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: 2007 2008 2009
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
TITLE: Scale up HIV Prevention through Abstinence and Being Faithful in Seven Regions of Tanzania and
Zanzibar
ACCOMPLISHMENTS: By March 2008, BIG reached more than 75,000 people with prevention messages
that promote AB. Many of the accomplishments were the result of complementing religious teachings with
HIV prevention messaging. Focal points have included youth counseling, marital counseling, religious
classes, and prayer sessions. Capturing audiences in these situations continues to build faith-based
organization (FBO) capacities to intervene within their own institutions, and has become a unique and best
practice of the program. During FY 2009, BIG intends to expand outreach in the Shinyanga, Lindi, Mtwara,
Kigoma, and Singida Regions. Other best practice models are being adopted for replication in target
geographic communities. Trained AB promoters, peer educators, religious leaders, and teachers will be
equipped to implement these best practice models. To date, approximately 100 Islamic teachers, 250
women Muslim community leaders, and 150 Christian teachers have been trained to integrate religious
HIV/AIDS prevention education. Each religious teacher has an outreach capacity to educate facts of HIV
transmission, reduce stigma and discrimination and promote prevention through abstinence. During this
period, 16,500 adolescents and youth have been reached.
ACTIVITIES: BIG will continue to scale-up community outreach as indicated in COP 08 and will reach at
least 35,000 people in FY 2009. It will strengthen risk reduction messages by adapting existing best-
practice models and incorporate strategic priorities identified by USG during its prevention portfolio review in
April 2008. Approaches will involve developing and disseminating focused prevention interventions that
have shown evidence of influencing attitudes and risk behaviors in neighboring countries of sub-Saharan
Africa. The models, "Families Matter" and "A Time to Talk" (ATT) are holistic and family centered by nature.
These approaches offer greater opportunities for sustained knowledge of HIV transmission, and for the
adoption of safer sex practices, including partner reduction and delay in adolescent and youth sexual debut.
Specifically, Families Matter will train parents to engage in sexual health-related conversations with their
children. Although these discussions will largely focus on abstinence, the training provides an opportunity
to address partner reduction and faithfulness with parents and guardians. ATT is designed to reach adults
over age 25 by providing them with communication skills within adult relationships. ATT focuses on inter-
related messages that instill knowledge of HIV and practices, stigma reduction, gender discrimination,
sexual violence, and safer sexual behavior including reducing multiple concurrent partnerships. In addition,
the approaches used by BIG will address gender norms and gender-based violence among participants.
These important areas are addressed further through BIG's active participation in the MenEngage Tanzania
Network. The goal of the network is to create a supportive environment that increases awareness and
knowledge of male involvement in HIV prevention and SRH promotion. BIG incorporates these best
practices and information into its programming with faith communities.
*END ACTIVITY MODIFICATION*
NEED and COMPARATIVE ADVANTAGE: According to reported national statistics, 93% of Tanzanians are
HIV negative and need to protect themselves from being infected. There is need to develop relevant,
focused, and appropriate prevention interventions that aim toward eventual behavior changes of social
norms regarding HIV, by creating a social and cultural climate that supports protective practices. The
cornerstone of Balm In Gilead (BIG) s program is recognizing that faith-based institutions have a great
capacity to reach community members. Religious leaders play an integral role in understanding cultural
sensitivity and providing prevention methods that fit within traditional, faith-based values. BIG's program of
AB education teaches, supports, and empowers recipients to abstain from pre-marital and multi-partner
sexual activity and delay sexual debut for youth.
ACCOMPLISHMENTS: By March 2007, BIG reached more than 75,000 people with prevention messages
practice of the program. During FY 2007, BIG intends to expand outreach in the Shinyanga, Lindi, Mtwara,
equipped to implement these best practice models.
ACTIVITIES: BIG proposes to scale-up community outreach by reaching at least 35,000 people. It will
strengthen risk reduction messages by adapting existing best-practice models. Approaches will involve
developing and disseminating focused prevention interventions that have shown evidence of influencing
attitudes and risk behaviors in neighboring countries of sub-Saharan Africa. The models, "Families Matter"
and "A Time to Talk" are holistic and family centered by nature. These approaches offer greater
opportunities for sustained knowledge of HIV transmission, and for the adoption of safer sex practices,
including partner reduction and delay in adolescent and youth sexual debut.
In FY 2009, BIG will complete the following activities:
1. Reproduce materials and disseminate the "Families Matter Program (FMP)" in Kigoma, Shinyanga,
Dodoma, Mtwara, Iringa, Tanga and Zanzibar. This best practice is designed to increase parent/child
communication channels with the goal of promoting healthy sexual decision-making for children. The
targetpopulation is parents of pre-adolescents ages 9-12 years. A total of 12,600 parents will be trained
usingFMP, benefiting an estimated 25,000 pre-adolescents. Partner organizations offer routine family-
basedcounseling, youth peer education and other religious gatherings. Facilitating FMP within these
Activity Narrative: structured
gatherings helps to strengthen the foundation for AB prevention and further scale-up.
2. Reproduce materials and conduct adult BCC model "A Time to Talk" (ATT). ATT is designed to reach
adults over age 25 by providing them with communication skills within adult relationships. ATT focuses on
inter-related messages that instill knowledge of HIV and practices, stigma reduction, gender discrimination,
sexual violence, and safer sexual behavior. This activity will reach 12,000 people.
3. Develop and reproduce training curriculum for empowerment/negotiation skills for girls attending
religious schools and women attending religious sessions. The training curriculum will be infused in formal
settings, which include Sunday school, Catechism and Koranic classes. Trained religious teachers will
reach girls and women ages 9-24. It is estimated that 2,500 girls will be reached in seven target regions.
4. Reproduce a variety of IEC materials (e.g., posters, fliers, and audio/visual) and conduct
communitybased
assemblies and campaigns to targeted audiences that reinforce HIV awareness and promote
abstinence and being faithful. This activity is designed to reach wider audiences through scheduled
faithbased
events.
5. Conduct refresher trainings for existing AB promoters. Each of the four national partner organizations will
train and deploy about ten AB promoters. At least 40 AB promoters will have been trained in each of the
seven target regions, representing 280 trained AB promoters deployed.
6. Conduct needs assessments in two expanded geographical areas to determine faith-based congregation
populations; knowledge of HIV transmission and risks; perceptions of HIV/AIDS; awareness and access to
CT; and sexual practices.
7. Monitor and evaluate effectiveness of behavior change models through evaluation reports. This will be
done by developing pre- and post-intervention assessments that will examine and measure participant
responsiveness, knowledge, and practice outcomes.
LINKAGES: BIG collaborates with the Ministry of Education and Vocational Training and the German
Technical Corporation (GTZ). The program will also seek opportunities to link with other appropriate
projects, including the Youth Alive Organization, PRIDE/TZ and FINCA.
CHECK BOXES: 1. Ages 9-12; "Families Matters" (parent/child focus group BCC). 2. Youth 13-24; youth
forums, religious schools; life skills. 3. Adults; marital guidance and life-coaching for PLWHA. 4. Families; "A
Time to Talk," (focus BCC for parent/parent and adult/adult). 5. Gender issues will be emphasized in the
program because of the low social status of women and girls arising from cultural norms; issues that
increase the susceptibility of women to HIV infection. 6. Human resources are developed within the
participating faith-based institution. A cadre of religious and lay AB promoters are trained and provided with
activity-based incentives.
M&E: Best practice models will be evaluated for effectiveness to deliver appropriate interventions. 1.
Conduct pre- and post-intervention evaluations 2. Conduct mid term and final intervention 3. In BIG
monitoring and evaluation has always played an important role. There are four full time employed valuators
at the partner level and one at the national level. Tools are in place for the collection of data from service
outlets to the national level. All levels are encouraged to use the data collected to improve their
performance.
SUSTAINABILITY : This program belongs to the faith-based partners who are interwoven with community
members. Families are one avenue for promoting healthy behavior, sexuality, and life skills. As the
program endeavors to equip them, it is expected that knowledge, which is accessible within families, has a
greater chance of being passed along within the family extended structure. Hence, when families are
positively impacted through imparted best practices, the results will roll up to impact the entire society.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13440
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13440 8687.08 HHS/Centers for Balm in Gilead 6499 4896.08 $750,000
Disease Control &
Prevention
8687 8687.07 HHS/Centers for Balm in Gilead 4896 4896.07 Balm in Gilead $845,000
Table 3.3.02:
THIS IS A NEW ACTIVITY
TITLE: Scale up Community and Home-based Care in Kigoma Region through Tanzania Interfaith
Partnership
NEED and COMPARATIVE ADVANTAGE: It is estimated that over 2 million people in Tanzania are HIV-
positive. Since 2005, the Tanzania Interfaith Partnership (TIP) has supported community faith groups in
providing palliative care for people living with HIV/AIDS (PLWHA) through PEPFAR funding and technical
guidance of Balm in Gilead (BIG). The National AIDS Control Programme (NACP) seeks to provide
comprehensive services to PLWHA at three levels; facility-based, community-based, and home-based care
(HBC). With the advent of demand creation for HIV screening, the demand for post-test and community
and home-based care and support is expected to rise. The TIP is well-positioned within their communities
and homes to provide quality programs and strengthened support services.
ACCOMPLISHMENTS: Faith-based organizations (FBOs) are actively involved in providing healthcare and
spiritual support in their communities. During the past two years, BIG and FBOs have deployed community
volunteers from churches and mosques to assist and serve PLWHA. With carry-over funds from FY 2005,
nearly 2,500 PLWHA have been reached in the regions of Shinyanga, Lindi, Mtwara, Mara, Dodoma and
Kigoma with HBC. Under the umbrella of TIP, FBOs have established foundations and linkages that have
become well-known within communities. The services provided to date have included basic clinical needs,
psychological, and social care.
ACTIVITIES: In order to scale-up community and HBC in Kigoma Region, BIG intends to:
1. Train health workers from Kigoma Region in the care and management of PLWHA.
- support both clinical services and referral systems.
- coordinate and facilitate training for HBC volunteers that are in line with the NACP 21-day training course.
2. Initiate HBC services in Kigoma Region.
- Conduct identification and mapping exercises at ward levels in respective districts.
- Enroll all beneficiaries in local Community Health Funds, which are operated by districts and provide
limited health insurance at local hospitals and health centres.
- Ensure delivery of full basic needs support package. This will provide beneficiaries with basic sanitary
necessities including blankets, bed sheets, gloves, soap, disinfectants, and mackintoshes, to keep bed
sheets clean.
3. Support continuum of care by strengthening the link between treatment sites and communities.
- Work in collaboration with Columbia University's International Center for AIDS Care and Treatment
Programs (ICAP) Care and Treatment Program. To ensure comprehensive care, BIG will strengthen
linkages between communities and health facilities, and within each health facility, between the CTC and
various units (TB and prevention of mother-to-child transmission - PMTCT). Through existing district-based
Continuum of Care committee meetings and regular feedback sessions between facility and HBC programs,
BIG will ensure implementation and monitoring of two-way referrals.
- Work together with ICAP to engage consultancy to analyze situation of PLWHA and assess HBC support
services when needed.
- Utilize FBO-based service delivery program for orphans and vulnerable children (OVC) to determine,
integrate, and better identify and serve OVC and PLWHA within households. The BIG program relies on its
spirituality as the cornerstone for its holistic approaches; therefore, there will be continuous provision of
psychosocial and faith-based services.
4. Strengthen district-level HIV/AIDS coordination mechanisms, working within the existing Ministry of
Health and Social Welfare (MOHSW) district systems and operating under national guidelines as the
program evolves.
5. Scale-up greater involvement of PLWHA.
- Work with beneficiaries on stigma reduction and prevention.
- Foster an enabling environment where PLWHA enjoy full rights within their societies; such as legal
services in succession planning and inheritance.
- Provide prevention care packages to all beneficiaries, which includes insecticide-treated bed nets, water
vessels, Cotrimoziole, prevention methods (including condoms), adherence and disclosure counseling,
reduction of risky behavior for the spread of HIV, as well as testing of family members.
- Provide nutritional counseling to all clients, and refer for nutritional support as needed.
- Strengthen referrals to community opportunities for income-generating and livelihoods activities.
6. Program coordination and monitoring. Recruit a Palliative Care Coordinator for program coordination and
monitoring within the sub-partnership; particularly to oversee service support integration.
7. Promote gender equity to address cultural norms in the project areas that often discriminate against
women. Efforts will be made to give women equal opportunities and provide access to income-generating
activities (IGAs); resources made available to women are generally used for the good of the whole family.
LINKAGES: The program will link with district health services including HBC and public and private health
providers for the provision of referral services, and Civil Society Organizations working in HIV/AIDS
prevention to avoid duplication of efforts. The program will be linked with BIG's OVC care and support, as
well as Abstinence/Be Faithful prevention and behavior-change programs. BIG will identify linkages that
support food supplements and those that help alleviate economic hardship of PLWHA through IGAs and
vocational training skills. Leading community actors include the Social Action Trust Fund, faith-based
institutions, UNICEF and micro-lending institutions.
CHECK BOXES: M&E: NACP/MOHSW collaboration. BIG endeavors to help meet the overall goal to
provide HBC for all in need and general care for all. BIG will coordinate with and support NACP to develop
Activity Narrative: a national HBC monitoring system. While the NACP has not yet developed an automated national
monitoring system, BIG will draw upon methodologies being used from other implementing partner
organizations which have stationed paper-based and have begun electronic data collection tools. BIG will
link with Pathfinder and Family Health International, which have both developed systematic M&E tools.
M&E management coordinators are responsible for collecting data from service outlets, which is then
entered electronically. The coordinators conduct first-level data analysis, which is subsequently rolled-up to
the program M&E manager who reviews information, conducts quality assurance, and provides technical
assistance and consultation.
BIG will monitor and evaluate services to ensure that they conform to national standards; conduct pre- and
post-test training evaluation; and collect data and conduct analysis to improve program performance at
service outlets and roll it up to the district and national levels. Furthermore, the M&E manager ensures
overall quality and frequency of service provider and liaises with all program levels.
BIG will update monitoring forms; routinely review and update (in line with NACP) paper-based monitoring
forms to capture any new additions to the HBC program (preventive care package); and better measure
"successful" referrals to care and treatment centers, TB treatment, counseling and testing, PMTCT,
nutritional support, and livelihood programs.
BIG will develop and implement a computerized database system at select levels for HBC monitoring in-line
with NACP/MOHSW systems; introduce innovative ways to collect and use data (e.g., phones for health
initiative) in-line with updated tools and computerized systems.
Data use for decision-making will be emphasized at all levels. BIG will train HBC workers and supervisors
on HBC monitoring forms and use of this information for program planning. Quarterly supportive
supervision on the data system will be instituted to aid in improving data quality and timeliness.
SUSTAINABILITY: Sustainability depends on the capacity of the locally-based community initiatives. BIG
activities demonstrate long-term capacity building through its work with religious institutions that serve as
spiritual and social community catalysts. With complementary program-sponsored skill development, OVC
caregivers will be well-positioned to strengthen community responses.
Building capacity of sub-partners is essential in order to strengthen ability of HBC workers to report
accurately and timely, and to use the information for patient management and program planning. The
program will employ four M&E officers to serve four districts in Kigoma. Each M&E officer will be aligned
with Kasulu, Kibondo, Bakwata, and Kigoma Rural districts.
Sustainability is attainable by strengthening clients' abilities to be as self-reliant as possible. Coupled with
local district and council strengthening, a considerable investment of resources originates from the
communities' own coping mechanisms through volunteerism.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $100,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.08:
In addition to those activities undertaken in FY 2008, in FY 2009, PFI will focus on improving quality of
services for OVC through adaptation of the standardized national quality standard of OVC services. This
will be initiated with the provision of direct support to OVC in the Shinyanga region. PFI will select one
district with high HIV/AIDS prevalence to set an example as a "program learning district." This district will
serve as a model to demonstrate linkages between referral systems, prevention programs, and treatment
programs stemming from a collaborative effort from implementing partners. Specifically, PFI will work in
collaboration with the OVC food and nutrition implementing partner to pilot the community nutrition support
program in its learning district. PFI is in the best position to pilot the program as it currently implements
both home-based care and OVC services. PFI works collaboratively with the treatment partner in their
regions (the Elizabeth Glaser Pediatric AIDS Foundation--EGPAF), to ensure that services are coordinated,
and neither duplicated nor insufficient. EGPAF also implements prevention of mother-to-child transmission
services in these communities, and monitors adolescent HIV/AIDS prevalence growth rates. EGPAF then
links OVC with the Maternal and Child Health (MCH) community outreach activities or care and treatment
clinics for HIV care and support, based on need. HIV-positive OVC are linked to existing programs that will
provide facility-based food by prescription, or whatever available services they may require.
PFI will enhance its work with MVCCs to ensure that OVC are formally identified and linked with community
services that provide food and nutrition assessment and education, as well as referral for MCH services.
Through MVCC linkages, services can be particularly focused on OVC under five years of age, children who
are primarily responsible for the household, and to elderly caregivers of OVC.
To ensure sustainability, PFI will strengthen poor households through trainings on food security, increased
income generating activities, and development of entrepreneurship skills. In addition, PFI will build capacity
at all levels to ensure community participation and ownership of the program. PFI will work with the district
councils to ensure integration of the OVC programs in the districts plans and budgets.
Best practices and lessons learned will be shared across the OVC implementing partners. Other OVC
stakeholders will have opportunities to visit and learn about the ongoing activities and linkages as well as to
gain knowledge of how to solicit the community to take ownership of the program and for OVC in their
catchment areas.
TITLE: Tutunzane Integrating Community Program for Orphans and Vulnerable Children (OVC).
NEED and COMPARATIVE ADVANTAGE: Tanzania has approximately 2.5 million orphans and vulnerable
children (OVC). Previously, orphanhood did not pose a problem to existing coping mechanisms. However,
the increasing numbers of OVC have overburdened traditional coping mechanisms. In response, Tanzania
has developed different strategies to improve and scale up services to assist OVC and families affected by
HIV/AIDS. Pathfinder International (PFI) has worked in Tanzania since 2001, building strong working
relationships at the community level and providing home-based care to people living with HIV/AIDS
(PLWHA). This provides an opportunity to do case finding for HIV-exposed OVC and provide services to
them. The home-based care program, called Tutunzane (which translates to "let us take care of each
other"), will be expanded to include support for OVC, leveraging its relationships with communities and
expertise in home-based care.
ACCOMPLISHMENTS: Tutunzane already serves 18,000 PLWHA. Its key sub-partner, the Axios
Partnership in Tanzania (APT) also has considerable expertise working with OVC and communities. With
Abbott funding, APT served 4,698 OVC in paralegal cases; 15,000 in medical and psychosocial support;
11,000 with nutritional support; 1,148 with birth certificate registration; 165 with income generation activities
(IGA); and trained 811 volunteers. APT also built capacity for vocational training, worked with school health
programs and district OVC management teams, developed a business coalition model, produced guidelines
for institutional care, and developed an exit strategy for mature OVC to transition from institutions into the
community.
ACTIVITIES: With FY 2008 funds, Tutunzane will collaborate with APT as a sub-partner to scale up the
OVC National Plan of Action (NPA) by applying the national OVC identification process and provision of
comprehensive, effective, and high quality services. Tutunzane will build on existing local initiatives and
programs to establish interventions that are culturally appropriate in care giving and suitable to the
communities. Emphasis will be placed on ensuring that OVC receive better care within communities than in
institutions. This project is proposed to be implemented in the regions where Tutunzane is already active, in
addition to expanding to seven districts of Shinyanga Region. It will operate both in urban and rural areas,
with preference for areas with referral facilities for wraparound services. The program is expected to reach
9,800 OVC.
By the end of year one, PFI and APT will have completed a baseline survey, including an identification of
the OVC, and a market analysis of micro enterprise opportunities; trained project staff in psychosocial
outreach to OVC; and solidified project partnerships for rollout. PFI will provide educational support to OVC
identified by the community during the baseline assessment. Methods of operation will also be established,
laying out procedures to identify children who have been exposed to HIV so that they are referred for testing
and care/treatment, if necessary. OVC served during this period will include those children and adolescents
already identified by communities through other community-based organizations (CBOs) and local Most
Vulnerable Children's Committees (MVCCs). Established indigenous and other organizations will receive
necessary training in order to carry out project activities, and MVCC will be supported in building capacity to
provide oversight. Lessons learned and insight gained from this process will be used to inform, encourage,
and facilitate replication to other communities. In subsequent years of the project, PFI will work with
established partners to rapidly take to scale, model interventions, and mentor newly identified CSOs to
replicate the project and share relevant experiences. The programmatic responses will be complemented
Activity Narrative: and supported by implementing activities that strengthen the policy and program environment to adequately
address the needs and interests of OVC.
The Tutunzane Program will train community home-based care providers (CHBCPs) on the provision of
psychosocial support (PSS) to quickly catalyze and coordinate community PSS for OVC. Cultural,
recreational, and life-skills activities will be accessible to all children and adolescents in the community, with
a particular emphasis on the inclusion of OVC. Educational opportunities for OVC will be facilitated in
partnership with local CBOs through activities such as awareness raising by CHBCPs; provision of
scholastic materials to OVC; and teacher training on PSS. Vocational and life skills training for adolescents
will be developed following the program baseline survey and market surveys. Tutunzane will link with
community programs for food provision, coordinated by sub-grantees, to reduce food insecurity felt by
households caring for OVC. CHBCPs will provide nutritional education both inside and outside the home.
Tutunzane will collaborate with other OVC programs to ensure that child protection, social welfare, and
succession programs will be in place to bridge the gap between law and traditional practices, strengthen
child protection capacity at district and community level (to protect children from abuse and exploitation),
and provide a focal point to link all OVC related interventions.
Throughout the project intervention, particular attention will be given to child protection and minimizing girls'
vulnerability to exploitation and abuse. CHBCPs will ensure that those girls identified as being particularly
vulnerable to sexual exploitation are actively recruited for vocational training.
LINKAGES:
This activity will link with all USG-funded OVC activities, especially through the OVC Implementing Partner
Group network. It will also be closely aligned with the PFI home-based care activity. Basic mapping will be
accomplished in program regions to identify other programs for potential wraparound activities. Replication
of the national OVC IPG activities at district and regional levels will be encouraged in order to enhance
linkages, reduce duplication, and support the districts' social welfare capacity to coordinate OVC activities.
PFI will also link with Peace Corps to strengthen nutritional and economic needs of OVC households.
CHECK BOXES: The project will be implemented in five regions and the target populations are OVC. Both
urban and rural areas will be targeted for service provision with preference for areas with referral facilities
for wraparound services. Tutunzane will also assist to the MVCCs and CBOs to strengthen managerial
capacities in order to improve program quality and ensure compliance with the national programs. The
project will strive to ensure that every individual in the operational area in need of OVC service has access
to the services, with particular attention given to child protection and minimizing girls' vulnerability to
exploitation and abuse.
M&E: Tutunzane will adopt the national Data Management System, and will use that system for monitoring
and evaluation. They will ensure that sub-grantees are responsible and accountable for inputting
information about identified OVC. Tutunzane will also ensure that the data from the local level feeds not
only into the national system, but is also available to MVCCs at the local level for planning, decision making,
and monitoring. Tutunzane will also work with FHI to build capacity of the district social welfare and M&E
officers and purchase them computers to ensure data quality and integrity. In addition, PFI will conduct
quarterly field visits to assess the quality of services provided, collect data, and provide onsite refresher
training as needed. Lastly, PFI will support CBOs that are implementers at the district level to ensure
correct monitoring of the Emergency Plan program. Monthly data will be compiled, reviewed, and
aggregated from all districts/regions on a quarterly basis, to be shared with stakeholders and the USG.
SUSTAINAIBLITY: Tutunzane will support capacity development of the MVCCs, district social welfare
officers, and local CSO sub-grantees to ensure sustainability. Tutunzane will have memoranda of
understandings with council health management teams and implementing partners stipulating each party's
roles, responsibilities, and expectations, including the stipulation that OVC activities be included in
comprehensive district plans. At village levels, households will be strengthened through training and
income generating activities and entrepreneurship skills. With the support of district leaders, MVCC and
community leader's strategies will be developed to leverage local food production to create community
reserves for the child and elderly headed households. Tutunzane-supported CSO will be offered training in
project proposal development to open other grant opportunities.
MAJOR ACTIVITIES:
1. Identify and provide high quality care and support services to 9800 OVC.
2. Train Most Vulnerable Children Committees and strengthen provision of integrated services for OVC at
the community level.
3. Support district and regional coordination of the OVC implementing partners.
4. Perform basic mapping of the region and build partnerships and referrals to achieve integrated service
networks and wraparound programs.
5. Expand access of OVC to the continuum of care and comprehensive HIV/AIDS services as well as
preventive care and interventions.
6. Build the capacity of government and civil society for sustainable delivery of OVC services.
7. Purchase computers for the district social welfare officers, as well as two for APT, to ensure quality data
and feedback report to the community
Continuing Activity: 13441
13441 8699.08 HHS/Centers for Balm in Gilead 6499 4896.08 $400,000
8699 8699.07 HHS/Centers for Balm in Gilead 4896 4896.07 Balm in Gilead $200,000
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $15,000
and Service Delivery
Estimated amount of funding that is planned for Food and Nutrition: Commodities $50,000
Estimated amount of funding that is planned for Education $120,000
Table 3.3.13:
TITLE: Our Church/Mosque Lights the Way: Tanzania Interfaith Partnership HIV Counseling and Testing
Campaign and Services
NEED and COMPARATIVE ADVANTAGE: In 2006, The Balm in Gilead (BIG) conducted an assessment of
VCT needs in Kigoma, Mtwara and Iringa and found that access is an issue in these rural regions. This
confirms information from TACAIDS, which revealed that Tanzanians in rural areas have especially limited
access to counseling and testing (CT) services. The BIG program intends to increase access to CT services
in underserved, difficult to access areas by providing community-based mobile services. Faith-based
institutions are uniquely equipped to fill this void because they are crosscutting in communities. For
example, nearly 50% of private hospitals and health centers in Tanzania are run by faith-based institutions.
BIG has worked in Tanzania since 2003, and has tremendous experience implementing prevention
activities and accessing individuals in need of services.
ACCOMPLISHMENTS: Since March 2007, the program has reached over 75,000 people with HIV
education and prevention messages. Staff have noted that with increased knowledge and understanding of
HIV, there is increased demand for CT services. The Shinyanga Catholic Diocese currently operates a
community-based health centre which includes CT services. As a partner organization, the diocese can
share lessons learned about strategies for providing CT services for faith-based congregants and the
community at large. BIG intends to initiate three mobile testing units in regional locations with high rates of
HIV. Additionally, partner organizations are geared up to reach out to regional rural areas untouched by the
national testing campaign using the theme, "Our Church/Mosque Lights the Way," to encourage testing.
Newly created mobile services will address demand created by the campaign. The campaign was rolled out
in Shinyanga Region, with immediate coverage in Shinyanga Urban and Rural districts where 46 faith-
based organizations are initially participating. Health Coordinators from each FBO have been trained in
delivery of IEC promotion to encourage voluntary counseling and testing. In addition, BIG collaborated with
John Hopkins University, in developing technical skills of local radio programs with pre-recorded and live
shows in an effort to ensure community outreach through media. Six CT sites, 3 static sites and 3 mobile
sites have been established. The community has responded overwhelmingly, as field reports reveal that
2,500 people tested within the first 9 days. It is estimated, that by end of the 3-month campaign, at least
10,000 people will get tested.
ACTIVITIES: In FY 2009, BIG proposes to:
1) Strengthen the three mobile testing units in Shinyanga, Kigoma and Iringa. This will involve identifying
and training counselors; procuring vehicles and tents; buying test kits according to the approved national
algorithm, which is suitable for testing in field conditions; and marketing the newly available services.
Counselors will be trained by AMREF.
2) Provide risk reduction counseling and screen for alcohol abuse and gender based violence.
3) Provide referrals to those who test positive to care and treatment services available in the area and link
individuals regardless of test results to appropriate support groups and prevention services.
4) Support three post-test clubs. Each testing site will support clients who have tested and received their
results to form clubs that will encourage individuals to adopt safer sexual behavior practices through support
groups, drama, and sports.
5) Conduct routine monitoring and evaluation (M&E). There will be quarterly M&E visits to the three mobile
testing units by the regional coordinators from the consortium partners. Semi-annual M&E visits will also be
conducted by the BIG M&E manager. Ten persons will receive training in M&E and supportive supervision.
Supportive supervision will include checking registers completed by counselors, reviewing counseling and
testing protocols, and observing counseling sessions. A quality assurance and testing supervision plan will
be developed in collaboration with lab personnel in the three regions.
confirms information from TACAIDS has revealed that most Tanzanians have limited access to counseling
and testing, especially in rural areas. The BIG program intends to increase access to counseling and testing
(CT) services in underserved, difficult to access areas by providing community-based mobile services. Faith
based institutions are uniquely equipped to fill this void because they are crosscutting in communities. For
activities and accessing individuals in need of services. Additionally, BIG brings seven health professionals
to its program - the organization is headed by an immunologist, and has the contributions of two public
health experts and four program staff medical doctors.
ACCOMPLISHMENTS: Since March 2007, our program has reached over 75,000 people with HIV
community at large. BIG intends to initiate three mobile testing units in strategic regional locations.
Additionally, partner organizations are geared up to expand the national testing campaign in regional rural
areas using the theme, "Our Church/Mosque Lights the Way," to encourage testing. Newly created mobile
services will compliment demand created by the campaign.
ACTIVITIES: In FY 2008, BIG proposes to:
1) Establish three mobile testing units in Kigoma, Mtwara and Iringa. This will involve identifying and
Activity Narrative: training six counselors; procuring vehicles and tents; buying test kits according to the approved national
algorithm, which is suitable for testing in field conditions for testing; and marketing the newly created
services. Counselors/health care workers will be trained by AMREF.
2) Support three post-test clubs. Each testing site will support clients who have tested and received their
results to form clubs that will encourage individuals to adopt safer sexual behavior practices through
discussions,
drama, and sports. Staff at the units will also refer those who test positive to care and treatment services
available in the area.
3) Conduct routine monitoring and evaluation (M&E). There will be quarterly M&E visits to the three mobile
testing protocols, and observing counseling sessions. A quality assurance plan will be developed in
collaboration with lab personnel in the three regions
LINKAGES: BIG and its consortium partners will collaborate with district health services to establish a
referral system for HIV positive clients who will need treatment or other social services and referrals and
coordination of male circumcision. The consortium will work closely with other CT providers such as AMREF
to replicate the best practices in counseling and testing. Collaboration will also facilitate suitable
deployment of mobile services to avoid duplication. Mobile CT services will link with organizations that are
working on prevention of drug and alcohol abuse so that they may lead discussions and provide learning
materials to post test clubs. The BAKWATA run mobile CT
Center in Kigoma will provide outreach CT services to The International Rescue Committee in Kasulu as
need arises.
M&E: BIG has a M&E system that covers the national office and regional desks and will adapt its M&E
system to be in line with the National Monitoring System on HIV/AIDS. Paper-based data collection tools
have been developed for the collection of data from service outlets which will be colleted at regional level by
partners and passed to the M&E manager of BIG . The program also is in line with PEPFAR monitoring and
evaluation practices.
SUSTAINABILITY: BIG has already built linkages with NGOs, CBOs and the local government in all areas
where HIV counseling and testing services will be established. The program is owned by the local
communities. They have contributed resources through voluntarism. The sustainability of the mobile
services is based on the linkages with government and other non-governmental organizations as well as the
local ownership. The FBOs will continue to maintain and manage the testing facilities as the FBOs are more
trusted by the communities in terms of confidentiality.
Continuing Activity: 13442
13442 8684.08 HHS/Centers for Balm in Gilead 6499 4896.08 $351,140
8684 8684.07 HHS/Centers for Balm in Gilead 4896 4896.07 Balm in Gilead $200,000
Table 3.3.14:
