Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 12401
Country/Region: India
Year: 2010
Main Partner: FHI 360
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $600,000

Under the newly initiated (September 2009) "Technical Assistance to the National AIDS Control Organization (NACO) for HIV/AIDS Surveillance" Project funded by Centers for Disease Control (CDC), Family Health International (FHI) will provide technical assistance (TA) at the national, state and district levels in specific strategic information (SI) areas. The Project will ensure synergized TA efforts with other USG and non-USG partners and will not duplicate existing SI resources and efforts.

The core areas of TA on SI as envisaged over the medium and long-term include: 1) Monitoring and Evaluation (M&E) of CDC-funded projects; 2) Surveillance TA including developing quality assurance (QA) for existing surveillance systems; and 3) Data Use TA including analysis, epidemiological modeling, estimation and projection; and data reviews.

The geographical focus of the project activities will be National and select CDC states.

Key collaborating partners under this Project include: NACO; USAID; WHO; UNAIDS; National Institute of Medical Statistics (NIMS); National Institute of Health and Family Welfare (NIHFW); the Indian Statistical Institute (ISI); and the six Regional Surveillance Centers (Post Graduate Institute of Medical Education and Research (PGIMER), National Institute of Epidemiology (NIE), All India Institute of Medical Sciences (AIIMS), National AIDS Research Institute (NARI), National Institute for Cholera and Enteric Diseases (NIECD) and the Regional Institute for Medical Sciences (RIMS).

In FY10 (October 2009-September 2010), the key focus of the Project was on completion of preparatory activities to support the roll-out of TA in the above areas. The key activities included: staffing and drawing-on global and in-country resources; meeting with key stakeholders at the national and state level for consensus building and clear delineation of TA areas to avoid non-duplication; protocol/manual review, adaptation and development (as necessary); and seeking necessary approvals and compliances from NACO and CDC.

Funding for Strategic Information (HVSI): $600,000


In FY11, FHI will provide TA on SI in the following three prioritized categories: 1) Monitoring and Evaluation (M&E) of CDC-funded projects; 2) Surveillance including developing quality assurance (QA) on existing surveillance systems; 3) Data Use including analysis; modeling, estimation and projections; triangulation and data reviews.


FHI will build-on the preparatory work undertaken in Year 1 of the grant. The staffing will be revisited based on the detailed TA areas identified in consultation with key stakeholders including NACO, WHO, USAID and CDC. Besides the full-time Principal Investigator and senior SI Specialist recruited on this Project in FY10, an additional full-time Surveillance Specialist will be hired in quarter 1 of FY11. The FHI India Country Office support units including the Country Director, Director, Shared Services and Director, Programs will continue to provide oversight and support to the Project. FHI will also continue to draw on its pool of in-country and international experts as well as resources and tools for TA provision in the defined areas.


Efforts undertaken in FY10 to build consensus and ensure non-duplication of TA in SI areas would result in a clear delineation of TA at the national, state and district levels. Active dialogue, consultations and discussions will continue to be held with key stakeholders including: Technical Resource Groups on Surveillance and M&E at NACO, UNAIDS Modeling Projection Group, WHO, and the national institutes especially NIMS, NIE and NIHFW. Based on the results of the mid-term review (MTR) of NACP III, new areas of TA may be identified for which FHI will engage in a dialogue with NACO, other USG and non-USG partners. For the evaluation of CDC-funded projects in India, the Evaluation Core Group (ECG) constituted by FHI in FY10 will meet at least twice in FY11 for the following: sharing of key evaluation findings and recommendations and working-out a dissemination plan.

In FY11 the following activities will be undertaken:

ACTIVITY 1: Monitoring and Evaluation (M&E) of CDC-funded projects:

Guided by the CDC approved evaluation protocols, FHI will undertake end-line evaluations of pre-defined CDC-funded projects in India. As indicated by CDC, these will include: Public Health Nurses Project in communities implemented by Christian Health Association of India (CHAI); AP-AIDSCON project with universities; and a HIV Care, Support and Treatment project implemented by Myrada. Evaluation teams will be constituted for each of the projects and timelines for the evaluations will be worked-out in consultation with CDC and the implementing agencies. Once evaluation results are documented, FHI in consultation with CDC will decide on appropriate dissemination channels that may include publications and dissemination meetings to be held in FY11 and FY12.

ACTIVITY 2: Surveillance TA

Sentinel Surveillance: FHI as a member of the National Technical Working Group on Surveillance will provide TA to strengthen second generation surveillance activities; including strengthening QA systems of the six Regional Surveillance Centers and monitoring the quality of surveillance activities such as site selection, sample collection, sampling, data management and analysis. A key contribution will be towards strengthening sentinel surveillance of high-risk-groups (HRGs). FHI will share tools, guidelines and conduct trainings for the six Regional Surveillance Centers on QA for improved surveillance systems at the state and district levels.

Behavioural Surveillance: At the national level, the protocol for IBBA (-lite) has been developed. Building on FHI's current experience in providing TA on the IBBA, FHI in collaboration with WHO and UNAIDS, will provide TA to NACO to design and implement IBBA (-lite) in select districts/epidemiological zones of the country. This will be contingent on NACO plans. FHI along with the National AIDS Research Institute (NARI), the implementing partner for the FHI-led IBBA, will fine-tune the protocol, provide the tools and operational guidelines for undertaking IBBA (-lite) in select sites.

Mapping: In collaboration with WHO and UNAIDS, FHI will initiate a comparative analysis of different mapping methodologies applicable for HRGs and bridge populations in HIV high prevalence and vulnerable states.

ACTIVITY 3: TA on data use

TA on Integrated Analysis: Integrated analysis is being currently undertaken for the 'A' and 'B' category districts in all the high prevalence states (except Nagaland) and West Bengal, Uttar Pradesh and Gujarat. Through this Project, FHI proposes to undertake integrated analysis of available HIV data in the 'C' and 'D' category districts, many of which are considered 'vulnerable' districts by NACO. Information garnered from the analysis will be used to inform the national program and provide data for better policy and programming in these districts.

TA on Estimation of PLHIV: FHI will provide TA to two priority CDC states on arriving at state estimates of HIV cases using latest epidemiological models, including the Asian Epidemic Model (AEM), that will support revision/updating of the NACP projections and assumptions for both HRGs and People Living with HIV (PLHIV). This will be done through the setting-up of state-level working groups that will include the relevant Regional Surveillance Centers; State AIDS Control Societies (SACS), and other state level stakeholders.

Size Estimation for HRGs: Building on the size estimation undertaken during Round 1 of the IBBA, FHI will provide TA on different size estimation methodologies (Multiplier, Capture-Recapture) to the Regional Surveillance Centers to undertake size estimation for HRGs in at least two states. To enable states to eventually lead the process, guided by the results of the training and TA needs assessment, FHI will undertake a series of capacity building interventions with the relevant staff of NIMS, NIHFW, State Training and Resource Centres (STRCs), Technical Support Units (TSU) and the Regional Surveillance Centers. This will include a mix of sharing technical resources and tools, on-site mentorship through deputing experts on surveillance, and structured trainings and workshops organized in consultation with NACO/SACS.

Data Review: In order to improve the quality of HIV data being collected at different levels and through different sources, FHI in partnership with NACO, SACS and the National Institutes will initiate a comprehensive data review which will entail listing of different data sources, analysis of different methods and system of data collection; and review of data quality to recommend steps on how the system of data collection and quality can be improved. This exercise will be initiated in the CDC-priority states.

TA on Modeling: FHI in collaboration with WHO, NIHFW and NIMS will undertake trainings in modeling (using existing modules) for staff from SACS, state level institutions and NIE. Once trained, FHI will provide TA on use of different models at the state-level in the CDC-priority states.

Indicator targets: The activities under this budget code area will be monitored by the following output level indicators:

Number of local organizations provided with technical assistance for strategic information activities; and

Number of individuals trained in SI (includes M&E, surveillance, and/or HMIS)

In FY11, a total of 20 organizations and 100 individuals will be reached under this budget code area.

Subpartners Total: $0
To Be Determined: NA
Cross Cutting Budget Categories and Known Amounts Total: $80,000
Human Resources for Health $80,000
Key Issues Identified in Mechanism
End-of-Program Evaluation