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: 2008
In COP08, LMS will continue the activities initiated in seven project-supported sites in Kogi and Niger states
during COP07, and will initiate services in an additional ten sites. Using the revised National PMTCT
Guidelines, 9300 women will be tested, 8, 800 will receive their results and up to 410 HIV positive pregnant
women will receive ARV prophylaxis. To achieve this, LMS, in collaboration with UNICEF, will train 220
health care workers (in addition to the 90 trained in COP07) to work in ANC clinics and delivery wards in
PICT and PMTCT.
In Nigeria, PMTCT services were originally available only at tertiary level, but are now being expanded to
secondary level. However, PMTCT services need to be made available at primary care and community
level, to ensure that pregnant women can take advantage of PMTCT services after being diagnosed as HIV
positive. LMS will emphasize and support the provision of PMTCT services at primary care level facilities.
During COP08, LMS will institute and train health care workers in provider initiated counseling and testing
(PICT) to be offered during ANC, and labor and delivery. Point of service, group, and outpatient counseling
and testing with same day results will be offered to clients. All women tested will receive post test
counseling including HIV negative women, to encourage them to remain negative. Peer support
coordinators will provide continuing support after testing and encourage pregnant women to adhere to their
ART prophylaxis and safe infant feeding choices. Peer support groups will be facilitated and trained to offer
these services. Partner and family testing will be encouraged so that PMTCT becomes the entry point for
family centered HIV care, support and treatment (PMTCT plus). CD4 testing will determine those needing
ART for their own health and they will be referred for ART. When feasible, women not needing HAART for
their own health will receive Zidovudine (AZT) from 28 weeks or Combivir from 34 weeks and single dose
Nevirapine (sdNVP) during labor with a seven days combivir tail. If these are not available then sdNVP will
be administered during labor. Women who receive no antenatal care during their pregnancy or who have
had only limited antenatal care but presented to the facility with no record of PMTCT services will receive
C&T during labor and if positive, will receive sdNVP. Infants of positive women will receive NVP syrup at
birth and AZT for six weeks. All HIV-exposed infants will be followed up postnatally and will be provided
cotrimoxazole prophylaxis from age 4 - 6 weeks until their HIV status is confirmed and they are no longer
exposed to HIV if they are not HIV infected.
LMS will participate in the GON scale up of sites for EID and establish linkages with other sites using the
dry blood spot (DBS) strategy in conjunction with other IPs who have PCR lab capability. This will ensure
earlier diagnosis of positive infants and earlier link to care and treatment.
All mothers in project supported areas will be encouraged to exclusively breast feed their infants for six
months as this strategy will reduce mother to child transmission of HIV while not stigmatizing HIV positive
mothers. HIV positive mothers will receive guidance on safer infant feeding although few mothers in project
areas will be able to make an AFASS choice to exclusively replacement feed their infants. Health workers
will be taught that recent research has demonstrated far better outcomes for exclusively breastfed infants of
HIV positive mothers even in more affluent situations (such as Botswana and South Africa) than project
communities in Nigeria. Further, recent evidence again from South Africa has shown that health workers are
not able to guide mothers to make decisions to replacement feed that are AFASS resulting in mothers who
do not have AFASS conditions replacement feeding and increasing mortality from respiratory and diarrheal
diseases amongst their infants. In addition to receiving PMTCT services, each woman will be referred to
OVC services upon her HIV diagnosis in order to facilitate care to all of her affected children.
The project will also seek to employ women living with HIV as peer support coordinators in antenatal care
(ANC) settings providing PMTCT services. The peer support coordinators will facilitate mothers' groups that
provide peer support to pregnant women who are diagnosed as HIV positive to encourage them to accept
PMTCT services, return to the ANC for their ARVs, take the ARVs as prescribed, and adhere to their safer
infant feeding choice in the face of family pressure for mixed feeding of their infants. The peer support
coordinators will also provide positive role models to reduce stigma and act as champions for HIV positive
pregnant women to ensure that they are not discriminated against during their antenatal and maternity care.
These peer support groups will reduce the drop outs from PMTCT and increase the use of both ARVs and
safer infant feeding choices, thus greatly increasing the accessibility of these services to pregnant women.
Because many pregnant women will attend ANC but deliver at a different facility or, more likely, deliver at
home in the community, introducing mechanisms for use of ARVs—particularly Nevirapine—in the
community, if this is possible, will also greatly increase the accessibility of PMTCT. LMS will support a
national zonal training in Infant Feeding Counseling and train some of its facility staff in Infant Feeding
LMS, working with the peer support coordinators and local TBAs, will explore the possibilities for extending
PMTCT services into the community to reduce the numbers of HIV positive women who are lost to follow up
after testing positive in ANC. This might include training and supporting of TBAs and others using a
curriculum adapted to the Nigerian situation, so they practice universal precautions in delivery services;
refer women for HCT and, where appropriate, administer single dose NVP during labor and to the newborns
(assuming availability of single dose packaging and agreement of NASCP and State MoHs).
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
Activities in this area will strengthen the capacity of facility and community based resources to provide ARV
prophylaxis, counseling and support for improved maternal nutrition and safe infant feeding, and additional
HCT and support as included in PMTCT plus activities. They will also contribute to the more general
interest of improving the lives of children and families directly affected by AIDS-related morbidity and/or
LINKS TO OTHER ACTIVITIES:
This activity relates to the HVCT (15645.08), Basic Care and Support (15642.08), ARV drugs (12414.08)
and Prevention Program Areas (9758.08, 10197.08).
POPULATIONS BEING TARGETED
This activity focuses on pregnant women and their families from the communities served by project
supported sites (17 by end of COP08).
This activity addresses gender concerns related to the specific HIV/AIDS-related care and treatment needs
of pregnant women. The activity emphasizes developing the capacity of a wide range of persons (health
personnel, mothers' peer support groups, PLWHA and TBAs) to increase testing, counseling and treatment
and prophylaxis for pregnant women and their infants, to provide them and their families the appropriate
protection and care to reduce the risk of HIV infection or mitigate transmission and negative health effects.
This activity will address the need to counsel and test pregnant women in order to prevent future HIV
infections, to the mother, child or spouse/partner. Male involvement will be encouraged through various
strategies including partners testing together and sensitizing men through fora appropriate to them.
This activity relates to OVC (15644.08) and TB/HIV (15643.08) ARV treatment (15647.08), and Prevention
(15641.08) Program Areas. In COP 08 the LMS project will continue the activities initiated in project-
supported comprehensive care and treatment secondary health care facilities and their feeder primary
health care facilities in Kogi and Niger states during COP07. An additional 10 comprehensive care and
treatment sites [secondary health care facilities] will be selected in COP08. The target for the number of
individuals provided with HIV-related palliative care, including persons affected by AIDS, as well as HIV-
infected individuals is 22,200. The number of HIV+ persons in this group is estimated at 7400. (See ART
Basic Care and Support will focus on four priority aspects of palliative care: (1) medicines (30%):
cotrimoxazole prophylaxis for all HIV positive adults with CD4 counts of less than 350 and others in line with
the national clinical guidelines;, treatment for OIs, malaria, STIS (using syndromic management protocols)
and other AIDS related conditions. (The national guidelines advocate for cotrimoxazole prophylaxis for
primary and secondary prevention,) (2) Laboratory services 20% - including general blood tests (FBC,
ESR, renal and hepatic function tests), CD4 counts and OI diagnosis with tests for STIs, malaria, gastro-
intestinal and urinary infections for HIV positive patients. (3) Community /home-based care (15%) and
training (35%) - which will be implemented through local NGOs, FBOs, CBOs and associations of people
living with HIV, with additional potential for some health facility outreach through the mobile VCT clinics.
The project palliative care advisor and project state staff including the care managers will work with local
organizations to identify their staff and volunteers who will be trained to provide community/home-based
care. Community /home-based care providers and support groups will provide basic nursing care; mental
health and psychosocial care; spiritual care; nutrition and locally raised financial support for families in dire
need; health, hygiene and sanitation education; prevention for positives; and support for treatment
adherence in the home. (4) Human capacity development for palliative care through training, equipping and
supporting a wide range of non-traditional service providers including family members, faith based
congregations and people living with HIV to provide basic care and support services in the community and
Forty (40) clinicians in medical outpatient and inpatient wards will receive training and supportive
supervision in prevention, diagnosis and management of OIs and management of distressing symptoms
including pain, and in recognition of and referral for signs & symptoms of TB. Wider basic care and support
including end of life care, the importance of mental health care, psycho-social and spiritual support, and the
holistic needs of patients and families for economic strengthening, as well as legal protection for property
and inheritance rights will be emphasized in all the trainings for health facility clinical staff as well as for
community/home-based care volunteers. All clinical trainings will conform to the national clinical guidelines
and OGAC guidelines for palliative care and draw on existing materials and training resources in use in
Nigeria. Care coordinators and managers will be trained in holistic patient care and support, and care
managers will work to identify local NGOS, FBOs and CBOs providing care and support services for people
living with HIV and their families, to facilitate referrals of patients and families in need to the relevant
resources in the community, e.g., for legal and financial support.
The project will ensure supplies of medicines for treatment of STIs and prophylaxis and treatment of OIs.
Laboratories at comprehensive care and treatment sites will be strengthened to ensure capacity to diagnose
STIs and other OIs.
In COP08, project staff (including the palliative care advisors, palliative care specialists, care managers and
care coordinators) will identify local NGOs, including CBOs, FBOs and associations of persons living with
HIV that have assets and provide services in the community, and will form a community network of
providers of basic care and support in the community, including home-based end of life care. Project care
managers and care coordinators, with the consent of persons who are diagnosed as HIV positive, will
ensure their clients are referred to the appropriate providers in their local network of community and home-
based providers. Training will be based on the national palliative guidelines—which are currently under
revision—and other existing curricula that government , IP's and others use in Nigeria, and will conform to
NASCP approved harmonized curricula as they are published.
Monitoring and evaluation of basic care and support activities will be accomplished several ways. Data for
monitoring the PEPFAR specific indicators will come from: (1) the LMS internal quarterly reporting system
which collects data on the achievement of outputs and outcomes as defined in the work plan and (2) data
collected at the facility level using the federal MOH standard tools and aggregated by project staff at the
state level on the number of clients served. Special attention will be given to data quality through training of
health facility staff and inclusion of data quality monitoring in all supervisory visits.
LMS partner, Axios Foundation, will ensure that their patient management monitoring software (PMM) is in
place with the necessary resources to support the system.
Activities will contribute 22,200 persons towards the PEPFAR target of 1,350,000 receiving basic care and
support in COP08. LMS will strengthen the capacity of facility and community based resources to provide
on-going basic care and support from diagnosis, management and treatment STIs, OIs and other HIV-
related conditions for HIV positive clients and wider basic care and support for adults living with HIV and
their families and others in the community affected by AIDS. LMS will achieve this through expanded
training of service providers, introduction of training for local NGOS, CBOs, FBOs and associations of
PLHA, and community and family members in holistic care and support, improved diagnostic capabilities,
strengthened, prophylaxis and treatment of opportunistic infections (for PLHA) and implementation of
community/home based care.
This activity links to prevention, TB/HIV, OVC, ARV treatment, and prevention activities. Activities will
improve the care and treatment of people living with and affected by HIV by linking medical, psychosocial,
legal, financial, and spiritual resources at the facility, community and community and home levels.
POPULATIONS BEING TARGETED:
This activity focuses on meeting the needs of HIV positive adults and their families, and communities served
Activity Narrative: by the LMS project; and building the capacities of a wider constituency of providers of community and home
-based care, and support services.
Great emphasis (35%) is placed on training to build the capacities of a wide range of non-traditional health
care service providers including family, friends, faith-based congregations and people living with HIV to
provide community and home-based care (15%). An emphasis will also be placed on local organization
These activities and this program area address the larger issue of not just "quantity" of life (increasing life
expectancy) but "quality" of life for patients and their friends and families. LMS will advocate for more
community involvement of care of PLHA and for the administration of opiate pain relief by nurses as well as
doctors to inform policy for enhanced practice. LMS will also advocate for harmonization of training
curricula for HBC in Nigeria.
This activity relates to the TB/HIV (12369.08), Basic Care and Support (15642.08) and Prevention Program
Areas (15641.08, 5271.08, 10197.08). In COP08, the LMS project will continue the activities initiated in
COP07 project-supported sites in Kogi and Niger states in COP07 and in up to an additional 10 sites
selected in COP08.
In COP08 LMS will build on established TB diagnostic and treatment services and ensure integration of TB
control in HIV service points and integration of HIV services into TB clinics. At service points, LMS will
continue to focus on improved clinical management of TB/HIV, integration of TB/HIV diagnosis and
treatment, TB-HIV co-infection diagnosis and treatment, basic palliative care, diagnosis and management of
OIs as well as end of life care. LMS will ensure that established referral mechanisms are in place to
facilitate TB/HIV collaborative activities.
There will be continuous training and retraining of health staff and supervision of TB/HIV activities at the
medical, pediatric outpatients and inpatient wards and TB and DOTS clinics. This on the job training (OJT)
will include provider initiated counseling and testing (PICT), clinical examination, appropriate laboratory
testing and use of drugs as per the national clinical guidelines for TB/HIV co-infection. Training will be
based on the national clinical guidelines and the Federal MOH TB/HIV training modules. These activities will
provide quality of service that meets national and international standards. LMS will continue to work with the
National TB and Leprosy Control Program (NTBLCP) in the Federal Ministry of Health to strengthen
management information systems at all sites.
In COP08, LMS will forge links with local NGOs, FBOs associations of people living with HIV, and CBOs.
These links will provide opportunities for case finding and screening and adherence to treatment. These
linkages will build and strengthen referral networks.
In COP08, LMS will activate 10 new sites. Activities for the activation of sites include, renovations, staff
trainings, establishment of efficient systems and processes for forecasting, inventory management and
control, establishment of management information systems and monitoring and evaluation to ensure
collection of quality data.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
Activities will strengthen the capacity of health facilities to deliver TB palliative care to HIV-infected
individuals. The number of detection and service entry points will be increased by emphasizing the need to
check for co-infection in patients presenting at TB and/or HIV/AIDS service delivery points.
LINKS TO OTHER ACTIVITIES:
This activity links to other Palliative Care services (Basic Health Care), Counseling, Testing, and provision
of ART. In addition, MSH/LMS through its Capacity Building project will strengthen the leadership and
management skills of health facility managers to assist them in the integration of health facility TB and HIV
POPULATIONS BEING TARGETED:
This activity targets persons presenting at TB clinics or health facilities who are at increased risk for HIV and
TB co-infection. Conversely, HIV infected persons (diagnosed or presumed) are targeted for determination
of possible TB co-infection
This activity emphasizes renovation and human capacity development. In addition, NGO and volunteer
community training and education will increase community awareness and demand for TB/HIV services.
This activity will support improved prevention and clinical/medical care services to address the issue of
under treatment of individuals with TB/HIV co-infection.
This activity relates to LMS's activities under the ART (15646.08) ART services (15647.08), Basic Care and
Support (15642.08) and PMTCT (15641.08) program areas. In COP 08, the Leadership, Management and
Sustainability (LMS) will continue those activities initiated in COP 07 project-supported sites in Kogi and
Niger states and in up to an additional 10 sites selected in COP ‘08.
During COP 08, the LMS Comprehensive AIDS Services (COMPARE) project strategies for OVC will be to
strengthen family coping capacity, mobilize and support community responses and provide essential
services to OVC and their families. Key activities will be identification, enrollment and provision of essential
services to OVC, training for care providers including clinicians and emphasizing the importance of referring
the families of their HIV positive patients both for screening for HIV infection and for community services for
their children. The Health Facility Care Coordinators will play a key role in ensuring all HIV positive patients
and their families are offered available comprehensive care and treatment support services. Support will be
provided in the OVC core areas of health care, psychosocial support, birth registration for under-fives and
education. Food and nutritional support services will include nutritional assessment, counseling and micro-
nutrient supplementation when indicated. Linkages for food supplementation will be fostered with the USG
supported wrap-around initiatives in States where they co-locate with the COMPARE project. Networking
with Clinton Foundation will be explored for provision of ready to use therapeutic food for malnourished HIV
Project care managers and care coordinators, with the consent of persons who are diagnosed as HIV
positive via, PMTCT, ART and HCT activities, will ensure their children are referred to the appropriate
providers of OVC services in their local network. Clients will be offered HIV testing for their children to
ensure any infected children are identified and offered co-trimoxazole prophylaxis, screening and treatment
for OIs and AIDS. Basic care kits for prevention of common opportunistic infections obtained from SFH will
be provided to vulnerable children and their families. Materials used to support programming will include
adaptations of the International HIV/AIDS Alliance OVC Toolkit. Target is to reach 6,400 orphans and
vulnerable children with OVC programs. Monitoring of the well being of these children and data collection
will be conducted utilizing the Child Status Index and the existing GoN tools.
In COP 08, LMS will seek increased community support for OVC by forging links with local NGOs, FBOs,
associations of people living with HIV, and community based organizations. These links will ensure referrals
for psychosocial, support, education for OVC and their families etc. Project staff will identify the local NGOs
that have assets and are providing services in their communities. They will form a community network of
providers of basic care and support in the communities. The project aims to identify at least one
organization for each site, with a total of 17 NGOs, CBOs and FBO in providing OVC activities in COP 08,
and community health workers and volunteers.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
In providing services to 6,400 OVC and building the capacity of 200 care providers the COMPARE Project
will contribute to PEFAR Nigeria meeting it's five-year emergency plan targets of providing care and support
to 400,000 OVC. It will add to the implementation of Nigeria's National Plan on OVC. Activities will
strengthen the capacity of facility and community based resources to provide support aimed at improving
the lives of children and families directly affected by AIDS-related morbidity and/or mortality.
LINKS TO OTHER ACTIVITIES:
This activity links to Prevention, HCT and HTXD, HTXS activities. Activities will improve the health and
education of individuals made vulnerable by HIV/AIDS and create a supportive social environment that will
support prevention activities in this group and in their peers. Linkages with other USG PEPFAR activities
and GFATM activities existing in the same states will be initiated and strengthened. In addition, the LMS
comprehensive AIDS Services project is linked to the LMS capacity project that will continue to develop
leadership and management skills of the National OVC Coordinating unit in the Federal Ministry of
Women's Affairs as well its counterparts in the State Ministries of Women Affairs. This support will also
include strengthening organizational and programs management capacity to efficiently and effectively
address the National OVC response.
POPULATIONS BEING TARGETED:
These activity targets children 0-17 years old in the catchment areas of the secondary and primary facilities
supported by the project as well as OVC as a result of HIV AIDS to receive appropriate health care,
HIV/AIDS information and psychosocial counseling/referral services.
This activity includes an emphasis on local organization capacity development and human capacity
development. LMS, working with Local NGOs and CBO in the communities, will strengthen the care and
coping capacities of families and communities. The primary strategy will be the identification of children
most in need, and filling the gap in the safety net traditionally provided by the extended family. This will be
an efficient, cost effective and sustainable way of caring for orphans and vulnerable children.
This activity will support health staff and local community organizations (NGOs, FBOs) in helping to care for
and re-integrate orphans and vulnerable children, contributing to social stability and improving future
economic well-being. COMPARE will work with state government, local government, NGO, and CSOs in
ensuring that appropriate policies are put in place to protect orphans and other vulnerable children and their
families. These policies must contain clauses to prohibit discrimination in access to medical services,
education, employment, and housing, and protect the inheritance rights of widows and orphans.
This activity links to activities in PMTCT (15641.08), Basic Care and Support (15642.08), TB HIV
(15643.08), OVC (15644.08), and prevention activities of other IPs and the GON.
LMS is presently supporting HCT services (integrated) in 7 secondary health care facilities in 2 states, Kogi
and Niger states, and 2 PHC feeder sites in Kogi state.
In COP 08, the LMS Comprehensive AIDS project will continue to build upon the counseling and testing
activities initiated during COP 07. Counseling and testing services will be further strengthened and
expanded to 10 additional secondary facilities in 3 additional states. These states will be identified in
conjunction with the GON based on assessed needs and the GON'S HCT expansion strategy. HCT
services will also be expanded to 15 PHCs that will serve as feeder sites. These feeder sites will provide
HCT services and provide referral to the secondary sites for treatment, care and support services as
Counseling skills will be strengthened in the existing secondary facilities and feeder sites through
appropriate retraining and short term training focused on enhancing skills. LMS will further provide training
on HCT to 124 new counselors in the 10 new hospitals and 15 feeder sites in the focus states. Training
shall be provided in collaboration with other USG-IPs such as FHI/GHAIN and IHVN-ACTION, who have
many years of experience and proficiency in HCT training. This will also build the capacity and proficiency of
LMS training staff. Trainings focusing on supplies management, HCT QC/EQA, Biomedical safety, and HCT
ethics shall be provided to appropriately selected LMS and point of service staff.
LMS shall support 3 Mobile HCT Team in each state which will be deployed to extend counseling and
testing to remote areas by way of Community Outreach programs, and HCT for most at risk populations,
MARPS, such as commercial sex workers, long distance truck drivers and uniformed services. HCT
services will also be extended to incarcerated populations (prisoners) in the focus states. Clients accessing
the mobile HCT services shall be linked to treatment, care and support programs of LMS and other IPs in
the focus areas based on clients' convenience and ease of access. A referral system that ensures feedback
from the referred facility to the referral site shall be adopted for this purpose, and LMS will provide training in
management systems including referral systems and patient tracking.
LMS will begin to identify and partner with local NGOs and CBOs in the communities surrounding the
seventeen secondary facilities and their feeder sites to enlist them to mobilize and support the general
population to be tested. These NGOs will also play a crucial role in dealing with the stigma of HIV/AIDS,
encouraging HIV positive parents to seek testing and treatment for their children, and supporting persons
living with HIV/AIDS. LMS will also collaborate with private health care providers in the locality to provide
HCT services with LMS support after appropriate training, following national guidelines. HIV testing at all
sites will be conducted using the current national algorithm and a switch will be made to the serial algorithm
once approved. LMS project will provide counseling and testing with result to 46,667 individuals in COP08.
LMS will adopt the Provider Initiated Testing and Counseling (PITC) strategy in all supported health
facilities. This shall be done by providing HCT points of services wherever possible, in the Out Patient
Departments, Emergency units, TB and STI clinics, and other hospital wards. In facilities where this
approach is not feasible, HCT services shall be linked to the various hospital wards and clinics, and patients
shall be routinely offered HIV counseling and testing using the opt-out model. LMS shall provide appropriate
training and orientation to the facility health care workers, and collaborate closely with the hospital
administration to ensure compliance and uptake of services. HCT services shall also be provided routinely
to blood donors as a component of the blood transfusion services in supported sites. This will enable blood
donors to get to know their HIV status and to be linked to treatment, care and support as appropriate, and to
benefit from HIV prevention messaging based on Abstinence, Be faithful and Correct and consistent
condom use (ABC), as appropriate.
In order to increase HCT uptake and help deal with issues of discordance amongst couples, LMS shall offer
couples counseling and testing (CHCT), following standard protocols and guidelines. In order to strengthen
these services, LMS will support its staff to receive CHCT training to be provided by USG as part of its
couples counseling roll - out plan for Nigeria. Appropriate post test counseling will be provided to discordant
couples, with emphasis on prevention for positives. Household HCT services will also be offered to families
to enable family members know their status and depending on the results linked to appropriate of treatment
care and support services. Prevention messaging based on ABC will be provided to families. Pediatric HIV
testing also will be offered following standard guidelines and protocols.
Prevention for positives is a key area of emphasis for the project. The prevention for positives strategy will
include provision of condoms and information on correct and consistent use, especially to MARPs,
discordant couples and prevention of super infection in couples that are concordantly positive.
LMS supported HCT sites will be branded with the national "Heart to Heart" logo for easy recognition as a
center for high quality HCT services. IEC materials focusing on abstinence be faithful, and correct and
consistent use of male and female condoms (ABC), shall be made available in all of these sites. To ensure
appropriate condom messaging, models shall be provided in all HCT sites for the demonstration of correct
condom use and condoms provided through the Society for Family Health shall be made available at all
HCT sites including mobile HCT units.
To ensure uniform and consistent data collection and M&E processing, LMS shall use the national HCT
registers and other M&E tools for data collection at the secondary and primary sites alike. Aggregate site
data shall be summarized and reported to the national M&E program officer and the HCT TWG as required.
LMS will through its dedicated quality control lab staffs provide routine HCT sites monitoring and
appropriate mentoring to site staff. Personnel involved in HIV testing shall undergo a quarterly proficiency
testing, while testing accuracy will be routine re-checked using limited retesting of patient samples. EQA for
HIV serology will be linked to other USG IPs EQA programs until LMS can develop its own program. As part
of quality control measures instituted at all HCT sites, the quality control staff will also ensure that standard
procedures are strictly followed in the safe handling and disposal of medical waste and other lab waste
materials. Training for PEP will also be provided to all staff involved in HCT services.
HIV test kits shall be procured through the USG-SCMS partnership mechanism, while the LMS logistic
partner, AXIOS, shall be responsible for the appropriate warehousing and distribution of the kits to the sites.
T o ensure consistent availability of test kits and supplies at the sites, LMS shall adopt the use of Supplies
Consumption Data Feedback Form from all the sites. This will be used to determine the actual test kits and
reagent consumption and based on this, provide appropriate replenishment.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
Counseling and testing is a vital entry point for HIV positive individuals into treatment and support for
positive living. Widespread HCT activities support and contribute to the success of ARV treatment, TB-HIV,
PMTCT, OVC, and prevention, and strengthen the capacity of facility and community based resources to
provide comprehensive HIV/AIDS services, serving the wider interest of improving the lives of adults,
children and families directly affected by HIV.
LINKS TO OTHER ACTIVITIES:
This activity links to activities in PMTCT (15641.08), Basic Care and Support (15642.08), TB HIV
(15643.08), OVC (15644.08), and prevention activities of other IPs and the GON.
POPULATIONS BEING TARGETED:
This activity focuses on the needs of adults and children from the catchment areas of the project supported
sites (17 by end of COP '08).
This activity focuses on increasing the availability and accessibility of HCT (a crucial entry point to
comprehensives AIDS care and treatment, and prevention) through provider initiated counseling and
testing, increasing static VCT centers, and provision of mobile VCT services. It also addresses gender
concerns related to HIV/AIDS care and treatment by promoting access to diagnosis, care and treatment for
women, particularly pregnant women through PICT in antenatal clinics and delivery wards. This activity
addresses the need to counsel and test to find and treat persons with HIV/AIDS and the need to prevent
future HIV infections.
In COP08 LMS will build upon its achievements and experiences of COP07 to meet its COP08 target on
ART by training 124 persons to provide ARV drugs to 8,200 including 7,150 new PLWHAs during the
reporting period. The cumulative number of PLWHAs that LMS will have supported with ARV drugs by the
end of COP08 will be 10,000. This will be achieved by supporting seven existing ART sites in Kogi and
Niger States and establishing 10 new sites in three other yet to be identified states.
This activity has several components namely: forecasting and procurement, inventory management,
warehousing and quality delivery of antiretroviral (ARV) drugs to people living with HIV/AIDS (PLWHA) for
antiretroviral therapy (ART). It emphasizes the following core project areas: capacity building and systems
strengthening, forecasting for ARVs and opportunistic infections (OIs), procurement, port clearance,
warehousing, and distribution of ARVs and related commodities to facilities under the project. LMS partner
Axios Foundation has developed a functional logistics system to ensure consistent availability of secure and
high quality ARVs and related commodities plus accountability for the deliveries/usage. The process is
guided by USG regulations, National Treatment Guidelines, National Agency for Food and Drug Control
(NAFDAC) registration or waivers with a view towards utilizing generic ARV's once the United States Food
and Drug Administration (FDA) approved.
LMS will ensure uninterrupted availability of ARV to all ART facilities through close relationship with
Government of Nigeria (GON), USAID and other PEPFAR implementing Partners (IPs). This concerted
effort will efficiently promote a sustainable supply of ARVs and other HIV related products to all health
facilities covered by these programs.
To effectively manage ARVs and related commodities, LMS supported facilities will use a paper based
Logistics Management Information System (LMIS). A computerized Inventory Management System with
ability to interface with the Patient Management and Monitoring System (PMM) has also been developed
and will be introduced into supported sites. These systems ensure generation of management reports
required for decision making at facility level and program management level.
Our strategic priorities for COP08 will include: (1) strengthening health facility commodity management
systems to build sustainable logistics management capability for ARV drugs, Drugs for OIs, Rapid Test Kits
(RTKs) and Lab reagents; (2) continued effort to improve the efficiency and effectiveness of mechanisms for
procurement, warehousing, distribution and Logistics MIS; (3) continued rollout of our computerized
Inventory Management System and ensuring a feedback mechanism that will promote analysis and
utilization of collected data for making appropriate policy decisions; (4) integrating the warehousing function
into the MOH system at Federal, State and Local Government wherever applicable; (5) consolidation of
capacity building through, tools development, training, on-site training, supportive supervision and
mentoring; and (6) design and implementation of Supply Chain Management Quality Assurance
The project will be guided by the memorandum of understanding with the FMOH and the States Central
Medical Stores in continuing to build capacity for warehousing and distribution by implementing already-
developed standard operating procedures (SOPs) for warehousing and distribution at the central medical
stores. It will build capacity of the GON, State Central Medical store's counterpart logistics officers and
project staff at the State Central Medical Stores through training and on-the-job mentoring on forecasting
and procurement planning, warehousing and distribution of ARVs and related commodities at the central
and state levels. All commodities procured are stored at the central medical stores from where they are
distributed to facilities via the state program office.
In COP08, the strategy will focus more on the state FMOH owned Central Medical Stores and utilize their
linkages to the ART facilities (State Government owned) to serve the needs of the focus states and build
partnerships with private/not for profit sector by sub-contracting warehousing and distribution services at
state government level. Quality assurance and monitoring of the logistics system is through development of
SOPs at all levels regarding forecasting, procurement, warehousing and distribution, stock management
and reporting. At state level, the state logistics officer will enforce the standards and provide on site support
supervision. The long term plan is to coordinate the distribution and utilization of the drugs from all sources
through a harmonized system.
The project will continue to work to strengthen its exit/sustainability plan for drug logistics management both
at the State and National level showing how it will work with the health facilities implementing
comprehensive ART programs to build their capacity and to customize a specific plan and schedule for
each facility. The plans will include an assessment phase, customized plan for building capacity, and a set
of clear objectives and indicators for measuring capacity as well as a timeline based on key benchmarks.
Effective synergies will be established with the Global Fund to fight AIDS, Tuberculosis and Malaria
(GFATM) round 5 grants to Nigeria. The new sites will be assessed using the site assessment tool and
implementation will be based on the minimum start up requirements of the site. Specific attention will be
paid to ensuring security of drugs as a component of new sites assessment and its implementation or
Commodity availability at facility level is the cornerstone of the strategy to increase access to the drugs and
diagnostics for PLWHA, and to significantly contribute to the achievement of PEPFAR goals of access to
care. The provision of ART services through this program will contribute to strengthening and expanding the
capacity of the Government of Nigeria's response to the HIV/AIDS epidemic, and increasing the prospects
of meeting the Emergency Plan's goal of providing life-saving antiretroviral treatment to 10,000 individuals.
This program will also contribute to strengthening the national drug/commodity logistics management
systems, especially as it relates to ARVs, OIs, Test Kits, lab reagents and consumables among others.
This program element relates to activities in HVCT (3.3.09), MTCT (3.3.01) HTXS (3.3.11) and HBHC
(3.3.06). Links to these programs include covering areas such as logistics/ supply chain management and
management of test kits (CT), ARV drugs (HTXS) for adults and children, drugs for opportunist infections -
OIs (HBHC), prophylactic ARV drugs for pregnant women and infants (PMTCT).
Activity Narrative: The provision of supplies for laboratory diagnostics links directly into the ART program by providing for
monitoring patient progress, toxicity levels and clinical chemistry.
This activity targets all health care workers directly involved in the management of ARV's and diagnostics
for ART services including pharmacists, doctors, nurses, lab scientists, counselors and others.
Emphasis areas for the COP08 ART Drugs component will include strengthening of health facility logistic
systems to sustainably manage ARV drugs, Drugs for OIs, RTKs and lab reagents and quality assurance,
quality improvement and supportive supervision. This will be achieved through the integration of the
project‘s distribution system into the national network and also building capacity at state and site level to
ensure sustainability of the developed supply chain management system. Building upon the Integrated
Inventory Management Systems implemented at the facility levels, the project will continue to provide
regular on site support to sustain usage. Finally LMS will continue to work with GON and implementing
partners to ensure the harmonization and standardization of the LMIS tools & standard operating
procedures in pharmacy.
The establishment of drugs storage facilities in or close to the LMS focus states will ensure that the drugs
are proximal to health facilities and thus will increase access of such drugs and services to the resource
poor communities and increase gender equity in HIV/AIDS programs. By this endeavor, beneficiaries have
closer access to drugs and are able to live healthier lives. Increasing access to drugs also provides a
supportive environment for women's access to income and productive resources given an improved health
In COP08, the LMS Comprehensive AIDS Services project will continue the activities initiated in project-
supported comprehensive AIDS care and treatment sites in Kogi and Niger states during COP07, and 10
comprehensive AIDS care and treatment sites selected in COP08. LMS will provide antiretroviral (ARV)
services including laboratory monitoring to 7150 individuals including 715 children at a total of 17
comprehensive aids care and treatment sites in COP08. It is expected that at the end of COP08, 9,000
individuals will be on treatment and the total ever received ART will be 10,000. To achieve this, an
additional 124 health care workers will be trained in ART service delivery.
MSH will provide training for clinicians including staging of HIV infection, diagnosis of AIDS and monitoring
of ART using modern technology as detailed in the lab section. The trainings will be in accordance with
national ARV clinical guidelines and will emphasize quality of care and client satisfaction as well as how to
support adherence to treatment.
Clients identified as HIV positive at PHC and DOTS feeder sites (in the hub and spoke model) will be
referred for care, diagnosis, staging and treatment as appropriate. The care coordinator in each feeder site
will be responsible for ensuring clients understand the importance of early diagnosis, treatment and care,
and for following up to ensure all patients have received quality diagnosis, care and treatment. The care
coordinators will also ensure referrals, with the client's consent, to local NGOS providing relevant
community services and associations of people living with HIV for peer support. Mobile VCT clinics with a
physician or nurse led outreach team and HCT will increase the accessibility of entry points to ARV
treatment. In COP08, where possible and supported by the state MoH and NASCP, provision of follow up
treatment including refills of ARV prescriptions will be decentralized to PHC sites - and potentially through
the mobile VCT clinics - for patients that are stable on ARV treatment and wanting to receive their
treatment closer to their home.
Pediatric ARV care will be included at all secondary sites. LMS will be part of the national Early Infant
Diagnosis testing scale up, which will increase children identified for care and treatment. An active case
finding for children will be in place with entry points including under-5 clinic and inpatient wards amongst
others and children will make up 10 - 15% of persons on treatment in COP08. LMS will collaborate with the
FMOH/PHCDA to adapt and expand the IMCI curriculum to facilitate high quality pediatric AIDS diagnosis
and care at the PHC level. Primary feeder sites offering PMTCT will be linked to adult and pediatric ARV
care, and referrals facilitated through the facility peer support coordinator and her links to the care
coordinator at the secondary referral facility (the "hub" in the spoke and hub model). The LMS project will
enhance the referral SOP, and champion team approaches and family centered care in all health provider
trainings, and monitor referrals and linkages at sites through regular site visits with the relevant state
MOH/SASCP staff and LGA staff for primary health care facilities.
In PHC facilities with DOTS clinics, TB-HIV services will be strengthened to ensure that all clients receipt
PICT. With state MOH and NASCP agreement, in COP08, PHC staff at selected facilities will receive
additional training to enable them to provide follow up care and refills of ARVs for stable patients referred
back from the secondary health with the goal of improving adherence and retention on ART.
LMS will capitalize upon in-country ARV treatment expertise to ensure high quality of care using an
approach which combines both instructional training and on-the-job training and coaching during
supervisory visits by project state team staff and State MoH personnel. Clinical health workers (physicians,
nurses, community health officers and community health extension workers) and pharmacists at all points of
service will have been trained in adult and pediatric ARV care utilizing existing Federal Ministry of Health
curricula and training manuals. Using NASCP and State MoH staff and others as resource persons, staff
from new COP08 points of service will participate in project facilitated state level trainings on
comprehensive AIDS care and treatment including adult and pediatric ARV care, and adherence support.
All trainings will include approaches to prevention for positives to be integrated into the clinic and
community setting. The project will use WHO IMAI and IMCI modules adapted for use in Nigeria for PHC
and DOTS clinic staff. The project will provide training for health facility pharmacy staff in the management
and dispensing of ARVs including patient guidance, adherence to treatment support and appropriate actions
to take if experiencing side effects.
National ARV Guidelines were updated in 2007 for consistency with WHO 2006 Guidelines and a national
ARV SOP exists. These guidelines and SOP will represent the standards for ARV care at LMS supported
sites. Basic renovations will be supported at the sites to ensure clinic facilities are adequate and particularly
that pharmacy stores and dispensing areas are able to securely store ARVs consistent with manufacturer
guidelines. Training materials will be harmonized and upgraded to ensure that all providers are in touch
with the latest standards. Job aides like dosing guides, pocket cards and SOPs will also be provided for
staff use. Strong PLWHA support groups are a valuable adherence support strategy and LMS will identify
associations of people living with HIV and work with them to provide peer support for ARV treatment.
These associations will be offered IEC materials focusing, inter alia, on adherence and ART education. All
sites will employ treatment coordinators: PLWHAs who will participate in patient education, client advocacy,
and home visits to track defaulters as well as support referrals for facility and community services.
ARVs are procured utilizing Emergency Plan funds with pharmacy commodity management subcontracted
to Axios Foundation. Limited pediatric formulations will be donated by the Clinton Foundation. Some sites
may have limited access to high quality first line adult ARVs provided by the government of Nigeria (GON)
financed by the Global Fund and other sources. When this is the case, LMS provides pharmaceutical
commodity management, ensures access to alternative first line and second line ARVs, pediatric
formulations, and wrap around services including lab monitoring and high quality on going clinical training to
ensure a common high standard across all programs in the network of care. Coordination with the FMOH to
plan site targets will ensure a single comprehensive HIV care program although there may be multiple ARV
sources. Collaboratively with the USG and GON, LMS carries out site program review visits.
LMS will support and use GON/WHO standardized HMIS forms and oversee site data management and
M&E. LMS will be actively involved in the USG Clinical Working Group Meetings and the USG ART
technical working group meetings. LMS will participate with other stakeholders in ART in the GON national
task team meetings and quarterly joint USG/GON supportive supervisory site visits.
Activity Narrative: CONTRIBUTIONS TO OVERALL PROGRAM AREA:
Harmonization of the ARV program around drug sourcing and QI, including decentralization of follow-up
ARV treatment to selected primary health facilities as ARV points of service, and expanding the role of
nurses and health care workers will support the scale up of ARV care which is a high priority for both the
PEPFAR and the GON. As expansion of ARV drug services is decentralized to rural facilities and DOTS
clinics, LMS will strengthen existing referral channels and support network coordinating mechanisms. This
will address a key FMOH and OGAC priority to improve access to care.
LINKS TO OTHER ACTIVITIES:
This activity is linked to activities in Antiretroviral services (15647.08), Counseling and Testing (15645.08),
Condoms and Other Prevention (10197.08), Orphans and Vulnerable Children (3.3.08), Care & Support
(15642.08), TB/HIV (15643.08), PMTCT (15641.08), and Lab (15648.08).
A major challenge to successful implementation of ARV services is to ensure that all persons identified in
need of ARV treatment are routinely linked to comprehensive care and treatment services. Persons who
are identified as HIV positive through HCT are the entry point for their family members to access
comprehensive HIV diagnosis care and treatment services. Thus, all ART patients are offered a care
package as described in the BC&S program area. The enhanced network model, linking to ARV services for
HIV+ women identified through PMTCT, and for HIV-exposed infants are in place, and the project care
coordinators and peer support coordinators will support clients to attend for referral care and ARV
treatment. High quality laboratory services supported by an LMS facilitated laboratory QI program are
available at comprehensive care and treatment facilities with appropriate laboratory investigations or
specimen transport systems to be established for primary health facility laboratories.
POPULATIONS BEING TARGETED:
ARV services are offered, when clinically indicated, to HIV positive infants, children, adolescents and adults
living with HIV. Clinical health workers and pharmacists are targeted for training in both the public and
Emphasis areas include human capacity development and SI. This activity's emphasis is in increasing the
entry points to diagnosis, care and treatment for HIV+ , increasing the demand for the services, supporting
adherence to treatment and putting in place systems (people, equipment, drugs and supplies) to make this
The LMS program currently provides high quality laboratory services in support of HCT, ART, PMTCT,
TB/HIV, OVC and Blood Safety, as part of its comprehensive HIV/AIDS services. LMS is presently in 7
secondary facilities in 2 states: Kogi and Niger. In COP08, LMS will further activate 10 additional
secondary sites in 3 states, bringing the total of LMS supported lab sites to 17 in 5 states. The 3 new states
will be identified in conjunction with the Government of Nigeria (GON), based on needs assessment and
ART scale-up strategy. Each of the secondary sites will be further linked to at least 2 primary feeder sites in
a "hub and spoke" model. The primary sites will serve as HCT centers and referral points (not counted as
To ensure that high quality and reproducible laboratory services are provided using appropriate modern
technology, while guaranteeing safety of staff, patients, communities and the environment, LMS is currently
providing structural renovations, upgrading of infrastructures and provision of essential amenities including
portable water and electricity supply in all of the selected sites. This will also be undertaken in all the 10 new
sites and primary feeder sites in COP08.
In all supported labs HIV diagnosis, CD4 counts, hematology assays, chemistry assays will be routinely
offered using appropriate automated laboratory equipment, and following internationally accepted standards
and national guidelines. LMS will also provide support for VDRL, HBsAg, malaria parasite, pregnancy and
routine microbiology tests for STIs. Opportunistic Infections (OIs), diagnosis will also be offered. This shall
on a minimum include TB microscopy, Cryptococcus serology test and diarrhea and respiratory tract
infections. It is estimated that LMS will provide a minimum of 127,270 tests.
In COP 08, LMS will embark on an integrated expansion of laboratory training, covering HIV diagnosis,
Good Laboratory Practice, Quality Control and Quality Assurance procedures, biomedical safety, laboratory
equipment care and maintenance, specific lab assays, lab ART monitoring, and others based on identified
training needs. These trainings will be provided through collaboration with other USG-IPs such as
FHI/GHAIN and IHVN-ACTION, who currently have training labs and experienced and proficient laboratory
trainers. This collaboration will also build the training capacity of LMS training staff that will be identified.
LMS will also participate in the lab management training to be provided by the USG through APHL.
LMS will provide training at all supported sites for the collection of dried blood spots (DBS) for DNA PCR
testing at tertiary level sites supported by other USG- Implementing Partners (IPs) in support of the national
EID scale up plan. Clinton Foundation will provide supplies for DBS collection and support for
LMS in conformity with LTWG will have 1 Medical Lab Scientist staff person for every 3 labs supported.
LMS employs a full-time laboratory specialist in Abuja and lab coordinators for each state. The
responsibilities of the lab team will include overall capacity building/technical assistance and supervision of
all supported sites, coordination of inventory management system for commodities, QA/QC support and
oversight; promote collaborations and networking opportunities with other IPs under the leadership of GON,
and participating actively in the LTWG programs.
LMS would like to move towards gaining local accreditation through the Medical Laboratory Science Council
of Nigeria (MLSCN), for all its PEPFAR supported laboratories. To this end, 5 of the supported labs will be
accredited in COP08. The project will also continue to work with the PEPFAR Lab Technical Working Group
for the development of a common Lab equipment platform appropriate for laboratory services at different
levels of care.
Quality assurance/quality control of laboratory services will be ensured to support HIV diagnosis, treatment
and care. The essential components of a quality system will be put into place at each site and quality
assurance (QA) will be ensured through quarterly on-site monitoring visits using standardized checklists.
Reports will be generated and fed back to the sites. All non-conformities will be addressed and remedial
action taken to rectify problems in the testing process. LMS will work in collaboration with FHI/GHAIN, IHVN
-ACTION and HAVARD-APIN for External Quality Assurance (EQA), for specific laboratory assays.
Outcome of these QC and EQA programs will also be fed into the LTWG system on a quarterly basis.
The Axios Foundation has set up an efficient supply chain management system that will provide continuous
and uninterrupted supply of rapid test kits, laboratory reagents and consumables. They will be responsible
for forecasting, procurement, warehousing and distribution of the lab materials to all LMS supported sites.
HIV rapid test kits will be procured through SCMS and LMS will be responsible for warehousing and
distribution of these kits.
LMS will work with JSI/MMIS to provide training on injection safety, provision of AD needles and training on
safe handling and disposal of bio-medical wastes in all supported facilities. In this vein, LMS will provide
standard sharp containers at all supported sites. The quality control staff will ensure strict compliance with
national standards of biomedical waste handling and disposal. Clinicians will be trained in offering post
exposure prophylaxis (PEP) in all sites. Laboratory staff will also be trained on steps to follow in case of
accidents that could lead to exposure to HIV infections.
Information management and inventory management systems will be strengthened to support these lab
activities. LMS project will train 90 laboratory managers/staff at all supported sites and will also provide
ongoing on-site capacity building and monitoring. TB microscopy will be carried out at all lab sites at the
secondary health facilities. TB microscopy training will be provided using the CDC/WHO TB microscopy tool
that has been adapted for use in the country.
The provision of Laboratory services through this program will contribute to strengthening and expanding
the capacity of the GON response to the HIV/AIDS epidemic, build the capacity of laboratory staff at the
project sites and contribute to infrastructural upgrade of the health facilities and provision of necessary
equipment. Considering the complexity of antiretroviral therapy (ART) and the strict requirements for
standards and procedures, the laboratory component will aim to establish a well coordinated and efficient
quality assurance, supervision and monitoring system at all supported sites.
Activity Narrative: LINKS TO OTHER ACTIVITIES:
This program element relates to activities in 15645.08, 15641.08, 15647.08, 15642.08, 15643.08 and
15644.08. A referral linkage system will be strengthened to ensure that clients are referred from sites with
limited or no laboratory infrastructure to properly equipped laboratory sites using an integrated tiered
national laboratory network. LMS will work with the GON to implement approved testing algorithms and will
work with the GON and other stakeholders on the use of non-cold chain Rapid Test Kits (RTK) for HIV
testing. With the new scale up strategy for counseling and testing (CT), LMS will build the capacity of
counselors both at the CT and PMTCT sites on the use of non-cold chain dependent algorithm for HIV
testing. The project will also introduce sputum smear microscopy and tuberculosis (TB) treatment in all CT
This activity will provide laboratory services to PLWHAs, (including pregnant women), HIV positive children,
tuberculosis (TB) patients including those that are HIV positive and are eligible for ART, HIV positive infants
and other most at risk populations (MARPS). These clients will be generated from PMTCT, Care and
Treatment, mobile and facility based counseling and testing and TB-HIV programs.
Emphasis will be placed on quality assurance, quality improvement, and supportive supervision, as well as,
laboratory infrastructure upgrade, including commodity procurement (laboratory equipment and reagents)
and local organizational capacity development through trainings and on-site technical assistance and
This is a new activity that is linked to Program Service Delivery Areas through the strategic information
provided for improved oversight, management, and learning from these activities.
During COP 08, the LMS Comprehensive AIDS Services Rapid Expansion (COMPARE) project will
continue to monitor and report on output and achievements of program level results initiated in COP '07
project sites in Kogi and Niger states, as well as new sites in COP08. Program monitoring will allow for
tracking of results; analysis of scale up; improved program management; and feedback to service providers
which will enhance quality of not only data collection, but service provision as well.
Technical assistance provided to sites will be coordinated with other SI programs and aligned with the USG
data quality assessment/improvement (DQA/I) and capacity building plan. Capacity building in this area
will be achieved through a combination of approaches, including workshop training (training content will
include M&E skills building, surveillance topics, and HMIS concepts), on the job training, and facilitative
supervision. Technical Assistance will focus on: self-guided assessment of information systems; use of
existing methods and tools for collecting, analyzing and disseminating data; use of data for service
planning, monitoring and evaluation; and measuring and improving data quality.
The implementing partner (IP) will provide technical assistance to 17 service delivery locations (fixed and
mobile) and M&E training to at least 80 individuals.
Activities will strengthen the capacity of individuals and units (facilities) from project-supported sites to
identify, properly collect, analyze and use HIV/AIDS related data, for reporting as well as program
management and planning.
Strategic information links to the other PEPFAR Program Areas LMS is engaged in, primarily by ensuring
accurate data collection, reporting, and utilization. The current program areas funded in this LMS project
are: PMTCT; Basic Care and Support; HIV/TB; OVC; Voluntary Counseling and Testing; ARV Drugs; ARV
Services; and Lab. Strategic Information activities will serve as a vital link between these areas, ensuring
not only data collection and sharing, but enabling program managers to adapt programs to strengthen
linkages, build support networks, and provide comprehensive and holistic care for clients and their families.
This activity targets health providers, facility managers and other individuals in the community or in
organizations in LMS supported states that are involved in the collection, analysis, reporting and use of
HIV/AIDS related data.
This activity includes an emphasis on capacity development in M&E. It will promote understanding among
service providers and health managers regarding the nature of data they are asked to collect and report on,
as well as the importance and utilization of the information obtained. In addition, this activity contributes to
gender equity in HIV/AIDS programming through data collection. Data on services received, by gender, can
inform program planning and intervention design changes. In line with the USG DQA/I plan, this project will
develop capacity of GoN staff at State, LGA, and facility level.