Through the PEPFAR-funded HIGA UBEHO program, USAID and its partners (led by CHF) will support stability and resiliency among 72,000 HIV/AIDS affected and other vulnerable Rwandan households. The strategic objectives of HIGA UBEHO, which means 'be determined and live' in Kinyarwanda, include increasing vulnerable household access to quality health and social services; improving household resilience through economic, nutritional and educational investments; and strengthening local government and civil society capacity for health and social service provision.

In its second year, the local and international partners of HIGA UBEHO will build upon the holistic HIV/AIDS care, treatment, prevention and household resilience framework established FY 2009 (year 1 of the program). Key features included expanded technical assistance to OVCs through economic, educational and nutritional outreach; and health and social service system strengthening through Rwandan Partner Organizations and local government capacity building.

Targeted Sexual Prevention: In FY 2010, HIGA UBEHO will reach households with OVC, and PLWHA with organized communication activities to influence community and social norms, and promote behavior change. HIGA UBEHO will deliver behavior change messages through a variety of approaches including interpersonal communication, radio, community events and print materials. These messages will give voice to PLWHA and their families, as well as service providers, providing practical, immediate actions that they can take to improve their quality of life. Messages will focus on the full package of community- based health, social and economic development services provided within HIGA UBEHO, as well as other wrap-around programs such as malaria, sexual and gender based violence prevention, tuberculosis, prevention of mother-to-child transmission, family planning.

Economic Stability and Household Resilience: In FY 2010 HIGA UBEHO's Adult Care and Support efforts will be geared towards achieving 3 major effect objectives, using a stratified approach to economic strengthening, based upon varying levels of household skill sets and resource bases: 1) increased revenue of targeted abahizi (the term will be used for program beneficiaries. It refers to individuals who are committed to reach their objectives) through integration into profitable value chains; 2) increased employment opportunities of CHH and other youth (18-22) through marketable vocational training and apprenticeships, building upon the work of CHAMP; and 3) increased household savings through increased participation in Internal Savings and Lending Groups (ISLGs) for abahizi households. Integrated within this framework, HIGA UBEHO will provide targeted food security assistance to vulnerable households through promotion of improved agricultural process and production (e.g., Farmer Field Schools) and improved household nutrition (e.g., use of the positive deviance hearth model and media-based behavior change outreach efforts).

OVC Care: In FY 2010, HIGA UBEHO program will continue to serve as the main coordinating mechanism for PEPFAR-supported OVC activities. Using a network approach, HIGA UBEHO will link HIV/AIDS clinical and community partners by connecting community members with wrap-around and non- HIV/AIDS services that are supported by other funding streams to ensure that OVC and their families receive a comprehensive package of services tailored to their needs. In FY 2010, HIGA UBEHO will also strengthen existing natural social linkages in the community for child protection, care and support, work closely with RPOs and districts to strengthen OVC identification and create a national OVC database, assess the needs of individual OVC and their families, and offer multiple services and/or refer OVC and their families to other services in the community, based on these needs. Specifically, HIGA UBEHO will expand its support to OVCs from 43,000 to approximately, 55,000. The program will use the child status index and link closely with the GOR's National OVC M&E system to ensure proper OVC follow-up, referral

and service provision. Dovetailing on the school fees and uniforms distribution effort undertaken in FY 2009, HIGA UBEHO will indirectly engage with the schools in which they are enrolled, to address constraints to continued school enrollment and retention. The "Living A Productive Life" campaign will utilize multiple channels to mobilize greater support for school attendance and retention, including radio programming, community fairs, fun-academic (educational events which include entertainment and cultural activities) competitions and cultural performances.

Health Systems Strengthening and Capacity Building: In FY 2010, HIGA UBEHO will continue to provide financial and technical support to 17 RPOs to improve their capacity to provide quality services to Abahazi. During the operational year, HIGA UBEHO will also introduce a community of practices to link RPO with capacity to those in need. The Community of practices will help RPOs learn from one another in technical and organizational development areas. HIGA UBEHO will increase its focus on organizational mentorship during COP 10, providing additional onsite interaction between HIGA UBEHO facilitators (CHF, CRS, CARE staff) and RPO service providers for the technical implementation of activities, financial management, service quality assurance and organizational development.

This is continuing activity under a new award

CHF/Higa Ubeho was awarded in FY 2009 to continue to support community based activities for people living with HIV/AIDS (PLHA) and their families. In FY 2010 CHF will focus on increasing the financial stability of vulnerable households through economic initiatives. These activities will be targeted towards OVC, PLHA, and their families. The overarching strategy of this program is to strengthen the stability of households through improved finances, advanced vocational skills and better nutrition. Through selection process based on the revised MIGEPROF tools for identification and profiling of vulnerable children, Higa Ubeho will identify households in need of assistance and target them for specific economic strengthening activities. Existing PLHA groups, associations and cooperatives from the previous CHAMP program will also be targeted in this initiative. A referral system which provides forward and backward linkages across the components of Higa Ubeho will engage community groups and abahizi (participants) in this program.

Higa Ubeho activities will be geared towards achieving the major objectives: increased revenue of targeted abahizi through integration into profitable value chains; increased employment opportunities for CHH and other youth (age group 18-22) through marketable vocational training and apprenticeships; and increased household savings through greater participation in Internal Savings and Lending Groups (ISLGs) for abahizi households. Higa Ubeho will adopt a tiered and stratified approach to economic strengthening of vulnerable households, a strategy based on the reality that individual households have different resource and skill sets, and thus different needs. At the top of this pyramid, Higa Ubeho will identify strong, well organized and long established cooperatives of abahizi which will act as models for the abahizi groups in the process of organizing economic activities.. The model cooperatives will be given specialized support to ensure that they remain efficient, which will lead to increased revenues for their members. This will ensure that they not only serve as examples to the many pre-cooperatives and groups of vulnerable abahizi but also provide them new potential market outlets and sources of income.

For the resource-constrained, poor and vulnerable groups at the bottom of the pyramid, Higa Ubeho will focus on building their asset base by providing support in establishment of ISLGs and linking them to formal banking institutions (as well as the Umurenge SACCOs) as means of accessing credit. Higa Ubeho will train the ISLG members in market literacy, financial literacy and basic house hold budgeting, including prioritization of payments for health insurance, school materials and basic nutrition. Trainings in succession planning and the legal rights of children to property will be provided as well.

Higa Ubeho will also work towards building the productive capacity of the more organized pre cooperatives by engaging private input dealers to develop seed and input distribution systems. Support

to agronomic excellence through farmer field schools, field days and demonstration will ensure wide dissemination of farming best practices to beneficiary communities. This will lead to enhancing food security for the most vulnerable households.

In FY 2010 Higa Ubeho will build on the work of CHAMP by targeting CHH and out of school OVC (18-22 years) with vocational training. Emphasis will be placed on identifying marketable vocational skills and providing training on these skills to CHH and youth referred through Higa Ubeho's program linkages. A select number of vocational institutions will be supported in integrating business skills training into their standard package of vocational training. In order to increase the inclusion of youth into employable vocational training, the program will initiate an apprenticeship program through which CHH are exposed to real world business environments and gain hands on skills in various sectors. Higa Ubeho will continue to provide vocational education subsidies for this training.

In FY 2009, the Higa Ubeho program provided financial and technical support to nine Rwandan Partner Organizations (RPOs) in 20 districts, reaching over 45,000 OVC with a menu of services and training 6,000 OVC mentors. In FY 2010 Higa Ubeho will continue to build the institutional capacity of RPOs working to give vulnerable groups access to essential health and social services, and to build more resilient families through economic and social coping mechanisms. This program will also consider the end of the Track 1.0 OVC agreements during FY 2009 and will ensure a smooth transition for their beneficiaries in the 20 districts where Higa Ubeho is operating.

Higa Ubeho will serve as the main coordinating mechanism for PEPFAR-supported OVC activities by providing TA, training and financial support to local partners to support and strengthen their capacity to provide care directly, as well as by supporting GOR programs and policies for OVC by seconding technical staff at the central level.

Higa Ubeho will continue to advance the network model by linking HIV/AIDS clinical and community partners, and by connecting community members with wraparounds and non-HIV/AIDS services which to ensure that OVC, PLWHA, and their families receive a comprehensive package of services tailored to their needs. To ensure sustainable change, Higa Ubeho will: support and strengthen existing natural social linkages in the community for child protection, care and support; work closely with RPOs and districts to strengthen OVC identification and support the GOR to build a national OVC database; assess the needs of individual OVC and their families; and offer multiple services and/or refer OVC and their

families to other services in the community, based on their needs. The child status index (CSI) will be utilized to monitor the well-being of children and all information reported to the GOR's national OVC M&E system.

In addition to supporting individual OVC and their families, Higa Ubeho will indirectly engage with their schools to address constraints to continued school enrollment and retention. The "Living a Productive Life" campaign will utilize multiple channels to mobilize greater support for school attendance and retention, including radio programming, community fairs, academic competitions and cultural performances. Higa Ubeho will identify (or establish, if necessary) and build the capacity of Parent- Teacher Associations (PTAs) at participating schools, in line with MINEDUC objectives. Schools targeted under this intervention will be identified in partnership with district education officers. Criteria for selecting schools will include willingness to participate in the project and having a minimum threshold of project-supported OVC enrolled at the school. And to break the chain of absenteeism and poor performance, Higa Ubeho will establish 'Drop-Out Prevention Response Teams' within the supported PTAs. Trained PTA members will form these teams and use common profiles to recognize the signs that a child is at risk of dropping out of school and proactively intervene using a toolkit of strategies to be developed by Higa Ubeho, based on demonstrated good practice in Rwanda.

To support primary education Higa Ubeho will offset family financial constraints by providing school kits consisting of essential school supplies and uniforms, tailored to the different needs of each grade. In addition, Higa Ubeho will sensitize communities to the importance of education, particularly for vulnerable populations such as girls and CHH as part of the "Living a Productive Life" messaging.

For children completing primary education who do not qualify for upper secondary education, or who choose not to go, assistance will be provided to enroll in a Technical and Vocational Education and Training (TVET) program. Higa Ubeho will complement existing TVET services by providing program youth with an initial interest survey and/or self-assessment tool to help them identify the program which best matches their interests.

Higa Ubeho will continue to give special attention to child-headed households and take a family centered approach to providing care. Higa Ubeho will continue to support the implementation of the OVC policy through participation on the OVC TWG, and secondment of a technical advisor in the MIGEPROF, the GOR entity charged with coordination of OVC services.

In FY 2010, Higa Ubeho is projected to reach 55,000 OVC with the comprehensive menu of services outlined in the national strategic plan of action for OVC. The program will also train 7,000 OVC mentors in psychosocial support, protection, HIV prevention, and referral strategies for education, healthcare, food

and vocational training services. This program will continue to serve as a wraparound with other USG- funded programs and activities as appropriate, including for food assistance and other general health services for children supported by USG's child survival and health program, such as vitamin A distribution and immunization.

In FY 2010, Hiba Ubeho partners will continue to support the promotion of HCT among OVC and PLWHA and their families. Building upon CHAMP's success and ensuring a smooth transition of services for households with PLWHA and OVC, this program will continue to build the institutional capacity of Rwandan Partner Organizations and mobilize Community Intermediaries (including many of those trained under CHAMP) to promote utilization and increase availability of high quality, sustainable HIV and AIDS services and wrap-around services. Higa Ubeho will support the provision of community services in the 20 PEPFAR-supported districts, especially referrals to PEPFAR-supported health facilities and programs.

Through the "Living a Productive Life" campaign, messages will be delivered to promote HCT among OVC and PLWHA and their families through a variety of approaches including interpersonal communication, radio, community events and print materials. This targeted promotion of HCT services will identify those most likely to be infected and ensure they are referred to appropriate sites to receive care and treatment. In collaboration with clinical partners and mobile HCT providers, secondary school OVCs attending holiday camps and who seek to know their HIV status will be encouraged for HCT. Higa Ubeho partners will not have any direct targets in this area, but will contribute to increasing the number of people served by clinical partners and mobile HCT activities.

Building on experience gained from collaborating with decentralized and national level structures, HIIGA UBEHO will provide capacity building assistance to decentralized level structures such as districts and sectors. The goal of capacity building to government entities will be to strengthen the knowledge of key staff in four core areas: (1) Beneficiary selection, (2) Service provision, (3) Program monitoring and (4) Best practices dissemination.

Higa Ubeho will conduct a capacity assessment to ascertain the capacity of districts in the above mentioned four core areas. After the assessment, Higa Ubeho will work with the district offices to

develop district capacity building plans to guide the capacity building process and ensure buy-in from district-level officials. Based on the resulting plans, Higa Ubeho will train these officials on skills related to the four core areas. Higa Ubeho looks forward to training district authorities and sector staff. This training process is facilitated at the district level by the RPO point of contact of Higa Ubeho within the district.

Higa Ubeho will continue to provide technical assistance as needed to the National AIDS Control Commission (CNLS), MOH, the Ministry of Gender and Family Promotion (MIGEPROF), the Ministry of Local Government and Social Affairs (MINALOC) and other GOR stakeholders.

In FY 2010, Higa Ubeho will provide financial and technical support to 17 RPOs to reach over 55,000 OVC and 60,000 households of most vulnerable people within the intervention areas. In addition, these RPOs will deliver a "Live a Productive Life" message to Higa Ubeho beneficiaries through 3,000 community intermediaries (CI) and 3,600 ISLG and 11,000 caregivers trained.

Higa Ubeho will work with these local organizations to build their capacity to manage programs, finances, and human resources with the goal of directly receiving donor funding in the future. As part of its efforts to strengthen civil society organizations, Higa Ubeho will initially conduct a brief assessment of each organization's management capacities, including financial, human resources, strategic planning, M&E, QA, and fundraising. Subsequently each RPO will develop individual capacity building plans to address issues not already covered in the required trainings. Higa Ubeho will then tailor support to each organization depending on its identified needs. Higa Ubeho will provide specific training to RPO staff in the following areas: human resource procedures; monitoring and evaluation; business development; project financial and grant management; organizational and good governance; program management and ethics; communication and community mobilization and participation. Higa Ubeho will also build the organizations' technical capacity by training RPO staff in a number of technical topics related to HIV prevention, care and treatment including: child rights and protection against abuse; adolescent reproductive health; family planning; psycho-social support in OVC programs and education; sexual and gender based violence, economic development; food security; and mainstreaming gender. In addition to organizational capacity building and training RPO staff on technical topics, Higa Ubeho will provide TA to these sub-grantees and their members to provide comprehensive quality services by supporting the training of community intermediaries in data collection; prevention through AB and methods beyond AB; and spiritual and psychosocial counseling skills.

Higa Ubeho will use a customized blend of formal participatory learning, on-site assistance, and practical monitoring and evaluation that ensures RPOs are using their new skills in their daily implementation. HIV/AIDS-specific intervention capacity building addresses technical weaknesses identified through the

capacity assessments, while ongoing capacity building and TA are tailored to each organization's particular needs and are monitored regularly. Higa Ubeho will regularly evaluate RPO performance and capacity building effectiveness and adjust capacity building and implementation plans accordingly.

With the goal of having RPOs directly receiving and managing donor funding in the future and to ensure the link between the service providers in capacity building, Higa Ubeho will introduce a Community of Practices model to link RPO with capacity to those in need. The community of practices will help RPOs learn from one another in technical and organizational development areas. Secondly, CHF will build RPO mentoring capabilities by teaching capacity building techniques to RPOs. In this way, RPOs will, at different points, be both teachers and learners, initiating collaborative relationships that will last beyond the life of the project.

In FY 2010, the Higa Ubeho (Be determined and live) program will commence activities, under a new agreement. Building upon the success of the CHAMP project and ensuring a smooth transition of services for households with PLWHA and OVC, this program will continue to build the institutional capacity of Rwandan partner organizations (RPO) and mobilize community intermediaries (including many of those trained under CHAMP) to promote utilization and increase availability of high quality, sustainable HIV/AIDS services and wrap-around services. Higa Ubeho will support the provision of community services in all PEPFAR-supported districts, especially referrals to PEPFAR-supported health facilities and programs.

In FY 2010, Higa Ubeho will target households with OVC and PLWHA with organized communication activities to influence community and social norms, and promote behavior change. Health communication messages, on abstinence, sexual delay, fidelity and partner reduction, as well as topics on social and community norms, will be delivered through a variety of approaches including interpersonal communication, radio, community events and print materials. These messages will give voice to PLWHA and their families, as well as service providers, providing practical, immediate actions that they can take to improve their quality of life. Messages will focus on the full package of community-based health, social and economic development services provided by Higa Ubeho, as well as other wrap-around programs such as malaria prevention, sexual and gender based violence prevention, tuberculosis, prevention of mother-to-child transmission and family planning.

In addition, an effective community-based referral system will allow PLWHA and their families to receive

appropriate services in a timely manner without the fear of stigma or discrimination. Integrating PLWHA and their households into a network of services in health, education, social services and food security, as well as the economic stability will improve resilience.

Supportive supervision will be provided to RPOs to collect, analyze and monitor data. With this infrastructure in place, sectors should be able to collect and enter data into the beneficiary database and each sector will then be able to use the database to track beneficiaries and services in their catchment areas. Villages and Cells (Village is the lowest and Cell is the next higher administrative structure) will benefit by being able to access information to ensure better service provision and decision-making as well. RPOs will be responsible for providing regular reports and feedback at the sector level. Given the integrated nature of the proposed social services for vulnerable populations (SSVP) program, Higa Ubeho will use a comprehensive M&E system to monitor and evaluate activities effectively to inform programming, monitor progress, and evaluate impact.

In FY 2010, the Higa Ubeho (Be determined and live) program will commence activities, under a new agreement. Building upon the success of the CHAMP project and ensuring a smooth transition of services for households with PLWHA and OVC, this program will continue to build the institutional capacity of Rwandan partner organizations (RPO) and mobilize community intermediaries (including many of those trained under CHAMP) to promote utilization and increase availability of high quality, sustainable HIV/AIDS services and wrap-around services. Higa Ubeho will support the provision of community-based services in all PEPFAR-supported districts, especially referrals to PEPFAR-supported health facilities and programs.

In FY 2010, Higa Ubeho will target households with OVC and PLWHA with organized communication activities to influence community and social norms, and promote behavior change for condom use, STI management, and risk reduction. Messages will be delivered through a variety of approaches including interpersonal communication, radio, community events and print materials. These messages will give voice to PLWHA and their families, as well as service providers, providing practical, immediate actions that they can take to improve their quality of life. Messages will focus on the full package of community- based health, social and economic development services provided by Higa Ubeho, as well as other wrap- around programs such as malaria prevention, sexual and gender based violence prevention, tuberculosis, prevention of mother-to-child transmission and family planning.

In addition, an effective community-based referral system, and community-based psychosocial support will allow PLWHA and their families to receive appropriate services in a timely manner without the fear of stigma or discrimination. Integrating PLWHA and their households into a network of services in health, education, social services and food security, as well as the economic stability will improve resilience.

Supportive supervision will be provided to RPOs to collect, analyze and monitor data. With this infrastructure in place, sectors should be able to collect and enter data into the beneficiary database and each sector will then be able to use the database to track beneficiaries and services in their catchment areas. Villages and Cells (Village is the lowest and Cell is the next higher administrative structure) will benefit by being able to access information to ensure better service provision and decision-making as well. RPOs will be responsible for providing regular reports and feedback at the sector level. Given the integrated nature of the proposed social services for vulnerable populations (SSVP) program, Higa Ubeho will use a comprehensive M&E system to monitor and evaluate activities effectively to inform programming, monitor progress, and evaluate impact.