The TASO Experiential Attachment to Combat HIV/AIDS Project (TEACH)

Sida Evaluation 2008:43

Final Evaluation Report

Denis Okello Atwaru

Sida

The TASO Experiential Attachment to Combat HIV/AIDS Project (TEACH)

Final Evaluation Report

Denis Okello Atwaru

Sida Evaluation 2008:43

Sida This report is part of Sida Evaluations, a series comprising evaluations of Swedish development assistance. Sida’s other series concerned with evaluations, Sida Studies in Evaluation, concerns methodologically oriented studies commissioned by Sida. Both series are administered by the Department for Evaluation, an independent department reporting to Sida’s Director General.

This publication can be downloaded/ordered from: http://www.sida.se/publications

Author: Denis Okello Atwaru.

The views and interpretations expressed in this report are the authors’ and do not necessarily refl ect those of the Swedish International Development Cooperation Agency, Sida.

Sida Evaluation 2008:43 Commissioned by Sida, Sida

Registration No.: UF 2008/660 Date of Final Report: July 2008 Printed by Edita Communication, 2008 Art. no. Sida47283en ISBN 978-91-586-8124-8 ISSN 1401— 0402

SWEDISH INTERNATIONAL DEVELOPMENT COOPERATION AGENCY Address: SE-105 25 Stockholm, Sweden. Offi ce: Valhallavägen 199, Stockholm Telephone: +46 (0)8-698 50 00. Telefax: +46 (0)8-20 88 64 E-mail: [email protected]. Homepage: http://www.sida.se Table of Contents

Acronyms and Abbreviations ...... 3 Executive Summary ...... 5 1. Background ...... 7 1.1. Overview of TASO ...... 7 1.2. TASO Programs ...... 8 1.3. Overview of TEACH Project ...... 8 1.4. Overall TEACH Project Goal and Purpose ...... 8 1.5. Specifi c Project Objectives ...... 8 1.6. Evaluation Purpose and Scope ...... 8 1.7. Evaluation Methodology ...... 9 1.8. Limitations of the Evaluation ...... 10 2. Evaluation Findings ...... 10 2.1. Teach Project Design and Implementation ...... 10 3. Actual Project Performance against Planned Targets ...... 14 4. Impact on Service Provider Competence ...... 17 5. Project Impact on Replication of TASO Service Delivery Models/Best Practices ...... 19 5.1. Other Project Evaluation Findings ...... 23 6. Unintended Results (Project Spin-offs) ...... 24 7. Sustainability of the Project ...... 25 8. Key Lessons and Experiences ...... 25 9. Conclusions and Recommendations for TEACH-Two ...... 26 10. References ...... 28 Appendix One: Pictures Showing TASO Models Replicated in Some Countries ...... 29 Appendix Two: Detailed Evaluation Methodology ...... 32 Appendix Three: List of Evaluation Participants ...... 34 Appendix Four: Countries that benefited from teach 1 project by Region in Africa ...... 38 Appendix Five: Evaluation Instruments ...... 39 Appendix Six: Terms of Reference ...... 50 Appendix Seven: Evaluation Schedule ...... 53

Acronyms and Abbreviations

AEF Adherence Education Forums

ART Anti Retroviral Treatment

ARVs Antiretrival Virus

CBC Cameroon Baptist Health Board

CBO Community Based Organization

CHAI Community HIV/ AIDS Initiative

CRS Catholic Relief Services

CSOs Civil Society Organizations

FGDs Focused Group Discussions

GIPA Greater Involvement of People Living with HIV/AIDS

HIV/AIDS Human Immune Virus/ Acquired Immune Defi ciency Syndrome

HOD Head of Department

ICT Information and Communications Technology

IEC Information, Education and Communication materials

KIs Key Informant Interviews

M & E Monitoring and Evaluation

MOH Ministry of Health

MOU Memorandum of Understanding

NAPLA National Association of People Living with AIDS

NGO Non-Government Organization

OVC Orphans and Vulnerable Children

PLWAs People Living with HIV/AIDS

PMTCT Prevention of Mother to Child Transmission

PROs Public Relations Offi cers

RUWDEC Rural Women Development

Sida Swedish International Development Agency

SIPAA Support International Partnerships Against AIDS in Africa

SLP Sustainable Livelihood Programs

SPSS Statistical Package for Social Scientist

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 3 SWAA Society for Women and AIDS on Africa (SWAA) represented by the

TB Tuberculosis

TEACH TASO Experiential Attachment to Combat HIV/AIDS

TOT Trainer of Trainers

TV Television

UNAIDS United Nations Agency for AIDS

VCT Voluntary Counseling and Testing

4 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Executive Summary

This report presents evaluation fi ndings of TEACH project (2005–2007) which was initiated at TASO in 2005. The aim of the project was to build critical mass of effective service providers in Africa in HIV/AIDS programming and service delivery models. The project strategy to achieve this was premised in improving service provider competencies through experiential in-service apprenticeship for one month at TASO. This evaluation which was carried out between June–July 2008, was commissioned to establish its impact to extract lessons, experiences and strategic recommendations to facilitate and inform the design and development of TEACH phase two project and future HIV/AIDS programming for similar or related projects.

The evaluation methodology adopted both quantitative and qualitative approaches. A total of 150 respondents were involved in the evaluation out of 186 planned sample size. These included: Alumni and their supervisors, TASO senior management staff, TEACH staff, and TEACH implementing partners and clients. They were drawn from 8 African countries namely Swaziland, Ethiopia, Ghana, Malawi, Zambia, Uganda, Kenya and Cameroon. Key methods of data collection used were individual interviews, focus group discussion, document review and fi eld visits.

The major evaluation limitations were lack of previous TEACH studies against which to compare these fi ndings and diffi culty in mobilizing some respondents as they were scattered and limited time due to delays in obtaining clearances for air-ticket at various embassies. Lack of time affected some depth of interviews. However, these limitations do not affect the power of these fi ndings, lessons, conclusions and recommendations therein

Overall, according to the project results framework, TEACH project met the major set targets in Attachés enrolment. Findings indicate that there was 100% performance in this area. The project also established that the Alumni had improved their competencies through acquiring various skills and experiences while at TASO. The major skills identifi ed across counters visited were: Community mobilization; Memory book writing; ART Case conferencing; Data management; Project management; Counseling and listening; Lobbying and advocacy; Child counseling; Communication; Resource mobilization;; Record keeping and Public relations and customer care skills

From fi eld visits and interviews with Alumni and their supervisors in the countries that were visited; the Alumni demonstrated having translated the skills into practice by replicating TASO models in their organizations. Some of the key models/best practices that the evaluation established were; Home-based HIV/AIDS counseling and testing (HBHCT); Community mobilization and sensitization using drama strategy; Client empowerment model through sustainable livelihood programming (SLP); Community ART model through community drug distribution points; Counseling model (in particular-couple counseling), community and family counseling; Community programming/ service delivery model using community volunteers; Client positive living model through memory book and will making; Client appointment system; Gender main-streaming model; Advocacy models using drama, GIPA and radio talk shows; Group counseling model; Community training model using TASO community care training manuals; Community outreach and home care models in service delivery; ART Case conferencing; Information management system and HIV/AIDS integration service delivery model;

Based on the fi ndings, the team made the following conclusions and strategic recommendations for TEACH-Two programming:

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 5 1 The duration of one month attachment was favorable to mainly frontline (direct implementers). To other staff at programming level, it was considered long time. TASO should consider restructuring TEACH program by targeting two levels of Attachés namely frontline staff and program managers to be placed for a period ranging from 1–2 months and 2–3 weeks respectively.

2 The team observed a very limited number of Attachés attracted from the policy decision making level such as Board members. TASO needs to review its selection criteria to balance direct program implementers and policy makers to facilitate replication of TASO models.

3 TEACH volunteers felt they were not treated well to work as volunteers for three years. TASO should assess and make the current TEACH PRO volunteers full time staff.

4 Given the rate of expansion of TEACH, the team observed that TEACH offi ce was understaffed. There is need to recruit more staff into the TEACH program

5 The team established that there was no training strategy for TEACH staff/ and volunteers to handle various Attachés. There is need to train the PROs and other frontline staff at Centres to increase their competencies in handling different Attachés

6 The team observed limited TEACH focus on accessing IT services to Attachés. TASO should facilitate TEACH Attachés with information technology facilities e.g. computers linked to internet, to support exchange of information and learning between and among themselves and TASO program staff.

7 Findings revealed that TEACH had meaningful partnerships to facilitate TEACH project. TASO should continue to strengthen the existing partnerships by engaging them more effectively, and further seek to develop new action oriented partnerships with other potential organizations.

8 The fi nancial sustainability of TEACH was questionable if Sida ceases funding. TASO should consider diversifying funding for the TEACH project to take on more Attachés for the period recommended above.

9 The project M&E plan was developed late in 2007 and the MIS was not well computerized. TASO should review its monitoring and evaluation frame work for TEACH project with the view to improving it to be able to track progress made by Attachés after their placement period.

10 The fi ndings indicate that a number of Alumni formed TEACH Alumni associations in their respective countries. TASO should tap into this opportunity by engaging the leadership of these associations in TEACH strategic activities in Uganda. These may include for example involving leaders of associations in TEACH bi-annual and annual reviews to continuously share lessons and give input into TEACH programming process.

11 While the project focused on Africa, the project had reached only 24 countries in Africa (which is about 43% of coverage). In order to maximize access to TEACH services, it is recommended that the project be scaled up to the rest of Africa

12 It was observed that the demand for TEACH project is beyond Africa. While the team feels that this should remain the main TEACH geographical target, TASO should open this project to parts of the world especially those where the HIV incidence rates have soared in the recent years such as Asia.

13 There is a fair balance between female and male Attachés selected for the scholarships. It is recommended that this balance be maintained.

14 TASO facilitated TEACH with offi ce space at all levels to facilitate their leaning. However, due to competing needs with other activities, the space was found inadequate. There is need for TASO to

6 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 proactively strengthen TEACH infrastructure particularly space to maximize Attaché leaning environment.

15 Many Alumni formed TEACH Alumni associations in their respective countries. It is the view of the evaluation team that this effort be strengthened as it is one of the sustainable mechanisms to facilitate replication of TASO models.

16 It was observed that attaché’s were not exposed to other fundamental successful HIV/AIDS programs such as the Millennium Development Goals (MDGs) being implemented in Uganda. It is recommended that all attaché’s be exposed to Uganda millennium development project villages to facilitate replication of TASO models in the context of millennium develop goals.

17 The evaluation team discovered other areas for further research which could not be covered under this evaluation and yet are essential for TEACH programming. The major area for immediate and further research is effective replication of HIV/BEST best practices/models in limited resource settings.

Given the achievements TEACH has registered in three years and the growing demand for this project in and beyond Africa, the evaluation team strongly recommends that the project be extended beyond 2007. The extension of TEACH will facilitate consolidation of achievements made and scale up this service in Africa to meet the growing demand.

1. Background

1.1. Overview of TASO

TASO, founded in 1987, is the oldest and most experienced NGO providing HIV/AIDS care and support services in Uganda and Sub-Saharan Africa. TASO, whose vision is “A World without AIDS”, has the widest HIV/AIDS service delivery network in Uganda and directly complements the efforts of MoH. TASO has 11 Service Centers located in all the 4 Regions of Uganda (Central, Eastern, North- ern and Western), in the districts of Gulu, Jinja, Kampala, Masaka, Masindi, Mbale, Mbarara, Rukun- giri, Soroti, Tororo and Wakiso. Through these centers, TASO provides services for the host district and up to 4 surrounding districts raising the total number of districts served to 74 out of the 81 districts in Uganda serving both rural and urban communities in these districts.

TASO also operates one International HIV/AIDS Training Centre and 4 Regional Training Centers. The 5 Training Centers conduct various HIV/AIDS courses for service providers both locally and internationally. TASO also established the Elly Katabira facility, as an expansion to the TASO training center and to TASO Mulago. The facility was established to provide experiential training for local and international health workers in HIV/AIDS medical care. This facility has an outpatient clinic that offers a comprehensive care package to 500 PHAs, both adults and children, including the provision of ART. The facility provides diagnosis and management of opportunistic infections, counseling for positive living, psychosocial support, HIV pre and post testing and for sensitization about and adherence to medication especially ART. As part of the expansion of the training function, TASO in 2005 initiated the TASO Experiential Attachment to Combat AIDS (TEACH) project. This project (de- scribed below) is the focus for this evaluation.

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 7 1.2. TASO Programs

TASO provides a continuum of comprehensive HIV/AIDS prevention, care, treatment and related support services to HIV-positive people and their families. TASO activities include provision of antiret- roviral therapy; counseling services for empowering PHA and supporting ART adherence; providing TB screening and treatment services; providing services for prevention, diagnosis and treatment of Opportunistic Infections; providing PHA with the Basic Care Package (BCP); providing services for prevention-with-positives; providing confi dential Home-Based HIV Counseling and Testing (HBHCT) services for clients’ family members; providing Home Care for the sick; training and capacity-building of different calibers of staff in HIV/AIDS service delivery; supporting and maintaining linkages and referral mechanisms for expanded access to services; and conducting advocacy on the driving factors of the epidemic, issues inhibiting access to services and addressing stigma due to HIV/AIDS.

1.3. Overview of TEACH Project

TEACH project at TASO began in 2005. The project arose out of need from many African countries and beyond most affected by HIV/AIDS to learn and get experience in HIV/AIDS management at TASO. TASO, the largest and pioneer Civil Society Organization to respond to HIV/AIDS epidemic had gained this experience over 17 years. TASO responded to meet the increasing demand by rolling a three-year project (2005–2007) with support from Sida. The aim of the project was to build a critical mass of effective service providers that would apply best HIV/AIDS programming and service delivery models by improving service provider competence through experiential in-service apprenticeship for one month. Both government and private institutions sent their staff representatives for experiential attachment at TASO for practical and interactive “hands on” exposure on its HIV/AIDS service delivery models and best practices. TASO with support from Sida offered scholarships to deserving individuals from organizations from the CSOs, public and private sector in Africa. The experiential learning was conducted through TASO’s 11 direct service delivery centers spread over the country, 4 TASO regional offi ces, TASO international training facility and TASO headquarters.

1.4. Overall TEACH Project Goal and Purpose

The Goal of TEACH Project was to contribute in building the capacity of the public and private organizations in Africa involved in the provision of HIV/AIDS care and support services. The purpose of the project was to enable the trainees/attachés acquire all-round, practical and interactive “Hands on” experience on TASO service delivery models and best practices.

1.5. Specific Project Objectives

To Improve service provider competence through experiential in-service apprenticeship To build and strengthen the strategic partnerships for TEACH program To strengthen TASO institutional capacity to implement TEACH strategy

1.6. Evaluation Purpose and Scope

This evaluation was commissioned to establish the impact of the TEACH project in building the capacity of service providers in Africa. In establishing the impact, the evaluation was intended to extract lessons, experiences and strategic recommendations to facilitate and inform the design and development of TEACH phase two project. The evaluation also aimed at establishing what worked and what did not work well during project implementation to inform future HIV/AIDS programming for similar or related projects at TASO and beyond (specifi c evaluation objectives and scope of work are

8 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 contained in appendix 8) The geographical scope of this evaluation was 8 African Countries, namely Swaziland, Ethiopia, Ghana, Malawi, Zambia, Uganda, Kenya and Cameroon.

1.7. Evaluation Methodology

This evaluation was conducted by a team of fi ve consultants from Makerere consult Limited. It was carried out between June–July 2008 in 8 countries listed above (evaluation schedule is appended in appendix 7). The evaluation process and procedure was guided by the inception report and scope of work that was agreed upon between TASO as contained in appendix six.

The evaluation approach included the following steps: preparation of an inception report; development and pre-testing instruments; review of key and relevant documents and interviews. The interviewing process which involved Alumni and their supervisors, TASO senior management staff, TEACH staff, TASO centre management staff, TEACH implementing partners and clients was highly consultative and interactive in nature.

The evaluation sample size was 150 respondents (Alumni (75) Supervisors (32) and Clients (43). The female population constituted 45% of total respondents implying that the females adequately participated in the study. In terms of alumni samples during evaluation; most respondents came from Uganda (17), Cameroon (14), Zambia (8), Kenya (9), Ghana (8), Malawi (7), Swaziland and (5), and Ethiopia (7). The sample size was scientifi cally determined. Selection of respondents was both random and purposive depending on evaluation questions. A detailed list of participants can be found in appendix three of this report.

This evaluation was both quantitative and qualitative in approach. Quantitatively, the team established quantitative fi ndings in terms of project performance both at output and outcome levels. Qualitatively the evaluation team carried out in-depth interviews to validate quantitative fi ndings. For quantitative data, semi-structured Interview Questionnaires were used while for qualitative data, key Informant Interviews were done using key informant guides and focus group discussions were conducted using checklists. Other methods used were document reviews, observation, history taking of successful stories and photographs. Details of evaluation methodologies and instruments used can be found in appendix two and fi ve of this report.

To maximize data quality, evaluation instruments were presented in Uganda. In addition, continuous data cleaning was done during and after fi eld work. Quantitative data was analyzed using SPSS statistical functions while qualitative analyzed was done by establishing major and sub-themes to derive meaningful information patterns. The fi ndings, conclusions and recommendations were refi ned and interpreted according to the project objectives. In addition, contextual factors were considered in various countries during data analysis, interpretation and conclusions.

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 9 1.8. Limitations of the Evaluation

During the execution of the evaluation, the team encountered the following major challenges;

The evaluation team found out that there was no TEACH baseline study. In addition, the project midterm carried out was rather limited in scope to facilitate comparison of these results with results from other formal studies. This would have, in addition, further helped the team to track project performance changes over the three year TEACH strategic period.

The team experienced challenges in locating some respondents (Alumni, supervisors and clients) as they were scattered in various parts of their countries. This to some extent affected the level of in-depth interviews with some respondents due to limited time.

In addition, due to delays in obtaining visas from some embassies for air tickets the evolution schedules were affected. This prompted the team to schedule some interviews over the weekend. However, the team encountered challenges in meeting respondents especially Alumni supervisors who were scheduled over weekends.

As the result of these challenges the evaluation team interviewed 150 respondents out of 186 planned sample size.

Not withstanding the above limitations, the team is confi dent that with information obtained through document reviews, interviews and fi eld visits, the fi ndings presented in this report refl ect a balanced impact assessment of the TEACH project.

2. Evaluation Findings

2.1. Teach Project Design and Implementation

2.1.1. Attaché selection and standard operating procedures (SOPs) The evaluation fi ndings indicated that the selection process and attachment was fully guided by the TEACH objective (improving service provider competences through in-service apprenticeship) and the standard operating procedures (SOPS). The TEACH Standard Operating Procedures (SOP) Manual was developed by TASO technical staff to ensure quality implementation of the project. It was observed that the project operated strictly in conformity with the guidelines and procedures stipulated in the document. This facilitated maximum learning by maintaining strategic focus on objectives of individual Attaché while at TASO. The consultant team found out that TEACH instituted a selection committee that sits monthly to review Attachés applications to select most appropriate/suitable candi- date for attachment. However interviews with Alumni revealed that much as TASO had clear selection criteria, it was not solid enough to eliminate candidates not suitable for attachment.

2.1.2. TEACH Attaché geographical target The TEACH project (phase one) targeted HIV/AIDS service providers from Africa. From the review of records, TEACH demonstrated that Attachés recruited came from this continent. By the end of 2007, TEACH had reached 24 African countries (see appendix 4) as follows:

10 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Figure 1: Attaché enrolment by region

9 9 9

6 4 5

3 2

a a ic fr fric frica .Africa .A .A W E S N.A

According to the fi gure, most Attachés came from South Africa followed by W. Africa. These are some African regions that have been hit hard by the epidemic. Given the levels of HIV/AIDS epidemic in Africa, the team found out that this target (Africa) was and remains a strategic region for TEACH focus. The relevance of this region (Africa) was refl ected in the high response with applications in response to the project. Based on the selection lists, majority of the Attachés selected were from the HIV/AIDS service organizations who specialized in various areas related to HIV/AIDS management. The evaluation team feels that this selection criterion was fundamental and facilitated the replication of TASO models in their respective countries. However, it was observed that, majority number of Alumni came from English speaking countries of Africa i.e. East and South Africa (65%) compared to French and Arab speaking countries (35%). In addition, TEACH mainly attracted Alumni involved in programming and implementation. In rare occasions, they attracted people in key decision making positions. However, the team did not establish whether attracting people in policy making or infl uencing positions was TEACH’s priority or not. The evaluation team discovered that language factor infl uenced regional distribution of Attachés.

2.1.3. Attachment to TASO units Findings indicate that Attachés were attached to programs of their own/organizational interests. From the interviews, the evaluation established that the Attaches interviewed had been mainly attached to the following TASO program areas.

Table 1. Attaché placement by program

Program of Attachment No. of Alumni Valid Percent HBHCT 25 33 Medical Care (ART) 15 20 Home Care 5 7 Social Support 9 12 AIDS Research 1 1 Capacity Building 2 3 AIDS Education 1 1 Counseling 10 13 Others 7 9 Total 75 100

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 11 From the table above, majority of Attaché’s visited had been attached in HBCT program (33%) followed by Medical (20%), Counseling (13) and social support (12%).

Review of records and interview revealed that Attachés are placed in TASO for one month. It was also found out that some Alumni found one month of placement inadequate as Sister Gladys of Catholic Hospital (Cameroon) put it “TASO should increase the number of days of attachment and follow up because some critical areas were not visited by Attaches to see many realities due to limited time”. This observation was made not only in Cameroon but also in other countries including Malawi and Ghana. Contrary to this observation, some Alumni felt that one month of attachment was a long time. Amare Bedada from Addis- Ababa remarked “TASO should shorten the period of attachment to accommodate the busy Executives of private organizations who do not want to lose any business in their organizations”. The implication of this fi nding is that the standard attachment period of attachment for one month does not favor all people who would be interested to apply for attachment.

2.1.4. TASO Technical support to TEACH TASO structurally has three management/administrative levels; TASO headquarters, Regional offi ces and TASO centers. Evaluation fi ndings indicated that TEACH management structure is well integrated into TASO established structure from the headquarters to the Centre level. Due to this integration, the project naturally obtained technical support at all levels. At headquarters, the Directorate of fi nance extends support in fi nancial management while programming and implementation is supported by Directorate of training and capacity development. It was also found out that TEACH also receives support from other directorates of programs, planning and strategic information. The project also receives management support from the TASO regional and centre offi ces through the Regional and Centre Management including all heads of departments at Centre offi ces.

2.1.5. TEACH staffing TEACH project is directly headed by the Project Coordinator. This Coordinator worked with TASO in the projects and planning department before he joined TEACH. He is directly assisted by the Project Assistant. The Project Coordinator is functionally supported by public relations volunteers at all TASO service delivery centers/branches. The evaluation team feels that the recruitment of the project Coordi- nator who was already in the TASO system was strategic. Interviews with the Coordinator revealed that it helped him translate the project objectives into tangible results. The recruitment of the Project Coordinator, other staff and volunteers was also done in time which facilitated smooth implementation of TEACH activities. However the consultants found out that TEACH project was understaffed and the Public Relations Offi cers (PRO) volunteers had stayed with the project for three years as volunteers. In addition, TASO had no clear capacity/training strategy to improve their competencies in mentoring and handling people of various professional backgrounds and cultures from various countries. Interviews with TEACH volunteers revealed that they needed to be considered as full time staff to further motivate them and effectively implement TEACH activities.

2.1.6. TEACH infrastructure TEACH project is housed at TASO Kanyanya International training complex. There is a designated TEACH facility where Attachés are coordinated, oriented and supported. The evaluation found out that the facility has basic facilities such as computers, communication and internet facilities to facilitate the coordination and implementation of TEACH. Due to TEACH integration in other TASO main stream services, TASO headquarters, Regional and Center level offi ces also provide space to allow conducive and maximum learning for Attaché during the attachment. However, the study found out that designated computers for Attaché’s in some offi ces lack internet facilities. The offi ce space was also found limited much as TASO had provided substantial support in this.

12 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 2.1.7. TEACH Partnerships and collaborations The evaluation fi ndings indicated that TEACH program had institutionalized partnerships in order to implement the TEACH strategy. The partnerships were both local and international. Locally, the partners identifi ed included: Mildmay: Infectious Disease Institute (IDI); Joint Clinical Research Council; Medical Research Council(MRC); Center for Disease Control (CDC); Straight Talk Founda- tion; Christioan Helping Community; Red-Cross Uganda; Jinja Diocesan Development Organization (JIDDECO); Masaka Diocese Development Organization(MADDO) Farming for development organization Mbale (FADEP); International Rescue Committee in Gulu; Kinyara Sugar Works; World Vision Gulu, AIDS Information Center (AIC); Uganda AiDS Commission (UAC: and Mini-TASOs and CBOs partnering with TASO.

Internationally, all the Alumni organizations were institutionalized partners who co-opted others in implementing the TEACH strategy. Some of the partners identifi ed included, Ghana Aids Commis- sion; Swaziland AIDS Control Program and Society for Family Health in Zambia.

These partners helped in scaling up sharing of HIV/AIDS management and service delivery models in addition to what TASO could offer. Based on the learning objectives of the attaché’s, TEACH project supported the attaché’s to obtain additional orientation on certain specifi c HIV/AIDS delivery models of interest to the attaché’s. However, this collaborative arrangement was found informal i.e. with out offi cial MoU signed between TASO and the partners spelling out specifi c roles and responsibilities of each partner in implementation of the TEACH project. During the interview with TEACH project coordinator, it was found out that most partners were long standing partners with TASO.

2.1.8. TEACH management and financial Systems Control The Consultants found out that there is an integrated fi nancial systems for the entire TEACH project embedded in the TASO structure. In order to ensure checks and balances for TEACH fi nances, TASO involved a number of its existing and qualifi ed people in fi nancial controls. These are: Finance Director; Chief Accountant; Accountants (Management); Assistant Accountants; Cashier and the Store Keeper. TASO also put in place systems that ensure effective and effi cient utilization of funds. These are:

Finance & accounts procedures manual. The team found out that this manual was followed as duties were executed in conducting financial transaction for TEACH.

Computer systems were used to keep records and registers. Vouchers and requisitions were properly filed.

Financial reporting system was found to be adequate. Sida financial flows, expenditures and projection reports were prepared routinely and generated electronically. The financial reports from the accounts department indicate that there has been a continuous and uninterrupted on-time flow of funds from Sida. This has enabled the project achieve its financial obligations over the period of three years.

Overall, TASO ensured that the TEACH Project funds were fully utilized to achieve the intended objectives of the project. To maximize value for money, fi nancial reports were accompanied with program outputs for the same fi nancial reporting period. The evaluation team also explored if there were other funding sources for TEACH project. Findings revealed that Sida was the only Donor at the time of this evaluation. The evaluation did not establish TASO’s immediate and documented plans to diversify funding for TEACH Project should Sida cease its funding.

2.1.9. TEACH project M&E plan The TEACH Project M & E Plan was developed in 2007 to track project performance. The M&E plan was found clear and specifi c to project planned activities. It shows the data that the project need to collect, methods of its collection, source of data, data collection instruments and frequency of reports. Using this M&E plan, TEACH was able to document project progress and generated timely quarterly

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 13 and annual reports per year that facilitated decision making and planning. Major M&E activities were implemented including the proposed fi nal evaluation. In addition to the M&E plan, the project staff continued to prepare routine supervisory reports that facilitated staff adherence to SOPS. However, the M&E framework was developed rather late in 2007. As a result, some key activities/events may not have been properly carried out and documented like international follow up of Alumni. The project M&E responsibility lies with the Project Coordinator who also is overwhelmed with planning, design, implementation, operational and strategic issues. The evaluation team however found out that TEACH being integrated in the main stream TASO service delivery, the project received support from the directorate of planning and strategic information(responsible for M&E function) that enhanced TEACH M&E activities.

3. Actual Project Performance against Planned Targets

The Consultant carried out a comprehensive and critical review of the project documents and interviewed key project staff to establish project performance. Documents that were reviewed include; Standard Operating Procedures (SOPs), project annual and progress reports, project proposal and its log-frame, work plans, among others. Staff interviewed included the Directors, Senior Managers, and the Project Coordinator.

Overall, TEACH project met the set targets. 100% performance was achieved in Attaché enrollment, orientation and mentoring. Detailed description of project performance is presented in the log-frame below:

14 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Service delivery models that have been adopted include drama, use of community volunteers, SLP, HBHCT, child service centres, Drama strategy has and home based ART service delivery. GIPA been adopted in 95% of the alumni institutions visited. willing to adapt Important to note is that alumni institutions were limited by inadequate funds and existing models but were more policies. organizational include counseling, case confer- reported Most skills that were encing, conducting field visits, management and leadership, mobilization, community mobilization and sensitization, resource data management skills drug distribution and records/ reported for other Alumni not applying skills were Main reasons and transfers. to be internal promotions service Models articulated most included drama, child centre and home use of community volunteers, GIPA HBHCT, delivery, counseling, based ART service delivery, This achievement was made possible due to timely disbursement TEACH applicants. Actually, from of funds and positive response of documents and interviews with KIs indicated more review qualified applicants for TEACH than earlier anticipated. This achievement was made possible due to timely disbursement TEACH applicants. from of funds and positive response Attaché mentoring was done by allocated technical supervisors at places of placement. end of placement as a Each Attaché developed an action before requirement. operate in districts where Most of the Attaché placement centres with well no experienced HIV/AIDS organizations are there developed service delivery models. 500 Attaché’s trained in action 500 Attaché’s plan development 500 action plans developed. 100% of the alumni organizations 100% of the alumni organizations visited had adopted at least two service delivery models. TASO 87% of the alumni visited (75 having been able to alumni) reported during their apply skills acquired placements in TASO. 100% of the alumni interviewed demonstrated knowledge about at service delivery least two TASO models. by end females) had been enrolled of 2007 (100% achievement) 30 orientation workshops attended conducted by 500 Attachés were during the period under review. were enrolled 100% of the Attaché’s mentored – – 20% of Attaches visited other HIV/ AIDS organization 500 Attachés trained in action plan development Each Attaché supported to develop an action plan by the end of placement 70% of institutions which benefited adapting the TEACH program from HIV/AIDS components of TASO service delivery models to improve service delivery with in one year after placement at their workplaces. 60% of Alumni will have their skills in HIV/AIDS management improved within one year after placement At least 80% of Alumni knowledge- service delivery able about TASO models with in one year after placement at their workplaces 10 orientation workshops conducted annually (20 Attachés per workshop) 100% Each Attaché receive service delivery mentoring on TASO by the end of models of interest placement – – 30% of Attaches visit other HIV/ to share AIDS service organizations and learn other models Enroll attachesEnroll orientation Conduct Attaché’s workshops on various TASO Mentor Attaché’s 500 Attaches HIV/AIDS service delivery models attachés in the development of Train action plans (253 males and 247 500 Attaché’s Objective 2. Build and strengthen strategic partnerships for TEACH program Table 2: TEACH performanceFrame work based on results Table Specific objective Objective 1. Build the capacity of in HIV/AIDS service providers and treatment delivering quality care support service. Outcome/output targets Level of achievement Comment

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 15 again. In process of carrying another partnership analysis for again. In process new partners with well Few experienced HIV/AIDS partner organizations developed service delivery models. with TASO in long term relationship Most partners selected were including TEACH. programs and understood TASO before Attaché in enrollment, registered Higher achievements were to SOPs, action plan development and orientations, Adherence of partnerships. in the area least achievements registered fully oriented were staff at Attaché placement centres Frontline support visits. and guided on the use of SOPs during routine a copy which was photocopied to all received centre Each TASO Attaché technical supervisors. a wide range of skills including public covered This refresher public speaking, mentoring and coaching. relations, development of two additional data collection tools. generation requiring no major changes in the project were There of additional data. One partnership analysis made no need for analysis Selected partners did well and therefore 23 partners selected to collaborate TEACH nationally with TASO TEACH of TASO Introduction made to partners. program 87 individual partner meetings were held was a 90% On average there achievement of the planned target staff 100% of TEACH frontline to SOPs adhered in 2005, 10 PRO Assistant hired in 2005 and 2 volunteers (hired in 2007 other volunteers hired One SOP manual developed. 12 SOP copies printed staff oriented on SOPs 65% of TASO and management staff. frontline Orientation targeted course conducted One refresher benefiting 15 TEACH staff. M&E plan developedFour data collection tools developed necessitated for TECH project of data requirements The nature workshops were 3 MIS review M&E is functional conducted.

TEACH program able to achieve TEACH program 90% of annual planned targets staff 100% of TEACH frontline placement adhering to Attaché’s guidelines or SOPs One SOPs manual developed 200 copies printed per year 4 joint planning meetings with partners 1 partnership analysis conducted annually identified 12 partners per region and selected Conduct 4 TEACH orientation TEACH workshop for TASO/ per year) partners (one per region annually (1 meeting per region) – – by end of 2005 be hired To and Project Coordinator Project – oriented on SOPs courses conducted each 3 refresher staff benefiting 100 TEACH frontline per year of 2007 by end of 2007 ducted annually Identify and select partners for joint implementation of TEACH program per Region Conduct Orientation workshops for partners on TEACH strategy Carry out joint meetings with partners TASO strengthen Objective 3: To institutional capacity to implement TEACH strategy Coordina- staff (Project project Hire Volunteers) tor and Public relations Develop and print TEACH SOPs staff in TEACH SOPsOrient TASO – staff of TASO 80% percentage Carry out selective refresher line staff courses for TEACH front Establish TEACH Monitoring and evaluation system Develop TEACH M&E planDesign a functional MISDevelop TEACH data collection tools data collection tools developed TEACH M&E plan developed by end Two workshopsConduct MIS review MIS designed by end of 2007 workshops con- MIS review Two Functional MIS for TEACH developed MIS system functional. Specific objectiveCarry out partnership analysis for TEACH Outcome/output targets Level of achievement Comment

16 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 4. Impact on Service Provider Competence

Project impact on service provider competencies in this evaluation is presented to mean the skills, Knowledge and experience that the TEACH Alumni obtained during placement period. Findings from the evaluation indicated that the Alumni had acquired more knowledge and skills, and had gained experience in a variety of HIV/AIDS service delivery models and practices while at their placement sites in TASO. The Alumni reported having acquired the following skills:

Community mobilization skills Memory book writing skills ART Case conferencing skills Data management skills Project management skills Counseling listening skills Lobbying and advocacy skills Child counseling skills Communication skills Resource mobilization skills Record keeping skills Public relations and customer care skills

4.1.1. Community Mobilization skills: In majority of alumni organizations visited, there were clear reports and expressions of praise by alumni about the immense community mobilization work they were currently involved in through application of the mobilization skills they obtained during their placement in TASO. The Alumni had mobilized community members to participate in community out reach programs for VCT and PMTCT. Alumni apply various community mobilization skills acquired in TASO including using drama groups. In Ghana, community mobilization activities focused on fi ghting stigma and pursuing advocacy for accelerated access to HIV/AIDS services. Desk Mansu, TEACH Alumni of Golden Joy Foundation in Ghana said “While at TASO my main area of specialization was social support and administration…..during the attachment, I gained major skills in community mobilization and sensitization on HIV/AIDS and TB”.

4.1.2. Memory book writing skills: An interesting skill area in which alumni reported excitement about to the evaluation team was memory book writing. They underlined the importance of memory books in informing their children in the years to come and highlighted their children as the fi rst direct benefi ciaries. In Swaziland, efforts to support parents to write memory books had already begun. MS Ruth Kunene who works with Swazi- land National AIDS Program said…. “While at TASO for an attachment, I acquired memory book writing skills and I have used the skill to introduce and support memory book writing in Swaziland”

4.1.3. Communication skills: The Alumni obtained communication skills which they were already applying in their routine services to clients in their organizations. The most cherished skills reported by the alumni were listening, empathy and probing skills during counseling. The Alumni indicated that their client-service provider relationships had greatly improved in all areas. Mr. Obbo Michael of Red Cross society-Tororo Uganda said “I learnt communication skills which I am using to effectively deal with various categories of clients”

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 17 MS Jane Nyaranga from Kenya AIDS Watch Institute remarked during the interview ………“During my placement at TASO, I acquired listening and counseling skills. I am using this skill to address school pupils’ challenges at school” Ms Miriam, Alumni at Ghana Teaching Hospital remarked “I have counseled a number of couples on HIV/AIDS and many have accepted to live positively. This is because my relation ship with clients has improved”

4.1.4. Child counseling skills: Evaluation fi ndings indicate that child counseling was one of the most liked and enjoyed skills by the alumni while at their placement in TASO. In fact, alumni in 6 countries visited underscored the value of child counseling. Below are some of the voices:

Moses Banda, an Alumni supervisor from Malawi said… “The Alumni acquired child counseling skills from TASO. These skills are being practiced in the organizations which has been lacking in Malawi. It is now helping the organizations to grow by establishing child counseling centers”

Dr. Atanga Pascal Nji working with the Provincial hospital-Buea in Cameroon remarked “While at TASO Mbale, I learn child counseling skills and I am in the process of implementing the skills. I have already established a child counseling centre where 10 children have registered”

4.1.5. Monitoring, Evaluation and Data Management skills Alumni who had interest in monitoring, evaluation and data management during their placements in TASO reported and praised TASO for its outstanding organization in these areas. They particularly mentioned data management at TASO as excellent. In Cameroon, the alumni, Martin working with rural women development said of TASO …. Many things were done in TASO which were not done in my organization especially on data management. I am now improving information and management systems in my organization” Thomas Orungo from Youth Education Network in Kenya remarked that “TASO helped me to acquire monitoring and evaluation skills”

4.1.6. ART Case conferencing skills: The evaluation team found out that some alumni learnt and were exposed to ART management skills. Of interest to them was case conferencing in TASO, which they mentioned was a complete new approach, conducted with specifi c skills. The alumni elaborated how they keenly followed through the conferencing session to obtain the skill. In her interview, Sister Gladys of Mount Mary Health centre Buea (Cameroon) remarked… “I acquired many skills while in TASO; and in particular I obtained ART case conferencing skills as a new thing which I have developed in my hospital”

4.1.7. Proposal writing skills: The evaluation team found out that some alumni had started applying proposal writing skills acquired during the placements. Their supervisors alluded to this, acknowledging the proposal writing and project design initiatives the alumni had started for their organizations. In some countries like Ethiopia, this skill had been widely exploited as alumni mobilize funds from various donors to support their activities.

Amare Bedada, the TEACH Alumni from Social services for AIDS (OSSA) in Ethiopia, while being interviewed, said ……..“One of the key skills I acquired through exposure at TASO was proposal writing skills”

4.1.8. Training skills: The evaluation team found out that some alumni acquired community training skills using TASO community training manual during their placement at TASO. In Cameroon, the alumni were found already utilizing this skill through training of community members to provide community HIV/AIDS care.

Martin, an Alumni had this to say… “While at TASO, I learnt how to use the TASO community training manual and using this knowledge, I transferred the knowledge to community AIDS committees in Cameroon. The committees are using this training manual to train communities in community care”

18 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 The above serve to conclude that Alumni organizations visited in and outside Uganda had started practicing knowledge and skills learnt from TASO to improve service delivery and programming.

5. Project Impact on Replication of TASO Service Delivery Models/Best Practices

Project impact on replication in this evaluation means the models/best practices that the Alumni introduced at their respective organizations after placement.

One of the key objectives of the TEACH project was to expose the Attachés to TASO’s best practices and models in service provision and programming. The ultimate result would be Alumni adaptation of the models in their organizations to improve service delivery to PHAs in their countries. The evaluation team paid particular focus on this objective in all the TEACH alumni organizations that were visited. Evaluation fi ndings indicated that indeed, a number of service delivery and programming models and best practices Alumni found in TASO were relevant to the service delivery and programming contexts in their countries. Hence a number of models and best practices had been adopted at the alumni organizations visited. Following is a list of models that were found to have been adopted by alumni organizations.

Home-based HIV/AIDS counseling and testing (HBHCT) Community mobilization /sensitization using drama strategy Client empowerment model through sustainable livelihood programming (SLP) Community ART model through community drug distribution points Counseling mode in particular-couple counseling, community and family counseling Community programming/ service delivery model using community volunteers Client positive living model through memory book and will making Client appointment system Gender main-streaming model Advocacy models using drama, GIPA and radio talk shows Group counseling model Community training model using TASO community care training manuals Community outreach and home care models in service delivery ART Case conferencing Information management system HIV/AIDS integration service delivery model

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 19 Country Ethiopia treach sites treach an clients alone. Home-based HIV/AIDS counseling and testing (HBHCT) community drug distribution points (CDDPs)The ART community model through This involves supporting members of the family clients rather th The family holistic model in HIV/AIDS service delivery. Uganda The counseling model through hotline telephone learnt from TASO hotline telephone learnt from The counseling model through delivery model by taking both medical and counseling services to clients homes Home care service model The community HIV/AIDS outreach The Home-based HIV/AIDS counseling and testing (HBHCT) model encouraging participation of clients in service delivery especially at ou principle through The client empowerment model a GIPA STDs) PMTCT, to clients (FP, Integration of vital information provision also followed up in their homes. Clients are model in service delivery. and home care Community outreach delivery model using community volunteers Community programming/service clinic in Red-Cross integrated into mental health care HIV/AIDS integration model in other services. services were TASO Client fellowships adopted at URCS as one of the best practice from schools through model among the youth and children HIV/AIDS prevention out to many people in need of HIV/AIDS services. use of community volunteers to reach Community service delivery model through raising in community mobilization and HIV/AIDS awareness use of drama approach is strong There STDs) PMTCT, to clients (FP, Integration of vital information provision model (SLP sustainable livelihood programming Client empowerment model through ART Community drug distribution model Swaziland Organization for Social Organization Services for AIDS (OSSA) Mbarara Regional Referral Hospital Zewditu Hospital-Adds-Ababa strategy The community sensitization model using drama group Uganda Red cross STDs) PMTCT, to clients (FP, Integration of vital information provision AHEAD (HIV/AIDS Education Health) and Reproductive Council -Rakai Town Swaziland National AIDS program Table 3. Models/best practices adopted by organization and country 3. Models/best practices adopted by organization Table TEACH Alumni Institution model/best practices replicated TASO

20 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Country ) to l. ion and as a care training model care management of clients files are being implemented. management of clients files are mode and now working in the field with German Development Service Support using TASO created Community AIDS committees were The GIPA principle from TASO. PLWAs are at the front line to fight stigma among the population at the front are PLWAs TASO. principle from The GIPA data cleaning, documentat Information Management System. Best practices in data management such as routine The TASO share information on ART adherence information on ART adherence share result of SLP result being pursued for specialized treatment Partnership strategies aimed at enhancing client referrals drama strategy Community sensitization/mobilization through education forums (AEFs have formed Adherence The groups formation of community peer support groups. model through ART adherence Client appointment system model to manage numbers of clients in communities formation of peer supportClient support groups model through Communication model using radio talk shows model in service delivery Community outreach Community mobilization using drama strategy initiated male HIV/AIDS clinics Though this, the organization Gender as a key strategy in HIV/AIDS service delivery. principle GIPA Client empowerment through of PLWA formation of peer support groups Community mobilization through STDs) PMTCT, to clients (FP, Integration of vital information provision Child counseling model drama strategy Community sensitization/mobilization through Child counseling model STDs) PMTCT, to clients (FP, Integration of vital information provision model (SLP). Counseling on nutritional support has expanded sustainable livelihood programming Client empowerment model through Rural Women Development Rural Women Community training manuals. This manual is being used in their community adopted TASO The organization Provincial Hospital BueaProvincial Integration of child counseling model TESA HIV/AIDS Foundation STDs) PMTCT, to clients (FP, Integration of vital information provision Baptist Health Cameroon (CBC)-Mutengene Board Mount Mary Health Centre Buea-Cameroon Cameroon TEACH Alumni Institution model/best practices replicated TASO

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 21 Country Ghana Kenya Zambia r week in and mobiliza- living among the tize other peers about HIV/AIDS in is high. People were found to fear is high. People were lt the Program Officer-HIV/AIDS (Mr. Officer-HIV/AIDS (Mr. lt the Program counseling group sessions counseling group Adopted the Home-based HIV/AIDS counseling and testing (HBHCT) model drama and community mobilization model through creation Adopted HIV/AIDS awareness Godslove) is the Alumni and country HIV/AIDS focal point for Ghana championing formation of Association (network) and sustainability of various models in Ghana tion of all Alumni to facilitate replication by friends or relatives to be seen in groups counseling as many people feared group fund IGA in the form of a revolving Client empowerment model through Home-based HIV/AIDS counseling and testing (HBHCT) visits. home care and at homes through served at outreaches models. Clients are and home care outreach Adopted TASO drama approach model through creation Community HIV/AIDS awareness memory book writing Adopted client positive living model and empowerment through schools to counsel 1,000 pupils pe enables the organization counseling sessions model was adopted for schools. This approach group TASO Swaziland Child counseling model adapted and being used in the hospital STDs) PMTCT, of vital information to clients (FP, The hospital integrated provision home visits service delivery model both medical and counseling. This is done through home care Introduced Integration of couple counseling at their HIV/AIDS clinics. Findings indicated that is facilitating positive clients. using drama groups HIV/AIDS community sensitization approach TASO people living with Aids to fight stigma Drama members are drama strategy. Community sensitization/mobilization through and community volunteers formation of peer supportCommunity level support groups systems through This is being implemented in the organization Social support model using sustainable livelihoods approach. and radio talk shows Advocacy models using drama, GIPA encouraging clients to eat particularAdopted the social support local foods. model through Light-House, Malawi (SLP) sustainable livelihood programming Client empowerment model through Malawi Swaziland National AIDS program Education NetworkYouth youth volunteers to sensi this, they recruited Club model. Through AIDS Challenge Youth Adopted the TASO Catholic Relief Services (CRS) local HIV/AIDS networks. As a resu Adopted the sustainability models of HIV/AIDS services through Ghana Hospital-Okalebee Hospital Teaching National Association of people living with AIDS (NAPLA) Golden Joy Foundation Centre Horizon Training of PLWHAs Community mobilization model using drama groups (Part of society for family health programs) KARA Counseling centre stigma Adopted the family counseling model. It was found that this model works well in society where TEACH Alumni Institution model/best practices replicated TASO

22 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 The evaluation fi ndings presented in the above table support what various Alumni in section 4 reported about the skills, knowledge and experiences obtained while at TASO. Analysis of the above fi ndings indicates that each organization replicated at least two or more TASO models/ best practices. However, consultants observed some signifi cant variations across countries regarding the extent to which organizations in specifi c counties adopted/replicated the TASO models.

In-depth analysis of the fi ndings indicates that countries of Cameroon, Ethiopia, Ghana and Uganda were leading in replicating TASO models/ best practices. Investigation into factors associated with this fi nding revealed the following factors;

TASO SIPAA project. TASO in partnership with Action Aid carried out capacity building for HIV/AIDS service delivery in the African countries of Cameroon, Ghana and Ethiopia. The project aimed at building capacity of organizations in these countries to plan, implement and monitor HIV/AIDS activities. This earlier exposure to TASO training facilitated easy replication of the models in these countries. Reputability, funding levels and establishment of organizations over years. The Alumni organizations that had long time tested experience in HIV/AIDS programming found it easy to adopt models as they did not fear risks of jeopardizing their established program set up. Level of innovation and creativity. Innovation and creativity was observed in alumni forming associations, passing over skills to other staff in their organizations and sensitizing leaders of their organizations about models and best practices learnt from TASO. Positions Alumni were holding in organizations. The Alumni in influential decision making positions were able to influence replication of models.

On the other hand, in countries where replication was rather limited, analysis of the fi ndings revealed that the following were limiting factors; Organizational policy and culture; fi nancial and other resource challenges such as limited infrastructure; exposure to TASO models for the fi rst time; stigma and discrimination and political atmosphere prevailing in some countries such as Kenya and in Swaziland. In relation to political atmosphere, Dr. John Mukene (Director general health services in Swaziland remarked. “Swaziland is a small country with only one million people. HIV/AIDS prevalence rate seems low because many cases are not reported. The political atmosphere does not give attention to HIV/AIDS prevention and other services. With TEACH partnership, we pray that TASO builds more capacity of Swaziland people to fi ght this scourge”

In Zambia, two TEACH alumni interviewed expressed great appreciation of the models and best practices learnt in TASO. However, they had not implemented them due to limited facilitation from their organization. Other alumni interviewed indicated that they had plans to form an association to be able to access funding but were scattered all over the country and had inadequate funds to facilitate their travel.

5.1. Other Project Evaluation Findings

In the course of carrying out this evaluation, the evaluation team found a number of positive changes that had occurred as a result of TEACH alumni placements in TASO. It was explicit during interviews with alumni and their supervisors that there were psychological and attitudinal transformation behav- iors that were accordingly being demonstrated and observed among TEACH alumni. Notable changes clearly observed were in the following areas:

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 23 Reduction in self stigma and discrimination Improved customer/client care Positive attitude towards PLWHAS More commitment to serve PLWHAS Commitment to the value of team work, respect and family spirit

6. Unintended Results (Project Spin-offs)

While the primary TEACH objective was to improve service provider competence, the project generated a number of spin-offs. The key project spin-offs identifi ed during the evaluation were:

• Formation of NGOs and associations such as Golden Joy Foundation in Ghana, Code Hope Cam- eroon, Alumni Association of Ghana and other community based groups which were formed by TEACH alumni in most countries visited.

• Some Alumni have won grants through proposal writing to donors. For example Catholic Relief Services and National Association of People Living with AIDS (NAPLA) in Ghana

• Introduction of new HIV/AIDS services in Alumni institutions. For example VCT and PMTCT services which were not acceptable in Catholic Hospital (Cameroon) were easily introduced and accepted; “Sister Gladys said “Alumni have convinced management to implement VCT and PMTCT services which was diffi cult for people to accept”;establishment of new child counseling centers in Malawi and Ethiopia; introduction of aromatherapy services in the HIV/AIDS unit in Ethiopia.

• Promotion of TEACH Alumni at their places of work. Starnford Mansaka, who was the supervisor at Horizon Training Centre in Zambia before exposure to TEACH project was promoted to the position of site Manager after TEACH placement. In the interview with starnford Mansaka, he said….‘I was promoted after I reported back to my organization in order to implement what I had learnt in TASO’.

• Greater strategic advocacy for increased access to HIV/AIDS services including ART. Alumni organized and conducted HIV/AIDS conferences, HIV/AIDS workshops, charity walks and other form of HIV/AIDS campaigns. The TEACH alumni association was committed to follow through such advocacy strategic issues to realize the greatest impact. This was observed in Ghana and Cameroon.

• New strategic partnerships and collaborations have emerged in Alumni institutions. For example in Cameroon, American partners are supporting Cameroon and AIDS support organizations (ASOs) due to improved organizational capacity to manage HIV/AIDS.

• While TEACH project geographically targeted Africa, it received other applicants (28 in total) from developed countries outside Africa. These were Japan (2), USA (8), and United Kingdom (14).TASO was fl exible and allowed them for experiential learning at their own costs. The implication here is that the demand for this service is beyond Africa.

• TEACH also received a total of 56 Attachés from institutions who were facilitated by their organizations and benefi ted from the experiential learning for two to three days. Although they wished to stay longer for a month, their organizations were fi nancially unable to facilitate them.

24 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 7. Sustainability of the Project

TASO-TEACH program has been successfully implemented based on full and uninterrupted funding from Sida and this contributed to outstanding achievements indicated in this report. The sustainability of this program however hinges on donor funding. From the fi ndings in this report, it is the view of the evaluation team that the program can be made more sustainable by applying the following strategies:

• Encouraging cost sharing among the majority who intend to participate in this program

• TASO to include TEACH program in the overall budgeting and strategic planning processes and outsource additional funds to supplement Sida funding.

• In future TASO could encourage and support self sponsorship on full board.

• TASO needs to maintain the quality of services offered to keep attracting service providers in Africa and beyond.

8. Key Lessons and Experiences

From the evaluation fi ndings, the team established the following key lessons and experiences:

The team learnt that some organizations in developed countries are able to facilitate their staff for a one month placement at TASO without Sida funding. On the other hand, institutions from developing countries such as Uganda are willing but unable to support their staff for one month period at TASO due to resource limitations. This justifi ed why most of these staff came for a short exposure visit for the period ranging from two to three days.

Stigma and discrimination remains a challenge in many African countries compared to Uganda. People have not openly come up to talk about HIV/AIDS. This calls for continued HIV/AIDS interventions in these countries.

The team learnt that acquiring skills from TASO is one thing and translating them into tangible results is another. Most Alumni have good will to transform their societies using TASO models but their institutional capacities have challenges. The alumni have had diffi culties in changing policies in their organizations and to have their TEACH action plans incorporated in organization budgets to meet new desired changes.

Some alumni did not want to stay and live in the remote areas of Uganda such as Tororo and Rukun- giri. They wanted to remain at TASO Head offi ce in Kampala. For example, some Attachés from South Africa and other countries came with high expectations to live luxurious/most comfortable lives. Other Attachés wanted a more fl exible timetable to accommodate private interests such as local site seeing and other stress management events. Future timetabling of TEACH may need to refl ect on this lesson to harmonize Attaché learning and other interests that do not interfere with experiential learning or impose additional unnecessary costs.

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 25 9. Conclusions and Recommendations for TEACH-Two

1. It was clear from the evaluation fi ndings that there were two categories of Attachés that enrolled for the TEACH project namely; frontline HIV/AIDS program implementation staff and those in senior program management positions. These two categories had different HIV/AIDS program interest scopes; hence their opinions on duration for placement vary. The evaluation team recommends that TASO should consider restructuring TEACH program by targeting two levels of attaches namely frontline staff and program managers to be placed for a period ranging from 1–2 months and 2–3 weeks respectively.

2. The current TEACH project Volunteers placed at each of the TASO centers have a work scope that engages them as fulltime staff and are inadequate in numbers. Additionally, these staff are not adequately trained to handle the different Attaches that come from diverse backgrounds. It is recommended that:

• TASO makes the current TEACH PRO volunteers fulltime staff

• Recruits more staff into the TEACH project

• Train PROs and other frontline staff at centres to increase their competencies to handle all types of Attachés

3. Information technology is critical in facilitating Attachés to access information, and share learning between and among each other. This service was found limited at centers where attaches were placed. It is therefore recommended that TASO facilitates TEACH attaches with information technology facilities such as computers linked to internet, to support exchange of information and learning between and among themselves and TASO program staff at Centres. This will minimize interruption with the TASO main program work and at the same time assist Attachés in communicating to their families and home organizations.

4. The TEACH Attachés underscored the experiences and skills they obtained from the TASO partners they visited. This experience widened their understanding of HIV/AIDS work. The evaluation team observes this as a fundamental achievement. It is therefore recommended that TASO continues to strengthen the existing partnerships by engaging them more effectively, and further seeks to develop new action oriented partnerships with other potential organizations.

5. There were enormous achievements that TEACH project registered in the three years of its implementation. Despite this, fi ndings indicate that the demand for TEACH is still high. It is therefore anticipated that more attaches will apply for the attachment. It is recommended that TASO considers diversifying funding for the TEACH project to take on more Attachés for the period recommended above.

6. The current M&E system for TEACH project is not adequate. The TEACH Attachés were not adequately followed up to assess their performance especially those from outside Uganda. It is recommended that TASO reviews its monitoring and evaluation frame work for TEACH project with the view to improving it to be able to track progress made by Attachés after their placement period. It should specially include tangible indicators for monitoring attaches from other countries. The evaluation team further recommends that TASO supports TEACH to establish a soft ware for capturing all the data on TEACH program. It is also needful for TEACH to support alumni associations where they have been formed e.g. Ghana, Malawi and Swaziland through support supervision

7. It stands unchallenged that TASO TEACH project has spread in many countries in Africa, with tangible results and impact in countries where Alumni came from. While the project focused on Africa,

26 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 the project had reached only 24 countries in Africa (which is about 43% of coverage). In order to maximize access to TEACH services, it is recommended that the project be scaled up to the rest of Africa.

8. The TEACH alumni gender distribution indicated a fairly skewed distribution presenting more males having benefi ted from the attachments than females by a ratio of 55:45. While this is generally a good gender distribution, we recommend that future TEACH project move a deliberate step to increase the number of females enrolling into the project.

9. The evaluation fi ndings revealed that, TASO facilitated TEACH with offi ce space at all levels to facilitate their learning. However, due to competing needs with other activities, the space was found inadequate. There is need for TASO to proactively strengthen TEACH infrastructure particularly space to maximize the Attaché learning environment

10. The fi ndings indicate that a number of Alumni formed TEACH Alumni associations in their respective countries. TASO should tap into this opportunity by engaging the leadership of these associations in TEACH strategic activities in Uganda. These may include for example involving leaders of associations in TEACH bi-annual and annual reviews to continuously share lessons and give input into TEACH programming process. TASO should also visit TEACH alumni organanizations to support and build their capacity.

11. It was observed that the demand for TEACH project is beyond Africa. While the team feels that this should remain the main TEACH geographical target, TASO should open this project to other parts of the world especially those where the HIV incidence rates have soared in the recent years such as Asia.

12. Many Alumni formed TEACH Alumni associations in their respective countries. It is the view of the evaluation team that this effort be strengthened as it is one of the sustainable mechanisms to facilitate replication of TASO models.

13. It was observed that attaché’s were not exposed to other fundamental successful HIV/AIDS programs such as the Millennium Development Goals

(MDGs) being implemented in Uganda. It is recommended that all attaché’s be exposed to Uganda millennium development project villages to facilitate replication of TASO models in the context of millennium develop goals.

14. The evaluation team discovered other areas for further research which could not be covered under this evaluation and yet are essential for TEACH programming. The major area for immediate and further research is effective replication of HIV/BEST best practices/ models in limited resource settings.

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 27 10. References

Cameroon Baptist Convention Health Board (2007): AIDS Care and Prevention Program: Annual Report

Jeffrey M. Mwala (May 2006): Report on TEACH Training, Mission Hospital, Malawi

NAPLA Secretariat Ghana Organizational Manual

TASO (2005–2007): TEACH 1 Project Proposal

TASO (2006): TEACH Project Annual Report

TASO (2007): TEACH Monitoring and Evaluation Plan

TASO (2007): TEACH Project Annual Report

TASO (2008): Annual Draft Evaluation Report

TASO (2008): TEACH Project 1 Inception Report

TASO (September, 2005): TEACH Project Review Report

TASO Standard Operating Procedures for Implementing TEACH Project

TASO(2008–2012) Strategic plan

28 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Appendix One

Pictures Showing TASO Models Replicated in Some Countries

Community HIV/AIDS sensitization by TEACH Alumni Sam Mbera in Malawi

Ntokota Cecelia a clinical officer & TEACH Alumni in ZAMBIA addressing discordant couples

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 29 Ntokota Cecelia a clinical officer & TEACH Alumni in ZAMBIA handling VCT in ZAMBIA

Jane Nyambura TEACH Alumni from Kenya conducting a child counseling session

30 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 HBHCT Activity in Malawi being carried out by Mbera Sam aTEACH Alumni

Client in Malawi benefiting from introduced SLP model by Bahat Nyirenda, a TEACH Alumni

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 31 Appendix Two:

Detailed Evaluation Methodology

Evaluation Design and Approach The evaluation was a cross- sectional survey across African continent of Africa covering the countries of Ghana, Cameroon, Malawi, Zambia, Swaziland, Kenya, Ethiopia and Uganda. The evaluation highly involved various stakeholders and employed both qualitative and quantitative aspects of data collection methods. To measure the results of the evaluation, the alumni, alumni supervisors, clients and TASO staff were selected, visited and treated as key data sources (respondents). The evaluation also involved critical analysis of all relevant documents of the project for the period (2005–2007). The study was carried out during the period of June–July 2008

Population, Sampling Size and Sampling Strategies The TEACH project interest groups especially the alumni, leaders of the partners organizations/departments, alumni supervisors at their work places, implementing partners, and TASO TEACH project management staff were included in the samples selected for data collection. Samples were selected from the sample frames provided for by TASO against each country. The consultants used a 5–10% margin of error with confi dence level of 95% when drawing the samples. The population size under study of 500 alumni with a margin error at 10% at 95% confi dence level yielded a sample size of 83 respondents. A sample of 118 respondents catered for non-response of 30%. This means a sample size of 118 Alumni from the 8 countries were selected using a simple random technique. However, it was assumed that each selected alumni had at least one supervisor who was automatically included in the sample for an in-depth interview by the consultant. The sampling also took into consideration gender perspectives of the respondents

Purposive sampling was applied when selecting the TASO project management staff, and implementing partners. The Consultant in this case, took due consideration into program and stakeholder interests and contribution as well as the type of data required. The consultant worked hand-in hand with TASO to determine sample frames for the interest groups from the project source documents and reports where appropriate samples were determined and selected.

In each selected country, alumni were drawn from which sample sizes of each category, as respondents were determined before fi eldwork began as shown in table below.

The Sample Size Framework for the Evaluation by Gender and Country Beneficiary Sample Size Per Country and by Gender Total Country Alumni Alumni Supervisors Alumni Clients MFMFMF Uganda 10 7 332227 Ghana 5 3 322318 Cameroon 5 9 333427 Malawi 5 2 123316 Swaziland 1 4 113111 Zambia 5 3 114216 Ehiopia 5 2 221315 Kenya 5 4 323320 Total 41 34 17 15 21 22 150

32 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 The methods of Data Collection included the following Semi-structured Interviews using questionnaires

The Questionnaire was designed for the Alumni. The Client approved the Questionnaire developed during the Inception Report phase for use in the fi eld.

Key Informant Interviews [KII] and Focused Group Discussions: The Consultant made contacts with all the country focal persons, and met the key informants (alumni supervisors and alumni clients) at various organizations. A list of questions was developed to target the key informants. The Consultants also held meetings with the offi cials of TASO before and after the commencement of the study.

Observations and Field Visits The Consultant interfaced with various benefi ciaries (clients, alumni, supervisors, offi cials of institutions) and TASO staff to collect some additional information especially on the achievements of the project.

Recruitment, Training and Responsibilities of Field Staff The consultancy team consisted of 5 Consultants who were thoroughly trained for one day on how to administer the research instruments in the fi eld to collect high quality data. The Technical Team from TASO monitored the work of consultants.

Data Quality Control The questionnaire was pre-tested in Kampala district by the Consultants before implementing it in the fi eld. The support of the country focal persons must be commended as they helped the consultants in the identifi cation of various categories of respondents approached and interviewed. Gender concerns were keenly taken care of in this study (30% female) (see table 2.1 above).

Data Processing, Analysis and Management The data for the study was analyzed using windows based package, SPSS statistical functions, and Word Processing Programs (Ms Word, for Windows) to investigate clear trends and patterns, thus facilitating quick and effective analysis of the data. A competent Statistician did data coding and analysis. The fi ndings, conclusions and recommendations were refi ned and interpreted

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 33 Appendix Three:

List of Evaluation Participants

TEACH Alumni

Uganda Dr. Nyakoojo Francis AHEAD-Rakai Uganda Dankaine Alifa Amuza Budaka HIV Testing Center Uganda Onyango Jagire Kibwon Bundibugyo District Hospital Uganda Akello Lillian Grace World Harvest Mission Uganda – Bundibugyo Uganda Kanyonyozi John Bushenyi District Local Government Uganda Tusingwire Lillian Rubindi Health Centre Uganda Akol Sarah Partricia Students Partnership Worldwide – Jinja Uganda Babiyre Christine Micro Enterprise Development Network (MED NET) Uganda Benjamin Amaitum Police/Min. of Internal Affairs Uganda Christopher Kawanguzi Mulago Hospital Kampala Uganda Pelagia W Nziramwoyo AIDS Information Center – Kampala Uganda Agaba Andrew Population & Health Research Consult – Kampala Uganda Ramathan Nsubuga Kibuli Hospital Uganda Muthende Augustine Presidential Guard Brigade Uganda Mugoowa Charles Mbarara Regional Referral Hospital Uganda Muhindo Hodilla Kule Kilembe Mines Hospital Uganda Obbo Michail Red Cross Society – Tororo Uganda

Ghana Godslove Bansah Catholic Relief Council – Accra Ghana Ahudey Manasseh Karl Williams Ghana Health Life International Ghana Wornameh Selase Ghana HIV/AIDS Counselors ass. Ghana Nortey Joyce Women united against AIDS in Ghana Ghana Miriam Larbey Korle Bu Teaching Hospital Accra, Ghana Ghana Kotoka Joyce Esimam Mab Medical Centre Ghana Julia E Duodu Ghana Sustainable Change Project Ghana Divine E Sackey k Mansu Golden Joy Foundation – Accra Ghana

Cameroon Nfor Kevin Mbrunka Community Development Social welfare & Health Foundation Cameroon Lukong Felicitas Sevidzem Mt Mary Health Centre Cameroon Atanga Pascal Nji Provincial Hospital Annex – Buea Cameroon Njumbe Isidore Sr. Jacqueline Atabong Cameroon Totouom Armand Ass. Sunaids Douala Cameroon Edmond Njang Tiku MAMFE Council Cameroon Cliford Muluh Clinique St. Pierre Cameroon Mary Gladys Diyen Nain Mount Mary Health Centre, Buea Cameroon Martin Ndorh Ekumbo Reach Out– NGO Cameroon Tah Ndum Ferdinand CAMYAIDS & Clinique St. Pierre Cameroon

34 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Ewane Theophile Palle Noble Social group Health Services Cameroon Stella Nzelle Ekukole TESA HIV Foundation – Sisters of Saint Therese Cameroon Lilian Yiyen Lukong Catholic Health Services Cameroon Lekenzi Lucia Menji Council AIDS Control Committee Cameroon

Malawi Mwala Jefrey Malizani CCAP SYNOD of Livingstonia Health Dept Malawi Masiye Chimweme Kalengo Welcome Trust Research Labaratories Malawi Chimenya Dennis Population Service International (PSI) Malawi Nyirendah Bahat Counselling of Adolescent & Youth Organ (CAYO) Lilongwe Malawi Kaledzera Robson MICRO Malawi Mbera Samuel Tidziwe Centre – Kazumu Central Hospital Malawi Patricia Binali Light House Malawi Ntokata Cecelia Kamuzu Central Hospital Malawi

Swaziland Mamba N Margaret Ministry of Defence Swaziland Swaziland Irene Nxumalo Simunye Health Services Swaziland Marx Beverley Simunye Community Church Swaziland Mr. Teluleko Maseko Mananga Centre Swaziland Dumile F Sibandze Min. of Health and social welfare Swaziland Ruth Kunene Swaziland national AIDS Program Swaziland

Zambia Daka David Ministry of Agriculture & Cooperatives Zambia Wapela Musonda Churches Heakth Association of Zanbia (CHAZ) House Zambia Mafwela Bornface Family Health Trust Zambia Banda Aaron Churches Health Ass. of Zambia Zambia Kalamba Mwamba Pamela Society for Family Health Zambia Munsaka Stanford Society for Family Health Zambia Shatunka Arnold Shatunka KAARA Counseling centre Zambia Doctor Jinja Newstart UTH Society for Family Health Zambia

Ethiopia Dessie Girma Assefa Organisation for Social Service for AIDS (OSSA) Ethiopia Gebre Salew Gebretsadik Plan Ethiopia Ethiopia Zewdie Tenaw Mengist Ethiopian Youth Network Ethiopia Jaleta Tesea Amente Addis Ababa Evangelical church Mekane yesus Ethiopia Aboma Paulos Kanea Organisation for Social Services for AIDS Ethiopia Abera Gemechu Imana Organisation social service for AIDS Ethiopia Amare Bedada Organisation for Social Services for AIDS Ethiopia

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 35 Kenya Maurice Audi Odhaji Mission for Essential Drug & Supplies (MEDS) Nairobi Kenya Bernard Oima Danso Community Support Group Kenya Matseshe Sarah Achieng Kenya Association of Professional Counselors Kenya Kefah Nyagaka Maranga Viviji Help Community Organization Kenya Maina Judith Nyambura Campaigners for an aid free Society Kenya Nyaga Jane Nyambura Ministry of Health Kenya Kenya Oteyo Jane Nyaranga Bamako Self Help Project Kenya Bulimo Margaret Kenya Association of Professional Counselors Kenya Orungo Thomas Otieno Youth Education network Kenya

Alumni Supervisors Clara Lamisi Neobong Catholic Relief Services Ghana Sekasamba Paul Mpumudde Primary School Uganda Gloria K Mbewe UNC Project Malawi Moses Banda UNC Project Malawi Frason Chodza Counseling of Adjectives Youth Malawi Kengni Flues Seye District Hospital Cameroon Bern Dash Fidelis Calvary Health Services Cameroon Alemayehu Tassew Organization for Social Services Ethiopia Mwase John Municipal Council Uganda Ogutti R International Rescue Committee Uganda Katema Levija HAPSCO Ethiopia Catherine Society for Family Health Zambia Hendrix Sikwibele New Start Centre – Horizon Zambia Katanda Mumbi Joan Society for Family Health Zambia Osaka Tamimu NAP + Ghana Ghana Dr Jacob Acumoah B Mab–Medicare Centre Ghana Philohiha Mahuh Mab– Medicare Centre Ghana Crysat Clettey Korle Bu Teaching Hospital Ghana Lucy Meensah WUAAG Ghana Clement Azigiwe Global Disease Centre Ghana Crystal Clottey Korle Bu Teaching Hospital Ghana Isaaka Tamimu Golden Joy Foundation Ghana Nana A.K. Mansu Golden Joy Foundation (Supervisor for DESK) Ghana Alice Pwemeng Coordinator Ghana Nana A.K. Mansu Society For Family Health Zambia Mwachikoloma Judy Korle Bu Hospital Ghana Ransford Vanderpoye Kara Counseling and Training Zambia Namwayi Membe Golden Joy Foundation Ghana Miriam T. Dorgbor Golden Joy Foundation Ghana Majory Saint Senti Society for Family Health Zambia

36 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Clients Majory Saint Senti Society for Family Health Zambia Brenda Nyaleso ASABOUE Kenya Sr. Esther Wairimu St. Francis Kasaiani Kenya John N. Muota Makadana H/C Kenya Mary Okwiri STC Cansino H/C Kenya Ann Ndirango Jericho Health Centre Kenya Loise N Mwaniki Mhare North Health Centre Kenya Mary A. Omollo YEN Kenya Samuel Aloyo KAPC Kenya Henry Okumu DC5G Kenya Margrat Muchui Tigoni Hospital Kenya Annros W. Njeru Ministry of Health Kenya Sande Caroline ASABOUE Kenya Kauki Tom M SAME Kenya Irene James N. NA Kenya Had Madey A German Directorate Kenya Philip Drwaki DANSCO Kenya Martine A. C. DANSCO Kenya Shiela. W. Waweru KAWI Kenya Tabitha Mati Patti Fishers International Kenya Mrs. Nagwayu Margaret CBCHB Nursing services Cameroon Mr Nkfusai Joseph Supervisor ACP ASC Mutengene Cameroon Mrs. Asongle Lawrence Njuzy Divisional Delegate for Secondary Education Cameroon Kevin Nfor Counseling Coordinator Cameroon Olang’o Fredrick Obuolo St. Christine School Kenya Peter Ng’ola Owiti Mathere North Health Centre Kenya Netondo Mathews Wepo Mbarara Referrel Hospital Uganda Jaffer O Ouma Ntungamo Hospital Uganda Jaleta Tesea Amente Luwero Diocese Uganda Chirwa Kumbukani Manobeok Malawi Udedi Michael HIWOTE Ethiopia Micheal Obbo Mukuju Health Centre IV – Tororo Uganda Muzaaya Januarius Ntugamo Local Gov’t – Education Sector Uganda Batambulamu Richard Rakai AIDS Information Network Uganda Mawanda Fredrick Orphans and Elderly Development Initiative – Rakai Town Council Uganda Wasukira Maliki Sironko Youth Life skill network Uganda Owaga Patrick Valentino Sule Intergrated Dev’t Organisation – Tororo Uganda Christopher Dapaah Kwaku Resource Link Foundation Ghana Attandoh Pius Kwasi Ghana Rural Action Support Program Ghana Atsu Cynthia Dede Megavest Medical Centre Ghana Amoako Julius Bekoe Young activists against HIV/AIDS Organisation Ghana

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 37 Appendix Four:

Countries that benefited from TEACH 1 project by Region in Africa

Western Africa Eastern Africa Southern Africa Northern Africa Ghana Kenya Swaziland Ethiopia Cameroon Uganda Zambia Sudan Sierra Leone Tanzania Malawi Nigeria Rwanda DRC Liberia Burundi Mozambique Togo Zimbabwe Angola S. Africa Namibia Botswana

38 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Appendix Five: Evaluation Instruments

An Evaluation Survey Questionnaire for TEACH Project (Confidential) Instructions: Please, Only Alumni of TEACH Project are eligible and allowed to write (fill) in this questionnaire and are requested to provide as accurate answers and perceptions as possible to each question. Filling the Questionnaire may take approximately about 5–10 minutes. Filter Question: Have you ever been attached to TEACH Project in Uganda from 2005–2007? 1. YES 2. NO If “NO” Close the interview. (You are not eligible!!) If “YES” continue to answer all the questions provided in the questionnaire.

Part One: Profile Details of Respondents (ALUMNI) 1. Name of Respondent (optional) Date 2. Respondent’s Current Occupation/Title 3. Respondent’s Previous Occupation/Title before joining the TEACH Project 4. Current Department of Work/Operation 5. Type of organization ALUMNI currently works for (Tick one) 1. Private 2. Government 3. NGO/CBO 4. Self employed 5.Other (specify) 6. Respondent’s Physical/Contact Address and Tel

7. Sex/Gender of Respondent (Tick one) 1. Male 2. Female 8. Age group (in years). Please tick the appropriate category 1. (Under 25) 2. (25–35) 3. (36–45) 4. (46–55) 5. (Over 55) 9 Highest level of education before ALUMNI joined the TEACH project. Please tick the appropriate category 1. Degree 2. Diploma 3. Certificate 4. A level 5. O’ level 6. PLE 7. None (did not attend school) 10. Current highest qualification 1. Degree 2. Diploma 3. Certificate 4. A 5. O’ 6. PLE 7. Other (specify) level level 11. Select Name of program(s) of attachment at TEACH project you attended (multiple choice possible) 1. VCT 2. Medical 3. Home care 4. Social 5. AIDS 6. Capacity building care (ART) support Research 7. AIDS 8. Guidance & 9. Public 10. HIV/AIDS 11. PMTCT 12. Other (Specify) education Counselling Relations Advocacy (rights) & Collaboration 12. Place/Centre of attachment at TEACH project Year (Month) 13. Working Time of attachment 1. Day 2. Weekend 3. Evening 4. Night 5. Other (specify) 14 Who paid for the TEACH project Attachment? 1. Employer 2. Self-Sponsor 3. TEACH Full 4. TEACH Partial 5. Cost sharing 6. Other (specify) Scholarship Scholarship with government 15. Country of Residence of ALUMNI 1. Ghana 2. Swaziland 3. Cameroon 4. Ethiopia 5. Malawi 6. Zambia 7. Uganda 8. Kenya

1 The attachment programs abbreviated above are: ART= Antreviral Therapy, PMTCT= Prevention of Mother to Child Transmission, TEACH=TASO Experiential Attachment to Combat HIV/AIDS

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 39 Part Two: Section A. The Role of TASO in Building Capacity for HIV/AIDS Service Providers in Africa Q1 How did you come to know about the existence of the TEACH Project training opportunities in your country/place of work? (Tick or circle any option that applies and multiple choices are possible) 1. Radio 7. Meeting 2. Television 8. Brochure 3. Workshop 9. Posters 4. Internet/ Website 10. Friend 5. Conference 11. Other (specify) 6. Newspaper Q2 What should be the best ways to publicize the TEACH Project training opportunities to the general public in your home country or your place of work? (Tick any option that applie) 1. Radio 7. Meeting 2. Television 8. Brochure 3. Workshop 9. Posters 4. Internet/ Website 10. Friend 5. Conference 11. Other (specify) 6. Newspaper Q3 What immediate reason attracted you to enroll into the TEACH project? (Tick any option that applies) To get employment from government or private sector since I was unemployed To get better employment from government or private sector though I was employed Create my own job (start similar projects in HIV/AIDS) I was given full scholarship and so I could not refuse the offer It was required in my job to improve and have such skills for performance improvement To get promotion from my employer To further my education in HIV/AIDS To develop my career in the same job line as I hold strategic position in organisation I had nothing to do Just to get a popular certificate of TASO Uganda Other reason (specify) Q4 What major skills did you acquire from the TEACH project attachment (s) you attended? (List them down) 1. 2. 3. 4. Q5 How have you put the skills/knowledge into practice since you completed the attachment (s)? (Select those that apply, multiple choice possible) Used skills in my job to improve my job performance Started private business Started my own NGO, CBO Started my own training institution (specify) Got promotion in the job TASO certificate helped me get another scholarship for further studies Participated in the international workshop, seminar or conference Started community based project for your people. Introduced the TEACH project skills and knowledge in my country/work place Nothing, still thinking what to do with the skills I got from TEACH project Planning to go back to school to upgrade my skills

40 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Other (specify) Other (specify) Other (specify) Q6 Please, have you got value for money by attending the TEACH project? i.e. (are you satisfied?) (Choose only one option and give reason for your answer) Very satisfied, If so, why? Fairly satisfied, If so, why? Poorly satisfied, If so, why? Not satisfied a tall, If so, why?

Section B: Current Aggregate Demand for the TEACH Project and Skills in the Countries and Work Places of ALUMNI Q7 What is your assessment about the current demand (by your place of work or district or country) for the services offered at TEACH Project?. (Tick/cycle one option in each location and give answer for each preferred Option) Location Demand for TEACH services Give Reason for your Choice High Average Low Zero (Not there) In Your Place of work In Your Current District/country of Residence Q8 Arrange the following TEACH Project Services in terms of the level of aggregate demand in your current district or country of residence. Rank them in terms of their demand and give reason to support your choice. Attachment Aggregate Demand for TEACH project Services in your District or home country Reason for your services offered (Tick one option in each course) selection at TEACH project /TASO High Average Poor No Demand VCT PMTCT Counseling/ Guidance Public Relations Social support Home care Social support AIDS Research ART HIV/AIDS Advocacy & Collaboration Capacity Building AIDS Education Other (Specify) Other (Specify) Other (Specify)

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 41 Section C: Assessing the Relevance, Suitability and Appropriateness of the Content and Methodology (the Curriculum) of TEACH Project to the Skills and Knowledge Needs of ALUMNI and their Organisation Q9 How relevant, suitable and appropriate was the TEACH Project curriculum of attachment to the skills and knowledge transfer in your organisation? (Please, select by ticking only one score against each course component in the space provided on the table below) Attachment Component Evaluation Criteria of Course Components Excellent Good Fair Poor Course Content Relevance to your needs Suitability for knowledge & skills transfer Appropriateness in problem solving General Curriculum design to stimulate Creativity and Innovation Affordability of the attachment to attachees Other (specify) Q10 What did you like or dislike about the TEACH project attachment (s) you attended? (List them down against each option in the table below) What did you like most in the attachment? What did you dislike most in the attachment?

Q11 What gaps are existing in the TEACH Project curriculum and what should be added to improve the Curriculum of the attachment you attended to address HIV/AIDS problems in your country? Fill the table below Identified gaps (What is missing in the curriculum?) What areas should be added to improve curriculum and enrich course content?

Q12 Do you think the TEACH Project attachment you attended has contributed to capacity building and creativity within you to solve problems professionally in your country ? 1. Yes 2. No 3. Don’t Know If “No”, state the reasons If “Yes”, state the reason Q13 Was the Attachment affordable to you? 1. No 2. Yes If “No” state why

42 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Q14 What problems did you personally meet while attending the previous TEACH project attachment offered by TASO Uganda? How did you solve some of the problems? Problem How did you solve the identified problem?

Section D: Attachment Training Needs Assessment Q15 Which new courses (attachment) at higher level should TASO Uganda introduce to TEACH Alumni (service providers) like you to effectively fight HIV/AIDS Epidemic in African Continent and at what level? (List down against each course level if you can) List of Degree Level Courses List of Diploma Level Courses List of Certificate level Courses

Q16 If you are to come back for TEACH Project Phase 2 attachment in TASO Uganda, which area of attachment would you come for? State (tick) the level, the name of course and reason for selecting it, when to start it and fill table below Attachment Areas Reason for choosing When (Year) to start? this attachment area

Q17 Which time of attachment did you find most appropriate during your attachment period and why? 1. Evening (daily, Mon–Friday) 2. Weekend (Sat–Sun) 3. Day (Mon–Friday) 4. Night (Mon–Frid) 5. Any time 6. Don’t know 7. Other (specify) Give reason for your answer

Q18 Which type of collaboration/partnership should exist between TEACH Project (TASO) and your organization or country and also with communities? Level of Collaboration/Partnership Reason/Benefit for Partnership

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 43 Q19 Please, List all the institutions in your country (you know) offering similar services(s) you attended at TEACH project, TASO Uganda attachment List of Names of Institutions Offering similar Services like TASO Uganda

Q20 What is the institutional capacity of the TEACH Project, TASO Uganda (where you attended the attachment) in terms of facilities, equipment, and staff Establishment? (Choose only one option) 1. Excellent 2. Good 3. Fair 4. Poor Give reason for your answer

Q21 What management problems did you witness with TASO Uganda during your time of attachment in implementing TEACH project? What would be the best solutions to these problems you identified? Problem Proposed Solution(s) for a problem identified 11 22 33 44 Q22 What is the quality of TEACH Project staff in terms of competence, responsiveness to performance excellence and Innovations for service providers? 1. Excellent 2. Good 3. Fair 4. Poor

Section E: Potential for Knowledge and Skills Transfer Q23 What employment opportunities currently exist in your home country both in the public and private sector which require skills and knowledge acquired at TASO Uganda attachment? (List them down on table below) Public Job Opportunities Private Sector Jobs Special Skills required to address (Government) the identified job opportunities

Q24 What are the expectations of your supervisors and leaders in your organization of you as an ALUMNI of the TEACH Project, TASO Uganda? (Tick those that apply) 1. Hard work 2. Experience 3. Multiskilled 4. Technical 5. Problem 6. Others knowledge solving (specify)

Q25 Since your graduation from the TEACH project, what major innovations or contribution have you made in your organization (place of work) or country?

44 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Q26 To what extent do you agree or disagree with each of the statements about TEACH attachment below (Tick appropriately against each statement) Statement about Disagree strongly Disagree slightly Neither disagree Slightly agree Strongly agree TASO Capacity nor agree There is continuous 12345 demand for TASO services in many parts of my country Current Institutional 12345 and resource capacity of TASO is weak Contribution of 12345 TASO Uganda to capacitybuilding and HIV/prevention is high TEACH Project 12345 services are still relevant to the needs of most people in my country The curriculum of 12345 TEACH project is relevant to capacity building needs of service providers in my country TASO policies, 12345 standards and regulations of TEACH program attachment are compatible with the vision of my organisation There are clear 12345 standards and procedures of operating the TEACH program attachment at TASO TASO Uganda has 12345 brought HIV/AIDS Education nearer to the people of Uganda TASO TEACH 12345 program attachment is affordable to my organisation Learning environ- 12345 ment in TASO in terms of facilities, language, and people is favourable

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 45 Q27 To what extent are you applying the knowledge, skills & positive attitudes acquired in the attachment? 1. Excellent 2. Good use 3. Fair use 4. Poor use 5. None (no use at all) use

Section F: Innovation and Spirit for TASO Model Replication, Adoptation and Development Q28 Do you think the attachment you undertook in TASO Uganda has stimulated creativity spirit in you? 1. Yes 2. No 3. Don’t Know If “No” Go to Q30 (Skip Q29) Q29 What Key attachment areas (fields or modules) have contributed a lot to innovation and creativity for you?

Q30 What TASO model areas are you already implementing or intend to implement in your place of work since you completed the attachment? (Fill in table below) TASO model areas implemented in organization Reason for implementation

Q31 How many people are currently employed in your Organization/Enterprise? Male Female When was it established (year)? Q32 What HIV/AIDS services does your organization render to the people in your country? 1 2 3 4 Q33 How many people (clients) do you serve daily? (cycle only options that apply) No. of Clients Served by ALUMNI Daily Before attending the TEACH After attending the TEACH in the Organisation (place of work) project attachment project attachment 1–5 6–15 16–30 31–50 51–100 More than 100 Q34 What links does your organisation have with TASO apart from TEACH project? List the programs, projects if possible? 1 2 3 Q35 What tips/lessons can one learn from you especially in the management of the next phase two of TEACH project? 1 2 3 4

46 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Q36 To what extent has TASO attachment programs improved the welfare of alumni, and capacity building needs and performance improvement in your organization since you graduated from TEACH project? (Choose only one) 1. Excellent 2.Good 3.Fair 4. Poor 5. Very poor Q37 What is the current working relationship between your Organisation or country and TASO Uganda? 1. Improved (positively) 3. Remained the same 5. Don’t know (constant) 2. Reduced (negatively) 4. None (poor relationship)

Section G: Framework & Strategies for TEACH Project Phase Two Q38 Using your attachment experience at TASO, what type of support do you think should be given to TASO Uganda by three (3) parties namely; beneficiary organizations, Development Partners and Uganda Citizens in order to improve the role played by TASO for the successful implementation of Phase two of the TEACH project in Uganda? Support by ALUMNI organisation Support by Development Support by ALUMNI Partners 1. 1. 1. 2. 2. 2. 3. 3. 3. 4. 4. 4. 5. 5. 5. Q39 What is your general view on continued existence of TEACH program for service providers in Africa over the next 5–10 years? Completely negative (TEACH program should be abolished due to lack of innovation and direction) Very positive (TEACH Program needs more support as it plays a leading role in capacity building) New HIV/AIDS capacity building programs should come up quickly to replace the TEACH program Neither positive nor negative (neutral) Q40 Was the support from the full scholarship sufficient for the attachees for the period of internship at TEACH project? 1. Yes 2. No If “No” give reasons What additional support should be given to attachees on partial scholarships by their organizations during attachment period of 3 months? Support by attachee organisation Reason for the support 1. 2. 3. Q41 Can you recommend some of the best modern ways of managing TEACH project in phase two and how to make them more relevant and responsive to the needs of various Stakeholders for HIV/AIDS service provision in Africa? 1 2 3 4 5 6

Please, incase of any diffi culty or unclear issues during fi lling or delivery of this questionnaire, ring team leader tel No. 256-0772365032 (24 hours working, Uganda).

Please, fi ll this questionnaire in clear readable letters and deliver it to the Consultant in your country within 6 hours of receipt during the evaluation exercise.

Thank you for your attention and time.

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 47 Key Informant Interview Guide

Target Groups The ALUMNI ALUMNI supervisors Leaders of benefi ciary organizations Clients of benefi ciary organizations Implementing partners TASO TEACH project Staff including trainers

(a) Supervisors and Leaders of Beneficiary Organisations Key Areas of Investigation Relevance of Skills and knowledge acquired by alumni to organisations Relevance of the TEACH Training curricula to the organisations Comparing the Past and current Services rendered by benefi ciary organizations Past and Current responsibilities of the alumni Past and current clients served by alumni Criteria used by organizations and TASO to select the alumni for the TEACH project. Performance of alumni in organisations Support/facilitation given to alumni by TEACH Project and their organizations (partial/full scholarship) Current demand for the TEACH project in the benefi ciary organizations Type and nature of New institutional arrangements developed to work with TEACH project phase two Contribution of each benefi ciary organization to the TEACH project. Problems and challenges of existing partnerships The lessons learnt from the project Strategies for expanding the partnership networks for the TEACH project How should the project work best next time? Possibility of replication of TEACH model in the organisations

(b) Clients of Beneficiary Organisations Key Areas of Investigation Performance of alumni in organizations in service provision (quality and quantity of services and products provided) Competence of alumni in service delivery to clients Services rendered by the alumni to the client Performance gaps of the alumni and organizations Recommendations for service delivery improvement

(c) Implementaing Partners Key Areas of Investigation Relevance of Skills and knowledge acquired by alumni Relevance of the TEACH Training curricula to service providers in Africa Type and nature of New Partnership arrangements developed to work with TEACH project Contribution of each partner to the TEACH project. New funding resources acquired as a result of the partnerships (Potential Donor funding) Who else could have been involved in the partnership? What additional support from funders and community sponsoring agencies are useful to the partnership for TEACH program? Problems and challenges of existing partnerships

48 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 The lessons learnt from the project Level of public and community participation in the partnership No. and nature of community groups strengthened through the partnerships Sources of funding supporting the partnerships Strategies for expanding the partnership networks for the TEACH project

(d) TEACH Project Staff, TASO Key Areas of Investigation Past and current TASO institutional capacity arrangements for the TEACH project Performance gaps in TEACH project (e.g. Workplan completion, Training timelines, etc) TASO Resource base capacity and usage Changes in management and administrative systems in the TEACH program TASO clientele base demanding for more services Institutional Challenges and weaknesses faced during implementation of TEACH program Level of collaboration with benefi ciary countries and organizations TASO’s competitive advantage and Strategy New program planning (new priorities for action, policy infl uence and research priorities) for phase two of TEACH project. Unexpected changes during the program implementation (e.g. infl uence of new partners, benefi ciary organisations and donors Level of donor support required for TEACH project to expand Strategies and new priorities for expanding the institutional capacity of TEACH project Strategies for expanding the partnership networks for the TEACH project Risks factors, bottlenecks and performance gaps of TEACH project Support/facilitation given to alumni by TEACH Project and their organizations (partial/full scholarship) Learning environment in Uganda in terms of facilities, language, and people. Current demand for the TEACH project in the benefi ciary organizations Lessons learnt from the project by the service provider (alumni) and strategies for improvement How should the project work best next time

(e) ALUMNI Questionnaire Key areas considered in the Questionnaire Design Timing of training and conditions of attachment Competence of trainers (Trainer Qualifi cations and experience) Past and current positions held by alumni (career development) Courses studied by alumni and program of attachment Effectiveness of Training Methods and strategies used by the TEACH Project trainers. Comparing the Past and current Services rendered by benefi ciary organizations Past and Current responsibilities of the alumni Past and current clients served by alumni Criteria used by organizations and TASO to select the alumni for the TEACH project. Risks factors, bottlenecks and performance gaps of TEACH project Support/facilitation given to alumni by TEACH Project and their organizations (partial/full scholarship) Learning environment in Uganda in terms of facilities, language, and people. Current demand for the TEACH project in the benefi ciary organizations Lessons learnt from the project by the service provider (alumni) and strategies for improvement How should the project work best next time? Strategies for expanding the partnership networks for the TEACH project

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 49 Appendix Six: Terms of Reference (Scope of Work for TEACH Consultancy)

Background

The AIDS Support Organization (TASO), is one of the leading premier HIV/AIDS care and support organizations in Uganda. It exists to contribute to a process of preventing HIV, restoring hope and improving the quality of life of persons and communities affected by HIV infection and disease.

Established in 1987 as a mall initiative in Kampala, TASO has since grown to become the largest AIDS organization in Uganda, providing HIV/AIDS prevention, care, support, mitigation services through its 11 established service centres situated in 11 districts in Uganda. TASO also provides capacity building support to other organizations and government/mission hospitals that together with the 11 centres reach PHAs and those affected in more than 56 districts.

Since 2005, TASO has been implementing a TASO Experiential Attachment To Combat HIV/AIDS (TEACH) project to respond to the needs of countries most affected by HIV/AIDS, to build a critical mass of effective service providers that would apply best HIV/AIDS programming and service delivery models to meet the increasing demand for HIV/AIDS care and support in Africa. This initiative is premised on the principle that organizations within Uganda and other African countries send their staff representatives for a one month in-service experiential attachment at TASO for a practical and interactive “hands on” exposure to TASO HIV/AIDS work and practice that have been developed over a period of 20 years.

TASO with support from the Swedish International Development Cooperation Agency (Sida) has been offering both full and partial scholarships to deserving individuals from organizations from both the public and private sector (including civil society). The project targeted a total of 500 experiential attachment scholarships in a period of three years to individuals from resource-limited HIV/AIDS service organizations in Uganda, and other countries in Africa.

Over All Objective of TEACH Project

To build the capacity of public and private organizations in Africa involved in provision of HIV/AIDS care and support services.

Specific Objectives of TEACH Project

Improving service provider competence through experiential in-service apprenticeship

Build and strengthen strategic partnerships for TEACH program

To strengthen TASO institutional capacity to implement TEACH strategy

About the TEACH Evaluation

TEACH project implementation fi rst phase started in 2005 and ended in December 2007. Before the implementation of the second phase there is need for the evaluation carried out by the external evalua- tor hence this TOR. The evaluation fi ndings will inform our next design and implementation.

50 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Specific Objectives of the Consultancy

To assess the extent to which TASO/TEACH is adhering to project objectives as spelt out in the initial Project Document

To assess the effectiveness of activities in meeting the set objectives

To evaluate the effectiveness of the programme in integrating experiences from attaches and from other development interventions by NGO’s, and CBO’s and how synergies with these have been explored

To asses the sustainability of project activities beyond the project life

To briefl y assess the impact of project activities on the own organisation and on the organisation of the attaché’s

To evaluate TASO/TEACH’s management, implementation and fi nancial controls in relation to cost effectiveness, effi ciency and accountability

To evaluate and assess the effectiveness of the monitoring an evaluation procedures and follow up mechanisms adopted by TASO/TEACH

To asses the relevance of the project objectives in relation to the ever changing HIV & AIDS environment, sector priorities, funding fl ows in the fi ght against HIV & AIDS, and poverty reduction.

To propose strategies of improving this concept for the future

To identify implementation bottlenecks and recommend improvements

To document the lessons learnt from this programme

To recommend future direction of TEACH

Scope of Work

The TEACH evaluation will include primary data/information collection in seven countries: South Africa, Ethiopia, Zimbabwe, Zambia, Uganda, Cameroon, Nigeria, Information about TEACH alumni in the other countries will be gleaned from previous assessments. The timeframe will be from May 1st 2008 to May 31st 2008

The Consultant will undertake a comprehensive/rigorous assessment of the processes, implementation and outcomes of the TEACH project and produce information and make recommendations that are valid and dependable based on the data obtained during the evaluation. Specifi cally, the consultant will perform the following tasks:

Specific Tasks of the Consultancy

Review all relevant documentation of the project

Develop evaluation instruments and prepare an evaluation strategy and action plan, which will be previewed by the evaluation team. The fi nal sign off on the strategy will come from TASO Manage- ment. The consulting fi rm is expected to present at this point, a proposed structure for both the detailed report and the summary report that may be subject to change as the evaluation progresses.

Implement the evaluation process in a participatory manner

Critically analyse the fi ndings and make recommendations for the improvement of the TEACH

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 51 operations, management and service delivery, and through ongoing discussions with the Evaluation team, seek and provide feedback in the process. As a result generate a draft report that should be ready for discussion and circulation by 25thMay 2008.

Make a quantitative and qualitative report including quotations from the project benefi ciaries.

Management of the Consultancy

Areputable independent consultanting fi rm/individual will work in a participatory manner with a TEACH Evaluation Team that will be identifi ed by TASO management.

The competence of the consulting firm/individuals Have knowledge in evaluation in the fi eld of HIV/AIDS and training programmes

Should be a reputable fi rm, organization or group of individuals with proven programme evaluation skills. The skills must include research and evaluation skills, qualitative and quantitative/statistical analysis and interpretation of results and synthesising fi ndings to inform programming.

Should have knowledge on HIV/AIDS programming in sub-Saharan Africa

Ability to carrying out the evaluation as stipulated in these TOR

Excellent documentation skills

Expression of interest Prospective Consultants can express interest to be considered for the consultancy by submitting a technical proposal to the Project Coordinator TEACH The technical proposal should be submitted along with the following documents:

Updated profi le showing competencies and experience of the consultant

An action plan with time frame

A technical proposal (three copies) with fi nancial quotation and the proposal should not exceed eight pages (excluding annexes)

Commitment letter to undertake and complete the consultancy assignment, indicating previous jobs undertaken at this level.

The expressions of interest should reach the project co-ordinator by Tuesday 25th March 2008 at 4.30pm

Profile and Qualifications of the Consultant(s)

Excellent analytical skills

Evidence of proven involvement in carrying out an M and E of an organization

Applicants with specialization in HIV/AIDS programme management and M&E will have added advantage

Previous experience conducting programme evaluations: quantitative and qualitative

Profi ciency in Word-processing and writing skills

Experience in HIV/AIDS programming and training will be required.

52 THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 Appendix Seven: Evaluation Schedule

Country Region Represented Working Days Ghana Western Africa 9th–12th June 2008 Cameroon Western Africa 12th–15th June 2008 Swaziland Southern Africa 17th–20th June 2008 Zambia Central Africa 20th–23rd June 2008 Malawi Central Africa 23rd–26th June 2008 Kenya Eastern Africa 29th June–2nd July 2008 Ethiopia Northern Africa 2nd–5th July 2008 Uganda Eastern Africa 6–10th July 2008

THE TASO EXPERIENTIAL ATTACHMENT TO COMBAT HIV/AIDS PROJECT (TEACH) – Sida EVALUATION 2008:43 53 Recent Sida Evaluations

2008:32 The Swedish Support to Institutional Capacity Building of the National Institute of Statistics in Cambodia 2006–2008 Tobias Stern, Claes Norrlöf, Pernilla Lundin Department for Democracy and Social Development

2008:33 Southern Africa AIDS Trust Project Evaluation, 2008 Ron Titus, Unity Chari Sida

2008:34 Contribucioned de Asdi al Desarrollo del Sector Privado en Bolivia, 2003–2007, Resultados e Impactos Erik Larrazábal Antezana, Miguel Zalles Denegri Sida

2008:35 Sida’s Support to the Swedish Committee for Afghanistan (SCA) Göran Carlsson, Staffan Engblom, Tove Myhrman Sida

2008:36 Performance Analyses of the Cooperation between Swedish Radio and Radio Republic Indonesia 2000–2005 Madeleine Elmqvist, Lars Rylandaer, Lukas Luwarso Sida

2008:37 Programa Regionalizado de la Gestión Defensorial en Colombia Francesca Jessup, Elisabeth Hayek Sida

2008:38 Environmental Sustainable Support to Civil Society in Asia, Africa and Latin America – Results and Effects of Sida’s Framework Agreement with the Swedish Society for Nature Conservation (SSNC) 2005–2007 Hans Peter Dejgaard, Hans Hessel-Andersen, Maria del Socorro Peñaloza, Emelia Arthur, Sunitha Bisan Sida

2008:39 Mid Term Review of Sida/Lake Victoria Initiative Support to Community-Based Strategies for the Management of the Environment and Resources of Lake Victoria (COSMER-LAV) 2005–2008 Irene Karani, Mike Wekesa Sida

2008:40 Study of the International Organization for Migration and its Humanitarian Assistance Anders Olin, Lars Florin, Björn Bengtsson Sida

2008:41 Uri Hydro-Electric Project, India: Evaluation of the Swedish Support Mike J. McWilliams, L.V. Kumar, A.S. Wain, C. Bhat Sida

2008:42 What is SwedBio and what does Sida want to do with it? An external evaluation of the Sida-supported Swedish International Biodiversity Programme 2003–2007 Thorsten Celander, Anders Fahlén Sida

Sida Evaluations may be ordered from: A complete backlist of earlier evaluation reports may be ordered from: Infocenter, Sida SE-105 25 Stockholm Sida, UTV, SE-105 25 Stockholm Phone: +46 (0)8 779 96 50 Phone: +46 (0) 8 698 51 63 Fax: +46 (0)8 779 96 10 Fax: +46 (0) 8 698 56 43 [email protected] Homepage: http://www.sida.se

SWEDISH INTERNATIONAL DEVELOPMENT COOPERATION AGENCY SE-105 25 Stockholm, Sweden Tel: +46 (0)8-698 50 00. Fax: +46 (0)8-20 88 64 E-mail: [email protected]. Homepage: http://www.sida.se