Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 14277
Country/Region: Rwanda
Year: 2012
Main Partner: Catholic Relief Services
Main Partner Program: NA
Organizational Type: FBO
Funding Agency: USAID
Total Funding: $1,098,180

COP12 will be the last year of Ibyringiros implementation. Consequently, activities related to the three strategic objectives will be mostly focused on the phase out process and on sustainability of the existing and viable structures and systems established over the past years.

In COP12 efforts will mainly focus on: 1)Training of government agriculture extension workers and linking with the existing Farmer Field Schools by increasing the coverage and strengthening the linkages; 2) Linkages with ISAR (Institut des Sciences Agronomiques au Rwanda) for provision of bio-fortified seeds and additional training for FFS members on fruit trees and improved species; 3) Promotion of food processing; and 4) Strengthened collaboration with GOR officers to ensure a smooth transition of Ibyringiros agricultural services to the Ministry of Agricultrue. Regular assessments of nutritional status and nutrition counseling will continue every month during the cooking demonstration sessions in the community and the links with health centers will be reinforced to continue with nutrition support follow up of the beneficiaries.

The continuum of activities including nutrition assessment, counseling and support within HIV/AIDS care and treatment at health center level, community follow-up and cooking demonstration sessions through Positive Deviance Hearth groups will make the community-based nutrition interventions more dynamic and effective.

During COP12, Ibyringiro will standardize the CHW trainings and link them to MOH systems during the phase out process, and establish linkages between savings and internal lending communities (SILC) and cooperatives.

Since the beginning of project implementation through COP11, 8 motorbikes and 4 cars have been purchased.

Funding for Care: Adult Care and Support (HBHC): $232,108

The Ibyringiro project will continue its activities with clinical sites and CHWs to ensure adequate palliative care support to adult PLHIV. Activities include assessing nutritional status using mid-upper arm circumference and body mass index measurement and providing nutrition counseling. CHWs and clinics will continue to strengthen the continuum of care of PLHIV between clinical care and community care and support. PLHIV will be linked to the CHWs and to the clinics, all moderately and severe cases of malnutrition will be immediately reported to the health center and the severe cases followed by the District Hospital. CHWs and the different community groups will refer HIV exposed children, pregnant and lactating women living with HIV/AIDS who need nutrition and food support to PMTCT/food distribution sites. In COP12, Ibyringiro will continue its family/household centered approach by working with different community-based associations/groups to improve the health and nutritional status of over 15,500 beneficiaries (PLHIV and families) through the positive deviance nutrition approaches. Nutrition education programs will be integrated with hygiene and sanitation sessions, and with agriculture and economic strengthening. The project will also increase the capacity of SILC groups to reach the next stage managing self-identified IGAs. During the cycle, SILC groups will receive basic business skills training in order to help them manage IGAs. Promotion of food processing that began in COP11 will continue in COP12. Processing activities will be strengthened through linkages with GOR technological centers, facilitating transport and storage facilities and training in food processing skills through support from ISAR. IGA schemes will be expanded to investing in equipment for food processing depending on groups priorities and motivations, also linking with other partners like ISAR.

Funding for Care: Pediatric Care and Support (PDCS): $118,873

In COP12 Ibyringiro will continue to provide food supplements for HIV-positive children who are moderately malnourished. Since COP11, Ibyringiro has been implementing food by prescription (FBP), which provides food and nutrition interventions as part of clinical HIV care and treatment. The objectives of FBP are to improve health, nutrition, and drug adherence and survival outcomes. The primary components of FBP are:Provision of food and nutrition services as part of care and treatment with strong links to community-based services ;Supplemental food is provided for a limited duration on the basis of clear entry and exit criteria based on anthropometry measurement.

These activities target HIV-positive children on ARVs aged 19 to 59 months, who are moderately malnourished. Ibyringiro procures and distributes Foundation Plus (which is bio-fortified flour) to these HIV positive children with a ration of 9kg/month/beneficiary for duration of six months. These activities/services are provided at 45 selected USG supported health facilities in 13 districts. In addition, health workers at selected centers assess and monitor the nutrition status of pediatric clients on a monthly basis. Infant feeding counseling is provided to parents as well as home visits, coupled with growth monitoring and nutrition counseling.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $747,199

This component will support nutrition and food supplements in USG PMTCT sites. Services will be coordinated by CRS (commodity management), while EGPAF will manage the technical component in collaboration with FHI, Intrahealth and the MOH. Ibyringiro will ensure a smooth and effective transition of the nutritional support component of PMTCT services as sites transition to the MOH. In COP12 Ibyringiro will assess local suppliers (quality, capacity, etc.) in order to transition to local commodity purchases.

CRS staff and clinical partners will regularly participate in the nutrition steering committee led by RBC/IHDPC to ensure a continuous improvement of the interventions through joint supervision and continuous feed-back and monthly exchange.

The project will continue to ensure the procurement of corn-soy blend (CSB) and its distribution to the PMTCT sites, whose numbers will be jointly defined and selected by CRS and clinical partners. EGPAF will continue to ensure the technical lead among the different partners, including training of health center staff, provision of job aids and BCC tools.

Cooking demonstrations will continue at PMTCT sites on how to prepare the CSB as a complementary food and other child foods. Health center staff will continue to provide counseling sessions to mothers in infant feeding practices, breast health, proper lactation, and maternal nutrition for pregnant and lactating mothers who are in the program.

USG will support the training of community health workers and health centers staff on the effective use of the infant and young child feeding counseling package as well as the counseling skills.

The Ibyringiro project will continue to contribute to the national efforts to improve the nutrition education and providing high quality weaning food to HIV-positive mothers pursuant to TRACPlus standards.

Subpartners Total: $0
Africare: NA
Caritas Internationalis: NA
Elizabeth Glaser Pediatric AIDS Foundation: NA
Cross Cutting Budget Categories and Known Amounts Total: $1,098,180
Economic Strengthening $516,310
Food and Nutrition: Commodities $279,250
Food and Nutrition: Policy, Tools, and Service Delivery $302,620
Key Issues Identified in Mechanism
Addressing male norms and behaviors
enumerations.Impact/End-of-Program Evaluation
Increasing gender equity in HIV/AIDS activities and services
Increasing women's access to income and productive resources
Family Planning