Kara Counselling and Training Trust (KCTT) implements four main activities: 1) comprehensive HIV prevention training; 2) counseling and testing (CT); 3) palliative care for in-patients and those in the outreach (HBC); 4) pediatric care and support at the daycare center. During 2012, KCTT will continue to provide the four services in order to contribute to preventing further spread of HIV and support adults and children living with HIV/AIDS. Thus KCTT will continue to provide care, medical (treatment), psychosocial, spiritual and nutritional support to adults and children infected and affected by HIV/AIDS. The prevention training program will contribute towards enhancing the capacity of health staff and community volunteers to implement HIV interventions; they will also scale-up HIV CT services in their catchment areas of operation. The home-based caregivers (HBC) will provide palliative care services in their respective catchment areas and also play a role in mobilizing communities to access CT. The HBC providers identify clients in need of (a) spiritual and emotional support (b) medical attention (c) nutritional support. Those who need further care and treatment are referred to Jon Hospice in Kamwala where they are admitted for symptom control and pain management. KCTT will strengthen prevention with positives (PwP) services and family centered approaches to CT. The program will identify discordant couples and provide them with the appropriate prevention interventions to reduce new infections. The daycare center will continue to enroll children for educational and psychosocial support. It will also continue to support children in the outreach program.

The adult care and support program provides palliative care and support to chronically and terminally ill clients at Jon hospice in Lusakas Kamwala township. Palliative care services are closely linked to the home-based care (HBC) program that works in the surrounding communities and serve to identify and refer patients to the hospice. The HBC providers identify clients in need of (a) Spiritual and emotional support (b) medical attention (c) nutritional support. Eligible clients are then referred for further clinical care or admission to the hospice.During 2012, palliative care services will continue to be provided to in-patients at the hospice and out-patients through outreach or home based care activities. The staff from the hospice and community caregivers trained in palliative care will conduct outreach visits to communities to identify and provide psychosocial, adherence counselling and medical care to clients. Those clients needing further management will be referred to the hospice. To ensure that patients at the hospice receive quality care, the clinical staff will regularly monitor the patients and make necessary referrals to UTH and Kara Clinic for further investigations and management. KCTT will strengthen prevention with positives (PwP) services.

KCTT runs a childrens daycare center Ambuya Day Care center located at Jon hospice. The Ambuya Day Care center aims at mitigating the impact of HIV/AIDS on the infected and affected children through the provision of educational, medical, psychosocial, nutritional and spiritual support. The children at the daycare center are enrolled through the support of a social worker and the home-based community caregivers. The community caregivers identify these children who are then assessed by the Social Worker to see whether they qualify to be on the programme or not. Those that qualify are then enrolled at the Day care center. The daycare center enrolls children between ages 5 and 13 years.

During COP 2012, the following services will be provided:School support to ensure continued schooling for children in the outreach;Pre-school education for children at the day care center;Basic health and nursing care for those in need;Food and nutrition support;Trauma-focused cognitive behavior therapy and ART adherence counseling;Sensitizations on the rights of the child and general HIV/AIDS information;Home visits and support to families of sick children through trained care givers;Psychosocial and spiritual support for integration back into the communities/homes;Regular home visits will continue as a means of monitoring and assessing progress of the OVCs at home and family members continuously sensitized on the needs of these children.

KCTT provides counseling and testing (CT) program in 3 static sites namely Kamwala Clinic, Matero Reference centre and Jon Hospice. The program enables individuals and communities to access CT services which are provided in 3 static sites as well as through mobile CT including door-to-door. Community mobilization and sensitization activities, such as community based drama performances are used to encourage community members to access CT services. During the same sensitisation meetings, the Join In Circuit (it comprises 6 stations with pictures depicting different issues and topics on HIV/AIDS) is used as a sensitisation tool before individuals decide to be counselled and tested.

During 2012, KCTT will intensify CT services to ensure that as many people as possible are counseled and tested and know their HIV status. The program will strengthen couples and families (children and dependents) CT through door to door approaches. Counselors will also use CT as the opportunity to identify individuals needing further care and support. Greater emphasis will be placed on appropriate prevention education for all clients based on their HIV test results, disclosure, and appropriate links and traceable referrals for continuum of care and support services. KCTT will encourage the formation of post-test clubs or support groups where all those that have undergone CT would meet and discuss various issues that affects them.

Monitoring will be an on-going process and will comprise of the review meetings, monthly, quarterly and annual reports, site visits and annual audit.

KCTT will continue to implement the comprehensive overview of effective HIV prevention interventions training program. The goal of the training program is to contribute to the strengthening of HIV prevention services by training health care workers from the Ministry of Health and Program managers and implementers from different organizations in the HIV and AIDS field. The training program imparts skills and knowledge on combination (biomedical, behavioral, and structural) prevention. During the 2012 and 2013, the training program will enhance the capacity of health workers, program managers and program implementers from different organizations that mainly concentrate on working at different levels of behavioral and biomedical interventions with more knowledge on the: The individual level, couples and sex partners, family, community, structural levels and also organizations that mainly look at social marketing of behaviors, to provide and implement comprehensive HIV prevention interventions.

KCTT will tailor the training towards prevention interventions that work at different levels ranging from individual, couple, family, community and structural. The focus of the training will be on understanding behavioral and structural barriers to effective social and behavioral change. Biomedical prevention interventions like male circumcision, mother to child transmission, post exposure prophylaxis, pre-exposure prophylaxis and researches that have been done previously focusing on what has worked, what has not worked and what seem to most likely work in the future will also be the focus of the training. Training will be facilitated by KTCT trainers who will take up the first three days of the training and will be complimented by medical doctors specialized in biomedical interventions who take up the last two days of the training.