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; ONLY CHANGES RELATED TO RUKWA PREVALENCE DATA
New Tanzania HIV/AIDS and Malaria Indicator Survey indicate that the estimated HIV prevalence in Rukwa
region is around 4.5%.
ACTIVITIES
Coordinate expansion of activities to convey AB messages to address needs of communities along the
transport corridor road construction to be undertaken as part of the Millennium Challenge Compact
*END ACTIVITY MODIFICATION*
TITLE: Respect for human and gender rights as a foundation for abstinence and fidelity in Rukwa Region
NEED and COMPARATIVE ADVANTAGE: The estimated HIV prevalence in Rukwa region is around 6%,
and anecdotal information indicates that newly identified HIV cases are due to infidelity and the subordinate
position of women. Without strengthening the foundation of respect for human and gender rights, AB
messages cannot fully take hold. General infrastructure in Rukwa is poor. The region has no paved roads
and during the rainy season, many are impassable. There are few established NGOs providing HIV
services in Rukwa, and fewer able to manage regional service provision. RODI, registered in 2004, has
exhibited a strong record of accomplishment of capacity building and training for a variety of Rukwa projects
in just a short period. As a sub-grantee under a DOD umbrella organization in 2007, this organization has
shown the capacity necessary to coordinate service provision by a network of NGOs in Rukwa and has
graduated to prime partner status.
ACCOMPLISHMENTS: FY 2007 funding supported initiation of PEPFAR-funded HIV prevention services in
Rukwa region, including identification of appropriate sub-partners in Rukwa districts where NGOs had yet to
be identified.
ACTIVITIES: RODI will focus on service delivery through "clusters" based on the three main regions:
Sumbawanga (which includes both Sumbawanga Rural and Urban), Nkasi, and Mpanda. 1) Provide
education regarding human and gender rights and their relationship to HIV, helping to create social norms
conducive to HIV prevention. 1a) Identify educators to be trained to provide the curriculum through Mbeya
HIV Network Tanzania (MHNT), a prime partner under a separate submission. 1b) Trained educators will
provide training in Rukwa region at NGO sites, and link with community groups to host training sessions in
villages, schools, workplaces, and other settings.
2) With training from MHNT, sensitize the community and convey AB messages through creative public
presentations. 2a)Enlist volunteer artists to create and perform motivational and educational presentations
promoting AB messages. 2b) Coordinate with village executives, schools, and other community leaders to
schedule presentations throughout the community. 2c) Perform presentations at large-scale community
events including World AIDS Day and HIV testing events organized by RODI and its sub-partners to spread
the "Know the Facts" campaign.
3) Conduct a community-wide campaign in Rukwa region to raise awareness and promote AB messages.
3a) In consultation with MHNT, plan an effort based upon the local and long haul buses campaign, which
included production of cassette tapes and videos with AB messages, distribution and use of these tapes
and videos, especially in reception areas of NGOs and health facilities. 3b) Produce cassettes and/or other
promotional materials and distribute to outlets. 3c) Coordinate among sub-partners to promote campaign
messages through community education activities.
4) Train youth and adult peer counselors at the village level and higher to ensure a widespread and more
accurate knowledge base, encourage discussion to reduce stigma, and de-emphasize previous traditional
responses to HIV/AIDS. 4a) Consult with community leaders to identify influential individuals of all ages to
be trained as peer counselors, maximizing the potential for changing social norms. 4b) Provide initial
training for peer counselors and refresh as necessary. 4c) Convene regular meetings of peer counselors to
motivate volunteers, monitor efforts, identify challenges, and improve quality of service.
LINKAGES: Along with executing prevention activities, RODI members also provide a number of other
services, including counseling and testing (CT), OVC services, and home-based care. RODI members
collaborate to maximize impact and coverage of their collective activities and eliminate overlap. This activity
also links with the Evangelical Lutheran Church of Tanzania (ELCT) Mbeya District in training in legal and
gender issues and activities. Additionally, this activity 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 with a particular focus on
youth with efforts designed to shift social norms toward greater respect for gender, legal, and human rights.
Individuals of all ages will be targeted 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 throughout Rukwa region.
M&E: RODI has considerable M&E expertise, having supported a number of projects in efforts to improve
M&E practices. In addition to instituting standard processes for monitoring indicators on a quarterly basis,
RODI will ensure implementation of standardized tools for collecting detailed data on service delivery.
Compiling data from sub-partners will allow for identification of major service needs and gaps. These data
will be shared with local leaders to highlight key needs and enlist community support in meeting these
Activity Narrative: needs. Data collected regarding client referral routes to VCT will help refine and better target community
education efforts.
SUSTAINABILITY: RODI is a local, grassroots Tanzanian-run NGO that has cultivated capacity-building
expertise in the health, environmental, and agricultural arenas. Its holistic approach to health addresses
HIV, malaria, and water-borne diseases. RODI has expanded activities slowly within the southern highlands
zone, so as not to exceed current capacity and therefore compromise quality of service. Few local entities in
Rukwa have experience managing service delivery on a regional scale, yet RODI has the background and
skill base for this responsibility. Nurturing RODI in this role will not only help to ensure quality services,
regional coverage, and fiscal oversight of sub-partners, but will also lend needed administrative capacity to
Rukwa. RODI and its sub-partners will become increasingly well positioned to apply for and administer
additional funding for this under-served region.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17021
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17021 17021.08 Department of Resource Oriented 7571 7571.08 $97,230
Defense Development
Initiatives
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing women's access to income and productive resources
* 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:
Coordinate expansion of activities for OP services to address needs of communities along the transport
corridor road construction to be undertaken as part of the Millennium Challenge Compact
TITLE: RODI promoting safer choices to reduce sexual transmission of HIV in the Rukwa Region.
NEED and COMPARATIVE ADVANTAGE: The estimated HIV prevalence in Rukwa region is around 6%.
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. General infrastructure in Rukwa is poor; the region has no paved roads, and during the rainy
season, most dirt roads are impassable and many areas are reached only by boat year round. There are
few established NGOs providing HIV services in Rukwa, and fewer able to manage regional service
provision to unique populations of farmers, fishermen, and miners. RODI, registered in 2004, has a strong
record of accomplishment of capacity building and training for a variety of Rukwa projects. RODI has the
capacity necessary to coordinate service provision by a network of NGOs in Rukwa.
ACCOMPLISHMENTS: FY 2007 funding supported initiation of PEPFAR HIV prevention services in Rukwa
region, including identification of appropriate sub-partners in Rukwa districts where eight NGOs were
identified especially among the miners and fishermen.
Sumbawanga (which includes both Sumbawanga Rural and Urban), Nkasi, and Mpanda.
1. Continue to train youth and adult peer counselors at the village level and higher 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 permanent and mobile 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.
1c. Convene regular meetings of peer counselors to motivate volunteers, monitor efforts, identify
challenges, and improve quality of service especially in workplace venues (e.g., fisheries, mines).
2. Convene post-test clubs of PLWHA 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 support group 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 permanent and mobile 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 for themselves the 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. 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 the Evangelical Lutheran Church of Tanzania (ELCT) through MHNT to provider 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. With guidance from KIHUMBE (a prime partner under a separate submission), and in collaboration with
marketing and radio groups, develop and implement a community-wide media campaign, ensuring
messages include encouraging sexually active individuals to use condoms consistently and correctly and to
avoid preventable risky behaviors.
services, including CT, OVC services, and home-based care. RODI members collaborate to maximize
impact and coverage of their collective activities and eliminate overlap. This activity also links with: the
ELCT Mbeya District in training in legal and gender issues and activities; KIHUMBE, a prime partner under
a separate submission, which provides training on OP services throughout the Southern Highlands Zone -
schools, faith groups and village associations; secondary schools, faith groups and village associations;
Saturday and after school youth programs; ward leaders and other local government officials; other
providers of counseling services; VCT sites to facilitate referrals; PEPFAR marketing groups such as
Activity Narrative: 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 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, who cannot or will not abstain from sex. Training of peer educators and
group facilitators is a key component of this program area, as volunteers constitute the primary human
resources delivering HIV prevention education.
Compiling data from sub-partners will allow for identification of major service needs and gaps by the M&E
staff person. 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 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.
HIV, malaria, and water-borne disease. RODI has expanded activities slowly within the Southern Highlands
Zone, so as not to exceed current capacity and therefore compromise quality of service. Few local entities
in Rukwa have experience managing service delivery on a regional scale, yet RODI has the background
and skill base to continue this responsibility. Nurturing RODI in this role will not only help to ensure quality
services, regional coverage, and fiscal oversight of sub-partners, but will also lend needed administrative
capacity to Rukwa. RODI and its sub-partners will become increasingly well positioned to apply for and
administer additional funding for this under-served region.
Continuing Activity: 17005
17005 17005.08 Department of Resource Oriented 7571 7571.08 $95,200
* Increasing women's legal rights
Table 3.3.03:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
ACTIVITIES: In FY 2009 there will be an increased emphasis in provision of prevention with positives
services for PLWHA. PLWHA will be provided with counseling, and linked to support groups or peer-led
interventions through the HBC system. There will be increased involvement of PLWHA in the communities
in service provision as HBC providers. PLWHA will be provided with information about ways they can
protect their own health, prevent common illnesses, and improve safe water usage and hygiene practices.
RODI will ensure that interventions address the comprehensive needs in an environment free from stigma
and discrimination. All sexually active PLWHA will be provided with condoms, which is an essential
component of prevention of further HIV transmission. Coupled with condoms provision, PLWHA will be
linked with sexually transmitted infections treatment services and high-risk behavioral counseling. RODI will
discuss specific strategies with PLWHA for disclosing one's HIV status to sexual partners and offer
confidential HIV testing to the partners of and children born to all PLWHA in their coverage areas. The
following specific activities will be implemented by RODI in providing preventive package services:
Procurement and/or distribution of insecticide treated bed nets (ITNs) to PLWHA and promotion on correct
usage of ITNs; ensure that all PLWHA are receiving Cotrimoxazole for prevention of opportunistic
infections; provide water treating tablets and water vessels in provision of safe drinking water.
Implementing partners will also train HBC providers on screening for TB and linking the clients to services.
HBC volunteers will also be addressing and monitoring adherence to TB treatment.
The importance of nutrition in determining clinical outcomes for people on ART is becoming increasingly
more apparent. In FY 2009, USG/Tanzania will put more emphasis on addressing food and nutrition needs
of clients receiving care and support. In home visits, RODI partners will conduct nutritional counseling and
refer patients to the facility for nutritional assessments, which will help to inform the clinical management of
PLWHA, pregnant women under PMTCT programs, as well as HIV-exposed infants and children receiving
care and support.
FY 2007 funding supported initiation of PEPFAR-funded HBC services in Rukwa region for PLWHA. Under
this funding, RODI conducted a thorough needs assessment of HBC capacity in early 2008, and is currently
working to identify appropriate sub-partners in Rukwa districts where eight NGOs have been identified. The
findings of the needs assessment have helped to shape service provision and capacity building efforts in
the region.
TITLE: Rukwa Community Home-based Care to Support Health and Self-sufficiency
NEED and COMPARATIVE ADVANTAGE: Care and Treatment Clinics (CTCs) were established in the
Rukwa region beginning in late 2005/early 2006. The general infrastructure in Rukwa is poor; the region has
no paved roads, and during the rainy season, many are impassable. There are few established non-
governmental organizations (NGOs) providing HIV services in Rukwa, and fewer still are able to manage
regional service provision. RODI, registered in 2004, has exhibited a strong track record of capacity
building and training for a variety of Rukwa projects in a short period of time. As a sub-grantee under a DOD
umbrella organization in 2007, RODI has shown the capacity necessary to coordinate service provision by a
network of non-governmental organizations (NGOs) in Rukwa and has graduated to prime partner status.
ACCOMPLISHMENTS: FY 2007 funding supported initiation of PEPFAR-funded home-based care (HBC)
services in Rukwa region for people living with HIV/AIDS (PLWHA). Under this funding, RODI conducted a
thorough needs assessment of HBC capacity in early 2007, and is currently working to identify appropriate
sub-partners in Rukwa districts where NGOs have yet to be identified. The findings of the needs
assessment will help to shape service provision and capacity building efforts in the region.
ACTIVITIES: Working in a coordinated and cooperative manner, members of RODI, the Mbeya HIV
Network Tanzania (MHNT), KIHUMBE, and SONGONET (see other submissions for these partners) will
ensure similar packages of services are available for clients in the Mbeya, Rukwa and Ruvuma Regions. In
addition, implementation of services has been standardized across these partners, though allowing for
some flexibility in focus/approach depending on regional conditions. With FY 2008 funding, RODI will:
1. Expand provision of community HBC to additional in the Rukwa Region to include nutrition counseling
and assistance, psychosocial/spiritual support, opportunistic infection (OI) and pain management,
cotrimoxazole/malaria prevention, referrals for malaria and TB diagnosis and treatment, access to safer
water, training in income generating activities (IGAs), legal and human rights education and ART adherence
counseling. 1a. 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. 1b. Link clients to agriculture activities
where available in the region for training in home gardens for both personal food production and as an
income generating opportunity. 1c. Link to USG procurement programs for distribution of insecticide treated
nets (ITN) and water purification supplies to clients. 1d. Provide training and support for IGAs for caregivers
and able PLWHA, and help to develop sustainable associations for income generation. 1e. Assist with short
-term nutrition for malnourished children of HIV-positive clients unable to work. 1f. Identify and refer
pediatric and adult cases of TB, malaria, and/or HIV to health care providers.
2. Convene monthly education and support group meetings for CHBC clients. 2a. Establish and inform
community HBC clients of regular client meeting times. 2b. 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. 2c. Inform clients of IGA opportunities and trainings.
3. 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. 3a. Community HBC providers will provide
ongoing training to caregivers as part of regular visits, creating a plan for reducing visits to longer intervals
Activity Narrative: and, as appropriate, ceasing visits except as needed/requested by the caregiver. 3b. Identify and address
special training needs for elderly caregivers with literacy, health, or other barriers.
4. Incorporate prevention for positives and partner/child VCT referral into community HBC visits wherever
appropriate. 4a. Ensure community HBC providers are trained to discuss HIV prevention with clients.
Modify the existing HBC curriculum in prevention for positives approaches based on USG findings in FY
2007. 4b. Include prevention for positives and partner VCT referral as part of in all visits as appropriate. 4c.
Discuss themes, successes, and challenges of HBC prevention efforts as part of organizations' regular HBC
provider meetings to evaluate and improve services on an ongoing basis.
5. Pilot using solar-powered handheld electronic devices to connect community and facility levels for
palliative care referrals, linkages, and back-up support. In remote areas, this will allow data on patients to be
transferred more effectively.
LINKAGES: Community HBC services are provided by five sub-partner NGOs, using the national HBC
guidelines. The NGOs refer clients to one another based upon clients' areas of residence, need, and
specific area of expertise of a member organization. RODI convenes community HBC provider meetings to
exchange ideas and support. RODI will also coordinate with other HBC providers in other regions of the
country to work under the guidelines set by the National AIDS Control Programme (NACP).
RODI and its sub-partners link with: KIHUMBE; ward leaders and other local government officials; 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; and district
and/or regional hospitals for treatment and provision of cotrimoxazole and morphine as necessary for care
on a case by case basis.
CHECK BOXES: Home-based care 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 will 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, through coordination with
KIHUMBE, as volunteers constitute the primary human resources delivering community HBC services.
M&E practices. RODI will have a staff member dedicated to monitoring and compiling all data collected by
member organizations in collaboration with the data system to be rolled out in the future by NACP. The
Henry Jackson Foundation Medical Research International (HJFMRI) will spot check the present tools for
collecting detailed data on service delivery to assure transparency and completeness of HBC services.
These tools, developed by the MHNT (separate submission), will serve as a visit checklist which includes a
menu of services to be provided to 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 community HBC services.
All new and active HBC providers will be provided refresher courses regarding this paper based system so
it may efficiently be transmitted 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 and highlight innovative program linkages. These data will be shared
with local leaders to highlight needs and enlist community support in meeting these needs. Once the
national palliative care monitoring system is ready for implementation, RODI will switch to this system for
program monitoring.
and skill base for this responsibility. Nurturing RODI in this role will not only help to ensure quality services,
Rukwa. RODI and its sub-partners will become increasingly well-positioned to apply for and administer
Continuing Activity: 18276
18276 18276.08 Department of Resource Oriented 7571 7571.08 $324,970
Health-related Wraparound Programs
* Malaria (PMI)
* TB
Workplace Programs
Estimated amount of funding that is planned for Human Capacity Development $125,000
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $5,000
and Service Delivery
Estimated amount of funding that is planned for Food and Nutrition: Commodities $25,000
Estimated amount of funding that is planned for Education $5,000
Table 3.3.08:
ACCOMPLISHMENTS: FY 2007 funding supported the establishment of PEPFAR-funded OVC support
services in Rukwa region, including identification of appropriate sub-partners in Rukwa districts where eight
NGOs were identified. By SAPR 2008, 1,573 children have been supported by the NGOs under RODI.
About 80 caregivers have been trained to provide services to OVC.
ACTIVITIES: The program will continue as in FY 2008, though there will be additional focus placed on case
finding of HIV-positive children among orphans and vulnerable children (OVC) being served and attention to
nutritional status so that those who require nutritional support can be linked with services. There will also
be additional efforts to promote prevention among older OVC. The program will also work with Prevention
of Mother-to-Child Transmission sites to follow up on exposed children.
Sumbawanga Urban district will be the "program learning district" in which RODI will install the national
DMS and train staff on its use. RODI will focus on provision of quality services and work with other partners
to ensure that the MVCCs are operational. RODI will monitor and report on progress of implementation of
the "program learning district," and share experiences across partners via exchange visits and, where
possible, electronic communications. The program will document and disseminate best practices to
facilitate scale up of successful practices.
M&E: In addition, computers will be purchased for the district/municipal social welfare officer. RODI will
install the national DMS and train data clerks on its use.
TITLE: Improvement of OVC services to support the most vulnerable children.
NEED and COMPARATIVE ADVANTAGE: Rukwa region has an estimated 18% OVC per capita, yet due
to limited resources, most of these OVC (as well as other vulnerable children) do not receive care and
support services. Addressing the needs of these youth is complex as it involves not only building financial
support, but psychosocial support as well as health, educational, nutritional, as well as broad community
support to address any issues of stigma. The majority of households and caregivers that support these
youth have limited resources and need economic strengthening as well.
In addition, there is very poor infrastructure to support the provision of the necessary services to OVC in the
Rukwa region. There are no paved roads in this region, and these roads are often impassable during the
rainy season. There are a few established NGOs providing HIV-related services in the Rukwa region,
though these NGOs do not have the capacity to provide comprehensive service provision across the entire
region. One implementing partner, RODI, does have a strong record of capacity building and training for a
variety of projects in the Rukwa region. RODI also have the capacity necessary to coordinate service
provision by a network of NGOs throughout Rukwa.
ACCOMPLISHMENTS: FY2007 funding supports establishment of PEPFAR-funded OVC support services
in Rukwa region, including identification of appropriate sub-partners in Rukwa districts where NGOs had yet
to be identified.
ACTIVITIES:
1. Provide support to OVC, including educational support, shelter, nutrition assistance and
psychosocial/spiritual support, according to individual needs.
a. Work with local government and MVCCs as they become established, to identify OVC and their needs
and ensure against duplication of service.
b. Provide training in income-generating activities for OVC caregivers and older OVC.
2. Coordinate with Mbeya HIV Network Tanzania (MHNT), a prime partner under a separate submission, to
ensure training of OVC caregivers.
a. Communicate with MHNT to schedule initial comprehensive training and organize attendance of
volunteers serving OVC.
b. Plan refresher trainings with MHNT as necessary (particularly to coincide with any changes to local or
national OVC policy) for volunteers who previously received comprehensive training.
3. Establish referral system for OVC to ensure a comprehensive approach to meeting individual needs.
Include follow-up with the entity to which the client is referred.
a. Institute standardized referral process for assessing service needs and linking OVC to services (including
medical care, VCT and HIV prevention, as appropriate).
b. Continue to cultivate relationships with municipal and NGO service providers to facilitate referral follow-
up.
c. Include these referral activities, including follow-up, on standardized forms to facilitate monitoring and
evaluation and quality improvement.
LINKAGES: Five sub-partner NGOs, all of which refer clients to one another based upon clients' area of
residence, will provide OVC services. Each NGO links with:
- District and/or regional hospitals to facilitate referrals;
- 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);
-Faith groups and other providers of counseling services;
- NGOs working to establish village OVC funds, to collaborate and reduce duplication
CHECK BOXES: OVC program services support OVCs (whether HIV-positive or HIV-negative) as well as
their caregivers. Linkages to health care address child survival, malaria and other health issues in addition
Activity Narrative: 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. The developing program in Rukwa will particularly benefit from
training by MHNT.
These tools, developed through the Mbeya HIV Network Tanzania (MHNT), a prime partner under a
separate submission, will also serve as a checklist, ensuring a menu of services is provided to each child,
based upon individual need. Along with submitting these data to the local government, compiling data from
sub-partners will allow for identification of major service needs and gaps within OVC services. These data
needs.
expertise in the health, environmental and agricultural arenas. Its holistic approach to health addresses
HIV, malaria and water-borne disease. RODI has expanded activities slowly within the Southern Highlands
Zone, so as not to exceed current capacity and compromise quality of service. Few local entities in Rukwa
have experience managing service delivery on a regional scale, yet RODI has the background and skill
base for this responsibility. Nurturing RODI in this role will not only help to ensure quality services, regional
coverage and fiscal oversight of sub-partners, but will also lend needed administrative capacity to Rukwa.
RODI and its sub-partners will become increasingly well positioned to apply for and administer additional
funding for this under-served region.
Continuing Activity: 16988
16988 16988.08 Department of Resource Oriented 7571 7571.08 $160,000
Construction/Renovation
* Child Survival Activities
Estimated amount of funding that is planned for Human Capacity Development $28,000
Estimated amount of funding that is planned for Food and Nutrition: Commodities $10,000
Estimated amount of funding that is planned for Education $50,000
Table 3.3.13:
ACTIVITY NARRATIVE REMAINS UNCHANGED FROM FY 2008.
TITLE: MHNT voluntary counseling and testing (VCT) to further prevention and treatment goals.
NEED and COMPARATIVE ADVANTAGE: The estimated HIV prevalence in Rukwa region is 6%, but few
are aware of their HIV status. General infrastructure in Rukwa is poor. The region has no paved roads and
during the rainy season many are impassable. There are few established NGOs providing HIV services in
Rukwa, and fewer able to manage regional service provision. RODI, registered in 2004, has exhibited a
strong track record of capacity building and training for a variety of Rukwa projects in just a short period of
time. As a sub-grantee under a DOD umbrella organization in 2007, this organization has shown the
capacity necessary to coordinate service provision by a network of NGOs in Rukwa and has graduated to
prime partner status.
ACCOMPLISHMENTS: FY 2007 funding supported initiation of PEPFAR-funded HIV counseling and testing
services in the Rukwa Region. RODI conducted a thorough needs assessment of home-based care and
VCT capacity in early 2007, and is currently working to identify appropriate sub-partners in Rukwa districts
where 8 NGOs have been identified. The findings of a needs assessment conducted by RODI will help to
shape service provision and capacity building efforts in the region through clusters focusing on the three
large districts in the region (Sumbawanga Urban/Rural, Nkasi and Mpanda).
In an effort to deliver a consistent packages of services across the three region Zone, RODI, in collaboration
and cooperation with KIHUMBE and members of SONGONET-HIV and the Mbeya HIV Network Tanzania
(MHNT) (see other submissions for these partners) will ensure VCT services are available for as many
clients as possible in the Rukwa Region. In addition, implementation of services has been standardized
across these partners through cross-training of each other and shared lessons learned, 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) Mobilize test counselors from Rukwa NGOs and MOHSW sites to provide VCT at large-scale community
events, capitalizing upon opportunities to reach many individuals in a single setting.
1a) Provide VCT at the annual regional World AIDS Day event sponsored and executed by the Regional
AIDS Control Office.
1b) Plan, advertise and provide VCT for monthly "HIV Testing Day" events to be held in each of the three
Rukwa "clusters".
2) Provide VCT services at member organizations' and community sites in accordance with national
standards and using NACP tools to document service delivery.
2a) Provide VCT at NGOs' service sites.
2b) Coordinate with local entities to provide VCT at non-HIV-specific NGOs, youth centers, workplaces and
other community sites.
2c) Work with local leaders, District Health Management Teams (DHMT) and health facility directors to
identify sites in which to provide mobile.
2d) Use data gathered as part of mobile VCT to prioritize return visits to villages based upon identified
prevalence and or risk behaviors.
2e) Maintain RODI network offices and an adjacent VCT site to house network records and serve as venue
for regional meetings and trainings.
3) Expand VCT provision in Rukwa, ensuring thorough regional coverage by establishing additional VCT
sites where services are not available.
3a) Identify new sites for VCT by reviewing mobile VCT statistics and through communication with local
government, DHMT and service organizations.
3b) Ensure training of new VCT counselors in accordance with national standards.
3c) Promote awareness of newly established sites, and include sites in informational materials about
available services.
4) Produce and distribute pamphlets of all sub-partner services, to increase community awareness of
available services and facilitate referrals.
4a) Create a list of service sites to receive pamphlets (e.g., NGOs' sites, CTCs) and contact sites monthly to
monitor need to replenish supply.
4b) Evaluate effectiveness of this information & referral strategy by documenting client self-report of referral
mechanism to a given service.
5) Establish a formal referral system for individuals accessing VCT services, incorporating follow-up with the
entity to which the client is referred.
5a) Establish standardized referral process for linking individuals testing HIV-positive to services, to include
at minimum medical services and home-based care "prescription" to RODI members.
5b) 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.
5c) Include these referral activities and follow-up on standardized forms to facilitate monitoring and
LINKAGES: VCT services will be provided by five sub-partner NGOs which refer clients to one another
based upon clients' areas of residence, need and specific area of expertise of a member organization (see
entries under this partner in HBHC, HKIC and HVAB/OP). Each of these members links with: District and/or
regional hospitals to facilitate referrals, secure test kits and distribute pamphlets; Ward leaders and other
local government officials; Faith groups and other providers of counseling services; and PEPFAR marketing
groups, STRADCOM and AED, to encourage event participation.
CHECK BOXES: VCT services target the general population. Coordination with home-based care (among
network members and with those outside the network) 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
Activity Narrative: participation in community events.
M&E: RODI, having supported a number of projects in efforts to improve M&E practices, has considerable
M&E expertise. In addition to instituting standard processes for monitoring indicators on a quarterly basis,
Compiling data from sub-partners by a designated M&E staff person will allow for identification of major
service needs and gaps. Supportive 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. This 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 RODI outreach and identification efforts, and test results via mobile VCT
services will help identify sites with high-risk groups requiring particular focus. Data will be provided to
NACP and USG for reporting purposes.
expertise in the health, environmental and agricultural arenas. Its holistic approach to health addresses HIV,
malaria and water-borne disease. RODI has expanded activities slowly within the Southern Highlands Zone,
so as not to exceed current capacity and therefore compromise quality of service. Few, local entities in
regional coverage and fiscal oversight of sub-partners, but will also lend needed administrative capacity to
Continuing Activity: 16968
16968 16968.08 Department of Resource Oriented 7571 7571.08 $217,760
Table 3.3.14:
