TITLE: Improving Economic Opportunities for People Living with HIV/AIDS in the Horticulture Industry in

Tanzania

NEED and COMPARATIVE ADVANTAGE: High value horticulture is a suitable income-generating activity

(IGA) for people living with HIV/AIDS (PLWHA) because such crops are hand-cultivated in a small area that

can be close to one's home. Consequently, PLWHA can be involved in part-time labor and family members

can provide support. Horticulture also results in significantly higher returns to labor than field crops such as

maize. ACDI/VOCA (AV) has extensive experience in developing successful economic programs around

the world and is prepared to collaborate with the PEPFAR project. AV's Horticulture Competitiveness of

Tanzania (HCTZ) project will assist PLWHA to increase income through sales of high value horticultural

crops and enriching the dietary base for targeted households. AV will use its comparative advantage to

promote improved nutrition and nutrient-rich food preparation among workers with HIV. AV is also the lead

of the horticulture producer association, providing broad reach for its approach.

ACCOMPLISHMENTS: AV is a long-time USAID economic growth partner.

ACTIVITIES: The program will build the capacity of producer associations to provide services for PLWHA

related to income generation, improved nutrition, and reduced stigma. High value horticulture is an

excellent source of income for families with infected members, as well as providing an avenue for providing

advice and support for PLWHA who can generate income by working in horticulture near the home.

Using the relationship that AV has with the horticulture producer associations, the Tanzanian Horticulture

Association (TAHA), AV will promote economic opportunity among PLWHA. It will encourage PLWHA to

remain healthy contributors to their household income, and provide referrals for community home-based

care (HBC) and to treatment services. To strengthen the ability of PLWHA to remain in good health and

contribute to income generation for their families, AV will use existing materials developed by HBC

programs to promote improved nutrition education and consumption among PLWHA beneficiaries.

Understanding nutritional value of various horticulture products and how they can be most efficiently

prepared to ensure the necessary balance of vitamins and minerals will improve general health status. The

program will promote urban gardens for PLWHA to improve nutrition and economic opportunity. Training

sessions designed around health and nutrition needs for PLWHA will be organized and provided. It will also

organize village-based cooking and nutrition demonstrations to encourage the healthy preparation of food

while incorporating available vegetables from the horticultural programs.

Because AV is the lead organization in TAHA, it will also work with industry stakeholders to ensure that

PLWHA are not marginalized in industry activities, rather, they will benefit from them. Horticulture is a key

economic industry in Tanzania focused around the northern parts of the country (Arusha and Lushoto).

Though HIV/AIDS is widespread in this part of Tanzania, few industry stakeholders actively address the

disease and its impact on the community. TAHA will ensure widespread dissemination of information while

ensuring sustainability of activities beyond the life of the project. An assessment of constraints faced by

PLWHA in participating in the horticulture industry will be conducted in order for TAHA to develop strategies

to reach PLWHA among rural vegetable producers. Interventions designed for PLWHA will be highlighted

at industry events and regional/national horticultural fairs (e.g., Nane Nane and Farmers' Day), in

collaboration with industry stakeholders to promote the improved income, nutrition, and health benefits of

horticulture.

LINKAGES: AV will leverage the economic growth horticulture activity recently awarded by USAID for work

in the Arusha, Kilimanjaro, Moshi, and Tanga regions. AV will link with existing palliative care partners in

those regions to provide quality wraparound programming for income generation and nutrition, and to

ensure that participants receive quality training and information. These partners include Pathfinder

International, Selian, Foundations for Hospice in Sub-Saharan Africa, the American International Health

Alliance, and Mildmay. In addition, the project will link with local nutritionists to develop engaging and

relevant workshop sessions on healthy living, as well as with theater groups such as Arusha Living Positive

with HIV/AIDS (ALPHA). It will also link with the Peace Corps-initiated permaculture program to incorporate

successful practices of that program into other parts of the country. It will incorporate the government,

community health, and extension agents as partners in the planning, implementation and evaluation of the

health promotion activity. Lastly, it will partner with local non-governmental organizations (NGOs), Rural

Urban Development Initiatives (RUDI), and technical trainers to incorporate HIV/AIDS care and treatment

services in association information, capacity building, and training. Partnership with TAHA and RUDI has

already been secured through a letter of agreement. Because this is a wraparound activity, no direct

targets are indicated.

CHECK BOXES: These areas of emphasis were selected because approximately 11% of blood donors in

the target area are HIV-positive. Horticulture is a prominently female activity, with female membership in

horticulture producer associations typically reaching 60%. Youth are also included because children who

are not enrolled in school in rural areas are generally engaged in their family farms. The business

community is included through industry activities, and through the fact that the program is focused in the

workplace of the horticulture industry actors. AV's business-oriented approach to development will ensure

that PEPFAR funding will have a positive impact on economic strengthening.

M&E: AV will track the number of beneficiaries receiving enhanced palliative care services through

improved nutrition and income generating activities from project interventions. Village and association-

based training and education provide easy venues to track progress over the two-year project period. AV

will explore additional qualitative indicators reflecting the availability and quality of palliative care among

beneficiaries and include them in the project's M&E system. In addition, the project will analyze the specific

constraints faced by PLWHA in the high-value horticulture sector and report on findings and

recommendations.

SUSTAINAIBLITY: Through producer associations and partnerships between public and private sector

stakeholders, AV will promote collaboration between multiple agencies in order to develop local and

community ownership of the interventions to ensure sustainability beyond the life of the project, including

through cost-sharing of activities. AV's horticulture competitiveness project uses the value chain approach

to ensure sustainability, as target populations will engage in commercially sustainable income-generating

activities. The study analyzing the constraints of PLWHA and their caregivers in the horticulture sector will

also assist TAHA and other industry players to address constraints and incorporate such programming in

Activity Narrative: their activities.