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Epic) Project Cooperative Agreement No Meeting Targets and Maintaining Epidemic Control (EpiC) Project Cooperative Agreement No. 7200AA19CA00002 NIGERIA QUARTERLY PROGRESS REPORT OCTOBER 1 TO DECEMBER 31, 2019 SUBMITTED BY FHI 360: JANUARY 31, 2020 EpiC Nigeria Quarterly Report (October-December 2019) 1 EpiC Nigeria Quarterly Progress Report October 1 to December 31, 2019 A. Summary of Key Results The reporting period was characterized by rapid project start-up for Key Population Investment Fund (KPIF) activities which included development of sub award documents for six community- based organizations (CBOs), development of EpiC FY20 work plan which was subsequently approved by USAID, and onboarding of EpiC staff for Nigeria. KPIF is implemented in two regions of Nigeria; Niger and Bayelsa states over a period of two years with a funding ceiling USD $4,000,000. Table 1 below shows a breakdown of KPIF implementing partners, regions of implementation, target population and funding levels Table 1: Epic Nigeria KPIF Implementing Partners Organization KP-led? Target Population Geography Subaward Value (US$)* Passion and Concern Yes Female sex workers (FSW) in all the 8 Bayelsa $148,000 for Women Welfare local government areas (LGAs) in Bayelsa and Empowerment state (Brass, Ekeremor, Kolokuma, Initiative Nembe, Ogbia, Sagbama, southern Ijaw (PACOWWEI) and Yenagoa) Kindling Hope Across No People who inject drugs (PWID) and Bayelsa $105,000 All Nations (KHAN) Prison Inmates in Yenagoa, Southern Ijaw, Brass, Ogbia and Nembe in Bayelsa Centre for No Prison Inmates in Chanchaga, Kontagora, Niger $226,000 Communication and Suleja, Borgu and Bida LGAs Reproductive Health Services (CCRHS) Initiative for Yes MSM and Transgender (TG) people ; in Bayelsa $170,000 Advancement of Brass, Southern Ijaw, Ogbia, Nembe & Humanity (IAH) Yenagoa all in Bayelsa State with HIV/AIDS prevention and treatment services. Elohim Foundation No FSW and PWID in Bida, Borgu, Niger $184,000 Chanchaga, Gurara, Kontagora, Suleja, Tafa, Mokwa and Boso in Niger state HIV/AIDS prevention and treatment services Achieving Health No AHNi will in collaboration with EpiC Niger and $511,000 Nigeria Initiative provide TA to CBOs and promote Bayesla (AHNi) coordination with other KP programs in Bayelsa and Niger *The initial subgrants are 10 months, from December 2019 to September 2020 (except for AHNi which started in November 2019), to be renewed for another year based on performance. During this quarter, the project team received two rounds of technical assistance (TA) support from EpiC headquarters (HQ) on monitoring and evaluation (M&E) and technical strategies. Further to the EpiC Nigeria Quarterly Report (October-December 2019) 2 TA support, the project targets were revised, strategic information flows developed, and commodity needs quantified. Niger and Bayelsa state offices were set up and CBOs were supported to conduct programmatic mapping and size estimation. EpiC team carried out advocacy visits to key government stakeholders at both county and state levels to sensitize them on the KPIF/EpiC project, its implementation approaches and modalities for government engagement. The team also participated and funded the PEPFAR Civil Society Organization (CSO) engagement meeting. Key challenges during the period included the delays in signing of sub agreements with CBOs due to protracted negotiations and delayed decision on the procurement of antiretroviral drugs (ARVs), rapid test kits (RTKs) and sexually transmitted infection (STI) drugs using KPIF funds. Also, there were further delays in getting costing for commodities from USAID on drugs and test kits for the project which has resulted in a slow pace of implementing project activities. • Mapped 8 Local Government Areas (LGAs) in Niger State o 112 hotspots mapped with an estimate of 2,984 men who have sex with men (MSM) and 10 transgender persons (TGs). o 39 hotspots mapped with an estimate of 510 FSW o 22 hotspots mapped with an estimate of 1325 PWID • Mapped 5 LGAs in Bayelsa State with 112 hotspots mapped o 1889 estimated number of MSM and 18 TGs mapped o 134 estimated number of PWID mapped o 2292 estimated number of FSW mapped • Mentored 10 Peer Educators (PE), 3 Peer Mobilizers and 7 Peer Navigators (PN) in Bayelsa State on HIV case finding and referral strategies. • Conducted 11 supportive supervision visits to one stop shops (OSS) and drop in center (DIC) supported by Initiative for the Advancement of Humanity (IAH) and Passion and Concern for Women Welfare and Empowerment Initiative (PACOWWEi) in Bayelsa • Sensitized 2 health facilities with a total of 17 health care workers in Bayelsa State on sexual diversities and service provision to the key populations. • Distributed 288 packs of 4 units each of condoms and 50 units of lubricants during the mapping and size estimation exercise in Bayelsa State. B. Key Results by Objective Objective 1. Increased availability of comprehensive prevention, care, and treatment services, including reliable coverage across the continuum of care. The reporting period was characterized with project start up activities. Though one (1) OSS and two (2) DIC locations were identified in Bayelsa as well as one (1) DIC in Niger, service provision did not commence during the reporting period. Mapping and Size Estimation: During the period, mapping of hotspots and key populations size estimated was conducted by IAH, PACCOWEI and Elohim Foundation in Niger and Bayelsa states as shown in the tables below. EpiC also supported CHIYN to conduct mapping and estimation of the MSM population in Niger state The mapping exercise in Bayelsa provided an avenue for; Distribution of 288 EpiC Nigeria Quarterly Report (October-December 2019) 3 packs of 4 units of condoms, 50 lubricants to community members and sensitization of community members on availability of Sexually Transmitted Infection (STI), Tuberculosis (TB) preventive services, and Index Client Testing (ICT) services. Table 2: Hotspot mapping by KP Type in Niger State No of No of No of Estimated Estimated Estimated Estimated S/N State LGA hotspots- hotspots- hotspots- No of MSM No of TG no of PWID no of FSW MSM&TG FSW PWID Bida 16 333 Bosso 19 5 5 475 10 295 54 1 Niger Chachanga 17 10 2 541 30 96 Gurara 4 8 5 148 285 53 Kotangora 21 517 Mokwa 12 305 Suleja 23 1 5 665 440 35 Tafa 15 5 275 272 Total 112 24 17 2984 10 1050 238 Table 2 shows the results of the hotspot mapping exercise in Niger state by KP type in 8 LGAs. The estimated population size (4,282) across all KP type is far less than the HIV testing targets (20,413) set for the project for FY20 in the state. Nevertheless, the project is yet to conclude mapping exercise as various population types are blank for some LGAs in table 1. Size estimation is also yet to be conducted among the prison inmates in the state. From the preliminary findings from the mapping exercise, there may need to revisit the TG testing targets (3,062) in the state. Table 3: Hotspot mapping by KP Type in Bayelsa State No of No of No of Estimated Estimated Estimated Estimated no S/N State LGA hotspots- hotspots hotspots- No of MSM No of TG no of PWID of FSW MSM&TG -FSW PWID Ogbia 14 2 192 40 2 Bayelsa Sagbama 1 28 Yenagoa 33 9 11 732 11 85 2,292 Nembe 2 49 Brass 21 411 Ekeremor 26 335 Southern 18 219 7 Ijaw Total 112 10 13 1,889 18 134 2,320 Table 3 shows the results of the hotspot mapping exercise in Bayelsa state by KP type in 7 LGAs. In comparing these preliminary numbers (4,361) with the current estimated testing targets (30,619) under EpiC for the state, the project may need to revisit the targets set for FY20 for various population types. Objective 2. Enhanced and sustained demand for comprehensive prevention, care and treatment services among KP. • Supported Initiative for the Advancement of Humanity (IAH) and Passion and Concern for Women Welfare and Empowerment Initiative (PACOWWEi) in Bayelsa State to improve EpiC Nigeria Quarterly Report (October-December 2019) 4 demand creation for prevention packages through mentoring of 10 Peer Educators, 3 Peer Mobilizers and 7 Peer Navigators. • Conducted advocacy visits advocacy visits to proposed Key Population (KP) friendly facilities in Yenagoa Bayelsa state to sensitize 17 health care workers of the need to readily provide HIV comprehensive services to KP clients who choose to visit such facilities. • Provided technical support to community members through IAH and PACOWWEi on general awareness on the use of condoms and lubricants Objective 3. Strengthened systems for planning, monitoring, evaluating, and assuring the quality of programs for KP. • Strengthened project performance monitoring through TA support by the Deputy Director, Strategic Information from HQ • Revised the project targets and set targets for custom indicators for cascade monitoring, disaggregated the targets by population type and CBOs through the HQ TA support. • Conducted orientation by HQ TA M&E support for the country office project staff on Infolink as the reporting platform for the project. • Initiated the modalities for adapting Lafiya Management Information System (LAMIS) for the EpiC project by the FHI 360 health informatic Country office team during HQ TA M&E support visit • Adapted/developed data collection and reporting tools. • Incorporated the revised targets into the sub grantee’s subawards to ensure proper foundation and serve as basis for evaluating performance. • Initiated the process for printing and distribution of tools. • Provided on the job training and mentorship to staff working at the OSS and DIC, on the modalities of ART treatment and the required proper documentation using job aids and adherence strategy tools. • Conducted 11 routine supportive supervisory visits to the OSS supported by IAH and DIC supported by PACOWWEi CBO in order to assure quality of care and service delivery.
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