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.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
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
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
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 2009
THIS IS AN ONGOING ACTIVITY FROM FY 2008. ACTIVITIES LISTED HAVE BEEN INITIATED AND
WILL PROCEED DURING FY 2009 AS IN THE PREVIOUS YEAR. ACCOMPLISHMENTS WILL BE
REPORTED IN THE FY 2008 APR. PLEASE NOTE THAT THE ACTIVITY NARRATIVE REMAINS
UNCHANGED FROM FY 2008.
The funding for this activity has decreased from 600,000 to 400,000.
*END ACTIVITY MODIFICATION*
TITLE: AED/T-MARC PMTCT Communications Initiatives
NEED and COMPARATIVE ADVANTAGE: According to the 2003/4 Tanzania HIV/AIDS indicator survey,
while almost 69% of women know that HIV can be transmitted from a mother to her child by breastfeeding,
only 17% know that there are special drugs that can reduce the risk of transmitting the virus to the baby. In
addition, while approximately 90% of pregnant women access antenatal care (ANC) services, the uptake of
ARV to prevent HIV transmission is approximately 12%. AED/T-MARC works with, and through community
partners with the most-at-risk populations (mobile business people, market women, sex workers, women
engaged in transactional sex, and people in communities where high risk behaviors occur) in the 10 highest
prevalence regions of Tanzania to communicate and motivate behavior change with regard to HIV
prevention. With reproductive health (RH) and child survival (CS) funding from USAID, AED/T-MARC is
also utilizes funding to implement a nationally-aired, well-established radio program (Mama Ushauri)
targeting women of childbearing age (WCBA). AED/T-MARC will continue to design appropriate messages
advocating increased PMTCT service, demand, and utilization among Tanzania's most-at-risk populations.
AED/T-MARC's community presence, communications expertise, current initiatives, and legitimacy with
most-at-risk populations provide an excellent framework for increasing knowledge and demand for PMTCT
prevention services for individuals who are most vulnerable.
ACCOMPLISHMENTS: AED/T-MARC did not receive funding for PMTCT in FY 2006 or FY 2007.
ACTIVITIES: AED/T-MARC will collaborate with USG PMTCT partners and the government of Tanzania
(GoT) to develop messages, materials, and tools to be integrated with T-MARC's current HIV/AIDS and FP
communication initiatives, targeted at the most-at-risk populations in Tanzania.
AED/T-MARC will develop behavior change communication messages including materials and tools (for
providers, outreach workers, and beneficiaries) on core PMTCT issues (e.g., the benefits of testing for HIV
when pregnant, the benefits of ARV and cotrimoxazole prophylaxis for both the mother and infant, family
planning options and exclusively breastfeeding for 6 months etc). These materials will be developed
specifically for most-at-risk populations.
In order to accomplish this task, AED/T-MARC will conduct a materials development workshop with PMTCT
partners and collaborate with an advertising agency to design initiative materials, complete pretest review,
and print finalized materials. Furthermore, AED/T-MARC will disseminate materials to partners for national
use. These materials will include PMTCT messages integrated into T-MARC's community-based HIV
prevention activities including Sikia Kengele: Tulia na Wako (Listen to the Bell, Stick with Your Partner)
faithfulness campaign. Sikia Kengele is targeted at communities where high-risk sexual activities occur -
particularly along the transportation corridors in the 10 regions with the highest HIV prevalence in Tanzania
(Mbeya, Iringa, Dar es Salaam, Mtwara, Mwanza, Kilimanjaro, Pwani, Shinyanga, and Ruvuma) and in and
around workplaces such as mines, plantations, and markets. It addresses multiple concurrent partnerships
while promoting faithful relationships between partners.
Sikia Kengele involves the implementation of community mobilization events (e.g., road shows and
edutainment theatre) and "bell ringers" implementing interpersonal communications activities (including peer
-education and outreach). Curricula to help faith leaders talk with their congregations about faithfulness and
teach faithfulness skills have been developed for both Christian and Muslim audiences. With PMTCT funds,
AED/T-MARC will coordinate with USG partners working in Kengele regions to ensure linkages with
appropriate services. Additionally, AED/T-MARC will implement Kengele interpersonal, community, and
mass media activities advocating a strong push to increase knowledge of, and demand for PMTCT
services. Some activities will focus on raising awareness of the benefits of getting tested.
PMTCT messages will be incorporated into the Christian and Muslim faithfulness curricula currently being
implemented by Word and peace organization (WAPO) and Tanzania Muslim Council (Baraza la waisilamu
Tanzania-BAKWATA) as part of Sikia Kengele. The curricula will target men, encourage them to be
supportive in asking their pregnant partners to get tested, and advocate strong support for HIV positive
pregnant women who need treatment. AED/T-MARC will conduct PMTCT awareness activities during the
National Uhuru Torch campaign, which includes a mobile festival that visits every district in the country and
reaches more than 1 million Tanzanians each year.
In order to successfully reach as many people as possible in Tanzania, AED/T-MARC will develop and
integrate a PMTCT storyline into the long-running Mama Ushauri (Mama Advice) radio program. Mama
Ushauri airs 6 times per week on three national radio stations. It targets WCBA with reproductive health
and child survival messages. With FY 2008 funds, AED/T-MARC will work with USG partners to develop
objectives and scripts for the integration of a strong PMTCT storyline into the Mama Ushauri program for
recording and utilization for one year. This will include a bi-monthly question and answer program regarding
PMTCT inquiries which will be evaluated with T-MARC's established M&E mechanisms (Steadman Media
research, T-MARC Knowledge Attitude Practice (KAP) study, and regular listener focus group discussions
(FGDs).
In addition, AED/T-MARC will develop and print PMTCT-specific messages to support the radio program
and provide resources for listeners to access additional information. PMTCT-specific informational material
will be distributed at clinics and public places with a high volume of WCBA.
Activity Narrative: LINKAGES: Since there are no PEPFAR indicators for outreach/communication to drive demand for
PMTCT services it is imperative that AED/T-MARC's activities are closely linked to the implementation
plans of USG and GoT entities responsible for PMTCT. AED/T-MARC's prevention communications
activities are strongly linked to prevention partners, particularly STRADCOM and Ujana. Activities are
implemented with the consultation and assistance of district and regional GOT officials: District Medical
Officers (DMOs), Regional Medical Officers (RMOs) and Community Health Management Teams (CHMTs).
AED/T-MARC's collaboration with the Tanzania Commission for AIDS (TACAIDS) and the National AIDS
Control Program (NACP) information education and communication (IEC) Unit will provide guidance on
program and materials design. Advertising agencies, graphic design firms, experiential media houses, and
other Tanzanian agencies will also have creative input into the design of the initiative. WAPO, BAKWATA
and other TBD NGOs/CBOs/FBOs grantees will play key roles in the implementation of this initiative on the
ground.
CHECK BOXES: Because Sikia Kengele addresses male norms, the PMTCT initiatives implemented by
AED/T-MARC will have a strong focus on the role of men in protecting their families. The training of NGOs
and their staff to implement PMTCT initiatives - as they are incorporated into Sikia Kengele - will be part of
the capacity building directed at NGO grantees, BAKWATA, and WAPO who implement the Kengele
curriculum. The program also targets adults 18 and over, mobile populations, women and men involved in
transactional sex, and HIV positive women. Messages regarding reproductive health are incorporated into
the Mama Ushauri radio serial drama program signifying a wrap-around activity.
M&E: Approximately 7% of AED/T-MARC's PMTCT funding will be devoted to M&E. In FY 2008,
AED/TMARC
will implement the second round of the T-MARC KAP study that will examine the reach and recall of
PMTCT messages incorporated into Sikia Kengele and Vaa Kondom (wear a condom), as well as other
initiatives. The KAP also examines reported behaviors and attitudes of the target populations and questions
about PMTCT can be incorporated. Through hired experiential media agencies and NGOs monthly-reach
data (on a tool developed for that purpose) will be submitted into the T-MARC Project monitoring database.
Steadman Media Group provides monthly statistics reflecting quantity of listeners to AED. AED will conduct
spot checks of activities in the field to check on data quality. Data will be reviewed and updated quarterly
according to revision standards set by the GoT. With FY 2008 funds, T-MARC expects to reach a total of 1
million individuals with Sikia Kengele community outreach activities and 1.5 million people monthly with the
Mama Ushauri radio program.
SUSTAINAIBLITY: AED/T-MARC will enhance implementation of prevention initiatives throughTanzanian
NGOs utilizing communication strategies. A major deliverable of the T-MARC Project is to create a
sustainable Tanzanian communications and marketing company capable of continuously implementing high
-quality initiatives. AED/T-MARC continue to provide technical assistance, marketing, and management
skills and will scale-up capabilities in these areas. USG/GoT partners will benefit from these increases in
technical and managerial skill-building.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16364
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16364 16364.08 U.S. Agency for Academy for 6487 1175.08 $600,000
International Educational
Development Development
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $20,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Estimated amount of funding that is planned for Education $380,000
Water
Table 3.3.01:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
TITLE: AED/T-MARC Partner Reduction Initiatives
AED's Sikia Kengele program, addresses perceived social norms supporting multiple partnerships, such as
nyumba ndogo (extra-marital relationships) and trans-generational relationships and challenges these
norms via interpersonal communication (IPC) "bell ringers", community mobilization "big bell events",
advocacy efforts and mass media. AED/ T-MARC will continue to implement Sikia Kengele with a few
modifications as described below.
In FY 2008, the Sikia Kengele initiative was expanded throughout the country with enhanced promotional
and interpersonal communications efforts - increasing the depth of one-to-one contacts and deepening
message penetration. This effort focused on regions, districts, and communities most threatened by HIV
reaching more than 750,000 individuals with community outreach activities. Aggressive media placement
have resulted in 12 million people being exposed to Sikia Kengele radio spots, developed in collaboration
with the Stradcom Project, and well over a million people exposed to T-MARC's outdoor media promotions
placed at bus stops, ferries, transport hubs and along trucking routes. The messages conveyed through
these media support faithfulness and partner reduction. Activities to promote faithfulness and partner
reduction were also a prominent feature of AED/T-MARC's contribution to the national Uhuru Torch rally -
which reached every district in Tanzania - and a total of 95,000 persons.
Other accomplishments include the development of a draft Faithfulness Manual that includes chapters from
both Christian and Muslim faith perspectives. AED T-MARC has also been actively engaged in start up
activities for Initiatives on HIV and Alcohol and Safe Passages (for high-risk youth) with Stradcom, ROADS
and FHI/UJANA. AED/T-MARC's proposed PPP with the local wireless provider Selcom has also advanced,
with the terms of reference drafted and the design of the communications piece well underway. The
Selcom campaign will engage mobile phone owners in a contest in which prizes can be won for correctly
answering questions about the dangers of multiple partnerships, correct and consistent condom use,
PMTCT, gender norms and HIV testing.
AED/T-MARC will continue to focus on deepening the impact of Sikia Kengele at the community level via an
expanded grants-making program along the transportation corridors and in other high risk geographic
areas. This will involve more intensive capacity building and systems strengthening efforts targeting an
expanded number of grantees. On the technical side, grantees will be provided with TA in the development
of more complex prevention messages, the use of specific communications techniques to effectively target
specific populations with effective communication modalities. Grantees will also be trained in how to
establish reliable monitoring and evaluation systems for continuous quality improvement. This increased
focus on capacity building will infuse new life into ongoing IPC and mass media communications and will
challenge target audiences, including couples, to discuss the affects of gender and social norms that
promote multiple concurrent partnerships, transactional and coerced sex and alcohol and drug abuse and to
develop appropriate risk reduction strategies.
COP 2009 activities will involve an increased focus on facilitating communication within married and
cohabitating couples. T-MARC will redouble its efforts to more closely link its Sikia Kengele and Vaa
Kondom (T-MARC's condom promotion) activities, recognizing that HIV risk reduction is part of a continuum
which includes both partner reduction and the correct and consistent use of condoms. T-MARC will also
upgrade its M&E system in response to recommendations from an M&E audit which occurred in June 2008.
Finally, AED will continue to provide mentoring and coaching to the T-MARC Company to further solidify the
new business developments and long-term sustainability gains achieved by this Tanzanian health marketing
institution. All other activities listed in COP 2008 have been initiated and will proceed as in the previous
year.
TITLE: AED/TMARC Partner Reduction Initiatives
A reduction in sexual partners can have a dramatic impact on HIV prevalence as has been demonstrated in
Uganda and Thailand with similar data now from Zambia, Kenya, and Ethiopia. The 2005 Tanzania
HIV/AIDS Indicator Survey (THIS) identified that
Continuing Activity: 13421
13421 3425.08 U.S. Agency for Academy for 6487 1175.08 $1,900,000
7668 3425.07 U.S. Agency for Academy for 4510 1175.07 $425,000
3425 3425.06 U.S. Agency for Academy for 2849 1175.06 $200,000
Table 3.3.02:
The USG has been the largest supporter of condom social marketing in Tanzania. Since 2004, AED has
implemented USG's condom social marketing efforts to promote branded condoms (male and female), as
well as implement generic communications initiatives that increase demand for condoms and their use. The
audience for these efforts continues to be most-at-risk populations (MARPS), especially mobile populations,
workers in industry and agriculture, sex workers and people who live and/or work in and around high-risk
HIV/AIDS hotspots. AED TMARC will continue to expand these activities with COP 09 funding.
ACCOMPLISHMENTS: During the past year, AED/T-MARC continued to successfully implement key HIV
prevention activities contributing to an impressive 25% expansion of the total condom market in Tanzania.
AED/T-MARC also launched its small grants program targeting NGOs/CBOs that work closely with sex
workers and vulnerable women engaged in transactional sex. Community outreach activities reached
nearly 1.7 million Tanzanians, and nearly 19 million were reached with Dume (branded) and Vaa Kondom
(generic) radio spots. Millions more were exposed to strategically placed outdoor media supporting AED/T-
MARC's varied condom and other prevention initiatives. The number of condom service outlets expanded
to over 1200 new outlets resulting in a total of 23,000 condom service outlets penetrated since the
beginning of the project. This year, AED/TMARC also introduced "Risk Reduction Days" that target higher
risk communities and venues with multilayered communication campaigns focusing on partner reduction,
correct and consistent condom use and the promotion of nearby VCT services.
Other accomplishments include drafting of a curriculum for awardees of the small grants program listed
above and significant expansion of female condom promotion and distribution within these populations.
AED TMARC has also been actively engaged in start up activities related to its joint HIV and Alcohol
initiative and Safe Passages program (for high-risk youth) with STRADCOM, ROADS and FHI/UJANA.
AED/T-MARC's proposed PPP with the local wireless provider Selcom has also advanced, with terms of
reference drafted and the design of the communications piece well underway. Other efforts such as T-
MARC's collaboration with the Ministry of Youth, Labor and Sports for the national Uhuru Torch rally, which
reaches every district in Tanzania, continue to be hallmarks of AED/T-MARC's synergistic efforts.
ACTIVITIES: AED/T-MARC will continue to expand the reach of its core prevention initiatives. This will
involve expanded grants-making along the transportation corridors and in other high risk geographic areas
and more intensive capacity building and systems strengthening of grantees for continuous quality
improvement and sustainability. On the technical side, grantees will be provided with TA in the
development of more complex prevention messages and the use of specific communications techniques to
effectively target specific populations with effective communication modalities. Grantees will receive
support in how to establish reliable monitoring and evaluation systems and on how to use this data for
improved programming. It is expected that this increased level of technical support will infuse new life into
ongoing interpersonal communication and community mobilization efforts and enable sub-grantees to
implement more sophisticated prevention programs that effectively increase individual risk perception,
facilitate sustained behavior change, increase demand for and access to condoms for high risk populations
and more adequately address the needs of couples. AED is exploring the use of a Geographical
information System (GIS) together with Geographical Positioning System (GPS) to more effectively target
condom distribution efforts to recognized geographic hot spots. AED will also work with T-MARC to explore
the viability of new business prospects and new product lines that could potentially generate return-to-
project revenue and thus improve the long-term sustainability of the T-MARC Company. To better track
condom outlet penetration and access to condoms by key target groups, T-MARC will implement an
initiative to put in place.
AED/T-MARC will redouble its efforts to link its Vaa Kondom (generic condom promotion) and its Sikia
Kengele (faithfulness) initiatives, recognizing that HIV risk reduction is best supported through a continuum
of interlinked essential behavior change strategies. AED/T-MARC will also upgrade its M&E system in
response to recommendations from an M&E audit which took place in June 2008. Finally, AED will continue
to provide mentoring and coaching to the T-MARC Company to further solidify new business developments
and long-term sustainability gains achieved by this Tanzanian health marketing institution. All other
activities listed in COP 2008 have been initiated and will proceed as in the previous year.
TITLE: AED/T-MARC Project OP and Condom Initiatives
NEED and COMPARATIVE ADVANTAGE: In years past, the USG has been the largest supporter of
condom social marketing in Tanzania. Since FY 2004, AED has implemented USG's condom social
marketing efforts to promote branded condoms (male and female), as well as implement generic
communications initiatives that increase demand for condoms and their use. The audience for these efforts
is most-at-risk-populations (MARPs), especially mobile populations, workers in industry and agriculture, sex
workers, and people who live and work in communities where high-risk sexual behaviors are frequent.
AED's unique public-private partnership with Shelys' Pharmaceuticals, Ltd. forms the backbone of effective
social marketing initiatives. In order to effectively increase condom use, AED must also address contributing
factors such as alcohol use, sexual violence, and prevailing myths and misconceptions.
ACCOMPLISHMENTS: With FY 2006 funding, AED continued to expand the reach, relevance, and
desirability of Dume male condoms and Lady Pepeta female condoms. More than 10,000 new outlets were
reached and more than 8.8 million condoms were sold. In April 07, T-MARC launched the Vaa Kondom
generic initiative to promote correct and consistent condom use. A major accomplishment of both the
branded and generic initiatives was the implementation of more than 1000 bar and market interventions
Activity Narrative: along the transportation corridors. With FY 2007 funding, T-MARC is prepped to continue to improve these
efforts, adding a mass media component to promote the male condom brand and adding a grants program
for reaching sex workers with plus-up funding.
ACTIVITIES: 1.T-MARC will increase Dume's reach to district towns and rural communities in the 10 most
HIV affected regions of Tanzania and along the transport corridors. 1a) Build on Dume's base in
nontraditional outlets (bars, nightclubs, guesthouses) to go from 30% penetration to 70% penetration. 1b:
Recruit district wholesalers to uplift products to rural areas. 1c: Increase brand affiliation through
interpersonal communications (IPC) efforts, road shows in rural gathering places (bus stops, train stations,
etc.), and extend radio and outdoor media efforts. 1d: Reinforce business via trade activations and re-
branding in new and current outlets. 1e: Expand the institutional accounts outreach program to ensure
condom availability at workplaces (i.e. mining, construction). 1f: Collaborate with income generation
organizations to provide income-generation opportunities for sub-grantees. 1g: Ensure audience is aware of
where they can get free condoms at government facilities.
2. AED will focus on nurturing Lady Pepeta's relevance among a core audience (sex workers, bar maids
and other most-at-risk women) in five regions with the highest HIV prevalence among women (Iringa,
Mbeya, Dar es Salaam, Tabora, and Pwani) and in regions with seasonal migration of sex workers (Arusha,
Dodoma, and Mwanza). 2a: Increase penetration in non-traditional outlets through highly targeted trade
activations. 2b: Implement face-to-face marketing activities in bars, brothels, and nightclubs targeting both
staff and sex workers. 2c: Via TBD NGOs, train bar maids to work as condom distributors. 2d: Expand the
institutional accounts outreach program for industries with female workers. 2e: Collaborate with Ujana,
ROADS, Walter Reed, and other USG prevention partners to take advantage of opportunities to promote
female condoms.
3. The Vaa Kondom generic initiative will take advantage opportunities to reach a vast and comprehensive
population through increased visibility in hot spots such as bars and guesthouses. This initiative will include
collaboration with other USG partners along the transportation corridors. 3a: Award 10-15 NGO grants to
implement IPC activities targeting mobile populations, workers in industries, sex workers, and others
engaging in high-risk sexual behaviors. 3b: Implement up to 1000 bar and guesthouse activations targeting
venues where high-risk sexual behavior occurs. 3c: Develop the next generation of Vaa Kondom tools and
materials - with special materials to be developed specifically targeting women. 3d: Increase "visibility" of
generic condom initiative via outdoor media, radio programming, in targeted communities.
3e: Develop PPP with Selcom (the company that manages SMSing for Tanzanian mobile phone
companies) to support Vaa Kondom and take advantage of widespread presence of mobile phones along
the corridor (e.g. implement audience response contests on the radio - getting people to text answers to
HIV-related questions). 3f: Implement Vaa Kondom activities as part of the national Uhuru Torch campaign
- a mardi-gras-type event that reaches all districts in Tanzania over four months - and nearly 1 million
people - each year. 3g: Link condom promotion to STI services and C&T activities (see AED C&T
submission). 3h: Implement Vaa Kondom in collaboration with Ujana and STRADCOM on joint high-risk
youth prevention initiative called "Safe Passages"
4. Continue and extend the sex worker grants program initiative started with FY 2007 plus-up funds. 4a:
Implement a competitive process to select three to five NGOs to implement IPC communities with sex
workers and women engaged in transactional sex. 4b: Provide grantees with technical assistance and
materials (developed in 07 to implement the initiative) to implement risk reduction activities. 4c: Provide
income opportunities for sex workers as condom salespersons. 4d: Provide appropriate referrals to services
(e.g. STI services, PMTCT, C&T).
5. Launch and implement HIV and alcohol initiative with Ujana and STRADCOM designed to raise
awareness of the role that alcohol plays in contributing to risky sexual behaviors and violence against
women. 5a: Develop HIV and alcohol strategy. 5b: Take lead role in working with ad agencies to develop
creative concepts. 5c: Print and disseminate materials for all partners. 5d: Link initiative into Dume and Vaa
Kondom activities (grants, training, small venue activities, etc.) along transport corridor. (See concept note
for additional details.) Workplace programs can leverage all the activities listed above for their HIV
prevention activities.
LINKAGES: AED's C activities will be coordinated with other USG prevention partners (esp. STRADCOM,
Ujana, ABCT, ROADS). T-MARC's involvement in the joint prevention initiative, "Safe Passages" will be
funded via this line item. T-MARC will collaborate with district and regional GOT officials (DMOs, RMOs,
and Community Health Management Teams) to ensure effective implementation of programs. T-MARC's
collaboration with TACAIDS and the NACP IEC unit will provide guidance on program and materials design.
Advertising agencies, graphic design firms, experiential media houses, and other Tanzanian agencies will
have creative input into the design of the initiative. PPPs include Shelys Pharmaceutical, Selcom, and
workplaces.
CHECK BOXES: This program addresses male norms and behaviors around condom and alcohol use.
Lady Pepeta marketing opportunities will provide women an opportunity for income generation activities.
The training of NGOs and their staff to implement T-MARC's initiatives will build the capacity of local
institutions to effectively address HIV prevention and will include, if necessary, training in financial systems,
M&E, and management of HIV prevention programs. The program primarily targets sexually active adults
18 and over, mobile populations, and women and men involved in transactional sex, women in prostitution
(including many who are HIV-positive) and the business communities of many towns and cities.
M&E: Approximately 7% of AED's C funding will be devoted to M&E. In FY 2008, AED expects to implement
the second round of the T-MARC KAP study (the first was implemented in FY 2005/ FY 2006) which will
examine the reach and recall of Dume, Lady Pepeta and Vaa Kondom and reported behaviors and attitudes
of the target populations. Through hired experiential media agencies and NGOs, monthly reach data (on a
tool developed for that purpose) will be submitted into the T-MARC project database. AED will conduct spot
checks of activities in the field to check on data quality. In FY 2008, T-MARC will reach 1.2 million people
with upstream and downstream activities combined - 500,000 of whom will be reached with community
outreach activities.
SUSTAINAIBLITY: AED intends to enhance the ability of Tanzanian NGOs to implement prevention
Activity Narrative: initiatives, including those focusing on condom social marketing and promotion. A major deliverable of the T
-MARC project is to spin off a sustainable Tanzanian communications and marketing company that is
capable of implementing high quality initiatives. The T-MARC company "spun" off the Project in April 07 and
AED continues to provide technical assistance to the company in marketing and BCC. Other NGOs funded
through this initiative will benefit from technical skills building (in BCC & marketing), as well as HIV program
management and M&E.
Continuing Activity: 13422
13422 3424.08 U.S. Agency for Academy for 6487 1175.08 $3,900,000
7667 3424.07 U.S. Agency for Academy for 4510 1175.07 $3,550,000
3424 3424.06 U.S. Agency for Academy for 2849 1175.06 $2,800,000
* Reducing violence and coercion
Table 3.3.03:
THIS IS A NEW ACTIVITY.
AED/T-MARC Initiative to Test Communication Messages on Male Circumcision
This is a new project initiative for FY09.
At the request of the GOT, the USG will implement a pilot male circumcision program through 5 partners
including: Jhpiego, Columbia University, AED/TMARC, Pharm Access and Mbeya Referral Hospital.
Jhpiego will provide technical oversight, training and support with systems development (i.e., supervision,
quality improvement, etc.) to the other implementing partners as well as implement the MC demonstration
program at Iringa Regional Hospital. Jhpiego will also conduct formative research on traditional
circumcisers in Mara. Columbia University will implement the MC demonstration program in Kagera, Mbeya
Referral Hospital will implement in Mbeya, and Pharm Access in Dar es Salaam (with the TPDF).
AED/TMARC will work closely with Jhpiego in the development of appropriate communications initiatives
targeting health care providers as well as surrounding demonstration site communities.
Need and Comparative Advantage:
Male circumcision (MC) has been shown to sharply reduce men's risk of becoming infected by HIV through
heterosexual intercourse. Three randomized clinical trials have shown that men who were circumcised
were less than half as likely to become infected with HIV within the trial periods. This finding is supported by
over 40 sociological and epidemiological studies which show a strong link between MC and reduced HIV
prevalence. Since male circumcision is now shown to be effective in reducing the risk of HIV infection for
men, care must be taken to ensure that men and women understand the benefits and risks of the
procedure, and that male circumcision does not provide complete protection against HIV infection - but
rather is one more element in a toolbox of HIV prevention actions including condom use and partner
reduction
Activities:
With FY09 funding, T-MARC will develop and test patient education messages and materials targeting men
and their partners with appropriate information on male circumcision and also engage in demand creation
efforts in demonstrate sites. For patient education, materials will explore the benefits and risks of male
circumcision, the potential cultural, social, and health affects, and provide post-operative care instructions
such as wound management, and critical post-procedure HIV prevention measures such as post-operation
abstinence and future partner reduction and condom use. These materials will emphasize that MC is not
completely protective and will address other relevant topics such as sexuality, sexually transmitted
infections, family planning, parenthood and emphasize respect for women's sexual and reproductive health
needs and concerns. With TA from JHPIEGO, AED will draft and print job aids and communication tools
for partners implementing male circumcision activities at demonstration sites. AED will also lead advocacy
and demand creation efforts in communities surrounding MC demonstration sites.
AED will collaborate closely with JHPIEGO, who will act as the TA provider to key partners in several
regions (DOD in Mbeya at the referral hospital and in Dar es Salaam at Lugalo Hospital (Tanzania People's
Defense Forces (TPDP); the Iringa Regional Health Management Team (or other appropriate institution) at
the regional hospital in Iringa; Columbia University/ICAP in Kagera at the regional hospital).
Linkages:
AED's MC activities will be coordinated with other USG prevention partners working on MC activities in the
selected locations. T-MARC will collaborate with district and regional GOT officials (DMOs, RMOs,
Community Health Management Teams) to ensure effective communication messages for the MC
demonstration projects. T-MARC's collaboration with TACAIDS, NACP IEC Unit and the HEU will provide
guidance on national messages and materials design.
M&E:
A large portion of this initiative is M&E related, including the pre-testing of the materials developed. In
addition, T-MARC will work with JHPIEGO and I-CAP to ensure feedback data on the retention of pre- and
post- client education activities/messages, track behaviors and recidivism, post-procedure abstinence and
interest in the procedure.
Sustainability:
The tools developed with this funding will be resources made available to all partners eventually involved of
the scale up of male circumcision activities in Tanzania.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.07:
