Detailed Mechanism Funding and Narrative

Years of mechanism: 2007 2008

Details for Mechanism ID: 5078
Country/Region: Mozambique
Year: 2008
Main Partner: FHI 360
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $9,151,200

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $3,249,270

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

dedicated sites.

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

be trained.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $249,795

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.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $100,000

August08 Reprogramming:

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.

Funding for Care: Adult Care and Support (HBHC): $1,525,000

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.

Funding for Care: Adult Care and Support (HBHC): $0

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

reinforced counseling.

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

Project Description:

Study Question: What are the best practices in the integration of syphilis screening and treatment within

ANC/PMTCT services?

Study Design:

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.

Funding for Care: TB/HIV (HVTB): $1,062,135

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.

Funding for Care: Orphans and Vulnerable Children (HKID): $630,000

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.

Funding for Testing: HIV Testing and Counseling (HVCT): $1,300,000

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

Health units.

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

integrated model.

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

selected cases.

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).

Funding for Treatment: Adult Treatment (HTXS): $925,000

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.

Funding for Health Systems Strengthening (OHSS): $110,000

This is a new activity under COP08.

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

Subpartners Total: $220,000
Associacao de Apoio Esperanca e Vida: $65,000
KEWA Group: $35,000
Not Identified: $80,000
Muslim Association of Quichanga: $10,000
ACCEVE: $15,000
Promoters of Health (Paquita Sisters): $15,000
Consórcio de Organizacões de Luta contra SIDA: NA
Associação Moçambicana para o Desenvolvimento da Familia: NA
Cross Cutting Budget Categories and Known Amounts Total: $80,000
Food and Nutrition: Commodities $80,000
Food and Nutrition: Commodities $0