Table of Contents
I. Executive Summary
II. Background and Country Context
III. Country Program Description
A. Introduction
B. Situation Analysis
C. Accomplishments and Outcomes
D. Implementation and Management Issues
E. Subproject Highlights
IV. Attachments (See Below)
Glossary of Acronyms
Attachments
Attachment A: Nepal Country Office Technical Assistance Summary
Fiscal year
TA type |
Person days |
Person weeks |
|
| 1994 |
| BCC |
16 |
3.2 |
| STI |
22 |
4.4 |
| Evaluation |
10 |
2.0 |
| Condom |
10 |
2.0 |
| 1995 |
| BCC |
34 |
6.8 |
| STI |
54 |
10.8 |
| Evaluation |
31 |
6.2 |
| Condom |
14 |
2.8 |
| Prog Mgt |
8 |
1.6 |
| Prog Review |
24 |
4.8 |
| EPI-Model |
5 |
1.0 |
| 1996 |
| BCC |
30 |
6.0 |
| STI |
19.25 |
3.85 |
| Evaluation |
13 |
2.6 |
| Condom |
10 |
2.0 |
| Prog Mgt |
23 |
4.6 |
| RRF |
29.75 |
5.95 |
| PPT |
44 |
8.8 |
| 1997 |
| BCC |
9 |
1.8 |
| STI |
91 |
18.2 |
| Evaluation |
9 |
1.8 |
| Prog Mgt |
11 |
2.2 |
| RRF |
25.5 |
5.1 |
| Training |
11 |
2.2 |
| Cap Building |
43 |
8.6 |
| Report Prep |
8 |
1.6 |
| EPI-Surveillance |
5 |
1.0 |
Attachment B: AIDSCAP/Nepal Publications and Presentations
AIDSCAP/Nepal Publications
Final report on Nepal HIV Surveillance and Estimates Workshop, Dhulikhel
January 6-8, 1997
STI/HIV/AIDS Cross-Border Intervention Workshop Sharing the India-Nepal Experience, Raxaul, India
December 16, 1996
NMA/AIDSCAP Training Package: Case Management of Sexually Transmitted Infections, Volumes: I and II
Workshop Report, Lessons-Learned by AIDSCAP/Nepal Subprojects, Dr. Paul Janssen, Consultant
March 14, 1997
Final Report: Technical Assistance to AIDSCAP/Nepal, Dr. Paul Janssen, Consultant
May 1997
Final Consultancy Report, Mr. Mahesh Pradhan, Consultant
May 1997
CRS Hotline Rapid Assessment Report, Dr., Stacy Leigh Pigg, Consultant
July 1997
Executive Summaries from the Final Project Reports, Prepared for the July End of Project Lessons Learned Meeting, AIDSCAP/Nepal.
July 22, 1997
Final Report on Nepal HIV Surveillance and Estimates Workshop, Dhulikhel, Nepal,
January 6 - 8, 1997
AIDSCAP/Nepal Brochures
The Nepal Country Program, June 1995
The Nepal Country Program, July 1995
The Nepal Country Program, March 1996
The Nepal Country Program, April 1996
The Nepal Country Program, October 1996
Presentations
End of Project Lessons Learned Meeting, Asha Basnyat and Joy Pollock, FHI/AIDSCAP July 22, 1997, Kathmandu
HIV/AIDS and Cross Border Issues.. Presentation to Journalists Workshop on CRC/CEDAW/GAD, Asha Basnyat, FHI/AIDSCAP June 9-13, 1997, Dhunkuta, Eastern Nepal
The Nepal AIDSCAP Strategy. New ERA Dissemination Workshop, Joy Pollock, FHI/AIDSCAP June 3, 1997, Kathmandu
Presentation at FPAN Lessons Learned Workshop, Joy Pollock, FHI/AIDSCAP April 29, 1997, Sauraha, Chitwan
Stimulus' Lessons Learned Workshop Presentation, Joy Pollock, FHI/AIDSCAP April 23, 1997, Kathmandu
Presentation to the "India-Nepal Cross Border Intervention Strategy On HIV/AIDS" Meeting, Asha Basnyat, FHI/AIDSCAP April 3-4, 1997, Delhi, India
AIDSCAP Program in Nepal. Presentation to SAVE/US NGO Meeting
Asha Basnyat, FHI/AIDSCAP May 28, 1997, Kathmandu
Lessons Learned On The AIDS Awareness and Condom Promotion Multimedia Campaign. Presentation during the Communications Officers Summit-Asia (COSA) , Asha Basnyat, FHI/AIDSCAP Feb. 3-8, 1997, Chang Mai, Thailand
Mass Media's Role in Promoting Behavior Change . Presented at the "Advertising for Social Change" Workshop, Sponsored by UNICEF and Kathmandu Post, Joy Pollock, FHI/AIDSCAP February 97, Kathmandu
Introduction to The AIDSCAP Project. Address to Nepal Jaycees The HIV/AIDS and STI Prevention & Control Symposium Workshop. (In Nepali), Asha Basnyat, FHI/AIDSCAP December 21-23, 1996, Naranghat, Chitwan District
Presentation on Cross-Border Perspectives: India and Nepal, Joy Pollock, FHI/AIDSCAP December 16, 1996, Raxaul, India
Presentation to the Save/US HIV/AIDS Team Meeting, Joy Pollock, FHI/AIDSCAP November 19, 1996, Kathmandu
Presentation to The Asia Pacific Consultancy Meeting on HIV/AIDS, Joy Pollock, FHI/AIDSCAP November 5, 1996, Kathmandu
Presentation at the Launch of AIDSCAP's Multimedia AIDS Awareness and Condom Promotion Campaign, Joy Pollock, FHI/AIDSCAP July 25, 1995, Kathmandu
STI/HIV/AIDS: Chemists and the Community. Oral Presentation by Mahesh Pradhan, NCDA (with assistance from AIDSCAP CO for oral presentation and accompanying slide set) July 7, 1996, Vancouver, Canada
Dhaaley Dai Speaks HIV/AIDS Messages In Nepal. Poster Presentation Prepared for the Vancouver International Conference. Asha Basnyat, FHI/AIDSCAP July, 1996
Presentation at FPAN/Chitwan Reproductive Health Clinic Inauguration, Joy Pollock, FHI/AIDSCAP June 30, 1996, Chitwan
An Overview of the Nepal Country Program. Tripartite HIV/AIDS Workshop, Joy Pollock, FHI/AIDSCAP April 1996, Calcutta, India
Promotion of Standard STI Case Management Guidelines in Nepal. Oral presentation by Dr. Ram Kumar Shrestha, Bir Hospital, Kathmandu at September 1995, Chiang Mai Asia Conference (Prepared by Dr. Doris Mugrditchian, ARO with Dr. Ram K. Shrestha)
AIDSCAP/Nepal: A Country Program Status . Report to the AIDSCAP/Nepal Program Review Meeting at USAID/Nepal, Joy Pollock, FHI/AIDSCAP September 1995, Kathmandu
Presentation on "The Donor Perspective" to the AmFAR Grantees, Joy Pollock, FHI/AIDSCAP, June 30, 1995
Briefing on AIDSCAP/Nepal, Presentation to American Ambassador Sandra Vogelgesang and USAID Mission Director Frederick Machmer, Joy Pollock, FHI/AIDSCAP June 1995, Kathmandu
Orientation Training Presentation on AIDSCAP, Joy Pollock, FHI/AIDSCAP, January 22, 1995, Hetauda, Makawapur
Briefing on the AIDSCAP/Nepal Implementation Strategy for Assistant Administrator, USAID, Ms. Margaret Carpenter, Joy Pollock, FHI/AIDSCAP September 28, 1994
NCASC Donor's Meeting Presentation/Update on AIDSCAP, Joy Pollock, FHI/AIDSCAP September 15, 1994, Kathmandu
NCASC Donor's Meeting Presentation/Update on AIDSCAP, Joy Pollock, FHI/AIDSCAP April 21, 1994, Kathmandu
Attachment C: LogFrame
|
Narrative Summary |
Measurable Indicators |
Means of Verification |
Important Assumptions |
|
Goal: Reduce the rate of sexually transmitted HIV infection in the Terai region of Nepal |
Stabilization in gender-specific HIV prevalence in the Terai through 1996* (below 1 percent) |
HIV sentinel surveillance in the Terai region |
|
|
|
Purpose: Reduce high risk sexual behavior among core groups in the Terai |
1. 50 percent decrease in syphilis seroprevalence in women ages 15-24 attending ANC by EOP* |
1. Syphilis sentinel surveillance in ANC in Terai |
There is sufficient interaction between members of the highly mobile core groups targeted in this project and the community to have a significant impact on the HIV epidemic in the Terai (e.g. Clients of CSWs include local clients) |
|
2. 70 percent of targeted populations reports consistent condom use in high-risk sexual encounters by EOP* |
2-5. KABP surveys complemented by focus group discussions |
|
3. 30 percent of targeted clients of CSWs report decrease in the number of sexual partners by EOP* |
|
|
|
Output 1: Access of targeted populations to improved STI prevention treatment services increased |
1.1) >80 percent of target population can identify a source of high-quality HIV/AIDS services by EOP |
KABP surveys |
Effective drugs for the treatment of STIs are accessible to target groups |
|
1.2) Decrease in prevalence of syphilis among CSWs to below 10 percent in the Terai by EOP |
STI prevalence surveys of CSWs |
|
1.3) >50 percent of health care providers serving target populations in the Terai are trained in use of STI diagnosis and treatment algorithms by EOP |
Project process data |
|
1.4) >70 percent of target populations seeking STI services from participating drugstores/clinics receives treatment according to national guidelines by EOP* |
1.4-1.6) Surveys of target populations and /or "mystery shopper" surveys |
|
1.5) >70 percent of target populations seeking STI services from participating drugstores/clinics receives appropriate preventive education including advice about partner notification and condom use by EOP* |
|
|
1.6) >50 percent of target populations seeking STI services from participating drugstores/clinics receives a condom* |
|
|
|
Output 2: Existing condom distribution system to reach target populations extended |
2.1) 70 percent of brothels in target areas become condom outlets by EOP |
Process data/logistic reports surveys |
Condom supply to CRS is maintained
CRS remains a viable business venture
Mass media campaign allowed to air |
|
2.2) 8 million condoms sold per year to target populations in the Terai by EOP* |
|
2.3) 60 percent condom distribution outlets participating in program activities by EOP |
|
2.4) 90 percent of target population(s) covered by condom promotion activities |
|
2.5) Fewer than 10 percent of participating condom outlets experience stock-outs |
|
|
Output 3: Targeted communication interventions to reduce high risk behavior implemented in the Central/Terai region |
3.1) At least two local NGOs in each target district recruited to co-implement (with major contracted NGOs) outreach activities to CSWs and their clients by end of year 1 |
Project process data
Implementing agency reports |
Indigenous NGOs have the capacity to expand their programs |
|
3.2) 80 percent of staff of participating NGOs trained in HIV/STI/AIDS awareness and IEC strategies for HIV/STI prevention by end of month 18 |
Resident Advisor monthly reports |
Gate-keepers can be sensitized to be supportive of project activities |
|
3.3) 20,000 CSWs and 30,000 clients in target areas reached by communication activities by EOP |
|
|
|
3.4) 80 percent of targeted populations perceive their risk realistically by EOP |
|
|
|
3.5) 95 percent of target population can name two correct ways to prevent transmission of HIV by EOP* |
|
|
|
|
Output 4: Policy makers' awareness of HIV/STI/AIDS issues in Nepal increased |
4.1) Policy makers participating in project activities have a heightened awareness of policy issues and options. |
Pre and post activity questionnaire scores. |
Stability within the public sector
Awareness of policy issues contributes to positive policy changes |
|
|
Activities:
1. STI component
1.1 Algorithms for the screening and syndromic diagnosis of STIs in CSWs developed/ validated
1.2 Syndromic algorithms for the management of GUD and urethritis in men developed/validated
1.3 STI workshops for medical store personnel conducted
1.4 STI workshops for private sector health care providers conducted
1.5 Access to STI services to CSWs improved
1.6 Syphilis sentinel surveillance in ANC in Terai region established and functioning |
See Budget |
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|
|
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|
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2. Condom Component
2.1 Recruit two sales representatives dedicated to sales in the targeted areas through traditional and non-traditional outlets and high risk groups
2.2 Provide logistical, equipment and training support to the new reps.
2.3 Develop and launch IE & M Condom Promotion Campaign including:
• Four separate radio treatments broadcast through 730 prime time spots
• Two separate TV treatments aired though 156 prime time spots
• Thirty-five 200 square foot wall paintings
• Plus, funding for street drama troupes, POP materials, promotional items (T-shirts, key chains, rickshaw/bus signs and cinema hall advertisements) |
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|
|
|
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3. Communication Outreach Component
3.1 Rapid assessment for better understanding of target population and channel to reach
3.2 Subagreements with major NGOs to implement outreach program developed
3.3 Training for development of outreach strategies for sub-target groups among staff of implementing agencies |
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|
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3.4 Development and distribution of small media and education materials
3.5 Education and awareness activities among gate keepers of the target population, e.g. trucker associations, hotel managers, factory owners, police, customs
3.6 Implementation of outreach education to CSWs and clients
3.7 Training of Peer leaders of each sub-target groups
3.8 Lessons learned workshops for implementing agencies |
|
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4. Policy Component
4.1 A series of workshops and seminars conducted for media personnel
4.2 Policy seminars for national and community leaders
4.3 Policy tours to Thailand conducted for key Nepalese leaders |
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*WHO/GPA Priority Prevention Indicators (PPIs)
Attachment D: AIDSCAP Nepal Country Program Financial Summary
|
LOP Funding/Estimated Expenditures |
| USAID Funding(Nepal Mission and ANE Bureau) |
Obligated Funds |
| ANE Bureau |
881,035 |
| Q Contract |
1,464,866 |
| Field Support and Project Core Funds |
418,121 |
| Total Funding |
2,764,022 |
| Expense Detail Summary |
Estimated Expenses |
| I. Subgrants |
| Contraceptives Retail Sales Company |
42,071 |
| Family Planning Association of Nepal |
38,544 |
| Futures Group International |
233,634 |
| General Welfare Pratisthan |
321,341 |
| Life Saving and Life Giving Society- Human Resource Development for GWP: Part I |
17,665 |
| Life Saving and Life Giving Society- Human Resource Development for GWP: Part II |
29,230 |
| Life Saving and Life Giving Society- Human Resource Development for GWP: Part III |
18,367 |
| Nepal Chemists and Druggists Association-Prevention Education |
94,217 |
| Nepal Chemists and Druggists Association-Strengthening Project |
22,331 |
| Nepal Medical Association-STD Case Management and Training Workshops |
40,899 |
| New Era - Evaluation of Interventions Targeted to CSWs and Sex Clients |
19,745 |
| New Era - Chemists STD Drug Dispensing Behavior and HIV Prevention Communication |
12,759 |
| New Era - Baseline Study of CSWs, Sex Clients, and Chemist Shops |
22,115 |
| New Era - Rapid Qualitative Assessment of AIDSCAP Behaviour Change among CSWs |
4,188 |
| New Era - Baseline Study of STI Services Provided by Chemists |
10,086 |
| Population Services International |
26,786 |
| Program for Appropriate Technology in Health |
106,779 |
| Save the Children |
36,011 |
| Stimulus Advertizers, (P) Limited |
109,529 |
| Valley Research Group |
17,566 |
| Total Subgrants |
1,223,863 |
| II. Country Program Support* |
1,384,230 |
| Total Projected LOP Expense |
2,608,092 |
| * Country Program Support consists of country office costs, direct funded program activities (e.g. international conference participation, micro-grants, trainings), technical assistance, program support, evaluation, audits, etc. |
