3488001S
Background Over the past decade, Namibia has made impressive progress in the fight against HIV/AIDS. The recent NAMPHIA study shows that of people living with HIV (PLHIV) aged 15-64 years, 86% reported knowing their HIV status, and once diagnosed over 90% of PLHIV were linked to antiretroviral therapy (ART) and virally suppressed. The Government of the Republic of Namibia (GRN) has taken decisive steps to scale up best practices, including integrating preexposure prophylaxis (PrEP) into the national ART guidelines, increasing HIV testing access and yield through targeted index partner testing and HIV self-testing and introducing community-based ART models that have demonstrated high retention rates. Despite this progress, key and vulnerable populationsâ particularly sex workers (SWs), men who have sex with men (MSM), and transgender (TG) womenâ continue to be left behind. Overall HIV prevalence among adults 15-49 stands at 11.8% but rises to 53.2% among SWs in Katima Mulilo and Keetmanshoop and 20.9% among MSM in Windhoek. While little data on TG men or women are available, the PLACE study conducted by the Ministry of Health and Social Services (MOHSS) in Windhoek found that TG women reported the lowest rates of HIV testing at 12%, compared to 30% and 57% for female SWs (FSWs) and MSM, respectively. Treatment coverage for key populations (KPs) was low (33.7% of HIV-infected FSWs and 15% of HIV-infected MSM) with significant loss to follow-up along the continuum of HIV prevention, care and treatment, significantly increasing the risk of HIV transmission or reinfection of HIV positive sex partners. Recent data from IBBS study done in 2019 at three selected sites of Katima Mulilo, Windhoek, Walvis Bay & Swakopmund has shown that HIV prevalence among young FSW aged 18-24 years, a proxy for HIV incidence, has remained high and ranges from 4.8% to 27.4%. There is a high syphilis prevalence 8.9% among FSW and 30% of KPs reported never using a condom, both data points indicating low uptake of prevention initiatives and perceived risk of HIV acquisition by KP community. The IBBS 2019 study has demonstrated that the HIV viral load suppression among KPs remains at all study sites with 77.2%, 69.4% and 28.3% at Windhoek, Katima Mulilo and Walvis Bay/Swakopmund respectively. The key challenges facing KPs include high rates of stigma and discrimination (S & D) and violence against KPs; weak bidirectional linkages/referral mechanisms between community and health facility-based services; lack of KPsâ knowledge about HIV and their risk of HIV acquisition and how to access services and support; and a lack of holistic resiliency and risk reduction interventions. Achieving and sustaining epidemic control in Namibia will require a rapid acceleration of the HIV response for KPs, using coordinated, data-driven approaches at scale to effectively address the major biomedical, structural, and behavioral factors that increase KPsâ vulnerability to HIV, alongside meaningful engagement of KP-led and KP-serving organizations that are best equipped to reach these most hard-to-reach populations. Under KP-STAR, KPs will benefit from seamless integration of interventions so that HIV transmission is reduced, and people diagnosed with HIV obtain early access to services. Our implementation framework prioritizes key areas along the cascade that require concentrated attention, including targeted, high-yield HTS approaches; early/same-day initiation on ART; and the expansion of differentiated service delivery (DSD) models for KPs. KP-STAR Consortium Members and Roles The KP-STAR consortium is led by IntraHealth Namibia (IHN), a trusted independent Namibian not-for-profit organization that has past experience implementing PEPFAR-funded projects with great success including sub-roles on USAIDâ s HIV Clinical Services Technical Assistance Project (UTAP) and DREAMS/Twagamenwa Project. Consortium members include: Walvis Bay Corridor Group (WBCG): A public-private partnership operating in the transportation and logistics space that has established an HIV/AIDS Wellness Service initiative to serve employees and other clientsâ including large numbers of KPsâ along transportation corridors. WBCG will provide comprehensive clinical and community activities aiming at HIV prevention, Care and treatment. â ¢KP-led civil society organizations (CSOs): Several established Namibian KP-led organizations already working in the PGAs will play a central role in community mobilization, advocacy, linkages, and peer support for the KP groups they serve: oRights not Rescue Trust (RnRT): A leading human rights organization that promotes access to health, rights, and education for sex workers in Namibia. Will provide community-based activities, linking their clients to clinical/psychosocial care and reporting. oRights for All Movements (RAM): A lesbian, gay, bisexual, transgender and intersex (LGBTI) and MSM organization that promotes equal rights regardless of sexual orientation and educates the public on sexual diversity and tolerance. It will provide community-based service, linkage to psychosocial/clinical care and reporting. oWings to Transcend Namibia Trust (WTTN): A Namibian NGO that advocates and lobbies for equity and inclusion of transgender people. It will provide community-based service, linkage to psychosocial/clinical care and reporting. â ¢IntraHealth International (IHI): A global nonprofit organization with 13 years of experience implementing HIV programming in Namibia, IHI brings a wealth of expertise in HIV care and treatment for KPs, including as a partner on the global PEPFAR-funded Linkages across the Continuum of HIV Services for KPs (LINKAGES) project. In KP-STAR IntraHealth International will provide technical, operational, and compliance support to IHN and will lead technical approaches for online outreach to KPs Project Goal Strengthening HIV Prevention for Key Populations and other HIV KP programs while scaling-up innovative, evidence-based approaches to reduce the incidence and mitigate the impact of HIV among KPsâ specifically SWs, MSM, and TG individual Project objectives Successful implementation of the project will result into three expected results namely: i.Increase and expand the access to comprehensive HIV prevention and treatment services and interventions for KPs. The KP-STAR consortium will organize capacity building of staff through trainings, identification of KPs networks using online facilities and provide services and use of data for decision making. The Health Care Workers in MOHSS facilities supporting KP-STAR will receive training on offering KP-Friendly services. IntraHealth International will provide technical support in developing and deployment of the APP/ online systems which will link the KPs community to clinical, psychosocial care and prevention messages. IntraHealth International will also provide technical guidance to the contractors hired to support staff training and conduct the geospatial mapping of hot spots in the 9 priority geographic areas. The consortium will expand the availability of self-testing for HIV and introduce assisted self-testing activities both at KP-led safe spaces and health facilities, with all facilities providing uninterrupted HIV rapid test. The mobile vans will provide testing service during moon-light campaigns and outreach services while also providing ART outreach services. The consortium partners will work together to develop IEC and use the social media App platform to improve the KPs awareness of risks facing them, design and deliver the HIV prevention messages and reminders for clinic appointments. The team will work together to initiate the Community ART Adherence support Groups (CAGs) in each clinic/centre and provide outreach ART service to improve the retention and VL suppression. The CSOs partners will lead in developing Violence Prevention and Response (VPR) plan including screening tools, emergency response system, referral system and plan for assisting victims of the violence acts. The consortium team will partner with GBV help desks of Ministry of Gender and other stakeholders to implement the plan. ii.Strengthen the capacity and sustainability of KP-led CSOs and other key stakeholders to advocate for and implement KP-focused HIV activities IntraHealth Namibia will conduct the Integrated Technical Organizational Capacity Assessment (ITOCA) to RAM, WTTN and RnRT and work with the organizations to develop the Institutional Development plan customized to each partner with monthly monitoring on improvement. The prime will continue with coaching, training and will work with CSO s in building the capacity of their organizations in fund raising skills. The KP-led CSOs will form part of the MOHSS technical working group and will work with IntraHealth International to deliver presentations on the KP-STAR project progress during monthly TWG meetings. The KP-led organization work with IntraHealth to secure space and develop the standard Fair Share exhibitions package and IEC material design which will be used at different exhibitions. The CSOs will work with IntraHealth Namibia to develop the advocacy plan for creating awareness and sensitization of the KPs-led organizations work, human rights and fight against stigma and violence against the KPs persons. IntraHealth International will support the Namibia finance team in delivering the capacity building package to the IPs. iii.Strengthen data management systems for planning, monitoring, use, and assuring the quality of KP HIV programs IntraHealth International will provide technical input to the development of DHIS2 project instance customized to KP-STAR needs and train the CSOs partners in using this database and roll-out for use by all KP-STAR partners. The IntraHealth Namibia team will conduct KPs-led institutional MEL capacity and work with them to develop SOPs and data handling manuals, train staff and continue providing coaching to partners on compiling the reports. The learning plans will be implemented by each partner and will be used to share the experience across the network on working ideas The capacity of KPs-led CSOs MEL teams will be built for them to conduct Data Quality Audits (DQAs), general reports, design and implement the data quality improvement plans. Scope of work In KP-STAR IntraHealth International will provide technical, operational, and compliance support to IHN. To provide technical support to IHN, IntraHealth International will embark on performing the following functions: â ¢Support the country team in project start-up, including development of the annual workplan and budget, and regularly liaise with finance, grants, procurement and administrative project staff to ensure full compliance with USAID rules and regulations and IntraHealth policies and procedures. â ¢Support the team in producing quality, error-free data and extrapolating key project information from the data, as guided by the projectâ s results framework. â ¢Support the online outreach activities, including working with stakeholders to develop an online outreach strategy to reach KPs for referrals and train outreach workers in online approaches and in using data to identify virtual hotspots. â ¢Regularly liaise with finance, grants, and administrative project staff to ensure full compliance with USAID and IntraHealth rules and regulations. In addition to monitoring monthly expenditures against the activity budget and reviewing monthly financial reports, the Program Officer will assist with writing quarterly and annual reports â ¢Provide subaward and procurement guidance for staff, partners and grantees, ensure compliance and training to build capacity of partners and technical program staff to successfully manage all project issues related to subaward management
Intrahealth International, Inc.
Cooperative Agreement 72067320CA00003
$462.7k 10/1/22