PEPFAR Community Led Monitoring – Mozambique

Questions Deadline: 11:59 PM 07 August 2022

A. PROJECT DESCRIPTION: The U.S. Embassy in Mozambique/Bureau of African Affairs at the U.S. Department of State (DOS) announces this an Open competition for organizations interested in submitting applications for the projects that support Community Led Monitoring.

Geographic Region: Projects which may be funded will cover the following Geographic Regions: PEPFAR-supported HIV treatment (AJUDA sites) in Maputo Province, Inhambane Province, Gaza Province, Nampula Province, Manica Province, Sofala Province and Tete Province.

Note: Projects will be in these provinces with districts and health facility sites determined by the applicant during the application phase. The list of the health facilities can be found in the US Embassy website: https://mz.usembassy.gov/our-relationship/pepfar-us-presidents-emergency-plan-for-aids-relief-2/pepfar-community-grants/ . Organizations can select up to 4 Health Units each. A proposal for 4 Health Units is eligible for 50,000USD per year and for 2 Health Units is eligible for 25,000USD per year. Funder will ensure that sites will not overlap with current organizations supporting community led monitoring activities at the same health facility or in the same communities.

The selection committee will endeavor to fund organizations in each of the selected provinces.

Should there not be a proposal submitted from one of the provinces listed above, the discretion will fall to the PEPFAR Coordination Office to determine which additional organizations to fund.

A.1. Background

The President's Emergency Plan for AIDS Relief (PEPFAR) guidance for the Country Operational Plan for FY23 (COP22) states that it is a minimum program requirement that HIV affected populations are provided continuous, quality, client-centered services, and that independent, routine, national community-led monitoring efforts to improve the accessibility and quality of services are part of the HIV response. Towards this end, the PEPFAR Coordination Office intends to fund Non-profit Mozambican Community Based organizations (CBOs) including Faith-Based Organizations (FBOs) and group of persons living with HIV/AIDS or Affected by HIV/AIDS and networks of Key Populations + individuals with disabilities to initiate, lead, and implement community-led monitoring (CLM).

HIV community-led monitoring (CLM) is an accountability mechanism for HIV responses at different levels, led and implemented by local community-led organizations of people living with HIV, networks of key populations, other affected groups, or other community entities.

Community-led monitoring (CLM) is a process initiated, led, and implemented by local community-based organizations and other civil society groups, networks of key populations, people living with HIV, and other affected groups or other community entities that gathers quantitative and qualitative data about HIV services and develops and advocates for solutions to the gaps identified during data collection. The focus is on getting input from recipients of HIV services, especially key populations, and underserved groups, in a routine and systematic manner that will translate into action and change. CLM is central to PEPFAR’s person-centered approach because it puts communities, their needs, and their voices at the center of the HIV response.

These organizations will document the experiences of beneficiaries of HIV services in a routine and systematic manner, using data routinely collected from clinic users. These data will focus on the accessibility and quality of HIV services. These data will be analyzed by communities and used to develop community-led interventions at the facility, district, provincial and national levels to correct the problems uncovered by community-led monitoring, ultimately leading to improved HIV outcomes.

Technical assistance, including training on methods and tools as well as other needed support, will be provided to all recipient organizations.

A.2. Goals

Objectives and Expected Outcomes: The Recipient agrees to perform the program and meet the specific objectives below:

1.Education on health-related rights and duties for People Living with HIV and Key Population;

2.Listening and monitoring of patients’ barriers and concerns identified on access to health services;

3.Improve patients’ literacy on stigma and discrimination;

4.Independent evidence-based advocacy based on findings from community-led monitoring.

A.3. Expected Results: Expected results include the following:

• Improve the quality of services provided at the health facility;
• Create demand for humanized health services;
• Reduce stigma and discrimination at affected communities;
• Increase the proportion of PLHIV on treatment retained in Anti-Retroviral Treatment at the health facility.

A.4. Main Activities:To achieve the goals and expected results, the program should include the following:

• Implement 5 cycles of CLM, including quantitative and qualitative data collection (patient interviews, health provider interviews and health facility observations):

1.Data collection: Collect information at facility and community level

2.Analysis and translation: Translate data collected into actionable insights

3.Engagement and Dissemination: Bring information to the attention of facility, national, and funding decision-makers

4.Advocacy: Advocate for changes and policy and practice

5.Monitoring: Monitor implementation of promised changes

• Conduct community education sessions around health rights for PLHIV including Key Population;
• Convene smaller groups to hear concerns/grievances regarding barriers to care and treatment;
• Participate in the health (community) and co-management (facility) committees to discuss about the identified grievances and advocacy and follow up purposes;
• Collaborate with health facility staff to ensure presentation/discussion of grievances reported by patients and to seek resolution of grievances that meet the needs of patients and PLHIV;

A.5. Performance Indicators: The following are required indicators:

• Output 1: Reach to patients at the health facilities and communities (numbers of unique patients reached with sessions)
• Output 2: Number of barriers/grievances identified during education sessions, health facilities observations and health provider’s interviews
• Output 3: Number of actions taken, and the results obtained based on grievances identified

Other indicators will be developed according to the national CLM program guidance, which is currently being finalized.