ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

In COP08, Pro Health International (PHI) provided HCT services at two (2) health facility sites in Plateau

state. HCT was made available in the general outpatient department, TB/DOTS clinics, immunization

clinics, inpatient wards and antenatal clinics. The project used provider initiated counseling and testing

(PITC) to maximize the uptake of HCT services at the healthcare facilities. PHI actively referred all HIV

positive clients to access ARV drugs.

HCT activities for COP09 will lay emphasis on providing services to individuals most in need of HCT and

link positive clients to appropriate care services. The PHI HCT activities will stress: (1) providing technical

assistance, particularly in identifying most at risk persons in need of HCT, and (2) working with sites to

identify potential additional resources (from the GON, other donors, Global Fund, etc.) to provide

commodities and increase uptake of HCT services in all points of service in the facilities. PHI will provide

HIV Counseling and Testing services to 2,500 people who shall receive pre- and post-test counseling,

testing services and their results. The project will take place in one health facility in Plateau state, and will

utilize the provider initiated testing and counseling (PITC) model to maximize uptake of HCT services at the

health care facility. The HCT services will be provided using two (2) facility-based HCT service points and

will be fully integrated with other health services. Point of service testing will be made available in the

general outpatient departments (GOPD), inpatient wards, TB/DOTS clinic, and ANC and immunization

clinics. The overall framework of the program targets the most at risk populations (MARPS) in Plateau

State.

The program shall be integrated into the national framework for HCT by using the national ‘Heart to Heart'

logo. All HCT services carried out shall be in accordance with the national algorithm. Individualized

abstinence, be faithful and correct and consistent use of condoms shall be the main message design for the

counseling sessions as well as the information, education and communication (IEC) materials provided

during those sessions. Positive clients shall be provided with the appropriate prevention messages and

linked to the appropriate support services. Other services that meet the needs of positive clients like HCT

for family members and sex partners, counseling for discordant couples, counseling on positive

lifestyles/disclosure and prevention messages shall be offered. Negative clients shall be counseled using

the ABC approach and where appropriate follow-up tests shall be advocated.

PHI facility based HCT services shall be of the PITC approach. This shall be done with full participation of

the facility authority while making adequate provisions for respect of client/patient right to refusal. A more

intense advocacy will be directed towards high risk individuals who access clinical services at the facility.

HCT services will be provided for all TB suspects/patients. All HCT clients will be screened for TB using

standard questionnaires and referrals made as appropriate for TB diagnosis and treatment based on

scores. Patients attending sexually transmitted infection (STI) clinics will have access to HCT while HCT

clients will be screened for STI using a standard questionnaire and referrals made as appropriate. Patients

who are positive shall be linked to ART services provided by other PEPFAR supported implementing

partners.

10 health care providers (HCT counselors) will be trained to provide HCT services to clients at the facility

using the national HCT curriculum. Training and retraining on HIV testing based on the WHO/CDC HIV

testing training package will be conducted. This training will be provided by appropriately trained Lab

scientist and will be aimed at trained counselors, lab scientists, nurses, community health workers in

supported facilities of Plateau state.

Quality evaluation in counseling will be done using QA tools in counseling such as client exit interview forms

to assess client satisfaction, counselor's reflection forms, supportive supervision of counselors by trained

counselor supervisor, regular monthly meetings by counselors and testers. At the sites, External Quality

Assurance (EQA) activities will be conducted by linking up with a reference laboratory or supporting lab,

while quality control (QC) will be done daily by the counselor/tester.

Test kits will be procured using the USG supply chain management system. Test kits and other

consumables will be stored in the PHI warehouse and distributed to the site based on projected needs using

a proper inventory tracking system by designated staff.

PHI will adopt the use of the National monitoring and evaluation tools to ensure standardized data capturing

and reporting. PHI will collaborate with JSI/MMIS to provide training on medical waste management and

injection safety for all supported staff. Orientation will also be provided on post-exposure prophylaxis (PEP)

following a standard protocol.

Contribution To Overall Program Area

This activity supports the national HCT scale up plan by promoting the accessibility of HCT services using a

Federal Ministry of Health (FMOH) approved training curriculum and procedures. PHI will provide HCT

services to two thousand and five hundred (2,500) clients who will be counseled, tested and receive their

results. HCT services are essential to identify HIV+ people to meet national prevention goals and the

national ARV/HIV care scale up goals. HCT services will target most at risk persons to maximize this

impact. In addition, it also compliments PHI's partnership effort with USAID in providing prevention through

Abstinence and Be faithful messages, Prevention of Mother To Child Transmission, Condoms and Other

Prevention (C&OP), and HIV Counseling and Testing. Furthermore, the PHI free healthcare program which

has recorded much success has an HCT component which still further strengthens PHI's resolve to fight the

spread of the HIV virus.

Link To Other Activities

This program is linked to Abstinence and Be faithful (AB) program area in that persons who are negative will

be linked to AB after testing, based on their age. Also, other organizations carrying out AB messaging will

be encouraged to refer their clients to PHI facility based HCT centers for testing as it has been discovered

that people who have done their counseling and testing are more likely to retain and practice AB messages

than people who have not. Condoms and other prevention is also linked by way of helping people who are

Activity Narrative: negative (but are at high risk of infection) or those who are positive to adopt correct and consistent use of

condoms after testing. On the other hand it can also be a referral point for high risk persons who are being

reached with C&OP messages. Orphans and vulnerable children who are above eighteen or who are

sexually active can voluntarily access the HCT services. Where this is not applicable, their guardians may

give the consent for them. Conversely, this group of children whose parents have been lost due to

HIV/AIDS may be referred using national guidelines for HCT. Patients who are diagnosed with tuberculosis

will be referred for HCT owing to the high prevalence of HIV infection among patients with TB. Partners and

family members of exposed or high risk persons will also be actively sought after to ensure that timely and

adequate intervention to curtail spread is initiated. Referral of positive clients to comprehensive PEPFAR

sites to link them up with ART services will be implemented.

Populations Targeted

The program targets the general population as everyone is at risk in the HIV/AIDS epidemic. The program

shall be gender sensitive and shall also attend to the needs of children when required by providing pediatric

counseling as is stipulated in the national HCT guideline. Special attention shall be accorded to high risk

populations like commercial sex workers, and partners/clients of commercial sex workers. Health workers

and other indigenes of Jos East Local Government Area (LGA) in Plateau state will have their capacity built

to ensure sustainability and eventual transfer of ownership of the program to the community.

Legislative Issues

Owing to the ability of HCT to contribute directly to stigma reduction, PHI intends through this program to

help to reduce the stigmatization and ostracism associated with HIV/AIDS.

Emphasis Areas

In a bid to ensure program sustainability, the areas of emphasis will include developing local human

capacity for the provision of quality HCT services within Plateau state, and targeting commercial sex

workers as key MARPS in Plateau state.

Monitoring and Evaluation

PHI will adopt the use of the National monitoring and evaluation tools to ensure standardized data capturing

and reporting.

New/Continuing Activity: Continuing Activity

Continuing Activity: 22504

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

22504 22504.08 HHS/Centers for PROHEALTH 9693 9693.08 $200,000

Disease Control &

Prevention

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $1,500

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.14:

ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:

Pro-Health International (PHI) is working in 5 program areas across the 2 agencies. The HCT & SI program

areas belong to CDC while Sexual Prevention & PMTCT are for USAID. Currently PHI is working in 3 sites

in Plateau state providing HCT services, 60 AB sites, 66 C&OP sites and 4 PMTCT sites in both Cross

River and Rivers states. In COP09, PHI will continue to provide services in the above mentioned areas.

However, we are scaling down the number of HCT sites in Plateau state from 3 to 1 because of the

decrease in funding.

SI activities established in COP08 will be strengthened in COP09. As in COP08, the focus of PHI will be on

the capacity building in the 3 states and the enhancement of the capacity of local organizations to collect,

analyze, disseminate and use HIV/AIDS-related data.

In COP09, PHI will strengthen the capacity of 5 local organizations by providing technical assistance. These

will include 2 organizations in Plateau State (YARAC & PLANET), 2 in Cross River (TBD) and 1

organization in Rivers state (TBD). To achieve this, Pro Health International will collaborate with M&E

personnel of Plateau, Cross River and Rivers State Action Committees on AIDS to identify the SI needs of

these organizations such as developing or improving M&E models or systems; developing or improving

program monitoring; improving program efficiency and effectiveness by monitoring and disseminating best

practices; and/or improving data quality. PHI will facilitate M/E meetings with the State AIDS Control

Agencies and the local organizations by providing transportation, venue, and materials needed for the

meetings. A total of five organizations and seven individuals will be trained.

Trainings will be provided to 7 local facility based and PHI personnel in Plateau (3), Cross River (2) and

Rivers states (2) on program level reporting, Health Management Information Systems (HMIS), and quality

assurance. These activities will be aligned with the USG data quality assessment/improvement (DQA/I) and

capacity building strategy. These personnel will be trained on the proper use of nationally approved data

collection tools to ensure compliance with one M&E framework. Furthermore, PHI will strengthen the

strategic information framework at the state level by advocating for stronger implementation of the ‘3 ones'

and participating in routine state level meetings with other partners operating in the states.

Data collection will be done on site regularly and will be collated monthly. To ensure that the quality of data

is maintained, quality assurance and continuous quality improvement through periodic site visits and

assessments of the programs will be carried out along with the States M&E officers. Data collected will be

reported on monthly, semi-annual and annual bases according to CDC and GON requirements. Logistics

and Health Program Management Information Platforms (LHPMIP) will be used to capture and transmit the

data in all program areas.

Contribution To Overall Program Area

The strategic information framework of this program, will contribute to the improvement of the quality and

credibility of data reported on HCT, AB, C & OP, and PMTCT activities. Building the capacity of local

organizations and individuals will enhance the establishment and sustainability of quality HIV/AIDS program

delivery and uptake in Nigeria. Through SI, PHI will also enhance the USG/GON strategy by providing

qualitative and timely information needed for decision making.

Link To Other Activities

Using the SI fund, PHI will provide smooth referral systems for its clients to access other services that are

not provided by its programs.

Populations Targeted

The program targets PHI HIV/AIDS service delivery personnel, local organizations and state level M&E

officers in Plateau, Cross River and Rivers states to ensure sustainability and eventual transfer of

ownership to the state governments.

Legislative Issues

This program will help decision makers including the program managers, facility management, communities,

SACA and MOH to carry out effective and relevant policies and strategic decisions that will help to improve

the coverage, sustainability and effectiveness of HIV/AIDS programs.

Emphasis Areas

The areas of emphasis will include total data quality management and human capacity development.

New/Continuing Activity: Continuing Activity

Continuing Activity: 22505

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

22505 22505.08 HHS/Centers for PROHEALTH 9693 9693.08 $10,000

Disease Control &

Prevention

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $2,500

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.17: