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.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
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
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
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
In COP 08, Positive Living (PL) Abstinence and Be Faithful (AB) component will be implemented in 20
states (FCT, Bauchi, Edo, Enugu, Kano, Anambra, Cross River, Lagos, Kogi, Imo, Niger, Benue, Taraba,
Adamawa, Sokoto, Zamfara, Kebbi, Nassarawa, Katsina, and Akwa Ibom). The program will reach 80,000
people with AB interventions, reach 20,657 with abstinence (A) only, and will train 2,400 as peer educators
and facilitators to disseminate information for AB through a systematic community-based program. This
activity will embrace counseling, mentoring, peer support, information sharing, and provision of technical
guidance and support to Anglican Communion AIDS program (ACAP) and the AIDS Program for Muslim
Ummah (APMU) a project of the Nigerian Supreme Council for Islamic Affairs as multiplier organizations.
CEDPA's AB prevention strategic approach involves a series of interrelated interventions (community
mobilization, social marketing, advocacy, targeted inter-personal communication, capacity enhancement of
individual and community groups) directed at different levels of society to enhance individual behavior
change in a supportive environment.
A total of 2,400 Peer Educators will be trained of whom 350 are teachers, 450 are parents, 2000 are youth
in and out of school, 350 are religious leaders and 150 are PHA. Special attention will be given to children
who act as family heads to strengthen their coping mechanisms. PL will expand by increasing access to
community-level, gender-sensitive and targeted prevention services. PL will also forge networks and
linkages between outreach activities and Government of Nigeria (GoN) and other USG partners that provide
AIDS care, support and treatment.
Intensive community mobilization and sensitization will reach underserved rural and hard to reach
communities. Each individual will be reached with a minimum of three interventions i.e. community
awareness, peer education and family level services. CEDPA will ensure that each beneficiary is reached
through community awareness, peer education and one other targeted strategy within the year. The other
interventions will include focus group discussions to identify community HIV needs and possible solutions;
formation of anti-AIDS clubs for youth in school; public debates on HIV/AIDS and other social interactive
events for out-of-school youth for information sharing and channeling their energies towards less risky
behaviors; and skills building sessions for PHA and OVC to promote supportive relationships with peers and
sexual partners. Religious leaders will be supported to integrate HIV/AIDS activities within all religious
events and services.
PL AB program activities are implemented at 4 levels: 1) Individual level where activities promote
development of life skills that support practicing abstinence by young people and adults in low risk settings;
encourage delay of sexual debut, denounce intergenerational sex, rape, incest; and promote counseling
and other means of interpersonal communication techniques; 2) Family level where services will be
provided by Peer Educators during home visits. Services will focus on couple counseling to promote mutual
fidelity/partner reduction/elimination of casual sex relationships, VCT, dovetailing with prevention in
discordant relationships. Family members will be guided to recognize symptoms of common STIs and TB.
3) Community-wide prevention programs which are provided by pastors, Imams, peer educators, teachers,
parents including Church/Mosque sermons/pulpit preaching and club activities, in-school peer-education
and out- of- school youth prevention programs that address sexual development, reproductive health and
promotion of secondary abstinence particularly for at-risk out-of school youth through alternative livelihood
opportunities. 4) National prevention programs where a collaborative effort with ENHANSE project will
implement a 3 pronged program with the Nigeria Teacher's Union that addresses HIV awareness and
prevention by teachers; teachers ethics- coercive sexual relationships with students; teachers as role
models to guide in-school youth peer AB prevention programs.
Using standardized forms, IA/MO/PL M+E Officers collect data monthly, detailing numbers/demographics of
clients reached and messages provided. This provides timely information for effective decision making,
particularly the breadth and depth of AB coverage. AB M+E activities develop sustainable capacity at IAs
and MOs to collect relevant data. Direct M+E expenditures by PL, MOs and IAs will total $196,000.
PL targets children (10-14 years), young people (15-24 years) in and out-of school, PHA, religious leaders
and the general population. Teachers are targeted to act as change agents.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
HVAB emphasizes human capacity development through training, task-shifting and volunteer retention and
therefore enhances sustainability. Scaling up prevention, involving PHAs and youth, and encouraging peer
educators to work together with community health care providers contributes directly to the US Global
HIV/AIDS Strategy by reaching 173,598 people indirectly through cascaded training by Peer Educators. The
activities stimulate demand for other HIV/AIDS services offered by GoN and USG partners throughout the
20 states. This contributes to increasing sustainability of institutions by vesting program responsibility in 56
indigenous Nigerian organizations.
LINKS TO OTHER ACTIVITIES:
AB activities relate to HVCT (#3230.08, #5424.08), by increasing awareness of HIV, to HBHC (# 9839.08,
3237.08, 5369.08), HVOP (# 9779.08, 3236.08), as a complementary prevention strategy and on HKID
(#12378.08, 12373.08, 3229.08) and other services that will be provided at GHAIN, ACTION project,
Harvard ART, and PMTCT sites through cross referrals. Public-private partnerships and collaboration with
local business groups will also be explored. High risk individuals will be referred PL and SFH service outlets
for condoms; as well as Nigerian Network of Religious Leaders Living with AIDS (NINERELA) and the
Association of Women Living with HIV/AIDS in Nigeria provide support for prevention among positives.
PL promotes a rights-based approach to prevention among positives and other vulnerable members of
society and equal access to information and services; enlightens men on special needs of women and
youth; and challenges traditional gender norms of male dominance, female subservience and gender
inequality in sexual relationships. Reduction of stigma and discrimination is also key.
WRAP AROUND ACTIVITIES: PL will scale up the prevention initiative with the Nigerian Union of Teachers
that addresses HIV awareness and prevention by teachers for teachers; teachers ethics- coercive sexual
Activity Narrative: relationships with students; teachers as role models to guide in-school youth peer AB prevention programs.
Youth curricular will focus on building life skills such as negotiation and self esteem issues for youth
especially girls. Primary target populations are in-school youth 10-19 and school teachers.
Positive Living (PL) activities of HVOP will be implemented in 19 states of FCT, Bauchi, Edo, Kano,
Anambra, Adamawa, Cross River, Lagos, Kogi, Benue, Imo, Niger, Taraba, Sokoto, Zamfara, Kebbi,
Nassarawa, Katsina and Akwa Ibom. This activity is a key component of PL's strategy and encompasses
provision of information and access to correct and consistent condom use, prevention of HIV among
discordant couples, promotion of counseling and HIV testing, partner reduction, and mutual faithfulness as
methods of risk reduction. PL will reach 15,275 persons, train 2,400 peer educators, distribute 6,000,000
condoms and open 65 service outlets.
HVOP will augment the HBHC component of PL and enhance the capacity of Primary Health Care and
other referral facilities in communities to diagnose and treat STIs by providing laboratory equipment such as
specimen bottles, reagents, consumables, etc. These facilities will serve as referral centers for diagnosis
and treatment of STIs and will be considered as some of the service outlets for HVOP. All HVOP activities
will be coupled with information about abstinence as well as the importance of HIV counseling and testing,
partner reduction, and mutual faithfulness as methods of risk reduction. PL will build on past achievements
by continuing to target long distance truck drivers, migrant workers, out of school youth, Orphans and
Vulnerable Children, people living with HIV/AIDS (PHA) and clients of commercial sex workers.
Peer educators (PE) including religious leaders, teachers, persons living with HIV/AIDS and parents (trained
in HVAB and HKID) will be trained to act as condom distributors, provide prevention options for people at
risk who cannot practice A&B. Such options include support for PLWHA to disclose their sero-status to
sexual partners and significant others, proper nutrition and boosting body immunity, prevention of
pregnancy among PLWHA, PMTCT and early diagnosis and treatment of STI. PEs will hold discussions in
homes, communities and workplaces with their peers focusing on prevention for positives during one-on-
one and group discussions in support group meetings using CEDPA's Prevention manual.
Each individual will be reached with a minimum package of three interventions. The package will consist of
community-wide AIDS awareness campaigns, targeted AIDS education programs at community level and
various institutions, participation in focus groups and peer support groups for people identified as being at
high risk of HIV infection, psychosocial support, and ‘prevention with positives' programs. Community-wide
prevention activities will disseminate messages on prevention and stigma reduction during wedding
receptions, naming ceremonies, age grade meetings, rallies, and youth club activities such as celebration of
solidarity days. Existing media materials on prevention will be adapted and reproduced for distribution
during these events.
Condoms will be made available to all sexually-active individuals and PLWHAs through PL's comprehensive
service delivery points at primary health care facilities, workplace programs and community condom
distribution points run by PE and other commercial vendors who will be trained. The PE will provide one-on-
one counseling; distribute condoms, facilitate support group discussions and act as peer buddies to ensure
and maintain behavior change. Mobile populations will be reached through comprehensive activities
reinforced by necessary follow-up. Activities will be integrated with an emphasis on MARPs, strengthened
linkages, training and on-going support.
Using standardized forms, staff of implementing agencies (IA) multiplier organizations (MO) and Monitoring
and Evaluation officer of PL will collect data on a monthly basis, detailing numbers/demographics of clients
reached and messages provided. This will provide timely information for effective decision making,
particularly the regarding the breadth and depth of HVOP coverage.
HVOP will be focused on most at risk populations (MARPs), e.g. long distance truck drivers, migrant
workers, out of school youth, PHAs including OVC and clients of commercial sex workers, sexually active
men, women, adolescent girls and boys in the general population. Prevention for Positives will target mainly
discordant couples. Pregnant positive women will be mobilized and referred for PMTCT services.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
Condom and Other Prevention activities of PL will contribute to PEPFAR's 5 year strategic plan for Nigeria
by reaching selected individuals considered to be at high risk of HIV infection with information and services
that enhance their abilities to adopt risk reduction measures. Combined, these activities will contribute to
averting new HIV infections. With the number of discordant couples on the increase, PL will promote active
participation of PHA in prevention activity to encourage disclosure of sero status and protecting their sexual
LINKS TO OTHER ACTIVITIES:
HVOP activities relate to HVAB (9759.08) as a complementary prevention strategy, to HBHC (9839.08) by
potentially decreasing demand for HBC services, to HKID (12378.08) by targeting young people in and out
of school, parents and guardians and by increasing awareness of the virus. PL will liaise with DFID and
SFH to ensure the provision of condoms. Activities will be linked to other reproductive health activities
provided by CEDPA in Bauchi, Kano, and Lagos states. HIV+ pregnant women will be referred to MTCT
EMPHASIS AREAS: Commodities procurement and distribution, particularly of condoms, will be an area of
emphasis. Other areas include community mobilization and demand creation for HIV related services and
training. The program will address will include increasing gender equity in HIV programs and promoting
male norms and behaviors that encourage HIV prevention. Violence and coercion reduction will be
addressed through couple counseling for disclosure and collaboration with legal aid clinics.
This activity also relates to HVAB (3.3.02), HVOP (3.3.05), HVTB (3.3.07), HKID (3.3.08), HVCT (3.3.09)
HTXS (3.3.11) and HLAB (3.3.12). The community/home-based services of Positive Living (PL) compliment
facility-based palliative care provided at secondary and tertiary level hospitals. In COP 08, HBHC activities
will focus on consolidating structures for palliative care delivery and community level referral networks
developed in COP 06-07. PL HBC coverage will be offered to all GHAIN clients in "GHAIN states", including
six new states (Sokoto, Zamfara, Kebbi, Katsina, Nasarawa, Akwa Ibom) as well as to GHAIN, other USG
and GoN clients in 14 COP07 states: Federal Capital Territory (FCT), Lagos, Bauchi, Kano, Edo, Cross
River, Anambra, Kogi, Niger, Benue, Imo, Enugu, Taraba and Adamawa. PLHAs (112,060) will be reached
(93,600 referred from GHAIN sites and 18,460 from PL's comprehensive sites and self referrals) and
224,120 PABAs (187,200 are from GHAIN sites and 36,920 from PL's comprehensive sites). A total of
336,180 individuals will be reached with community base HBC services by CEDPA but only 242,580 will be
attributed to CEDPA since GHAIN is providing clinical basic care to 93,600 to avoid double counting. At
least 3,800 home-based care (HBC) volunteers, 240 professional health care providers and 25,271 family
members will be trained. PL will maintain partnerships with 58 IAs to provide HBHC services.
PL services will reach clients referred from GHAIN and other USG implementing partners, and directly
generated from communities as identified by HBC volunteers and self-referrals. All clients will be assigned
to one of three categories and provided appropriate services: 1) those who have just been tested but
without major need for medical care will be assisted to access services that promote prevention of
opportunistic infections and emphasize the need to protect others; 2) those with opportunistic infections will
be provided with home-based care and supported to access medical care and routine medical tests
including CD4 count; 3) those on ART will receive intensive adherence counseling, regular home visits for
monitoring and referral. All clients will be offered psychological and spiritual counseling. Twenty percent of
the total 112,060 clients to be served are estimated to require home-based nursing care and will be served
by home-based care (HBC) volunteers trained at the community level. Following the National Palliative Care
Guidance and USG PC Policy, PL will provide a Basic Care Package including clinical care, prophylaxis and
management of opportunistic infections, laboratory support, counseling and adherence support, home-
based care, and active linkages between hospitals, PHCs and communities; and training of healthcare
providers and community volunteers.
Clinical care services will be provided at primary health care facilities (PHC) to compliment care and support
services offered at ART centers and general health care facilities and utilize an outreach HBC volunteer
program. Staff at various PHC facilities will be introduced to standardized clinical management of AIDS
related infections and the cross referral procedures to USG service sites. PL will enhance the capacity of
PHC and other referral facilities in communities to diagnose and treat STIs by providing laboratory
equipment such as specimen bottles, reagents, and drugs, while health workers will be trained on
syndromic management of STIs where laboratories are not available. These facilities will serve as referral
centers to which HBC volunteers and peer educators under PL's HVAB and HVOP programs will send
clients for diagnosis and treatment of STIs.
PL will support 24 community-based clinical facilities to handle OI management, basic laboratory and
prophylaxis services for PHAs. Of these 4 will be additional to the 20 PHCs supported in COP07. Based on
outcomes of needs assessments, PL will facilitate renovation and/or refurbishment of basic laboratories at
PHC; provide reagents, STI drugs and essential drugs for treatment and prevention of opportunistic
infections and other HIV/AIDS-related complications e.g. malaria and diarrhea. Each new client will receive
a self-care kit consisting of ORS, ITN, water guard, bleach, cotton wool, gloves, soap, calamine lotion,
Vaseline, and gentian violet (GV). A total of 10,258 kits will be distributed to newly registered clients in
COP08. Water guard and other consumable supplies will be purchased and distributed to all clients
including those carried over from COP07. HBC volunteers and health care providers will be given home
based care kits containing drugs for pain relief; the kits will be replenished to ensure constant supplies
needed for first aid. Care coordinators will head the homecare teams in providing home-based nursing care.
The HBC volunteers will link PHAs, their families, and community members to HIV/AIDS related services
and social welfare services for orphans and vulnerable children (OVC).
To strengthen the HBC volunteer program and improve quality of care, PL will train 3,800 HBC volunteers,
240 professional health care providers mainly nurses and community health extension workers (CHEWS)
and family members. If funds allow, refresher trainings will be provided to all care providers trained in
COP07. PHAs will be trained to enhance skills in advocacy and public speaking, and supported to disclose
sero-status to partners and immediate family members. Trained volunteers will offer psychological and
spiritual support to PHA and their families through group and individual counseling. Culturally appropriate
methods will be adopted for end-of-life care and bereavement services. PHA will further be supported to
promote the philosophy of "prevention for positives" to peers, especially for family members and those in
Social-economic support enhanced by seed grants and vocational training, income-generating activities,
linkages to social and legal protection, and training and support of caregivers will be maintained in Kano
and Benue and extended to Bauchi and Imo states. Priority will be given to households headed by children,
the elderly, and PHAs who lack regular sources of income. Seed grants will be provided to small groups of
PHAs and their families to invest in small-scale businesses and revolving funds for health care. PL will
support PHA in their communities and improve the economic capacities of additional 40 groups of PHA and
Using standardized forms, M+E Officers collect data monthly, detailing numbers/demographics of clients
reached and services provided. This provides timely information for effective decision making, particularly
regarding the breadth and depth of HBHC coverage. HBHC M+E activities develop sustainable capacity at
IAs and MOs to collect relevant data. Direct M+E expenditures by PL, MOs and IAs will total $ 328,071.
The primary beneficiaries for PL palliative care services are PHA and their families. Community members,
professional health care workers, CHEWs and caregivers of PHA will be trained. Since women form most of
PL's beneficiaries, extra effort will be taken to reach out to men as community leaders and partners of PHA
to increase male involvement in palliative care.
Activity Narrative: CONTRIBUTIONS TO OVERALL PROGRAM AREA:
The planned community/home-based palliative care interventions will contribute to the overall PEPFAR care
and support goal by reaching 112,060 PHA and 224,120 PABAs with basic care and support services. PL
will work with stakeholders at all levels, to strengthen community systems for the provision of quality care to
PHA and their families; build community capacity to deliver palliative care by training a total of 4,040
community resource persons and improve the economic capacities of 1,500 PHA.
LINKS TO OTHER ACTIVITIES:
PL will consolidate linkages, with GHAIN and other USG partners providing palliative care at healthcare
facilities, to ensure that all PHA receive community/home-based care services. Care coordinators will be
placed in facilities providing ART, VCT, PMTCT and pediatric palliative care services to register all those
patients who may require HBC services and offer information on follow-up support for PHA. Planning and
review meetings will be held regularly with partners to maintain effective referral. PL will collaborate with
Howard University to train community pharmacists and health care providers including community health
extension workers and patent medicine vendors. Activities will be linked to HVAB (3.3.02), HVOP (3.3.05),
HVTB (3.3.07), HKID (3.3.08), HVCT (3.3.09) through training PHAs on various aspects of HIV prevention
and control Of OIs.
PL will advocate for reduced stigma and discrimination at all levels, increasing acceptance of PHA within
communities. Interventions will increase gender sensitivity in programming by targeting vulnerable young
girls and women, and promote male involvement in care and support. PL will contribute to development of
legal frameworks that uphold the rights of PHA.
This activity also relates to HBHC (9839), HVOP (9779), HVAB (9759), HKID (12378). The TB component
of Positive Living (PL) will address the increasing TB case load among HIV positive persons by increasing
access to treatment and improving treatment outcomes. This activity will link TB and HIV prevention, care
and treatment activities at community and primary health care level.
In collaboration with state TB control programmes, PL will build the capacity of 36 CBOs/FBOs and six
NGO/FBO owned primary health facilities to expand community based TBHIV services to an additional two
states making a total of 14 states (Bauchi, FCT, Lagos, Kano, Anambra, Edo, Enugu, Taraba, Adamawa,
Niger, Cross River, Imo, Kogi and Benue) in COP 08. All sites will be provided with necessary facilities that
will ensure holistic patient care according to IMAI guidelines. These services will provide a network, linking
facility-based TB/HIV services provided by GHAIN in secondary facilities with primary and community based
services. A total of 6,554 HIV infected clients receiving TB treatment in GHAIN supported sites will have
access to community based TB/HIV activities.
The 36 CBOs will contribute to TB/HIV care in the following ways: 1) provide treatment support services
through out-patient treatment until cure; 2) provide patient, family and community education on TB/HIV co-
infection; 3) complement case finding efforts of traditional facility-based TB treatment programs; 4) increase
accountability of local health services to the community; and 5) lobby the state and local authorities for
increased commitment to TB/HIV control, including through work practice, administrative and environmental
control measures.A total of 30 individuals will be trained to provide treatment for TB to HIV-infected
individuals while 1,800 community health workers, home based care volunteers and peer educators will be
trained in TB/HIV education, care and support including adherence to TB treatment regimens. Family
members (two per PHA) will be given basic skills to provide continuous care and support.
PL will support a total of six community-based clinical facilities to handle TB management and to provide
basic laboratory and community services for HIV positive persons. Following assessments, PL will assist
health facilities to do basic renovations, to purchase equipment and laboratory reagents, to develop storage
space for drugs and commodities and to write up and publish infection control plans. In addition, clinics will
be assisted to augment extant quality assurance standards, particularly by implementing Nigerian national
guidelines for external quality assessments (double-blinded slide rechecking).
Medical officers from community-based clinical facilities will be trained in X-ray diagnosis of TB while
laboratory technicians/scientists will undergo training in sputum smear microscopy. This activity will ensure
that 800 HIV positive persons and their family members are referred and supported to access routine
screening for TB. It is anticipated that 300 HIV positive persons will require treatment for TB. Co-infected
TB/HIV patients will be linked to medical services at GHAIN, other USG-funded health care facilities and
DOTS centers. Communities will have increased knowledge on prevention and control of TBHIV and
increased capacity to provide care and support for dually infected patients.
PL IAs will counsel partners and family members of HIV/TB patients and refer them for TB screening. In the
process partners/family members will be linked to appropriate care and support services. TB/HIV activities
will be integrated into ongoing palliative care (HBHC #9839) and prevention programs (HVAB and HV0P).
HBC volunteers will be trained to recognize TB symptoms and danger signs; to conduct proper referral of
PHAs for TB screening and treatment; to provide home-based nursing care, infection control, follow-up and
adherence counseling; and to trace clinic defaulters. Care coordinators at CBOs will undergo mandatory
clinical TBHIV training and in supportive supervision. Care coordinators will supervise HBC volunteers, and
provide continuing education during volunteer meetings. This activity will incorporate standard operating
procedures; training manuals and IEC materials will be adapted and updated. The ELICO maps model will
be adopted to help HBC volunteers keep track of individuals and families they visit, and organize follow-up.
Project activities will be properly documented at every stage of implementation.
Using standardized forms, M+E officers collect data monthly, detailing numbers/demographics of clients
reached and messages provided. This provides timely information for effective decision making, particularly
regarding the breadth and depth of TB/HIV coverage. TB/HIV M+E activities will develop sustainable
capacity at IAs and MOs to collect relevant data. . Direct M+E expenditures by PL, MOs and IAs will total $
Referral for TB/HIV screening will be done for all PHAs who will be enrolled into the care and support
program in the four PL states. Their family members will be recommended for screening as well. PHAs
infected with TB will be linked to DOTS centers and supported for drug adherence. Healthcare providers at
DOTS centers and other PHCs will be facilitated for training and re-training in TB prevention and
management. Family and other community members will be provided with information on TB and infection
This activity will contribute to prevention and control of TB among HIV positive persons. HIV positive
persons will be screened for TB by members of their communities and referred for treatment. In a
pioneering effort, treatment support will be provided to HIV positive patients on TB treatment to ensure
completion of treatment and prevent the onset of drug resistance. Community linkages will strengthen
facility based TB/HIV service providers' collaboration.
TBHIV activities will be linked to activities in HVAB (3.3.02) and HVOP (6735, 6707) through community and
faith-based organizations and to CEDPA's palliative care program for follow up and psychological and
spiritual support. These linkages will ensure that all TB/HIV patients are provided with co-trimaxozole
preventive therapy (CPT) and other prophylaxis for opportunistic infections. TB/HIV activities will be linked
to HVSI (3.3.13) with improved tools and models for collecting, analyzing and disseminating TB/HIV data,
and also to the newly approved NTBLCP tool for reporting. TB/HIV efforts will also support HVCT (3.3.09)
activities to ensure that counseling and testing is done for all TB cases; and to MTCT (3.3.01) to ensure that
HIV positive pregnant women are screened for TB.
Activity Narrative: This activity has an emphasis on human capacity development and local organization capacity building. All
support activities are undertaken in collaboration with the STBLCP.
This activity will address infection control and gender and age equity by providing TB/HIV information and
services at community levels. This will ensure access to TB/HIV services for PHAs who are on ART and
other community members - especially women - who may otherwise not know their risk of TB infection.
Educative and preventive messages targeted at children (10-14), young people (15-24) and adults will
address the importance of TB prevention and care. The thrust will be to ensure that all population cohorts
seek TB/HIV services in a timely manner. A secondary activity will be to train community outreach workers
to deliver such messages effectively.
This activity also relates to activities in HVAB (3.3.02), HBHC (3.3.06), HVTB (3.3.07), HVCT (3.3.09),
HTXS (3.3.11) and HLAB (3.3.12). Positive Living (PL) is presently in four sites in four states. Positive Living
(PL) is presently in four sites in four states: Kano, Cross River, Bauchi and Edo. By the end of COP07, PL
will have opened 4 additional sites in these same states. In COP08 PL will expand to 10 new sites in 10
states: FCT, Anambra, Adamawa, Lagos, Kogi, Benue, Imo, Niger, Kogi and Taraba. OVC is an on-going
activity and in COP08, PL will focus on scale up, tripling COP07 figures, ensuring increased coverage of
present sites and going on to new sites.
PL activities in COP08 will respond to the OVC situation in project states, consolidating structures initiated
in COP07 and strengthening community linkages and referral networks, while initiating services in the new
states. PL will limit expansion of the OVC services to the geographical scope of the Implementation
Agencies (IAs) and Multiplier Organizations (MOs) within the 14 PL states. Three thousand OVC will be
reached via family centered approaches. Through partnerships with 16 IAs and MOs, 600 caregivers among
family members and 300 home based care (HBC) volunteers will be trained in OVC care.
Volunteers and community health extension workers (CHEWs) will reach OVC in homes and communities,
maintaining stability, care, and protection. PL will work at extant structures within PL HBHC and collaborate
with OVC stakeholders at all levels - the Federal Ministry of Women Affairs and Social Development, their
State counterparts, GHAIN, and other USG IPs - and contribute to sustainability by expanding community
resources to improve quality care for OVCs.
PL's OVC services will be provided to children referred from GHAIN/other USG IPs and clients referred by
community members. 0 - 4 yr. olds (and/or guardians) will receive safe water kits, growth monitoring,
counseling on routine immunization protocols, CT for HIV, birth registration, nutritional counseling,
prevention and treatment of OIs and malaria services. 5 - 17 yr. olds will receive CT for HIV, nutritional
assessments and counseling, enrolment into formal education settings (back to school)/vocational skills
acquisition), AIDS education and on-going counseling. In addition HIV+ OVC will be assisted to access
ART, OI diagnosis and treatment (including STIs) and malaria prevention and treatment services at GHAIN
or other USG/GoN supported sites. They will also receive preventive kits. PL will provide nutrition support to
families as needed. To accomplish this in COP08 PL will make appropriate linkages with and leverage
resources from the new USG supported food and nutrition wrap around activities being implemented by the
MARKETS is states where they are co-located. An OVC will be considered served when he/she receives
the three services as recorded during an assessment and that follows the nationally approved plan of action
and guidelines, including the harmonized National OVC Vulnerability and child status indices.
PL has agreements with the GoN and FBOs (Anglican Communion AIDS Programme and the National
Supreme Council for Islamic Affairs) to place OVC, especially girls, in selected 10 and 20 schools. These
are the schools targeted by PL's AB program (avoiding duplication of efforts). In selected schools PL will
continue to contribute overhead in exchange for free tuition and education materials (uniforms, books, etc.)
for OVC. PTA members will be trained to recognize and respond to academic needs of OVC, to support
PTA levy waivers, and to provide three different, OGAC-recognized forms of psychological support. Where
indicated, PL will leverage further educational support for needy OVC from the ABE-Link wrap-around
activity. Out of school OVC, particularly those heading households or caring for sick parents/siblings, will be
supported to attend evening classes in the community. Others will be enrolled in contracted institutions that
provide specific training in vocations and business entrepreneurship. OVC who have completed vocational
training will be given seed grants to purchase equipment for microenterprises. OVC needing additional
funds for economic activities will be linked to banks and microfinance institutions to source soft loans.
The adapted curriculum equips OVC with life skills and age appropriate HIV/AIDS and sexuality/RH
information; it will be used for refresher training. PHA from support groups will be models for PL and
demystify stigma and discrimination. Peer facilitators from PL prevention (AB, OP) will mentor and guide
OVCs by counseling and engaging OVC in physical and social activities. Youth volunteers already trained
by PL will continue to provide HIV/AIDS prevention information to colleagues and siblings, focused on AB.
Age appropriate prevention messages and education to prevent abuse will be shared. Sexually active youth
will be provided with appropriate information on prevention and treatment of STIs.
Health care services will be provided at PL supported PHC facilities to supplement C&S support services
offered at ART centers and general health facilities. These services will follow the basic care and support
model. PL will continue to negotiate for subsidized/free medical care for OVC at GoN-owned and privately-
owned health facilities. Staff at PHCs will be trained on OVC health needs. Each HIV positive OVC will be
screened for TB, provided with a self care kit containing an insecticide treated net, water-guard (refilled
regularly) and receive OI prophylaxis. She/he will be linked to GHAIN, GoN and other USG sites for
pediatric ART and treatment for advanced OIs.
To expand the core of the program, caregivers will be recruited from members of extended families to care
for more OVC. COP08 and COP07 caregivers will be provided training and refresher training respectively
on psychological and spiritual support to OVC, pediatric treatment adherence, nutrition issues, diet and food
preparation techniques, communicating with children, and healthy life decision-making. Caregivers will be
linked to USG support sites to access other services for OVC. Seed grants will be given to care givers to set
up IGAs that augment household income, for transportation of OVCs to access services, for support of OVC
staying in schools and vocational facilities. PL will monitor these grants through structured guidelines.
HBC volunteers will also serve as OVC volunteers. Refresher training on OVC services will be provided to
support best performance. Topics will include promoting birth registration, carrying out nutritional
assessments, counseling, monitoring immunization status of infants, and monitoring growth. They will
support supervision of care givers; monitor OVC, assist youth headed households to maintain their homes
and refer OVC for treatment of ailments, immunization, child welfare and wrap around services.
particularly regarding the breadth and depth of OVC coverage. OVC M+E activities will develop sustainable
capacity at IAs and MOs to collect relevant data.
Activity Narrative: POPULATIONS TARGETED:
The primary beneficiaries for the OVC program are children aged 0-17 yrs. who have lost one or both
parents to HIV/AIDS and/or are vulnerable because they are HIV positive; live without adequate adult
support; live outside of family care or are stigmatized, marginalized or discriminated against. Stigma
reduction activities and training will target caregivers, PTA members and HBC service providers.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
The planned OVC interventions will contribute to the overall PEPFAR C&S goal of mitigating consequences
of the epidemic by reaching 3000 OVC with care and support services. PL, working with all stakeholders at
all levels will contribute to the sustainability of interventions by strengthening community systems to improve
quality care for OVC, build community-capacity of 600 caregivers to support OVC by training and providing
PL will strengthen and consolidate linkages with stakeholders, particularly GHAIN, SFH, and GoN, to
provide care and support packages for OVC and establish linkages between HVCT (3.3.09) centers and
care outlets. This will improve utilization of MTCT (3.3.01), HBHC (3.3.06), HVTB (3.3.07), HTXS (3.3.11)
and HLAB (3.3.12) services and enhance community participation in care for OVC and ensure service
quality. PL will refer for wrap around activities - social services, food and livelihood opportunities. Girl-
headed households will be linked with supportive women's groups to provide them with psychosocial
support and protection. Follow-up supportive supervision will be provided. At each site, PL activities will
strengthen linkages to AB and OP prevention activities as integral parts of home-based care for OVC
offered by care givers. Those linkages already established will be strengthened with TB/HIV intervention
programs, PMTCT services, USG-funded immunization projects (COMPASS) and child welfare services.
Successes recorded on gender issues will be consolidated, particularly sensitivity in programming that
targets vulnerable young girls, and address women's rights to income and productive resources. PL will
work with legal aid initiatives to develop legal frameworks that uphold the rights of OVC, particularly
inheritance. Wraparound activities related to food will be another emphasis area.