PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2008 2009
THIS IS AN ONGOING ACTIVITY FROM FY 2008. ACTIVITIES LISTED HAVE BEEN INITIATED AND
WILL PROCEED DURING FY 2009 AS IN THE PREVIOUS YEAR. ACCOMPLISHMENTS WILL BE
REPORTED IN THE FY 2008 APR. PLEASE NOTE THAT THE ACTIVITY NARRATIVE REMAINS
UNCHANGED FROM FY 2008. USG WILL CONTINUE TO WORK WITH ROADS TO ENSURE THAT ITS
ACTIVITIES REINFORCE THE USG PREVENTION STRATEGY.
TITLE: Expanding AB in Makambako, Tunduma, Isaka and port of Dar es Salaam
Roads sites in Tanzania have been selected in collaboration with TACAIDS and NACP to bring services to
high prevalence areas that have been historically underserved and host a critical mass of truckers
overnight. AB activities in the sites have been underdeveloped and ad hoc, mostly operationalized through
faith-based organizations. ROADS has made progress in reaching MARPs (truckers, community men and
women, sexually active youth) with AB, though there is a need to scale-up AB programming. ROADS is
USAID's regional platform to address HIV along the transport corridors of East/Central Africa. It is a
comprehensive program focusing on the most underserved communities, extending prevention, and care
and support as appropriate to address gaps and add value to bilateral programs. With its network of
approximately 70 indigenous volunteer groups, including 20 FBOs, ROADS is well placed to extend AB
services.
ACCOMPLISHMENTS: During January-June 2007, ROADS established the Safe-T-Stop model in the two
sites, linking indigenous volunteer groups, businesses, and FBOs through common branding. ROADS
trained 300 peer educators and community mobilizers from indigenous volunteer group's community to
convey AB messages, reaching 14,330 people. AB prevention is disseminated to truck drivers, community
men and women, out-of-school youth, and OVC. ROADS will strengthen peer education and community
outreach to examine barriers to abstinence and being faithful to MARPs (especially truck drivers who spend
much of their lives away from home). ROADS will also help youth and OVC to develop more positive, safe
sexual behaviors and norms (including secondary abstinence for youth) in Makambako and Tunduma,
expanding programming to Isaka and potentially the Port of Dar. ROADS will expand programming into
primary schools, particularly focusing on creating positive gender norms through extra-curricular
programming such as creating positive self-images through art and other forms of expression, healthy
attitudes, and safe behaviors. ROADS will continue integrating with existing activities and services as a
priority. This includes linking HVAB activities with such services as counseling and testing (C&T) (ANGAZA
sites in Makambako and Tunduma), ART, and PMTCT. ROADS will continue to link and strengthen these
services through the Safe-T-Stop model, which mobilizes the community around HIV prevention, care,
treatment, and mitigation services as well as addressing gender norms, alcohol use, stigma, and
discrimination, that promote or lead to high-risk sexual behavior. ROADS works with transport workers to
create opportunities to strengthen family ties while the men are on the road (e.g., through email linkages at
resource centers) and to provide alcohol-free programming and venues (e.g., adult learning activities, men's
discussion groups, and sports activities linked to the resource centers) to provide safer alternatives. In
Makambako, ROADS will continue working with the faith-based community and youth groups to promote
AB, including partner reduction for truck drivers, community men and women, and sexually active youth.
ROADS will link AB audiences with local health facilities, including pharmacy/drug shop providers, to
promote C&T and other services. The project will reinforce AB prevention programming for military
personnel, particularly at sites where they congregate off base. ROADS will strengthen the referral system
with the four existing C&T services and the USAID care and treatment partner for Iringa Region (FHI). In
Tunduma, ROADS will continue mobilizing indigenous volunteer groups, particularly those linked with faith-
based organizations, to expand HVAB programming for MARPs. ROADS will continue using its strategically
located Safe-T-Stop resource center as a center for truck drivers, community men, women, and youth
providing HIV and AIDS education around AB, counseling and support services. This site is an alcohol-free
alternative recreational site for transient populations and Tunduma residents. Finally, ROADS will introduce
an innovative MP4 device with HVAB content for use by drivers on the road and discussion groups where
they stop.
LINKAGES: As a regional program, ROADS integrates with and adds value to USAID bilateral programs.
This entails linking closely with USG and non-USG partners. In Tanzania, ROADS has linked with T-MARC
on HIV prevention and with FHI on care and treatment. In Tunduma, ROADS has coordinated closely with
Walter Reed/DOD to ensure synergy and to jointly fund selected activities. In Makambako, ROADS has
linked with the FHI care and treatment team (Njombe) to link AB audiences to clinical and non-clinical
services and build AB programming into its work with COTWU. In addition, the SafeTStop strategy is
predicated on building local capacity. In Makambako and Tunduma, ROADS has linked with 51 indigenous
volunteer groups, strengthening and supporting their HVAB activities. ROADS also liaises regularly with
district leadership and health teams. District commissioners from Mbozi and Njombe attended the official
SafeTStop launch in Tunduma in May 2007.
CHECK BOXES: For this activity, ROADS focuses on addressing gender and social norms (partner
reduction), human capacity development, local organization capacity building, and strategic information.
ROADS target populations are children 5-9 (A for OVC), adolescents 10-24, adults, mobile populations
(including military in Makambako), and street youth. The project works on HVAB with discordant couples,
PLHA, religious leaders, and teachers.
ROADS M&E system will be fully integrated with the National Monitoring System. Qualitative and
quantitative data will continue to be collected by the ROADS Site Coordinators in liaison with indigenous
volunteer groups reporting to districts and ROADS. The project will conduct focus groups and in-depth
interviews with beneficiaries, community volunteers, and community leaders to gauge the quality and impact
of AB programming provided. Integration with the National Monitoring System will build M&E capacity of the
myriad community groups who report data through ROADS/SafeTStop.
SUSTAINAIBLITY: Almost all partners on the project are local entities that exist without external funding. As
a result, project activities are highly sustainable. Indigenous volunteer groups collaborating with the project
were established without outside assistance and will continue functioning over the long term. Local
Activity Narrative: businesses, market sellers, and farmers are also part of the fabric of community life and will be present over
the long term.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16395
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16395 16395.08 U.S. Agency for Family Health 6517 3490.08 ROADS $840,000
International International
Development
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
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:
TITLE: Expanding OP in Makambako, Tunduma, Isaka, and possibly the Port of Dar
Other Prevention initiatives have been underdeveloped, although ROADS has made progress in reaching
most at risk population (MARPs) which include truck drivers, sex workers, and sexually active youth.
However, there is a need to scale up OP (condom promotion/distribution, peer education, community
mobilization), and wrap-around programming (food/nutrition, norm change surrounding alcohol abuse, and
GBV).
ROADS is USAID regional platform to address HIV along the transport corridors of East/Central Africa. It is
a comprehensive program focusing on the most underserved communities, extending prevention, and care
approximately 70 indigenous volunteer groups, ROADS is well placed to extend OP programming.
trained 292 peer educators and community mobilizers from indigenous volunteer groups community to
convey HIV prevention messages including, but not limited to, AB. In the first quarter following initial
training, 390 people were reached. Other prevention messages and condoms are disseminated to MARPs
targeted by ROADS.
ACTIVITIES: ROADS will strengthen work initiated with FY 2007 funds to reach MARPs in Makambako and
Tunduma and expand programming to Isaka and potentially the Port of Dar. ROADS will continue to
coordinate and link with such services as C&T (ANGAZA sites in Makambako and Tunduma), ART,
PMTCT, and existing efforts to promote and distribute condoms, such as the collaboration with T-MARC in
the existing two sites). ROADS will continue to strengthen these services through the Safe-T-Stop model,
which mobilizes the community around HIV prevention, care, treatment, and mitigation services addressing
critical societal factors such as stigma, discrimination, and social norms around gender and alcohol
consumption.
ROADS will continue working with the private sector, especially bar and guest house owners, to reduce risk
for bargirls and patrons through condom distribution and peer education (focusing on an "immediate social
network" model). Pharmacy/drug shop providers will receive refresher training in managing STIs, condom
promotion, and referral for counseling and testing (C&T). ROADS will continue linking with local health
facilities, including pharmacies/drug shops, to promote expanded C&T and other services for truck drivers,
sex workers, other low-income women, and sexually active youth. ROADS will strengthen community
outreach addressing alcohol use, gender-based violence (GBV), and prevention among discordant couples.
ROADS will collaborate closely with the four existing C&T services and the USAID C&T partner for Iringa
Region. In Tunduma, ROADS will continue mobilizing the private sector (bar and guesthouse owners, liquor
club members, and pharmacy/drug shop providers) and indigenous volunteer groups to expand condom
promotion and distribution. ROADS will continue using its strategically located Safe-T-Stop resource centers
to provide HIV/AIDS education, counseling, and support services for truck drivers, sex workers, other high-
risk women, and youth. These centers will also provide on-site C&T services, alcohol counseling, and
referral to pharmacy/drug shops for STI and other needs. These sites are alcohol-free alternative
recreational sites for transient populations and the host communities.
ROADS will collaborate with community and religious leaders in addition to local community services to:
address male norms that influence women's access to services; legal protection for women; post-rape
health; legal and law enforcement services; and economic strengthening for vulnerable women. With the
support of local businesses, ROADS will expand its community food-banking strategy, which identifies
sources of excess food and distributes it to AIDS-affected families. Additionally, jobs for low-income
women/older orphans will be created through ROADS' LifeWorks Partnership. ROADS will also introduce
an innovative MP4 device with HVOP content for use by drivers on the road and in discussion groups where
LINKAGES: In 2007, ROADS linked with T-MARC to jointly launch regional programs such as SafeTStop
and the VAA condom campaign. ROADS has integrated VAA branding in SafeTStop branding and linked T-
MARC with bars/guest houses collaborating with the project. In Tunduma, ROADS has coordinated closely
with DOD to ensure synergy in HVOP and to jointly fund selected activities. In Makambako, ROADS has
linked with the FHI care and treatment team (Njombe) to link HVOP audiences with clinical and non-clinical
services. In addition, the SafeTStop strategy is predicated on building local capacity. In Makambako and
Tunduma ROADS has linked with approximately 70 indigenous volunteer groups, strengthening and
supporting their prevention activities. ROADS also liaises regularly with district leadership.
CHECK BOXES: ROADS focuses on gender norms, economic empowerment of women, strategies to
address GBV, human capacity development, local organization capacity building, strategic information,
economic strengthening, and food security. ROADS target populations are adolescents 15-24, adults,
mobile populations (including military in Makambako), non-injecting substance abusers (alcohol), people
who engage in commercial/transactional sex, and street youth. The project works on HVOP with the
business community, discordant couples and PLHA. ROADS M&E system will be fully integrated with the
National Monitoring System.
Activity Narrative: were established without outside assistance and will continue functioning over the long term. Local
businesses, market sellers, and farmers are also part of the fabric of community life and will be present over
Continuing Activity: 13480
13480 4846.08 U.S. Agency for Family Health 6517 3490.08 ROADS $1,103,286
7717 4846.07 U.S. Agency for Family Health 4538 3490.07 ROADS $800,000
4846 4846.06 U.S. Agency for Family Health 3490 3490.06 REDSO $350,000
International International Transport
Development Corridor
Initiative
* Increasing women's access to income and productive resources
* Increasing women's legal rights
Health-related Wraparound Programs
* Family Planning
* Malaria (PMI)
Military Populations
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $150,000
and Service Delivery
Estimated amount of funding that is planned for Economic Strengthening $300,000
Table 3.3.03:
ACTIVITY HAS BEEN REVISED SIGNIFICANTLY FROM FY 2008 COP.
TITLE: Expanding Home-based Care in Makambako, Tunduma and Isaka
ROADS is USAID's regional platform to address HIV along the transport corridors of East/Central Africa. It
is a comprehensive program focusing on the most underserved communities, extending prevention, care,
and support to address gaps and add value to bilateral programs. ROADS has made progress in reaching
most-at-risk populations (MARPS) including truck drivers, sex workers and others engaged in transactional
sex, as well as sexually active youth. However, there is a need to scale up care and support programming
given the severe impact of AIDS in project sites. ROADS has a strong comparative advantage in providing
palliative care through its array of community partners in HIV transmission hotspots along Tanzanian
transport corridors.
ACCOMPLISHMENTS: Through the end of FY 2008, ROADS established the SafeTStop model in two
sites, linking indigenous volunteer groups and businesses through common branding. ROADS trained
nearly 150 providers/caregivers to provide home- and community-based care and support, and successfully
reached about 550 people living with HIV/AIDS (PLWHA) with care services.
ACTIVITIES: In Tunduma, ROADS will continue strengthening home-based care (HBC) through faith-based
organizations (FBOs) and ABC Group, the lone community-based organization offering HIV support
services in the community. ROADS will train additional caregivers in HBC using National AIDS Control
Programme curriculum and accredited trainers. The caregiver training will include hygiene; monitoring
antiretroviral therapy (ART) adherence; identifying and treating simple opportunistic infections; basic
nutritional assessment and dietary counseling; referral for clinical services; and psychosocial, spiritual,
social, and preventive support, including reproductive health services. The project will take a family-
centered approach to care, referring family members for counseling and testing and other needed services.
ROADS will train providers/caregivers in pediatric care and link HIV-positive children with essential
community- and facility-based services. ROADS will provide a basic care package for use by volunteers, to
include condoms, Cotimoxazole, safe water tablets, safe water vessels and insecticide-treated bed nets.
The project will continue to strengthen pharmacy-based HIV counseling, support and referral, recognizing
the reach of these outlets and their role as first-line provider for MARPs and other community members.
The project will also develop alcohol support options for ART patients, linking closely with the Tunduma
Health Centre and FBOs. ROADS will link with wraparound programs addressing economic empowerment
and livelihoods for PLWHA and caregivers to enhance self-sufficiency. At the SafeTStop Resource Center,
ROADS will extend primary health care services to truck drivers through the Wellness Center model
developed by North Star Foundation in southern Africa. Finally, ROADS will promote a community food-
banking strategy, where families will contribute food during the harvesting seasons; this food will be used to
address food shortages in HIV-affected households and other vulnerable groups in the community.
In Makambako, ROADS will work to strengthen pharmacy-based HIV counseling, support, and referral.
ROADS will link closely with the Tunajali program to ensure that all clients are accessing care and treatment
as well as care and support. In both sites, ROADS will link with health wraparounds (e.g., family planning,
TB, malaria, child survival, safe motherhood). The program will purchase basic care kits for both sites using
in-country suppliers. ROADS site coordinators will work closely with the community clusters and health
care staff to strengthen the reporting, feedback and referral mechanisms to ensure quality services are
developed, accessed, and sustained.
on HIV prevention and with Tunajali on care and treatment in their sites in Makambako and Njombe. In
Tunduma, ROADS has linked closely with Walter Reed Department of Defense program to ensure synergy.
This activity will also be linked with other ROADS activities in prevention.
M&E: ROADS will use the National Monitoring System and support the local health management teams in
adopting the system in the project area sites. Collection of qualitative and quantitative data will continue by
the ROADS Site Coordinators in liaison with indigenous volunteer groups reporting to districts and ROADS.
ROADS will adopt and support the roll out of the National Monitoring system for Palliative care, through
provision of appropriate support to the local government and health system management teams in the
districts where the project is being implemented.
SUSTAINAIBLITY: Almost all partners on the project are local entities that exist without external funding.
As a result, project activities are highly sustainable.
Continuing Activity: 13481
13481 3460.08 U.S. Agency for Family Health 6517 3490.08 ROADS $650,000
7716 3460.07 U.S. Agency for Family Health 4538 3490.07 ROADS $75,000
3460 3460.06 U.S. Agency for Family Health 2864 1219.06 $400,000
Estimated amount of funding that is planned for Human Capacity Development $40,000
Table 3.3.08:
ACTIVITY HAS BEEN REVISED SIGNIFICANTLY FROM FY 2008 COP
TITLE: Expanding OVC Support in Makambako, Tunduma, and Dar es Salaam
NEED and COMPARTIVE ADVANTAGE: ROADS has made notable progress in reaching most-at-risk
populations including truck drivers, sex workers, others engaged in transactional sex and sexually active
youth. However, there is a need to scale-up programming for orphans and vulnerable children (OVC) given
the severe impact of HIV and AIDS in project sites. ROADS is USAID's regional platform to address
HIV/AIDS along the transport corridors of East and Central Africa. It is a comprehensive program that
focuses on the most underserved communities, extending prevention, care, and support to address gaps,
while adding value to existing bilateral programs. ROADS has a strong comparative advantage in reaching
OVC through its array of community partners who work in HIV transmission hotspots along Tanzanian
ACCOMPLISHMENTS: ROADS established the SafeTStop model in two sites, linking indigenous volunteer
groups and businesses through common branding. ROADS trained 57 providers/caregivers in caring for
OVC, who served 272 OVC.
ACTIVITIES: In FY 2009, the project will continue to work with existing child-welfare organizations, faith-
based organizations, local officials, and the private sector/business community to meet the daily needs of
OVC, using the national quality standards package. The project will continue OVC programming in
Makambako and Tunduma, and expand to the port of Dar es Salaam. Following a USG service demand
analysis and geographic profiling of OVC, consultation with ROADS has resulted in conducting upcoming
OVC activities in Dar es Salaam instead of Isaka in the Shinyanga region.
Child-focused needs assessments will identify services to be provided. All OVC, under both primary and
secondary support, will receive psychosocial support (PSS) in the form of counseling and/or training in life
skills. Depending on results of the identification process, issues regarding support for education; nutrition;
basic health management; access/referral to health services; shelter and economic strengthening (linking to
income-generating activities including opportunities in business management training) will be addressed.
ROADS will continue to work with the private sector through public-private partnerships, based on the
specific needs and opportunities at each site. ROADS expects to continue its work with farmers and traders
in Tunduma to use community food banks initiated with FY 2008 funding. With FY 2009 funding, ROADS
will continue programming for orphan headed households, recognizing their unique vulnerability and needs.
To address the long-term needs of orphan-headed households, ROADS' LifeWorks partnership will conduct
job training, job creation, and develop other economic opportunities for child-headed households.
The project will also continue supporting HIV risk-reduction, prevention, and care strategies specifically for
OVC who are heads of households, linking them with abstinence and faithfulness messaging, counseling
and testing, and services for sexually transmitted infection and family planning, if required. ROADS will also
provide PSS, linkages to food/nutritional support and emergency care in cases of rape and sexual assault.
ROADS will focus additional attention of nutritional status of OVC, monitoring mid-upper arm circumference
to identify nutrition problems. Children with faltered growth or malnutrition will be referred to health clinics
for HIV pediatric testing and food supplementation. For OVC identified with an immediate need, living in a
food-insecure household, ROADS will provide support, while linking the household to a livelihood activity.
ROADS will introduce programming specifically to address the needs of OVC caregivers by providing PSS,
education/training in nutrition and parenting, medical and social services, access to economic strengthening
through agriculture and other business development, and community-sharing of child support. Health
services for OVC will include voluntary counseling and testing for all children and caregivers in the family.
Health-related wraparounds will include referrals for family planning, malaria services and insecticide-
treated nets through the national under 5 campaign, and child survival programs.
FHI/ROADS will test a cash-transfer model in one site as a methodology for addressing the needs of OVC
living in desperate poverty situations. "Cash" for the cash-transfer will be leveraged from public-private
partnership donations with PEPFAR funds managing and evaluating implementation. As an OVC program,
ROADS will scale-up the implementation of the National Costed Plan of Action for Most Vulnerable Children
and the national Data Management System (DMS). The data will be transferred to the national DMS for
dissemination.
This entails linking closely with USG and non-USG partners. In Tanzania, ROADS has linked with
FHI/Tunajali and the Department of Defense programs on care, support, and treatment and FHI/UJANA for
youth programming that includes outreach to older OVC. The SafeTStop strategy is predicated on building
local capacity in Makambako, Tunduma and Dar es Salaam. ROADS also work closely with district
leadership and the health teams.
M&E: ROADS will adopt the national DMS for monitoring and evaluation. The program will ensure that sub
-grantees input information about identified OVC at the local level, which will feed into the national system.
Data must also be available to Most Vulnerable Children's Committees at the local level for planning,
decision making, and monitoring. ROADS will also build capacity of the district social welfare and M&E
officers and purchase computers to ensure data quality. FHI will conduct quarterly field visits to assess the
quality of services provided, collect data, and provide onsite refresher training as needed. In addition,
ROADS will support implementers at the district level to attend the PEPFAR M&E capacity building trainings
and meetings. Lastly, qualitative and quantitative data will be collected by the ROADS site coordinators in
liaison with indigenous volunteer groups and local child welfare authorities.
As a result, project activities are highly sustainable. ROADS activities will continue to be integrated into the
Activity Narrative: district plans through collaboration with the Department of Social Welfare during program design,
implementation and reporting.
Continuing Activity: 13482
13482 3459.08 U.S. Agency for Family Health 6517 3490.08 ROADS $500,000
7715 3459.07 U.S. Agency for Family Health 4538 3490.07 ROADS $100,000
3459 3459.06 U.S. Agency for Family Health 2864 1219.06 $600,000
* Child Survival Activities
Estimated amount of funding that is planned for Human Capacity Development $50,000
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $5,000
Estimated amount of funding that is planned for Education $50,000
Table 3.3.13:
ACTIVITY REMAINS UNCHANGED FROM FY 2008.
TITLE: Expanding HVCT in Tunduma, Isaka and Potentially the Port of Dar
NEED AND COMPARATIVE ADVANTAGE: Until recently quality CT was largely unavailable in Tunduma.
Historically, CT has had low uptake and has not been well promoted in the community, particularly among
MARPs. The new ANGAZA site has improved the situation, though there is still a need for outreach CT at
locations/hours convenient for truck drivers, their sexual partners, and sexually active youth. ROADS is
comprehensive program focusing on the most underserved communities, extending prevention, care, and
support to address gaps and add value to bilateral programs. With its network of indigenous volunteer
groups and ties with the Mbozi district health team, ROADS is well placed to extend CT through fixed
outreach sites in Tunduma.
ACCOMPLISHMENTS: During January-June 2007 ROADS established the SafeTStop model in two sites,
linking indigenous volunteer groups, businesses, health facilities, and FBOs through joint community
planning, implementation, and branding. During January-June 2007, 147 people in Makambako and
Tunduma were referred for testing, accessed testing, and received their result.
ACTIVITIES: ROADS will work with the Mbozi district health team, medical professionals in Vwawa and
Tunduma, ANGAZA, and the youth and faith-based organization (FBO) clusters to establish fixed outreach
CT sites in Tunduma targeting truck drivers, their sexual partners, and sexually active youth. With FY 2007
funds, ROADS will address the gap in CT services for the above populations by establishing CT at the
SafeTStop Resource Center situated near the intersection of two major strips of bars. Services will be
provided by existing district CT counselors and by medical professionals to be trained by ROADS according
to national guidelines. ROADS has already collaborated on CT with Vwawa Hospital, which provided CT at
the official SafeTStop launch in May 2007. With FY 2008 funds, ROADS will extend CT to five additional
fixed outreach sites in Tunduma and five in Isaka, again focusing on MARPs at hours and locations most
preferable to them (e.g., in Tunduma drivers spend business hours queuing at customs; trucker assistants
spend almost all of their time in Tunduma at the truck park on the outskirts of town). With FY 2008 funds
ROADS will train 40 health professionals in the district to provide quality CT, in liaison with district partners,
to efficiently expand the pool of professional CT counselors. ROADS will also explore the possibility of using
lay counselors to further expand access to CT services. Training will include counseling skills related to
hazardous drinking behavior, a major driver of HIV risk behavior in Tunduma.
ROADS will coordinate with the DMO, ANGAZA, and Walter Reed to maximize coverage. As part of its work
with surrounding communities, ROADS will promote testing to all family members where the index patient is
found to be positive as appropriate. In Makambako, ROADS will continue to focus on referral to the four
existing CT sites. In both existing sites, as well as Isaka, CT services will benefit from and work in concert
with community mobilization to address stigma, discrimination, and gender-based violence that are major
barriers to CT services. The project will also strengthen referral of CT clients for family planning. In 2008,
ROADS will assess CT at the Port of Dar and strengthen and extend services as appropriate, while liaising
with USAID/Tanzania and other partners. ROADS will continue to look for innovative and new ways to reach
high-risk populations and will explore the possibility of introducing C&T services in pharmacies under the
GoT's direction and in accordance with national guidelines and policies.
LINKAGES: As a regional program, ROADS integrates with and adds value to USAID bilateral programs. In
Tanzania ROADS has linked with Tanzania Marketing and Communication for HIV/AIDS, Reproductive
health and Child Survival Project (T-MARC) on OP and with Family Health International (FH)I on care,
support and treatment. Since June 2006, ROADS has coordinated closely with Walter Reed in the Mbeya
Region to ensure synergy and jointly funded selected activities. In Makambako, ROADS has linked with the
existing CT sites, referring OP and AB audiences for CT. The SafeTStop strategy is predicated to build on
local capacity: in Makambako and Tunduma ROADS has organized more than 70 indigenous volunteer
groups and local businesses into clusters, strengthening and supporting referral for CT. ROADS also liaises
regularly with district leadership.
CHECK BOXES: For this activity ROADS focuses on gender, human capacity development, local
organization capacity building, strategic information, and integration of family planning. ROADS target
populations are adolescents 15-24, adults, mobile populations (including military in Makambako), non-
injecting drug users (alcohol), persons working in commercial/transaction sex, and street youth. The project
works on CT with PLHA, FBOs, discordant couples and the business community.
M&E: As ROADS establishes CT at the SafeTStop resource center with FY 2007 funds and extends CT
through fixed outreach sites with FY 2008 funds, it will harmonize its M&E system with the national CT
monitoring system. Integrating with this system will build the M&E capacity of the myriad of community
groups who report data through ROADS/SafeTStop. Training of the 40 medical professionals in CT will
include training on the national CT monitoring system. Supportive supervision of these sites will include
M&E, specifically data collection (staff's understanding/ability to fill out forms, completeness of forms),
management and storage of data (registers and forms), and reporting of data to the district-level. We will
use the established national CT guidelines and training materials to assist in strengthening M&E capacity in
these facilities.
SUSTAINABILITY: Almost all partners on the project are local entities. As a result, project activities are
highly sustainable. Indigenous volunteer groups partnering with the project were established without outside
assistance and will continue functioning over the long term. Local businesses, market sellers, and farmers
are also part of the fabric of community life and will be present over the long term. It is critical to manage the
roster of volunteers so that individual volunteers are not overburdened and do not drop out of the program.
ROADS has developed strategies to motivate volunteers (non-monetary incentives, planning so people
implement activities within their immediate networks) to minimize attrition and enhance sustainability.
Continuing Activity: 13483
13483 8657.08 U.S. Agency for Family Health 6517 3490.08 ROADS $500,000
8657 8657.07 U.S. Agency for Family Health 4538 3490.07 ROADS $150,000
* Safe Motherhood
* TB
Table 3.3.14:
