Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 466
Country/Region: South Africa
Year: 2008
Main Partner: U.S. Agency for International Development
Main Partner Program: Health Policy Initiative
Organizational Type: Own Agency
Funding Agency: USAID
Total Funding: $3,200,000

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $944,750

SUMMARY:

HPI TO1 is follow-on to the POLICY Project funded by USAID. HPI TO1 will support the implementation of

policies and programs to integrate gender, stigma and discrimination into HIV prevention programs. The

project will work with faith-based organizations (FBOs), traditional leaders (TLs), and community-based

organizations (CBOs) to develop and implement Abstinence and Be faithful (AB) prevention messages and

programs. HPI TO1 will assist FBOs and CBOs to systematically identify program gaps and barriers to

uptake or dissemination. Activities will focus on improving knowledge about HIV, behavior change to reduce

risk, community mobilization and participation in HIV prevention programs.

Over the years, HPI TO1 has worked with the FBOs and TLs as a key target group. The organization aims

to respond to the needs of the groups in prevention. These needs have evolved variously from the need to

sensitize the leadership and membership on the necessity of including a prevention focus in their programs,

to helping groups set up prevention programs for their diocese and communities. Currently, HPI TO1is

targeting behavior change and emphasizing what needs to happen at the personal level. HPI TO1 will be

utililizing approaches that influence individual behavior as it relates to HIV prevention, using proven

approaches that reinforce person-to-person influences and decision making, and which will ultimately lead

to behavior change at the personal level.

Emphasis areas are training in AB, with special focus on behavior change; community mobilization and

participation; gender which will address male norms and behaviors, reduce gender-based violence and

coercion; and human capacity building for partners at the national, provincial and community levels.

Capacity building aims to identify and address the operational barriers that impede the expansion of HIV

programs. The target population is adolescents, adults, people living with HIV, and religious leaders.

BACKGROUND:

HPI TO1 empowers new partners to participate in the policy making process. The initiative helps

organizations translate policies, strategic plans, and operational guidelines into effective programs and

services. The project will work with FBOs, TLs, and CBOs to develop and implement AB prevention

messages and programs and to assist these organizations in systematically identifying program gaps and

barriers to uptake or dissemination. HPI TO1 will continue to build and strengthen the capacity of

organizations and institutions across all sectors to design, implement, and evaluate comprehensive HIV

prevention, care, and support programs and policies. Project assistance focuses on improving multi-sectoral

capacity and involvement in the country's national HIV and AIDS program by assisting different role players

in developing and implementing effective advocacy strategies for HIV and AIDS; facilitating effective

planning for HIV and AIDS programs; increasing the information used for policy and program development;

and strengthening collaboration between government and civil society organizations (CSOs) and institutions

working in HIV and AIDS. The activities proposed under HPI TO1 will (1) focus on the devolution of capacity

building and training in AB programs to district level for TLs and to FBOs; (2) provide technical assistance to

TLs and faith-leaders to ensure their training skills are used and appropriate prevention messages are being

disseminated in communities; and (3) build the capacity of traditional and faith leaders to identify barriers to

uptake or expansion of prevention programs. In this period HPI TO1 will also work in partnership with the

South African National AIDS Council (SANAC) and the National House of Traditional Leaders. HPI TO1 will

partner with SANAC to provide direct technical assistance to TL structures in South Africa.

Traditional Leaders: It is estimated that over 16 million people live in the rural areas that are under the

jurisdiction of TLs. These TLs command respect and have significant influence on the day-to-day running of

many rural/ peri-urban communities. They are also key players in the governance structures of South Africa,

particularly at the local level, and are therefore well placed to mobilize communities to access and use

services. In 2001, a partnership between the National Department of Health (NDOH) and the Nelson

Mandela Foundation (NMF) supported the formation of the National TLs' HIV and AIDS Forum and the

development of a national strategy by TLs to address the challenges of HIV and AIDS. Previously, the

activities in this program area focused mostly on Traditional Leaders at the provincial level and were

implemented in partnership with a small non statutory Traditional Leaders forum. In this period HPI TO1 will

be implementing this activity in support of the National House of Traditional Leaders. This is the biggest

body of Traditional Leaders in South Africa and is also a statutory body represented in the national

parliament and the South African National AIDS Council. The National House of Traditional Leaders is key

in assisting HPI reach as many Traditional Leaders in their various forms, kings, indunas, chiefs, traditional

councilors and will be implemented at the district level. Further in this period HPI will be implementing

activities in the Northern Cape which did not receive any interventions previously.

Faith-Based Organizations: South Africa is a multi-faith country. FBOs are rooted in the community and are

in a strong position to mobilize communities to address the challenge of HIV and AIDS. They can promote

prevention strategies, mobilize communities against stigma and discrimination, and provide community-

based care and support to people infected or affected by HIV and AIDS. The capacity of many FBOs to

develop appropriate training materials or to design and implement effective programs varies considerably.

In the previous interventions HPI TO1 worked with FBO's such as the National Baptist Church of Southern

Africa, the Southern African Catholic Bishops Conference and the Church of the Provinces of Southern

Africa. In this period HPI will be working with the mostly Africa traditional faiths such as the Zion Christian

Church and Shembe.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1. Traditional Leaders

HPI TO1 will conduct six provincial, three-day training workshops; each workshop will host 40 participants.

Each of 240 people trained will then conduct at least five activities to reach community members with A/B

messages within one year of receiving the training. These workshops will be focusing on encouraging TLs

to promote prevention messages in particular, the reduction of concurrent sexual partners being faithful to

one sexual partner, especially in older youth and adults engaged in sexual relationships, abstinence or

delaying sexual debut for young people aged 10-14 before they start engage in sexual activity, the role of

gender and gender based violence in prevention and prevention for positive individuals. This activity will be

implemented in KwaZulu-Natal, Eastern Cape, Mpumalanga, Free State, Limpopo, North West and

Activity Narrative: Northern Cape provinces. The training will focus on the design, planning, and dissemination of successful

AB prevention messages and will include strategies to reduce community level stigma and discrimination

and raise awareness of the impact of gender-based violence on women's access to prevention programs

including discussion of issues of the role of men in society. HPI TO1 will look at individual behavior and how

to reinforce positive behaviors in the community. We will look at addressing both individual and larger

community issues that are barriers to behavior change. Trainees who are TLs will include AB prevention

messages into one TL's council meetings once a month. As more TL's take the lead in addressing HIV and

AIDS, this would have more impact in behavior change of men in their different constituencies, because

most Traditional Leaders are men. The training materials used throughout this activity will be developed by

HPI TO1. HPI TO1 will follow up with a subset of trainees to (1) assess the activities carried out; (2) identify

the challenges and opportunities TLs are experiencing in disseminating AB messages; and (3) provide

technical assistance to the TLs to strengthen their skills in order to address implementation challenges.

ACTIVITY 2. Faith-Based Organizations

HPI TO1 will facilitate nine provincial workshops on integrating AB messages into the church activities of a

selected church group. Thirty participants will be reached in each provincial workshop. These workshops

will focus on encouraging FBOs to promote prevention messages, such as the reduction of concurrent

sexual partners, the delay of sexual debut for young people, being faithful to one sexual partner, the role of

gender and gender-based violence against women and girl children in prevention and prevention for

positive individuals. A total of 315 people will be trained. Each of the 315 people trained will then conduct at

least one activity to reach community members with A/B messages within one year of receiving the training.

Trainees will develop action plans to disseminate AB prevention messages and conduct prevention

outreach activities within the church communities. HPI TO1 will follow up with a subset of those who

participated in training to assess: (1) the degree to which participants were able to implement their action

plans; (2) the challenges and opportunities trainees encounter in their community; and (3) to reinforce skills

learned in the provincial training workshops in order to build a sustainable cadre of trainers. The trainees for

FBOs will be comprised of faith-based HIV and AIDS committee members and other members of the

broader church community. Technical assistance will be included in the training curriculum.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $388,000

SUMMARY:

While more coordinated strategies to improve women's reproductive health have been developed in South

Africa, comprehensive national guidelines and policies to improve men's reproductive health are still sorely

lacking. Gender norms play a crucial role in fuelling the HIV and AIDS epidemic, in terms of condoning

men's violence against women, granting men the power to initiate and dictate the terms of sex, and making

it extremely difficult for women to protect themselves from either HIV or violence or to access critical health

and education services. By equating masculinity with sexual conquest, gender roles also contribute to what

research suggests is the most significant factor driving the spread of HIV across sub-Saharan Africa -

multiple concurrent sexual partnerships. Studies by Dworkin SL & Ehrhardt AA, Going beyond "ABC" to

include "GEM": Critical reflections on progress in the HIV and AIDS epidemic and Noar, S.M. & Morokoff,

P.J. (2001), The Relationship between Masculinity Ideology, Condom Attitudes, and Condom Use, show

that traditional gender roles lead to men's "more negative condom attitudes and less consistent condom

use" and promote "beliefs that sexual relationships are adversarial. Men are also far more likely to drink

more heavily than women and more likely to be habitual heavy drinkers according to the 2002 World Health

Report. Alcohol consumption is a risk factor for gender-based violence and for the sexual disinhibition that

contributes to the spread of HIV and AIDS. Further research reveals that men are significantly less likely

than women to utilize voluntary counseling and testing (VCT) services. Recent national studies in South

Africa found that men accounted for only 21% of all clients receiving VCT and they also reflect the fact that

many reproductive health services do not address men's HIV, STI and other sexual and reproductive health

related needs. The National Strategic Plan recognizes the prevention role MC can play as part of a

prevention strategy.

The above evidence calls for more concerted efforts to improve men's opportunities to realize their sexual

and reproductive health and rights. In 2006 and 2007, HPI TO1 conducted a analysis to provide an

overview of the status of men's sexual and reproductive health and rights, especially as it relates to HIV, in

South Africa as well as the impact this has on women's health, an overview of current research that

addresses the needs of men in preventing the spread of HIV and AIDS, an overview of evidence-based HIV

and AIDS prevention interventions for men, currently being carried out by civil society and an overview of

policies and guidelines that currently exist in South Africa, which address the sexual and reproductive health

needs and rights of men including MC.

HPI TO1 will bring into the dialogue the myriad of key stakeholders, such as traditional leaders, community

groups, provincial authorities, and the medical establishment and in collaboration with NDOH, WHO,

UNAIDS, they will undertake to draft a national set of men's reproductive health and rights guidelines which

give strategic direction for improving male reproductive health and reducing men's vulnerability to HIV and

AIDS.

In support to the NDOH, HPI TO1 will conduct four day trainings for representatives from government, the

public and private sectors to implement the final national set of men's reproductive health guidelines which

give strategic direction for improving male reproductive health and reducing men's vulnerability to HIV and

AIDS.

BACKGROUND:

National reproductive health and rights guidelines for men would not only provide an opportunity to build the

capacity of programs and policy makers, but would also facilitate better cohesion and collaboration across

government and civil society in their work with men. An important component of these guidelines would be

to ensure that the reproductive health of more marginalized groups of men gain greater attention: migrant

workers, men who have sex with men, male sex workers, refugees and prisoners, for example. Providing

strategies which incorporate the needs of these vulnerable groups would facilitate the development of better

designed programs, particularly those which address issues such as high turnover of sexual partners, high

risk of sexually transmitted infections, non-use/inconsistent/incorrect condom use, lack of knowledge of HIV

status and alcohol and other substance abuse. The guidelines will become a vital resource for training

government and civil society on the different approaches outlined. As a result, more comprehensive and

cohesive programs will be rolled out which address the reproductive health needs and rights of different

groups of men in South Africa. HPI TO1 was a key partner involved in the development of the National

Reproductive Health Guidelines for Men in 2007. As a follow up on the COP FY 2006 and FY 2007 work,

HPI TO1 will be developing and implementing training programs that will address men's reproductive health

needs and reducing men's vulnerability. These programs will also assist in ensuring the increase in men's

utilization of reproductive services - especially with STI treatment, HIV testing, ARV uptake and circumcision

(MC).

ACTIVITY 1: Prevention Workshops

HPI TO1 will conduct workshops for nine provinces. A minimum of 15 participants per workshop per

province (135) will be trained. The workshop will target both the NDOH service providers as well as policy

makers at different workshops accordingly. The training will be in the form of four day workshops. HPI TO1

in collaboration with Sonke GenderJustice, a short term contractor developed training materials based on

the desktop review and the National Reproductive Health Guidelines for Men of 2007. The workshops will

focus on the guidelines themselves and will guide managers on how to develop programs that address

gender issues, that promote the increase in the uptake of health services by men, and that promote

community awareness on men's reproductive health issues and needs. The trainings will also be

mechanisms of fostering coalitions and networks among stakeholders. This will also be a form of

mobilization and advocacy. Through this training individual knowledge, skills and leadership capacity will be

strengthened and there will be influence/change in organizational practices. The trainings will not be

accredited. This training activity will strengthen the capacity and collaboration of National Department of

Health (NDOH), and civil society groups in their work with men to ensure implementation of the National

Reproductive Guidelines for Men.

ACTIVITY 2: Male Circumcision

No male circumcision training or service delivery will take place without the express consent of the National

Department of Health. In the absence of such approval and based on discussions with the PEPFAR South

Activity Narrative: Africa team, funds could fully or partially be reprogrammed. Should the approval for safe clinical male

circumcision activities be given, HPI TO1 is proposing the following male activities:

HPI TO1 will work closely with JHPIEGO and the NDOH TBD program to jointly develop prevention

messaging for traditional leaders, tradition healers and traditional surgeons that can be incorporated in to

existing traditional male circumcision activities.

ACTIVITY 3: Traditional Leaders and Healers

Using tools and messaging from Activity 2 above, HPI TO1 will work with traditional leaders, traditional

healers and traditional surgeons to build capacity in the delivery of appropriate, accurate prevention

messaging in the context of male circumcision. Activities will include trainings on prevention messaging

piloting and testing the impact of the messaging and monitoring and follow up to ensure that prevention

messaging is accurately delivered.

This activity contributes to the PEPFAR 2-7-10 goals by creating greater awareness of men's reproductive

needs thus reducing men's vulnerability to HIV and AIDS through addressing issues like MC, increasing

correct and consistent condom usage and preventing new infections, and by training individuals to promote

HIV and AIDS prevention through other behavior change beyond abstinence and/or being faithful.

Funding for Care: Adult Care and Support (HBHC): $291,000

SUMMARY:

This activity is aimed at partnering with key civil society organizations focusing on mobilizing people living

with HIV and AIDS (PLHIV) to access basic preventive care services. The Health Policy Initiative, Task

Order 1 (HPI TO1) has technical expertise and existing nationally-recognized materials to support this

activity which include 'To the Other Side of the Mountain - A Toolkit for People Living with HIV and AIDS in

South Africa', 'National Support Group Guidelines', as well as materials to address stigma and

discrimination at individual and community levels. Emphasis will be placed on mitigating stigma and

discrimination and addressing gender inequalities in palliative care.

BACKROUND:

The HPI TO1 will provide technical assistance to PLHIV organizations to equip them with skills to mobilize

and advocate for essential care and treatment support services, training on essential care messages and

referrals for essential HIV and AIDS PMTCT, ART, opportunistic infection (OI) management (including TB)

and counseling and testing (CT) services for its members and their families. The target populations for this

activity are HIV-infected TB patients, PLHIV, their families, and community-based organizations. The major

emphasis areas are local organization capacity development, with additional emphasis on community

mobilization/participation and training. HPI TO1 will increase access to basic preventive care services under

the umbrella of quality palliative care service delivery through a national rollout of the Toolkit for People

Living with HIV and AIDS and through strengthening the capacity of three TB/HIV outlets. The Toolkit was

developed in collaboration with PLHIV and the National Department of Health (NDOH) Chief Directorate on

HIV and AIDS, Care and Support, STIs and TB. The Toolkit was developed to address the needs of PLHIV

in South Africa particularly in the areas of disclosure, rights, communication, facilitation, advocacy and

mobilizing access to essential prevention, care and treatment services. This activity will also integrate

psychosocial support to family members of people living with HIV and AIDS.

ACTIVITIES AND EXPECTED RESULTS:

HPI TO1 will provide capacity development for PLHIV organizations in South Africa to equip them with skills

to mobilize and advocate for essential care and treatment support services, knowledge and awareness of

essential prevention and basic preventive care interventions and the importance of mobilizing and referring

for essential HIV and AIDS PMTCT, ART, OI management (including TB), family planning and CT services

for its members and their families. This activity will focus on strengthening and building the capacity of

PLHIV organizations at provincial and district levels to provide quality programs designed to meet the needs

of people infected and affected by HIV and AIDS. These organizations work with the South African National

AIDS Council (SANAC) and they will be selected through SANAC and provincial Departments of Health. In

FY 2008, HPI TO1 will provide training and technical support through nine provincial workshops for 10

participants per workshop per province who represents the Hospice Association of South Africa and its

provincial branches, HPI TO1 will further train individuals from several community-based organizations

providing community-based prevention and basic preventive care services, stigma and gender-based

violence mitigation, using the toolkit. Additional workshops for students from two nursing colleges in

Gauteng and Western Cape Province will be conducted, using the toolkit as part of their curriculum. The

workshops will focus on providing participants with advocacy skills, community group facilitation skills, skills

which support disclosure of HIV status, mobilizing for essential care services including prevention strategies

and prophylaxis and treatment for OIs, ART support, counseling on HIV prevention and behavioral change

and provision of condoms; mobilizing for counseling and testing (CT) of family members; counseling in

nutrition and personal hygiene; psychosocial support and mitigation of gender-related violence and

mobilizing for PMTCT, ART, OI management (including TB), CT services and workplace interventions. This

activity will strengthen the capacity of NGOs and CBOs which are messaging and mobilizing for basic

preventive care services in South African communities. This activity will also address gender issues through

the provision of basic HIV screening and care and prevention messaging to large numbers of male and

female adult PLHIV, support for disclosure of HIV status and reduction of gender-based violence,

involvement of males in the program, mobilization of community leaders for promoting community efforts

against stigma and discrimination and for raising awareness regarding HIV prevention, care and treatment.

With the epidemics of HIV and TB interlinked, and the increasing incidence of active TB disease, HPI TO1

recognizes that the strengthening of HIV/TB outlets is essential to ensure that the people affected by the co-

epidemics receive appropriate care and treatment. HPI TO1 will focus on the integration of programs, the

decrease of TB among PLHIV and the increase of HIV care available for TB patients within these service

outlets. Three service outlets will be targeted VUKA TB/AIDS Project, NWATHA and a new outlet from the

Western Cape.

VUKA TB/AIDS Project operates in an urban area, Hillbrow, Johannesburg. This is an area that is

characterized by a diverse, overcrowded, poor, mobile and high risk community. Hillbrow has also been

identified by the National Tuberculosis Control Program as a focus area for TB. VUKA utilizes volunteers to

deliver a comprehensive service to the community of Hillbrow.

NWATHA has been a service provider to North West Provincial Department of Health in different districts in

the North West Province. Given the strong link between TB and poverty which is evident in the province as

it is predominantly rural, TB and HIV mobilization and awareness in these communities is needed.

The Western Cape has one of the highest TB prevalence in the world. It has also been identified as one of

the focus areas of TB by the National TB Control Program of South Africa. Through the TB Alliance in the

Western Cape, an organization will be identified that requires capacity and systems strengthening.

The activities outlined above will contribute towards meeting the vision outlined in the USG Five-Year

PEPFAR Strategy for South Africa by mobilizing PLHV organizations and individuals and equipping them

with skills to promote that mitigate stigma and discrimination

Funding for Strategic Information (HVSI): $121,250

SUMMARY

The Health Policy Initiative (HPI) will carry out capacity building activities and provide technical support to

ensure improved national and provincial level financial planning and effective resource allocation for HIV

and AIDS. The target populations are host county government workers at national and provincial levels, with

a specific focus on AIDS Control Program staff; and the emphasis area for this activity is other strategic

information (SI) activities, to include healthcare financing and local organization capacity development.

BACKGROUND

HPI has significant expertise in providing assistance to governments and donors in planning and allocating

future resources to manage national HIV and AIDS programs. This is an ongoing activity in South Africa,

first initiated in 2001 with the collaboration of the National Department of Health (NDOH) and several other

government departments. Since 2004, the activities were funded by PEPFAR and included provision of

technical assistance and training for staff at the Health Financing and Economics Unit (HFEU) of the NDOH

in applying the GOALS model. The GOALS model is a computer model designed to support HIV and AIDS

planning by linking expenditure on specific program interventions to coverage of the population in need and

to program goals, such as infections averted and deaths averted. HPI will continue to support the NDOH in

preparing resource allocation and human capacity building plans to implement the NDOH's HIV & AIDS and

STI Strategic Plan for South Africa, 2007-2011 (NSP) effectively. HPI has made it a priority to strengthen

the capacity of provincial governments to cost their Provincial Strategic Plans and to align it with the NSP.

HPI will provide technical assistance to all nine provinces and use information from the COP or other

sources to identify gaps in budget allocations and providing information on what set of interventions can

most effectively contribute to achieving the South Africa prevention and treatment targets.

ACTIVITIES AND EXPECTED RESULTS

ACTIVITY 1. Resource Allocation.

In this phase, financial staff from the NDOH HIV and AIDS, Comprehensive Care, Support and Treatment

Unit, will form part of the national training team to roll this intervention out further to the provinces. Training

and technical assistance will be provided to national trainers to conduct national and provincial training for

technical working group members on resource allocation, the use of data for decision making to prepare for

HIV and AIDS human capacity needs, programming and financing of the NSP. Financial staff from the HIV

and AIDS Care and Support Unit will also be trained to use the GOALS model and to teach staff at the

provincial level on the use of the GOALS resource model to design programs, and to allocate financial and

human resources. HPI staff will follow-up throughout the year with the HIV and AIDS, Care and Support

trainers to provide additional capacity building.

This activity will contribute substantially towards meeting the vision outlined in the USG Five-Year Strategy

for South Africa. It will contribute to reaching the goal of averting 7 million infections through improved

planning and resource allocation.

Funding for Health Systems Strengthening (OHSS): $1,455,000

SUMMARY:

Health Policy Initiative Task Order 1 (HPI TO1) provides an enabling policy environment as a foundation on

which to build quality, sustainable HIV programs and services. The HIV epidemic in South Africa (SA)

cannot be addressed by the health sector alone—it requires a strong, coordinated multisectoral response

from workplaces, faith-based groups, and civil society organizations to ease the burden on the health

system. They also have critical role to play in reducing stigma and discrimination (SD) against people living

with HIV (PLHIV) which is essential for encouraging counseling and testing, disclosure, and antiretroviral

(ARV) treatment. Multisectoral engagement, including involvement of PLHIV and other vulnerable groups, is

critical to ensure that: needs of those most affected are met; community leaders break the silence; stigma

that hinders HIV prevention and treatment is eliminated; and resources for implementation are mobilized

across all sectors.

In response, HPI proposes three activities that will strengthen HIV policies and programs of public and

private sector workplaces; reduce SD; and build HIV-related institutional capacity of civil society groups. HPI

will provide technical assistance to partners to build capacity to analyze and use data to enhance evidence-

based decision-making, and to identify and address operational barriers to effective HIV and AIDS

programs. HPI will also assist organizations in translating policies, strategic plans, and operational

guidelines into effective programs and services.

BACKGROUND:

The National HIV, AIDS and STI Strategic Plan for SA, 2007-2011 highlights "World of Work" as an

important sector for future management of HIV and AIDS in SA. Workplace policies in public sector and

National Operational Plan for Comprehensive HIV and AIDS Management, Treatment Care and Support

have been developed to support implementation of HIV and AIDS strategies. Adequacy of existing

structures should be assessed, and capacity to develop and implement public and private sector HIV and

AIDS programs should be strengthened. Workplace policies need to be developed and implemented in both

private and public sector, with special focus on encouraging acceptance of HIV-infected employees and

promoting open discussion of HIV and AIDS and non-discrimination.

In FY 2007, HPI TO1 developed "Managing HIV and AIDS in the Workplace: A Guide for Government

Departments" as a guide in implementing the Minimum Standards on HIV and AIDS. Use of this guide

within the Department of Public Service and Administration (DPSA) has mostly been done at national and

provincial levels for managers leading and developing HIV and AIDS programs. HPI TO1 has launched

several HIV and AIDS Management Programs for senior managers and executive leaders in 2007 with key

tertiary institutions (TIs). Primary objective of the leadership training programs is to secure commitment by

leaders in South Africa to actively and openly address HIV in their business environments.

For many years women have been suffered from discrimination. Gender inequality hinders social and

economic development and is a critical element of the transformation agenda in SA. HPI TO1 will

strengthen capacity of women by conducting a leadership course for women to capacitate and mobilize

them in leadership to play vital role to ensure accountability and gender sensitive responses that will

increase reach of HIV and AIDS programs run by them.

Evidence from programs in South Africa suggests that people still fear testing for HIV and treatment. In

partnership with HPI TO1, Center for the Study of AIDS (CSA) has implemented the Siyam'kela Project,,

focusing on HIV-related stigma. To date, the project has been successful in developing conceptual and

theoretical tools to understand and mitigate stigma for government and civil society to inform the mitigation

efforts, build capacity, design advocacy messages and materials, and offer training and technical assistance

(TA) around stigma.

ACTIVITIES AND EXPECTED RESULTS

ACTIVITY 1: HIV and AIDS Workplace Programs

A. Program Managers and Graduate Students. HPI TO1 has worked closely with University of Stellenbosch

to design training modules and facilitate training sessions as part of its diploma course on HIV program

management and the workplace. As a follow-up to this activity, HPI will identify graduates of the program

who have become HIV policy champions in their workplaces. HPI will provide capacity building and TA to

these policy champions to strengthen development and implementation of HIV workplace policies and

programs in their respective workplaces. In addition, HPI will assess the impact of the overall diploma

course. HPI will identify a sample of 50 graduates to explore extent to which they are engaged in HIV

workplace policies, dialogue, advocacy, and program implementation.

B. Executive Business Leaders. HPI TO1 will build leadership capacity of key business personnel to

strategically and effectively respond to HIV in their work environments. Training participants will include

senior managers and executives, from both public and private sectors, who enroll for Masters in Business

Administration (MBA) and Executive Leadership courses through six TIs. These institutions will assist in

educating key role players and their contribution is in the form of integrating the HIV & AIDS workplace

module to the MBA and Executive courses. HPI expects to initiate, strengthen and improve more

appropriate workplace programming in the private sector.

C. Women Program Managers. HPI TO1 seeks to strengthen technical expertise, leadership abilities, and

program management skills of women working to prevent spread and mitigate effects of HIV. This responds

to need for greater and more meaningful involvement of women in designing and guiding HIV and AIDS

programs. Through their current programs, the national departments for Gender will help select women to

participate in the program who are from civil society, religious, and government bodies and are involved in

or manage HIV programs. Women's leadership courses will help improve focus, ensure accountability, and

increase reach of HIV programs by incorporating strategies that are gender sensitive.

D. DPSA and Government Departments. In partnership with DPSA, HPI TO1 will assist 30 departments to

plan, develop, implement, and maintain HIV workplace policies and programs within human rights and

gender framework. DPSA has mandate of instituting, strengthening, and upholding effective and efficient

human resource practices in all government departments in nine provinces. Heads of Departments will

oversee development and implementation of HIV workplace policies and programs. Heads of Departments

follow the "Managing HIV and AIDS in the Workplace: A Guide for Government Departments," which

provides guidance on Minimum Standards on HIV and AIDS. HPI will work with DPSA to develop and

Activity Narrative: improve existing guides and monitoring tools to strengthen HIV & AIDS programs in public sector

workplace.

ACTIVITY 2: Stigma Mitigation

SD has had a negative impact on HIV prevention in SA and has affected efforts to improve care and support

for PLHIV. This has been exacerbated by lack of concepts and theoretical tools to understand and measure

SD and their impact. Through ongoing implementation of Siyam'kela Project, capacity building for PLHIV

organizations and families was done to advocate for stigma mitigation. With FY 2008 funds, the activities

will focus on providing training to PLHIV organizations and their members at provincial levels on SD

mitigation using the National Stigma Framework (NSF). Training will take place in all nine provinces of SA

and through NDOH's HIV, AIDS, STI and TB directorate - Care and Support Unit; selection will take place to

ensure departmental representation of all provinces. Representatives of PLHIV networks in different

provinces will be included. Training and subsequent follow up will focus on implementation of NSF and

sector plans to reduce HIV-related stigma. Through NDOH sector plans resources have been allocated for

M&E of activities related to SD in provincial health departments. HPI TO1 will work with 405 representatives

from NGOs, PLHIV groups and provincial health departments. HPI TO1 will provide TA to the HIV, AIDS,

STI and TB directorate - Care and Support Unit to ensure implementation of their stigma plans. Evaluation

will be conducted to report on progress and implementation of NSF.

ACTIVITY 3: Civil Society Organizational and Institutional Capacity Development

The SA Government's AIDS Action Plan spearheaded a national capacity-building process for the interfaith

sector, in collaboration with POLICY Project which resulted in establishment of an interfaith program, FBOs

in HIV/AIDS Partnership (FOHAP), in 2002. As a continuation of assistance started in 2007, HPI TO1 will

provide institutional capacity building to two national FBOs, the National Baptist Church of Southern Africa

in Crossroads and an African traditional FBO such as the Zion Christian Church or the Shembe, as well as

three NGOs in three provinces which have been identified by the NDOH as key outlets in high prevalence

areas for support to strengthen their capacity to: 1) develop strategic plans for program implementation; 2)

provide institutional capacity building by facilitating governance and organizational development workshops

to respond to the need for designing and implementing HIV prevention programs; and 3) build capacity of

TB organizations to enable them to integrate HIV activities into their work. HPI TO1 is engaged with the

three organizations providing TB outreach under the palliative care section. These activities will result in

stronger TB/HIV technical programming and operations for the organization. HPI TO1 will provide

institutional capacity building to 5 organizations and 180 staff for COP FY 2008.

Subpartners Total: $285,203
University of Pretoria: $95,000
University of Cape Town: $10,000
Crossroads Baptist Church: $7,000
Southern African Catholic Bishops' Conference: $158,203
Positive Living Ambassadors: $15,000