THIS IS AN ONGOING ACTIVITY FROM FY 2008. ACTIVITIES LISTED WILL CONTINUE IN DURING FY

2009. ACCOMPLISHMENTS WILL BE REPORTED IN THE FY 2008 APR. PLEASE NOTE THAT THE

ACTIVITY NARRATIVE REMAINS UNCHANGED FROM FY 2008.

TITLE: IRC HIV Counseling and Testing Services in Nduta and Kanembwa Refugee Camps, Kigoma

NEED and COMPARATIVE ADVANTAGE: Tanzania hosts thousands of refugees who fled ethnic violence

and other conflicts in the Great Lakes Region of Central Africa. The International Rescue Committee (IRC)

has been serving this population in western Tanzania since December 1993 as a lead agency identified by

the UNHCR for provision of health and nutrition assistance in the Kibondo district. With PEPFAR funds, IRC

provides HIV counseling and testing services in the camps as part of health services.

Refugees in Tanzania are not allowed to travel beyond four km from the camps and therefore rely entirely

upon services provided by the implementing partners of UNHCR for their livelihoods.

Since the official transition of UNHCR country policy concerning Burundian refugees from facilitation to

promoting repatriation IRC provides support to the above process by providing medical screening and

ensuring continuity of medical care to refugees repatriating to Burundi.

The repatriation process is currently scaling-up, however exact numbers of beneficiaries that will leave the

country in the coming year is difficult to predict. Analyzing current trends, we can estimate that somewhere

between 2,000 to 4,000 Burundian refugees will repatriate to Burundi monthly and thus by June 2008 we

can estimate having between 7,000 and 31,000 Burundian refugees in the area. Along with the refugees,

IRC in Tanzania provides health care to the local communities residing in the areas neighboring refugee

camps. Currently nearly 20.3% of our beneficiaries visiting IRC CT centers come from the local

communities. IRC in cooperation with its partners, local authorities, and NGOs, will work towards

strengthening health systems in the Kibondo area and improving access and quality of health care provided

to local populations.

ACCOMPLISHMENTS: As part of health services and with PEPFAR funds IRC provides counseling and

testing services to a population of 55,300 refugees and an additional number of local Tanzanians through

four counseling and testing facilities.

In total 3,998 people were tested and received results of their HIV tests during the period from October

2006 to end of June 2007 at IRC CT sites in hospitals and youth centers. Eighty-seven clients were found to

be HIV positive (2.17%).

Until April 2007, eight counseling and testing sites were maintained by IRC in four camps (two in each

camp) when consolidation of Mkugwa and Mtendeli to Nduta and Kanembwa came to its end.

Subsequently IRC provided services through four sites located in two camps.

The HIV/AIDS services that IRC provides in Kibondo are characterized by their comprehensiveness and

strong linkages with services within and outside of the wider IRC program. This enables people accessing

CT to gain access to a variety of quality health and social support services such as post test clubs, home-

based care, maternal and child health services, nutrition, life skills training and referral to HIV care, and

treatment.

ACTIVITIES: The activities that will be implemented under CT with COP 2008 funds include:

1. Maintain and strengthen service provision and uptake of both client and provider initiated CT in Nduta

and Kanembwa refugee camps. More people will get to know their serostatus which will guide their life and

health choices and will allow timely access to existing support and treatment services. 1a) Ensure that at

any time there are at least 10 staff trained on provision of quality in depth counseling and testing at CT

sites. (20 people will be trained to compensate for rapid turnover of staff) 1b) Purchase necessary quantities

of quality HIV whole blood screening and confirmatory rapid tests and other supplies for smooth functioning

of CT sites. 1c) Carry out small group meeting sessions for informing community about CT. 1d) Carry out

community based mobilization campaigns and promote mass awareness through radio programs, informing

about CT services and their availability. 1e) Develop and disseminate in the beneficiary communities health

education materials, informing about CT as well as benefits of early testing and disclosure. 1f) Maintain and

strengthen referral links between CT and other programs within and outside IRC program. 1g) Continue to

develop linkages with HIV/AIDS organizations working outside the camps and government run health

facilities.

2. Support activities of post test clubs in Nduta and Kanembwa refugee camps. This will help overcome

negative impacts of the HIV epidemic such as stigma and marginalization and will foster active involvement

of community members in planning and implementation of the IRC HIV activities. 2a) Support post test

clubs in organizing meetings and events aimed at advocating on behalf of people infected and affected by

HIV. 2b) Involve post tests club members in planning and implementation of information, education,

communication (IEC) and behavior change communication (BCC) activities, including promotion of CT

services 2c) Support post tests club members by providing them with personal hygiene items and clothing.

3. Strengthen institutional capacity to implement routine CT quality assurance systems in Nduta and

Kanembwa refugee camps. This will ensure provision of the highest possible quality of counseling and

testing at IRC CT sites, which will uphold effectiveness of its HIV/AIDS intervention at high levels. 3a)

Provide refresher trainings to 20 staff members on counseling and testing in accordance with national

protocols and standards 3b) Train 20 staff on HIV testing quality assurance 3c) Identify reference laboratory

for quality assurance of HIV testing carried through in the IRC CT service outlets.

LINKAGES: IRC will continue to collaborate with the National Aids Control Program (NACP) to facilitate HIV

CT trainings. In addition, it will strengthen collaboration with the Kibondo district hospital and the PEPFAR

partner Columbia to organize provision of ART to refugees (and Tanzanian) who are found to be HIV

positive and eligible for treatment.

IRC will continue work with HIV/AIDS organizations serving the local populations since on average 20.3% of

person accessing health in the camps are Tanzanian nationals. In addition to Columbia University, IRC will

collaborate with local organizations and other PEPFAR funded organizations working in prevention, home

based care and counseling and testing.

CHECK BOXES: The areas of emphasis will be gender, human capacity development, strategic information

and "wraparound" programs. The target population will be adolescents 15 - 24 years (girls and boys) and

adults over 25 years.

Activity Narrative: M&E: IRC data collection and reporting procedures fully correspond to Tanzania's Ministry of Health

standards and procedures for CT services. In addition, IRC developed a database that conforms to

PEPFAR planning and reporting cycles and allows reporting on both refugee and Tanzanian nationals

receiving services though IRC counseling and testing sites.

The IRC monitoring and evaluation officers will be responsible for following up the accuracy of the data. At

the field office, the HIS officer will take the lead in analyzing electronically and summarize the data.

SUSTAINABILITY: IRC will continue to work with the local health authorities and strengthen coordination

with local NGOs working in the host communities on HIV/AIDS programs to better mitigate the effect of

refugees repatriation on these local communities.

New/Continuing Activity: Continuing Activity

Continuing Activity: 13493

Continued Associated Activity Information

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

System ID System ID

13493 4934.08 Department of International 6522 3532.08 $100,000

State / Population, Rescue

Refugees, and Committee

Migration

8659 4934.07 Department of International 4542 3532.07 $100,000

State / Population, Rescue

Refugees, and Committee

Migration

4934 4934.06 Department of International 3532 3532.06 $100,000

State / Population, Rescue

Refugees, and Committee

Migration

Table 3.3.14: