Community Concerns of Orphans and Development Association

COMMUNITY CONCERNS OF ORPHANS AND DEVELOPMENT ASSOCIATION

(COCODA)

P. O. BOX 712, NJOMBE - CHAUNGINGI STREET ALONG SONGEA ROAD, OPPOSITE

TANESCO REGIONAL OFFICE

Email: [email protected] Website: www.cocoda.or.tz

COCODA ANNUAL PROGRAMS IMPLEMENTATION REPORT FOR FY 2020

COMMUNITY CONCERN OF ORPHANS AND DEVELOPMENT ASSOCIATION

REPORTING PERIOD: 1 JANUARY – 31 DECEMBER 2020

Projects Implemented Councils

• EpiC Project Njombe Region councils:

• Njombe Town Council • USAID KIZAZI KIPYA Project • Njombe District Council • USAID Tulonge Afya • Makambako Town Council

• Makete District Council

• Wanging’ombe District Council

• Ludewa District Council

Prime Recipients Implementing Partners

• PACT TANZANIA • LGAs

• FHI360 • Health facilities

Programme/Project Budget/Year Programme Duration

• EPIC 401,395,902 5 Years

• USAID KIZAZI KIPYA 297,158,227 5 Years

• USAID TULONGE AFYA 159,376,560 5 Years

TOTAL: 639,505,370

Report Submitted By o Name: Mary Kahemele o Title: Executive Director o Organization: COCODA o Email address: [email protected] o Phone No: 0754 071 288

Table of Contents

List of Acronyms / Abbreviations...... 4

Executive Summary ...... 5

PROJECT IMPLEMENTATION...... 5

I. EpiC Project ...... Error! Bookmark not defined.

II. USAID KIZAZI KIPYA PROJECT ...... 10

III. USAID TULONGE AFYA ...... Error! Bookmark not defined.

Human resources ...... 19

Challenges ...... 19

Way forward ...... 20

Success story ...... Error! Bookmark not defined.

List of Acronyms / Abbreviations

AGYW Adolescent Girls and Young Women AIDS Acquired Immune Deficiency Syndrome ARV Antiretroviral CBHS Home Based HIV Services CBHSP Community Based Health Services Providers CDO Community Development Offer CHF Community Health Fund COCODA Community concern of orphans and development association COME Community mentors CTC Care and Treatment Clinic DC District Council FSW Female Sex Workers GBV Gender Based Violence GBV Gender Based Violence HBHCT Home Based HIV Counselling and Testing HIV Human Immunodeficiency Virus IGA Income Generating Activities KP Prev Key Population Prevention LGA Local Government Authority MSM Men Sex with Men MVC Most Vulnerable Children OHSP Other Hot Spot Population OVC Orphans and Vulnerable Children PFSW Partner of Female Sex Workers PLHIV People Living with Human Immunodeficiency Virus PLHIV People living with HIV and AIDS PMTCT Prevention of Mother-To-Child Transmission of HIV PP prev Priority Population Prevention PPT Periodic Preservatives Treatment SBCC Social Behavior Change Communication SILC Saving and internal Lending Community SWO Social Work Officer TB Tuberculosis TC Town Council VCT Voluntary Testing and Counselling VSLG Village Saving and Lending Groups

Executive Summary

Community Concern of Orphans and Development Association (COCODA) was formally registered as a non-governmental organization in Tanzania in year 2000 with registration No. 10278 under Ministry of Home Affairs. Later in 2015 it was assigned a new registration number 00NGO/00007795. COCODA was registered to operate anywhere in Tanzania Mainland but currently its activities are mainly located in Njombe region. The establishment of COCODA resulted from intensified concern among community members in Tanzania mainland over the surging number of orphans, mainly as a consequence to increased number of people infected with HIV and dying from AIDS, majority being adults leaving behind young children without parents. It was obvious then that this trend had a direct negative impact on social and community development. Hence, COCODA envisioned offering contributing its efforts towards addressing these challenges through awareness creation activities to local community members on facts about HIV/AIDS in order to cut down new HIV infections and stimulate mobilization for all matters related to HIV/AIDS including care of orphans. Since its establishment COCODA has recorded scaled achievement as evidenced by substantial numbers of community members reached by various programmatic interventions executed by the organization as well as heightened level of partnership with the government, community based implementing partners and funding partners. In the financial year of 2020, COCODA continued implementing three awarded project in all councils of Njombe Region. The three projects include; EpiC project under FHI360 being implemented in all six councils of Njombe Region, USAID Kizazi Kipya project funded by USAID under PACT Tanzania implemented in Njombe District council, Njombe Town council and Makambako Town council and USAID Tulonge Afya funded by USAID under FHI360 being implemented in Njombe Town Council and Njombe District Council. On one hand, COCODA through the three projects, has managed to implement demand creation interventions for HIV, STIs, FP and GBV screening services reaching 8636 KVPs in all six councils of Njombe region. On the other hand, the organization identified 13222 OVCs in Njombe DC, Njombe TC and Makambako TC and reached them with nutrition, health, psychological support, education, food and household economic strengthening services through PEPFAR OVCs program. Furthermore, COCODA managed to conduct Interpersonal Communication interventions for HIV test and treat services, FP and ANC services. The target for these SBCC activities was to reach 21936 beneficiaries in Njombe TC but we have managed to reach 20892 beneficiaries which is equal to 95.2 percent of performance. In Njombe DC the target was to reach 14316 beneficiaries but we have managed to reach 20657 people. This data translates to 144.3 percent of performance.

PROJECT IMPLEMENTATION

In supporting GOT human development initiatives, COCODA has implemented its activities in collaboration with other stakeholders. Majority of projects that have been implemented by COCODA have had their main percentage of work requiring management of field work activities at community level. At each one given time COCODA has been implementing multiple projects

5 in multiple community areas. The following is the description of projects implementation for the period of financial year 2019 in Njombe region basing on projects;

I. EpiC Project

The FHI360 has sub granted COCODA to implement the Meeting Targets and Maintaining Epidemic Control (EpiC) in Njombe region. EpiC is a global project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID), which is dedicated to achieving and maintaining HIV epidemic control. It is led by FHI 360 as prime and has a five-year period of performance from April 15, 2019 to April 14, 2024. EpiC provides strategic technical assistance (TA) and direct service delivery to break through barriers to 95-95-95 and improve HIV case-finding, prevention, and linkage to treatment among key and priority populations (PP). EpiC has three objectives, which focus on filling existing HIV prevention, case finding, and treatment gaps, and on building long-term sustainability to attain and maintain epidemic control. The three objectives are presented below.

Objective 1: Attain and maintain HIV epidemic control among at-risk adult men, women and priority populations (PP).

Objective 2: Attain and maintain HIV epidemic control among key populations (KPs).

Objective 3: Improve program management (including health information systems [HIS] and human resources for health [HRH]) and financial systems to ensure attainment and maintenance of epidemic control.

During this year 2020, COCODA through the EpiC project has managed to reach Key Population (KPs) and Priority Population(PPs) with HIV prevention minimal package of services to KPs( Biomedical ,and social and behavioral change communication package of services. Key Results by Objective

1. Attain and maintaining HIV epidemic control among at-risk adult men, women and priority populations (PP) and 2 also in attain and maintain HIV epidemic control among key populations (KP)

Reach and Test (Mobile testing modality and by Client catergory ) A total number of 15,244 (7472 PP and 7805 KP) were tested for HIV through mobile testing approach, among them 716 (322 PP and 394 KP) were identified as HIV positive and 566 (318 KP and 248 PP) clients of the identified HIV positive cases were enrolled to care and treatment.

Index Testing modality

A total number of 707 PP were offered index testing, among them 707 accepted the service. Among then elicited 2,784 index contacts 2,719 index contacts were tested, 388 of them were identified positive and 297 of them were linked to care and treatment.

A total number of 845 KP were offered index testing, among them accepted the service. Among them,3288 were elicited index contacts, 3227 index contacts were tested, 354 of them were identified positive and 276 of them were linked to care and treatment.

HIV Self-Testing modality In this Year (2020) both peers and Health care providers were deployed in distribution of HIVST kits. 4512 clients (3831 FSW, 613 AGYW and 68 MSM) were screened for HIVST, among them 3866 clients were eligible. The HIVST kits distributed were 3866 (Assisted 2666 (2034 FSW, 594 AGYW and 68 MSM) and Unassisted (1157 FSW), 13NAGYW 0 MSM). Of the HIVST kits distributed, 87 kits were reactive (69 FSW, 8 AGYW and 10 MSM), while 83 clients whose HIVST kits reacted were conventionally confirmed.

PrEP On year 2020, PrEP service was provided to 103 clients (43 Clients Wanging’ombe DC and 60 clients Njombe DC), up to September the number of clients reached with PrEP service dropped to 44 ( All from Njombe DC) while no client in PrEP service has remained in Wanging’ombe DC. The dropping of client out of service has been due to shortage of TRUVADA for refill in Njombe region. Made all groups in Wanging’ombe DC remain unsaved, while 1 client from Njombe DC couldn’t be reached during refill time.There are no newly established PrEP groups due to the shortage of TRUVADA in Njombe region. Effforts were made to get TRUVADA from facility, this was successful in Njombe DC that’s why groups in Njombe DC have remained in PrEP services while it was not successful in Wanging’ombe DC due to the shortage of TRUVADA for both community and facility services. The challenge has been addressed to EpiC regional office and Regional Medical Officer (RMO) office.

TB Screening/Coinfection A total of 16882 clients were screened for TB, among them 663 were TB presumptives, 171 were refered for TB checkup.

Slide for STI Results A total of 23,561 clients were screened for STI, 320were refereed for testing at health facilities. Health Care Providers are argued to provide STI services alongside other HTS services, for those diagnosed with STI should be refered to health facilities. There is no proper feedback for STI clients refereed for services at health facilities.Thus, providers have been argued to use the national referral forms for STI services in order to ensure the completeness of referrals. GBV Screening and Response A total of 21053 clients were screened for GBV, among them 1168 clients were identified as GBV survivors. Whereby 371 of GBV survivors were refered for post GBV services. Some HCWs have been reluctant to offer GBV services to clients, however they have been emphasized to provider GBV services to clients reached.

FP services Total 169,253 FP methods were offered, pills, 1270 injectables, 1201 implanone, 1016 female condoms and 156,408 male condoms were distributed. Shortage of FP commodities in many of the facilities, this has been addressed to councils FP focals to ensure the availability of FP commodities. Providers have been reporting the offering of FP services, however there is poor documentation of FP services at facility level. Providers have been insisted to document properly services offered with HTS services, also during supportive supervisions all documents for all FP services should be verified.

PP prev

COCODA has managed to reach 5340 clients through PP Prev. Whereby among the 2408 of AGYWs who recived HTS. We managed to reach only 56% of the target due to delay of training Peer Educators for SBCC sessionas and the COVID 19 where group sessions were not allowed hence affecting the reaching of target.

KP prev COCODA has managed to reach 3653 clients through KP Prev. Among them 2408 of KPs accessed HTS. The impact of COVID 19, which led to the bun of group education, which stopped SBCC sessions among KPs

2. Improve program management (including health information systems [HIS] and human resources for health [HRH]) and financial systems to ensure attainment and maintenance of epidemic control • Trained 16 Health Care Providers for PrEP services. • Trained 28 Peer Educatorss for PrEP services. • Trained 22 Health Care Providers for HIVST services. • Trained 25 Peer Educators for HIVST services. • Trained 55 FSW,MSM and AGYW Peer Educators on SBCC curriculum for 5 days. • Trained 27 AGYW Peer Educators for facilitation skills. • Conducted a 5 days Peer Navigation training to 17 Peer Navigators.

Management and Operations • Managed to work closely with government and other stakeholders to ensure the smooth operation of project activities. • Conducted monthly supervision for verification of the data • Managed to prepare and submit weekly data reports to EpiC (High Frequency Reporting-HFR). • On 17th August 2020, conducted the stakeholders meeting on how different stakeholders can integrate and jointly coordinate their activities, the meeting was organized by RMO’s office and attended by representatives from USAID Boresha Afya, USAID Tulonge Afya and EpiC regional team. • From 10th August 2020 to 21st August 2020, the COCODA jointly with EpiC regional team managed to conduct Joint supportive supervision with LGAs at Ludewa DC and Njombe DC, the activity which involved RHMT and CHMT members. The joint supportive supervision visit aimed at assessing the implementation of project activities at 19 wards (9 wards in Ludewa DC and 10 wards in Njombe DC). • By the support of the RHMT, managed to conduct Joint Data verification activity which involved USAID Boresha Afya, EpiC project staff, RHMT and CHMT members at Wanging’ombe DC and Njombe DC. • During August, the EpiC project managed to conduct index data verification in all 6 councils of Njombe region . • On 22nd September 2020, COCODA jointly with FHI 360 Njombe conducted PN sensization meeting to R/CHMT.The meeting was organized by RMO’s office and EpiC regional team.

SBCC PO (Musa Lukuwi) and HTS focal orienting the nurses on Index testing modality at Ulembwe Disp (Ulembwe Ward) – Wanging’ombe DC during Index data verification on 11th August 2020

RHTS focal and Ludewa DC DACC orienting providers on how to fill HTS register at Makonde Health Center during joint supportive supervision at Ludewa

Picture captured at Ilembula CTC during joint supportive supervision activity on 09/07/2020.

The picture captured during HIVST training to Peer Educators and SBCC PO

II. USAID KIZAZI KIPYA PROJECT

PACT Tanzania has sub-granted COCODA to implement USAID KIZAZI KIPYA Project activities in Njombe town, Njombe District councils, and two project wards in Makambako Town Council. The two project wards in Makambako TC are included by target and budget in Njombe district council. Interventions implemented through this project include; provision of services to beneficiaries (OVC) at households and community levels in collaboration with LGA, Lively-hood volunteers and community case workers (CCWs). To realize its intended objectives USAID Kizazi Kipya project has built on results areas which deliver services to its beneficiaries such services including Health, Education and vocation training, Shelter support, Psychological support, Nutrition and food security and Households economic strengthening.

Results areas that USAID Kizazi Kipya operated are; o Result 1: Parents and caregivers have the financial resources to meet the needs of vulnerable children and adolescents. o Result 2: Parents and caregivers have the skills to meet the needs of HIV infected and vulnerable children and adolescents. o Result 3: High-quality services are available to HIV infected and vulnerable children and adolescents. Summary USAID Kizazi Kipya Project Geographical Coverage USAID Kizazi Kipya project Geographical Coverage summary District Total number Number of % of wards covered Number of villages of wards in wards covered the Districts covered Njombe DC 12 12 100 45 Njombe TC 13 13 100 44 Makambako TC 12 5 41 9 Total 37 30 81 98

Under USAID Kizazi Kipya project there are four major Interventions/indicators that are used to measure the project progress and services that are delivered to beneficiaries (OVC and Caregivers). USAID Kizazi Kipya has four major indicators including; 1. OVC_SERV This counts the number of beneficiaries served by PEPFAR OVC programs for children and families affected by HIV. OVC_SERV is assessed at the individual level.

For the FY 20 COCODA through the USAID Kizazi Kipya Project has continued to provide high- quality services to the HIV infected and vulnerable children and adolescents in all its three councils of Njombe Town Council ,Njombe District Council and Makambako Town Council whereby COCODA managed to provide all the required services from all the key areas to the eligible beneficiaries (OVC_SERV) that counted to 5783 out of 6171 beneficiaries of Njombe Town Council (94%), 6241 out of 6163 beneficiaries of Njombe District Council (101%) and 520 out of 617 beneficiaries of Makambako Town Council (84%).

2. TZ_NUT This count on OVC under the age of 5 (0-4) who received nutrition services (NACS) outside the service delivery points. Throughout unchanging household home visits made by Community Case Workers, they was managed to conduct Nutrition assessment by using MUAC tape to a total number of 410 OVC from Njombe Town Council, 466 OVC from Njombe District Council and 41 OVC from Makambako Town Council, whereby; from Njombe Town Council severely malnourished were 0, from Njombe District Council the malnourished were 2 and 0 from Makambako Town Council. A total of 17 OVC from Njombe District Council were Moderate and Makambako Town Council and Njombe District Cuncil there was no moderate. In Njombe Town Council 402,

Njombe District Council 447l and 41 Makambako Town Council were found to have good nutrition

3. TZ_ECON This indicator takes count of beneficiaries (Caregivers and OVC aged from 15-18) who received a minimum economic strengthen services under USAID Kizazi Kipya project. In this reporting period of the FY 2020 , COCODA under USAID Kizazi Kipya Project has succeeded to link Worth Groups with LGA and receive funds which will help them to expand their business whereby; in Njombe Town Council the groups linked with LGA and receive funds were; Tujali and Tusaidiane Worth Group from lugenge has received loan with the amount of TSHS 3,000,000 for each group while in Njombe District Council there was two groups which was received 3,000,000 (Twitange and Mshikamano both group from Ukalawa village while in Makambako Town Council the group was received TSHS , 2,000,000 fund from LGA.

4. OVC _HIV STAT

For the period of 2020 COCODA facilitated Community Case Workers to support all HIV positive beneficiaries to be linked to CTC and start ART immediately and for those who are at risk they should be referred for HTS. During 2020 COCODA seceded to administer HIV Risk Assessment Quarterly Monitoring ( HRAQM) for 3511 OVC Njombe Town Council, 3613 OVC from Njombe District Council and 266 OVC from Makambako Town Council.

5. Education and vocational training. During the implementation period of the USAID Kizazi Kipya project for FY, 2020 COCODA project has successfully connected CLHIV beneficiaries with Focal Development College (FDC) so that they could join the Welding, Carpentry, Tailoring and electricity Corse. A total of 6 Children living with HIV (CLHIV) joined the college where; 5 of them was from Njombe Town Council and 1 from Njombe District Council.

Picture above shows OVC out of school conducting tailoring exercise

6. Shelter support. In order to ensure that households grow better CCW in partnership with COCODA staff has been providing education for caregivers on how to improve housing by connecting them with various groups of entrepreneurship. In Njombe Town Council we managed to support 35 caregivers in worth Yetu Group through provision of Solar Power and 40 caregivers in worth yetu groups in Njombe TC through provision of solar power. COCODA also managed to support one caregiver from Njombe Town Council and one caregiver from Njombe District Council who run a biasness of restaurant which have a children under 1 one year who living with HIV by providing all facilities needed for a restaurant business.

7.0. Psychosocial support. Likely wise, in this financial year psychosocial support has been a very important service to USAID Kizazi Kipya because it makes people feel better and continue with their life despite of being vulnerable and living with HIV.

Therefore; in this annual report of 2020, COCODA managed to provide psychosocial support to 220 Community Case Worker in Njombe District Council, 141 Community Case Worker from Njombe Town Council and 33 Community Case Workers from Makambako Town Council through provision of sanitizer to prevent with COVID19. So that they can help them to prevent OVC while they are conducting visit to their Household

In older to combat COVID19 pandemic, COCODA were provided Community Case Workers with guideline so that they can provide education to community on how to prevent with COVID19. Also, COCODA was managed to conduct training on psychosocial support to 381 Community Volunteer on COVID19

Picture above shows USAID Kizazi Kipya Volunteer from Ihanga Ward from Njombe Town Council reading COVID 19 guideline.

8.0. Provision of education subsidized COCODA under USAID Kizazi Kipya project for the financial year of 2020 in collaboration with PACT Tanzania under the support from USAID managed to provide educational Subsidies tool kit to educational Subsidies tool kit 83 CLHIV beneficiaries for Njombe DC, 87 educational Subsidies tool kit for Njombe TC and educational Subsidies tool kit for 10 CLHIV. This tool kit was includes bags and inside the bag there was asset of compass with, pencil, ruler, exercise book, pen and rubber. Picture below shows CLHIV from Njombe District Council and Njombe Town Council who received educational tool kit.

Picture above, Igombola OVCs (Lupembe Ward) with their Caregivers receiving education subsidies.

Picture above shows Kibena Village OVCs with their Caregivers receiving education subsidies.

9.0. Provision of CHF Cards

For the period of project implementation for FY, 2020 COCODA provides medical insurance (iCHF cards) to project beneficiaries to enhance access to health services. These cards were provided for active CLHIV without medical cover along with their family and who are in household economic categories of “Provision” and “Protection”. A total of 1931 Households received iCHF card from their respective councils and wards whereby; 920 iCHF Card was for beneficiaries from Njombe Town Council, 963 iCHFcard was from Njombe District Council and 48 iCHFCard was for Makambako Town Council

III. USAID TULONGE AFYA PROJECT

The USAID Tulonge Afya project catalyzes opportunities for Tanzanians to improve their health status by transforming socio-cultural norms and supporting the adoption of healthier behaviors. By addressing key social and cultural norms and social and behavior change (SBC) needs, USAID Tulonge Afya identifies the drivers of behaviors directly tied to health and leverages social and behavior change communication (SBCC) and other mutually reinforcing approaches to achieve the following results: • Result 1: Improved ability of individuals to practice healthy behaviors • Result 2: Strengthened community support for healthy behaviors • Result 3: Improved systems for coordination and implementation of SBCC interventions Our integrated approach blends best practices from behavioral health sciences to address the complex individual-to-societal interplay that encourages change. USAID Tulonge Afya uses participatory, evidence-based, and theory-informed approaches. Through this, the project 1) addresses norms and inequities that drive poor health; 2) advance health while promoting rights; 3) use data better to support regional needs; 4) harmonize messages and media; 5) strengthen institutional capacity to manage and deliver high-quality SBC; and 6) facilitate coordination to maximize SBCC impact and efficiencies. Under USAID Tulonge Afya, COCODA provides support across a range of health areas, which include, but not restricted to: i. Test and Treat awareness-raising campaign to promote HIV testing and treatment initiation ii. Prevention of mother to child transmission of HIV (PMTCT) iii. Voluntary medical male circumcision (VMMC) and early infant male circumcision (EIMC) iv. TB testing and treatment v. Youth-friendly health services, including sexual and reproductive health (SRH) vi. Family Planning (FP), including male partner involvement vii. Insecticide-treated net access and use (ITN) viii. Malaria care-seeking ix. Early initiation of Antenatal Care (ANC) x. Respectful maternity care xi. Facility-based delivery

16 xii. Early childhood development, including exclusive breastfeeding, new-born care, and vaccinations

Through the network of Community Health Workers (CHWs), Community Volunteers (CVs), and Peer Champions (PCs), COCODA implements activities within two social and behavior change (SBC) platforms: an adult platform, and a youth platform by conducting target audience mobilization activities and Interpersonal Communication (IPC) sessions through the following approaches: i. Household visits ii. Community dialogues- small group dialogue iii. Referrals and linkages to health services, including peer navigators iv. Community mobilization To support and reinforce the interpersonal communication work, COCODA works closely with local community radio by linking the selected radio stations with the target audiences.

Project Beneficiaries The beneficiaries of this project under the two platforms are categorized as follows;

Adult Platform 1. Pregnancy and pregnancy packages Primary audience: Pregnant women and their male partners Secondary audiences: health providers, other key influencers (mothers, mothers-in-law, aunties, peers, community and religious leaders) 2. Parenting and caregiving package Primary audience: parents and care givers 18-49 Secondary audiences: influential family members, traditional leaders, religious leaders 3. Furaha Yangu Phase I: at risk men 25-35, AGYW, Pregnant women, KP, OVC Phase II: Men 18-24, 25-49 and in highest risk occupation, pregnant women, key population, care givers of HIV exposed children, PLHIV and people with TB

Youth Platform Primary target audience 1. Unmarried, sexually active older adolescent girls (15-19) (Subira) 2. Unmarried, sexually active emerging adult women (20-24) (Maua) 3. Unmarried, sexually active young men (15-24) (Juma)

Secondary audiences 1. Parents 2. Female sexual partners 3. Health care providers

Achievements In this reporting period, COCODA managed to reach 20892 beneficiaries in Njombe Town Council and 20657 Njombe District Council from January 2020 to December 2020. Beneficiaries have been reached with SBCC messages of Furaha Yangu campaign through small group sessions conducted by CHWs and CVs. Small group sessions have been conducted reaching both male and female youth through the SITETEREKI youth platform, pregnant women and their partners have been reached through the NAWEZA adult platform and Time Household Visits have been conducted for targeted audiences for the parenting and caregiving package. These activities were implemented in all wards of Njombe Town council through household visits, small group sessions, community meetings, community events and workplace events. The target for these SBCC activities was to reach 21936 beneficiaries in Njombe TC but we have managed to reach 20892 beneficiaries which is equal to 95.2 percent of performance. In Njombe DC the target was to reach 14316 beneficiaries but we have managed to reach 20657 people. This data translates to 144.3 percent of performance.

Kayanda Malekela CHW of Ihanga ward in Njombe TC facilitating NAWEZA small group sessions during monthly supportive supervision visit in November 2020.

Maiko Kaduma a male peer champion of Ikuna at Lole Village in Njombe DC facilitating SITETEREKI male group sessions in October 2020.

Human resources

COCODA is equal opportunity institution employing staff from various backgrounds to implement projects. During financial year 2020, COCODA hired 53 employees to implement projects activities as well administrative functions of the organization. The table below illustrates number of staff hired by COCODA categorized by project.

In which Epic project had 21 staff, USAID Kizazi Kipya had 27 staff and USAID Tulonge Afya project had 5 staff.

SNo. Project Name Number of Staff 2. Epic Project 21 3. USAID Kizazi Kipya 27 4. USAID Tulonge Afya 6 Total 54

Challenges • Shortage of condoms at the community level in areas such as hotspot areas (Bars, tea plantations, mining areas and timber sewing areas, guest houses and lodges). • Lack of GBV data collection tool and GBV guidelines at community level.

• Improper channels in solving GBV problems arising in the community (many cases are channeled to WEOs and VEOs rather than CDOs or SWO). • Raining problem. During raining season, it was difficult to reach some areas for supervision activities as well as during provision of biomedical services. This was experienced on February, March and April. • CHF service is not applicable to some private centers and it discourages PLHIV clients and community to contribute for CHF services. • Long distance and lack of transports to PLHIV clients to reach CTC centers during CTC clinic days lead to missed appointment and LTF to PLHIV clients. • Wrong addresses of PLHIV clients during CTC registration, they are using nick names and wrong address it gives hard time to CHWs to be traced when they appear as missed or LTF clients. • Shortage of CHWs in project implementation areas hinders project activities such as enrolment of new PLHIV clients, enrollment of new household with OVCs. • Reallocation of the CHWs who trained on CCD package to other health facilities where there is no ECD corner established, then left ECD corner with no CHWs with prior CCD knowledge.

Way forward • Providing education support to the community level so as to be aware with GBV issues, food nutrition, economic issues, TB Screening, family planning issues and prevention of new HIV infections. • Increasing the enrollment of CHWs to support COCODA to implement projects and bring better results in areas such as enrollment of new PLHIV clients, educating PLHIV clients and non PLHIV clients on family planning issues, GBV cases, food and nutrition’s, economic issues, TB screening, missed up, provision of SBCC educations and LTF clients tracing. • Requesting private health sectors to agree with CHF services scheme in order to provide better health services to the community. • COCODA and other stakeholders should communicate to ensure the possibilities of collaboration in some of their activities.

SUCCESS STORY Support of CLHIV towards vocational studies to improve their wellbeing

A great effort made by USAID Kizazi kipya project to support six CLHIV from Njombe TC and Njombe DC on vocational scholarship brought out another opportunity and change life chain of the CLHIV. These six CLHIV were enrolled in the project in 2017 and they shared a common challenge where they were unable to attend secondary school due to excessive illness during their primary school education and lack of financial support to further their studies. CCWs from their wards played a great role in making sure they report every month and hopefully for their services to be a path to link them to a healthier and economic driven opportunity. “We are thankful for the USAID Kizazi Kipya project to enable these children to gain vocational skills as they still have capacity but lacked the resources to take them to the next stage of life” Anastasia Shoni –CCW from Yakobi ward, Nundu street, Njombe TC.

CLHIV group picture when they arrived at Njombe FDC

A few weeks later a vigorous selection process was done to identify and inform the six CLHIVs of their new found opportunity to change their career path’s focal personnel, CCWs and Health facility representatives were hands on the process to identify and collaborated to enroll the selected CLHIV at the college and for them to select their desired courses. “I was happy to see most of the children that are our clients being offered this opportunity as I knew some of their background and their greatest need relied on going back to school” Pilli Komba , CTC in charge , Njombe Health center

Left Picture is when Elika arrived at Njombe FDC , and the right picture is Elika on her graduation day at FDC.

Most of the CLHIV were still in disbelief of this new path they were about to take but showed positivity along in the process. The CLHIV were identified and enrolled at Njombe Folk Development College to begin gaining their new skills. Their caregivers and CCWs brought them to the college while CSO focus personnel received them and assisted with their registration at the principal office “I did not believe about the opportunity until I arrived at the college, I was afraid of the environment and new people but tears of joy poured as I saw other children like me also brought by their caregivers ‘’ Elika Ngailo , CLHIV from Ramadhani ward

To be able to follow up on their new environment, few weeks after arriving at the college we visited them for all welfare matters but to also see the progress in each course and address any challenges. The course instructors were positive and saw them as their own children making them to feel less homesick “I am thankful to continue the partnership with USAID Kizazi kipya project as our college hosts a second batch of OVCs and we are thrilled to impart vocational skills to these children, some are struggling because of their education background but I am confident with the commitment they are showing they will catch up with others” –Tulinagwe , Tailoring Course instructor at Njombe FDC. A great commitment and hard work showed by the CLHIV led to them being quick to grasp what they are being trained on. it came to a surprise to see the good results showed by CLHIV in such a short time as they were already showing tangible products.

Madame Tulinagwe supervising Birgita as she takes measurement in her tailoring course at FDC Njombe.

As CLHIV gained more skills so where their days of completing their scholarship, The college principal sat down with CSO focus personnel to organize a graduation ceremony for the CLHIV in a way to appreciate the work that USAID kizaza Kipya has done for them but also for their efforts to grasp a lot of knowledge in a little time, The graduation ceremony was prepared whereby caregivers , other student from the college , college staff and CSO representatives graced the ceremony to congratulate the achievements done by the CLHIV. “ I was surprised to see my child smiling and more active than ever ,this opportunity has not just given her a chance to learn vocational skills but also to boost up her confidence”, Flora Mlowe – Caregiver of Aneth Lusian Mgani (CLHIV). The graduation captured the transformation of the CLHIV from their personal traits to the output from their courses, where they showcased their products with ultimate confidence parading their public speaking skills, It was at this final moment where CLHIV danced and ate with the peers they had been used to for the three months waving a hearty goodbye when the college principal shocked everyone with the good news . “My fellow staff will agree with me when I say these children have shown great discipline, dedication and commitment in their learning , if half of our students would follow their steps they would truly achieve their learning , it with honor and respect of the USAID Kizazi Kipya project that I grant 8 spaces 2 from each course for a further three months scholarship to CLHIV to continue where the project has left off , “ Adam Rogers- Njombe FDC Principal This is surely a linkage to tell where the college saw how the scholarship benefited CLHIV and went on to lift their hands higher to offer another scholarship.

Galsi Haule (Centre)completing the electrical circuit project with his peers