The goal of the IOCC/EOC-DICAC, a care and support program is to improve the welfare and economic sustainability of targeted PLWHAPLWHAA households through the sponsorship of Income Generating Activities (IGAs). The program targets children between 0 and 17 years old and gives special priority to children who have lost one or both parents to HIV/AIDS and/or are HIV-positive. In addition, children of bedridden PLWHAAs are given particular consideration in selection for OVCs service.

The IGA program addresses OVC services in areas where the need is greatest. DICAC works with local Kebele administrations and Community-Based Organizations (CBOs) such as Idris to select OVC households using criteria developed with the aid of OGAC guidelines.

A cross-cutting budget attribution is the provision of medical and educational support as well as spiritual and psychosocial counseling to OVC due to HIV/AIDS. Community-selected para-counselors are trained to provide the abovementioned services to OVC.

IOCC has been providing and will continue to provide several evidence-based interventions defined as a preventive care package to reduce morbidity and mortality of HBC beneficiaries of people living with the virus. The support includes procurement and distribution of safe water systems, personal hygiene supplies, and long lasting insecticide treated nets.

The International Orthodox Christian Charities (IOCC) conducts HIV prevention, care and support activities with the Ethiopian Orthodox Church's Development Inter Church Aid Commission (DICAC).

The Ethiopian Orthodox Church (EOC) has approximately 40 million faithful, over 500,000 clergy and a network of 40,000 parishes found throughout Ethiopia. DICAC operates in over 200 districts in the country. The Church publicly declares that it has an obligation to mobilize human and material infrastructure for the national response to HIV/AIDS and that it should strive to influence positive social change, care for those affected or living with HIV/AIDS, promote abstinence and faithfulness and reduce stigma and discrimination. DICAC utilizes peer education and interactive communication to reach these goals.

This is a continuing activity implemented by the IOCC with DICAC. IOCC/DICAC implements home-based care services in twelve dioceses and its income generating activities and spiritual counseling support services in 140 districts. In the first half of FY 2007 alone, IOCC/DICAC provided over 8,400 individuals (53% women) with general HIV-related palliative care.

In FY 2008, IOCC/DICAC will reach 12,000 PLWHAPLWHAA with care and support activities including income generating activities, home-based care (HBC) and spiritual counseling. IOCC utilizes volunteers drawn from local Orthodox congregations to conduct home visits to clients who are bedridden or in the end-of-life stages of AIDS. These volunteers conduct several activities at least twice each week, including: counseling both the client and their family; providing basic physical and social care; serving as liaison for clergy to visit the home; referring patients to medical services including ART (or in reverse, accepting ART beneficiaries from the public health system); and leveraging nutritional support from the community including local businesses and hotels. The activities planned at each district will continue in close collaboration with the local district HIV/AIDS Prevention and Control Office (HAPCO) branch and other area stakeholders.

IOCC/DICAC encourages networking among groups to further strengthen the project's impact and sustainability. Gender equality is an important cross cutting theme of the IOCC/DICAC program. In FY 2008 the program will increase efforts to ensure increased female participation in youth clubs, advocacy groups, community-based discussion groups, income generating activities and counseling and training activities. The program will maintain targets of no less than 50% female participation for income generating activities (IGA), lay counselor and peer educator staffing. By the same token, steps will be taken to increase male participation in the program at all levels in response to male partner initiatives in collaboration with the Engender Health "Men as Partners" activity (ID 12232).

During 2008, IOCC/DICAC provided HBC services to 3,000 PLWHAPLWHAA and an estimated 12,000 family members, reaching a total of 15,000 clients. HBC services will include nursing care; spiritual counseling; referral of household contacts for VCT; screening for active TB and referral to local health facilities for prescription of prophylaxis when appropriate; provision of insecticide-treated mosquito nets; education on safe water and hygiene together with the provision of locally manufactured water treatment supplies; nutrition counseling; adherence counseling; and education and encouragement of PLWHAPLWHAA to seek HIV care and treatment at health centers and hospitals.

In FY 2005, IOCC/DICAC developed a strategy aimed to improve the welfare and economic sustainability of PLWHAPLWHAA households with IGA. In FY 2008, IOCC/DICAC will extend IGA support to an additional 1,500 PLWHAPLWHAA and will indirectly support 6,000 family members. During FY 2008 the program will increase IGA start-up capital from $90 to $136 per person to address the increased cost of commodities. IOCC/DICAC will foster linkages so that PLWHAPLWHAA enrolled in the program continue to receive regular follow-up guidance and technical advice from their local HAPCO and agricultural office regarding selection and management of their IGA. IOCC/DICAC will also support 5,625 PLWHAPLWHAA with spiritual counseling through trained spiritual hope counselors.

The Ethiopian Orthodox Church has taken a strong public stance against stigma and discrimination. This will continue to be a key message in FY 2008 and will be widely disseminated at public rallies, through the teachings of the church and trained clergy.

Orphans and Vulnerable Children component of the Ethiopian Orthodox Church Development and Interchurch Aid Commission/IOCC HIV/AIDS Response Mechanism Project.

The International Orthodox Christian Charities (IOCC) conducts HIV prevention, care, and support activities with the Ethiopian Orthodox Church's Development Inter Church Aid Commission (DICAC).

The Ethiopian Orthodox Church (EOC) has approximately 40 million faithful, over 500,000 clergy and a network of 40,000 parishes found throughout Ethiopia. DICAC operates in over 200 districts in the country. The Church publicly declares that it has an obligation to mobilize human and material infrastructure for the national response to HIV/AIDS and that it should strive to influence positive social change, care for those affected or living with HIV/AIDS, promote abstinence and faithfulness and reduce stigma and discrimination. DICAC uses peer education and interactive communication to reach these goals.

This is a continuing activity implemented by the IOCC with EOC/DICAC that provides a package of services to address the needs of orphans and vulnerable children. The package of services includes counseling by trained lay counselors, training of guardians and provision of small grants for the start up of income generating activities (IGA) to provide economic support.

In FY 2007, 2,000 new OVC and their households were enrolled in the IGA program that is expected to indirectly improve the lives of approximately 8,000 OVC household members. These household members benefit from the project's care and support components, including spiritual and practical counseling, start-up capital, and education on nutrition and sanitation in the home. All OVC beneficiaries attended school, a policy of the program that is reinforced through follow-up by lay counselors with guardians.

To increase program effectiveness and sustainability, IOCC increased networking and partnerships with organizations such as the national, regional and local HIV/AIDS Prevention and Control Offices (HAPCO), Red Cross, regional administration offices, Dawn of Hope and the Organization for Social Services for AIDS (OSSA). In FY 2008, IOCC anticipates supporting 28 diocese equaling about 140 districts in the regions of Addis Ababa, Amhara, Benishangul Gumuz, Oromiya, SNNP, and Tigray.

In partnership with other PEPFAR Ethiopia OVC partners, this activity will work with the new PEPFAR Annual Program Statement recipient to coordinate activities to achieve the most efficient use of resources for OVC in the highest HIV/AIDS prevalence areas. This includes harmonization on indicators, reporting, and OVC standards of care in line with Government of Ethiopia national guidelines and policies and OGAC OVC Program Guidance, as well as achieving quality assurance in OVC programming. Data from the Ethiopia Demographic and Health Survey (EDHS) 2005 and the results of USG Ethiopia mapping will used to further identify geographic priority areas ranked highest for children affected by HIV/AIDS. As an exit strategy IOCC focuses on strengthening the community and the diocesan partners to sustain the program.

Gender remains an underlying principle to DICAC and is given attention as a cross-cutting theme. Efforts to increase participation of women in youth clubs, community-based discussion groups, income generating activities and counseling and training activities will continue. By the same token, steps will be taken to increase male participation in the program at all levels in collaboration with Engender Health (ID 12235). In FY 2006, explicit female participation targets were raised to 50% for lay counselor and peer educator staffing, with satisfactory results. IOCC will maintain these targets in FY 2008.

In addition to the explicit multi-year planned transfer of responsibility from IOCC to the Ethiopian Orthodox Church/DICAC, IOCC and DICAC will collaborate with the National Partnership Forum and the Interfaith Forum for Development Dialogue and Action both to assure sustainability of this program as well as to reinforce Ethiopia's faith-based organization response to the HIV/AIDS epidemic.

Prevention Component of the Ethiopian Orthodox Church Development and Interchurch Aid Commission/IOCC HIV/AIDS Response Mechanism Project

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

The International Orthodox Christian Charities (IOCC) conducts HIV prevention, care, and support activities with the Ethiopian Orthodox Church's Development Inter Church Aid Commission (DICAC). The Ethiopian Orthodox Church (EOC) has approximately 40 million faithful, over 500,000 clergy and a network of 40,000 parishes found throughout Ethiopia. DICAC operates in over 200 districts in the country. The Church publicly declares that it has an obligation to mobilize human and material infrastructure for the national response to HIV/AIDS and that it should strive to influence positive social change, care for those affected or living with HIV/AIDS, promote abstinence and faithfulness and reduce stigma and discrimination. DICAC uses peer education and interactive communication to reach these goals.

This is a continuing activity implemented by the IOCC with DICAC. The comprehensive HIV/AIDS activity started in FY 2006 and provides a package of prevention modules to include peer education, public rallies, information-education-communication (IEC) materials, media intervention and clergy training, all of which interact to slow the spread of the epidemic. During the first half of FY2007 alone, the partners reached almost 1.2 million individuals (54% women) with abstinence and be faithful (AB) messages and trained 6,700 persons in AB outreach approaches.

During FY2008, the activity operated in 140 districts in 28 dioceses. IOCC anticipates that several districts will be transitioned to the status of "areas of higher HIV prevalence" using both antenatal care (ANC) and Ethiopia Demographic and Health Survey (EDHS) data. This will allow communities at risk to be reached with interactive and interpersonal communications utilizing AB messages. Similar AB approaches utilizing interpersonal peer education and interactive communication will be conducted through Sunday schools, lay counselors and 55 public rallies (five by the Patriarch and 50 by the Archbishops).

The communications strategy uses several approaches:

1) Interpersonal Peer Education: During FY 2005, DICAC implemented a youth prevention program through the existing Sunday school structure, with 2,000 peer educators reaching 50,000 youth. In FY 2006 and FY 2007, DICAC adapted the Youth Action Toolkit (YAK), produced by Johns Hopkins University/Health Communications Partnership, for the Sunday school setting. In FY 2006, 80,000 youth were enrolled in YAK activities at Sunday schools throughout the 100 districts. An additional 2,000 peer educators were trained or retrained.

2) Interactive Communication and Public Rallies: In FY 2006 and FY 2007, DICAC supported interactive HIV-prevention and stigma-reduction communications (i.e. Archbishop Rallies, Clergy outreach) within AB prevention activities at the community level. These activities targeted community attitudes and social norms of the congregation, including delay of sexual debut, return to abstinence, mutual fidelity, HIV burden among young women, empathy for persons living with HIV/AIDS and identifying addressing misconceptions. Interactive communication and mass rallies held by the Patriarch and his Archbishops played an important role in catalyzing discussion on HIV/AIDS at the community level. These types of interventions will be continued in FY 2008 with strategic emphasis on the vulnerability of young girls and sanctioning male behavior in relation to multiple sexual partnerships and cross generational sex.

In FY 2005, IOCC/DICAC trained 100 clergy trainers who in turn trained 40,000 clergy and community members on key AB issues. During FY 2006, 8,000 additional clergy and community members were trained, bringing the total to 48,000 trained clergy in operation. These clergy discuss HIV prevention and stigma with members of the congregation during community outreach and reach millions of individuals during the course of one year. Discussions use church doctrine and clergy training materials to support improvements in risk perception and AB approaches to HIV prevention by individuals and households. Trained clergy openly encourage premarital voluntary counseling and testing (VCT) and support discordant couples and others seeking advice, by referral to local service providers, on condoms, secondary prevention, care, and support and ART. Lastly, a new module was incorporated into the training manual for clergy on the complementarity between holy water and ART.

3) Pre-Service HIV/AIDS Curriculum in Theological Colleges: During FY 2005, the Ethiopian Orthodox Church, with support from the IOCC, integrated HIV/AIDS modules into the core curriculum of eight clergy training institutes and three theological colleges. During FY 2006 and FY 2007 further supportive supervision was provided to these training institutes and colleges to ensure that the curriculum is effectively implemented. In addition, clergy in training will perform an internship that includes community outreach during the summer months in the regions. A section of that internship drew on lessons from the core curriculum.

Activities in COP 10 will include the above three, as well as supportive supervision of district activities by the Ethiopian Orthodox Church to ensure consistency, quality assurance and improvements in programmatic performance against management indicators. This program will continue to use interpersonal communication through Sunday school and clergy counseling. IOCC anticipates additional technical assistance from the Johns Hopkins University Health Communications Partnership to implement the Youth Action Toolkit to support risk reduction, improved knowledge of HIV/AIDS and adoption of AB practices. Ninety-five thousand youths and young adults will be reached through Sunday Schools. Other strategies include interactive communications and mass rallies with the Patriarch and Archbishops to support changes in social norms and attitudes surrounding HIV/AIDS. The rallies draw on messages that emphasize empowerment, support and empathy for those living with HIV/AIDS and HIV prevention through AB.

IOCC will continue to integrate the HIV/AIDS core curriculum into 18 clergy training institutes and three theological colleges. Training through these outlets will reach 2,000 individuals. The maintenance of training standards will be fostered through the modification of curricula on an as need basis, refresher courses and regular reporting. The program will support in-service training for 10,000 clergy with follow-up from district branch coordinators. IOCC will provide capacity building and exit strategy/planning with the Ethiopian Orthodox Church/DICAC to support a multi-year transition of activities from IOCC to the Ethiopian Orthodox Church, thus assuring sustainability of the program. This program will continue to provide IEC materials on HIV prevention, care, and misconceptions regarding the Ethiopian Orthodox Church's stance on the complementarities of holy water and ART will be distributed. These IEC messages and materials will be reinforced by development and dissemination of new audio visual presentations. Community members and PLWHAA trained as lay counselors to support community outreach will help disseminate these materials and messages to the general population. These persons will function as messengers of hope to give public testimony about their experiences with the program.

DICAC has supported the development of local community networks linking community organizations offering HIV prevention, care, and treatment services. Efforts during FY05 allowed important partnerships to be formed with local government, the Ethiopian Red Cross, PLWHAA associations and the Organization for Social Services for AIDS. In FY 2008, the program will continue to support these networks with technical assistance from DICAC staff in the regions. DICAC will cultivate additional partnerships with other organizations active in interpersonal communications, including Population Service International, Population Council, Family Guidance Association, World Food Program, and Action Aid.

Gender remains an underlying principle to DICAC and is given attention as a cross-cutting theme. Efforts to increase participation of women in youth clubs, community-based discussion groups, income generating activities, and counseling and training activities will continue. By the same token, steps will be taken to increase male participation in the program at all levels in collaboration with Engender Health (12235). In FY 2006, explicit female participation targets were raised to 50% for lay counselor and peer educator staffing with satisfactory results. IOCC will maintain these targets in FY 2008.

In addition to the explicit multi-year planned transfer of responsibility from IOCC to the Ethiopian Orthodox Church/DICAC, IOCC and DICAC will collaborate with the National Partnership Forum and the Inter Faith Forum for Development and Dialogue and Action both to assure sustainability of this program as well as to reinforce Ethiopia's faith-based organization response to the HIV/AIDS epidemic.