This mechanism is a $73 million contract between USAID/Zambia and Population Services International/Society for Family Health (PSI/SFH) to implement a Private Sector Social Marketing Program from August 1, 2009 to September 30, 2014. The new program builds on the achievements of the previous social marketing program known as "Better Health for Zambians through Social Marketing" in preventing and/or controlling childhood illnesses, unintended and unsafe pregnancies, HIV infection and STIs, and malaria.

With FY 2010 funds, PSI/SFH will socially market HIV prevention products and services nationally, targeting the entire Zambian population, including people living with HIV/AIDS (PLWHA), discordant couples, female and male commercial sex workers, long distance truck drivers such as those on the Great North and Great East roads, people in multiple concurrent sexual partnerships, fishing communities such as those on the shores of lake Bangweulu in Luapula province and along the Zambezi plains in Western province, and communities living in busy border towns such as Nakonde and Livingstone.

PSI/SFH will collaborate closely with the Ministry of Health, other USG implementing partners, and all other stakeholders in HIV control in selecting sites for social marketing of HIV prevention products and services to avoid geographic overlap of HIV activities, promote synergies, and ensure equity of access to health services and products by the Zambian population. PSI/SFH will also ensure that all HIV services and products will be socially marketed in close collaboration with the MOH and the National HIV/AIDS/TB/STI Council (NAC) structures at the national, provincial, district, and community levels.

PSI/SFH will implement five activities to reduce the spread and impact of HIV in Zambia with FY 2010 funds: 1) HIV testing and counseling (TC), 2) promoting Abstinence and being faithful (AB), 3) male circumcision (MC), 4) others sexual prevention activities, including distributing female and male condoms, promoting correct and consistent use female and male condoms, reducing concurrent sexual partnerships, and promoting prompt treatment of sexually transmitted diseases, and 5) providing care and support to people living with HIV/AIDS (PLWHA).

Health System Strengthening will be an integral part of activities to be implemented by PSI/SFH with FY 2010 funds. PSI/SFH will implement the following activities to strengthen the Zambian health system: 1) participate in HIV policy and strategy dialogue with the Government of the Republic of Zambia (GRZ) and other key stakeholders, including in the refinement of the male circumcision strategy and the development and harmonization of communication materials for HIV prevention, 2) work with CARE International to train communities in health promotion, including distribution of health products to reduce the spread and impact of HIV such as Clorin and condoms, and 3) integrate HIV services with other services including reproductive and child health.

PSI/SFH will adopt strategies for cost containment, including cost recovery, cost share and developing the ability of a commercial/private sector entity to produce and market Clorin in a sustainable, self-sufficient manner. The aforementioned cost containment measures will be implemented after appropriate surveys/research, including willingness and ability to pay studies by the social marketing clients.

PSI/SFH will develop and implement a monitoring and evaluation plan that will ensure that targets in child health, HIV/AIDS, and integrated reproductive health are being met. PSI/SFH will be monitored through biennial and annual reports, special reports on demand, project reviews, and field visits by the USAID mission to Zambia.

PSI/SFH will also put systems in place to ensure that infection prevention is integrated into the program. Approaches will include correct handling and disposal of medical waste that might be generated during project implementation, information to the public on how to handle medical waste, and training community-based distributors on how to handle medical waste.

PSI/SFH will also implement integrated reproductive health, child health, and malaria control activities in FY 2010 using non PEPFAR U.S.G funds. The non PEPFAR funds to PSI/SFH will represent 35% of all USG funding to the partner in FY 2010.

Narrative (2250 characters)

This adult care and support activity will be implemented by PSI/SFH in FY 2010 as an integral part of the Private Sector Social Marketing Program. Adult care and support activities under this mechanism will be implemented in close collaboration with other HIV prevention, care, support, and treatment activities implemented by other USG partners, the GRZ, and other donors. Adult care and support services will be provided across the entire country, targeting HIV-infected adults between the ages of 15 and 49 years, including those under home based care and in hospices.

The program will not run any care and support site. The program will donate Clorin to other USG adult care and support programs for distribution to HIV-infected adults to reduce the incidence of diarrhea. The program will donate 200,000 bottles of Clorin to treat 133,400,000 liters of drinking water to USG-supported care and support programs and train 70 care-givers on the benefits of consistent and correct use of Clorin in households with PLWHA.

The donation of Clorin home water treatment solution will be implemented alongside the safe water education campaigns conducted by the Government of Zambia, which promote good personal hygiene such as regular hand washing, boiling of drinking water, and proper storage of drinking water.

The program will collect data on the number of Clorin bottled donated routinely and the impact of the donated Clorin on the incidence of diarrhea through special surveys.

The program will provide onsite demonstration of correct use of Clorin to community-based programs/health workers to promote correct and consistent use of Clorin.

This testing and counseling (T&C) activity will be implemented in FY 2010 by PSI/SFH as an integral part of the Private Sector Social Marketing Program. T&C activities under this mechanism will be implemented in close collaboration with other HIV prevention, care, support, and treatment activities implemented by other USG partners, the GRZ, and other donors. T&C services will be provided across the entire country, targeting females and males between the ages of 15 and 49 years, including individuals in multiple concurrent sexual partnerships, discordant couples, people living with HIV/AIDS (PLWHA), and commercial sex workers.

The program will implement a comprehensive range of T&C services, including client initiated T&C, provider-initiated T&C, couples testing, and special events highlighting T&C such as national T&C day, world TB day, and World AIDS day using the national testing algorithm. In addition, the program will integrate reproductive health activities such FP counseling and distribution of FP products into T&C services. The program will use existing communication strategies and materials developed under the previous social marketing program to promote T&C. In addition, the program will work with the GRZ, USG-supported programs, and other partners to develop additional materials if deemed necessary.

The program will run a network of 10 mobile and 10 static T&C facilities across Zambia in FY 2010. The network of T&C services will provide T&C to 185,000 clients reach 5,500 individuals with FP counseling and train 460 individuals in T&C. The program will provide onsite mentorship to all affiliated sites and collaborate with other T&C stakeholders to standardize T&C services through joint development of T&C training materials and messages. The program will also ensure that clients are linked to other HIV services, including antiretroviral therapy, post-HIV test clubs, MC, and continued psychosocial support.

This pediatric care and support activity will be implemented by PSI/SFH in FY 2010. Pediatric care and support activities under this mechanism will be implemented in close collaboration with other HIV prevention, care, support, and treatment activities implemented by other USG partners, the GRZ, and other donors. Pediatric care and support services will be provided across the entire country, targeting HIV-infected children between the ages of 0 and 14 years, including those under home based care and in hospices.

The program will not run any care and support site. The program will donate Clorin to other USG Pediatric care and support programs for distribution to HIV-infected children between 0 and 14 years to reduce the incidence of diarrhea. The program will donate 200, 000 bottles of Clorin to treat 133,400,000 liters of drinking water to USG-supported care and support programs and train 70 care-givers on the benefits of consistent and correct use of Clorin in households with children infected with HIV.

The donation of Clorin home water treatment solution will be implemented alongside the safe water education campaigns conducted by the Government of Zambia, which promote good personal hygiene such as regular hand washing, boiling of drinking water, and proper storage of drinking water.

The program will collect data on the number of Clorin bottled donated routinely and the impact of the donated Clorin on the incidence of diarrhea through surveys.

The program will provide onsite demonstration of correct use of Clorin to community-based programs and to promote correct and consistent use of Clorin.

This male circumcision (MC) activity will be implemented by PSI/SFH in FY 2010 as an integral part of the Private Sector Social Marketing Program. MC activities under this mechanism will be implemented in close collaboration with other HIV prevention, care, support, and treatment activities implemented by other USG partners, the GRZ, and other donors. MC services will be provided across the entire country, targeting HIV-negative males between the ages of 15 and 49 years, including those deemed to be most at risk such as those in multiple concurrent sexual partnerships and men with HIV-infected sexual partners.

Using national and international guidelines, the program will implement a comprehensive package of MC services, including onsite testing and counseling (T&C) for HIV, MC surgery and post surgical care, and referral of clients to appropriate service providers for incidental disorders discovered during the provision of MC services. The program will implement the following activities: train 40 individuals (doctors, clinical officers, and nurses) in MC and 30 counselors in HIV T&C with emphasis on benefits of MC, procure sufficient MC equipment, ,to perform at least 5,000 MC procedures including surgical beds, MC kits containing MC consumables (needles, syringes, cotton wool, suture materials, and an anesthetic drug), and MC surgical instruments, and develop lessons learned regarding cost-effective, sustainable MC service-delivery models to rapidly scale up services nation-wide.

The partner will collaborate with MC stakeholders to develop MC training materials, provide onsite mentorship in MC to the private and public sectors, and to standardize MC services, including the MC surgical kit, MC procedure, and MC messages.

This Abstinence and Being faithful activity (AB) will be implemented by Population Services International/Society for Family Health (PSI/SFH) in FY 2010. AB activities under this mechanism will be implemented in close collaboration with other HIV prevention, care, support, and treatment activities implemented by other USG partners, the Government of the Republic of Zambia (GRZ), and other donors. AB services will be provided across the entire country, targeting females and males between the ages of 10 and 49 years, including adolescents and secondary and tertiary education students.

With FY 2009 funding, PSI/SFH will train 60 counselors in HIV counseling and testing (CT) with emphasis on Abstinence/Being faithful (AB) and will reach 50,000 individuals with AB messages through CT counseling, interpersonal communication, radio and television broadcasts, drama shows, and print media, and will be a complementary activity to PSI/SFH's Other Prevention activities where many of the same individuals will also be reached with HIV prevention messages beyond abstinence or being faithful

The program will provide standard training and onsite mentorship to peer educators, schools, communities, and other affiliated organizations to maintain the quality of AB services. The program will collect data on the actual number of individuals reached with AB messages routinely and the impact of the interventions through special surveys.

This budget code narrative describes Other Sexual Prevention (HVOP) activities to be implemented in FY 2010 by PSI/SFH as an integral part of the Private Sector Social Marketing Program. HVOP activities under this mechanism will be implemented in close collaboration with other HIV prevention, care, support, and treatment activities implemented by other USG partners, the GRZ, and other donors. HVOP services will be provided across the entire country, targeting females and males between the ages of 15 and 49 years, including individuals deemed to be most at risk such as discordant couples, individuals in concurrent partnerships, female and male sexual workers, long distance truck drivers, and PLWHAs.

The program will implement HVOP activities alongside other HIV prevention activities such as abstinence and being faithful (AB), male circumcision (MC), and T&C for HIV. The program will 1) distribute 16.5 million pieces of maximum male condoms through 2,100 distribution outlets, comprising pharmacies, drug stores, retail shops, and kiosks to ensure increased access, especially in the rural areas and 330,000 female condoms, 2) train 300 individuals to promote HIV/AIDS prevention through other behavior change beyond abstinence and/or being faithful, including consistent and correct use of condoms, addressing discontinuation and irregular use of condoms, dual protection of condoms from HIV infection and pregnancy, partner notification about HIV status, positive health seeking behaviors such as seeking prompt treatment for sexually transmitted diseases, and family planning, and 3) reach 96,000individuals with HIV prevention messages through community-based condom distributors.

The program will provide onsite mentoring and standard training to community-based distributors and workers to promote correct and consistent use of condoms and accurate HIV prevention messaging.

The program will track outputs and outcomes through routine collection and interpretation of data on activities such as commodities distributed and people trained, track surveys, and support visits to commodity outlets.