I-TECH will support the NDoH HCT campaign by hosting sixteen Wellness Days per month in eight community-based venues in two districts in North West Province for any person over the age of 18 years of age. Wellness Days will include client-initiated HIV counseling and testing (using Bioline rapid tests) augmented with pregnancy testing, rapid RPR syphilis testing in pregnant women, syndromic management for STIs (using the NDoH guidelines), symptomatic screening and referral for TB, personalized risk-reduction counseling for family planning, education on one’s sero-status, actively and safely facilitating mutual disclosure to sexual partners and appropriate household members, screening for interest in safe medical male circumcision, promotion of safer sexual behaviors (including partner reduction and alcohol risk-reduction), and emphasizing the importance of consistent and correct condom use. Condoms will be widely disseminated and female and male condom demonstrations will be integrated into counseling activities during Wellness Day activities, post-test clubs and in training at PHCs. The counseling standard for this program will be modeled on the client-centered, personalized risk model recommended by the U.S. CDC and World Health Organization (WHO). This counseling model is grounded in personalized risk assessment and the development of a realistic, personalized risk reduction plan for each participant. Furthermore, to optimize HCT services, I-TECH will encourage use of couples-based HCT for wellness days, where both partners are tested simultaneously and disclose their results to each other during post-test counseling, a strategy that has been documented to decrease rates of sero-conversion and reduce sexual risk behavior. A standard protocol for conducting couples-based HCT (including training testing counselors) will be used.
Referrals and linkages to follow-up services are a primary focus during Wellness Days. Persons testing positive for HIV, women presenting with vaginal discharge and lower abdominal pain, persons screened positive for TB using the screening tool, any pregnant woman regardless of HIV status, and men seeking medical male circumcision (MMC) will be referred to local PHCs. In order to increase linkage to care, those referred to a PHC will be given “incentive cards” to present to staff at the PHC in addition to the patient passport. If persons referred for follow-up at a PHC present their incentive card at primary health centers within two weeks of the Wellness Day, they will be given 20 Rand of cell phone air time at the conclusion of their appointment. All routine testing and treatment patient data will be collected during Wellness Days using the national data collection forms to ensure standardization of data collection and reporting. The data process will mirror that of the PHCs; HCWs will use tick sheets, registers, and other national tools.
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
HVOP
1,500,000
0
Narrative:
I-TECH will conduct community mobilization through Post Test Clubs (PTC’s). This will include establishing 64 PTC’s (12 members each) and they will reach 302,400 community members. I-TECH will also conduct training for about 768 PTC members (the course will cover PwP messaging, HIV transmission risks, STI and other related content). I-TECH will conduct training on Prevention with Positives (PwP) for healthcare workers (HCWs). PwP will be added when training the clinical nurse mentors for NIMART. The target is to produce 1020 Nurse Trainers and 540 Nurse mentors. In addition, I-TECH will develop training and mentoring programs for M & E assistants and HCW in selected Primary Health Care facilities. The target is to train 20 officers per year. I-TECH will conduct a training of trainers which will includes staff in the NW-DOH supported by I-TECH, as well as staff from other districts in Northwest, so that they can roll out the training in their areas. The HCWs that will be trained on PwP will include lay counselors, nurses, health promoters and others staff who conduct patient counseling. This will enhance integration of PwP in all service points and it will improve linkages to care and treatment. This program plans to reach about 1,700,000 people in 5 years (340 000 per year) and the estimated unit cost is about $4.5 for each person reached.
Implementing Mechanism Details
Mechanism ID: 13618
Mechanism Name: GH1151
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention
There are two objectives of this project; 1)To build governmental and community-based capacity to reduce HIV infections in South Africa among MSM and their partners by providing appropriate comprehensive HIV prevention services to MSM in Eastern Cape, KwaZulu-Natal, Free State, Northern Cape and Limpopo, and 2)To strengthen capacity of NDOH and other stakeholders to develop HIV-related strategic information systems for MARPs in South Africa. This project aligns with PEPFAR goals and the Partnership Framework in that it aims to strengthen evidence-based decision making to increase HIV prevention, and build local capacity, sustainability and country ownership. The project contributes to prevention within a subgroup at high risk in the country with the highest number of HIV-infected individuals, thus making a significant contribution to the PEPFAR prevention goal of preventing 12 million new infections by 2012. ICAP will ensure that project activities have full government ownership and buy-in, and are increasingly financed and directed by the SAG. ICAP’s M&E activities incorporate new indicators, identified based on consensus with the NDOH. M&E CQI exercises include root cause analysis and participatory methods so that service delivery is adjusted based on monitoring results. Indicator reporting will be developed for project milestone and used for programmatic and financial reporting using PEPFAR’s Next Generation Indicators as adapted for the South African context (described in the 2010 South African Strategic Information Guidelines). As the project advances, ICAP will incrementally transfer project activities to local and community organizations ensuring that subsequent MSM projects and MARPs strategic information systems are completed and implemented by South Africans.
Cross-Cutting Budget Attribution(s)
Human Resources for Health
150,000
Motor Vehicles: Purchased
153,432
TBD Details
(No data provided.)
Key Issues
(No data provided.)
Budget Code Information
Mechanism ID:
Mechanism Name:
Prime Partner Name:
13618
GH1151
Columbia University Mailman School of Public Health
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
HVCT
800,000
0
Narrative:
In FY2012 ICAP will provide MSM appropriate services for HCT and STI screening, and increased access of MSM to post-exposure prophylaxis for HIV exposure. Innovative HCT methods such as peer outreach and social networking strategies (utilizing trained MSM peers to encourage members of their social and sexual networks to be tested); couples testing, venue-based testing and home-based testing will be conducted. Those found to be HIV-positive or screen positive for STIs will be effectively linked to appropriate clinical and support services. Social mobilization, anti-stigma campaigns and innovative technologies, such as the use of mobile phone technologies, will be employed to increase the utilization of HCT and prevention services by MSM. ICAP will provide technical assistance and capacity building to the DOH and other implementing partners on indicator selection, M&E and reporting of HCT interventions targeting MSM and other MARPs.
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
HVOP
1,500,000
0
Narrative:
ICAP activities in FY2013 will promote the development and implementation of comprehensive prevention packages for MSM that incorporate behavioral, biomedical, structural, and community elements through the ICAP Mosaic Men's Health Initiative approach. Behavioral interventions will be delivered through one-on-one or small-group sessions or at the community level to address mediators of risk behavior (i.e., HIV risk-related knowledge, emotional states, social influences, and service utilization, including testing and treatment for HIV/ STI, substance abuse treatment and men’s health). Evidence-based behavioral risk reduction interventions aimed at behaviors and norms related to MSM risk will be tailored to the needs and resources of the project areas. Sustainable provincial and district-level systems will be strengthened to distribute condoms and water-based lubricant to MSM. To address barriers to HIV prevention services for MSM (i.e, homophobia-driven stigma and discrimination in health care settings), ICAP will support integration of MSM Peer Educators in health facilities. ICAP will establish and integrate Prevention with Positives into the package of care for MSM, and strengthen linkages for entry in care and treatment and referral systems to coordinate social, mental health, medical, and HIV prevention services for MSM. Community mobilization aimed at decreasing community stigma and discrimination and increasing awareness and demand for MSM-specific health services will be conducted. ICAP supports development of sustainable government-led mechanisms to identify and prioritize knowledge gaps about MARPs and has developed a coordinated MARP strategic information agenda at national and provincial levels, which will include data dissemination and the promotion of data use to inform MARPs programming and policy. ICAP will provide technical assistance and conduct capacity-building activities for DOH and other organizations providing prevention services for MARPs on M&E of MARPs-specific interventions and activities, and will capacitate other implementing partner and DOH to provide appropriate and non-judgmental health services to MSM, PWID and SWs through provision of sensitization training to health care workers.
Implementing Mechanism Details
Mechanism ID: 13619
Mechanism Name: JHPIEGO SA
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention
Procurement Type: Cooperative Agreement
Prime Partner Name: JHPIEGO
Agreement Start Date: Redacted
Agreement End Date: Redacted
TBD: No
New Mechanism: No
Global Fund / Multilateral Engagement: No
G2G: No
Managing Agency:
Total Funding: 1,200,000
Funding Source
Funding Amount
GHP-State
1,200,000
Sub Partner Name(s)
(No data provided.)
Overview Narrative
JHPIEGO MMC program goal is to build sustainable capacity within Nkangala District to promote primary prevention of HIV by scaling up safe, comprehensive MMC services with: provision of high quality, high-volume, integrated adult MMC services; collaborate with circumcising communities and leaders to offer MMC as a component of traditional initiation rites; work in partnership with local workplaces and unions generate demand for MMC services; and collaborate with other HIV partners in the district to ensure the continuum of care and promote and refer clients to MMC. JHPIEGO will enter year 2 of an intensive MMC program in 3-4 hospitals and roving services. This program directly supports the prevention goal of the PF, including addressing female vulnerability to HIV and other STI infection. It is also supportive of the NSP goal to reduce new HIV infections by 50%. Providers of HCT and other health services will be oriented to MMC and provided with tools to refer HIV-negative men. This and regular follow up from JHPIEGO will strengthen bidirectional referrals and linkages between MMC and other services. Clients recruited for MMC will be encouraged to bring their partners. Training and knowledge development of staff from area clinics will increase cost efficiencies by reducing JHPIEGO’s follow up burden. Bulk procurement of MMC consumables will ultimately reduce costs as well. The project will build sustainable local capacity with a cadre of trained professionals and equipped facilities for transition to SAG management at the end of project period. JHPIEGO will work with SAG and other partners to implement a quality assurance training program per national guidelines. JHPIEGO plans to purchase one vehicle with COP 2011 funds; and three with COP 2012 funds.
Cross-Cutting Budget Attribution(s)
Motor Vehicles: Purchased
150,000
TBD Details
(No data provided.)
Key Issues
(No data provided.)
Budget Code Information
Mechanism ID:
Mechanism Name:
Prime Partner Name:
13619
JHPIEGO SA
JHPIEGO
Strategic Area
Budget Code
Planned Amount
On Hold Amount
Prevention
CIRC
1,200,000
0
Narrative:
JHPIEGO will contribute towards provincial and national MMC targets by circumcising 32,000 males in FY 2013. Four percent of HIV-negative males aged 15-49.This will be achieved with fixed services at district hospitals and mobile services in hard-to-reach populations in Nkangala District, Mpumalanga. JHPIEGO proposes to conduct MMC in high volume settings. The unit cost for MMC in the second project year in a high volume setting is estimated at $100/procedure, inclusive of the full package of services and supportive activities such as social mobilization and program monitoring. JHPIEGO will conduct MC in District hospital, they will place Doctors and Nurses to support DOH staff in the MC Procedures. JHPIEGO will operate against a sustainability plan to capacitate health facilities and their staff for MMC impact beyond the completion of the project. JHPIEGO will build on best practices in MMC, including use of forceps-guided surgery, employing models to optimize volume and efficiencies, incorporating messaging on gender norms and proper treatment of females, and delivering these as part of a package of prevention services, including HCT, age-appropriate risk reduction counseling, condom demonstration, provision and promotion,linkages to family planning, supportive supervision and QA, STI, HIV, TB, and other treatment services.Demand creation will include formative assessments of clients, their partners and communities to understand facilitators, barriers and preferences in MMC service delivery; resulting demand creation activities will utilize a mix of media and grassroots approaches to attract adequate client flow.The program will use reporting mechanisms that fold into SAG district, provincial and national systems.This will integrate the project within the larger MMC effort in South Africa and avoid creating parallel structures.The MMC activities are intended not only as a single biomedical intervention to reduce HIV acquisition risk, but also an opportunity to engage men in health services and maximize linkages to other key resources for males’ improved long-term engagement in the health sector, increasing their likelihood to seek support for sexual and reproductive health and chronic disease management.
