SUMMARY:

The message of Abstinence and Be Faithful (AB) is promoted through two interventions: (1) youth mentors

are equipped to deliver a values-based AB curriculum to youth in a school context or as part of a peer

education group; and (2) pastors are equipped to promote AB to their congregations through integrating

messages into standard church activities (sermons, funerals, groups of women, men, and youth.). The

major emphasis area of this activity is information, education and communication of AB messages; and the

minor area will be training and community mobilization in promoting AB as a lifestyle.

BACKGROUND:

The Salvation Army is an international Christian denomination with specific community programs to address

all aspects of HIV and AIDS through community-based care and prevention programming: home-based

care, provision of OVC psychosocial support, individual pre- and post-test counseling, clinical care of

opportunistic infections, community counseling, and youth mobilization. Matsoho A Thuso is a care and

prevention project that has received PEPFAR funding since FY 2004. Prevention activities focus on

capacitating Salvation Army churches to address HIV prevention through training pastors and church

volunteers to conduct outreach in churches, schools and the wider community. The project currently

operates in 58 sites with Youth Mentors going to different schools to promote AB during the Life Orientation

classes. This is done in conjunction with the Department of Education on local levels. Salvation Army also

operates in 33 sites with pastors promoting the message in churches and surrounding communities, in eight

of South Africa's nine provinces, many of which are in rural and underserved areas.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Training of Youth Mentors

Salvation Army will train South African volunteers as youth mentors. These youth mentors will be equipped

to assist in the facilitation of life orientation lessons, conduct school assemblies, and lead peer support

groups for youth who wish to commit to a lifestyle of abstinence before marriage. The curriculum used for

this purpose contains 30 lesson plans complete with student activities that will assist youth in building the

skills they need to pursue abstinence before marriage. These include development of the ability to attach

consequences to actions, assertiveness and the ability to withstand peer pressure. The curriculum also

challenges misperceptions about male norms and behaviors in order to assist in addressing issues related

to gender. The learners are challenged to see that boys and girls have the same responsibility with regards

to reducing the spread of HIV. Girls are empowered with the necessary information and skills to delay their

sexual debut even when they are pressured by their male counterparts. These lessons are planned to suit

learners from higher primary to secondary school levels. Youth mentors will be expected to represent the

values of the program and act as role models to in-school youth. As of FY 2006, 95 youth mentors have

been trained to implement A and AB outreach activities in the school setting. FY 2007 funding will be used

to train additional Youth Mentors and to increase the support and supervision provided to program

volunteers to ensure the intensification of services. Refer to explanation of training activities section for FY

2008 plans.

ACTIVITY 2: AB Outreach in Schools/Peer settings

Youth mentors will promote abstinence before marriage for children aged 14 and below, and abstinence

before marriage and faithfulness within marriage to youth aged 15 and above in a school or peer group

setting. The program will support the South African Government (SAG) life skills program in schools through

providing AB prevention services throughout the country. Youth mentors will be assigned to schools

identified in collaboration with the SAG Department of Education for two terms. Each youth mentor will

conduct 30 lessons for each class. Lessons also include development of character and promotion of

abstinence as a way of life. The curriculum also challenges misperceptions about male norms and

behaviors. This has been a useful tool to address issues of gender equality and gender equity among the

youth and the prevention programs are made accessible for both boys and girls. Initially it was planned that

youth mentors would visit schools twice a week, however most schools have requested that youth mentors

provide services daily. Youth mentors will ensure that all OVC identified in schools are referred to the OVC

program. As of June 2006, this activity has reached over 16,000 youth with A and AB messages. Refer to

explanation of training activities section for FY 2008 plans.

ACTIVITY 3: Mobilization and Training of Church Leadership

The third activity is to mobilize church leaders (pastors) to engage their congregations on issues of

abstinence and faithfulness. The Salvation Army will capacitate pastors to find positive language that extols

the benefits of abstaining before marriage and being faithful within marriage, and to aid them in giving their

congregations tools that will further reinforce the message. Pastors will be trained using a field-tested

curriculum to introduce abstinence, fidelity and related topics of character building into sermons and Bible

Studies curricula. In the period ending June 2006, a total of 62 pastors were trained from 62 churches. In

FY 2007 the project will train an additional cadre of pastors to intensify and expand service delivery. Project

staff will provide supervision and support to pastors to ensure that prevention activities are being

implemented in each church. Pastors will also be encouraged to take a leadership role supporting the care

and support and OVC programs run by the Salvation Army. This will ensure that linkages are made

between the different components of the project and will provide mentorship to the volunteers. Refer to

explanation of training activities section for FY 2008 plans.

ACTIVITY 4: Outreach activities for congregation members

Pastors will exercise their influential status in communities to address the prevention of HIV through

encouraging the adoption of A and B behaviors. Pastors will discuss the reduction of multiple and/or

concurrent partners as a methodology to mitigate the spread of HIV in their communities. Anecdotal reports

indicate that the corps/churches that are implementing the program demonstrated an increased awareness

to the fact that benefits of prevention will be attained through Abstinence and Being Faithful. Pastors will

disseminate values-based information and education in church and community gathering settings including

at sermons, funerals, and during women's, men's and youth group activities.

Activity Narrative: Salvation Army's prevention activities will contribute to PEPFAR's goal of averting seven million HIV

infections among adults and youth. Refer to explanation of training activities section for FY 2008 plans.

SUMMARY:

A trained cadre of Salvation Army volunteers will provide home-based palliative care (HBC) to people living

with HIV and AIDS in order to contribute to their quality of life, provide spiritual and psychological support to

the client and their family, monitor the client's health, and facilitate access to clinical care. This activity will

focus on training, in addition to community mobilization/participation and the development of linkages and

referral systems.

BACKGROUND:

The Salvation Army is an international Christian denomination that addresses all aspects of HIV and AIDS

through community-based care and prevention programming: home-based care, provision of OVC

psychosocial support, individualized pre- and post-test counseling, clinical care of opportunistic infection,

community counseling, and youth mobilization. Matsoho A Thuso is a care and prevention model begun in

November 2004 with PEPFAR funding. Palliative care activities focus on capacitating members of Salvation

Army churches to provide psychological, social, spiritual and limited clinical support as well as prevention

services to people living with HIV and AIDS in their communities. The project currently operates in 50 sites

in eight of South Africa's nine provinces, many of which are in rural and underserved areas. In FY 2008

Salvation Army will expand and enhance care activities through retraining of caregivers as well as providing

a comprehensive range of services to the HBC clients.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Training of Caregivers

The main objective of the training is to increase skills in delivery of quality palliative care services including

elements of the preventive care package. Utilizing the Salvation Army's extensive volunteer base, the

Salvation Army will train and equip community members to carry out basic home-based care services. The

training will be conducted by an accredited service provider with South Africa's Health and Welfare Sector

Education and Training Authority. Each home-based caregiver will also receive a basic home-based care kit

containing equipment such as gloves, disinfectant and bandages to ensure that they are able to provide an

acceptable quality of care to people living with HIV and AIDS throughout the country while maintaining

adequate precautions. In the first year of the project, a total of 101 caregivers have been trained to provide

services. In order to intensify and improve the quality of services in FY 2008, additional caregivers will be

trained. On-going mentoring and supervision will be provided by health facility staff and Salvation Army

trainers to promote the retention of volunteers and to minimize burn-out. Increased participation by men will

be encouraged in service delivery.

ACTIVITY 2: HBC Services

Trained caregivers will identify clients in consultation with the community. Home visits will be conducted four

times a month to provide clinical as well as social, psychological or spiritual services. Services provided will

include elements of the preventive care package, assistance with bathing the client when s/he is unable to

do so, tending to household duties when needed, providing spiritual and psychological support to the client

and their family, and monitoring the client's status over time which will assist qualified health care providers

in the management of opportunistic infections. A checklist with comprehensive palliative care services will

be used to track the services rendered. Thus far Salvation Army has provided care and support to 538 HIV-

infected individuals. In FY 2008 Salvation Army intends to intensify and expand services provided to HIV-

infected individuals and their families. This activity will also contribute towards reducing stigma and

discrimination against people living with HIV. The project aims to foster a culture of support and acceptance

for people living with HIV and AIDS and their families by involving community members in care and support

activities. Home-based care volunteers also make use of the opportunities given to address any

misconceptions the family or the community may have about HIV and AIDS as well as applying the

preventive care package. Family members of the HIV-infected individuals will also receive at least two

support services (psychosocial, spiritual, etc) from the checklist of the services. Any OVC identified during

HBC visits will be referred to the OVC program.

ACTIVITY 3: Strengthen Referrals Networks

In order to ensure that HIV-infected individuals and their families receive appropriate care and support,

Salvation Army will improve their linkages with other organizations, particularly in terms of increasing

access to clinical care. Salvation Army will regularly map services available in each site and develop a

formal referral system to other community health structures. This will ensure that beneficiaries are able to

access services that are not provided by the Salvation Army (such as provision of ARVs). The patients will

be referred and a proper follow-up will be made by home-based caregivers so that the program can track

their progress and address any problems identified with the relevant authorities. The program will focus on

strengthening relationships between caregivers and public clinics and hospitals in order to facilitate effective

referrals and to provide additional support for volunteers from clinically trained professionals. In addition,

Salvation Army will also explore partnerships with other private organizations and institutions in order to

provide additional support for the program and to move towards ensuring the sustainability of activities.

Monitoring and Evaluation (M&E) is an important component of this program and a comprehensive M&E

structure has been set up to help track number of services provided by the caregivers as well as the

progress made by patients.

ACTIVITY 4: Support Program for Caregivers

The Salvation Army has identified the need to provide care and support services to caregivers to ensure

that caregivers avoid burnout, receive care for medical conditions and are able to provide services to clients

effectively. TSA will partner with local health facilities to offer on-going counseling and testing and health

screening (for TB, diabetes etc.) to all caregivers. These screening services will be an entry point for further

services from a specialized cadre of senior HBC service providers who will be trained to provide on-going

HIV prevention education and counseling, debriefing services, run support groups for caregivers, provide

support for clinic visits and adherence, counseling and referral for services related to gender-based violence

and to assist with linking caregivers to income generation projects and with further educational

Activity Narrative: opportunities. These interventions will assist in improving the health and well-being of caregivers and

increase the sustainability of the program.

These activities contribute towards PEPFAR's goal of providing 10 million people with care including people

living with HIV and AIDS and their families by increasing access and quality of care.

SUMMARY:

The Salvation Army will provide OVC with a comprehensive range of services through the establishment of

OVC Support Centers, which will offer psychosocial support, access to government grants for eligible OVC,

school fee exemption, and referrals to other service providers such as social workers. Through leveraging

community resources, trained community members will also facilitate access to feeding schemes and

educational support (including assistance with uniforms and school materials). The major and minor

emphasis area for this activity is training and building the capacity of the volunteer caregivers to respond

more effectively to the needs of the OVC, community mobilization/participation and the development of

networks, linkages and referral systems. Key target populations are OVC, families affected by HIV and

AIDS, caregivers and volunteers.

BACKGROUND:

The Salvation Army is an international Christian denomination with specific community programs to address

all aspects of HIV and AIDS through community-based care and prevention programming including home-

based care, psychosocial support for OVC, individualized pre- and post-test counseling, clinical care for

opportunistic infections, community counseling, and youth mobilization. Salvation Army developed Matsoho

A Thuso, a care and prevention model in November 2004 with PEPFAR funding. This model includes care

and support activities for OVC in accordance with South African Government (SAG) OVC policy. Salvation

Army works to capacitate communities to care for OVC through training volunteers, offering outreach

services and mobilizing community resources. The project currently operates in 70 sites in eight of South

Africa's nine provinces, many of which are in rural and underserved areas. In FY 2007 Salvation Army will

intensify and enhance OVC care and support activities through training new caregivers as well as retraining

existing caregivers on a range of care and support services for OVC and their families.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Training

To respond to the needs of OVC, The Salvation Army has developed a training course for its community

networks to establish and strengthen services for OVC. Volunteers attend a 5-day training course based on

a collection of resources used practically in the field to equip them with skills to employ child-friendly

interactive methodologies to identify and support OVC and to set up OVC Support Centers in their

communities, providing children with a range of support services. The collection of resources that will be

used includes practical exercises which cover the following topics: defining and identifying OVC, practical

skills for care and support, establishing and managing an OVC support center, understanding and

accessing the SAG social support system, and basic monitoring and evaluation. Community volunteers are

identified and profiled from local congregations and return to serve their communities after training

increasing community support for OVC. Community volunteers will be provided with ongoing, on-site

support and mentorship by skilled program staff. In the period ending June 2006, 85 volunteers were trained

as OVC caregivers. In FY 2007 the Salvation Army will train additional caregivers to expand service delivery

and enhance the quality of care provided through intensive supervision.

ACTIVITY 2: Establishment of OVC Support Centers

This activity involves the establishment of OVC Support Centers in communities where The Salvation Army

already has a presence. Through extensive outreach to churches, community leaders and networks,

community volunteers will inform the community of the establishment of the OVC Support Center and its

services. As a result of this outreach, OVC will come to the OVC Support Center where their needs will be

assessed and documented. OVC will then be provided with a comprehensive range of services based on

each child's individual needs that include, but are not limited to, psychosocial support (primarily through

child-friendly participatory approaches), building resilience, life skills and assistance in accessing SAG

social support systems (including HIV prevention advocacy on behalf of OVC and their families). Volunteers

will also negotiate with schools to help OVC obtain school-fee exemptions to ensure OVC have access to

education. In addition, OVC will be linked to existing community resources for the provision of food, school

uniforms and supplies. All outreach activities will be sensitive to gender and will address gender issues that

arise in the equity of access to services through the routine monitoring of service data. Any imbalances

detected will be addressed. In the period ending June 2006, Salvation Army provided services to just over

2000 OVC. FY 2007 funding will be used to intensify and enhance OVC services. Salvation Army will

facilitate the referral system to ensure that the OVC have access to health and treatment services.

ACTIVITY 3: Establishment of referral networks and linkages

When volunteers identify cases they are not equipped to deal with, referrals will be made to relevant service

providers such as child protection services, health care providers and social workers. The Salvation Army

will form linkages and partnerships with existing specialized service providers such as social workers,

police, child protection units and child health systems to improve and/or increase access to such services

as well as to public and private institutions providing pediatric ARV treatment and services for HIV-infected

children. Through utilizing established networks (such as women's groups, study groups, and Sunday

School programs) and private and public sector partnerships, the Salvation Army will be able to access

other community resources to further enhance OVC outreach initiatives. Reports on activities and data will

be routinely forwarded to the local Departments of Social Development to share data and information

contributing to national statistics of the OVC profiles the country and leveraging more support and resources

for the OVC. This will improve the quality of service delivery and the services rendered and ensure that the

program is in line with SAG policy, guidelines and priorities. With the incorporation of Abaqulusi child

survival program and Community youth and OVC response into Matsoho A Thuso, attention will be given to

documenting the best practices from their way of working and try and replicate them in other service hubs.

Wherever feasible, The Salvation Army will retain the knowledge and services of the staff and volunteers

associated with the Abaqulusi Child Survival program Northern KwaZulu-Natal and Western Cape

Community Youth and OVC response program.

This activity will contribute to the PEPFAR goal of providing care and support to ten million people affected

by HIV and AIDS including OVC and their families.

Activity Narrative: SUMMARY: