This activity relates to activities in HVAB (7183), HVOP (7184), HVCT (7182), HBHC (7187), HKID (7186), OHPS (7189), and MTCT (7179, 8185, 8698).

The Community HIV/AIDS Mobilization Program (CHAMP), through financial support and technical and institutional capacity building for Rwandan partner organizations, is working to ensure Rwandan communities have equitable access to high quality, sustainable continuum of HIV & AIDS care services. CHAMP supports the provision of community services in all EP-supported districts, especially around EP-supported health facilities.

In FY 2006, CHAMP is training trainers from various community and faith-based organizations to promote PMTCT services by including messages on early ANC attendance, facility deliveries, infant feeding practices, early infant diagnosis and male involvement through home visits and group talks. CHAMP trains volunteers to promote and support exclusive breastfeeding for HIV-positive lactating mothers and to support mothers during the cessation period and provide information about appropriate weaning foods and nutrition counseling.

In FY 2007, CHAMP will continue to provide training for community volunteers to promote PMTCT as part of their training for care to OVC and PLWHA. CHAMP will work with EP-supported clinical partners to strengthen the referral system to get pregnant women to PMTCT services and assist the clinic-based case managers who will provide follow-up to ensure proper treatment adherence. CHAMP will also link women in PMTCT and their families to other key community services, including PLWHA associations, income generating activities, community gardens, malaria prevention and treatment, child survival and health programs, and food assistance. CHAMP will not have any direct targets in this area, but will contribute to increasing the number of people receiving PMTCT services by EP clinical partners.

These activities support the key legislative issues of increasing gender equity in HIV/AIDS programs and decreasing gender and discrimination by assisting pregnant women to access PMTCT services as a routine part of ANC. These activities will indirectly contribute to the PMTCT targets achieved by EP clinical partners and will contribute to the goal of averting new HIV infections.

This activity relates to MTCT (7181), HVOP (7184), HVCT (7182), HBHC (7187), HKID(7186), OHPS (7189), and HVAB (8130, 7199).

CHF/CHAMP, through financial support and technical and institutional capacity building for Rwandan partner organizations, is working to ensure Rwandan communities have equitable access to high quality, sustainable continuum of HIV & AIDS care services. CHAMP supports the provision of community services in all EP-supported districts, especially around the EP-supported health facilities.

The CHAMP program will mobilize and support community-based HIV prevention efforts, including prevention for positives, that focus on abstinence and/or fidelity. CHAMP will provide technical and financial assistance to Rwandan CBOs and FBOs who will incorporate prevention messages into their programs for community and religious leaders, youth, families affected by HIV/AIDS, and OVC including child-headed households.

In FY 2006 CHAMP-supported partners are reaching over 9,000 individuals with abstinence and/or faithfulness messages and training over 300 community volunteers to provide these messages.

In FY 2007 many of the general prevention activities will be transferred to the new prevention RFA being issued by USAID. However, CHAMP will continue to provide technical and financial support to Rwandan partner organizations to include appropriate and targeted prevention messages in their programs for OVC and PLWHA. Messages will be delivered through face-to-face interactions and will use a family-centered approach, addressing the entire household. These messages will include the linkages between alcohol use, violence and HIV; stigma reduction; abstinence; fidelity; partner reduction; the vulnerability of young women; and, the importance of knowing you and your family HIV status. This program will reinforce the norms of Rwandan society which have led to a relatively late age of sexual debut (20.3 among women 25-49 and 20.8 among men 25-59). This is especially important as traditional family and community structures are affected by HIV and AIDS. In addition, the programs will support activities which will enable individuals to practice abstinence and/or faithfulness, such as life skills and income generating activities, and will address the societal norms surrounding cross-generational and transactional sex.

CHAMP will continue to use and distribute IEC materials developed in FY 2006 and will ensure their partners have access to best practices developed by other EP implementing partners. The messages and tools used by this activity will increase the effectiveness of CBOs and faith-based networks and their volunteers to change high-risk behaviors and norms and to effectively promote abstinence before marriage and fidelity in marriage.

These efforts address key legislative issues related to gender, specifically increasing gender equity in HIV/AIDS programs, addressing male norms and behaviors, and violence and coercion, and support the Rwanda EP five-year strategy to support youth peer education and parent/child counseling through church networks and support mass media and church-based campaigns addressing HIV risk.

This activity relates to MTCT (7181), HVAB (7183), HVCT (7182), HBHC (7187), HKID(7186), OHPS (7189), and HVOP (7200, 8138).

Through financial support and technical and institutional capacity building for Rwandan partner organizations, the CHF/CHAMP is working to ensure Rwandans have equitable access to high quality, sustainable continuum of HIV & AIDS care services. CHAMP supports the provision of community services in all EP-supported districts, especially around EP-supported health facilities.

CHAMP mobilizes and supports community-based HIV prevention efforts, including prevention for positives and discordant couples, by providing technical and financial assistance to Rwandan CBOs and FBOs who will incorporate these messages into their programs for community and religious leaders, youth, families affected by HIV/AIDS, and OVC including CHH.

To date, CHAMP-supported partners have reached more than 4,000 individuals with prevention messages that went beyond abstinence and being faithful. CHAMP also trained more than 100 community volunteers to provide these messages. During FY 2006, CHAMP trained Rwandan partners to incorporate prevention messages, especially for high risk populations, into their community-based activities. CHAMP is producing IEC materials with other prevention messages and is conducting IEC sessions in EP supported districts.

In FY 2007, many of the general prevention activities will be transferred to the new prevention RFA being issued by USAID. However, CHAMP will continue to provide technical and financial support to Rwandan partner organizations to include appropriate and targeted prevention messages in their programs for OVC and PLWHA. These messages will include the linkages between alcohol use, violence and HIV; stigma reduction; abstinence; fidelity; condom awareness and use; partner reduction; shifting social norms; and, the importance of CT for the entire family.

CHAMP will continue to use and distribute IEC materials developed in FY 2006. CHAMP will also collaborate with other EP partners to implement best practices. These C/OP messages and tools will increase the effectiveness of Rwandan partner organizations to educate communities about risky behaviors and the correct and consistent use of condoms among appropriate target groups.

These efforts address key legislative issues related to gender and stigma and discrimination. This activity also reflects the Rwanda EP five-year strategy to target high risk groups.

This activity relates to activities in MTCT (7181), HVAB (7183), HVOP (7184), HVCT (7182), HBHC (7187, 7160, 7163, 7165, 7177, 8141, and 8144), HKID (7186) and OHPS (7189, 8181).

The Community HIV/AIDS Mobilization Program (CHAMP), through financial support and technical and institutional capacity building for Rwandan partner organizations, is working to ensure Rwandan communities have equitable access to high quality, sustainable continuum of HIV & AIDS care services. CHAMP supports the provision of community services in all EP-supported districts, especially around EP-supported health facilities.

CHAMP works with three Rwandan umbrella organizations which collectively support over 1,000 associations representing women, PLWHA and the religious community, and six other Rwandan partner organizations. CHAMP provides financial and technical assistance to these organizations to provide comprehensive, quality services to PLWHA. In addition to building their technical capacity, CHAMP works with these organizations (and their member associations as appropriate) to build their capacity to manage programs, finances, and human resources with the ultimate goal of directly receiving donor funding in the future.

In FY 2006, CHAMP is providing over 20,000 PLWHA with a package HIV-related palliative care services, including income generating activities, psychosocial and spiritual support, improved nutrition and links to food assistance, community gardens, HIV prevention, HBC, and legal and human rights support. CHAMP is training 3,000 volunteer caregivers (primarily family members and members of PLWHA associations) in communities to provide these services. CHAMP is supporting the finalization and implementation of a national palliative care policy and is providing technical input to the national palliative care TWG.

In FY 2007, CHAMP will continue to provide a menu of community-based services to PLWHA with a focus on expanding availability, improving quality, and strengthening referrals. CHAMP will work closely with clinic-based case managers to ensure PLWHA and their families receive a comprehensive package of services. Case managers in the health facilities will support PLWHA receiving clinical care to ensure follow-up and continuity of clinical services as well as link them to community services. CHAMP-supported community groups will provide a variety of services for PLWHA and the availability of these services will be documented and shared so that case managers and other clinic-based staff will be able to easily refer clients to these activities. Community-based services will also include referral to health facilities, especially for testing and care. CHAMP will ensure that communities are aware of and have access to other USG-supported clinical and community initiatives such as PMI, child survival and health programs, and food assistance. CHAMP-supported partners will reach 22,000 individuals with a comprehensive menu of services in FY 2007.

In FY 2007, CHAMP will train or offer refresher training to 3,000 community volunteers and caregivers and provide support to those caregivers trained previously. In order to ensure sustainability of these programs, CHAMP will use a training of trainers approach, building the knowledge and capacity of the staff of partner organizations and their association members to further train their members as community volunteers. These community volunteers will take a family-centered approach during home visits to PLWHA, monitoring and referring the children of HIV-affected households to OVC community services as necessary and encouraging parents and guardians to test their children. In this way, volunteers will help identify more HIV-positive children and family members and link them to appropriate care and treatment. CHAMP will also work to increase male involvement in providing care as well as support women and girls as they tend to be the majority of primary care givers. CHAMP will work closely with the Rwandan Association of Trauma Counselors (ARCT) to build the capacity of CHAMP partner organizations to provide quality counseling services and psychosocial support.

CHAMP will also provide support to the Palliative Care Association of Rwanda (PCAR) to build their capacity to ensure the future of quality palliative care services in Rwanda. PCAR has received limited technical and financial support from the African Palliative Care Association (APCA) in Uganda to train palliative care service providers and advocate for a supportive environment for community-based care. CHAMP will support PCAR with

technical, administrative, financial and managerial capacity building.

CHAMP will work with its partners and the GOR to conduct appropriate M&E, data collection and use, and management of resources in order to improve the quality of HIV care and support services at the community level. CHAMP will continue to support existing local partners and add additional partners in FY 2007.

This activity addresses the key legislative issues of gender, stigma and discrimination and wrap-arounds, especially of food and income generation. This activity supports the EP five-year strategy to integrate HIV prevention, care and treatment, expand pediatric HIV care, and mobilize community coordinated action.

[CONTINUING ACTIVITY FROM FY 2006 -- NO NEW FUNDING IN FY 2007]

Scaling up the integration of TB and HIV services is a fundamental component of the Rwanda EP five-year strategy. Through the Global Fund TB grant, PNILT piloted community DOTS in three districts in Cyangugu, Butare and Umutara provinces. PNILT, which is responsible for the National Tuberculosis Program in Rwanda and also serves as a key coordinating entity for GFATM implementation of Rwanda's TB grant, is an active participant in the development and piloting of the community-based DOTS approach. In line with PNILT national protocols, CHAMP will fund additional community DOTS activities in five USG-supported districts to reach 100 HIV/TB co-infected patients. Building from the experiences of PNILT and Global Fund, CHAMP will train 50 volunteers in the following technical areas: TB DOTS, recognition of symptoms and signs of TB among HIV-positive patients and their family members, referrals for TB screening and treatment, and promotion of and referral for HIV testing of TB patients of unknown status. The TB DOTS approach includes selection of suspect cases in the community, directly observed treatment, adherence support, contact tracing, follow-up at clinics to ensure treatment completion, and regular communication with HIV/AIDS care service providers at health facilities. CHAMP will also train HBC volunteers to refer suspected family members and caregivers of PLWHA and OVC for HIV and TB testing and treatment. This will increase the identification of TB/HIV co-infected individuals and their access to clinical and community HIV/TB services.

CHAMP will collaborate and plan with other USG partners supporting clinical services in the five districts to establish a system of support and referrals between health facilities and the TB DOTS volunteers, including the use of referral slips and the provision of transport fees to the health facility. CHAMP will work with PNILT and the EP clinical service partners to integrate TB/HIV related indicators and patient information into volunteer monitoring tools and registers to better ensure TB treatment adherence and the quality of services. EP-supported health centers and PNILT-identified supervisors will provide periodic supervision and monitoring of community DOTS volunteers. With support from PNILT, EGPAF and Columbia/UTAP, CHAMP will integrate pediatric TB/HIV tools and messages into all TB/HIV activities. CHAMP will sensitize communities around USG-supported health facilities to TB/HIV co-infection and promote TB/HIV testing and treatment through the dissemination of IEC materials. CHAMP will also work with RRP+, district authorities, PNILT, Columbia UTAP, WHO and Global Fund to implement a national policy and scale-up plan for community-based DOTS. Expanding community DOTS activities will indirectly contribute to the TB treatment goals of the EP and increase adherence to the treatment.

With additional funds, CHAMP will continue to work through their Rwanda partner organizations to both improve the quality of existing services and expand the number of OVC receiving services. Additional funds will supplement regular COP07 funding for expanding and improving the quality of services currently being offered, i.e. education, vocational training, health, food aid, protection, psychosocial support, shelter and basic needs. Since secondary school education in Rwanda is costly and start-up kits for vocational training graduates are expensive, CHAMP will use a portion of these funds to increase the number of current OVC who have access to the two services

In addition, CHAMP will use remaining funds to identify and serve 3,684 new OVC and ensure they have access to the full range of services, including health mutuelles, education, vocational training, food aid, protection, psychosocial support, shelter and basic needs. In identifying new OVC, CHAMP will address the needs of special populations such as children under five, adolescent girls, children living outside of family care, and out of school youth. CHAMP will also need to prioritize OVC in the same family due to the recent change in health insurance policy.

This activity relates to MTCT (7181), HVAB (7183), HVOP (7184), HVCT (7182), HBHC (7187), OHPS (7189), and HKID (8727, (7148, 7155, 7156).

Through financial support and technical and institutional capacity building for Rwandan partner organizations, CHAMP is working to ensure Rwandan communities have equitable access to high quality, sustainable continuum of HIV & AIDS services. CHAMP supports the provision of community services in all EP-supported districts, especially around EP-supported health facilities.

CHAMP works with three umbrella organizations - which collectively support over 1,000 associations representing women, PLWHA and the religious community - and six other Rwanda partner organizations. In FY 2007, CHAMP will continue to provide technical and financial assistance to these partner organizations and their members to provide comprehensive, quality services to OVC. CHAMP will also add new partners. In addition to building their technical capacity, CHAMP will work with the partners (and their member associations as appropriate) to build their capacity to manage programs, finances, and human resources with the ultimate goal of directly receiving donor funding in the future.

In FY 2006, CHAMP serves as the main coordinating mechanism for EP-supported OVC activities through three activities. First, CHAMP provides TA, training, and financial support to local partners to support and strengthen their capacity to directly provide care. Second, CHAMP supports the GOR programs and policies for OVC by seconding technical staff at the central level. Third, CHAMP incorporates Track 1.0 OVC programs in national planning and data collection through M&E training. CHAMP advances the network model by linking HIV/AIDS clinical and community partners, and by wrapping around non-HIV/AIDS services that are supported by other funding streams.

To ensure sustainable change, CHAMP will support and strengthen existing natural social linkages in the community for child protection, care and support.

To date, CHAMP has provided financial and technical support to nine subgrantees in 20 districts to reach over 17,000 OVC with a menu of services and trained 745 caregivers. In addition, CHAMP has been actively involved in the finalization of the GOR's OVC NPA, which implements the 2003 National Policy for Orphans and Other Vulnerable Children. The GOR's menu of essential services for OVC closely mirrors the EP's core services and includes education, health, shelter, food, economic strengthening, psychosocial support, protection and HIV prevention. The GOR developed the OVC NPA with the input of children through two National Children's Summits. The ongoing participation of children in these decisions will be supported by the district and sector level children's forums and orphan care committees.

In FY 2007, CHAMP will continue to support the OVC NPA through participation on the OVC TWG, participation in a national OVC mapping exercise in conjunction with MIGEPROF, and secondment of a technical advisor in MIGEPROF to oversee implementation of the OVC NPA. CHAMP will continue to work closely with its subgrantees and the EP Track 1.0 partners to assess the needs of individual OVC, and offer multiple

services and/or refer OVC to other services in the community based on their needs. This approach will be standardized among all EP OVC partners using forms and referral systems established in FY 2006. CHAMP will work to fill gaps and improve the quality of services currently being offered and expand services to ensure OVC have access to them, especially in the catchment areas around EP-supported health facilities. CHAMP will give special attention to child headed households and to OVC in communities surrounding military camps. CHAMP-supported partners will reach 35,400 OVC with a comprehensive menu of services.

CHAMP will train 5,000 OVC caregivers in psychosocial support, protection, HIV prevention and ways to link to other services such as education, healthcare, food and vocational training. CHAMP will ensure that caregivers trained in FY 2006 receive follow-up support and refresher training as needed.

CHAMP will continue to wrap around other USG-funded and CHAMP-supported OVC programs where appropriate. This includes Title II food support, the Ambassador's Girls Scholarship program, the Presidential Malaria Initiative, and other general health services for children supported by USG's child survival and health program, such as vitamin A distribution, immunization, and deworming.

This activity supports the key legislative issues of gender, stigma and discrimination, and wraps around food and education. This approach reflects the EP five-year strategy to integrate HIV prevention, care and treatment; expand pediatric HIV care; and mobilize community coordinated action.

This activity is related to activities in MTCT (7181), HVAB (7183), HVOP (7184), HBHC (7187), HKID (7186), OHPS (7189), and HVCT (7178, 8164, 8168, 8169).

The Community HIV/AIDS Mobilization Program (CHAMP), through financial support and technical and institutional capacity building for Rwandan partner organizations, is working to ensure that Rwandan communities have equitable access to a high quality, sustainable continuum of HIV/AIDS care services. CHAMP supports the provision of community services in all EP-supported districts, particularly around EP-supported health facilities.

In FY 2006, CHAMP is training trainers from various community and faith-based organizations to promote CT services among OVC, PLWHA, their families and caregivers through home visits and group talks. By the end of FY 2006, over 3,000 individuals will have received messages on the importance of counseling and testing for HIV prevention, care, and treatment.

In FY 2007, CHAMP will continue to support the promotion of CT among OVC and PLWHA and their families who are being served by CHAMP-supported partners. This targeted promotion of CT services will identify those most likely to be infected and ensure they are referred to appropriate sites to receive care and treatment. CHAMP will not have any direct targets in this area, but will contribute to increasing the number of people served by clinical partners and mobile CT activities.

This activity supports the Rwanda EP five-year strategy to scale-up quality CT services and addresses the key legislative issue of stigma and discrimination.

[CONTINUING ACTIVITY FROM FY 2006 -- NO NEW FUNDING IN FY 2007]

Rwanda is decentralizing all HIV/AIDS prevention, care and treatment services, with HIV services, including ART, being expanded to the lowest level of care. To reduce the burden on health center staff, CBOs will take on a larger role in the care and support of patients on ART. Community and HBC volunteers will provide follow-up treatment adherence counseling, basic nursing care and monitoring of ART patients in their homes and at approximately 90 ARV sites in collaboration with clinical ART service providers and DHTs. CHAMP will support TRAC, USS and CNLS in developing a training curriculum for HBC volunteers in coordination with HCs and DHTs. Training content will include basics of ARV treatment and care, including basic care, referrals recommendations, IMCI and growth monitoring for HIV-infected and exposed infants, and counseling for treatment adherence, nutrition, and ART support. TB/HIV will be integrated into the curriculum to build capacity of volunteers to identify and monitor TB and TB treatment adherence through DOTS for ART patients and their family members. CHAMP will support the DHT to develop formal referral plans, forms and registers to ensure appropriate referral for ART patients to HBC and community ART support services.

CHAMP will support TRAC, USS, and CNLS to develop a system for transferring patient information between ART sites and community HBC services, including development of patient monitoring cards for use by medical facilities and HBC volunteers. CHAMP will support TRAC, USS and CNLS to integrate HBC ART patient information, such as deaths, into the national ART reporting system. CHAMP-trained community volunteers will refer family members of ART patients for HIV testing and treatment. CHAMP will identify wrap-around food support for ARV patients, particularly HIV-infected children and pregnant HIV-infected mothers. This program will promote ART treatment, stigma reduction, community support of PLWHA, and community-adapted IEC materials (building from existing IEC prevention, care and treatment materials developed by TRAC and FHI). No targets are counted for this activity because all sites and patients are included in direct ARV service counts. These activities contribute to successful attainment of direct ARV service targets and treatment adherence, as described in the Rwanda EP five-year strategy.

This activity relates to MTCT (7181), HVAB (7183), HVOP (7184), HVCT (7182), HBHC (7187), and HKID (7186).

Through financial support and technical and institutional capacity building for Rwandan partner organizations, CHAMP is working to ensure Rwandan communities have equitable access to a high quality, sustainable continuum of care through HIV and AIDS services. CHAMP supports the provision of community services in all EP-supported districts, especially around EP-supported health facilities.

In FY 2006, CHAMP is providing financial and technical support to nine sub-grantees in 20 districts to reach over 17,000 OVC and 20,000 PLWHA with various support services. In addition, CHAMP sub-grantees is delivering prevention messages to 13,000 individuals and trained over 2,000 volunteers in the promotion of abstinence, fidelity, condom use, counseling testing, PMTCT, and a menu of services for OVC and PLWHA.

This support was largely provided through local Rwandan NGOs, of which CHAMP currently counts nine organizations as partners. Of these nine, three are considered "umbrella" organizations which collectively support over 1,000 associations representing women, PLWHA and the religious community. In FY 2006, capacity building activities started with a brief assessment of each organization's management capacities, including financial, human resources, strategic planning, M&E, QA, and fundraising. Individual capacity building plans were developed based on these initial assessments. CHAMP is also working with partners to develop five-year strategic plans and is organizing a workshop on financial and grants management.

In FY 2007, CHAMP will work with these sub-grantees (and their associations as appropriate) to build their capacity to manage programs, finances, and human resources with the ultimate goal of directly receiving donor funding in the future. CHAMP will not only provide trainings to improve management capacities, but will also look at linking Rwandan NGOs with international organizations that are present and active in Rwanda for mentoring purposes. CHAMP will add an additional three sub-grantees in FY 2007.

In addition to managerial capacity building, CHAMP will continue to provide TA to these sub-grantees and their members to provide comprehensive, quality services, especially for OVC and PLWHA as well as their families and caregivers. The direct outputs of this activity is the provision of financial and managerial skills-building to 12 Rwandan NGOs and build the human resource capacity of 60 individuals.

This activity reflects the Rwanda EP five-year strategy to achieve sustainability by developing organizational and human resource capacity.