ROADS IIs goal is to stem HIV transmission and mitigate its impact among most-at-risk populations (MARPs) along the transport corridors and in cross-border communities. ROADS II harmonizes and coordinates with GOR priorities identified in the Partnership Framework related to prevention, care, support, impact mitigation, and community-based health systems strengthening. ROADS II fulfills transition and long-term sustainability objectives through strengthening community capacity in leadership, management, health information and health service delivery, community-led & owned activities, facilitative and TA roles vis-à-vis local institutions; and, assuring social and financial risk protection. ROADS II will continue to focus on high visibility Safe-T-Stop centers where transient populations access services; income generating activities like LifeWorks© dedicated to reducing socio-economic vulnerabilities; organizational strengthening and capacity development of cooperatives; outreach VCT; care and support to OVC and PLHIV; community-based Positive Prevention through PLWH associations to reduce risky behaviors, promote condoms, treat and manage STIs, and access counseling and support for VCT, family planning and reproductive health; and full integration of FP, MCH, child survival messages and linkages to all health services. In COP12, ROADS II will strengthen RPOs to implement activities and reinforce organizational competencies of the clusters of community-based organizations to ensure sustainability, increase cost efficiencies and conduct an end-of-project evaluation.

From the start of the mechanism through COP11, one vehicle and three motorcycles were purchased for project use. No new purchases are planned in COP12.

During COP12 ROADS II will support local civil society to target care and support services to 22,163 PLHIV and their family members. The services will include income generating activities, psychosocial, spiritual, shelter, water and sanitation, legal aid and nutrition through kitchen gardening and the introduction of urban and rural organic farming technology. ROADS II implementation strategy is focused on building local PLHIV civil society group capacity to address community care and support for HIV prevention. In COP12, ROADS II will continue to assist PLHIV clusters in Kigali city, Gatuna, Rusizi, Bugarama and Gisenyi. ROADS II will reinforce mentoring systems and conduct continuing education for 350 existing volunteers in basic palliative care including, ART adherence, HIV and STI prevention, referrals for clinical services and various forms of support (psychosocial, spiritual) as well as nutrition education and food security services, reproductive health services, water and sanitation. The income generating activities will enable PLHIV to assure social and financial risk protection so that no PLHIV becomes impoverished as a result of their status while building resilience to support basic needs such as paying health insurance. In total, 11,000 PLHIV and household members will be targeted with a minimum package of care.

Regular monthly meetings for volunteers and cluster technical staff will be used to ensure program fidelity and ROADS II sites-based data managers will continue to provide mentorship to clusters for quality improvement as they continue to assess the efficiency and effectiveness of data-management systems.

ROADS II will continue to monitor the performance of PLHIV clusters. The established quarterly coordination meeting for performance review will be used and strengthened. Data will be collected by the volunteers, validated at the cluster level then by the ROADS II site coordinators before being entered into an existing database at the cluster level for analysis at the Kigali level by the ROADS II M&E technical officer. Finally, in-depth data analysis and program evaluation will be done to document the outcomes of the intervention on the individual and household.

ROADS II provides technical and financial support to local civil society partners to support under 18-years old OVCs in five sites: Kigali city; Gatuna, Rusizi, Bugarama and Gisenyi. Key activities includes efforts to improve health care through health insurance subscriptions, food and nutrition support, and education of tutors and caregivers on balanced nutrition, psychosocial support, HIV prevention, child protection through children rights education. At the end of September 2011, a total of 4,506 OVC were provided services. In COP12, ROADS II will: strengthen its caregiver mentoring system through community clusters; provide at least one service to 3,475 OVCs ; and strengthen the capacity of household and local community groups to ensure program effectiveness. Services will be linked closely through a strong referral network including health facilities and CBOs, FBOs, and local NGOs to meet the daily needs of OVC as part of the transition strategy. In COP12, ROADS II will continue to address sustainability by addressing the longer-term needs of orphans through use the Lifework strategy to support OVC households to use identified economic opportunities to increase their income to help many OVC to graduate from ROADSIIs support.

Regular monthly meetings for care givers and cluster technical staff will be used to ensure quality of services and achievements. Sites based data managers will involve cluster members to conduct a data quality audit at IP levels to assess the efficiency and effectiveness of data-management systems and provide constructive feedback. The Child Status Index tool previously used to assess the quality of OVC services offered by the program will continue to be the reference of community care givers for quality services improvement.

The activities of this project will fit into the overall ROADS II M&E framework. The project will document results as well as impact achievements and local civil society partners technical staff will be trained on effective results reporting.

In line with the GORs policy to make CBOs more self-sustaining, ROADS II will support local civil society organizations through capacity building, financial management, monitoring and evaluation, data utilization and basic planning. In COP12, ROADS II will continue to work with local implementing partners through cluster management team training (technical staff and cluster steering committee members) on program and cooperative management and empowering cluster group members, especially women, in improved decision making to better respond to health system gaps in health and HIV/AIDS.

During COP12, the ROADS II project will provide technical assistance to 372 community based civil society organizations through 17 established clusters of community organizations to facilitate the empowerment of communities to understand and solve their own problems around health and determinants of health. ROADS II will continue to mentor civil society cluster steering committees to lead overall strategic design, coordination and planning of cluster activities and will continue to support efforts for cluster management, technical, administration and finance staff to oversee the daily operations, coordination and execution of cluster activities with the objective of promoting ongoing decision making beyond the life of the project and promotion of civil society in the national response to public health issues.

During COP12, ROADS II will conduct institutional capacity assessments of all local community implementing partners. Based on the results, a capacity building plan will be developed. During COP12, ROADS II will reinforce the capacity of civil society organizations, who will be currently implementing community interventions, based on capacity building plans to support civil society graduation to independently seek donor funds. In addition, ROADS II will train 91 civil society boards of directors and technical staff in proposal development and project management to ensure sustainability and support the transition from sub-grantee to independent grantee. For monitoring and Evaluation, ROADS II will conduct quarterly progress reviews based on the key benchmarks that will be fixed after the first evaluation.

During COP12 ROADS II will continue to reach most-at-risk groups and stop-over site communities that include the female sex workers whose HIV prevalence is estimated at over 50% (Rwanda BSS 2010), truckers, youth between 15-24 years, as well as other risk groups with less access to existing CT services. ROADS II will facilitate integrating CT services in outreach strategies from fixed CT services.

During COP12, ROADS II will continue to support outreach CT services in Kigali City; Gisenyi, Rusizi, and Bugarama to reach trucks drivers and their assistants, commercial sex workers and their partners, in-street youth, OVC, motor bikers and mechanics, low-income women, men and other community members. The innovative approach of systematic HIV testing for those MARPs screened for sexual transmitted infections and MARPs tracking-notification cards introduced in COP11, will continue to be supported. In total, ROADS II plans to reach 17,000 high-risk individuals with CT services in seven CT service outlets.

The quality of services being offered in the CT outlets will be assessed by using the client exit form and results analyzed on a semi-annual basis to assess client satisfaction; and as part of quality control 10% of all client lab samples will be sent to the national reference laboratory for verification and ROADS II will continue to work with district hospitals for formative supervision of the CT sites.

In COP12 ROADS II will continue to ensure evidence-based programmatic decision making by facilitation of on-going monitoring of CT service delivery.

ROADSII continues to serve MARPs in Kigali City, Gatuna; Rusizi; Bugarama, and Gisenyi. The targeted groups are truckers, motor bikers, fishermen, mechanics, in-street youth and other stop-over site communities that include high-risk youth, low income women, PLHIV, and sex workers. In addition to social networking used by peer educators (PEs), specific groups such as female sex workers are reached for STI screening and management by trained PEs and health centers. In COP12 ROADSII will reinforce HIV prevention for MARPs through PEs, the social networks model, and community mobilization aimed to promote HIV prevention behaviors like consistent and proper use of condoms, reduction of alcohol consumption, and reduction in sexual gender-based violence. During COP12, interventions targeting FSW, in-street youth, PLHIV and girls will continue as well as MARPs tracking-notification cards introduced in COP11. The MARPs bar-based interventions initiated in COP11 will be strengthened and documented. ROADS II will also reinforce linkages with health services to ensure MARPs receive the MOHs prescribed minimum package of care. In COP12 linkages with the private sector and ROADSIIs Lifeworks to create and provide opportunities for increasing access to income generating activities and markets, as an HIV prevention strategy will also be strengthened. In COP12 these combined strategies will target 137,500 people with individual and/or small group level evidence-based interventions. In addition, 128,000 individuals will be targeted through community wide events in support of PE interventions.

Continuing education and appropriate supervision will continue to ensure activity fidelity to maintain quality and achieve results. Site-based data managers with cluster members will continue to conduct data quality audits to assess the efficiency and effectiveness of data-management systems.