Detailed Mechanism Funding and Narrative

Years of mechanism: 2013 2014 2015 2016

Details for Mechanism ID: 12899
Country/Region: Ukraine
Year: 2013
Main Partner: Pact, Inc.
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $2,500,000

This project is the follow-on activity to the SUNRISE Project. The USG plans to expand support for improved HIV/AIDS services among MARPs.

Ukrainian organizations supported under this project include the three Global Fund Round 10 principal recipients. The project will provide TA to national and local Ukrainian organizations to improve MARPs access to and use of HIV/AIDS services. Supported HIV/AIDS services include behavioral, biomedical, and structural HIV/AIDS activities, community- and facility-based services, and communications. The project is national with intensified TA in nine regions. The target populations are IDU, MSM, FSW, vulnerable adolescents, and the sexual partners of MARPs.

The overarching goal of the project is to assist the GOU and civil society to reduce levels of HIV transmission among MARPs and their sexual partners through sustainable country-led programs. This will be achieved through two program objectives: (1) increase the quality of HIV/AIDS services targeted to MARPs and their sexual partners, and (2) strengthen the capacity of Ukrainian institutions to deliver quality HIV/AIDS programs.

The project contributes directly to all of Ukraines Partnership Framework goals and adds value to existing and forthcoming HIV/AIDS initiatives. At the end of the projects five years, Ukrainian organizations will have increased capacity to deliver cost effective, comprehensive HIV/AIDS services. Ukrainian organizations will access technical and capacity building resources offered through strengthened in-country organizations. The project will establish strong M&E and analysis components to ensure that program interventions are effective and replicable. USG Ukraine will conduct a mid-term and a final evaluation.

Funding for Care: Adult Care and Support (HBHC): $100,000

This is an RFA currently under development. The BCN can be updated upon receipt of the first work plan. The program will work with the GOU, Principal Recipients, and local organization to strengthen their technical capacity to deliver state of the art HIV/AIDS services, including positive prevention services. The program will support the Principal Recipients cascade of technical service delivery to sub-recipients to ensure the scale up of USAIDs investments. The scope of the project is national with intensified TA in nine regions. This project is not involved in the direct delivery of positive prevention services, but will work with the GOU and Global Fund to take evidence-based best practices to scale up throughout the country as per the National HIV/AIDS Response objectives.

The project's target audiences under this BCN are HIV-infected Ukrainians, most likely from a most-at-risk population (e.g. FSW, MSM, Prisoners, vulnerable adolescent, IDU, or a corresponding sexual partner). Through TA, the project will facilitate the testing, packaging, and dissemination of state-of-the-art and cost-effective HIV/AIDS service models to be taken to scale with GOU and Global Fund resources. This includes community- and facility- based models, with a focus on MARPs-friendly services and decentralized delivery. The positive prevention services package is integrated prevention, care, and treatment services targeted to PLHIV, including HCT, STIs and OI screening and treatment, ART management, condom distribution, behavior change communications, and psychosocial services. The project will also focus on strengthening package components, including referrals to family planning and reproductive health services and legal support.

The project will also provide TA to strengthen referral system models and mechanisms that facilitate clienteles access to a comprehensive package of services within an inherently vertical health care system. Additional TA will help construction quality assurance models, standards, and tools for positive prevention services, and in partnership with the GOU and GF, package and disseminate these models and resources at the national and regional levels, with corresponding national standards.

Funding for Care: Orphans and Vulnerable Children (HKID): $300,000

This is an RFA currently under development. The BCN can be updated upon receipt of the first work plan. The program will work with the GOU, GF Principal Recipients, and local organization to strengthen their technical capacity to deliver state of the art HIV/AIDS services, with a focus on HIV prevention. The program will support the GF Principal Recipients cascade of technical service delivery to sub-recipients to ensure the scale up of USAIDs investments. This includes working with vulnerable youth with a concentrated epidemic through public sector and civil society organizations. The scope of the project is national with intensified TA in nine regions.

This project will support global OVC PEPFAR goals of supporting the capacity of communities to create protective and caring environments and building the capacity of social service systems to protect the most vulnerable. This project links closely to the Removing Legal and Operational Barriers to HIV/AIDS Services project to address key barriers to services facing OVCs in Ukraine.

Applicants will propose a mix of evidence based activities and technical assistance they think will be effective in increasing access to HIV/AIDS services to OVC, with a focus on vulnerable adolescents. Illustrative activities include working with public and civil society providers and facility managers increase adolescents' access to HCT, CPSP, and positive prevention services. The project will provide TA to prepare, test, package, and disseminate state of the art and cost-effective HIV prevention models for at-risk youth. This includes youth-friendly CSO/public sector HIV prevention models for street children with wraparound elements (e.g. documentation services and legal support, job training), to be implemented within USAID-funded programs through sub agreements and taken to scale with GOU and Global Fund resources. Other activities include the conduct and use of rapid formative assessments to investigate dynamics and behaviors in HIV prevention. Priority research issues include the HIV prevention context, behaviors, and needs within specific MARA segments (e.g. injecting drug use, sex work, and migration and seasonality patterns)

The winning applicant will provide further details on target population segmentation (e.g. age groups, gender, geographic coverage) and how they intend to implement evidence-based technical assistance strategies to achieve project objectives.

Funding for Strategic Information (HVSI): $100,000

This is an RFA currently under development. The BCN can be updated upon receipt of the first work plan. The project will improve the design of HIV/AIDS services that are data-driven and respond to changing epidemic patterns. HIV/AIDS services, with a priority focus on HIV prevention, will be aligned to the drivers, context, and evolution of the Ukrainian HIV/AIDS epidemic. The project will contribute substantially to the evidence base in Ukraine in regards to HIV prevention among MARPs and their sexual partners.

The project will provide TA to increase data quality and the use of data for strategic and programmatic decision making. This includes: improved data quality data about MARPs populations (e.g. via higher-quality size estimation methods for MSM and sexual partners of MARPs by partner type; overlapping risk behaviors); strengthened capacity of the GOU and CSOs; and strengthened capacity of Principal Recipients and CSOs to oversee and supervise the application of strategic information and research by local organizations. The project will also pilot, evaluate, and disseminate an innovative strategic information (SI) and M&E tool kit.

Other SI activities include the development and execution of a national implementation science plan for Ukraine MARPs populations. The plan will incorporate linkages to other recommendations in strategic information, research, and the piloting and dissemination of best practices. The project will also link Ukrainian investigators to existing resources for training (e.g. NIDA/Humphrey Drug Abuse Research fellowships; Fogarty International Clinical Research Scholars).

Funding for Testing: HIV Testing and Counseling (HVCT): $150,000

This is an RFA currently under development. The BCN can be updated upon receipt of the first work plan. The project will work with the GOU, GF Principal Recipients, and local organizations to strengthen their technical capacity to deliver HCT services. The program will support the Principal Recipients cascade of technical service delivery to sub-recipients to ensure the scale up of USAIDs investments. The scope of the project is national with intensified TA in nine regions. This project is not involved in the direct delivery of HCT, but will work with the GOU and Global Fund to take evidence-based best practices to scale up throughout the country as per the National HIV/AIDS Response objectives.

Technical assistance will focus on increasing HCT among FSWs, MSM, prisoners, IDUs, and sexual partners of MARPs, with enhanced partner notification. Through TA, the project will work with public sector facilities and local Ukrainian organizations to enhance linkages between community-based VCT and and the local AIDS Centers, including confirmatory testing to decrease loss to follow up, especially for IDUs. The project will provide TA to strengthen linkages between HCT and services, including CPSP and MAT. Through advocacy and technical assistance, the project will address outstanding gaps in HCT. These include the revision of regulations to allow for a rapid testing algorithm for HIV confirmation, and a guarantee of confidentiality of medical records and the enforcement of such as per existing regulations.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $700,000

This is an RFA currently under development. The BCN can be updated upon receipt of the first work plan.

Target populations, funding level, coverage, and activities: 1) FSWs: $ 500,000, TBD, TA to Ukrainian organizations to support stronger segmented/tailored approaches to specific FSW sub-populations; increased provision of a comprehensive HIV prevention service package, addressing overlapping risk behaviors, targeted BCC, referrals to IDU and Positive Prevention services, and CPSP in mobile clinics and outreach; and increased engagement of gatekeepers, including sex work managers, to create a stronger enabling environment; 2) MSM: $ 500,000, TBD, TA to Ukrainian organizations to support: increased provision of a comprehensive HIV prevention service package , focused on overlapping risk behaviors, targeted BCC, legal support, and referrals to MSM-friendly clinical, IDU, and Positive Prevention services; HIV prevention interventions with MSM female partners; the test and scale-up the existing best practice MSM outreach program; and the test and scale-up innovative HIV prevention interventions for reaching hidden MSM; and 3) MARPs' sexual partners: $ 500,000, TBD, TA to Ukrainian organizations to support theory-based prevention of sexual transmission among MARPS and sexual partners.

The scope of the project is national with intensified TA in nine regions. The project includes TA to Ukrainian organizations to develop and test quality assurance models, standards, and tools for each intervention targeted to MARPs, which will be packaged and disseminated at national/ regional levels. The project will provide TA to strengthen comprehensive, quality HIV prevention service delivery, including the design of referral system models and mechanisms that facilitate clienteles access to comprehensive a package of services within a vertical health care system. With GF Principal Recipients, the project will design performance-driven models that tie technical and organizational development capacity building to performance standards. The project will support the Global Fund principal recipients with their condom promotion and distribution.

The winning applicant will further define populations by age, sex, population size, coverage, and risk behavior.

Funding for Prevention: Injecting and Non-Injecting Drug Use (IDUP): $1,150,000

This is an RFA currently under development. The BCN can be updated upon reseipt of the first work plan. The program will work with the GOU, GF Principal Recipients, and local organization to strengthen their technical capacity to deliver CPSP and MAT services and programs addressing the sexual transmission of HIV to IDUs. The program will support the GF Principal Recipients cascade of technical service delivery to sub-recipients to ensure the scale up of USAIDs investments. The scope of the project is national with intensified TA in nine regions. This project is not involved in the direct delivery of HIV/AIDS services to people who inject and use drugs, but will work with the GOU and Global Fund to take evidence-based best practices to scale up throughout the country as per the National HIV/AIDS Response objectives.

The program will conduct and use rapid formative assessments to investigate dynamics and behaviors in HIV prevention. This inclues behaviors and dynamics related to injecting drug use (e.g. types of syringes used; low dead space syringe use; overlapping IDU behaviors among cadres of MARPs; CPSP and adherence; and behaviors and accessibility of harder-to-reach IDU including youth, shorter career IDU, females, stimulant/poly-drug users). Other investigative themes include IDU use among MSM and vulnerable adolescents, and the causes and potential solutions to MAT dropout rates.

The project will work with GOU and GF Principal Recipients to strengthen service delivery technical capacity. This includes the increased provision of a comprehensive HIV prevention package of services to defined segments within injecting drug users, focused on overlapping risk behaviors, targeted communications, referrals to HCT and positive prevention services, and CPSP in mobile clinics targeting sex workers. Also, increased provision of MAT services embedded within a comprehensive package for the prevention, treatment, and care of HIV among IDUs, with strategies to increase retention to MAT programs.

The project will provide TA to prepare, test, package, and disseminate state of the art and cost-effective HIV prevention models, to be implemented within USAID-funded programs through subagreements and taken to scale with GOU and Global Fund resources. These include the existing best-practice pharmacy-based CPSP model, MAT service continuity across health care service points, MAT services in pretrial and prison settings, linkages to MAT services post-prison release, the existing best-practice wrap-around MAT model in AIDS Centers and TB clinics in Odessa, and theory-based prevention of sexual tranmission among male and female IDU and their partners.

Subpartners Total: $0
FHI 360: NA
Cross Cutting Budget Categories and Known Amounts Total: $950,000
Gender: Gender Equality $100,000
Human Resources for Health $350,000
Key Populations: FSW $250,000
Key Populations: MSM and TG $250,000
Key Issues Identified in Mechanism
Implement activities to change harmful gender norms & promote positive gender norms
Increase gender equity in HIV prevention, care, treatment and support
Increasing women's legal rights and protection
Tuberculosis
End-of-Program Evaluation
Family Planning