Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015

Details for Mechanism ID: 9978
Country/Region: Rwanda
Year: 2010
Main Partner: FHI 360
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $2,795,265

The Roads to a Healthy Future (ROADS II) Project-a five-year Leader with Associate award managed by FHI-extends HIV prevention, care, and support services to most-at-risk population (MARPs) in underserved, often remote communities. The project targets high-risk groups: drivers and their assistants and community with whom they interact such as sex workers, in street youth, members of the uniformed services and stop-over site communities that includes in and out of school youth, low income women, fishermen and fish sellers, motorcyclists, PLWHA, OVC and other community members living in those hot spot areas. ROADS II currently works in four Rwanda corridor communities: Kigali City, Gatuna (Uganda border); Rusizi (DRC border); and Bugarama (intersection of DRC, Rwanda, and Burundi). The project plans to add up to two sites, including Gisenyi. There are plans to extend activities implementation to Rusumo site bordering with Tanzania border. The focus will be to target the areas where the new HIV infections are mostly occurring

The overall goal of ROADS II is to stem HIV transmission and mitigate its impact among the most-at-risk populations while leaving communities stronger in their ability to address HIV. ROADS II also improves and extends FP and MCH services in target sites. To support these goals, ROADS II has the following primary objectives: (1) Develop and implement effective programs that increase services in prevention, care and treatment for HIV/AIDS, malaria, FP/RH and child survival. Services will be delivered to individuals who live/work along the transport corridors that link Rwanda to other countries in the region, as well as those residents in border towns, areas generally without access to high quality services and (2) Increase the capacity of local Rwandan organizations to respond to the health issues affecting their communities, with approaches that are innovative and appropriate and solutions that are locally relevant and sustainable.

ROADS II activities include community-based alcohol counseling, interventions to address SGBV, and job creation as an HIV prevention and care strategy, particularly focusing on MARPs. Building on work initiated under FY 2009, ROADS II will continue to strengthen skills in reduction of risk behavior, increasing quality treatment of STI through STI screening and treatment among MARPs. Furthermore the project will continue to support people infected and affected by HIV/AIDS by improving economic opportunities and social protection, promoting nutrition and food security by increasing vegetable farming through kitchen gardens and ensuring social protection for orphans and vulnerable children. ROADS II will expand interventions to more MARPs groups in Kigali beyond the transport corridor including street youth. ROADS II will also continue to market the SafeTStop concept, which uses consistent but adapted strategies, branding and materials across countries to reach MARPs as they move from country to country, to signal availability of quality services, including those provided through private drug shops and pharmacies.

The LifeWorks Partnership, an innovative strategy that was developed under the first ROADS project's

award, is contributing significantly to the increase of income for vulnerable groups. It is designed to provide small business services to local community associations and cooperatives. LifeWorks works with the private sector to create and provide opportunity for small community groups to have access to income generating activities and markets for their products. ROADS II supports the Government of Rwanda's (GOR) National HIV/AIDS plan and, through successful program implementation, intends to significantly contribute to halving the incidence of HIV by 2010, reducing morbidity and mortality among people living, and ensuring equal opportunities to those infected or affected by HIV, while also supporting the GOR's efforts to scale-up FP/RP and maternal child health (MCH) services.

Under this Associate award, ROADS II contributes to health systems strengthening. ROADS II has strengthened capacity of more than 300 community groups to manage HIV programming. This included training in process indicator reporting, data analysis, monitoring and evaluation, as well as financial management. ROADS will continue to provide TA in capacity development for association management, sub-agreements and community mobilization.

ROADS II M&E framework includes qualitative and quantitative data collection by volunteers, validated at the cluster level -Implementing agency, and validated at the second level by the ROADS II site coordinators in collaboration with PLWHA volunteers, cluster steering committees members, cluster coordinators and clinical care sites. ROADS II will collect relevant quantitative data using its reporting structure and integrate it into its existing database. Through case studies and success stories, the project will document person-level impact. ROADS II will also conduct focus groups with beneficiaries, different volunteers of the program and community leaders to assess the quality and impact of the support provided. Formative supervisory visits will be provided to local implementing partners as part of the routine monitoring and review mechanism. Best practices and lessons learned will be monitored and shared with other partners for possibility of bringing them to scale. The data will be used for local planning, budgeting, management, and decision-making.

Funding for Care: Adult Care and Support (HBHC): $247,500

During FY 2009, ROADS II's CBO partners continued to expand and strengthen care and support activities along the transport corridor, working at Gatuna (Rwanda /Uganda border), Kigali, Gisenyi, Rusizi, and Bugarama (Rwanda/DRC/Burundi border). With support from FHI/ROADS II, local partners provided community care and support to 2,610 PLWHA at 14 facilities, achieving 131% of the year targets. This work improved the quality of life for PLWHA by mitigating the health and socio economic effects of HIV/AIDS at individual and household level. Through home visits, 157 trained volunteers carried out activities including: provision of psychosocial support to PLWHA; formal and informal education on HIV prevention; adherence counseling; nutrition counseling and education on the importance of a balanced diet; life skills development; increased access to prevention and treatment of opportunistic infections; and referrals to home-based care services and health facilities. To respond to food insecurity among vulnerable PLWHA, FHI/ROADS II worked with a local agronomist identified at the sector level to improve agriculture technology. At the end of the reporting period, 1,587 PLWHA families

had established kitchen gardens to improve vegetable production and 6,982 PLWHA family members are benefiting from this support. PLWHA clusters have mobilized communities to support the most vulnerable PLWHA and as a result, 425 PLWHA have received direct nutrition and other support, including items such as clothes, sugar, food and sosoma (flour, soya, wheat, maize and sugar). The project uses a family-centered approach to care, sensitizing and referring family members for counseling and testing, and other needed services.

In FY 2010, FHI/ROADS II will provide 7,500 eligible adults and children with at least one care service at one of its five sites. During FY 2010, ROADS II will strengthen its LifeWorks program, under the rationale that economic strengthening, coupled with appropriate HIV/AIDS education can enable people to make positive decisions regarding their own HIV-behaviors. When appropriate, LifeWorks interventions will also aim to promote community volunteerism.

In FY 2010 FHI/ ROADS II will continue to apply the "Safe T Stop model" at its five current sites and expand the program to Rusumo as well. Through partners, ROADS II will train additional volunteers in basic palliative care, including counseling on hygiene and ART adherence, as well the provision of referrals for clinical services, various forms of support (psychosocial, spiritual, and social), and preventive services including reproductive health services and family planning. ROADS II will offer technical support to volunteers, providing them with condoms, safe water tablets (Sûr'Eau), safe water vessels, and mosquito nets to be distributed to the families of PLWHA. The project will also continue to support economic empowerment through household vegetables gardens and the LifeWorks program, which will enhance self -sufficiency clients and caregivers. In addition, the project will continue to help PLWHAS access health services by paying health insurance premiums for the most vulnerable individuals.

The implementation of activities will fit into the overall ROADS II M&E framework. Qualitative and quantitative data will be collected by the volunteers, validated at the cluster level and validated in collaboration with PLWHAs volunteers, cluster steering committees members, cluster coordinators and clinical care sites. ROADS II will collect relevant quantitative data using its reporting structure and integrate it into its existing database. Through case studies and success stories, the project will document person-level impact. ROADS II will also conduct focus groups with beneficiaries, PLWHAs volunteers and community leaders to assess the quality and impact of the support provided. Formative supervisory visits will be provided to local implementing partners as part of the routine monitoring and review mechanism. Best practices and lessons learned will be monitored and shared with other partners to determine the feasibility of scale-up. A data collection and analysis system will establish to measure and follow progress and results. Baseline data will be collected in FY 2010 and compared with annually- collected data subsequently. The monitoring and evaluation system will track several risky behaviors, including multiple partnering, use of condoms, incidence of sexually transmitted infections, as well as a

number of health-seeking behaviors. Results will be compared against economic process indicators to test the hypothesis that a positive change in household income, if set within wider HIV programming, can contribute to securing the basic needs for PLWHA and lead to positive behavior change.

In line with the Partnership Framework objectives, FHI is building the capacity of local organizations in program management, skills acquisition, quality improvement and M&E to ensure sustainability.

Funding for Care: Orphans and Vulnerable Children (HKID): $316,800

In FY 2009, FHI/ROADS II partners provided technical support to local community-based partners and ensured that services and support for OVC was strengthened at four sites: Kigali city; Gatuna (Uganda border); Rusizi (DRC border on Bukavu side); Bugarama (intersection of DRC, Rwanda and Burundi). Key activities carried out by the caregivers through home visits included: efforts to improve health care, food and nutrition support;, education of tutors on the importance of balanced diets; psychosocial support; education on HIV prevention; and child protection through children rights education. As of the end of September 2009, a total of 1,703 OVC were served by the local community members. Among them, 1,067 OVC were visited by caregivers to complete the child status index (CSI) developed by the Ministry of Gender and Family Promotion (MIGEPROF). A total of 961 OVC received direct assistance, which included educational support (i.e. school fees payment and material provision), enrollment and payment into the government insurance program, psychosocial support through holiday events, and home visits by OVC care givers. The quality of OVC services offered by the program was assessed using the CSI.

In FY 2010, FHI/ROADS II plans to extend activities in Gisenyi (it's fifth site) and continue to support activities initiated in previous fiscal years. Through community cluster networks, ROADS II will provide 4,000 OVC with at least three services and continue to strengthen the capacity of households and local community groups to ensure program effectiveness. Services will be linked closely through a strong referral network including health facilities, CBOs, FBOs, and local NGOs to meet the daily needs of OVC. This referral network is a key strategy for transition. To address the longer-term needs of orphan-headed households, ROADS' lifework partnership will conduct a baseline assessment to identify new economic opportunities, conduct job training for job creation, and develop other economic opportunities for OVC families and care givers. The kitchen gardening for vegetables and rabbit-farming activities initiated under previous fiscal years to ensure food security and alleviate financial instability will be reinforced. The platform for delivering services will continue to be the cluster model, which brings together community based partners in a coordinated response, with joint capacity building to care for vulnerable children. In

FY 2010, FHI/ROADS II will collaborate with the local authorities to reinforce the committee for OVC at sector and cell levels. This will help local authorities ensure sustainability.

Monitoring and Evaluation: The activities of this project fit into the overall ROADS II M&E framework. Qualitative and quantitative data will be collected by the volunteers, validated at the cluster level (implementing agency) and validated at the secondary level by the ROADSII site coordinators in collaboration with OVC caregivers, cluster steering committee members and cluster coordinators. ROADS II will collect relevant quantitative data using its reporting structure and integrate it into its existing database. Through case studies and success stories, the project will document person-level results as well as impact achievements. ROADS II will also conduct focus groups discussions with beneficiaries, OVC caregivers and community leaders to assess the quality and impact of the support provided. The child status index (CSI) initiated during FY 2009 will continue to be used to evaluate the program vis-à-vis OVC needs. Formative supervisory visits will be provided to local implementing partners as part of the routine monitoring and review mechanism. Best practices and lessons learned will be monitored and shared with other partners for possibility of bringing them to scale. The data will be used for local planning, budgeting, management and decision making.

In FY 2010, ROADS II will build the capacity of the Sector Social Affairs Officers in OVC data management and OVC care and support, as well as encouraging them to establish the OVC committee to take care all OVC matters. ROADS II will also strengthen its Lifeworks component, under the rationale that economic strengthening, coupled with appropriate HIV/AIDS education can enable people to make meaningful decisions regarding their own HIV-behaviors as well as to respond to the basic needs. Where appropriate, Lifeworks interventions will also aim at sustaining community volunteerism.

Funding for Testing: HIV Testing and Counseling (HVCT): $346,500

From July 2007 to September 2009, ROADS II worked with the existing health facilities to introduce an innovative strategy to identify those who are most at risk for HIV and have less access to existing HCT services. HCT services have been either integrated in the established recreational centers or outreach strategy from the fixed HCT service was used. At the end of September, ROADSA II supported five HCT outlets to provide counseling and testing services to targeted high risk groups in five sites. The community mobilization and sensitization through cluster model generated significant interest and demand for HCT at upgraded facilities. In total, the five HCT outlets served 29,315 people who were counseled, tested and received test results. In general, the HIV prevalence was high among people tested especially among those self-identified as at risk (15%): sex workers and truckers. The results

show outreach HCT in high risk environments is a key strategy to reach men (10,824 female verses 14,740 male). All tested HIV positive were referred to clinical services for care and support. FHI/ROADS II ensured quality assurance by applying the national guidelines. In addition, all HCT providers have been trained based on the national standards and requirements. Regular supervisions have been done by the district hospital supervisors and all qualified staff from the health facilities support by FHI technical staff.

During FY 2010, ROADS II will continue to extend HCT services and will integrate services in the newly established recreational centers. The strategy for offering HCT at later hours will continue. One of the new strategies will be home-based HCT once TRAC Plus begins implementation of finger-prick testing. Testing all family members will be the entry point to referring for the full menu of health services, including child survival, FP/RH, malaria prevention and treatment, PMTCT, TB and pediatric care and treatment. The second strategy will be to focus on high risk groups/zones identified by the community by using the checklist criteria that will be developed for that purpose. Building on the new strategy of identifying and managing STI patients that ROADSII will set up during FY 2010, all STI patients will be identified and counseled for HIV testing. All of those new strategies will be developed with direct beneficiaries to minimize or reduce stigma. These new strategies will be developed in close collaboration with TRAC Plus and local health facilities to insure sustainability. In total, ROADS II plans to reach 15,000 individuals with HCT services in 7 HCT service outlets.

Activities will be implemented in the sites of Kigali city, Gatuna, Rusizi, Bugarama, and Gisenyi. ROADS II will facilitate on-going monitoring of HCT service delivery. Monitoring and supervision of the HCT sites will help understand client profile, target high risk groups, ensure uniform high quality, obtain on-going feedback for program staff, and track progress towards increased service provision. In addition, data analysis of monthly reports will help to measure progress towards achieving objectives. Regular M & E will include the following activities: 1. Client Profile- A client intake form and a register will gather key information about HCT clients, and will be analyzed each month to obtain regular information about the profiles of clients accessing services. In addition, ROADS II will also use a register to note all clients. A client exit form will be used in each mobile HCT unit with results analyzed on a semi-annual basis to assess client satisfaction. Each client will be asked to fill the exit form, but it will be voluntary. Information will be examined every six months; for quality control reasons, 10% of all lab samples from clients will be sent to the National Reference Laboratory for verification.; 2. Quality Assurance-Quality of services is important to client utilization of HCT, it will be essential to assess the quality of the services being offered at outreach HCT sites.

In order to ensure a high quality of services, a technical staff from the health facility will supervise and conduct a weekly visit and feedback meeting with the HCT counselors. In addition, technical staff from

FHI Country office and the district hospital will visit the outreach HCT sites once a quarter to ensure that each site is adhering to standardized protocols and procedures, harmonized quality standards and to receive feedback from local partners. A supervision guide for HCT sites will be used for this purpose. Feedback will be provided to program staff on how to improve quality of service delivery. All HCT sites will report monthly on quantitative data for HCT; FHI will report to the Mission both quantitative data and narrative on activities undertaken during the reporting period; semi-annual reports will evaluate achievements against PEPFAR targets (i.e. progress indicators). The regular analysis of client intake forms, quality assurance activities, and site supervision visits will ensure a high quality of services and on-going improvement counseling to meet the specific needs of the clients. The data gathered will be analyzed at the end of the project to evaluate the overall impact in terms of increased access and HCT client-uptake, high risk targeting, and quality of services.

Funding for Health Systems Strengthening (OHSS): $198,000

At the end of FY 2009, FHI/ROADS II provided technical assistance to 338 community based organization through 13 established community clusters. To build the capacity of those clusters, FHI hired technical staff such as program coordinators and accounts for the clusters. Each cluster has now established steering committees to better coordinate the implementation of activities. FHI provided technical assistance to each team in financial and human resources management, governance, record keepings, conflicts resolution, procurement and inventory. Clinical based partners who are providing HCT, STI care and treatment were also strengthened in the same areas, with extra attention paid to quality assurance. Health service providers were hired through direct sub-agreements to support service delivery when applicable.

In total, FHI/ROADS II supported 47 training sessions during the fiscal year 2009 in which 1,483 individuals participated, including 746 cluster members, peer educators and PLHAs caregivers. These training addressed community mobilization for HIV prevention, as well as care and treatment issues. A total of 315 OVC caregivers and 47 primary school teachers were also trained. Furthermore, 24 religious leaders were trained in SGBV and family planning, and 19 cluster members were trained as trainers in Magnet Theater. Finally, 71 low income women were trained as trainers in mushroom farming as a strategy for income generation.

To ensure sustainability and transition, the following mechanisms have been put in place: establishment of community clusters; continuous involvement in programming and implementation; partnership with the local authorities; provision of technical support to clusters to hire qualified staff; training of technical staff

and steering committee members in governance; monitoring and evaluation; and financial and human resources management.

Despite these efforts, implementing agencies still face major challenges, particularly in program and financial management, monitoring and evaluation and data utilization. In addition, there is a need to build the capacities of the new partners who will implement the new strategy of providing comprehensive HIV intervention to MARPs.

During the FY 2010, activities supported by FHI/ROADS II will be designed to continue and strengthen on-going effort and to respond to the new needs. FHI/ROADS II will continue to apply the cluster model which permits extensive stakeholder participation in identifying priorities and delivering a locally-relevant set of responses. The stakeholders' participation to the decision making, planning and execution of activities ensures an appropriate response to local needs and leads to program sustainability.

FHI/ROADS II will continue to provide technical support to implementing partners building their capacity to institute and manage HIV prevention and care activities in their communities. ROADS II is instrumental in providing technical guidance around HIV in the transport sector, and will work closely with TRAC Plus and other GOR institutions to incorporate alcohol and GBV issues into HIV programming for MARPs.

FHI/ROADS II has established strong linkages with local authorities, which contributed significantly to achievements thus far. For example, local authorities took a lead in the establishment of recreational centers, providing the land and contributing to the support of cooperatives in strengthening the Lifeworks initiative. In most of the trainings supported by FHI/ROADS II, implementing partners are using the sectors' facilities free of charge. In addition, some supported anchor leaders are serving on district or sector recreational center advisory councils.

During the FY 2010, FHI/ROADS will continue to work closely with local authorities and partners, in addition to collaborating with other donors. To ensure the sustainability of outreach HCT activities, FHI/ROADS II will continue to support existing health facilities in close collaboration with district hospitals.

Training remains the cornerstone of ROADS II. In FY 2010 at least 1,400 individuals will be provided with technical assistance for various HIV-related activities, and more than 360 organizations will receive institutional support for community mobilization, care, and treatment efforts. To improve the services provided to street youth, particularly those who are HIV positive, ROADS II will strengthen the capacity of local organizations improve outreach efforts through direct sub-agreements.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $770,715

FHI/ROADS II, addresses HIV prevention, care and treatment activities reaching most-at-risk populations located and moving along the transport corridors in Rwanda (i.e., Kigali City, Gatuna, Rusizi, and Bugarama). The targeted high-risk populations include drivers and their assistants, commercial sex workers (CSW), members of the uniformed services and stop-over site communities that includes in- and out-of-school youth, low income women, fishermen and fish sellers, PLWHAs, OVC and other community members. These populations are targeted with regionally coordinated SafeTStop information and services. SafeTStops provide products, information and support for the prevention, care and treatment of HIV/AIDS in these communities.

During FY 2009, interventions to promote HIV/AIDS prevention through behavior change communication (BCC) was a major component of FHI/ROADS II approach to address key drivers of the epidemic. The behavior change interventions included peer education through small groups discussions, one-to-one contact, IEC/BCC material distribution, as well as other health promotion activities. These combined strategies reached 84,582 individuals with AB messages, which represent 100% of the annual target. Similar activities, in addition to scaled-up ones, will continue in FY 2010.

In FY 2010, ROADS II will continue to support and strengthen activities in six sites (one site in Gisenyi will be added) through the community clusters of low income women, youth, truckers, fishermen, motorcyclists, PLWHA, and OVC, to implement integrated HIV prevention services as well as address some of the underlying factors that exacerbate risk. AB activities will focus on vulnerable youth (between 12 and 18 years old) living in high-risk zones who may be prone to earlier sexual debut, low-income women, and other community members living around the truck stop areas. The combined messages that promote abstinence and faithfulness will be carried out among low-income women and community members over 18 years of age and to youth who are sexually active. Activities will include addressing key risk factors in hot spots along the ROADS Rwanda sites, where mobility, poverty and inadequate and insufficient health services exacerbate the risk for HIV-infection. HVAB activities will be integrated and linked to counseling and testing; reduced alcohol consumption; reducing gender based violence; and improved HIV outcomes through referrals. Dialogue among couples will be promoted through family day strategies and community magnet theater performances. Through these different strategies, FHI/ROADS II partners expect to reach 55,000 individuals.

To ensure quality supportive supervision, FHI/ROADS II will conduct regular formative supervision. Other mechanisms to support quality assurance include site assessments and programming (when indicated), trainings and refresher courses for all community volunteers, regular monthly meetings for

community volunteers and cluster coordination, quarterly coordination meetings for all clusters involved in activities implementation, local leaders, facilities and national umbrella organizations (e.g., Youth, RRP+, Women), FHI/ROADS II partners will continue to receive feedback on system weaknesses that have been identified for improvement.

To ensure sustainability and transition, FHI/ROADS II has developed the community clusters, who are involved in all steps of programming and implementation, partnership with the local authorities in all steps, providing technical support to clusters to hire qualified staff, training technical staff and steering committee members in governance, monitoring and evaluation, financial, and human resources management.

Implementation of activities will fit into the overall ROADS II M&E framework. Qualitative and quantitative (service statistic) data will be collected by the volunteers, validated at the cluster level by implementing agencies and validated at the second level by the ROADS II site coordinators in collaboration with peer educators, cluster steering committee members and cluster coordinators. FHI/ROADS II will collect relevant quantitative data using its reporting structure and integrate it into its existing database. FHI/ROADS II will regularly collect information and success stories to be shared with others partners. If applicable, FHI/ROADS II will collaborate with TRAC Plus to make sure the covered sites and target groups are included in the behavioral surveillance survey (BSS) to document person-level results as well as impact achievements. FHI/ROADS II will also collect qualitative information with beneficiaries, peer educators and community leaders to assess the quality and impact of the HIV activities implemented. Formative supervisory visits will be provided, to local implementing partners, as part of the routine monitoring and review mechanism. Best practices and lessons learned will be monitored and shared with other partners.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $915,750

FHI/ROADS II extends HIV prevention, care and support services to MARPs in underserved zones, often-remote communities. Activities are currently implemented in four Rwanda corridor communities: Kigali City; Gatuna (Uganda border); Rusizi (DRC border); and Bugarama (intersection of DRC, Rwanda and Burundi) with planned expansion to a Gisenyi site (DRC border) during FY 2010. The targeted high- risk populations include drivers and their assistants, commercial sex workers (CSW), members of the uniformed services and stop-over site communities that includes in- and out-of-school youth, low income women, fishermen and fish sellers, motorcyclists, mechanics located at Gatsata, PLWHAs, older OVC and other community members. These populations are targeted with regionally coordinated SafeTStop

information and services. SafeTStops provide products, information and support for the prevention, care and treatment of HIV/AIDS in these communities. ROADS II activities include messages that promote behavior change, increase access to condoms, and counseling and testing services. ROADS II also facilitates prevention for positives intervention by working with PLWHA association and focusing intervention on households.

Through direct sub-agreements, ROADS II uses different mechanisms to ensure quality of services, achievement of outcomes and impact. These include: initial training and refresher courses for all cluster members, hiring technical staff for each implementing agency, organization of regular monthly meetings for community volunteers and cluster coordination bodies, implementing quarterly coordination meetings between cluster members, local leaders, referral to facilities and national umbrella organizations (e.g., Youth, RRP+, Women), and formative supervision from ROADS II and districts technical staff. ROADS II trained all program coordinators and community volunteers from implementing agencies in data quality assurance.

In FY 2010, ROADS II will continue to support and strengthen activities implementation in sites through the community clusters to reach MARPs and other individuals interacting with the MARPs and will continue to work with strategic partners. ROADS II collaborates with more than 360 local community clusters. Activities will include addressing key risk factors in hot spots along the ROADS II sites, where mobility, poverty and inadequate and insufficient health services exacerbate the risk for HIV infection.

ROADS II will reinforce and expand the HIV intervention that targets street youth especially in Kigali City as a new high-risk group. ROADS II will conduct a baseline assessment in Kigali City to understand the life, the risk vulnerability and the needs of street youth. This baseline assessment will also provide information on different organizations that support street youth in Kigali. Through its sub-agreement mechanism, ROADS II will identify local partners to be supported to provide a comprehensive intervention for street youth and to prepare the transition process.

Those combined strategies will reach 244,000 people with individual and/or small groups level evidence- based interventions. This will include 67,000 MARPs composed of sex workers, truck drivers, in street youth, PLWHIV, mechanics, motorcyclists and low income women, that will be reached with a minimum package of compressive intervention that include trainings for new peer educators, to promote prevention messages, consistent and proper use of condoms , reduction of alcohol consumption, reduction of the violence and provide vocational training. ROADS II will continue to coordinate and link high-risk groups to other relevant health services. ROADS II will continue to strengthen these services through SafeTStop model that mobilizes the community around HIV prevention, care, treatment and impact mitigation.

For M & E, qualitative and quantitative data will be collected by the volunteers, validated at the cluster level by implementing agencies and validated at the second level by the ROADS II site coordinators in collaboration with peer educators, cluster steering committee members and cluster coordinators. ROADS II will collect relevant quantitative data using its reporting structure and integrate it into its existing database. ROADS II will regularly collect information and success stories to be shared with others partners. ROADS II will ensure covered sites and target groups are included in the behavioral surveillance survey (BSS) to document individual-level results as well as affect achievements. ROADS II will also collect qualitative information with beneficiaries, peer educators and community leaders to assess the quality and impact of the HIV activities implemented. Formative supervisory visits will be provided to local implementing partners as part of the routine monitoring and review mechanism. Best practices and lessons learned will be monitored and shared with other partners for possibility of bringing them to scale. The data will be used for local planning, budgeting, management and decision-making.

Subpartners Total: $0
Abishizehamwe: Bugarama: NA
ADESPCR: NA
Rwanda Network of People Living with HIV And AIDS: NA
Association de l'Esperance des Taxis Moto au Rwana: NA
Byumba Diocese: NA
Bugarama Low Income HIV AIDS Islamic Health Center: NA
CODEPEK: NA
COFEM: NA
COODIPRIB: NA
Gihogwe Health Center: NA
Howard University: NA
Dai Welfare Society: NA
Johns Hopkins University: NA
Ngoboka Dufatanye Rusizi PLHAs Cluster Comm.: NA
Johns Hopkins University: NA
North Star Foundation: NA
Program for Appropriate Technology in Health: NA
Rubaya Health center: NA
Rusizi Health Center St Francois: NA
Solidarity Centre: NA
To Be Determined: NA
Cross Cutting Budget Categories and Known Amounts Total: $620,000
Construction/Renovation $30,000
Economic Strengthening $300,000
Education $100,000
Food and Nutrition: Policy, Tools, and Service Delivery $100,000
Human Resources for Health $40,000
Water $50,000
Key Issues Identified in Mechanism
Addressing male norms and behaviors
End-of-Program Evaluation
Increasing gender equity in HIV/AIDS activities and services
Increasing women's access to income and productive resources
Increasing women's legal rights and protection
Child Survival Activities
Mobile Populations
Safe Motherhood
Family Planning