Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015

Details for Mechanism ID: 13792
Country/Region: Zambia
Year: 2013
Main Partner: John Snow, Inc
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $5,638,534

SHARe II provides technical support to develop and implement a sustainable multi-sectoral HIV/AIDS response. SHARe II activities are aligned with the Zambia National HIV and AIDS Strategic Framework 2006-2010 (ZASF) to ensure local relevance and sustainability, addressing gaps and challenges in the national response. SHARe II activities will support the national HIV response to create demand for MC, HTC, PMTCT, condom use, and ART,malaria and family planning services to increase impact through strategic coordination and integration. In 2012, SHARe II will continue to work with leadership at all levels to build credible and effective leaders to be HIV/AIDS advocates, role models and champions to be effective change-agents. SHARe II provides technical leadership to identify specific issues that require legal reform, and advocate for the necessary changes and trains law enforcement officers in handling HIV-related cases through in- and pre-service training. SHARe II will provide technical support to implement organizational capacity assessment processes for evidence-based strengthening of management, implementation and coordination of HIV/AIDS activities. In the public, private and informal work sector SHARe II will provide access to HIV services for employees, dependents and defined outreach communities, to reduce employee absenteeism. SHARe II will support NAC at both the national and sub-national levels to improve HIV response coordination, and provide support to develop and maintain a monitoring system. SHARe II will also receive PF funding to empower local leaders to mobilize communities and other stakeholders around HIV prevention and management and expand HIV related services.

Funding for Care: Adult Care and Support (HBHC): $0

SHARe II will strengthen collaboration and coordination of HIV/AIDS activities with the GRZ, USG funded partners, and other stakeholders. The partner will implement the counseling and testing strategies for ensuring that HIV positive individuals, couples, and families are linked with appropriate follow up HIV treatment, care and support, and prevention services based on their sero-status. Prevention interventions implemented by SHARe II at the work place programs to supporting HIV positive persons include 1) HIV testing and counseling of partners and children of HIV positive persons, along with couples counseling for discordant couples, 2) condom promotion and distribution, 3) counseling for safe disclosure of HIV status to partners, 4) adherence interventions to prophylaxis and treatment regimens, and 5) linkage to wrap-around programs.

Funding for Care: Orphans and Vulnerable Children (HKID): $510,000

AZ please beg NP to put some money here

Funding for Health Systems Strengthening (OHSS): $1,758,452

SHARe II OHSS programs address health systems governance and leadership, specifically structural and institutional factors that influence HIV vulnerability and affect the effectiveness national HIV response.

Activities address: 1) weak and inadequate HIV leadership to support and sustain the required scale-up of HIV prevention, treatment, care and support, including inadequate local resource allocation to the response; 2) weak and inadequate HIV-related policies and laws that do not offer full protection to PLWHA and those affected by HIV/AIDS; and 3) weak coordination and management of the HIV response.

OHSS activities strengthen and increase HIV leadership by engaging, mobilizing and equipping leaders at all levels with the skills to be effective change-agents including building understanding of HIV/AIDS roles and responsibilities, and providing platforms for leadership.

Activities to improve the HIV-related legal and policy environment include providing TA to: Revise the national HIV/AIDS policy; formulate the national alcohol and the workplace HIV/AIDS policies; strengthen the HIV/AIDS section of the employment act; review HIV-related pieces of legislations and lead efforts towards codification; and train legal and law-enforcement officers in HIV-related case management.

Activities to strengthen the capacities of HIV coordinating structures in the public and private sectors, and in selected civil society organizations and chiefdoms include providing TA for: Strategic planning that mainstreams HIV as a developmental issue; operational planning; hosting regular stakeholder meetings to foster awareness of the policy, strategic, operational expectations and milestones of the GRZ in the HIV response, and assist implementers to appropriately align their activities.

SHARe II forms collaborative partnerships, leveraging resources wherever possible, to move legal and policy processes forward. E.g., the alcohol policy formulation process is co-funded by SHARe II, GRZ and Zambian Breweries; strategic and operational planning for the DATFs is co-funded by SHARe II and UNDP; and stakeholder meetings at the national and district levels leverage resources for convening meetings from SHARe II and other NAC partners.

SHARe II will also receive Partnership Framework funding to empower local leaders to mobilize communities and other stakeholders around HIV prevention and management and expand HIV related services.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $500,000

SHARe II will work with traditional leaders to strengthen their leadership and advocacy ofr voluntary male circumcision using a taliored package of interventions. SHARe II will work with traditional leaders at behaviourial level to build skills and competencies to use their vast authority and reach to enhance the HIV/AIDS response through evidence based interventions such as VCMM.SHARe II will also work with chiefs and MPs to continue stimulating demand for VMMC,

and provide technical assistance for the development of VMMC campaigns.

Funding for Sexual Prevention: Abstinence/Be Faithful (HVAB): $620,082

SHARe II HVAB programs are mostly workplace-based, reaching male and female workers 15 years and older, at risk of HIV due to low condom use, multiple concurrent partnerships (MCP), and other drivers of the epidemic. Programs also reach workers living with HIV with specific interventions. Where workplace programs are extended to defined outreach communities and where SHARe II carries out HIV/AIDS social mobilization events, populations reached include both adults and children of all ages.

Trained peer educators provide interventions through small-group HIV education; at least 12 sessions per year are provided for each supported workplace/community. Interventions are also provided through at least four social mobilization events per year, using trained HIV/AIDS champions such as popular musicians, sport figures, and other leaders. Interventions primarily support increased uptake of HTC; decrease in number of sexual partners; increase in condom use; increased uptake of/adherence to ART, MC, and PMTCT. Interventions discourage alcohol abuse, gender-based violence (GBV), and HIV-related stigma and discrimination. Condoms are provided as needed.

SHARe II HVAB programs are implemented country-wide in 100 large/medium-sized private sector workplaces, including 25 Tourism HIV/AIDS PPP companies; 19 public sector line ministries and institutions; over 3500 small informal sector businesses; and in defined outreach communities and partner chiefdoms, with a combined target population of about 200,000 people.

A standardized peer education curriculum is used to train peer educators across SHARe II implementing partners. Peer educators receive quarterly in-person supportive supervision and have access to real-time phone support and consultation, to ensure quality.

The minimum SHARe II HVAB package includes provision of HIV prevention and HTC services, policy development, provision of condoms, and linkage to biomedical interventions including MC, PMTCT, and ART.

SHARe II captures the number of individuals reached by HVAB interventions, by gender and age. Data quality is ensured through regular data quality assessment (DQA), training and supportive supervision, and in-built data quality checks in the process of data management

Funding for Testing: HIV Testing and Counseling (HVCT): $1,250,000

Couple HTC is the focus of SHARe II HTC activities, with individual HTC provided where couple HTC is not applicable or feasible. HVCT activities are nationwide, but focused in partner workplaces and communities, with a target population of 200,000. In the past 10 months 2.4% of target population tested for HIV.

Client-initiated HTC is provided through outreach/mobile services and VCT centers, using workplace programs and special events/campaigns as entry-points. HVCT targets and results for 2011 were 20,000 and 4,778, respectively. HTC is an integral component of SHARe II workplace programs and targets the general population (Gen Pop), prevention with positives (PWP) and most at risk population (MARPs); proportional allocation of HTC funding is: Gen Pop 60%, PWP-10% and MARPs-30%.

Providers are trained in couple HTC, including managing discordant couples, and in rapid HIV testing according national standards and guidelines, using the national algorithm. 28 providers were trained in couple HTC and eight in HIV testing and quality assurance, in FY 2011.

HVCT activities aim at high coverage of HIV testing for at most at risks populations, support negatives to remain negative including MC referral for HIV negative men, and provide effective referral to early care and treatment for positives - referral of positives to HIV care, treatment and support is a required minimum standard for SHARe II HTC. Trained peer educators provide support and follow-up to ensure that referrals are acted on.

Quality assurance for HVCT includes yearly refresher training; updates as needed; supportive supervision; client exit and mystery client surveys; and counselor support groups for learning and stress management.

M&E activities for HTC ensure planned services are provided in a timely manner; reporting is accurate and incorporates all required elements; data quality is maintained; and HTC results are tracked internally and also reported to the District Health Management Team (DHMT) to facilitate client linkage and follow-up.

HTC promotional activities include workplace and outreach community health fairs that provide a range of health and HIV services including HTC for workers and their families, and HIV/AIDS social mobilization events.

Funding for Sexual Prevention: Other Sexual Prevention (HVOP): $1,000,000

SHARe II HVOP programs are mostly workplace-based, reaching male and female workers 15 years and older, at higher risk of HIV than the general population due to occupation and other reasons, but who also face general population HIV risks including low condom use, MCPs, alcohol abuse, and low levels of male circumcision. SHARe II HVOP programs serve: 1) uniformed services (police and prison officers); 2) mobile populations, specifically migrant/seasonal workers in partner mining, agricultural and tourism workplaces; and 3) prison inmates who are at very high risk of HIV, have limited access to HIV prevention services, and have no access to condoms.

HVOP interventions include provision of current information on HIV prevention, care, treatment and support; provision of condoms; support group activities; provision of HTC, and linkages to HIV services such as MC, PMTCT and ART. Individual and group interventions to reduce HIV risk are supported. SHARe II interventions for prison inmates are constrained by poor access to health service and legal barriers; provision of condoms to prison inmates is illegal in Zambia, and this remains an area for continued advocacy.

Interventions are implemented in selected uniformed service workplaces and defined outreach communities, in selected prisons for inmates, and in some private sector workplaces with a combined target population of about 45,000 people.

Trained peer educators provide most of the services to individuals or small-groups, providing at least 12 HIV/AIDS information sessions per year. A standardized peer education curriculum is used across SHARe II implementing partners to train peer educators. Peer educators receive quarterly in-person supportive supervision and have access to real-time support and consultation by phone to ensure quality.

The minimum HVOP package includes provision of HIV prevention, risk-reduction and HTC services, provision of condoms, and linkage to biomedical interventions including MC, PMTCT, and ART.

SHARe II captures the number of individuals reached by HVOP interventions, by gender and age. Data quality is ensured through regular DQAs, training and supportive supervision, and in-built data quality checks in the process of data management.

Subpartners Total: $0
Zambia AIDS Law Research and Advocacy Network: NA
Zambia Health Education and Communication Trust: NA
Zambia Interfaith Networking Group on HIV and AIDS: NA
Cross Cutting Budget Categories and Known Amounts Total: $250,000
Gender: Gender Based Violence (GBV) $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
enumerations.Malaria (PMI)
Mobile Populations
Workplace Programs
Family Planning