This is an ongoing activity which began in FY 2007. The Kara Counseling and Training Trust (KCTT)

Family Based Response (FBR) Project is a New Partner Initiative (NPI) project in Zambia. KCTT has been

working in Zambia for over ten years. With the NPI grant they will be able to not only expand their

programs, but also build capacity of local partner organizations in systems strengthening and enhance their

own sustainability for the long term. New emphases will include increased linkages to and coordinating with

other AB activities funded by PEPFAR, such as RAPIDS, as well as coordinating with Government of the

Republic of Zambia (GRZ)-led AB activities/initiatives. The program will continue to build upon the

experiences of the FY 2007 scale-up activities. The FBR Project will support the Zambia National HIV/AIDS

Prevention Strategy and campaigns, and will work with PEPFAR funds to reduce HIV transmission

accordingly, within its project mandate, and to the extent its resources permit

This activity has three components. The first component is the training of HIV/AIDS Educators in educating

the youth and adults and disseminating abstinence and being faithful (AB) messages. The Educators will

also be trained in the use of participatory techniques using video shows. Kara Counseling and Training

Trust (KCTT) and eleven partners will train 105 educators who will be able to educate their respective

communities through door-to-door campaigns with the aim of reaching individuals in their family settings.

The funding will specifically be used to pay for training resource materials, facilitation fees, transport, meals,

and lodging for trainers and educators coming from outside their own district during training.

This activity component will be carried out in twelve districts from seven provinces of Zambia, namely,

Choma (KCTT site) and Mazabuka (Ndekeleni Home Based Care) in Southern Province; Chipata (Action for

Positive Change and Mthunzi Development Foundation) in Eastern Province; Lusaka (KCTT site and

Mututa Memorial Day Care Center); Kafue (Kalucha Home Based Care) and Chongwe (Umphawi

Organization )in Lusaka Province; Mansa (Group Focused Consultations) in Luapula Province; Kabwe

(KCTT site) in Central Province; Masaiti (Community Health Restoration Programme), Luanshya (Happy

Children) and Mufulira (Iluka Support Group) on the Copperbelt Province; and Kasama (Northern Province

Health Education Programme) in Northern Province.

The second component will be the education and dissemination of AB messages to youths and adults. This

will be done through door to door campaigns where the educators will speak to families and distribute

brochures to these families. The educators will reach 5,040 families, totaling roughly 20,160 individuals

(estimated 4 people reached per family x 5,040 families). In this activity component the funds will be used

to pay for transport, brochures, office rentals, and personnel costs. This component will also be carried in

twelve districts in seven provinces of Zambia: Choma and Mazabuka in Southern Province; Chipata in

Eastern Province; Lusaka; Kafue and Chongwe in Lusaka Province; Mansa in Luapula Province; Kabwe in

Central Province; Masaiti, Luanshya and Mufulira on the Copperbelt Province; and Kasama in Northern

Province.

The third component will be the education and dissemination of information to groups of people in schools,

colleges, farms, workplaces, churches, and market places. This will be done with the aim of motivating

youths and adults to either abstain from sex or be faithful to their partners. Video shows followed by

facilitated discussions will be conducted by the trained educators. A total of 30,240 individuals will be

reached. The funding will be used to cover expenses for transport, procurement of television sets, video

cassette players, video tapes, batteries and costs for venue. This component will be carried out in twelve

districts in seven provinces of Zambia, as above.

In order to ensure sustainability of community education activities using the family based approach, KCTT

will work with existing community based organizations in respective districts and will train and involve

volunteers from these organizations.

All FY 2008 targets will be reached by September 30, 2009.

This is an ongoing activity which began in FY 2007. The "Family Based Response" (FBR) project of the

Kara Counseling and Training Trust (KCTT) is a New Partner Initiative (NPI) project in Zambia dating from

late 2006. KCTT has been working in Zambia for over ten years. With the NPI grant they are able to not

only expand their programs, but also build capacity of local partner organizations in systems strengthening

and enhance their own sustainability for the long term. New emphases will include increased linkages to

and coordinating with other palliative care activities funded by PEPFAR, such as RAPIDS, as well as

coordinating with Government of the Republic of Zambia (GRZ)-led palliative care activities/initiatives. The

program will continue to build upon the experiences of the FY 2007 scale-up activities.

This activity has several components. One component is to train caregivers and family members in palliative

care and antiretroviral therapy (ART) adherence respectively. The training will equip the caregivers with

knowledge on identification of HIV/AIDS disease progression for them to be able to identify and refer clients

who need to start treatment. Family members will acquire skills on how to ensure that their family members

on ART continue taking medication without missing doses.

The caregivers will each attend to up to 10 PLWHA and will be able to provide with a full range of palliative

care services and support following the OGAC guidance, including a Kara specialty, psychosocial support

for positive living. PEPFAR funding for the training will go principally to address the costs for training

resource materials, facilitation fees, transport, and meals and lodging for trainers and caregivers during

training. Specific target populations to be reached by trained caregivers will be PLWHA in their homes and

the affected family members, that is, adults and children.

This activity component will be carried out in 12 outlets: three Kara Counseling, Training Trust (KCTT)

outlets, and nine outlets from partner organizations. These outlets are located in: Lusaka District (one

KCTT outlet and one outlet for Mututa Day Care Center) and Kafue District (one outlet for Kalucha Home

Based Care [HBC]) in Lusaka Province; Chibombo District (Mwelebi HBC and Foundation for Development

of Children with one outlet each); Kabwe District (one KCTT outlet) in Central Province; Kasama District

(one outlet for Northern Health Education Programme) in Northern Province; Choma District (one KCTT

outlet) and Mazabuka District (one outlet for Ndekeleni HBC) in Southern Province; and Mufulira District

(one outlet for Iluka Support Group), Luanshya District (one outlet for Happy Children) and Masaiti District

(one outlet for Community Health Restoration Programme) in the Copperbelt Province. Overall, 120

community home-based caregivers will be trained.

The second component of this activity is to provide palliative care to PLWHA using the family-based

approach in which care will be provided to clients in their own homes and appropriate linkages will be made

for referral to hospices for needy clients. Tools for work will be provided to motivate the caregivers. Each

caregiver will receive a bicycle to serve as transport, a kit for basic home based care containing disposable

examination gloves, soap, a hand towel, pain killers, and anti-diarrhea drugs. In the rainy season

gumboots, raincoats and umbrellas will be given to encourage the caregivers to continue to visit their

patients despite the rains and muddy surfaces. The palliative care program will be strengthened by using

the Government of Zambia national guidelines on nutrition for PLWHA, involving nutritional assessment,

counseling, and therapeutic feeding. The trained community home-based caregiver will provide education

on personal hygiene and health to patients and immediate family members, and information on how to

prevent opportunistic infections (O.I.s). The caregivers will also provide ART adherence support to patients

on antiretroviral therapy in partnership with other trained family members. ART adherence support will aim

to ensure that patients on antiretroviral drugs take the medication as prescribed, without omitting any doses

for best treatment outcomes.

People infected with HIV will have different needs depending on the stage of HIV infection. While PLWHA

will be targeted, funding will be used for an array of interventions. For asymptomatic PLWHA, PEPFAR

funding will be used for skills training in farming, welding, carpentry, tailoring, printing, tie dye, batik making,

and knitting to enable them to generate income for their households. Farming would also help them

produce some food for themselves. Skills training will also be provided to PLWHA whose health improves

after commencement of ART. The skills learnt and applied will boost the self esteem of the PLWHA.

The PLWHA who will be manifesting HIV related signs and symptoms (usually in the symptomatic stage)

will be referred for ART and the treatment of opportunistic infections while those that are severely

malnourished as per OGAC guidelines will be given therapeutic food support. This funding will go

specifically to support the procurement of therapeutic food supplements for malnourished PLWHA, the

training of caregivers in palliative care and family members in adherence, skills training for PLWHA, and

procurement of caregiver's home-based care kits, and protective clothing. FBR HIV/AIDS palliative care

activities will be operated and supported in 12 Districts of five provinces, namely Southern Province,

Northern province, Lusaka Province, Central Province, and Copperbelt Province. This component of the

activity will provide support to 12 service outlets and reach 1200 individuals.

The final component of this activity is for KCTT to participate in the palliative care forums addressing

palliative and home-based care issues. KCTT will continue ongoing work with other U.S supported

palliative care NGO/CBO/FBOs, and agencies that support and are implementing palliative care programs

to ensure comprehensive palliative care service delivery to clients.

Partners will work with KCTT in implementing this activity in their respective communities, thus promoting

sustainability of programs. The training and involvement of volunteers in activity implementation will ensure

continuity and community ownership of activities. The participating partners will also gain experience in the

proper use of funds which they will be able to apply in the implementation of future activities.

All FY 2008 targets will be reached by September 30, 2009.

This is an ongoing activity which began in FY 2007. Kara Counseling and Training Trust (KCTT) Family

Based Response (FBR) project is a New Partner Initiative (NPI) project in Zambia. KCTT has been working

in Zambia for over ten years. With the NPI grant they will be able to not only expand their programs, but

also build capacity of local partner organizations in systems strengthening and enhance their own

sustainability for the long term. New emphases will include increased linkages to and coordinating with

other OVC activities funded by PEPFAR, such as RAPIDS, as well as coordinating with Government of the

Republic of Zambia (GRZ)-led OVC activities/initiatives. The program will continue to build upon the

experiences of the FY 2007 scale-up activities.

This OVC activity has several components. The first component is training OVC caregivers in

comprehensive care and support of orphans and vulnerable children using national protocols and following

the USG OVC strategy and OGAC guidelines. The training will enable caregivers to provide psychosocial

support to children with a family-based approach. The training will also enable caregivers to provide

guidance to OVCs, who live in the same household with the OVC, on how to care for OVC. The funding

under this component will be used to pay for resource materials, transport, and lodging and meals during

training. KCTT and the implementing partners (Ndekeleni Home Based Care, Moliswa Children's

Foundation, Foundation for Development of Children, and Happy Children) will train 95 caregivers in seven

districts and five provinces (Lusaka, Southern, Central, Western, and Copperbelt) and seven districts

The second component of this activity is provision of holistic care and support to 700 identified OVC. This

care and support will be in the forms of health care, psychosocial support, education, entrepreneurship skills

training, and food and nutritional support following OGAC and GRZ guidelines. Under this component,

access to medical care for children living with HIV/AIDS will be facilitated through linkages with the

government hospitals and health centers. KCTT and the four implementing partners will pay for medical

fees, medicines, and transport to health facilities for ailing OVC. Trained caregivers will provide

psychosocial support to the 700 OVC through one-to-one counseling; the counseling process will involve

other family members. KCTT and the implementing partners will train 100 out-of-school OVC in

entrepreneurship skills. The trained OVC will be linked to micro-finance institutions for soft loans for income

generation. KCTT and the four partners will facilitate peer support among the OVC. KCTT and the partners

will provide food to 700 individual OVC. In order to ensure food security at the household level,

grandmother and child-headed households will be linked to Government Ministry of Agriculture and

Programme Against Malnutrition. The funding under this component will be used to pay for school

requisites (books, uniforms, shoes and fees) for 600 school-going OVC, fees for entrepreneurship training,

and food and security funds for micro-financing. The funds will also be used to pay for procurement of

bicycles, safety boots, and umbrellas for caregivers. The implementation of this activity component will be in

five provinces and include three KCTT sites located in three districts, Lusaka, Choma and Kabwe from

Lusaka Province, Southern Province and Central Province respectively. The sites from four partners are in

four districts, Mazabuka, Mongu, Chibombo and Luanshya from Southern Province, Western Province,

Central Province and Copperbelt Province respectively.

The third component of this activity is to engage government at national and local level in dialogue for

holistic OVC care and support. Fourteen meetings will be held with key stakeholders and jointly engage

government on issues relating to orphan and vulnerable children.

All FY 2008 targets will be reached by September 30, 2009.

This is an ongoing activity which began in FY 2007. The Kara Counseling and Training Trust (KCTT)

Family Based Response (FBR) project is a New Partner Initiative (NPI) project in Zambia which began

operations in FY 2007. However, KCTT has been working in Zambia for over ten years. With the NPI grant

they will be able to not only expand their programs, but also build capacity of local partner organizations in

systems strengthening and enhance their own sustainability for the long term. This counseling and testing

activity has four components including: training caregivers in counseling and testing (CT); offering a family-

based approach to CT to by offering CT to families in their homes; offering outreach through mobile CT; and

advocacy and lobbying for improved counseling and testing services in Zambia. The program will continue

to build upon the experiences of the FY 2007 scale-up activities.

The first component is to train caregivers in counseling and HIV testing. Kara Counseling and Training

Trust (KCTT) and four partners (Mthunzi Development Foundation, Umphawi Organization, Group Focused

Consultations, and Community Health Restoration Programme) will train caregivers using the Zambia

National Guidelines for HIV Counseling and Testing. Ten caregivers will be trained in CT in 7 sites (three

sites- KCTT sites; one site per partner), totaling 70 caregivers trained. The training will enable the

caregivers to conduct family-based counseling and testing as well as counseling for couples and children.

The trained caregivers will also be able to provide group counseling. PEPFAR funding will specifically be

used to pay for training resource materials, facilitation fees, transport, and meals and lodging for trainers

and caregivers during training. This activity component will be carried out in seven districts from six

provinces of Zambia, namely, Choma (KCTT site) in Southern Province, Chipata (Mthunzi Development

Foundation) in Eastern Province, Lusaka (KCTT site) and Chongwe (Umphawi Organization) in Lusaka

Province, Mansa (Group Focused Consultations) in Luapula Province, Kabwe (KCTT site) in Central

Province and Masaiti (Community Health Restoration Programme) on the Copperbelt Province.

The second component is the provision of counseling and testing to individuals. This will be done with a

family-based approach by providing counseling and testing to families in their homes. The agreement to

undergo counseling and testing as a family will enhance support for members of the family that would test

HIV positive. Ten thousand and eighty (10,080) individuals will be counseled in their homes. KCTT

estimates that about 1 in 5, or 2,016 of these individuals, will be tested and receive their results. The

caregivers will provide counseling to individual families with special needs, especially those who will test

HIV positive. In this activity component the funds will be used to pay for HIV testing materials, transport,

office rentals, and personnel costs. The counseling and testing will be carried out by the trained care givers

in seven districts from six provinces of Zambia, namely, Choma in Southern Province, Chipata in Eastern

Province, Lusaka and Chongwe in Lusaka Province, Mansa in Luapula Province, Kabwe in Central

Province, and Masaiti in Copperbelt Province.

The third component is mobile counseling and testing. Counseling and testing under this component will be

done through group counseling of youth and adults aimed at encouraging testing for HIV. This will be

carried out in schools, colleges, farms, churches, and market places. For individuals opting to undertake an

HIV test, additional individual counseling will be provided. KCTT and its four partners from each of its seven

sites will provide this counseling and testing. Thirty three thousand and six hundred (33,600) individuals will

be reached through group counseling; KCTT estimates that about 13,440 of these individuals will be

counseled and tested for HIV, and receive their results, with a proportion of 50% females and 50% males.

Caregivers who are HIV positive and open about their status will be involved and will share their testimonies

to demonstrate the benefits of testing. In this activity component the funds will be used to pay for HIV

testing materials, transport, office rentals, and personnel costs. The mobile counseling and testing will also

be carried out by the trained care givers in seven districts and six provinces of Zambia, namely, Choma in

Southern Province, Chipata in Eastern Province, Lusaka and Chongwe in Lusaka Province, Mansa in

Luapula Province, Kabwe in Central Province, and Masaiti in Copperbelt Province.

Thus, from counseling and testing in two different settings, KCTT expects a total of 15,456 clients (13,440

plus 2,016).

The final component of this activity is advocacy and lobbying for improved counseling and testing services

in the country. This will be carried out through participation in national level counseling and testing

meetings and reaching 20 key persons per meeting every quarter. PEPFAR funding will be used to pay for

transport for those coming from outside the district and for meeting expenses.

In order to ensure sustainability of counseling and testing activities using the family- based approach, KCTT

will work with existing community based organizations in respective districts and will train and involve

volunteers from these organizations.

All FY 2008 targets will be reached by September 30, 2009.