Detailed Mechanism Funding and Narrative

Years of mechanism: 2008 2009

Details for Mechanism ID: 6079
Country/Region: Angola
Year: 2009
Main Partner: U.S. Centers for Disease Control and Prevention
Main Partner Program: NA
Organizational Type: Own Agency
Funding Agency: HHS/CDC
Total Funding: $552,000

Funding for Laboratory Infrastructure (HLAB): $75,000

New/Continuing Activity: New Activity

Continuing Activity:

Program Budget Code: 17 - HVSI Strategic Information

Total Planned Funding for Program Budget Code: $1,225,000

Total Planned Funding for Program Budget Code: $0

Program Area Narrative:


To date, national level HIV-related data in Angola is limited to surveillance in pregnant women and a limited number of Voluntary

Counseling and Testing (VCT) sites. The 2004, 2005 and 2007 national HIV (hepatitis B and syphilis) antenatal clinic (ANC)

surveys are the only estimates of HIV prevalence. During the first two surveys, the USG played a critical role in building local

government capacity enabling the National AIDS Institute (INLS) to take the lead in the 2007 survey. Angola has no systematic

process for monitoring and evaluation (M&E), routine surveillance, or standardized Health Management Information System

(HMIS). Consequently, the Government of Angola (GoA) and the INLS recognize the need for high quality data and technical

assistance support to program development and policy implementation.

Between 2007 and 2008, the Global Fund to fight HIV/AIDS, Tuberculosis (TB) and Malaria (GFATM) trained a total of 272

Angolan nationals in financial program management, program administration, strategic planning and M&E for HIV/AIDS, TB, and

Malaria. An additional 165 nationals will be trained in 2009. A USG partner, World Learning, leveraging GFATM funds, trained

150 of these people, who are members of NGOs funded through PEPFAR. The USG will support an M&E program officer tasked

with liaising with local government and other stakeholders to facilitate the fulfillment of PEPFAR reporting requirements as well as

coordinate efforts across donors so that the national M&E program conforms to the "three one's". The INLS' ability to perform

M&E for program effectiveness and inform critical indicators is not evident and relies on a technical working group comprised of

consultants from various stake holders and members of the INLS. The INLS continues to rely heavily on the Brazilian Corporation

(BC) consultancy group (a private company) to strengthen the national capacity, record and report national PMTCT data, and

create data collection tools for M&E of PMTCT, VCT and antiretroviral (ARV) distribution programs. The USG continues to

support the INLS with data management where requested however the INLS has begun implementation of the proposed Oracle-

based IT system for VCT and ARV M&E designed by BC consultant's. The extent of the functionality of the system is unknown.

The USG supports and maintains an Epi Info database for program data from 17 VCT sites. A CDC staff epidemiologist analyses

the information and produces monthly summaries which are shared with the INLS.

Discussions have been raised with the local government regarding the importance and need of conducting a census to inform and

facilitate future surveys, for example a DHS.

Leveraging and Coordination

Due to human resource limitations, the USG has collaborated on a limited basis with GFATM, WHO, UNICEF, UNAIDS and

HAMSET, and continues to offer technical assistance in the harmonization and standardization of M&E policies and indicators for

prevention, diagnosis, care and treatment of HIV disease.

The USG is actively involved in coordination of the GFATM proposed national population-based behavioral survey (BSS)

scheduled to commence in November 2008, to avoid overlap in programmatic activities and efforts. The USG coordinates with the

Brazilian Corporation and the M&E Officers from other donors like UNICEF in monitoring and evaluation activities to ensure

effective implementation and no duplication of effort. The arrival of the USG M&E program officer, and the physical presence of

50% of his/her time in the INLS, will enhance this collaboration.

Current USG Support

•In February 2008, the USG successfully assisted with capacity building in M&E by supporting the implementation and completion

of an M&E "101" course relying on technical assistance from CDC Brazil and Atlanta.

•The USG recruited for a full time M&E staff member to assist the INLS with M&E policy development and harmonization of

PEPFAR and local indicators. This position is yet to be filled, with the selection of a candidate anticipated to conclude in late 2008.

The M& E officer will be responsible for harmonizing national indicators with those of PEPFAR and other agencies such as

UNAIDS; working with INLS to improve recording and reporting in VCT centers; assessing the obstacles to better reporting and

recording utilizing CDC interagency expertise; supporting a standardized process for informing PEPFAR indicators; and gathering

information from all USG partners and sub partners.

•The USG continued dialogue with the INLS regarding routine information gathering and any technical assistance needs.

•The USG successfully concluded and officially presented the INLS with the National Epi Report.

•Dialogue was initiated with the MOH and INLS regarding the importance and the possibility of a national demographic health

survey (DHS) to create a national baseline for indicators in all areas of the health system.

•The USG continues to provide the INLS with technical assistance in developing epidemiological surveillance and M&E evaluation


•Formative research for the BSS is also ongoing with data collection is planned to begin in early March 2009. Completion of the

survey is projected for late 2009.

•The USG was a critical catalyst in establishing communication and coordination among the TB and HIV Institutes as well as other

stakeholders. Collaboration among these players will facilitate achievement of the following USG goals:

- To provide technical and logistical assistance with the establishment of TB/HIV sentinel sites for the purpose of providing routine

HIV surveillance and TB/HIV program M&E;

- To continue regular database and basic data analysis training for the INLS and TB/HIV personnel.

•FY08 funding for the Household Cluster survey will be reprogrammed for the TB/HIV sentinel surveillance system (see FY09


USG FY09 Support

Angola continues to face particular challenges regarding both HIV SI and the tools and trained personnel to implement SI

initiatives. In addition, several limitations in the working environment of HIV in Angola make the USG goals of capacity building in

SI difficult. Despite these limitations, in FY09, the USG will provide funding and technical assistance to the extent possible for the

following activities:

•The M&E officer, once on board, will continue to provide technical assistance to support the INLS with harmonizing national

indicators, improve recording and reporting systems and overall monitoring and evaluation;

•The USG will provide technical and financial support to HIV incidence studies (see Laboratory narrative) at the population level

and individual level, for risk determination in newly infected people (see Sexual Transmission narrative);

•The USG will provide technical and financial support for a qualitative circumcision survey, to determine the feasibility of

circumcision programs in Angola;

•To determine other drivers of the epidemic, the USG will support a behavioral study in groups of which we have limited

knowledge like PLWHA or men. During 2009 a protocol will be elaborated together with the INLS/CDC Atlanta, and others.

•Several TraC studies are planned for high risk groups to increase specific knowledge on risk groups in relation to behavior

change and IEC campaigns (operational research).

•USG will continue to support the management of information systems on provincial and municipal level where the Essential

Health Services Program (EHSP) is working, as well as the training of health workers in order to increase the quality of the

information system, the analysis of data and their use for decision making.

•USG implementers will continue to provide local organizations with technical assistance for strategic information activities and

train individuals in strategic information including within NGOs working with youth and PLWHA.

•The USG will augment FY08 funding to continue its TB/HIV SI activities. It will support the establishment of a national TB/HIV

surveillance system for routine recording and reporting in TB/HIV initiatives and support the establishment and management of a

Sentinel Surveillance database that will support the surveillance activities in TB/HIV and STIs. The USG will then support an initial

cross-sectional surveillance survey of TB/HIV data collected at sentinel sites (once the initiative is established);

•The USG will continue support of the BSS survey in Cunene.

•The USG will support a rapid assessment in Cunene of the socio-cultural demographic issues influencing HIV transmission;

•The USG will provide technical support to the GoA for proposed FY09 ANC survey as well as for STI surveillance.


13.1 Number of local organizations provided with technical assistance for strategic information activities 66

13.2 Number of individuals trained in strategic information (includes M&E, surveillance, and/or HMIS) 390

Table 3.3.17:

Funding for Strategic Information (HVSI): $375,000


New/Continuing Activity: Continuing Activity

Continuing Activity: 18940

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18940 11929.08 HHS/Centers for US Centers for 8303 6079.08 CDC $100,000

Disease Control & Disease Control

Prevention and Prevention

11929 11929.07 HHS/Centers for US Centers for 5857 5857.07 $400,000

Disease Control & Disease Control

Prevention and Prevention

Table 3.3.17:

Funding for Management and Operations (HVMS): $102,000

CDC staff all costs

New/Continuing Activity: Continuing Activity

Continuing Activity: 18937

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

18937 12189.08 HHS/Centers for US Centers for 8303 6079.08 CDC $392,000

Disease Control & Disease Control

Prevention and Prevention

12189 12189.07 HHS/Centers for US Centers for 6079 6079.07 CDC $331,000

Disease Control & Disease Control

Prevention and Prevention

Table 3.3.19: