In COP09 AIDSTAR will maintain services to the 14,400 OVC reached in COP 08 and train an additional 2,000 Caregivers in Enugu, Imo, Delta, Akwa Ibom, Rivers, Bayelsa, Gombe and Taraba States. COP 08 Narrative ACTIVITY DESCRIPTION: This is a new activity and it links to AIDSTAR activities in AB prevention to ensure that all OVC get age-appropriate prevention messaging integrated into their general health care. An analysis of the current USG Nigeria OVC portfolio, conducted by the USG Nigeria's Orphans and Vulnerable Children (OVC) TWG and reinforced by recommendations from previous technical assistance (TA) assessments, identified a number of key programmatic gaps: current paucity of indigenous partners to take programs to scale; poor understanding of OVC definitions by implementing partners; inadequate monitoring and supervision; weak referral networks between facility-based and community-based partners; lack of coverage in high prevalence states; few programs addressing the needs of adolescent OVC, particularly females; and little programming for young married girls in Northern Nigeria who have increased vulnerability. In addition to these programmatic gaps, the analysis identified a number of contracting constraints, as the current in-country capacity for making awards to new partners is limited by the current capacity of indigenous, civil society organizations (CSOs) to respond to the USG solicitation and award standards. The analysis also showed that to achieve community-level service provision and comprehensive services, a partner is needed with the technical expertise and implementation capacity to not only envision, but also have the ability to rapidly develop a large-scale effort in a country as large, complex and challenging as Nigeria. Finally, the analysis noted that implementing partners should have the mandate and capacity to engage local partners to ensure that the program is implemented comprehensively at the grassroots level. Based on these recommendations,

the AIDS Support and Technical Resources (AIDSTAR) Indefinite Quantity Contract (IQC) mechanism has been selected as a new partner under COP08, due to the fact that AIDSTAR contractors have demonstrated technical capacity in a range of technical areas related to care and support addressing multifaceted needs of OVC and palliative care. These include pediatric home-based care, gender, stigma and discrimination, and program-related data collection and analysis. This partner will work closely with the inter-agency OVC TWG and will be overseen by the PEPFAR Nigeria Senior Management team to ensure that it is integrated within the broader USG OVC portfolio. The scope of work will be developed in conjunction with the OVC TWG, and targets and specific activities will be shared with O/GAC prior to award, as is USG/Nigeria's practice for TBD activities. The Nigeria OVC task order will use AIDSTAR to provide: 1. Long-term in-country support for coordination and scale-up of HIV/AIDS activities in support of USG/Nigeria OVC strategies. 2. Service delivery focusing on the multifaceted needs of OVC, including home-based care for infected children, gender issues related to the vulnerability of female OVC and heads of household, stigma and discrimination. Specifically AIDSTAR contractors will: a) Identify OVC: Activities will be designed to build provider understanding of who is eligible for OVC services, and work with communities and clinical service providers to identify all children that are eligible for services. The geographic area of focus for AIDSTAR activities will be in areas of Nigeria with HIV prevalence at or above the national average that are underserved, particularly in the Southeast, South-South, North East and North West regions. Community-based and faith-based organizations in particular will be targeted as sub-partners. b) Develop a holistic OVC service model: AIDSTAR contractors will understand and establish the standard level of care for each of the 6+1 services using standards and practices that have been developed with USG support and GON collaboration. All OVC will receive at least 3 of these services, one of which must be psychosocial support. These services will be delivered through a family- centered and community-based model that reaches out to all children in a family infected/affected by HIV/AIDS. c) Ensure a multi-program and multi-sectoral referral system: AIDSTAR contractors will collaborate and form linkages/referrals between existing clinical and community-based partners within the geographical area of focus. In some states, AIDSTAR contractors will serve as case managers that coordinate referrals for OVC to ensure comprehensiveness of services. Wherever possible, community partners will engage with and link to clinical service providers; refer clients for HCT, care, and treatment; accept client referrals; and use this as a starting point to engage families in order to assist all children infected with or affected by HIV/AIDS. d) Address girls vulnerability issues: AIDSTAR contractors will focus activities in key Northern and Southern states where increased vulnerabilities of female girls are common, and provide support for girls' continuation in, or return to, school as well as improve outreach and linkages with HIV-related health services, particularly outreach efforts by USG projects (ACQUIRE, ACCESS, and Pop Council). 3. Increase the technical capacity of Nigerian decision-makers and personnel to design and implement effective, evidence-based HIV/AIDS interventions. Specifically, AIDSTAR contractors will: a) link with State Ministries of Women's Affairs (SMOWA) in focus states to build technical capacity so that they can roll out national-level policies, strategies, guidelines, quality

assurance, and data collection systems; b) provide technical support to FMOWAs to plan, manage, monitor and evaluate OVC service provision; and c) contribute to OVC program M&E in collaboration with the USG SI team and PEPFAR IPs tasked with overall M&E and SI capacity building. 4. Document and disseminate successful innovative approaches and sustainable models, evidence-based best practices and lessons learned, and new approaches, tools and methodologies in HIV/AIDS OVC programming. This activity substantively contributes to the overall USG Nigeria's Five-Year Strategy and to the implementation of Nigeria's National Plan of Action on OVC by developing and strengthening the community based service delivery for affected children. The suggested targets are determined based on the current estimated cost per targets for a minimum package of OVC interventions. As this is an IQC mechanism, the prime partner and final targets will be vetted with O/GAC and uploaded into COPRS after final award negotiations. The programs and activities implemented will increase the reach of OVC underserved populations and geographic areas with fairly high HIV/AIDS prevalence in comparison with the national average. LINKS TO OTHER ACTIVITIES: The activities implemented under the AIDSTAR IQC will achieve set targets for OVC served and caregivers trained while also providing clear linkages between their own activities and the wider OVC portfolio as implemented by other IPs. Strong linkages with the LMS project will be developed as LMS focuses on institutional capacity building in the FMOWA, while AIDSTAR focuses on increasing technical capacity. The emphasis on dissemination of best practices will also help develop the sustainability and efficacy of the program. POPULATIONS BEING TARGETED: Populations targeted in these activities will include all OVC, with particular focus on the female adolescent OVC in the Northern and Southern parts of Nigeria. Also targeted are community members, traditional leaders, religious leaders, men and women who act as caregivers for OVC. EMPHASIS AREAS: Emphasis areas will include human capacity development. The service delivery component of this award will have a key focus on community mobilization/participation and local organization capacity development. Other emphasis areas are development of network/linkages/referral system; information, education and communication and linkages with other sectors and initiatives.