Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 4893
Country/Region: Mozambique
Year: 2007
Main Partner: Johns Hopkins University
Main Partner Program: Bloomberg School of Public Health Center for Communication Programs
Organizational Type: University
Funding Agency: USAID
Total Funding: $1,970,226

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $150,000

This activity is related to JHU/HCP activities C&OP 8648; AB 8645; HTXS 9165; and OPHS 8646. These activities taken together form a major initiative for providing technical assistance to the MOH/RESP (health education unit) and the CNCS (National AIDS Council) and implementation of communication strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and support to other Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as well as the NGO community and other USG PEPFAR agencies. With regards to PMTCT, a communication strategy and IEC materials have been developed and are awaiting MOH approval. JHU/CCP will need to determine the status of the PMTCT communication strategy and IEC materials, and work with the MOH and all PMTCT partners to respond to their needs in implementing the strategy. This may include, but is not limited to, organizing consultation meetings at national and provincial levels, reproducing IEC materials and assisting the MOH to distribute them through their normal channels, carrying out formative research and development of additional materials to fill identified gaps, planning and working with partners for community mobilization, developing mass media programming. Given the broad portfolio assigned to JHUCCP for the communication activity, it is expected that opportunities will be found for integrating promotion of PMTCT services and destigmatization of use of those services in other program area activities.

The primary emphasis area is IEC, referring to the need for materials and educational activities for the promotion of PMTCT in the community and patient/client education in the health facilities. Job aides and other materials will improve quality of services delivered. Better understanding on the part of clients, staff and community members will help reduce stigma and discrimination.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $600,000

This activity is related to JHU/HCP communication activities OHPS 8646; HVOP 8648; PMTCT 9162; and HTXS 9165. These activities taken together form a major initiative for providing technical assistance to the MOH/REST and the CNCS and implementation of commmunication strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/HCP should phase out of prior year UEM programming, and devote attention to AB normative change, focusing on priority behaviors of reducing multiple concurrent partners, cross-generational and transactional sex. JHU/HCP is being asked to work with the MOH, CNCS, PEPFAR partners, USG agencies and other stakeholders to develop and implement large scale behavior change interventions. This may include, but is not limited to, organizing consultation meetings at national and provincial levels; developing and coordinating media strategies in print and electronic media (for example, a script with characters on radion programming, in comic books, on television, billboards); carrying out formative research, planning and working with partners for community mobilization, developing mass media programming. Given the broad portfolio assigned to JHU/HCP for the communication activity, it is expected that opportunities will be found for integrating AB messages in other program area activities. It is expected that JHU/HCP will assist other partners to leverage funding for AB behavior change from CNCS, and will provide the technical assistance required for large scale activities requiring the participation of a multitude of partners including private sector businesses, the public sector, advertising and graphic arts agencies, etc.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $222,400

This activity is related to JHU/HCP communication activities OHPS 8646; AB 8645; PMTCT 9162; and HTXS 9165. These activities taken together form a major initiative for providing technical assistance to the MOH/RESP (health education unit) and the CNCS (National AIDS Council) and implementation of communication strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and support to other Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as well as the NGO community and other USG PEPFAR agencies. This activity is conceptualized as a large scale media activity with local community mobilization components to effect real behavior change and to create a supportive environment for addressing the HIV/AIDS epidemic in Mozambique. While implementation of communication activities is important, attention to building capacity in Mozambique to design, carry out, implement and sustain behavior change is paramount to success in slowing down the HIV/AIDS epidemic. It is anticipated that this activity will focus largely on populations affected in a general epidemic with PSI focusing more on the most at risk populations, and FDC focusing more on traditional and cultural practices affecting HIV transmission.

JHU/HCP has worked with the MOH and the CNCS to finalize a national communication strategy which has now been approved and is being rolled out to the provincial nucleos. This Condoms and Other Prevention activity will provide the necessary expertise for implementation of the strategy and effective use of the media to accelerate change. Components of this activity include:

1. Municipal and local leaders: mobilization of local political leaders to promote and model ABC behaviors and to reduce stigma; 2. Technical assistance to the Health Education Unit of the MOH (RESP) for promotion of free condoms and better distribution. This TA will include a condom assessment with three objectives: a) to engage the MOH in identifying barriers and opportunities for distribution of free condoms in all services, but especially reaching at risk groups (STI, FP, TARV, PMTCT and MCH services, discordant couples); b) to engage the MOH and CNCS in identifying better ways of promoting use of these free condoms and assuring that no opportunity is missed in providing ample supplies with appropriate counseling and education to staff and clients within the health care system; c) to inform the development of condom distribution and promotion policies and procedures within the MOH and planning of condom promotion BCC interventions under the egis of the National Communication strategy. 3. Technical assistance to the CNCS for large scale implementation of the national communication strategy 4. Mozambique appropriate media and community activities directed towards older youth and young couples establishing families, with the purpose of addressing living a healthy life together, either as couple without HIV, a discordant couple or a positive couple. 5. Mozambique appropriate media and community activities reinforcing uptake of all HIV/AIDS services: prevention, care and treatment. 6. Mozambiqiue appropriate media and community activities addressing the role that alcohol plays in risky behavior and shifting norms around acceptable behaviors for men and women with regards to alcohol.

Indirect target estimates 50,000 individuals to be reached; 100 individuals trained are the municipal and local leaders. It is expected that more accurate targets will be developed when JHU/CCP provides a proposal and workplan for the activity.

Add to existing narrative: JHU/HCP should focus efforts on priority behaviors: multiple concurrent partnerships, transactional sex and cross-generational sex. Emphasis also should be placed on adult behaviors.

Funding for Care: TB/HIV (HVTB): $300,000

This activity is related to JHU/HCP activities C&OP 8648; AB 8645; HTXS 9165; and OPHS 8646. These activities taken together form a major initiative for providing technical assistance to the MOH/RESP (health education unit) and the CNCS (National AIDS Council) and implementation of communication strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and support to other Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as well as the NGO community and other USG PEPFAR agencies. With regards to HTXS, JHU will work with the MOH, CNCS and other partners to standardize, develop and produce according to the identified needs, IEC materials for TB/HIV activities such as TB education for PLWHAs, support for HIV testing of TB patients, need for TB treatment adherence. Because this activity is focused on IEC materials, targets are not applicable.

Table 3.3.07:

Funding for Treatment: Adult Treatment (HTXS): $434,230

Plus-up: Plus-up funding will incorporate pediatric AIDS in the JHU/HCP HTXS activity. JHU/HCP will support the MOH to adapt/develop and disseminate IEC materials on care for the HIV exposed adn infected child including OVC, targeting communities, caregivers. Specific topics to include nutrition and infant feeding, cotrimoxazole and INH prophylaxis, ART and adherence to treatment, disclosure, and infection prevention and control. Because this activity is focused on IEC materials, targets are not applicable.

Original COP: This activity is related to JHU/HCP communication activities C&OP 8648; HVAB 8645; MTCT 9162; and OHPS 8646. These activities taken together form a major initiative for providing technical assistance to the MOH/RESP (health education unit) and the CNCS (National AIDS Council) and implementation of communication strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and support to other Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as well as the NGO community and other USG PEPFAR agencies. With regards to treatment services, JHUCCP is being asked to work with the MOH, CNCS, PEPFAR treatment partners, USG agencies and other stakeholders to develop an effective community behavior change strategy to promote treatment adherence, treatment literacy and increased uptake of treatment services. The focus of these efforts should be in Zambezia and Sofala provinces where the treatment services will be greatly expanded in COP07. The MOH has set ambitious targets for people on treatment and is expanding sites and services rapidly. People must be able to overcome stigma and use those services and follow their treatment regimens correctly. Caregivers, support groups in the community, friends, neighbors and workplace colleagues also need to be able to assist the person on treatment and provide reinforcement for desired behavior change. This may include, but is not limited to, organizing consultation meetings at national and provincial levels, reproducing IEC materials and assisting the MOH to distribute them through their normal channels, carrying out formative research and development of additional materials to fill identified gaps, planning and working with partners for community mobilization, developing mass media programming. Given the broad portfolio assigned to JHUCCP for the communication activity, it is expected that opportunities will be found for integrating promotion of TARV services and destigmatization of use of those services in other program area activities. In this context, JHUCCP must work closely with and be responsive to the MOH and treatment partners in Zambezia and Sofala.

Funding for Health Systems Strengthening (OHSS): $263,596

This activity is related to JHU/HCP communication activities C&OP 8648; AB 8645; PMTCT 9162; and HTXS 9165. These activities taken together form a major initiative for providing technical assistance to the MOH/RESP (health education unit) and the CNCS (National AIDS Council) and implementation of communication strategies in support of all program areas at national and provincial levels, especially Zambezia and Sofala Provinces. JHU/CCP is also expected to serve as a resource and support to other Ministries such as the Ministry of Defense, Ministry of the Interior, Ministry of Education and Ministry of Women and Children as well as the NGO community and other USG PEPFAR agencies. This activity is conceptualized as a large scale media activity with local community mobilization components to effect real behavior change and to create a supportive environment for addressing the HIV/AIDS epidemic in Mozambique. While implementation of communication activities is important, attention to building capacity in Mozambique to design, carry out, implement and sustain behavior change is paramount to success in slowing down the HIV/AIDS epidemic.

JHU/CCP has worked with the MOH and the CNCS to finalize a national communication strategy which has now been approved and is being rolled out to the provincial nucleos. This activity will provide the necessary expertise for implementation of the strategy and effective use of the media to accelerate change. It will also provide the coordination and framework for bringing together the various programatic area activities to assure economies of scale, harmonization of messages, appropriate Mozambican approaches and ownership by the responsible central and provincial level authorities. Technical assistance to the MOH Health Education Unit(RESP) and to the CNCS will be key to the success of this activity. JHUCCP will need to explore the structures required to provide leadership to the communication initiative. This may take the form of a national commission or forum which brings together stakeholders (public sector, private sector, civil society) to oversee the roll out of the communication strategy, or it may take the form of smaller regional or provincial groups. Leadership and coordination with the donor community will also be important. Sustainability and planning for an exit should be considered from the beginning.

Components of this activity include:

1. Municipal and local leaders: mobilization of local political leaders to promote and model ABC behaviors and to reduce stigma; 2. Technical assistance to the Health Education Unit of the MOH (RESP) for promotion of free condoms and better distribution 3. Technical assistance to the CNCS for large scale implementation of the national communication strategy 4. Media campaigns and leadership supporting the presidential initiative 5. Mozambique appropriate media and community activities directed towards older youth and young couples establishing families, with the purpose of addressing living a healthy life together, either as couple without HIV, a discordant couple or a positive couple. 6. Mozambique appropriate media and community activities reinforcing uptake of all HIV/AIDS services: prevention, care and treatment. 7. Mozambique appropriate media and community activities addressing the role that alcohol plays in risky behavior and shifting norms around acceptable behaviors for men and women with regards to alcohol 8. Mozambique appropriate media and community activities directed towards AB norms 9. Mozambique appropriate media and community activities which involve health workers as community members as well as providers of care 10. Building capacity in both public and private sectors to plan and carry out BCC activities to reduce incidence of HIV/AIDS

Products will include a collection of IEC materials produced in all areas; documentation from a leadership structure for the communication initiative (terms of reference, minutes, correspondence)