PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Years of mechanism: 2007
August08 Reprogramming: Though the proposed re-programming will moderately increase FHI's funding
level, a decrease in two PMTCT indicators is requested. The original calculation, undertaken by USAID,
was incorrect in the percentage of women, relative to population size, who would be pregnant in the districts
where FHI works. The numbers within the algorithm have been changed and the adjusted targets are
reflected above. USAID is certian that FHI will fully meet, if not exceed, the targets listed above.
This is a continuing activity under COP08.
FHI will expand to include four additional sites in Niassa province, which will serve as key entry points to
ART treatment and community-based care and support. FHI will also work to strengthen food security by
creating a twenty hectacre community farm, benefiting HIV-positive pregnant and lactating women in
Quelimane and Nicodalawill, using land ceded by the Governor of Zambezia province. Once these women
are trained, the Governor has committed to providing them land so that they may use their skills to provide
for the nutritional needs of their families and themselves.
The program will continue to foster linkages with the Child at Risk Consult (CCR) as well as treatment
services. The referral system between PMTCT, treatment services, and the CCR will be the first line of
approach, which has broad Governmental support. However, the program will also explore manners to
reinforce testing and treatment linkages with vaccination campaigns, well baby visits, and weighing stations.
Using COP 07 plus up funds, PSI will map existing PEPFAR and non-PEPFAR partner interventions in
PMTCT and overlay this map with mosquito net distribution data from the President's Malaria Initiative (PMI)
and other donors and partners (Malaria Consortium, Government of Japan, the Global Fund, etc). The
assessment will be a gaps analysis of where present activities under PEPFAR, PMI, and other partners are
taking place and where, geographically and programmatically speaking, more concerted and coordinated
action is needed by the consortia of actors. PEPFAR and PMI will leverage each others' resources with
PMI providing the vast amount of LLINs for distribution to pregnant and lactating mothers. However,
PEPFAR, through PSI, will provide a buffer stock of LLIN for PMTCT partners to ensure that all pregnant
women receive a mosquito net. Finally, PMTCT partners will be crucial partners to PMI for the routine
integration of at least two doses (of the recommended three) of SP.
The program will also partner with WFP to support the nutritional needs of the most vulnerable PMTCT
clients through provision of short-term emergency food support. Please refer to the activity sheet for WFP
for funding levels and targets.
The below narrative from FY2007 has not been updated.
Per July 2007 reprogramming;
This addition of resources will allow FHI to reach an additional 1,000 women with counseling and testing
and an additional 100 women who receive a full course of ARV prophylaxis. The funds will also make it
possible for assistance with the District Director of Health in overseeing ongoing PMTCT activities at FHI
Plus-up change:Utillizing plus up funding, FHI will expand its PMTCT intervention to include three additional
sites in the province of Zambezia and begin to offer PMTCT services in two sites in Niassa province. The
sites in Zambezia are Alto Benfica in Mocuba district, and Micaune and Chinde Sede in Chinde District,
which have been strategically identified due to their high HIV prevalence. In Niassa, FHI will strengthen
MOH response at the provincial level in two sites, one in Massangulo with a 16% HIV prevalence; the HIV
prevalence in Massangulo is on the upward trend due to commercial activity and the high mobility of the
population. The second site in Niassa will be Cuamba, which currently has a 14% prevalence of HIV;
Cuamba is characterized by economic activity suroundingwood extraction. FHI will also hire a PMTCT
technical advisor for the province of Zambezia to assist the DPS improve the quality and quantity of PMTCT
services within the province, especially in sites that receive no direct NGO support. FHI will support the
provincial PMTCT advisor with funds to assist in supervisory visits, petrol, and communication expended
related to said visits.
This activity is related to a palliative care activity 9209. FHI will continue to provide comprehensive,
integrated PMTCT services in 10 existing sites and expand coverage to 7 additional sites, to serve a total of
17 sites in Zambezia province. Collaborating closely with MOH and central level and with health teams at
provincial level, FHI will provide training to health workers including nurses, counselors, and physicans, in
state-of-the-art PMTCT services to urban and rural pregnant women at antenatal facilities. Community
mobilization and primary prevention of MTCT also will take place through sub-partners. Using a national
protocol, CT is offered to all antenatal attendees and their partners. Nevirapine, infant feeding education,
exclusive breastfeeding education, and referral to treatment sites are offered to all pregnant women who
test positive. During postnatal follow-up, continued counseling and advice on infant feeding, nutrition, and
family planning are provided to mothers. Seropositive women are referred to facilities offering HIV/AIDS
care and treatment services, for CD4 counts and enrollment in ART as appropriate within the integrated
HIV/AIDS services network. HIV-positive pregnant women and their newborns receive Nevirapine, as well
as 18 months of follow-up education, counseling, and support. This activity further supports seropositive
women and infants at facility and community levels through the organization and implementation of mother-
to-mother support groups, and helps reduce stigma and discrimination. FHI intends to establish both
PMTCT and CT services in every suggested site in order create or meet (depending on the site) the
demand of services.Additionally, the MOH has set ambitious targets for provision of bednets and IPT for
ANC, and PMTCT will benefit from this program. However, it will take some time for the malaria initiative to
get up and running, and for bednets and IPT to flow to all parts of the country. FHI should plan for a 3-6
month supply of bednets and IPT to assure that the minimum package of PMTCT includes these malaria
With the total of 17 sites (10 existing and 7 new), FHI expects to reach 35,459 pregnant women with
counseling, testing and receiving results. Depending on actual HIV prevalence rates, an estimated 3,530
HIV+ pregnant women are expected to receive a full course of ARV prophylaxis; and 60 health workers will
Reprogramming August08: New activity - $249,795 reprogrammed funds are part of ABC Prevention
component and FHI will focus on multiple concurrent partnerships, gender norms, and cross-generational
sex as well as informal transactional sex. Interventions that also address adult-focused behavior change
and risk perception as well as encourage males (and couples) to be tested will be looked upon.
This is a new activity and will replace the male engagement/MCP activities previously under the
EngenderHealth activity #15911. The EngenderHealth award will end in late FY09.
The change in the N of C&OP reached indicator target reflects EngenderHealth's role in technical
assistance, rather than in direct implementation.
Reprogramming August08: Funding decrease $400,000. Funds reprogrammed to support Mission RFA
(RFA funded across 3 SOs to ensure an integrated package of services, leveraging each SO's strengths.
This is a continuing activity under COP08.
FHI will expand to an additional three sites in Zambezia; FHI will also add six sites in Niassa province and
offer a comprehensive package of services including counselling and testing, PMTCT, palliative care,
TB/HIV, and ART treatment. FHI will continue to provide technical assistance and support to the HBC
provincial program in Zambezia and initiate support of the HBC program in Niassa while also strengthening
the integration of HBC and OVC programs.
Quality assurance in the delivery of home-based care is of particular importance and FHI will be actively
assessing how to monitor and improve its clinical and community services. The issue of quality is of shared
concern of all palliative care partners; all of whom will participate in technical meetings and roundtables to
ensure a cohesive, singular, and quality approach in the future.
Under COP08 the program will create new, and utilize existing, community to clinic and clinic to community
referral systems to ensure that PLWHA are accessing treatment and other necessary services, particularly
food, to improve their health status. WFP, in conjunction with PEPFAR treatment partners including PSI,
will work to improve provision of food and nutrition to PLWHA registered at treatment sites based on clinical
and nutritional assessments. This model helps ensure that individuals are accessing health care and
receiving services along with food supplementation. The standard for determining malnutrition will be based
on adult non-preg/lact women patients with a BMI <18.5 at entry into the program. The food supplement
consists of short-term emergency food support. Please refer to the treatment activity sheet for WFP for
funding levels and targets.
The FY2007 narrative below has not been updated.
Per 07/07 reprogramming; Family Health International will reach an additional 1,000 people with home-
based health care services and train an additional 40 activists to provide care within communities. The
additional resources will also allow FHI more staff to properly oversee home-based care activities and
strategically improve the quality of care clients receive from FHI's partners.
This activity is related to HVCT 9111, HVTB 9206, and MTCT 9223.
FHI is currently providing HBC services to clients in Zambezia Province (Quelimane, Nicoadala, Mocuba,
Ile, Inhassunge) and Inhambane (Zavala and Inharrime). They have started an innovative program with the
police by delivering palliative care to 1000 HBC clients. FHI trained 100 police family members and
community care workers for this effort. FHI provides technical assistance to the national level MOH STI and
HIV/AIDS programs for improved linkages and integration including 1) establishment of integrated HIV-STI
service models at 18 sites (16 in Zambezia, 2 in Inhambane); 2) support for courses on STI diagnosis and
treatment for HIV/AIDS service providers in Zambezia and Inhambane; 3); assistance in syphilis prevalence
among pregnant women accessing PMTCT services at ANC/maternities and congenital syphilis among
newborns of HIV+ mothers.
In COP07, FHI will continue to provide home-based care activities for HIV/AIDS-infected and affected
households in the sites were HBC services were provided with PEPFAR funds during COP06 including
selected sites in Quelimane, Mocuba, Nicoadala and Ile and expand to four new sites within these districts.
FHI will sign a Memorandum of Understanding (MoU) with PSI to continue the distribution of mosquito nets
and "certeza" which will complement the benefit of those served under the HBC program. They will attempt
to establish collaboration with WFP to provide food to patients in selected cases. Through these efforst
2,083 PLWH will receive palliative care.
FHI continues to strengthen local capacity and has trained 79 individuals in HIV-related community
mobilization for prevention, care and treatment. In addition, they trained 55 person in institutional capacity.
One of FHI new FBO partners is the Association of Muslim Women. In FY07, an additonal 200 people will
be trained to provide palliatev care.
The identification of additional entry points to the continuum of care (e.g. PMTCT, CT and linkages for
clinical care to PLWHA) will be encouraged through FHI's facilitation of linkages between health facilities
and programs. The DPS-Zambézia and local partners will benefit from technical assistance to bolster their
capacity to implement, monitor, improve, and evaluate service delivery for chronically ill individuals as well
as share innovative caring practices for these populations.
Under COP07, mechanisms will be put in place to improve the community to clinic linkages. Although,
NGOs were encouraged to liaise with local clinics, many volunteers were comfortable working at the
community level only. In FY07, volunteers will be required to work along with clinics in caring for PLWHA
on ART, with TB patients, patients with OI, STI and other conditions. At least 50% of all HBC clients will
need to have a clinic record. Treatment adherence also will be supported by a related USG activity to
ensure TB and HIV patients are taking their medicines and not experiencing any overt reactions. In addition,
volunteers will be trained to further recognize OIs and to refer clients to the clinic for proper follow-up.
Coupons for transport or use of bicycle ambulances will be used to ensure clients attendance. Further
training will be held to ensure that HBC supervisors, and volunteers have the necessary skills to handle
these new activities.
Under COP07, capacity building of local CBO/FBO will continue with fervor. With a UGS funded AED
program, tools and materials will be available for NGOs to use with their nascent CBO in provide quality
services and assess and manage outside funding. AED will also provide training on several general topics
(on functional organizations, strengthened management, leadership, advocacy, financial management, etc.)
which will be open to all NGOs and their partners.
General Information about HBC in Mozambique:
Activity Narrative: Home-based Palliative Care is heavily regulated by MOH policy, guidelines and directives. USG has
supported the MOH Home-Based Palliative Care program since 2004 and will continue with the same basic
program structure including continued attempts of strengthening quality of services to chronically ill clients
affected by HIV/AIDS. In FY02, the MOH developed standards for home based care and a training
curriculum which includes a practicum session. Trainers/supervisors receive this 12 day training and are
then certified as trainers during their first 12 day training of volunteers. A Master Trainer monitors this first
training and provides advice and assistance to improve the trainers' skills and certifies the trainer when skill
level is at an approved level. All volunteers that work in HBC must have this initial 12 training by a certified
trainer and will also receive up-dated training on a regular basis. The first certified Master Trainers were
MOH personnel. Then ANEMO, a professional nursing association, trained a cadre of 7 Master Trainers
who are now training Certified Trainers, most of whom are NGO staff who provide HBC services in the
community. In the next two years, ANEMO will train and supervise 84 accredited trainers who will train
7,200 volunteers, creating the capacity to reach over 72,000 PLWHA.
In addition, the MOH designed 4 levels of "kits" one of which is used by volunteers to provide direct services
to ill clients, one is left with the family to care for the ill family member, one is used by the assigned nurse
which holds cotrimoxazole and paracetamol and the 4th kit contains opiates for pain management which
only can be prescribed by trained doctors. The kits are an expensive, but necessary in Mozambique where
even basic items, such as soap, plastic sheets, ointment, and gentian violet are not found in homes. USG
has costed the kits and regular replacement of items at $90 per person per year; NGOs are responsible for
initial purchased of the kits and the replacement of items once they are used up except for the prescription
medicine, which is filled at the clinics for the nurses' kits. An additional $38 per client per year is provided to
implementing NGOs to fund all other activities in HBC, e.g. staff, training, transport, office costs, etc.
MOH also developed monitoring and evaluation tools that include a pictorial form for use by all volunteers,
many of whom are illiterate. Information is sent monthly to the district coordinator to collate and send to
provincial health departments who then send them on to the MOH. This system allows for monthly
information to be accessible for program and funding decisions.
In FY06, the initial phase of the assessment of home-based care will be completed. Recommendations
from this assessment will inform the MOH on how to improve the palliative care services delivered at
community level and what is needed to strengthen the caregivers. Training in psychosocial support is
beginning to roll out and is meant to support HBC caregivers as well as the clients and their families. In
Zambezia, it was reported that 40% of the HBC clients died during a recent 3 month period. This puts a lot
of stress on the volunteer caregiver, who needs support to continue to do his/her job faithfully. A pilot
project in three locations will support an integrated care system, strengthening relevant government offices
as well as NGOs. The more varied resources, such as food, education, legal and other social services, that
are available to the chronically ill, the stronger the overall program.
This is a continuing activity under COP08, linked to the FY07 activity # 9209.07.
This study concerns the assessment of partner notification after introduction of HIV and syphilis rapid
testing at Antenatal Care/Prevention of Mother-to-Child (ANC/PMTCT) service sites with/without 1-minute
Title: Rapid Syphilis Testing and Counseling
Time and Money Summary: This study is currently being reviewed for reprogramming given ongoing
concerns about utility of results.
Local Co-Investigator: Elisabeth Inglesi, FHI
Study Question: What are the best practices in the integration of syphilis screening and treatment within
1. All pregnant women visiting ANC/PMTCT services in selected sites; 1)Quelimane City/17 de Setembro;
2)Nicoadala Sede and 3) Mocuba Sede will be checked for STI symptoms and signs.
2. All pregnant women will be screened for syphilis with the use of rapid non treponemic tests.
3. All pregnant women identified with an STI or reactive to syphilis testing will be treated according to
National Protocols for syndromic approach.
4. Reactive samples will be confirmed with a TPHA test. A number of randomly selected negative samples
also will be tested for quality control purposes.
5. A code will be written in the ANC cards and STIs registration book available at the selected sites.
Importance of Study: The Mozambican Ministry of Health launched its National PMTCT program in July
2004. UNICEF states that many newborns have died after completion of PMTCT due to congenital syphilis.
720,000 infants were born with HIV worldwide in 2001. Large sums of donor funds are rightly being made
available for PMTCT programs, yet many of the infants in whom HIV is prevented may die of syphilis.
Between 10% and 15% of pregnant women have syphilis in Zambezia Province and infant death from
congenital syphilis can be prevented by linking ANC/PMTCT services and syphilis diagnosis and treatment.
Syphilis in pregnancy causes stillbirth, spontaneous abortion, intrauterine growth retardation, or preterm
delivery in up to 50% of cases. In sub-Saharan Africa, syphilis is responsible for 20-30% of perinatal
Planned Use of Findings: The findings of this study will be useful in formulating efficient policies with the
GRM regarding the identification, care and treatment of syphilis among ANC attendees.
Status of Study: Protocols are currently being established with the Ministry of Health and a decision
should be made soon as to whether this PHE should be pursued further.
Lessons Learned: Research in Mozambique takes longer than anticipated due to long processes of
review and authorization by the Ethics Committee and the Minister of Health.
Information Dissemination Plan: The results will be publicly announced at both provincial and federal
Planned FY08 Activities: If it goes forward, the study will be completed and the results will be
disseminated by the beginning of FY08.
Budget Justification for FY08: There is no FY08 funding.
This is a continuing activity under COP08.
FHI will leverage TB-CAP funds to advance the integration of TB and HIV services, with special focus on CT
for HIV in TB patients and linkages/referrals to ART services. Trainings on TB infection and control will take
place across staffing in clinics and hospitals to include training on TB detection within HIV-related services.
FHI will continue to collaborate closely with community-based organizations to enhance TB/HIV follow-up
and adherence as well as assist in the strengthening of the monitoring and evaluation and supervision of
the integration of TB/HIV services. In selected sites in Nampula, Zambezia, Sofala, and Gaza FHI will fortify
community-based linkages between palliative care services and TB DOTS, including sub-agreements with
Mozambican NGOs. Finally, FHI, again leveraging TB CAP funds, will finalize the rehabilitation of the Beira
reference laboratory as well the Maputo central laboratory; FHI will also rehabilitate and equip one
counseling and testing sites at the TB clinics in each province.
The narrative below from FY2007 has not been updated.
A new activity, which will be initiated during FY07 addresses the need for a more collaborative processes
between clinic based and community based palliative care, especially in relationship to treatment adherence
for TB and ARV. Although this has been the focus of community based care since the beginning,
improvements can be made in the areas of collaboration and communication with NGO partners that are
working in both clinic and community sites. Small amounts of funding will be provided to five partners who
offer palliative care under the home-based care (HBC) model. HBC volunteers and their supervisors will
receive training on treatment adherence for ARV and TB. Columbia University will develop training
materials for ARV adherence under a separate USG supported activity and provide hands-on training to
HBC volunteers so that they can assist their HBC clients to adhere to treatment drugs and determine if
there is some reaction to the treatment regime. In addition, collaboration will occur with the MOH's TB
program to ensure that HBC volunteers are correctly trained concerning the DOTS model and the MOH's
vision for improving case detection and treatment success rates.
This activity was designed in collaboration with the emphasis in COP07 on improving TB/HIV programming.
The activity is deemed important because of the recent information of mutated strains of TB found in
neighboring countries that can easily cross the boarders.
Directly funding the NGO partners will help to build their own capacity in ARV and TB adherence support,
creating a permanent buy-in to the importance of this effort. Thus it is expected that all HBC providers will
receive training and that at least half of the HBC beneficiaries will be recipients of this expanded community
-based service on treatment adherence.
This OVC intervention is a new activity for Family Health International (FHI). FHI has provided PMTCT,
HBC and treatment services with PEPFAR funding in four districts in Zambezia province in close
cooperation with the Provincial Health Directorate.
In FY08, FHI will provide PMTCT, ART, HBC and OVC services in Niassa province, modeling a
comprehensive package of care.
Although providing OVC services is a new activity for FHI in Mozambique, FHI as an organization has
demonstrated a strong background in this program area. In 2007, UNICEF contracted FHI to conduct
regional workshops to improve mechanisms for monitoring and reporting at the regional levels and
coordinated monitoring and evaluation (M&E) efforts among stakeholders (which included Mozambique)
involved in the implementation of each member country's National Plan of Action. The general objective of
these workshops was to strengthen in-country capacities in M&E of orphans and vulnerable children
programming and frameworks.
Building on the lessons learned and experiences shared in the 2007 workshop, FHI is well positioned to
work with the Provincial Ministry of Women and Social Action (MMAS). During this workshop, Mozambique
acknowledged their relatively low level of preparedness in monitoring and evaluation in OVC programming.
MMAS identified the following technical assistance needs: 1) harmonizing OVC indicators in order to ease
the flow from specific project indicators to more general HIV/AIDS indicators; 2) learning about mechanisms
to create interconnected systems of data collection; and 3) providing support to implementers in order to
advise them on how M&E activities should be performed.
Under this activity FHI will provide direct OVC services. FHI strives towards two goals in OVC care: 1)
providing compassionate and comprehensive care and 2) strengthening and improving program quality.
Their approach is to work with FBO/CBO to develop long term responses to OVC needs by building their
capacity to coordinate and sustain OVC services. FHI also aims to strengthen linkages among service
providers to coordinate coverage and ensure sharing of lessons learned. The specific approach used in
Niassa will be developed in close collaboration with local communities and district and provincial authorities.
FHI will partner with WFP to support the nutritional needs of the most vulnerable OVC and their families
through provision of short-term emergency food support. Please refer to the activity sheet for WFP for
funding levels and targets. In collaboration with PSI, FHI will distribute LLIN and Safe Water Systems (SWS
- "Certeza") to OVC in an effort to improve the health status of targeted children and family members.
FHI will reach 650 OVC with the six essential services and train 35 individuals to provide OVC services.
This is a continuing activity under COP08
FHI will continue to provide technical resources and information, by supporting policy development, and by
documenting best practices in relationship to counseling and testing. The objective is to strengthen quality
counseling and testing services offered in Zambezia while expanding to three new sites. This activity will
also include establishing comprehensive and integrated counseling and testing services in Niassa province.
To better ensure access to comprehensive services FHI uses moments within pre and post-test counseling
to appropriately refer HIV positive clients to other health services of importance such as family planning,
MCH, TB, etc. HIV-negative clients are also referred but more active referral mechanisms are either being
developed or are already in place for those who are HIV-positive.
The activity narrative below from FY2007 has not been updated.
Continuation of 3 CT services (Nicoadala, Ile, Quelimane) and 9 new sites in Zambezia - integrated into
other existing health services such as TB, OI and STI treatment (request from the DPS in Zambezia to have
the same NGO support CT and PMTCT); This activity is expected to reach 48,960 individuals with C&T
results and to train 27 individuals in C&T.
FHI is planning to carry out the following activities under COP07:
1. Technical assistance to the MOH, through support in the conceptualization and conducting program and
monitoring and evaluation supervisions
2. Implement a model for the integration of STIs, PMTCT, CT, ART and management of opportunistic
infection including TB in Zambezia, moving towards the MOH's goal of creating Counselling and Testing in
3. Conduct trainings using newly developed syndrome approach in at least 8 sites
4. Conduct community activities for HIV and STI prevention in partnership with local organizations, using
and reproducing materials centrally produced
5. Maintain a buffer stock of test kits and materials, to avoid stockouts in the sites where implementing the
The second activity will allow FHI to continue to provide home-based care and support activities for
HIV/AIDS-infected and affected households in the sites were HBC services were provided with PEPFAR
funds during COP06 including selected sites in Quelimane, Mocuba, Nicoadala and Ile and expand to four
new sites within these districts. FHI will sign a Memorandum of Understanding (MoU) with PSI to continue
the distribution of mosquito nets and "certeza" which will complement the benefit of those served under the
HBC program and in addition will try to establish collaboration with WFP to provide food to patients in
The identification of additional entry points to the continuum of care (e.g. PMTCT, CT and linkages for
clinical care to PLHA) will be encouraged through FHI's facilitation of linkages between health facilities and
programs. The DPS-Zambézia and local partners will benefit from technical assistance to bolster their
capacity to implement, monitor, improve, and evaluate service delivery for chronically ill individuals as well
as share innovative caring practices for these populations ($1,200,000).
This is a new activity under COP08.
Family Health International (FHI) will begin to provide treatment services in Niassa province. FHI will be
cross-funded across HBHC, OVC, CT, and PMTCT to offer a comprehensive package of services in the
province. Niassa, being of considerable distance from Maputo, has few partners providing services and the
province as a whole poses a real challenge for implementation. However, FHI will provide technical support
at the central, provincial, and district levels to scale up ART services in the province. FHI will support the
district level health officials' ability to adequately monitor and supervise implementation throughout the three
districts they will work in as well as contribute towards quality management approaches and technical
quality assurance. FHI will use its relationship with direct service providers to improve the testing,
diagnosis, care, and referral of patients with opportunistic infections, including tuberculosis, to treatment
FHI will emphasize the integration of mother and child care and treatment and will support the integration of
pediatric services in both treatment facilities as well as PMTCT Plus sites in order to maximize on PMTCT
interventions. Special attention will be given to HIV exposed infants by establishing early infant diagnostic
capabilities at the model centers to allow for early identification of HIV infected children, and ensuring they
are engaged in care and treatment. Provincial trainings will be held on ART management, which will also
include a component on linkages and referral mechanisms with HIV/AIDS clinical and community services.
Finally, FHI will improve the conditions of the provincial laboratory to enhance its capacity for CD 4 testing.
FHI will work with new partners to strengthen both their organizational and technical capacity in the
provinces of Zambezia and Niassa. As a first step the capacity development needs of possible
implementing partners will be identified. Secondly, the partners technical capacity will be built in pertinent
program areas such as: PMTCT, stigma reduction, and HBC. Finally, FHI will strengthen their institutional
capacity through the provision of technical assistance and trainings on management, financial management,
proposal development, and organizational development.
• Technical assistance and training to build organizational and technical areas in new provincial partners