TITLE: Community sensitization to promote abstinence and fidelity

NEED and COMPARATIVE ADVANTAGE: The estimated HIV prevalence in Mbeya region is 13%, one of

the highest in the country, and prevailing social norms challenge HIV prevention efforts in the region.

KIHUMBE has established itself as a national leader in prevention education. Since 2000, KIHUMBE and

has won annual national awards from the Tanzanian Art Council and Kilimanjaro Music Awards for its

dramatic performances. KIHUMBE has also developed expertise in coordinating large-scale media

campaigns and is at the forefront of HIV prevention education in the community. In addition to conducting

these activities, KIHUMBE provides training to other members of the Mbeya HIV Network Tanzania (MHNT)

as well as NGOs in the Rukwa and Ruvuma regions.

ACCOMPLISHMENTS: KIHUMBE trained 75 representatives of MHNT member NGOs to provide accurate

AB HIV/AIDS prevention messages, and coordinated a collaborative prevention campaign, "Know the

Facts." Working with the MHNT, the campaign included promoting AB messages through cassette tapes

distributed to local commuter buses. KIHUMBE volunteers reached over 100,000 individuals with

performances and other activities, and collaborated with MHNT to provide HIV prevention education at large

scale events, including an annual eight-day festival (Nane Nane), World AIDS Day, and Valentine's Day

events.

ACTIVITIES: 1) Continue to sensitize the community and convey AB messages through creative public

presentations in Mbeya region.

1a) Continue to employ volunteer artists to create and perform motivational and educational presentations

promoting AB messages.

1b) Coordinate with village executives, schools, and other community leaders to schedule presentations

throughout the community and in three of the larger workplaces in Mbeya. 1c) Perform presentations at

large-scale community events, including the annual Nanenane festival, World AIDS Day, and monthly HIV

testing events organized by MHNT. 2) Build upon the success of previous years' efforts and coordinate a

community-wide campaign in Mbeya region in collaboration with other MHNT members to raise awareness

and promote AB messages. 2a) Consult lessons learned from previous years and plan an effort based

upon the Dala Dala campaign, which included production of cassette tapes with AB messages, distribution,

and use of these tapes on local commuter buses. 2b) Produce cassettes, videos, and/or other promotional

materials for distribution to KIHUMBE's outlets, 50 wards. 2c) Promote the campaign's messages through

community education activities. 3) Continue to train peer counselors at the village level to ensure a

widespread and accurate knowledge base, encourage discussion to reduce stigma, and de-emphasize

previous traditional responses to HIV/AIDS. 3a) Consult with community leaders to identify influential

individuals of all ages to be trained as peer counselors, maximizing the potential for changing social norms.

3b) Provide training for peer counselors initially, and on a refresher basis, as necessary.

3c) Convene regular Saturday meetings of youth peer counselors to motivate volunteers, monitor efforts,

identify challenges, and improve quality of service. 4) Train artists and other volunteers of NGOs in Mbeya,

Rukwa, and Ruvuma regions to create and perform presentations and provide other HIV prevention

education activities. 4a) Provide comprehensive training to new volunteers of DOD-funded NGOs in the

southern highlands zone.

4b) Offer refresher training to volunteers who previously received comprehensive training to refine skills

and share new techniques.

LINKAGES: Along with executing prevention activities, KIHUMBE also provides a number of other services,

including counseling and testing (CT), OVC services, and home-based care. KIHUMBE is also a founding

member of the MHNT, a coalition of 13 NGOs/FBOs providing HIV prevention and care in Mbeya region

that collaborate to maximize impact and coverage of their collective activities and eliminate overlap. This

activity also links with: schools, faith groups and village associations; Saturday and after school youth

programs; ward leaders and other local government officials; faith groups and other providers of counseling

services; VCT sites to facilitate referrals; and PEPFAR marketing groups STRADCOM and AED for local

advertising to encourage event participation.

CHECK BOXES: Promotion of AB messages will target the general population and youth with efforts

designed to sensitize the community and shift social norms toward greater respect for gender, legal, and

human rights. Individuals of all ages will be targeted with specific A and/or B messages in an effort to exert

broad influence on community norms. Training is a key component of this program area, as volunteers

constitute the primary human resources delivering HIV prevention education. Developing programs in

Rukwa and Ruvuma regions will particularly benefit from KIHUMBE's training activities.

M&E: In addition to established processes for monitoring indicators on a quarterly basis, KIHUMBE will

implement standardized tools for collecting detailed data on service delivery. These tools, developed by

MHNT under a separate entry, will allow for data from all MHNT member NGOs to be compiled, thereby

identifying gaps within service provision at the community level. These data will be shared with local

leaders to highlight key needs and enlist community support in meeting these needs. Data collected by the

network through clients' referral routes to VCT will help refine and better target specific KIHUMBE

community education efforts.

SUSTAINABILITY: KIHUMBE is a local, grassroots Tanzanian-run NGO that was established in 1991 and

has flourished under strong leadership. Along with maintaining and expanding its original site in the Mbeya

municipal area, KIHUMBE has established service outlets in Mbalizi, Tukuyu, and Chunya, extending its

area of service. DOD is one of KIHUMBE's multiple funding sources. In addition to its impressive record of

service delivery, KIHUMBE's organizational capacity to collect and manage data and secure funding is

among the strongest in the zone. Capacity building and other training opportunities through other USG

partners will remain available to KIHUMBE.

TITLE: KIHUMBE promoting safer choices to reduce sexual transmission of HIV.

NEED and COMPARATIVE ADVANTAGE: The estimated HIV prevalence in Mbeya region is 13%, one of

the highest in the country, and prevailing social norms challenge HIV prevention efforts in the region.

Mbeya borders Malawi and Rwanda, thereby supporting the main trade route via highway. The

transactional sex and high-risk behaviors associated with its location are the primary reason for its high

prevalence. While abstinence and faithfulness are important to stemming the HIV/AIDS epidemic, it is also

critical to empower sexually active individuals to make safer choices to protect themselves and their

partners from HIV infection. KIHUMBE has established itself as a national leader in prevention education

and has received awards annually from the Tanzanian Art Council and Kilimanjaro Music Awards for its

dramas since 2000. KIHUMBE has also developed expertise in coordinating large-scale media campaigns.

In addition to conducting these activities, KIHUMBE provides training to other members of the Mbeya HIV

Network Tanzania (MHNT) as well as NGOs in the Rukwa and Ruvuma regions.

ACCOMPLISHMENTS: OP has been a component of community-wide HIV prevention education activities

spear-headed by KIHUMBE. These large-scale activities have included media campaigns, outreach, and

education at regional and national festivals and other annual events reaching large parts of the population.

Planned efforts described in this narrative will complement general education with more intensive individual

and group-level interventions to promote behavior change in local secondary schools, youth groups of out-

of-school youth, young adults, and employees in the three large workplace venues in Mbeya.

ACTIVITIES: 1. Continue to train peer counselors at the village level to provide community HIV prevention

education, reduce stigma, encourage consistent and correct condom use by sexually active individuals, and

promote dialogue as well as utilization of voluntary counseling and testing (VCT) services.

1a. Consult with community leaders to identify influential individuals of all ages to be trained as peer

counselors, maximizing the potential for changing behavior.

1b. Provide training for peer counselors, both initially and on a refresher basis as necessary among youth

and at workplaces.

1c. Convene regular meetings of peer counselors to motivate volunteers, monitor efforts, identify

challenges, and improve quality of service.

2. Convene post-test clubs of PLHWA to share experiences and discuss disclosure and HIV prevention

issues, including safer sex.

2a. Continue to convene existing post-test clubs, and communicate with PLWHA served by a given NGO to

identify meeting times and venues favorable to PLWHA participation.

2b. In addition to providing a supportive environment for sharing feelings and experiences, identify and/or

develop and implement mini-curricula designed to assist PLWHA (including members of discordant couples)

in preventing further transmission of HIV.

3. Coordinate with VCT services to convene post-test safe choices discussion groups for individuals who

test HIV negative, supporting them to sustain their HIV-negative status. Focus efforts on empowering

individuals to identify safe choices they wish to make, and developing the skills each individual needs in

order to implement those choices consistently.

3a. Explore national and/or international resources to identify and/or develop a mini-curriculum that

addresses empowerment, assertiveness, and communication skills, including condom negotiation skills.

3b. Address alcohol use as an obstacle to making safer sexual choices, and encourage individuals to

consider safer choices regarding alcohol consumption.

3c. Through MHNT train MHNT members and NGOs in Rukwa and Ruvuma to provide youth and adult

peer education and post-test group facilitation.

3d. Establish a referral system with permanent and mobile VCT service sites, whereby all individuals

testing HIV-negative are encouraged to participate in post-test discussion groups.

4. Coordinate with other prevention efforts to ensure provision of education about safer sex to sexually

active individuals, including members of discordant couples.

4a. Work with providers of gender, human and legal rights training to incorporate education about condom

use and condom negotiation as appropriate.

4b. Collaborate with providers of educational performances to prepare and perform presentations

encouraging correct and consistent condom use by sexually active individuals.

4c. Join MHNT efforts with marketing and radio groups to develop a community-wide media campaign,

ensuring messages include encouraging sexually active individuals to use condoms consistently and

correctly and to avoid preventable risky behaviors.

5. Purchase and maintenance of vehicle to transport IEC educational team, materials, and equipment to

KIHUMBE sites and MHNT training sites in Ruvuma and Rukwa.

LINKAGES: Along with executing prevention activities, KIHUMBE also provides a number of other services,

including CT, OVC services and home-based care. KIHUMBE is a founding member of the MHNT, which is

a coalition of 13 NGOs/FBOs providing HIV prevention and care in Mbeya region. The MHNT collaborate to

maximize impact and coverage of their collective activities and eliminate overlap. This activity also links

with: MHNT for training in OP messaging; schools, faith groups and village associations; saturday and after

school youth programs; ward leaders and other local government officials; faith groups and other providers

of counseling services; VCT sites to facilitate referrals; ROADS/FHI program in accessing high risk

populations along the trans-African highway; and marketing groups such as STRADCOM and AED for local

advertising to encourage event participation.

CHECK BOXES: These services focus on sexually active individuals, including members of discordant

couples, as well as adults and youth who have or may become sexually active. Activities designed to

empower individuals, particularly women, to make safer choices regarding sexual behavior, address gender

norms and promote gender equality. These approaches also encourage risk reduction among persons

engaging in prostitution or transactional sex. Training of peer educators and group facilitators is a key

component of this program area, as volunteers constitute the primary human resource delivering HIV

prevention education.

M&E: In addition to established processes for monitoring indicators on a quarterly basis, KIHUMBE will

Activity Narrative: implement standardized tools for collecting detailed data on service delivery. These tools, developed by

MHNT, will allow for specific data from KIHUMBE to be compiled by an M&E staff person, thereby

identifying gaps within service provision at the community level. These data will be shared with local

leaders to highlight key needs and enlist community support in meeting these needs. Data collected by

KIHUMBE regarding clients' referral routes to VCT will help refine and better target community education

efforts, and test results via mobile VCT services will help identify sites to reach high-risk groups with

additional education.

SUSTAINABILITY: KIHUMBE is a local grassroots Tanzanian-run NGO that was established in 1991 and

has flourished under strong leadership. Along with maintaining and expanding its original site in the Mbeya

municipal area, KIHUMBE has established service outlets in Mbalizi, Tukuyu, and Chunya, extending its

area of services. DOD is one of KIHUMBE's multiple funding sources. In addition to its impressive record

of service delivery, KIHUMBE's organizational capacity to collect and manage data and secure funding is

among the strongest in the zone. Capacity building and other training opportunities through other USG

partners will remain available to KIHUMBE.

TITLE: KIHUMBE Community Home-based Care in the Mbeya Region

NEED and COMPARATIVE ADVANTAGE: As the number of HIV-positive individuals who know their sero-

status increases, so does the need for palliative care and for support adhering to antiretrovial therapy

(ART). Between clinic visits, people living with HIV/AIDS (PLWHA) need assistance to treat symptoms,

receive appropriate opportunistic infection (OI) prophylaxis, and ensure proper nutrition and support to

maximize treatment effectiveness. Clients with improved health need support in earning an income, and

those with failing health require end-of-life care. KIHUMBE pioneered community home-based care (HBC)

in the Mbeya region, providing HIV/AIDS services in HBC, counseling and testing, prevention, and support

to OVC since 1991 and has been a prime partner under PEPFAR since 2004. As additional NGOs begin to

provide community HBC to expand coverage of these services in Mbeya, KIHUMBE also provides initial and

refresher training to these providers.

ACCOMPLISHMENTS: KIHUMBE has supported 900 clients with palliative care, including nutrition

counseling and assistance, psychosocial/spiritual support, OI and pain management, cotrimoxizole/malaria

prevention, referrals for malaria and TB diagnosis and treatment, access to safer water, training in income-

generating activities (IGA), legal and human rights education, and ART adherence counseling. In addition,

KIHUMBE continued to serve as the provider of training for community HBC providers, training more than

350 community members to care for PLWHA.

ACTIVITIES:

KIHUMBE collaborates with members of the Mbeya HIV Network Tanzania (MHNT), SONGONET, and

RODI (see other submissions for these partners) in order to ensure that consistent packages of services are

available for clients in Mbeya, Rukwa, and Ruvuma regions. In addition, implementation of services has

been standardized across these partners while allowing for some flexibility in focus/approach depending on

regional conditions. In FY 2008, KIHUMBE will:

1. Continue to provide community HBC training for service providers in accordance with national

guidelines, curriculum, and standards. 1a. Train new providers for other MHNT, SONGONET, and RODI

member organizations in basic palliative care services described above. 1b. Provide refresher training for

providers in all three regions.

2. Expand provision of community HBC to additionalclients in the Mbeya region. 2a. Supply nutrition

evaluation and counseling as well as food (to those who qualify) and vitamin supplements to clients during

their first six months of ART. 2b. Link clients to Peace Corps agriculture activities in the region for training

in home gardens for both personal food production and as an income-generating opportunity. 2c. Link to

USG procurement programs for distribution of insecticide-treated nets (ITN) and water purification supplies

to clients. 2d. Provide training and support for IGAs for caregivers and able PLWHA, and help to develop

sustainable associations for income generation. 2e. Assist with short-term nutrition for malnourished

children of HIV-positive clients unable to work. 2f. Identify and refer pediatric and adult cases of TB,

malaria, and/or HIV/AIDS to healthcare providers.

3. Convene monthly education and support group meetings for community HBC clients. 3a. Establish and

inform community HBC clients of regular client meeting times. 3b. Develop a schedule of presentations and

activities to augment support group meetings, addressing issues such as nutrition and other topics of

interest identified by participants. 3c. Inform clients of IGA opportunities and trainings.

4. Train clients' caregivers in basic palliative care to increase community capacity and enable community

HBC providers to prioritize clients with the most need. These efforts will foster community responsibility as

well as expand program capacity to reach more PLWHA. 4a. Community HBC providers will provide

ongoing training to caregivers as part of regular visits, creating a plan for reducing visits to longer intervals

and, as appropriate, ceasing visits except as needed/requested by the caregiver. 4b. Identify and address

special training needs for elderly caregivers with literacy, health, or other barriers.

5. Incorporate prevention for positives and partner/child VCT referral into community HBC visits wherever

appropriate. 5a. Ensure community HBC providers are trained to discuss HIV prevention with clients.

Modify the existing community HBC curriculum in prevention for positives approached based on USG

findings in FY 2007. 5b. Include prevention for positives and partner VCT referral as part of all visits as

appropriate. 5c. Discuss themes, successes, and challenges of community HBC prevention efforts as part

of KIHUMBE's regular community HBC provider meetings to evaluate and improve services on an ongoing

basis.

LINKAGES: KIHUMBE is a founding member of MHNT, a coalition of 13 non-governmental

organizations/faith-based organizations (NGOs/FBOs) serving Mbeya region. These NGOs refer clients to

one another based upon clients' areas of residence, need, and specific area of expertise of a member

organization. The MHNT convenes community HBC provider meetings to exchange ideas and support.

KIHUMBE follows national guidelines for HBC.

KIHUMBE also links with SONGONET; RODI; ward leaders, and other local government officials; Peace

Corps and NGOs providing training and access to income-generating activities; faith groups and other

counseling service providers; VCT sites and dispensaries; water safety projects and water purification

commodities; district and/or regional hospitals for treatment and provision of cotrimoxizole and morphine as

necessary for care on a case by case basis; and NACP to facilitate TOT participation in certified HBC

provider courses. They will also link with the national voucher scheme organized for insecticide-treated

nets and nutritional supplementation.

CHECK BOXES: HBC allows for an integrated approach to the health and well-being of the patient and

his/her entire family, addressing malaria and TB, child survival and family planning, in addition to HIV/AIDS.

IGAs promote women's access to income, as well as foster economic strengthening and food security.

Training is a key component of the community HBC program area, as volunteers constitute the primary

human resources delivering services.

M&E: KIHUMBE employs various programs in efforts to improve their M&E practices. KIHUMBE will

dedicate a staff member to monitoring, compiling, and evaluating all data collected by its HBC providers in

Activity Narrative: collaboration with the data system to be rolled out in the future by NACP. Henry Jackson Foundation

Medical Research International (HJFMRI) will spot check the present tools for collecting data on service

delivery to assure transparency and completeness of HBC services. These tools, developed by the MHNT,

will serve as a visit checklist, which includes a menu of services to for each patient based on individual

need. Use of the tools will ensure documentation of which services are provided for patient and program

management. Compiling data from sub-partners will allow for identification of major service needs and gaps

within HBC services. These data will be shared with local leaders to highlight needs and enlist community

support in meeting these needs. All new and active HBC providers will be provided refresher courses

regarding this paper based system in order to ensure efficient transmission to an electronic system. This

system will thus measure successful linkages with care and treatment clinics, TB, counseling and testing,

PMTCT, prevention, safe water, nutritional programs, and livelihood programs in addition to highlighting

innovative program linkages.

SUSTAINABILITY: KIHUMBE is a local, grassroots Tanzanian-run NGO that was established in 1991 and

has flourished under strong leadership. Along with maintaining and expanding its original site in the Mbeya

municipal area, KIHUMBE has established service outlets in Mbalizi, Tukuyu, and Chunya. DOD is one of

KIHUMBE's multiple funding sources. In addition to its record of service delivery, KIHUMBE's

organizational capacity to collect and manage data and secure funding is very strong. Capacity building

and other training opportunities will remain available to KIHUMBE through access to other USG

partners/programs under PEPFAR.

TITLE: KIHUMBE provision of OVC services in the Mbeya Region

NEED and COMPARATIVE ADVANTAGE: Mbeya region has an estimated 18% of orphans and vulnerable

children (OVC) per capita, yet due to limited resources, many go without assistance. OVC children need

support to attend school and meet basic needs (food, shelter, and medical care), as well as psychosocial

and spiritual support. Caregivers of OVC have limited resources and need assistance to support their

families. KIHUMBE has been providing HIV services since 1991 and has been a prime partner since 2004.

Its organizational infrastructure, service capacity, community linkages, and reputation makes KIHUMBE one

of the most effective HIV service providers in the region.

ACCOMPLISHMENTS: KIHUMBE has supported 1,100 OVC, including providing educational support

(school fees, uniforms, and materials), nutrition assistance, and psychosocial /spiritual support.

ACTIVITIES: As in activities in other program areas for this organization, KIHUMBE will collaborate with

members of the Mbeya HIV Network Tanzania (MHNT), SONGONET, and RODI (see other submissions for

these partners) to ensure similar packages of services are available for clients in the Mbeya, Rukwa, and

Ruvuma regions. In addition, implementations of services have been standardized across these partners

while allowing for some flexibility in focus or approach depending on regional conditions.

1) Establish youth centers near each of KIHUMBE's three service sites: Mbeya municipal area, Mbalizi

town (Mbeya Rural), and Rungwe district. Each site will provide a venue for offering psychosocial or

spiritual support to OVC, HIV prevention education, and training or access to income-generating

opportunities. Priorities include to: renovate, furnish and staff youth center sites; coordinate and develop

memoranda of agreement with Mbeya HIV Network Tanzania (MHNT) members and other NGOs and

governmental groups to out-source provision of a range of services to youth at the sites depending on the

organization's specialty; and advertise youth centers, cultivating referral relationships with schools and other

entities serving youth.

2) Expand support and provide services to an additional 700 OVC. Activities include: working with local

government and Most Vulnerable Children Committees (MVCCs) to identify OVC and their needs, and to

maximize coverage without duplicating services; providing OVC with psychosocial support through

individual and group counseling; prioritizing services for the individual for educational support (fees,

uniforms, supplies), shelter, and nutrition assessment and assistance once a needs assessment has been

conducted; providing training in income-generating activities for OVC caregivers and older OVC; linking

OVC and caregivers to Peace Corps agriculture activities in the region for training in home gardens for both

personal food production and as an income generating activity (IGA); linking OVC to USG procurement

programs for distribution of insecticide treated nets (ITN) and water purification supplies to clients.

3) Improve referral system for OVC to ensure a comprehensive approach to meeting individual needs,

including follow-up with the entity to which the client is referred. Activities will include: establish

standardized referral process for assessing service needs and linking OVC to services (including medical

care, VCT, and HIV prevention); train OVC service providers and caregivers in identification and care for

HIV related illnesses and referrals for HBC and facility-based clinical services to increase treatment of HIV

infected OVC; continue to cultivate relationships with municipal and NGO service providers to facilitate

referral follow-up; include these referral activities, including follow-up, on standardized forms to facilitate

monitoring and evaluation and quality improvement.

LINKAGES: This activity will participate in the implementation of the NPA. KIHUMBE is a founding

member of the Mbeya HIV Network Tanzania (MHNT), a coalition of 13 NGOs/FBOs that provide HIV

prevention and care in the Southern Highlands Zone. All member organizations refer clients to one another

based upon clients' area of residence, need, and strength of the organization. KIHUMBE also links with the

Anglican church, which provides training for volunteers serving OVC; district and/or regional hospitals to

facilitate referrals; MVCC, ward leaders and other local government officials to identify and register OVC

and comply with data reporting requirements; primary and secondary schools and the vocational training

institute (VETA); Peace Corps activities and NGOs providing income-generating activities; faith groups and

other providers of counseling services; and USG and other donor sources of ITN and safe water

commodities.

CHECK BOXES: OVC services support HIV-positive and HIV-negative OVC as well as their caregivers.

Linkages to healthcare address child survival, malaria, and other health issues in addition to HIV/AIDS.

Education assistance and psychosocial/spiritual support promote OVC skills and well-being, while income-

generating activities foster economic strengthening and food security for OVC caregivers and older OVC.

Training is a key component of the OVC program area, as volunteers constitute the primary human

resources delivering OVC services.

M&E: KIHUMBE will utilize the standardized national OVC data management tools for collecting detailed

data on service delivery in compliance with government OVC data reporting requirements for the Ministry of

Health and Social Welfare (MOHSW). The MHNT M&E individual will train and oversee KIHUMBE staff on

a quarterly basis to ensure comprehensiveness of data input by field staff using the internal monitoring

tools.. These tools, developed by MHNT (including KIHUMBE), will also serve as a checklist to ensure a

menu of services is offered to each child based upon individual need. Along with submitting these data to

the local government, data from KIHUMBE and other MHNT member organizations will be compiled at the

network level, allowing for identification of major service needs and gaps. In addition, computers will be

purchased for the district/municipal social welfare officer. All reports will be shared with the local

government, and compiled data from sub-partners will allow for identification of major service needs and

gaps within OVC services. These data will be shared with local leaders to highlight key needs and enlist

community support in meeting these needs. KIHUMBE will collaborate with Salvation Army and PACT to

avoid duplication.

SUSTAINABILITY: KIHUMBE is a local, grassroots Tanzanian-run NGO that was established in 1991 and

has flourished under strong leadership. Along with maintaining and expanding its original site in the Mbeya

municipal area, KIHUMBE has established service outlets in Mbalizi, Tukuyu, and Chunya, extending its

service capacity area. DOD is one of KIHUMBE's multiple funding sources. In addition to its impressive

record of service delivery, KIHUMBE's organizational capacity to collect and manage data and secure

Activity Narrative: funding is among the strongest in the zone. Capacity building and other training opportunities through other

USG partners will remain available to KIHUMBE and its fellow MHNT members. KIHUMBE will play a

facilitative role to ensure the incorporation of its OVC work plan, budgets, and reports in the overall district

response plans as a sustainability measure. At the household level, OVC family members will receive

mentors and support with IGAs. KIHUMBE will ensure involvement of district leaders, MVCC, and

community leaders on the development of the viable response to OVC and elderly headed households.

TITLE: KIHUMBE voluntary counseling and testing (VCT) to further prevention and treatment goals in the

Mbeya Region.

NEED and COMPARATIVE ADVANTAGE: The estimated HIV prevalence in the Mbeya Region is over

13%, one of the highest in the country, with an estimated 90% unaware of their HIV status. KIHUMBE has

been providing HIV services since 1991, one of which has been VCT both at its static site in the Mbeya

Municipality as well as through its home-based care services. It has been a PEPFAR prime partner since

2004.

ACCOMPLISHMENTS: KIHUMBE directly provided VCT to 800 clients in FY 2006 and 1,000 in FY 2007,

18% of whom tested HIV-positive. As a member of the Mbeya HIV Network Tanzania (MHNT) (another

prime partner under this program area), KIHUMBE also helped provide VCT in 2006 to 755 individuals and

in 2007 to another1428 at the annual 8-day Nanenane regional farmers' exhibition, which draws over

300,000 attendants. KIHUMBE also participated with MHNT members at World AIDS Day and regional VCT

events. In FY 2007, KIHUMBE inaugurated a mobile VCT program in 60 wards which linked all tested with

appropriate health facilities for follow-up and local NGOs providing post test + and - clubs or other

supportive services.

ACTIVITIES: Working in a coordinated and cooperative manner, KIHUMBE and members of SONGONET-

HIV, the MHNT, and Research Oriented Development Initiative (RODI) (see other submissions for these

partners) will ensure VCT services are available for as many clients as possible in the Mbeya, Rukwa, and

Ruvuma Regions. In addition, implementation of services have been standardized across these partners but

allowing for some flexibility in focus/approach depending on regional conditions. All VCT activities will

include distribution of information to clients on appropriate referral for services depending on sero-status

and residence.

1) Participate with other MHNT and MOH test counselors to provide VCT at large-scale community events,

capitalizing upon opportunities to reach a large number of individuals in a single user-friendly setting.

1a) Along with other MHNT members' staff, execute presentations and provide staff to encourage testing at

the 8-day 2008 Nanenane festival, building upon the success of the preceding three years.

1b) Provide VCT at the annual MHNT World AIDS Day event as part of a local MOHSW sponsored

program.

1c) Participate in planning, advertising and executing VCT for monthly "HIV Testing Day" events to be held

in Mbeya region at rotating facilities through out the region.

2) Continue to provide VCT services at community sites and through HBC services in accordance with

national standards and using MHNT tools to document service delivery.

2a) Provide VCT at KIHUMBE service sites, including newly established youth centers (see OVC entry

under this partner).

2b) Refer HBC clients suspected of suffering from HIV related illness as well as their family members for

VCT services provided by KIHUMBE static sites, mobile sites and in homes or to other MHNT members or

facilities.

2c) Coordinate with local entities to provide VCT at non-HIV-specific NGOs, youth centers, workplaces and

other community sites.

2d) Train at least four new counselors to staff new sites through NACP certified VCT training.

2e) Procure test kits from Medical Stores Department (MSD) and Supply Chain Management Systems

(SCMS) when not available through central procurement mechanisms.

3) Provide mobile VCT in at least 35 more villages, creating easier access to VCT services.

3a) Work with local leaders, District Health Management Teams (DHMT), and health facility directors to

identify sites for providing mobile VCT, involving them in mobilization, testing and follow-up.

3b) Coordinate with other MHNT organizations and nearby health facilities to ensure VCT staff for mobile

VCT.

3c) Highlight mobile VCT data acquired by KIHUMBE to aid in identifying areas with particular need for HIV

prevention services and/or a new stationery VCT sites and at local workplaces.

4) Ensure effective referral for individuals accessing VCT services, incorporating follow-up with the entity to

which the client is referred, health facility, and/or NGO.

4a) Establish standardized referral process for linking individuals testing HIV-positive to services, to include

at minimum medical services and home-based care "prescription" to KIHUMBE or other MHNT members.

4b) Provide prevention education depending upon the client's sero-status and identify and refer individuals

testing HIV-negative to HIV prevention resources to help maintain their HIV-negative status.

4c) Include these referral activities and follow-up on standardized forms to facilitate monitoring and

evaluation and quality improvement.

LINKAGES: Along with providing permanent and mobile VCT services, KIHUMBE also provides a number

of other services, including HIV prevention and home-based care. KIHUMBE is also a founding member of

the MHNT, a coalition of 13 NGOs/FBOs providing HIV prevention and care in Mbeya region. All member

organizations refer clients to one another based upon clients' area of residence, need and strength of the

organization (submissions under HBHC and HVAB/HVOP). This activity also links with: District and/or

regional hospitals to facilitate referrals; Ward leaders and other local government officials; Faith groups and

other providers of counseling services; ROADS/FHI program in accessing high risk populations along the

trans-African highway: PEPFAR marketing groups STRADCOM and Academy for Educational Development

(AED) for local advertising to encourage event participation.

CHECK BOXES: VCT services target the general population. Coordination with home-based care and other

services ensures smoother referral of PLHA, their spouses and children to VCT. Relationships with

business entities provide VCT opportunities at workplace settings, reaching more members of the

population in the highest risk age groups. Funding supports commodity procurement, vehicle maintenance,

trainings, staff support and advertising and participation in community events.

M&E: In addition to established processes for monitoring indicators on a quarterly basis, KIHUMBE will

implement standardized NACP tools for collecting detailed data on service delivery. These tools will allow

for data from KIHUMBE and member NGOs to be compiled at the network level by the designated M&E

staff person, facilitating identification of major service needs, gaps and areas for improvement. These data

will be shared with local leaders to highlight key needs and enlist community support in meeting these

needs. Assessment of clients' referral routes to VCT will inform KIHUMBE outreach and education efforts,

and test results via mobile VCT services will help identify sites in greatest need of HIV services. Supportive

Activity Narrative: supervision of these sites includes data collection, management and storage of data (registers and forms)

reporting of data to district-level. National CT guidelines and training materials will be used to strengthen

M&E capacity in these facilities. Data will be provided to NACP and USG for reporting purposes.

SUSTAINABILITY: KIHUMBE is a local, grassroots Tanzanian-run NGO that was established in 1991 and

has flourished under strong leadership. Along with maintaining and expanding its original site in the Mbeya

municipal area, KIHUMBE has established service outlets in Mbalizi, Tukuyu and Chunya, extending its

catchment area. DOD is one of KIHUMBE's multiple funding sources. In addition to its impressive record of

service delivery, KIHUMBE's organizational capacity to collect and manage data and secure funding is

among the strongest in the zone. Capacity-building and other training opportunities through other USG

partners will remain available to KIHUMBE.