ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

Activities will stay the same, but the program content (e.g., illustrations, case studies, role plays and

exercises) will be adapted to recommendations from PEPFAR Interagency Partner Evaluation.

Multiple Concurrent Sexual Partnerships: The training manual, workbook and handbook will explore the

cultural and social norms relating to traditional gender roles and power imbalances within relationships, as

these are key to multiple concurrent partnerships and cross-generational and informal transactional sex,

thus contributing to disproportionately high infection rates among females. Choose Life, using a range of

exercises, case studies and role plays, based on values frameworks, will explore appropriate social norms,

and develop skills that will lead to partner reduction. Emphasis in FY 2009 will be on specific behaviors

resulting from the values of respect, responsibility, and integrity. The skills of assertiveness, decision-

making and negotiation will be practiced and translated into specific behaviors.

Cross-generational and informal transactional sex will be addressed among youth. Choose Life will build

skills to support behavior change, through in-depth exploration of the risk behaviors, contrasted with a life

style based on responsible values and choices. Self-image, life skills will be highlighted.

Gender Roles and Power Imbalances: The faith-based community creates a environment that helps

empower women to avoid or reduce risk behaviors, and to change harmful gender norms that place women

and men at increased risk.

Promotion of Mutual Monogamy: The choice for mutual monogamy will be motivated based on the value

frameworks and practical values. A choice for, and adherence to values like responsibility, love and service,

should lead to a commitment to testing to determine one's own and one's partner's HIV status.

Using Additional Fora: The Choose Life program will engage leaders, peers, family members, local

organizations, and the media to facilitate the widespread adoption and maintenance of safer behaviors.

Religious and community leaders, are particularly influential in reaching a wider audience.

Supporting Behavior Change: Behavior change is an ongoing process. The mentoring program will be

expanded to extend activities beyond single contacts with key target groups. Regular and ongoing contact

and support of participants will ensure a sustainable and effective community program.

Promotion of Counseling and Testing (CT): In FY 2009, community- and faith-based leaders will be asked to

promote CT. CT in each community will be explored and promoted via referral systems to other

organizations.

Geographic Expansion: In cooperation with the Baptist Union, an area coordinator for the Eastern Cape will

be appointed to expand the program to East London and Mthatha.

Choose Life supports the prevention goals of the HIV & AIDS and STI Strategic Plan for South Africa, 2007-

2011 (NSP) (i.e., reduce vulnerability to HIV infection, and reduce sexual transmission of HIV) Choose Life

aims to strengthen social cohesion in communities and to support the institution of the family. Other

activities include identifying the origin of values; appreciating, choosing and supporting values that promote

spiritual and physical well being; making decisions guided by values; managing needs, desires and

relationships in a value-based way; understanding basic facts about HIV and AIDS; and committing to a

personal program of action.

The Choose Life program supports the NSP by promoting personal responsibility so that people commit to

protecting themselves and others from HIV infection; empowering leadership to promote HIV prevention and

responsible behavior change; ensuring that interventions are informed and owned by communities and

leaders; supporting organizations to address gender-based violence; encouraging HIV testing; empowering

organizations and leadership to build AIDS competent communities; creating awareness and strengthening

behavior change programs for vulnerable and high-risk groups; implementing prevention interventions

targeting young people, especially women; promoting equality for women and girls by prioritizing

interventions focusing on gender inequality; facilitating life skills development; increasing open discussion of

HIV and sexuality among parents and children; facilitating greater involvement of people living with HIV;

challenging stigma; identifying and contributing to the removal of legal, policy, religious and cultural barriers

to effective HIV prevention; and developing and promoting research on behavior change and the long-term

impact of programs.

The Choose Life curriculum currently includes, (as recommended by the NSP) abstinence, especially

delaying first sex; safer sex practices; provision of information about HIV risk of different sexual practices

and concurrency; gender relations and gender-based violence; coercive and intergenerational sex.

Through experiential exercises, men are encouraged to be responsible in their sexual behavior, to respect

women, and to be involved in family life. Choose Life aims to reduce sexual violence and coercion, number

of sexual partners, and cross-generational and transactional sex. The positive roles that men can play in the

health and well-being of their partners are demonstrated and practiced. Gender inequality and

stigmatization are still prevalent in faith-based communities. Often power is vested in male leadership and

submission of women is seen as necessary. Choose Life promotes gender-appropriate behaviors and life-

style choices.

Women are empowered through understanding, and practice and implementation of life skills, particularly

assertiveness and negotiation. Faith-based communities are encouraged to implement programs that

highlight the plight of women and children, reduce stigma, promote gender equality, and support healthy

permanent relationships through conflict resolution. Talks and enrichment programs for couples, life-skills

training for teenagers, promoting responsible behavior towards women and children in church services, and

informational materials support this in a congregational context.

Activity Narrative: Young people, especially women, have shown leadership resulting from the Choose Life program. They

have initiated peer-based programs, motivating other young girls to be tested for HIV. Girls have also taken

a stance on gender issues and stigmatization.

Community Outreach: Kurima, implementing the Know Your Neighborhood program, is no longer part of the

overall program. The program will be done by Hospivision facilitators and care workers.

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

SUMMARY:

By training faith and community-based leaders, as well as youth leaders in "Choose Life", a value-based

Abstinence and Be Faithful (AB) prevention program, CompreCare and its prevention partner, HospiVision,

will empower these leaders to implement AB programs in their various constituencies. The emphasis area

for this intervention is training as well as community mobilization. Primary target populations include faith-

based organizations (FBOs), non-governmental organizations (NGOs) and community leaders, volunteers,

caregivers of people living with HIV and AIDS, people living with HIV (PLHIV), children and youth, orphans

and vulnerable children.

BACKGROUND:

CompreCare is a South African NGO, undertaking HIV prevention and care activities under a multi-partner

initiative called the CHAMPs Initiative. CompreCare's partner in this program is HospiVision, a FBO involved

in spiritual care, counseling and training. HospiVision is part of a network of FBOs involved in the prevention

of HIV by involving churches in the Tshwane (Greater Pretoria) metropolitan area in Gauteng. The

prevention program will strengthen value-based AB messages in faith-based and community networks, with

the goal of changing individual, social and community norms. This will lead to reduced risk behaviors and

strengthen stable family relationships thereby reducing the HIV infection rate in the target communities.

The program is accredited by the Powell Centre at the University of South Africa (UNISA) and Transforming

Tshwane, an ecumenical faith-based initiative focusing on networking and community mobilization in

Tshwane. This program is conducted in support of the Tshwane local government's HIV and AIDS strategy

which is in line with the National Department of Health (NDOH). HospiVision is also accredited by the

NDOH. The Christian AIDS Bureau for Southern Africa has cooperated in the development of the training

program and has provided support in the Western Cape. These partnerships and linkages will contribute

largely to the sustainability of the program.

This activity builds on the successes achieved with PEPFAR FY 2005, FY 2006 and FY 2007 funding.

During the first 18 months of the implementation of the AB program 700 leaders were trained, 57,596

people were reached and an estimated 540,000 people have already been reached through the mass

media program by Radio Pulpit. In addition, at no cost to CompreCare or to PEPFAR, the Northwest

University is conducting an evaluation and analysis of the impact of the personal and community impact of

the Choose Life Program. The results of this study will be made available, annually, in November and will

be used to improve and strengthen the program.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Human Capacity Development

The "Choose life" program is a value-based AB training program for faith, NGO, community and youth

leaders who are targeted and identified through existing networks. "Choose Life" is an experiential basic

(three days) and advanced (five days) accredited training program. The program focuses on two value

frameworks ("the golden rule" and Ubuntu "being through community") as well as six central spiritual values

(respect, responsibility, integrity, fairness, love and service) and enhancing decision-making, assertiveness

and negotiation skills. A trained facilitator conducts workshops with a group of (maximum) 20 participants.

Facilitator capacity building is conducted through a master trainer and mentor training program. By

increasing the number of master trainers, and faith, community, youth and NGO leaders trained, the number

of people reached will increase considerably. "Choose Life (Youth)" has adapted the program for the youth

context. The outcome of this program is to empower participants with knowledge, skills and attitudes to live

powerful, spiritual, self-confident lives by making wise ethical decisions. There will be a particular emphasis

on the role of FBOs in reducing stigma, addressing gender issues and empowering youth and unmarried

people to make abstinence and "be faithful" choices, and for active couples to make "be faithful" choices

that are based on values and supported by life skills. FY 2008 PEPFAR funding will ensure continued

support for fund trainers, workshops, adapt training manuals and handbooks. FY 2008 funding will ensure

geographic expansion of these activities to Free state, Western Cape, Limpopo and Mpumalanga and

expanding into new areas in Gauteng. Ongoing review and adaptation of the program will be based on

lessons learned from the previous year of implementation. This program will in turn reduce stigma and

discrimination on HIV and AIDS. The participants are identified in various faith-based communities and they

get nominated to attend the course. At the end of each course participants are given evaluation forms and

assignments which they have to perform and bring after six months. This is a train the trainer program,

where trainers are nominated from existing community structures. Once the training is completed, trainers

go back into the community to implement what they have learned and come back after six months for a

review.

ACTIVITY 2: Community Outreach

Leaders trained will form action teams that will initiate the community mobilization activities. The value-

based prevention approach, incorporating "Choose Life" program, includes raising awareness about HIV

and AIDS in faith communities, workshops for community members and youth as well as activities like

church services and catechism for children and youth. Apart from the "Choose Life" program implemented

by CompreCare's prevention partner HospiVision, other prevention activities will be implemented using

Activity Narrative: several modalities in cooperation with Kurima, a NGO, by means of the Know Your Neighborhood (KYN)

program. Prevention communication will be implemented via a network of trained KYN community

facilitators who are responsible for spreading AB messages within designated areas at the grassroots level

in target communities.

ACTIVITY 3: Mentoring and Implementation Support

Trained community, faith and youth leaders will receive ongoing support through trained mentors and during

follow-up workshops. Mentors will assist participants in the completion of assignments for certification as

well as in the implementation of the program in their communities. This will significantly increase the

numbers of people reached through continuous implementation by trained leaders. HospiVision will

continue to train the KYN Facilitators and Child Care Workers from the OVC program in value-based

prevention as well as provide counseling and debriefing services on a regular basis. The mentoring and

implementation support will form an essential part of a quality assurance and monitoring and evaluation

program. Through the monitoring and evaluation process, the impact and effectiveness of the value-based

prevention approach will be assessed. FY 2008 PEPFAR funds will support mentors and mentor

workshops.

ACTIVITY 4: Information, Education and Communication

Via the medium of Radio Pulpit, a national Christian radio station, and other community radio stations, a

media program will emphasize the value-based prevention approach, incorporating the messages of the

"Choose life" program about AB lifestyle choices and life skills based on value frameworks and value-based

behavior change principles. This will be done through interviews, discussion forums and listener-driven

programming. In addition, "Choose life: A value-based response to HIV and AIDS", a handbook will be

published on annually by the Powell Bible Centre. This will be linked with series of AB value-based leaflets

published by "The Christian Literature Fund" specifically aimed at targeting community members, pastors

and leaders of FBOs.

CompreCare and its prevention partner, HospiVision, will contribute towards meeting the vision outlined in

the USG Five-Year Strategy for South Africa (PEPFAR goal of seven million infections averted) by

improving AB preventive behaviors among the youth and adults and increasing effective CBO/FBO

prevention activities.

New/Continuing Activity: Continuing Activity

Continuing Activity: 13758

Continued Associated Activity Information

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

System ID System ID

13758 3292.08 U.S. Agency for CompreCare 6597 2798.08 $500,000

International

Development

7561 3292.07 U.S. Agency for CompreCare 4466 2798.07 $500,000

International

Development

3292 3292.06 U.S. Agency for CompreCare 2798 2798.06 $335,000

International

Development

Emphasis Areas

Gender

* Addressing male norms and behaviors

Human Capacity Development

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:

Child Welfare Tshwane (CWT) will be expanding their services to reach more OVC (400 new direct, 100

supplementary and 100 indirect services) and will be improving the quality of services. They will be

increasing the quality of their service by introducing the issues discussed below.

Education: CWT will be introducing structured homework classes with the assistance of local schools. CWT

has identified that OVC are not passing in the grade one and two levels. Care workers, students from

University of Pretoria and teachers will be involved in these classes and sandwiches will be provided for the

children. The classes will be held at three local schools. The progress of the children will be assessed

through the school reports and educational assessments developed with the educators involved in the

project.

Child Survival Activities: The health card system that has been implemented to monitor routine

immunization in cooperation with the various medical clinics will be expanded to include the treatment of life

threatening childhood illnesses as well as improved infant and young child feeding to those OVC identified

by the care workers. During the information days for parents/caregivers representatives from the clinics will

be requested to place emphasis on the importance of the usage of safe water and hygiene. This issue will

also be addressed during the holiday projects with OVC.

CWT will assess whether a savings and loans program for the members in this project is feasible and can

be implemented so as to increase the women's access to income and productive resources.

CWT's OVC program is currently focused on the primary school aged child. However, in FY 2009, CWT will

be looking to identify more adolescents (in secondary school) who are orphaned and vulnerable. CWT will

work with local high schools in the identification of OVC in this age group with specific attention to girls. The

care workers are well known and easily recognized in the community due to the identifying T-shirts they

wear, and many children respond to them by asking for help and this assists CWT to identify the OVC in the

community.

Vegetable gardens are established in the homes of OVC. The families are selected by the land available for

a garden, the quality of the soil and the motivation of the family to sustain the garden. CWT develops the

garden and trains a family member to maintain the garden. The care worker then includes the monitoring of

the garden as part of her service to the family. A separate measuring tool has been developed to monitor

the progress of the garden. These gardens can provide food for the family at a very low cost if they can

sustain the garden. If there are excess vegetables these can be sold for an income. However, CWT's

experience in the urban area is that there are no excess vegetables and the gardens are not seen as an

economic strengthening opportunity. These gardens are the backbone to provide fresh, healthy food for the

families.

Economic strengthening is a focus for the service to many families, mainly women and girls, that are

affected by HIV and AIDS as well those infected with AIDS to prevent them becoming dependent on social

security. CWT has an established beading project that has a detailed marketing plan and has been

identified as a supplier to 2010 Soccer World Cup. This marketing plan ensures the sustainability of the

project for the beneficiaries and where possible they bead by orders. The beneficiaries are selected from

the OVC program and are PLHIV. They are trained how to bead and are paid for each item they complete.

The profits from the sale of the items are placed back into the project to ensure sustainability. This provides

an income for these families, however it develops the self esteem of the beaders - many of them have gone

on to establish their own small business or find work on the open labor market. CWT will assess whether a

savings and loans program for the members in this project is feasible and can be implemented.

CWT has established a plant propagation nursery that provides seedlings to commercial farmers. Project

members were selected from the OVC families and PLHIV. They were trained in plant propagation. A shade

cloth nursery was erected in an area provided to the project by the City Council of Tshwane, who also

provides water and electricity to the nursery. The goal of this project is that the nursery should become a

fully functioning independent business. Farmers have visited the project and committed themselves to

buying plants from this project.

These activities have a proven track record and are essential to the success of the families CWT serve.

CWT makes a special effort to train their care workers to recognize signs of gender-based violence as well

as sexual exploitation of women and children and in unsafe housing conditions and appropriate counseling

and referral services are rendered. Male OVC are encouraged to act responsibly and respect female OVC

and women and are encouraged to play a positive role in their community.

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

SUMMARY:

CompreCare, through its partnership with Child Welfare Tshwane (CWT), will identify and provide a holistic

package of services to orphans and vulnerable children and their families. Program activities include

nutrition, shelter, psychosocial, educational, economic and health care support for OVC as well as outreach

and HIV prevention education. Primary target populations are orphans and vulnerable children (OVC), their

care workers, and people living with HIV and AIDS. The primary emphasis is human capacity development.

BACKGROUND:

CompreCare is a South African non-governmental organization (NGO) implementing HIV and AIDS

prevention and care activities under a multi-partner initiative called CHAMPS. The CHAMPS Initiative aims

to reduce the impact of HIV and AIDS on OVC and their families in the Tshwane metropolitan area,

specifically Mamelodi and Olievenhoutbosch, by raising awareness about HIV/AIDS preventative practices

and through strengthening care and response networks for OVC.

Activity Narrative: In partnership with Child Welfare Tshwane, the largest service provider addressing the needs of OVC in the

Tshwane metropolitan area, CompreCare recruits, trains and mentors care workers and facilitates

increased access to education and government services for OVC. To date, PEPFAR funding has enabled

CompreCare to train 76 care workers and service 2601 children with care and support services. Child

Welfare Tshwane is a member of the South African Government local Department of Social Development

Forum. This forum was created to strengthen linkages and networks between local government officials and

NGO, CBO and FBO members in order to improve coordination between public and private service

provider's programs. Child Welfare Tshwane has established a partnership with the Ford Motor Company

which donates a facility for their wellness center. The Wellness Center offers a range of services to OVC

and their families including; psychosocial services, prevention education, nutritional counseling and support,

and income generation activities.

ACTIVITIES AND EXPECTED RESULTS:

CompreCare's OVC care and support program will focus on the early identification of infected and affected

children and families and ensure that their basic needs (food, health care and education) are met. The

program will conduct household needs assessments and link OVC and their care workers to the appropriate

government and community services. Trained community care workers residing in the target areas enable

CompreCare and its implementing partner to provide comprehensive and holistic care for OVC.

ACTIVITY 1: Training

CompreCare, in collaboration with their implementing partner, Child Welfare Tshwane, will offer a

standardized OVC training and service package/strategy to train and support community care workers. The

training is based on the Iso labantwana ("eye on the children") model that was originally developed by Child

Welfare Cape Town. Child Welfare Tshwane has adapted the model to address the needs of children

infected and affected by HIV and AIDS and has produced a manual for trained volunteers. The training is a

10 module course that emphasizes community-based approaches for the early identification and care and

protection of vulnerable children. Care workers are recruited from the communities, in which they reside and

provided with training in the following; basic HIV and AIDS information and prevention, child abuse and

neglect, assessment counseling and resources, parenting skills, child care act, domestic violence and

maintenance act, substance abuse, management and administration skills. Care workers will also be

exposed to a value-based prevention program (accredited) so as to enable them to render a more

comprehensive prevention education to the OVC and their families. Care workers will also be given the

opportunity to be trained in basic first aid (accredited) which will enable them to more accurately assess the

clinical needs of the OVC. CompreCare and Child Welfare Tshwane provide on site follow-up training and

mentoring for all care workers. In addition, Child Welfare social and auxiliary social workers and M&E staff

provide group counseling sessions for care workers to provide additional mentorship and support and to

share best practices and lessons learned.

ACTIVITY 2: Care and Support Services

The program recruits care workers from target communities to ensure that care and support services are

readily available to OVC. As a result, the program, as a whole, benefits as the care workers are often well-

known and respected by community leaders. The CWT OVC care program already has a cadre of trained,

experienced and active care workers. The focus will be to recruit and train new care workers who can then

slot straight into the work with mentoring in place. The transition will be smoother and more effective.

Already trained and active care workers will be exposed to a continuous program of retraining and so

expanding their capacity to render a more comprehensive service and also to improve the quality of the

service rendered. Care workers are well positioned to easily access the services of other community groups

and service providers including schools, churches, and community care forums. Each care worker reports to

and receives ongoing support from a Child Welfare Tshwane social worker and M&E Officer. When a family

is identified, the care workers complete an initial assessment and develop a plan of action in collaboration

with the social worker for each child and their family. The plan of action details the type of assistance

required by the OVC which includes obtaining identity documents and government social grants, household

budgeting, and distribution of food parcels and establishment of food gardens (made possible through

public and private donations). Care workers provide these services during weekly home visits. Additionally,

care workers provide educational and psychosocial support including school fee exemptions, homework

supervision, care for ill parents/caregiver, succession planning and bereavement counseling for OVC and

their family members. When circumstances exist that require advanced or intensive support, such as health

related issues and child abuse, care workers refer OVC to the appropriate service provider and follow-up to

ensure that the relevant services are provided and that the continuum of care continues for each child. CWT

already offers a comprehensive range of services that are based on the needs of the clients. More

emphasis will be placed onto income generation opportunities and vocational guidance as OVC coming

through the education system are struggling to find employment. The income generation opportunities will

be made economically viable and sustainable.

ACTIVITY 3: Community Wellness Center

In addition to providing home-based support services, Child Welfare Tshwane also manages a community

wellness center that provides care services, five days a week, for OVC and their families. The center

operates a 12 -month intensive therapeutic program that includes individual and group support sessions to

provide information on HIV and AIDS and build coping skills for OVC and their ill caregivers. A full-time

social worker and community volunteers provide OVC with psychosocial support, referrals to social services

and on going training and mentoring to start income generation activities e.g. beading. The program also

offers life skills training for OVC, tailored to the specific needs of the child and includes HIV and AIDS

prevention. Life skills courses are provided through after-school activities, school holiday programs and

group play therapy.

Activity Narrative: ACTIVITY 4: Linkages

CompreCare and its implementing partner, HospiVision, train care workers in value-based HIV prevention

emphasizing abstinence and fidelity. The program focuses on six central spiritual values (respect,

responsibility, integrity, fairness, love and service) and enhancing the life skills of: decision-making,

assertiveness and negotiation. The training also addresses issues of stigma and discrimination and gender

through role play. Skills learned in the program empower care workers to further support OVC with

knowledge, skills and attitudes to make informed decisions about living healthy, productive lives. As the

CWT program is in an urban setting a comprehensive network of referrals is in place and CWT has a

leading role in this network. CWT has a particularly strong relationship in the health sector and so are able

to ensure that their clients receive the required care and treatment. These linkages will be further

strengthened so as to improve care received by the OVC. USG's contact with the Department of Home

Affairs who assist CompreCare with applications for birth certificates and identity documents is increasing

and this will be further addressed. This will contribute a great deal to the economic strengthening of the

OVC and their families as well as education.

Regarding expansion of FY 2008 COP activities, currently the OVC care program's main focus is on

Mamelodi and Olievenhoutsbosch - based on the greatest needs and under resourced areas. However, the

program will be expanded to other CWT sites in the Tshwane area. These sites are Sunnyside, Mid City,

Atteridgeville, Eersterust and Centurion - these will become the focus for the expansion of CompreCare

services.

New/Continuing Activity: Continuing Activity

Continuing Activity: 13759

Continued Associated Activity Information

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

System ID System ID

13759 3294.08 U.S. Agency for CompreCare 6597 2798.08 $1,175,000

International

Development

7563 3294.07 U.S. Agency for CompreCare 4466 2798.07 $560,000

International

Development

3294 3294.06 U.S. Agency for CompreCare 2798 2798.06 $335,000

International

Development

Emphasis Areas

Gender

* Increasing women's access to income and productive resources

Health-related Wraparound Programs

* Child Survival Activities

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $3,000

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Estimated amount of funding that is planned for Food and Nutrition: Commodities $10,000

Economic Strengthening

Estimated amount of funding that is planned for Economic Strengthening $10,000

Education

Estimated amount of funding that is planned for Education $20,000

Water

Table 3.3.13: