ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

Living Hope (LH) has modified its AB prevention program to address the needs of impoverished children

living in informal settlements and townships. LH aims to develop a formal referral network with other NGO

and government OVC programs where OVC identified in the AB program will be referred into social and

medical services to receive holistic services.

LH's Life Skills Educators will be trained on how to identify OVC within the AB program (school or after

school). This referral system will help fill the gaps between LH's effort to provide children with AB

messaging and helping vulnerable children (including child-headed homes) receive psychosocial and

medical support. Through interactions with the children during the AB activities, LH will also identify children

with other needs (e.g., school uniforms and supplies), who will then be referred to partners who can address

these needs. Through this referral system, children will access more services in line with their individual

needs and to apply the principles and lessons learned from the AB program. The aim is to enable children

to continue with their education and live in a more secure environment.

LH has started a new Wait4Me program that encourages pre-teens and teens to abstain from sexual activity

before marriage. This program creates an atmosphere of security and choice for teens that are often

pressured by peers to engage in sexual activity. The youth in the program sign a pact agreeing to abstain

from sex until marriage; this message is popularized among peers by wearing an identifying bracelet and

bandanas. The Wait4Me members routinely meet to discuss peer pressures, stigma, HIV risks and other

norms and behaviors. The Life Skill Educators will visit parents and guardians at home to encourage them

to support and reinforce the messages given to their children by the Life Skill Educators. Parents, guardians

and other members of the family will also be invited to Parent Days and special outreach activities, and

where necessary, referred to the basket of care offered by Living Hope or other partner organizations.

LH aims to reach 10,000 with AB message. The Life Skill Educators will conduct quarterly sessions using

drama, music and teaching for teenagers in 11 high schools. The following schools will participate: Ocean

View, Masiphumelele, Simon's Town, Muizenberg, Crestway, Lavender Hill, Steenberg, Grassy Park,

Heathfield, Sibeleus and False Bay College. This program aims to encourage young people to make good

choices, to delay sexual debut, and to access HIV counseling and testing and other health services. To

support more children in the communities, LH will start additional Afternoon Clubs in Ocean View and

Masiphumelele. These provide children with time to sing, play games and learn moral values via drama or a

story, and small discussion groups. The Afternoon Clubs offer more time to help them with the making of

good choices in their lives. It also enables the Life Skill Educators to assess the needs of the children so

that they can ensure that the program is relevant, meaningful and dynamic.

LH works in partnership with South African government primary schools to provide Department of Education

outcome objectives in Life Skills and attitude change towards HIV and AIDS. LH's focus on these skills-

based sexuality and HIV education programs in schools are directly in line with the HIV & AIDS and STI

Strategic Plan for South Africa, 2007-2011 (NSP). The adult and adolescent programs is also in line with the

NSP and South African government policy. LH is moving towards more programs that promote AB and

delayed sexual debut messages.

The LH AB programs target 4-14 year olds in public schools and the same age group through its community

-based Afternoon Clubs. It has been necessary to expand the afternoon programs to include more teens as

the youth graduate from our program and enter high school. The resulting Girls and Boys clubs have been

started to address gender related issues.

The Girls Clubs address issues such as understanding the menstrual cycle, mood changes, body changes

at puberty, fashion, hygiene, deportment, pregnancy, abortion and motherhood. The girls are encouraged to

understand themselves and to become more self-aware and to make positive choices with their lives.

Through this program, LH became aware of the fact that many girls stayed away from school during their

menstrual cycle due to not having sanitary ware, and in so doing missed 3-4 days a month of school, which

resulted in loss of education as they fell behind in the syllabus. LH, through various private donors is now

making sanitary ware available through the Girls Club, thus encouraging them to be better educated which

will result in more employment opportunities and sustainability in adulthood.

The Boys Clubs include sporting activities such as soccer and surfing. Several good male role models in the

Life Skills team seek to change the perception of males, and mentor and teach the boys the values of

responsibility, teamwork, taking instructions, integrity, the value of women, as well as understanding their

bodly changes, erections and the "breaking of their voices."

------------

SUMMARY:

Living Hope (LH) provides a comprehensive HIV and AIDS awareness and prevention education program

with an emphasis on abstinence and fidelity in schools, churches, workplaces, and community centers. The

program is values-based and targets vulnerable and impoverished groups residing in the Western Cape

peninsula, including migrants from the Eastern Cape into the Ocean View, Masiphumelele, Capricorn and

Red Hill areas of the Western Cape. The program's emphasis is gender and human capacity development

through life skills education for children and youth on HIV prevention.

BACKGROUND:

LH Community Center is an indigenous South African faith-based organization (FBO) formed in 1999 in

direct response to the HIV and AIDS epidemic. LH's response to HIV has grown to include a comprehensive

approach to the pandemic including HIV prevention programs for children, youth and adults, a 22-bed

Hospice for HIV care, home-based care, and pre- and post-test counseling. The LH network includes five

branches in different communities, with partnerships through local churches, local Department of Health

(DOH), hospitals, schools, as well as DOH clinics.

Activity Narrative: The prevention program curriculum utilizes the Scripture Union's "Jika" and "Reach for Life" program and

Family Impact's 'Positive Parenting' course. The success of LH's program is due, in part, to the development

of partnerships with other community stakeholders and service providers. LH works with over eight primary

schools, seven churches, and several private organizations including Homestead, All Nations, OIL,

Desmond Tutu Foundation, Vrygrond Development Trust, New World Foundation, and Next Generation.

LH's PEPFAR-funded activities are a continuation and expansion of some of the first programs conducted

by LH such as after school life skills programs and community interventions held in the clinic in

Masiphumelele. FY 2008 funding will be used to expand geographical focus to include new areas in the

Western Cape such as Muizenberg, Red Hill, Fish Hoek, Simon's Town, Ocean View and False Bay.

FY 2008 funding will be used to provide life skills education, youth clubs for children and teens, outreach

activities to increase risk perception and behavior change for adults, and training and mentorship for local

churches. Other community-based organizations (CBOs) will be supported to undertake HIV prevention

activities.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Human Capacity Development

LH's life skills educators are recruited from local communities and attend a life skills workshop with a local

CBO called Think Twice as well as Scripture Union. Each life skills educator also attends the AIDS Training,

Information and Communication, Basic HIV/AIDS information course. Several other short courses are

conducted to sharpen the skills of life skill educators, such that they are able to communicate effectively

with children and to be creative in their presentation of the prevention program.

The life skills educators will be educated on the needs of diverse audiences including children, youth and

adults. The educators address abstinence for pre-teens and youth as well as delayed sexual debut. The life

skills educators will be provided with ongoing follow-up support and supervision from LH's Prevention

Coordinator. Regular meetings to evaluate progress and monitor activities will be held.

As LH continues to build relationships with community and religious leaders, it will conduct HIV prevention

education at LH facilities and partner churches, workplaces, schools, and community centers with a focus

on behavior change. The behavior change communication (BCC) focus on abstinence for youth aged 10-14

before they start sexual activity and AB for youth aged 15-24 to encourage them to adopt secondary

abstinence and reduction of number of sexual partners. Adult men will be educated on male norms and

values to discourage cross-generational sex and multiple concurrent partnerships. Youth at risk due to their

sexual behavior and adults will be provided with full information on correct and consistent condom use and

referred to condom service outlets. HIV outreach activities aim to prevent youth at risk and adults from

becoming HIV-infected by (1) increasing understanding about the nature of the disease; (2) increasing

understanding about how HIV can be prevented through abstinence, or delaying sexual debut, being faithful

and partner reduction; (3) increasing personal risk perception about HIV infection; and (4) reducing

stigmatization and discrimination against people living with HIV.

LH is aware of the influence of community leaders and encourages community leaders to become

advocates for HIV prevention through ongoing outreach activities and training. LH equips community and

religious leaders with teaching materials and encourages them to teach others about male norms and

behaviors as well as gender roles and equity to discourage discrimination, violence, coercion and abuse

against women and girl children. LH provides ongoing support as requested by various community leaders

and will be available for further awareness and education in local churches, businesses or community

centers upon request.

LH's prevention activities aim to provide comprehensive health-related courses with an emphasis on HIV

and AIDS risk perception and behavior change. This activity is designed to increase HIV risk perception and

knowledge of HIV and AIDS, with an emphasis on AB as the best means of preventing transmission. Within

the Be Faithful messages, there is a strong emphasis on sexual partner reduction, discouragement of cross-

generational sex and multiple concurrent sexual partnerships.

ACTIVITY 2: Outreach and Education

FY 2008 funds will be used to provide in-depth education and training in life skills and basic health topics

with an emphasis on HIV prevention. The adolescents under 14 years are targeted before they start

engaging in sexual behavior through the outreach and education designed to change behaviors and

attitudes to prevent HIV. This activity will be conducted through a partnership with local government, in

public schools as well as community churches in underprivileged communities such Masiphumelele,

Vrygrond Ocean View and Red Hill.

The HIV prevention messages will be disseminated in various places where youth congregate. Prevention

messages and structured curricula will be delivered through church sermons, public school assemblies in

underprivileged communities, youth and after-school kids clubs in these communities, and holiday clubs

during school holidays.

LH has implemented a life skills development program for children and youth-based on an abstinence value

system. Specific activities will include weekly children's and teen's clubs that incorporate life skills training to

encourage healthy life choices, including delaying sexual debut, abstinence until marriage for children

before they start to engage in sexual activity and faithfulness once married, and to enable youth to resist

sexual pressures. Women and girls will be empowered through these workshops to say no to premarital,

extramarital, and unprotected sex.

ACTIVITY 3: Referrals and Linkages

Activity Narrative: Adults and youth at risk and those who are sexually active will be encouraged to test for HIV and will be

provided with referrals for counseling and testing at clinics in Masiphumelele, Red Hill, Ocean View, Fish

Hoek, Simon's Town, Muizenberg, Seawinds and False Bay. LH's lay counselors will offer a comprehensive

basket of services to people based on their HIV status. These services include South African government

ARV treatment programs, clinical services, LH and other home-based care, hospice care and support

groups. If an adult or youth know their status to be HIV negative they will likely be more empowered to

protect their negative status through AB and partner reduction if already sexually active.

LH has developed a partnership with the City of Cape Town Clinic in Masiphumelele, Red Hill, Ocean View,

Fish Hoek, Simon's Town, Muizenberg, Seawinds and at False Bay Hospital where LH's lay counselors

conduct pre- and post-test counseling for CT clients with clinic staff conducting the rapid-tests. The client is

also offered a comprehensive list of services for follow-up care or support. Full information on correct and

consistent condom use will be provided to youth at risk and adults. For individuals who test positive, the

program will provide referrals to support groups to encourage positive living and will ensure treatment

access.

FY 2008 funds will be used to expand the HIV prevention programs by using social workers to help needy

children and their families. The communities where the prevention program is active have high rates of

unemployment and drug and alcohol abuse coupled with little or no access to social assistance. LH will

seek to fill this social service gap by providing at least one social worker for the prevention program to help

link needy families with appropriate government or non-government social services. The social worker will

also help in conflict resolution and linking vulnerable or abused children with the appropriate authorities. The

prevention program will also network with other area service providers in the area to help coordinate needs

with service delivery which will help reduce overlap and redundancy.

New/Continuing Activity: Continuing Activity

Continuing Activity: 13993

Continued Associated Activity Information

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

System ID System ID

13993 3024.08 U.S. Agency for Living Hope 6679 481.08 $400,000

International

Development

7537 3024.07 U.S. Agency for Living Hope 4456 481.07 $400,000

International

Development

3024 3024.06 U.S. Agency for Living Hope 2675 481.06 $150,000

International

Development

Emphasis Areas

Gender

* Addressing male norms and behaviors

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $5,500

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.02:

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

Living Hope (LH) is due to receive its Council for Health Service Accreditation of Southern Africa

(COHSASA) accreditation in October 2009. This will give credibility to the service offered by LH and

provides an industry standard to work toward and maintain.

Living Hope will provide a family-centered holistic approach to people living with HIV and AIDS (PLHIV).

This will include symptomatic pain relief, medication optimisation and family respite relief. It also includes

counseling and education of family members of the patient with respect to HIV and/or TB medication

adherence.

LH's social worker, in addition to patient counseling for emotional needs, also provides practical assistance

in obtain disability grants, identity documents and where necessary, accommodation and placement in long-

term facilities. She will also refer to LH's sister organization, Living Grace, when faced with substance abuse

problems. Where applicable, bereavement counseling is provided. LH's in-house chaplains will provide

spiritual care and/or liaison with the individual patient's own spiritual counselor where required.

LH's in-patient unit provides linkages and referrals to its community-based staff, where patients are

residents within the geographical areas in which LH operates. LH staff will follow up and provide home-

based care, medication adherence advice, and general patient monitoring. When a patient is discharged

and resides outside of our area of operation, a referral is given to the provincial Department of Health for

them to ensure that adequate follow-up by other organizations is maintained.

Multi-drug Resistant (MDR) TB and Extremely Drug Resistant (XDR) TB are areas of concern. LH has

established protocols that require TB patients that are admitted to its in-patient unit to be on treatment for

14days prior to admission; otherwise, they will be isolated until their medication is proving to be effective.

Living Hope plans to enhance its isolation facilities in the in-patient unit facility as soon as funding allows.

Currently LH staff are under going training for TB DOTS and LH will therefore be able to provide TB

medication adherence and monitoring in the home context within the period of this operational plan.

Isoniazid preventive therapy, contact screening, active case finding and sensitivity testing is provided by the

local provincial government clinic or hospital. LH will coordinate its care program, which is HIV and AIDS-

focused, to that of a TB program to enhance the level of service to patients who are co-infected with HIV

and TB.

Both in-patient and community-based patients are referred to our Support Group Facilitators and are visited

by these people in either the hospice or the home. The patient therefore has a support system established

from the earliest opportunity where they can associate with people in similar circumstances and receive

ongoing advice, prevention counseling, general counseling and spiritual counseling..

Referrals to other services such as occupational therapy, physiotherapy, speech therapy and nutritional

services are also provided.

Living Hope seeks to increase the professionalism of all its care workers and provides specialized palliative

care training, IMCI (integrated management of childhood illnesses), Advanced Home-based Care and

Patient Advocacy training for LH's Community-based and facility-based care givers.

LH's community and facility-based care providers are given pre-service basic palliative care training. This is

an HPCA-accredited 59-day palliative care training. It enables LH carers to provide the basic elements of

palliative care service according to South African Government (SAG) standards and to provide a higher

standard of Community-based Care (CBC), including IMCI.

LH also encourages experienced CBC givers to participate in advanced home base care courses

administered by "Peninsula Training & Assessments". This training includes advanced issues such as

better management, patient environment awareness, infection control, patients with special needs, etc.

This training equips CBC's to provide comprehensive care to families of HIV-infected individuals, including

children. This will result in improved health status of for all family members.

Additional training includes advocacy training that encourages community members to consider HIV testing

and initiating ART and helps to reduce stigma in the community. Advocacy training includes education

relating to ARV medication and its side effects, monitoring of patient adherence to the taking of their

medication, the statistical reporting on patient condition and compliance, and the referral process.

All home-based and in-patient unit care givers are provided with regular in-service or refresher training on

the required medical services. This training is provided by peer HBC staff or Living Hope nurses.

Living Hope desegregates adult care data collected by gender to make informed decisions for planning,

identifying gaps in gender care to help LH develop a more family-centered approach to care and treatment

services.

In an effort to prioritize reaching more women in LH's adult care program, the majority of LH's palliative care

staff are women. This improves the confidentiality and comfort of women seeking HIV specific treatment or

care. LH also provides training for the women in its adult care program to recognize signs of gender-based

violence and provide appropriate counseling and HIV referral services to the community.

---------------------------

SUMMARY:

Living Hope (LH) will provide in-patient hospice care and home-based care (HBC) for HIV-infected

individuals in the Western Cape peninsula. The program will also provide elements of the preventive care

Activity Narrative: package, post-test counseling and support groups for PLHIV. The emphasis areas include human

resources, training and the development of referral systems. The main target population is people living with

HIV.

BACKGROUND:

Living Hope Community Center is an indigenous South African FBO formed in 1999 in direct response to

the HIV and AIDS epidemic. The activities below are ongoing; PEPFAR funding for this activity began in

2005, helping to expand LH's reach into high risk communities with HBC, caring for caregivers and

providing hospice-based services and referrals.

LH is working in partnership with the False Bay Hospital by providing a lay counselor for PMTCT counseling

and support and with a local government clinic in Masiphumelele, Fish Hoek, Muizenberg, Ocean View,

Simon's Town, Red Hill and Seawinds Clinic where lay counselors assist in offering pre and post-test

counseling.

LH coordinates with the DOH to ensure that their care activities complement the HIV and AIDS strategy of

local government facilities and strengthening their prevention and care policies. With non-PEPFAR funds,

LH has also constructed a 22 bed hospice to care for HIV-infected patients referred by local hospitals and

HBC givers in the surrounding communities to offer culturally appropriate end-of-life care, symptom and

pain management, and referral for ART.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Human Capacity Development

All members of LH's HBC and hospice staff receive specialized training in palliative care including the basic

preventive care package. LH is working in partnership with the Palliative Association of South Africa to

develop a carefully managed, outcomes-based, training curriculum for their home-based caregivers. The

training modules and time frames are still under development but will be have the accreditation of the

Hospice Palliative Care Association (HPCA) and will be tailored for the needs of the caregivers. LH has had

negative experience with some of the other outsourced training programs so this provided the motivation to

tailor-make a training program.

LH will provide comprehensive HBC to people in four Western Cape communities - Masiphumelele, Ocean

View, Red Hill, and Muizenberg. This specifically includes people living with HIV (PLHIV) and their family

members. HBC caregiver visits incorporate nursing care, personal hygiene, HIV and AIDS education to

infected individuals and family members, screening for symptoms and pain and referral when treatment it is

unavailable through routine nursing care. All patients are assessed, referred for ART, TB, STI, OIs and are

provided with follow-up and ongoing care and support including the provision of DOTS and cotrimoxazole

when appropriate.

LH utilizes a family-centered approach to the provision of care. HBC caregivers spend time in the homes of

those who are ill and get to know the client's family, presenting an opportunity to provide training and

support to the family caregivers. This includes discussions on knowing one's HIV status and PMTCT for

pregnant women that will include safe infant feeding practices and family planning. This training and support

for the caregivers of PLWA and their families will include a comprehensive package of basic information

about caring for their family member, pain and symptom management and relief in the administration of

care. Preventive measures in home-based care are also covered. The hospice also provides ARV treatment

and clinical care for those eligible (treatment is procured and funded by the Western Cape DOH).

The HBC program will include services also provided by the Wound Dressing Clinics in Masiphumelele,

Muizenberg, and soon to be Ocean View Communities. The wound dressing clinics provide basic clinical

services one would find in drop-in clinics including dressing of wounds, treatment for basic injuries and

referrals to social or hospital services. These locations and services provide an effective means to establish

relationship with those individuals who are HIV-infected and need HBC or other services. It is also an

opportunity to encourage all individuals to get tested.

As part of the HBC activity a system will be established for the referral of HIV-infected individuals needing

holistic inpatient and/or hospice services (including those experiencing acute HIV-related illnesses,

including TB and other opportunistic infections) to LH's hospice or other appropriate healthcare institutions

for preventive care and symptom and pain management. A system will also be established for the referral

and follow up of ARV treatment-eligible patients to the nearest public health treatment site.

ACTIVITY 2: In-patient Hospice Care

LH will provide holistic in-patient care at their 22-bed hospice facility (20 of those beds are funded by

PEPFAR and are shorter term). The hospice is designed to provide palliative in-patient care to adults and

children over 12 with pain and symptom management such as those who are experiencing acute HIV-

related illnesses including TB, other opportunistic infections, and any other HIV and AIDS complication

requiring inpatient care. In addition to short-term hospice care, LH and its staff provide a place to die in

peace and dignity with psychosocial and culturally appropriate bereavement and spiritual support to the

patient as well as their family members.

The hospice is part of a network of care and support offered by LH that works in collaboration with

government and other NGO HIV and AIDS services in the area such as ART, counseling and testing and

clinical support including the basic package of care. LH also provides transportation for clients to access

any of the medical or care services required in the area from hospital care, clinical results or collecting the

ARVs for patients at the LH hospice.

Activity Narrative: ACTIVITY 3: Non-clinical Care and Support

As part of providing comprehensive palliative care, LH places an emphasis on meeting emotional and

spiritual needs. There are weekly support groups and one-on-one counseling available for HIV-infected

community members where they find acceptance, hope, encouragement and support needed to live a

productive and satisfying life. Those who attend are also coached in how to plan for their family members

who may be affected by an HIV-infected member of the household. LH's social workers link the OVC and

other vulnerable family members to social services, government grants where applicable, non-USG

nutritional support through temporary food parcel delivery, skills training, as well as ongoing emotional and

spiritual support.

ACTIVITY 4: Referrals & Linkages

The referrals system links HIV-infected people from initial pre and post-test counseling with LH lay

counselors to appropriate next level of service such as psychosocial support, home-based care,

government clinic or hospital services, PMTCT support or hospice care.

The LH Hospice receives and sends out referrals via partnerships with local area government hospitals and

clinics. Local hospitals refer clients to the hospice or home-based care program if the patient requires this

level of care. LH's social worker and chaplain are also called upon in many cases to visit or work with clients

from the government hospitals and clinics.

Home-based caregivers also refer and receive clients from local area hospitals or community members that

are aware of LH's service. Many times, clients looking for home-based care inquire about these services at

local hospitals and then the client is referred to Living Hope. Home-based carers are also being utilized in

area clinics to assist in wound care. They are learning as well as providing additional medical support in

these clinics. From this, better cooperation and referral linkages are made.

LH is in the process of developing a planned approach to South African Business inviting partnerships with

those businesses looking to fulfilling their social responsibility to reduce HIV infections in the workforce.

FY 2008 activities will be expanded to include an additional full day professional care staff to help provide a

broader level of clinical and medical services to clients in LH's home-based care programs. This service will

contribute to the holistic care and improve the basket of services to care clients. The geographic reach and

number of sites will remain the same although targets will increase due to improved 'family member'

indicator tracking and counting and more integration between the prevention program linking clients who

require the service to care providers.

In the above activities, PLHIV will receive at least one clinical and one other category of palliative care

service. Palliative care to family members of PLHIV or OVC will be provided in at least two or the five

categories of palliative care services.

This activity specifically contributes to the overall PEPFAR objectives of 2-7-10 by providing direct health

care, emotional and spiritual support or those who are HIV-infected and their families.

New/Continuing Activity: Continuing Activity

Continuing Activity: 13994

Continued Associated Activity Information

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

System ID System ID

13994 3025.08 U.S. Agency for Living Hope 6679 481.08 $325,000

International

Development

7538 3025.07 U.S. Agency for Living Hope 4456 481.07 $325,000

International

Development

3025 3025.06 U.S. Agency for Living Hope 2675 481.06 $250,000

International

Development

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $3,500

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.08:

SUMMARY:

Living Hope will offer counseling and testing (CT) and adherence counseling services in partnership with

government clinics and hospitals of the Deep South Peninsula of the Western Cape as well as a mobile

clinic in partnership with Stellenbosch University.This will be achieved by the placement of trained

counselors or lay counselors in the identified sites, and utilising the facilities made accessible through the

partnerships.

BACKGROUND:

Living Hope endevours to maintain a family centred approach by encouraging partners, husbands and

children of the CT and PMTCT clients to come for testing and receive referrals to HIV care and support

services. In particular, Living Hope's CT and PMTCT programme targets partners of pregnant women to

provide them with couples CT and a referral network for prevention services and other health information or

services they may need. Living Hope offers support for disclosure and encourages couples counseling to

reduce stigma and potential violence in the community. The involvement of men in the programme also

improves prevention with positives and provides interventions for discordant couples. Living Hope provides

CT services through partnerships with government hospitals and clinics, as well as using its own facilities

where the government does not have a presence. Living Hope offers the following training through the AIDS

Training Information and Counseling Centre (ATICC): A 10 day information course, a 20 day intensive

counseling course, a 10 day ARV course, and a 5 day paediatric counseling course. The two primary

government partners are False Bay Hospital in Fish Hoek and the Nozamo clinic in Masiphumelele. These

partnerships contribute to improving the links and proper function between HIV services which encourages

community members to utilize them. The CT programme and the related PMTCT element also feeds HIV

individuals into a confidential support group system whereby members receive ongoing health, nutrition,

sexuality and HIV education as well as psycho-social support.

ACTIVITIES AND EXPECTED RESULTS:

Living Hope will carry out six separate activities in this program area.

ACTIVITY 1:Training

Living Hope offers the following training via other service providers: Nutrition counseling and breast feeding

(with the support of a nutritionist from the Provincial Administration of the Western Cape), condom training

and register training (with a sub-district co-ordinator), couples-counseling (through the Provincial

Administration of the Western Cape), and support group facilitation training (with Philippi Trust). Living

Hope also offers counselors in-house training via volunteers and its prevention manager on leadership (with

Rolling Hills), dealing with stress (with Brentwood), public speaking (with Shades Mountain), personal

motivation, and the "Seven Laws of the Learner" course.

ACTIVITY 2: Counseling

Living Hope provides pre- and post-test counseling in cooperation with Department of Health (DOH) at

seven clinics in six different communities including Fish Hoek, Muizenberg, Ocean View, Masiphumelele,

Simons Town and Red Hill. We also partner with government clinics and hospitals in Fish Hoek and

Masiphumelele to provide help to lay counselors for the pre- and post-test component of the desperately

needed voluntary counseling and testing (VCT) services.

ACTIVITY 3: Referrals

The clients that test positive for HIV are referred to False Bay Hospital, Ocean View clinic, Masiphumelele

clinic, Living Hope's In-Patient Unit (hospice) or home-based care (HBC) service, depending on the patient's

needs and location. The referrals involve access to services such as prevention of mother-to-child

transmission (PMTCT), antiretroviral therapy (ART), HBC, social services, counseling, chaplain care and

support group meetings. In addition, Living Hope counselors network with Living Hope support group

facilitators to refer clients to prevention or care services. This referral system ensures ongoing support for

clients going through the CT programme and creates a better safety and service net of HIV services for the

community.

ACTIVITY 4: Partner Counseling

Lay counselors continue to counsel the partners of post-test clients to educate them on the risks of

HIV/AIDS, as well as encourage them to come for testing. The result has been a slight increase of males

coming for testing and it is hoped that the partners will provide each other with mutual support as well as

remaining sexually faithful to one another.

ACTIVITY 5: Facilitative Support to Access PMTCT

Living Hope also provides testing and counseling for pregnant mothers and encourages them to take up

PMTCT services. After delivery, Living Hope follows up with new mothers to counsel them on proper

feeding and encourages mothers to test their children for HIV. During her pregnancy, if a pregnant woman

finds out that she is HIV-infected and has received counseling from a Living Hope counselor, she is referred

to a Mother 2 Mother mentor who becomes her companion and mentor during the pregnancy. All HIV-

infected pregnant women are also encouraged to attend regular support groups which are co-led by a

Living Hope counselor, a Living Hope support group facilitator and a Mother 2 Mother mentor. After the

delivery of the baby Living Hope discovered a gap of care for the mother and baby as they seem to get "lost

in the community." Living Hope seeks to follow up with the mothers up and encourages them to continue to

attend a support group where they are taught parenting skills, provided with information about early

childhood diseases and development, and encouraged to continue to follow all that they were taught in the

Activity Narrative: PMTCT programme such as no mixed feeding.

ACTIVITY 6: Community Outreach

As part of the CT programme, LH will also participate in community outreach and awareness campaigns to

raise awareness of HIV services, reduce stigma and increase the demand for CT services. To do this LH

has embarked on partnering with other community organisations or using volunteer teams to work alongside

its staff and offer blood pressure and sugar glucose testing at sites in the community, together with HIV

testing and tuberculosis (TB) screening. The volunteers have assisted in providing entertainment for the

community, while they wait for their respective tests to be done, as well as promoted the services offered at

Living Hope.

Living Hope disaggregates gender data to help maximize data use for informed decision making, program

design, budget allocation and developing recruitment strategies to improve the quality of the programme.

New/Continuing Activity: New Activity

Continuing Activity:

Emphasis Areas

Gender

* Addressing male norms and behaviors

Health-related Wraparound Programs

* Safe Motherhood

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $1,489

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14: