trained care givers will treat the

conditions they are able to, but will refer cases they are unable to handle to health facilities with which the

CBO/NGO/FBO already has a working agreement.

Prevention with positives: CBOs/NGOs/FBOs will provide abstinence and faithfulness massages,

counseling for discordant couples and referrals for other services. The Project will link with and network with

other IPs for the provision of other prevention services not provided by the project to clients. The services

Activity Narrative: provided by other IPs to which the clients will be referred to will include HIV counseling and testing including

disclosure to partner, condoms, PMTCT, FP and prevention IEC materials.

Development of network systems and fostering of linkages: The project will build/enhance the capacity of its

partners to identify and establish working relationships with other service providers to provide

comprehensive care to their clients. The partners include health care institutions for ART, diagnosis and

treatment of OIs, PMTCT, and laboratory services, programs providing care for OVC, and programs

providing HIV prevention and HCT services especially for PWP.

Facilitation and formation of support groups: The USG Care and Support TDY to Nigeria in July 2008 noted

a disproportionate representation of women in support groups, which may reflect low access to HCT and

HIV clinical services among men, and a disproportionate number of PLHIV on ART in support groups which

may reflect insufficient recruitment and referrals of pre-ART clients. To address this gap, which was also a

finding in the support groups already formed on the project; the project will make special efforts to recruit

more HIV infected, pre ART individuals through increased community education and advocacy. The project

will also establish strong linkages with other service providers in the area of economic strengthening

activities e.g. farming programs to increase appeal of support groups within the general community.

Nutritional support: Guidelines will be provided to the local partners on the eligibility criteria for nutritional

support. Preliminary eligibility criteria is one or a combination of the following:

•BMI = 18.5

•Active TB co infection

•Inadequate weight gain in pregnancy

During the nutritional supplementation period, and as soon as the physical condition of the PLHIV permits,

the client will be linked up with a service provider for economic strengthening. A potential partner for this

activity is the USAID Markets.

Other services that will be provided to the clients include psychological, social and spiritual support, creation

of an enabling environment to reduce stigma and discrimination through formation of support groups,

workshop/ seminars on HIV-related stigma and discrimination, community campaigns against stigma and

discrimination, and production and dissemination of IEC materials with messages on stigma and

discrimination; and counseling on drug adherence, disclosure of HIV status, grief, and anxiety. All supplies

for the provision of care and support services will be bought at the CBO level. The components of the HBC

and basic care kits are as stipulated by the C&S TWG.

The NECAIN project has made, and will continue to make efforts to involve PLHIV in the provision of basic

care and support services. Each CBO/NGO/FBO providing care and support services trained some of their

support group members as care givers, the percentage ranging from 25 - 50% of persons trained. During

the training of caregivers, training was provided in self care and ways to reduce and/or prevent caregiver

burn out. CBOs will provide stipends for their caregivers.

The project provides care and support services at the home and community level; therefore all other

services required by the clients will be procured through referrals and linkages. The local organizations

have been supported to identify and link up with other service providers to provide comprehensive care to

their clients. Linkages have been made and working relationships established with health care institutions

for ART, diagnosis and treatment of OIs, PMTCT, and laboratory services. Others include programs

providing support for OVC, and programs providing HIV prevention services and HCT especially for PWP.

To monitor the referrals and linkages, the project will use a two-way referral form that will track the service

provided to the client at the facility to which he/she was referred, and will make it possible for the service

provider to whom the client was referred, to give instructions on how the client can be further assisted by

the Care giver.

The CBOs will organize support group meetings for caregivers where they can discuss problems faced in

the care of clients and share experiences that will help them to prevent care giver burnout and enable them

to take care of their own health and ensure adequate rest.

New/Continuing Activity: Continuing Activity

Continuing Activity: 21707

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

21707 21707.08 U.S. Agency for Network on 9409 9409.08 $26,372

International Ethics/Human

Development Rights Law

HIV/AIDS-

Prevention,

Support and Care

Emphasis Areas

Gender

* Addressing male norms and behaviors

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $29,988

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 $3,478

Economic Strengthening

Education

Water

Estimated amount of funding that is planned for Water $602

Table 3.3.08:

In COP09, NECAIN will provide care and treatment to children born to HIV positive mothers in community

Based Facility supported by NECAIN in Osun, Jigawa, Borno, Adamawa, Nassarawa, Edo, Ebonyi and

Kebbi states. Through the support groups of PLHIV, NECAIN will provide care and treatment services to

572 children on ART by the end of the COP year.

Entry points where children would be identified for pediatric care and treatment would include the support

group of PLHIV, VCT centres where mothers who are identified as HIV positive would be encouraged and

supported to receive PMTCT services. Mothers will also be supported after delivery to attend required

children's clinic with their babies, at which time they would be weighed, receive routine immunizations and

nutritional counseling and education on safe infant feeding. At the age of 6 weeks, according to the Nigerian

National algorithm, these babies would all have DNA PCR diagnosis, and based on their results would be

referred for ART treatment if positive and supported to receive community based care. A second test would

be performed at the age of 18 months or six weeks after the cessation of breastfeeding, if the mother opted

for breastfeeding, to ascertain the child's final HIV status; the test will be performed at the occasion that

comes later of the two.

In COP09, NECAIN will establish linkages with other health care providers; public and private, proximal to

NECAIN sites, with full fledged PMTCT activities. This will encourage two-way referrals of HIV+ mothers

and their infants from NECAIN sites to these services. Key to increasing pediatric enrollment into the care

and treatment services will be to strengthen linkages at all service levels within the sites that NECAIN will

be working, as well as reinforce and expand community outreach activities. This will require staff training

and strengthening of referrals and linkages. In order to increase the number of children enrolled into care

and treatment, NECAIN will support organization of services to provide family centered care, and

community mobilization. All infants delivered by HIV+ mothers in the NECAIN support groups will be linked

to the HIV Comprehensive Care clinic for enrollment for further management and to NECAIN community

Adult care and treatment, and OVC programs.

The package of care services that will be provided to each HIV+ child/care giver includes a minimum of

clinical service plus basic care kit and two supportive services in the domain of psychological, spiritual, and

PwP to be delivered at the facility, community, and household (home based care) levels in accordance with

the PEPFAR and Government of Nigeria (GON) national care and support policies and guidelines. The

basic care package for HIV+ child/care giver in NECAIN sites will include the provision of Basic Care Kit

containing ORS & SSS, LLITN, water treatment solution, water vessel, soap, IEC materials, and gloves;

Home-Based Care (client and caregiver training and education in self-care and other HBC services);

Clinical Care (basic nursing care, pain management, OI prophylaxis and treatment, and STIs diagnosis and

treatment, nutritional assessment, micronutrient supplementation and referrals for nutrition rehabilitation

where indicated, Laboratory Services (baseline tests - CD4 counts, hematology, chemistry, malarial

parasite, OI and STI diagnosis); Psychological Care (adherence counseling, bereavement counseling,

depression assessment and counseling with referral to appropriate services); Spiritual Care (access to

spiritual care); Social Care (support groups' facilitation, referrals, and transportation) and Prevention Care

(Prevention with Positives). For all the clinical and laboratory services, the children enrolled on the NECAIN

project will be referred to nearby secondary and tertiary health institutions that offer such services. In

situations where the services need to be paid for, and where the parents/caregivers are unable to pay, the

project will pay for them. The project will draw up a set of criteria for determining the inability of a

parent/caregiver to pay.

The nutritional status of all HIV+ children will be assessed at contact and on follow-up visits, micronutrients

will be provided as necessary, and those diagnosed as severely malnourished will be placed on a

therapeutic feeding program. This will be done through wraparound services as well as direct funding.

Mothers would receive individual and group counseling using the Nigerian National HIV and infant feeding

protocol, and they will be further supported psychosocially after they have made informed decisions about

infant feeding choices to ensure they avoid mixed feeding which will be emphasized continually. Mothers

will continue to receive infant feeding support through the support groups, which will address the social

issues around breastfeeding or choosing not to breastfeed, as well as how to reduce stigmatization through

education of peers and family members. Nutritional assessment through the use of growth monitoring will

be accompanied by nutritional education around supplementary feeding and safe early weaning for mothers

that choose to breastfeed. Mothers will be encouraged to exclusively breastfeed their infants if the

conditions for safe artificial feeding are not met, i.e. the food is not accessible, feasible, affordable, safe and

sustainable (AFASS).

All sites will be strengthened in their capacity to provide comprehensive quality care and support services

through a variety of models of home based care delivery. This includes quality management of OIs and

referral for ART, treatment preparation for clients and their families and community based support for

adherence. The project will also support the development of site specific work plans and ensure that

systems are in place for financial accountability.

CONTRIBUTION TO THE OVERALL PROGRAM AREA:

The program will support capacity strengthening of community based organizations providing palliative care

and household OVC programs as set out in the Emergency Plan. It will directly contribute to serving 572

HIV+ children. The program will improve the lives of these children in accordance with the PEPFAR and

Government of Nigeria (GON) national care and support policies and guidelines.

LINKS TO OTHER ACTIVITIES:

This activity will be linked to programme such as PMTCT, VCT, OVC support programs and other wrap

around programs in the communities.

Networks will be created to ensure cross-referrals and sharing of best practices among NECAIN partners

and other implementing partners. Effective synergies will be established with the Global Fund to Fight AIDS,

Tuberculosis and Malaria through harmonization of activities with GON and other stakeholders.

POPULATIONS BEING TARGETED:

These activities targets children infected with HIV and their caregivers/HCWs from rural and underserved

communities.

EMPHASIS AREAS:

These activities will put emphasis on community care and support for HIV+ children. The care and treatment

services will also ensure gender and age equity in access to care and linkages with OVC and PMTCT

services in NECAIN sites and neighboring sites

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Health-related Wraparound Programs

* Child Survival Activities

* Malaria (PMI)

Human Capacity Development

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.10:

ACTIVITY UNCHANGED FROM FY2008

NELA consortium AIDS initiative in Nigeria (NECAIN) is a project made up of three multiplier organizations

and NELA, which is the lead organization. NELA with the PEPFAR funding will strengthen the capacity of

the multiplier organizations which are Society for Women and AIDS in Africa (SWAAN), Civil Society on

HIV/AIDS in Nigeria, North Central and Federation of Muslim Women Association in Nigeria (FOMWAN) to

support their networks and other NGOs to directly provide services to Orphans and Vulnerable Children and

advocate for the leveraging of additional support for OVC within the communities.

The COP 08 activities are expected to improve the quality of life for 3,004 OVC with direct primary support

to at least 2,102, Direct supplemental support to 902 OVC will be provided through 432 caregivers who had

been trained by the eight community based organizations and multiplier networks in Osun, Borno,

Adamawa, Nassarawa, Kebbi, Ebonyi,Edo and Jigawa states. There will be no training for caregivers in

COP 09. NECAIN Community Based Partner Organizations with support from the multiplier organizations

will directly provide a selection of three essential services from the six core areas (protection, health,

psychosocial support, education food and nutrition, shelter and care) depending on the child's needs. To

ensure quality service delivery at the community level, national OVC data monitoring tools will be adapted

and used to capture and monitor various activities that will be provided to OVC.

Health care services will be provided to HIV-positive children through appropriate referral to ART programs

and care and support groups closer to the OVC household. OVC will have access to age-appropriate HIV

prevention messages including ABC through their various support groups and to referral for HCT and

PMTCT where necessary. Children under 5 will be supported for preventive health care with focus on

common childhood diseases. For general health care, OVC will be linked with Primary Health Care Centers.

The project will facilitate appropriate linkages to other educational sponsored and government supported

programs within the communities. Where these supports systems are not available, Community Based

Organization will support provision of educational materials like uniforms, biros, bags, sandals and books.

The project will work with school authorities and government to waive tuition fees for OVC and, where this is

not feasible, OVC will be supported with tuition fees. In addition to the above, older OVC will be supported

to learn a trade or participate in skill acquisition programme such as tailoring and hairdressing that could

help them take care of themselves and their younger ones. On completion of the training, seed grants will

be given to them to purchase instruments as capital investment for micro enterprises. Teachers and

household caregivers will be trained to provide one on one counseling and support to children to encourage

school enrollment, attendance and retention.

The project will strengthen household capacity to provide good nutrition to OVC through nutritional

education programmes, with focus on locally availailable and low-cost foods. Nutritional assessment, growth

monitoring, food supplements and food/nutritional support will be provided for children under five during

home visits and kids club activities. Foods will be mobilized through the community and supported by the

project. Household will be supported for community gardening and animal rearing.

The project will actively encourage families through community mobilization and advocacy to take OVC into

their households, through special arrangements to be worked out at the community level. This will be the

preferred mode of provision of shelter to the identified OVC. Only in exceptional cases would a transit

institutional home be considered. Clothing materials will be mobilized from the religious institutions from

within the community to support the children.

Teachers, health workers, OVC Caregivers and other relevant people will be trained to identify signs of

distress and how to provide one on one counseling to OVC. The program will also establish kids clubs and

support groups targeting different age groups; less than 5, 6 to 12 years of age, and ages 13-17. Trained

peer educators in life skills will take the children through a structured manual adapted by NELA. In this way,

these children will receive quality structured psychosocial support.

Economic empowerment will focus on the most needy and vulnerable households and most especially

women caring for orphans will be assisted with vocational training and micro finance to meet the expanding

responsibilities of caring for additional children. To complement this economic strengthening work and

bolster their food and nutritional security, the households will be supported with self-help projects in

agriculture and animal rearing. Appropriate linkages will be established for fertilizers and seeds for farming

from relevant ministries.

This project will promote positive attitudes towards the reduction and elimination of stigma associated with

HIV/AIDS by providing basic facts about HIV/AIDS, and involving people living with HIV including children

as role models during advocacy meetings and community dialogue. The project will facilitate birth

registration for children under five. Community based assistance will also be provided to OVC for

inheritance claims. In cases of child abuse, the children will be linked with any of the following: community

support committee, Social Welfare Department the LGAs, Legal Aid Organizations and the Ministry of

Women and Youth Development for appropriate resolution.

CONTRIBUTIONS TO OVERALL PROGRAM AREA:

The program will support capacity strengthening of Community Based Organizations implementing

household OVC programs as set out in the Emergency Plan. It will directly contribute to serving 3,004 OVC.

The program will improve the lives of OVC in line with the National HIV/AIDS Strategic Framework by

delivering sustainable and comprehensive quality care and support services. This will encompass all six

components identified in the National OVC Plan of Action as being essential for scaling up OVC support

effectively

NELA through the case management unit will support national response by provide technical backstopping

for the Federal Ministry of Women Affairs to support the State Ministries of Women Affairs in Kebbi,

Activity Narrative: Nassarawa, Adamawa, and Borno to plan manage, supervise, monitor and evaluate OVC service provision

in the states. The state and LGA capacity will also be supported to implement National Quality Assurance

Standards.

LINKS TO OTHER ACTIVITIES:

All partners at the community level will facilitate referrals to other organizations to fill in significant gaps. For

example where the governments are active in agriculture, partners will key in to the programme to ensure

that OVC household benefits from the services. The same will be applied to other service areas such Health

Care (ART for HIV positive children, Prevention services such as PMTCT and VCT), education and

economic empowerment programmes within each state. Priorities are likely to include advocacy to remove

constraints to access essential services, universal basic education (UBE), services of organizations such as

NAPEP and private sector support for OVC services (e.g. school support).

TARGET POPULATIONS: This program targets OVC and families affected by HIV/AIDS. It will provide

services to OVC and family members in community settings using existing established and accepted

community organizations as service providers.

EMPHASIS AREAS This program includes an emphasis on Multiplier and Local Organizations Capacity

strengthening, and community mobilization for support to OVC through advocacy. In addition, an emphasis

will focus on increased access to economic empowerment for households. NELA and partners will

encourage greater access to income generation opportunities through advocacy to regional branches of

institutions such as NAPEP and will encourage provision of UBE through advocacy to local and State

Government stakeholders. The program will also aim to support male and female OVC and address cultural

and economic factors that limit access to services of either gender and develop opportunities for women to

increase their access to economic resources.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

* Increasing women's access to income and productive resources

Health-related Wraparound Programs

* Child Survival Activities

Human Capacity Development

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 $144,146

Economic Strengthening

Estimated amount of funding that is planned for Economic Strengthening $216,218

Education

Estimated amount of funding that is planned for Education $144,145

Water

Table 3.3.13: