Annual Progress Report GFATM HIV/AIDS Programme, 2010
Country / YemenDisease / HIV/AIDS
Round / 3
Phase / 2
Grant Title / Developing National Capacities to Address HIV/AIDS in Yemen
Grant number / YEM-307-GO5-H –project /programme number : 00049807
SR Agency; Name & Address / The Joint United Nations Programme on AIDS (UNAIDS)
Sana’a- Republic of Yemen
Reporting Period / January – December. 2010
Table of Contents
Executive summary………………………………………………………………..………..04
Programmatic results………………………………………………………………….……05
Monitoring and evaluation ……………………………………………………….…….09
Finance…………………………………………………………………………………………...10
LIST OF ABBREVIATIONS:
AIDS / Acquired Immune Deficiency SyndromeAUB
BBS
BCC
CSOs
FSW
GFTAM
HIV
IDUs
KABP
MARPs
M&E
MOPH&P
MSM
MENA
NAP
NPC
NGOs
PLHIV
PMU
PR
RST
SR
UCO
UNAIDS
UNICEF
UNDP
WHO
UNFPA
UNGASS / American University of Beirut
Bio Behavior Study
Behavior Communication Strategy
Civil Society Organizations
Female Sex Worker
Global Fund To Fight AIDS, Tuberculosisand Malaria
Human Immune-deficiency Virus
Intravenous Drug Users
Knowledge, Attitude, Behavior and Practices
Most At Risk Population
Monitoring and Evaluation
Ministry Of Public Health and Population
Men who Have Sex with Men
Medal East and North Africa
National AIDS Programme
National Population Council
Non- Governmental Organizations
Person /people living with HIV
Project Management Unit
Principle Recipient
Regional Support Team
Sub Recipient
UNAIDS Country Office
Joint United Nations Programme on HIV/AIDS
United Nations Children’s Fund
United Nations Development Programme
World Health Organazation
United Nations Population Fund
United Nations General Assembly Special Session
1 - EXECUTIVE SUMMARY
In supporting the implementation of Outcome Framework, UNAIDS country office increasingly focus its efforts on: Brokering and unifying the management of relevant technical support for appropriate national AIDS responses and producing strategic analyses of programmatic quality to improve results-based implementation;
UNAIDS also optimize UN support for applications to, and programme implementation of, the Global Fund to Fight AIDS, Tuberculosis and Malaria; assess and realign the management of technical assistance programmes; broaden and strengthen engagement with communities, civil society and networks of people living with HIV at all levels of the response. To this effect, and in accordance with the agreement between UNDP and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the first letter of Agreement (LOA) has been signed on 24th August 2008 between the United Nations Development Programme (UNDP) the Principle Recipient (PR) and the Joint United Nations Programme on AIDS (UNAIDS) country office as Sub Recipient (SR) in respect to provision of services in the implementation of the programme Developing National capacity to address HIV/AIDS in the republic of Yemento R3 grant -Phase two (Year 3 , Year 4 and year5)[1]till June 2010 the end of the grantwith work plan and a total budget ofUSD444,730 to provision technical supportin areas of consultants Contracts (17%), Training (22%), Research more than 50 % and miscellaneous (6%).
as the MOU was signed at the end of quarter three of year 3 ,in addition to other administrative arrangementsOnly one activity been implemented by 2008. With the appointment of the new PMU-UNDP manager UNAIDS has been received on 14th April 2009 a new letter of Agreementthat amalgamated the Y3 & 4 plan & budget, however,the actualimplementation of the activities started on June 2009, and within six months till end of 2009UNAIDS had implemented number of activities with the total expenditures of (US $ 84,588) and the remaining balance is (US $ 360,142).
At the beginning of 2010, the PMU has organized for meeting with all (SR) to prioritize and reprogram the unachieved activities in Y 3 ,Y4 and Y5 plan to be implemented on the remaining period of the grant (June 210) as a result of this ,UNAIDS country office has received the reprogrammed work plan with budget of (US $ 323,122).
The main objective of this programme is to build the capacity of the nationals to address HIV/AIDS in Yemen, while the three specific objectives to be achieved by this programme in accordance with agreed work plan are:
Objective1:To enhance HIV/AIDS prevention, care and support capacity among Government and Civil Society Stakeholders.
Objective2:Awareness of HIV/AIDS and other STI's among general population and identified vulnerable and high risk groups is enhanced and risk behavior is reduced
Objective3:Strengthen HIV surveillance system - both biological and behavioral studies
In accordance with the Grant Agreement , and project documents , UNAIDS country office as sub recipient (SR) has ensured that all services and relevant UN agency regulations and rules are complied with the principle of competitive bidding , and with closed consultation with UNDP,UNAIDS provided technical assistance and support to national counterpart implementers (NAP, NPC , NGOs and PLWAs Associations ).
2 - PROGRAMMATIC RESULTS:
Objective 1:To enhance HIV/AIDS prevention, care and support capacity among Government and Civil Society Stakeholders.
Activities Description:
1.1Recruitment of international M&E Consultants for strengthening M&E system
- Activity Management:
HIV/AIDS Epidemiology Synthesis has clearly shown that there is considerable amount of data on AIDS in Yemen contrary to wide perception of limited evidence. Yet, data is fragmented, often not collected using standard accepted methodologies, and not representative of key populations. Yemen is strongly encouraged to develop its M&E strategy, initiate the process of compiling existing information and to submit the Progress Reports for the 2008-2009 reporting. To this effect, UNAIDS country office has been recruited Pros. Kassem M. Kassak from AUB to undertake this assignment to provide technical assistance to the NAP , NPC to develop national M&E guide and tools on AIDS inline with international tools and the preparationof the country UNGASS report, in close collaboration with a national consultant Dr. Abdul Gabar Ali Abdullah – who recruited to ensure sustainability and transfer of skills to the nationals,
In addition, RST/MENA has recruited the consultant Ms. Hajer Yahyaoui to assist on developing the national M&E guidelines &tools on HIV/AIDS and the country UNGASS reportproduction.
Establishment of M&E working group composed of key actors from government, NGOs, UN system, and academic institutions to advise throughout the process. And Consultation meetings held with participation of different national counterparts and UN (NAP manager, NPC -AIDS Unit director, PMU-M&E officer , Academician- Sana'a University, UNICEF , UNAIDS country office ) National consultant and the international consultant on developing the national M&E guideline and tools with clear national indicators, and data reported on UNGASS report 2009
- Activity Results:
-National Monitoring and Evaluation Guideline 2010-2015 and Tools Developed.
-M&E plan and budget in line with the NSP developed.
-UNGASS 2009 Report produced.
-UNAIDS database populated.
1.2 Support to establish a network of PLWHIV
- Activity Management:
In consultation with RST/MENA,PMU-UNDP and PLHIV Associations, UCO has replaced this activity with the activity “PLHIV Stigma Index exercise” to be coordinated and Implemented by PLHIV Association - Yemen AID Association in Sana’a- to target around (150) HIV-positive Yemeni nationals in five governorates (Sana’a , Aden , Hodeida , Hadramout and Taiz Governorates)to answer the stigma index questionnaires.
I addition, UCO has developed the TOR of NGO (Yemen AID Association- Sana’a) and RST/MENA has contacted with the internationalconsultant, but no clear date identified.
Objective 2:Awareness of HIV/AIDS and other STI's among general population and identified vulnerable and high risk groups is enhanced and risk behavior is reduced
Activities Description:
2.1Recruit international expert to develop culture sensitive National Behavior Change Communication (BCC) strategy.
- Activity Management:
UNAIDS has placed particular emphasis and resources on supporting HIV response in specific contexts of risks and vulnerability, such as sex work , MSM , drug use, mobility, where prevention programmes and outreach activities remain limited in scope and scale, failing to meet the actual demands. Despite social tension and sensitivity around these topics, Yemen has recognized the importance of working with most at risk and vulnerable populations for national responses on AIDS.
The International Consultant Mrs. Rana Haddad has been recruited to provide technical assistance for developing National Behavior Change Communication Strategy (NBCCS), this strategy is considered as an essential component of any comprehensive HIV prevention program encompassing medical services (care and treatment), social, legal, and psychological support services in addition to ensuring preventive means and establishing critical linkages to other program components.
Four days Training conducted and 30 participants from National AIDS Programme from HQ and number of NAP focal points in governorates , National Population Council, NGOs working on HIV field and PLWH contributing to the development of the BCC messages , IEC materials and work plans targeting MARPs.
- Activity Results:
-Cultural and gender sensitive National Behavior Change Communication (NBCC) Strategy for MARPs 2010-2015 finalized
-BCC messages, IEC materials developed.
-Operational plan (not coasted) for MARPS developed
Objective 3: Strengthen HIV surveillance system - both biological and behavioral studies.
Activities Description:
3.1 Conduct KABP study among general, youth & vulnerable population.
- Activity Management:
UNAIDS has placed particular emphasis and resources on supporting HIV response in specific contexts of risks and vulnerability and that is by providing the technical support to the national partners to expand prevention programmes and improve the quality of ongoing interventions with the overarching objective of addressing HIV among those most at risk. To this effect, UNAIDS office has recruited the international consultants, Dr. Monique Chaaya (Epidemiologist Consultant) & Dr. Hani Dimassi (Statistics Specialist) to provide the technical assistance for developing KAPB study among general, youth & vulnerable population.
A national wide KAPB study among 3000 young people aged 15-49 Year has been conducted on July 2010 on eleven governorates (Taiz, Al-Hodeida ,Aden ,Lahaj ,Ibb ,Sana'a City ,Dhamar, Sana'a ,Amran ,Al-Jawf, Hadramout ) out of 22 governorates (rural, peri-urban and urban populations) using quantitative and qualitative methods where men and women young people targeted by this study . as the main objectives of this study to evaluate the current level of knowledge of young Yemeni adults about HIV /AIDS, to determine the proportion of participants who have misconceptions about modes of transmission and to determine sources of information , to assess attitudes of young adults towards HIV/AIDS, to assess sexual Yemeni practices, by determining the proportion of Yemeni males engaged in risky sexual behavior and to explore differences in knowledge, attitudes and practices by gender, age, place of residence and education, The study has conducted by national research institution- Yemen Polling Center- with technical support by consultants from American University Of Beirut –Lebanon and UNAIDS country office.
Draft study report shared with national population council (NPC) for review,the generated data is of great value on the planning and intervention programs targeting young population.
- Activity Results:
-KABP study among general population, young population and vulnerable conducted.
3.2Conduct BSS+ among Most at Risk Populations (MARPs)
- Activity Management:
As the global statistics suggests that at least 5-10 percent of HIV cases worldwide result from the sexual transmission between men, and the exploratory studies have confirmed in countries across the region, the reality is no different in the Middle East and North Africa and sex between men remain a significant part of the epidemic in MENA.
In this connection, UNAIDS Yemen has contracted an international institution ( Kerman University ) for the technical support through designing and undertaken of a bio-behavioral survey (BBS) among MSM in two governorates ( Aden & Hodeida) in Yemen aligning with national surveillance guidance and in order to improve strategic information in the country and building local capacity. And following to this, UNAIDS office has contracted the International institution – HIV-HUB center, Karman University-Tehran –Iran -& three local NGOs in Aden & Hodeida (Woman Association for Sustainable Development, Social Services Association in Adenand Abu Musa Al-Ashary in Hodeida) to assist the international institution by conducting the field work of the study, this activity is in collaboration with NAP –MOPHP and WHO.
- Activity Results:
-The contracting process of International Institution & the three local NGOs to conduct Bio Behavioral Study among MSM –AdenHodeida have been completed (the study launched on February 2011).
Project Personnel Capacity Built:
Through conducting & implementing the work plan activities many of the national staff from NAP, NPC, NGOs, PLWH and other national institution have built their capacity in addressing HIV/AIDS in Yemen, and it was built through:
- Developing M&E guideline and toolsand Preparation of UNGASS Report 2009:
Staff from NAP HQ and governorates,NPC,and PLHIV have built their capacity on developing the national M&E guideline and tools and produced UNGASS report 2009 as well.
- Developing the BCC Strategy, IEC materials and work plans targeting MARPs:
Over 30 participants from National AIDS Programme HQ and at governorates, National Population Councilstaff,NGOs representativesworking on HIV field and PLWH has been trained and built their capacity by the international consultant.
- Developing KAPB study among general, youth & vulnerable population:
The national institution, Yemen Polling Center, has received training by the two consultants from AUB to build their capacity on how to conduct a survey in the general population for the sensitive survey topics towards the society as HIV /AIDS (for first time ).
3 - MONITORING AND EVALUATION :
UNAIDS office has assured the quality of the implemented activities through:
-All the selection and recruitment processes for the consultants and institution are through the UNDP rules and regulations and that is to assure the pure competitiveness and transparency.
-UNAIDS Country Officer has involved in direct supervision and implementation for the conducted activities.
-Sharing all the deliverables with the national partners for their review and comments.
-Reviewing all the deliverables by the UNAIDS Country Office to make sure of the data quality and validity.
3.1 Implementation Challenges:
1 - Insufficient time to implement the work plan activities as per the agreed timeframe ( gap from January to June 2010 after reprogramming and activities prioritization)
2 - Very long recruitment process of national institutions toconduct KABP Study (more than six months for recruiting the national research institution).
3 - Unavailability of the fund at UNDP delayed theduepaymentsfor the YPC institution as per signed contract and deliverables.
4 - Unavailability of the fund at UNDP (Delay on the transfer of the fund from GF to UNDP) leads to delay the beginning of the recruitment process for the international institutions as well as the local NGOs to conduct the Bio-Behavioral Survey.
4 - Finance:-
After the reprogramming that took place at the beginning of 2010, total amount of USD 323,122has been allocated for UNAIDS as the activities budget for 2010, out of the total budgetUSD 303,160has been spent to implement the activities according the work plan and the remaining amount is USD 19,962.
UNAIDS Expenditures for GF Activities 2010The Activity / Budget $ / Spent $ / commitments $ / Balance $ / Remarks
1.1.5 / Recruitment of international M&E Consultants for strengthening M&E system / 26,772 / 27,660 / 0 / -888 /
• The over spent amount ( -888 ) will be balanced from the activity No. 3.4.9
2.1.1 / Recruit international expert to develop culture sensitive National Behaviour Change Communication (BCC)strategy / 11,450 / 12,432 / 0 / 368 / • The over spent amount ( $ -982) from the actvity No. 2.1.1 has been balanced with the remaining amount ($1,350) of the activity No. 2.2.2
2.2.2 / Build capacities of implementing partners on the newly developed BCC strategy and IEC materials / 15,000 / 13,650 / 0
3.4.9 / Conduct KABP study among general population , young population and vulnerable group / 134,000 / 117,854 / 16,146 / The planned budget in approved WP is over budgeted, while the actual study budget is $117,854.
With PMU consultation a total $888 been utilized to cover M&E consultant payment ,and $5,564 to add to BSS+ study budget , So , the remaining budget from this budget line is only $ 9,694
3.4.12 / BSS+ among Most at Risk Populations (MARPs) - Aden / 126,000 / 13,819 / 117,745 / -5,564 / - The actual budget for the study $ 131,564 US
- the remaining $5,564 will be balanced from the remaining amount (US $ 16,146) from the completed KAPB Study Budget As per the advice of the PMU- finance officer
1.8.4 / Support to establish a network of PLWAs
(Replaced to PLHIV Stigma Index) / 9,900 / 9,900 / Not implemented as the unavailability of the international consultant during Q4 2010
T O T A L / 323,122 / 185,415 / 117,745 / 19,962
Note:the above expenditures is based only on UNAIDS financial records as the UNAIDS does not have an access to the Atlas system and did not get any generated report from Atlas by the PMU for comparison.
UNAIDS Country Officer
Dr. Fouzia Gharamah
1
[1] Year 3 started from June 2008-June 2009