Operational Plan Report

Implementing Mechanism Indicator Information

(No data provided.)

Implementing Mechanism Details

Mechanism ID: 11413	Mechanism Name: Nyanza Province
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention	Procurement Type: Cooperative Agreement
Prime Partner Name: Columbia University Mailman School of Public Health
Agreement Start Date: Redacted	Agreement End Date: Redacted
TBD: No	Global Fund / Multilateral Engagement: No

Total Funding: 6,989,720
Funding Source	Funding Amount
GHCS (State)	6,989,720

Sub Partner Name(s)

(No data provided.)

Overview Narrative

This is a continuing mechanism from 2009.

Columbia University's International Centre for AIDS Care and Treatment (CU-ICAP) has been supporting HIV care and treatment and TB/HIV services in Nyando District of Nyanza Province since 2008, working in 20 health facilities. In FY 10, ICAP will continue to support these services, and expand to Bondo (which is transitioning in FY 09), and Siaya (will transition in FY 10) Districts. In addition, ICAP will support and expand prevention of mother to child activities and counseling and testing in the facilities where they are implementing care and treatment.
CU-ICAP will continue to work with the ministries of health at the provincial, district and health facility levels, to jointly plan, coordinate and implement HIV care and ART and TB/HIV services, in accordance with the Kenya National Strategic Plan III, the Kenya and United States Government Partnership Framework, and the district and provincial annual operation plans.


Cross-Cutting Budget Attribution(s)

(No data provided.)

Key Issues

(No data provided.)

Budget Code Information

Mechanism ID: Mechanism Name: Prime Partner Name:	11413 Nyanza Province Columbia University Mailman School of Public Health
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Care	HBHC	950,000
Narrative:
None
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Care	HTXS	3,500,000
Narrative:
None
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Care	HVCT	200,000
Narrative:
Nyanza province, which has a population of about 5.1 million people, carries the highest HIV burden in Kenya, with an estimated adult HIV prevalence of 14.9% (compared to the national 7.1%), and about 500,000 people are living with HIV. CU-ICAP has been supporting HIV care and treatment and TB/HIV services in Nyando District of Nyanza Province since 2008. The Counseling and Testing (CT) program in Siaya and Bondo Districts are supported by KEMRI, while in Nyando District by KEMRI (Provider Initiated Testing and Counseling- PITC) and Liverpool (Voluntary Testing and Counseling- CT). In the past, different partners have been supporting different program areas in the same geographic region and health facilities. Collaboration across these partners has been a big challenge, compromising the efficiency and cost-effectiveness of HIV service implementation. In COP10, in an effort to address this challenge, CU-ICAP, who will be supporting HIV care and treatment, TB/HIV and PMTCT services in Siaya, Bondo and Nyando Districts, will also support CT in these same districts. CU-ICAP will work with the Ministry of Health at the provincial, district and health facility levels, to jointly plan, coordinate and implement HIV CT services, in accordance with the Kenya National Strategic Plan III, the Kenya and United States Government Partnership Framework, and the district and provincial annual operation plans. In FY 10 CU-ICAP will ensure provision of CT services to 60,000 people in the 3 districts. CT approaches will include both client and provider initiated, and will be provided in both health facilities and in the community. CU-ICAP will support PITC by all health workers as part of routine minimum package of care for all patients, family members and relatives regardless of their presenting signs and symptoms. This shall be in line with the Kenya National AIDS Strategic Plan for HIV AIDS (KNASP III) that aims to attain universal access to HIV testing and counseling by 2013. Decentralization efforts to lower level facilities will continue to ensure coverage of all the health facilities in the 3 districts that CU-ICAP will work in. CU-ICAP will ensure that at least 30% of all out patient and 80% of all patients admitted in the medium to high level public facilities are provided HIV testing and counseling and received their results as per national guidelines. CU-ICAP will work closely with the ministry of health staff at provincial, district and health facility levels to ensure that a positive attitude and support is given towards routine HIV testing and counseling. In FY10 CU-ICAP will prioritize the identification of exposed/infected children < 5 years of age, through systematic provision of EID for those < 18 months of age at the MCH, PITC in clinical settings, family-testing through clinical and community HTC strategies, and the systematic use of the combined mother-child card at MCH. All exposed children until 18 months of age will be linked to pediatric care services and ART if HIV-infected. CU-ICAP will also support implementation of home based CT in the 3 districts, as part of a comprehensive community HIV/AIDS program. The home-based CT program will lead to many previously undiagnosed people knowing their status and being referred to care and treatment. It will also support community and client education about HIV/AIDS. Special efforts will be made to promote couples VCT and to provide prevention services for discordant couples. CU-ICAP will support training of 50 healthcare workers on CT, support staff salaries, continuous medical education, regional and district level coordination and program review meetings, quality assurance activities, printing of recording and reporting tools, supplies and other relevant logistics. CU-ICAP will work towards ensuring high level of quality for CT services through support of regular supervision, mentorship, and external test validation and proficiency testing as per the Kenya national quality assurance strategy. CU-ICAP will also work to ensure effective referral and linkage to prevention, and care and treatment depending on the outcome of the HIV testing and counseling.
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Care	PDCS	130,000
Narrative:
None
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Care	PDTX	245,000
Narrative:
None
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Prevention	MTCT	814,720
Narrative:
None
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Treatment	HVTB	1,150,000
Narrative:
None

Implementing Mechanism Indicator Information

(No data provided.)

Implementing Mechanism Details

Mechanism ID: 12047	Mechanism Name: MARPS Surveillance
Funding Agency: U.S. Department of Health and Human Services/Centers for Disease Control and Prevention	Procurement Type: Cooperative Agreement
Prime Partner Name: TBD
Agreement Start Date: Redacted	Agreement End Date: Redacted
TBD: Yes	Global Fund / Multilateral Engagement: No

Total Funding: Redacted
Funding Source	Funding Amount
Redacted	Redacted

Sub Partner Name(s)

(No data provided.)

Overview Narrative

The new partner will provide technical assistance to the GoK and implementing partners on MARPS surveillance activities. The overall objective is to establish and regularize surveillance among MARPs, initially targeting injecting drug users (IDUs), men who have sex with men (MSMs) and commercial sex workers (CSWs). There is no established national level surveillance system to monitor the behavioral and serological aspects among these populations in Kenya.

A number of partners, including NACC, NASCOP, UNAIDS, WHO, CDC, Population Council and others have established a technical working group and drafted a protocol to implement a surveillance system for MARPs in major urban areas in Kenya where networks to the MARPs have been established. COP 10 funds will be used to:
• Continue the use of respondent driven sampling (RDS) and other appropriate methods to recruit individuals in the target populations and estimate population sizes

• Obtain behavioral data and conduct HIV/STI testing to establish prevalence among these populations

• Apply HIV prevention messages

• Refer those with HIV/STI infection for care and treatment

• Inform interventions, e.g. tailored services for MARPs, and policy development for MARPs

• Inform further planning and development of MARPS surveillance, including potential modification of protocols and addition of new surveillance sites

Health workers and program managers will be trained on sampling methodologies for hidden and hard to reach populations, analyzing and interpreting qualitative data for decision making and to inform policy. This will ensure that relevant capacity is created among the technical level individuals in order to sustain MARPs surveillance in Kenya.


Cross-Cutting Budget Attribution(s)

(No data provided.)

Key Issues

(No data provided.)

Budget Code Information

Mechanism ID: Mechanism Name: Prime Partner Name:	12047 MARPS Surveillance TBD
Strategic Area	Budget Code	Planned Amount	On Hold Amount
Other	HVSI	Redacted	Redacted
Narrative:
The new partner will provide technical assistance to the GoK and implementing partners on MARPS surveillance activities. The overall objective is to establish and regularize surveillance among MARPs, initially targeting injecting drug users (IDUs), men who have sex with men (MSMs) and commercial sex workers (CSWs). There is no established national level surveillance system to monitor the behavioral and serological aspects among these populations in Kenya. A number of partners, including NACC, NASCOP, UNAIDS, WHO, CDC, Population Council and others have established a technical working group and drafted a protocol to implement a surveillance system for MARPs in major urban areas in Kenya where networks to the MARPs have been established. COP 10 funds will be used to: • Continue the use of respondent driven sampling (RDS) and other appropriate methods to recruit individuals in the target populations and estimate population sizes • Obtain behavioral data and conduct HIV/STI testing to establish prevalence among these populations • Apply HIV prevention messages • Refer those with HIV/STI infection for care and treatment • Inform interventions, e.g. tailored services for MARPs, and policy development for MARPs • Inform further planning and development of MARPS surveillance, including potential modification of protocols and addition of new surveillance sites Health workers and program managers will be trained on sampling methodologies for hidden and hard to reach populations, analyzing and interpreting qualitative data for decision making and to inform policy. This will ensure that relevant capacity is created among the technical level individuals in order to sustain MARPs surveillance in Kenya.

Implementing Mechanism Indicator Information

(No data provided.)

Implementing Mechanism Details

Mechanism ID: 12048	Mechanism Name: Nyumbani Village International
Funding Agency: U.S. Agency for International Development	Procurement Type: Cooperative Agreement
Prime Partner Name: Children of God Relief Institute
Agreement Start Date: Redacted	Agreement End Date: Redacted
TBD: No	Global Fund / Multilateral Engagement: No

Total Funding: 200,000
Funding Source	Funding Amount
GHCS (State)	200,000

Sub Partner Name(s)

(No data provided.)

Overview Narrative

Nyumbani Village has been an existing mechanism under Lea Toto (mechanism ID 9054 that has been split into 2). Although the activities remain unchanged, in COP10 it will be entered as a new mechanism.

Goals and Objectives

The goal of Nyumbani Village is to contribute towards poverty reduction among target communities by improving food security, nutrition and agro-income among vulnerable households particularly those headed by HIV orphans and vulnerable children and old grandparents through training in sustainable agriculture, food processing and marketing along with other vocational training opportunities.

Currently the program has 549 children and 54 grandparents in residence receiving shelter, food, clothing, medical care, education, spiritual guidance and leisure opportunities. The Village Medical Clinic currently serves approximately 300 clients per month, the majority coming from the outside community.

The main objectives are to ensure that enrolled families within the Village have adequate social support and have reached a certain level of self-reliance and expand of the Health Care Centre in order to provide high quality clinical, nursing, and counseling services to residents of Nyumbani village while integrating the Kwa - Vonza and Kwa - Mutonga communities. These activities will reach an additional 2,000 adults and 1,000 children by September 2011. An estimated 75 HIV+ adults and children will receive care and treatment.

Additional activities include provision of optimal holistic social support, quality care and counseling services to the Nyumbani village families as well as ensuring the residents and the surrounding communities reach certain level of self-reliance through sustainability program.
How does this link to Partnership Framework Goals

This activity will contribute towards Community support and mitigation programs including capacity building for households with OVC to expand care to reach at least 80 percent of children orphaned by AIDS and 80 percent of households with OVC. It will also contribute towards increasing the number of people (including children) tested in both clinical and non-clinical settings

Geographic coverage and target populations

This activity will be implemented in Kitui District in Eastern Province. It will target orphans and vulnerable children, caregivers of OVC, community leaders as well as community based Faith-Based organizations.

Contributions to Health Systems Strengthening

Nyumbani Village project supports the policy development in the National Strategies for the care of HIV affected persons, through cooperation and exchange of experiences with the National AIDS Control Council (NACC). To this end the program will gradually interact with the relevant stakeholders in documenting best practices and lessons learned which will be made available to any interested party, including civil society organizations, private and public sectors.

Cross-cutting programs and key issues:

This activity will support key cross cutting programs on Economic Strengthening through income generating and savings led activities to enhance household food security. The activity will also support educational activities targeting OVC enrolled in the program, provide safe water guards, food and nutrition commodities for house-holds looking after OVC.

IM strategy to become more cost-efficient over time (e.g. coordinated service delivery, PPP, lower marginal costs, etc):

Nyumbani Village is an eco-village with the farm registered as organic. A variety of income generating projects have been established to ensure that the outputs from the farm will be used to meet both the basic needs of the villagers as well as generate sufficient income to support the infrastructure of services. These projects include establishment of a forestry unit with a variety of trees for commercial use, rearing of livestock and chicken units and production of agricultural produce.

Budget allocation: $ 200,000