NATIONAL AIDS COMMISSION HIV AIDS Proposal Writing Guidelines for Private

NATIONAL AIDS COMMISSION HIV/AIDS Proposal Writing Guidelines for Private Sector Companies FINAL DRAFT 15 SEPT 2003 Correct NAC Activity Report Format included National AIDS Commission P.O. Box 30622 Capital City, Lilongwe 3, Malawi Tel: (265) 01 727900, 727773, 727742 Fax: (265) 01 727398 www.aidsmalawi.org.mw 1 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 Other Documents in This Series “Project planning guidelines for responding to HIV/AIDS – guide for NGOs and Faith Based Organisations” Introduction for NGOs and other organisations on how to apply to NAC for support for HIV/AIDS prevention, care and impact mitigation services. “Mainstreaming guidelines for responding to HIV/AIDS – guide for ministries and departments of the Government of Malawi” Step by step guide for public sector managers on how to mainstream HIV/AIDS. “Proposal writing guidelines for HIV/AIDS mainstreaming activities of Ministries and Departments” Introduction for public sector managers on how to apply to NAC for support for mainstreaming HIV/AIDS. Includes proposal-writing guidelines. “Project planning guidelines for responding to HIV/AIDS – guide for District Assemblies and District AIDS Coordination Committees” Introduction for DA and DACC members on how to apply to NAC for support for responding to HIV/AIDS at district level. Includes proposal-writing guidelines. 2 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 List of Acronyms AIDS ANC ARV BCI CBO CHBC FMA FBO GFATM HIV IA IEC MBCA MCCI M&E MIS MOHP MSM MTCT NAC NGO OI PLWA PMTCT SC STD STI TWG VCT Acquired Immunodeficiency Syndrome Ante-Natal Clinic Antiretroviral Behaviour Change Interventions Community Based Organisation Community Home Based Care Financial Management Agency Faith Based Organisation Global Fund for AIDS, Tuberculosis and Malaria Human Immunodeficiency Virus Implementing Agency Information, Education and Communication Malawi Business Coalition against AIDS Malawi Chambers of Commerce and Industry Monitoring and Evaluation Management Information System Ministry of Health and Population Men having Sex with Men Mother-to-Child-Transmission of HIV National AIDS Commission Non-Governmental Organisation Opportunistic Infection People Living With AIDS Prevention of Mother-to-Child-Transmission of HIV Steering Committee Sexually Transmitted Disease Sexually Transmitted Infection Technical Working Group Voluntary Counselling and Testing 3 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 Table of Contents PART 1. INTRODUCTION 1. Background and Introduction 1.1 Purpose of this document 1.2 Introduction to the National AIDS Commission 1.3 Introduction to the Grants Facility Private Sector HIV/AIDS Projects Eligible for Grants Facility Support Funding Support versus Technical Support Proposal Review 2. 3. 4. PART 2. 1. 2. 3. 4. 5. PROPOSAL WRITING FORMAT AND GUIDELINES Cover page Proposal summary Situation analysis and target population Organisational capacity Project design: objectives and activities 6. Project implementation: workplan 7. Monitoring and evaluation plan 8. Analysis of sustainability Detailed budget, inputs and human resources Attachments 9. 10. ANNEXES 1. 2. 3. 4. 5. 6. 7. 8. Project Overall and Specific Objectives and Activities Project Activity Annual Workplan Project Activity Report Format Project Progress Monitoring Format Budget Summary, and Details Procurement Planning Format Proposal Review Criteria and Format Checklist for Organisational Appraisal 4 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 Part 1: Introduction 1. Background and introduction 1.1 Purpose of this document This document is meant for private sector companies, small or large, wanting to submit an HIV/AIDS project proposal to the National AIDS Commission (NAC) for funding. Part 1 of this document explains the purpose and scope of the NAC Grant Facility, and proposal review procedures. Part 2 explains in detail the proposal requirements. Specific guidelines for other civil society organisations are also available from the National AIDS Commission: • • NGOs, AIDS Service Organisations and Faith Based Organisations to apply for a grant for HIV/AIDS prevention, care or impact mitigation services. Government departments and ministries to apply for technical or financial support for situation and impact analysis; strategic planning for mainstreaming HIV/AIDS and/or HIV/AIDS service delivery; District AIDS Coordination Committees or District Assemblies to apply for technical or financial support for situation and impact analysis; strategic planning for mainstreaming HIV/AIDS and/or HIV/AIDS service delivery; Communities or small community groups requiring technical, financial and/or organisational support for community-based prevention or support interventions. • • 1.2 Introduction to the National AIDS Commission The National AIDS Commission is responsible for coordinating the implementation of the National HIV/AIDS Strategic Framework 2000-2004. The Malawi National HIV/AIDS Strategic Framework has the following dual goal: 1. To reduce the transmission of HIV and other Sexually Transmitted Infections (STI) 2. To improve the quality of life of people infected and affected by HIV/AIDS Implementation and ultimate success of the national response to the HIV/AIDS epidemic depends on concerted and collaborative efforts by public, private and non-governmental sectors to support the implementation of HIV/AIDS prevention and mitigation programmes. The NAC recognizes that civil society -- including private businesses, NGOs, local government, central ministries and communities -- understand and appreciate the gravity of the HIV/AIDS situation in Malawi and that they are willing to organize themselves for concerted action. 5 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 1.3 Introduction to the Grants Facility NAC has instituted a “Grants Facility” to engage and support civil society partners. The goal of the Grants Facility is “increased utilisation of HIV/AIDS prevention and care services across Malawi”. Specific objectives are: 1. Increased financial resources available to civil society organizations to implement HIV/AIDS services and activities; 2. Increased number and range of civil society partners receiving resources and support; 3. Improved human and organizational capacities to implement quality services. 2. HIV/AIDS Projects Supported Through the Grants Facility. 2.1 Eligible Private Sector Organisations Any private sector organisation, whether large multi-national companies or small family businesses can apply for support through the NAC Grant Facility. Eligibility criteria for private sector organisations are: • Legal status as per the Companies Act allowing the institution to enter into contracts and carry out work1. • A minimum of 18 months of existence in business. • A clear and efficient accounting system that can handle the funds requested. • Skilled staff to implement proposed activities. • Ability to mobilise human and material resources. • An organisational structure in place to support effective decision-making, implementation, follow-up and accountability. 2.2 Eligible Private Sector HIV/AIDS Services The National AIDS Commission seeks implementing partners among private sector organisations to massively scale up prevention, care and impact mitigation interventions. Proposed services should be: • Consistent with national priorities. These are mentioned in the National Strategic Framework and the HIV/AIDS Operational Plan, including the workplans supported by the Global Fund for AIDS Malaria and Tuberculosis (GFATM).2 • Consistent with national technical guidelines and protocols. Preference is given to scaling up coverage of existing interventions, rather than for pilot projects. • Consistent with community needs. Preference is given to services that are based on participatory needs assessments. This excludes NGO's, Community Based Organisations and Government Parastatals except those that are exempt under the State Corporations Act. 2 These documents are available from NAC, or on the website: www.aidsmalawi.org 6 1 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 2.3 Workplace Interventions Workplace Prevention and Care Interventions NAC encourages private sector and public sector organisations to develop workplace interventions for workers, their families and/or clients, including: 1. Prevention information and education through IEC materials, training and peer education programmes; 2. HIV/STD prevention services such as STD treatment and condom distribution; 3. Voluntary testing and counselling (VCT) services, at the workplace or through referral 4. Care and support services such as nursing care, treatment of opportunistic infections 5. Provision of anti-retroviral treatment to people with HIV/AIDS according to national guidelines Workplace Policy Development NAC also encourages all companies to develop supportive workplace policies and procedures to reduce workers’ vulnerability, or the impact of HIV infection, for example 1. Development of workplace policies that adequately address HIV/AIDS related concerns, e.g. decreasing vulnerability of male workers by reducing male-only housing; 2. Restructuring of medical and retirement benefits for infected and affected, e.g. enabling positive workers to remain productive as long as possible; 3. Policies and programmes for succession planning, (re)training employees, etc.; 4. Establishment of mutual support fund for funeral costs; 5. Workplace level programmes to reduce stigma and discrimination, etc. Other Activities that can be supported Activities that are not service-oriented but increase capacity of organisations for service delivery are also supported. Examples are: 1. Networking and information support to increase collaboration, and share best practice between companies, NAC, NGOs; 2. Capacity building of private sector, e.g. a training module for managers, or for employee induction programmes; 3. Surveys, e.g. assessment of the impact of HIV/AIDS on companies, HIV/AIDS prevalence and needs assessments among workers. 7 Case Study Southern Bottlers Ltd. HIV/AIDS Workplace Policy and Programme The Southern Bottlers Ltd. HIV/AIDS programme is part of an initiative of 40 bottlers across Africa, in partnership with the Coca Cola Africa Foundation, UNAIDS and others, reaching 60,000 employees. The HIV/AIDS policy states that Southern Bottlers Ltd. • will not discriminate against any employee on the basis of HIV or AIDS status; • will ensure that any information related to an employee’s health status will remain private; • will offer voluntary HIV testing to employees but will not require employees to be tested; • will sponsor extensive education and awareness programmes to help prevent the spread of AIDS. The workplace program will offer employees, their spouses and children medical treatment for HIV and AIDS related conditions, including anti-retroviral drugs. The Chief Executive said: “no single organisation can stand up to AIDS alone, but Southern Bottlers Ltd. is determined to do its part” (Daily Times, 17/4/2003) www.aidsprogramsinafrica.coca-cola.com Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 3. Funding Support versus Technical Support Different organisations will have different support needs. Obviously, your needs, financial, technical or organisational, will depend on the characteristics of the intervention, and the target population: your managers, all workers, their families, clients, or the community surrounding your company. Some may need financial support; others may have sufficient resources, but need technical assistance for project design or research. Technical or organisational assistance needs, e.g. special training or consultant support, should be reflected in a project proposal. Costs for capacity building should be reflected in the proposed budget. The Private Sector Liaison Officer at the NAC, or the Malawi Business Coalition against AIDS (MBCA) can suggest sources for specific technical assistance. 4. Proposal Review 4.2 Proposal Review Process Proposals should be submitted to the Financial Management Agency (FMA) of the NAC, who will acknowledge receipt overnight, and start the proposal review process. If organisations are not sure if their plans are within the scope of the Grant Facility, or if they are not able to prepare a proposal, FMA can assist interested organisations with project planning, and proposal writing. In that case organisations should submit a one-page letter of interest instead of a full proposal, and you will receive guidelines. Each proposal is reviewed on merit and quality, and on the extent to which it conforms to the scope and objectives of the National Strategy. • Final proposals are reviewed on project content according to a set of criteria evolving 3 around intervention design, sustainability, organisational capacity, and budget . At least 3 4 independent expert reviewers, drawn from a national roster of reviewers , will score the proposal (in some cases, international reviewers may also be involved). Each reviewer judges the proposal as “acceptable as is”, “not acceptable”, or “acceptable under conditions/with clarifications”. Once conditions are met and/or clarifications given, the proposal is cleared for content/technical design. If reviewers do not agree, FMA will forward the proposal to NAC for mediation, if the proposal is satisfactory on the following two assessments (see below). FMA will assess the proposed budget against budgeting rules and guidelines, and will contact the applicant organisation if any changes are to be made. • 3 4 See Annex 9 for Proposal Review Format The Malawi Business Coalition against AIDS will suggest reviewers for the national roster 8 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 • FMA will visit all applicant organisations to assess organisational capacity to implement the proposed intervention, and to handle the requested grant5. Once organisational capacity, project content and budget are found in order, FMA will submit the proposal to NAC for approval. After approval, NAC will send an approval letter to the applicant agencies, with a contract for signature, and a Grant Operational Manual explaining grant and reporting requirements6. The Steering Committee of the Grants Facility ratifies criteria and procedures, and supervises their correct and impartial implementation. 4.2 Timeline for Proposal Review Proposal Letter of receipt (overnight) Proposal & budget review (1 month) Pre-award appraisal (1 month) Award letter (2 weeks) 5 6 See Annex 10 for Appraisal Checklist This manual is available from NAC Secretariat and from www.aidsmalawi.org 9 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 Part 2: Proposal Writing Guidelines Note: These guidelines describe all required components of a project proposal, and refer to formats where needed. Applicant organisations are encouraged to keep narrative sections as short as possible (maximum length is given per section). 1 Cover Page 1. Name(s) of the implementing organisation(s) Address Key Contact Person Managing Director Accountant Name of the project/programme7 Location of the project Duration of the project Amount of funding requested Date of submission 2. 3. 4. 5. 6. 2 Proposal Summary Maximum 1 page Provide the key information about the project, including: 1. Situation Analysis 2. Project goals and objectives 3. Main activities 4. Inputs, i.e. staff and requested budget 3 Situation Analysis Maximum 2 pages Describe the company, including: • Number of years in operation since date of registration • Size and number of employees: o Multinational o Large Domestic Corporate (>200 employees) o Small to Medium Enterprise (50-200 employees) o Micro- Enterprise Organisations (5-50 employees) o Other (please give details) • Number of permanent workers (pensionable employees) and casual workers (on contract or daily wages) • Area of work: Agriculture, Trade, Restaurant and Hotels, Manufacturing, Financial Services, Building and Construction, Information Technology, Health and Health Services, etc. 3.1 Company profile 7 These proposal writing guidelines are meant for (larger) programmes as well as (specific) projects. 10 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 Provide a situation analysis related to HIV/AIDS, including: 3.2 Problem and needs assessment • Description of target population plus socio-economic background. Are they employees, their (extended) families, clients and/or the wider community? • HIV/AIDS/STD epidemiology, prevalence of risk behaviours and factors of vulnerability; • The problem, and what are the needs of the target population(s); Describe if and how problems and needs are different for men and women, rich and poor, etc.; • Impact of HIV/AIDS at individual, family, community and company level; • Current HIV/AIDS policies and programmes in the company, or NGOs/others. Include any technical and organisational support needs; • Constraints facing a project, e.g. others who influence the lives of the target population; socio-political factors; threats to the target population or the way that the target population relate to one another. 4 Organisational Capacity Maximum 1 page Describe the organisation’s experience in: • HIV/AIDS workplace interventions • HIV/AIDS policy development • Coordination with other organisations and service providers • Non-HIV/AIDS projects/campaigns. Please describe campaign, achievements and approach used. the State the names and describe roles of key decision makers in the project. Is there a project committee, taskforce or dedicated project manager? Explain lines of responsibility in the organisation and the project. Provide an organogram. Identify needs for capacity building in relation to the proposed project, and propose a strategy to meet these Describe if, and how employees/target population are involved in identifying their needs, and the planning, design and implementation of the project. 5 Project Design: Objectives and Activities Format8 and maximum 1 page Describe what the project wants to accomplish and how this will be done. Be realistic about the length of time and the amount of resources available. Overall Objective: Mention the overall objective of your project, i.e. what you want to achieve in terms of providing HIV/AIDS prevention 8 See Annex 1 for format 11 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 and/or care services to your target population. Specific Objectives: List the objectives of your project, i.e. what specific outcomes do you expect at the end of the project year? Objectives should be SMART: Specific Measurable Achievable Relevant to the purpose Time-bound Project activities related to objective: Describe the major project activities to achieve the project objectives. How were these activities influenced by your prior experience? Describe how the project design recognizes and possibly deals with existing inequalities that affect the target population, such as disease status, behaviours, gender, and income. Describe any risks to the target population that the project may pose, and how these risks are mitigated through project design. 6 Project Implementation: Workplan Maximum 2 pages, plus workplan format9 List the activities in order of the objectives they relate to. Prepare a time line, listing what you will accomplish in each month of the grant period, and who will be responsible. Prepare a detailed implementation plan for year 1 7 Monitoring and Evaluation plan Maximum 1 page plus formats provided Monitoring service statistics10: Determine which of the project activity indicators are useful service statistics for your project to monitor. This format needs to be submitted monthly Monitoring progress towards objectives11: The format is an evaluation tool to assess if the objectives of the project are fulfilled. Define at least one meaningful and measurable indicator of success for each project objective. Determine targets to reach, and describe how you will verify each target. If an indicator cannot be measured quarterly, you fill in the annual target only. Mention if and how you will report progress and success to key stakeholders in and outside the company, e.g. employees, board, and media. Describe any additional evaluation activities you propose as part of your project. Indicate who will be responsible for designing and executing this evaluation. 9 See Annex 2 12 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 8 Analysis of Sustainability Maximum 1 page Describe how the intervention will continue after the NAC grant, in terms of • Project impact • HIV/AIDS services • Funding for the project 9 Detailed Budget, Inputs and Human Resources Project staff and volunteers Use formats12 9.1 Describe project positions and staff. Include all paid staff, volunteers, and consultants. Describe for each position whether it is full/part time; the main responsibilities; the qualifications and/or experience required, and the names and qualifications of the person(s) if already appointed Describe if/how the project you will recruit, support, and remunerate volunteers. 9.2 Project Budget Itemise all direct and indirect costs associated with your project. All costs must be specified. The project proposal budget must follow the formats given. Relevant budget notes, estimates and calculations should support all figures. During proposal review, NAC will assess the relative budget proportions for sub programme activities, salaries and office costs. “Personnel Costs, Travel and Office Operating Costs” 9.3 Budget Categories A: Contains the cost centres Office Operation, Travel and Personnel Costs: recurrent costs that cannot be apportioned to a fixed programme activity, e.g. office running, rent of premises, communication, bank charges, transportation and personnel. B: “Programme Delivery” Includes all costs related to programme activities (e.g. meetings, workshops, trainings, materials, networking, procurements). C: “Capital Assets” Includes one-off expenses needed to acquire the budgeted equipment and services to start programme operations and major capital expenditure. These are the programme and non-programme assets capitalised in the books of accounts. 10 11 See Annex 3 See Annex 4 12 see Annex 5 A-C for Budgeting Formats 13 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 9.4 Budget Items Cost centre See table below Line items Costs Category A - Personnel Costs, Travel and Office Operating Costs Personnel Salaries Individual positions (titles) and salaries of all proposed project staff. The percentage fulltime equivalent for the project should be noted for all programme and administrative staff. Salaries should be within the normal market range. Include consultants and staff support from headquarters here Travel Local travel Regular expenses incurred for project related transportation. Includes travel expenses such as bus fares, lodging and meal costs while travelling. Costs for project related supervision/field trips should be included under this line item. Indicate maximum diem/travel allowance rates for local or international travel Vehicle operating Fuel and maintenance of project bicycles, motorcycles, costs and vehicles. It does not apply to office vehicles used for private purposes. If a vehicle is used for more than one project, the proportionate cost should be budgeted Office Office Rent and Expenses related to office rent and office utilities, e.g. Operating Utilities electricity, water, garbage removal etc. Costs Office Supplies General office supplies for office and administrative use such as paper, stationary to support the project Postage and Mail and general communications such as telephone, fax Telecommunication charges, internet access fees, etc. Subscriptions Subscription for journals/magazines etc. Insurance Insurance of project related assets and office space Category B - Programme Delivery Costs Activity Costs per activity as mentioned in the programme proposal, insofar as these costs are not covered in other budget categories Medicines Cost of medicines used in the project Condoms Cost of procurement of condoms. (If condoms are socially marketed, then such income should be reflected as Income in the financial reports) Category C - Capital Assets Capital Costs Any non-consumable item of equipment, needed to start programme operations, and major capital expenditures 14 Proposal Writing Guidelines for Private Sector Companies Draft 15.9.2003 9.5 Budget Justification Use format Describe how you arrived at the amounts requested per line item in your budget. Justify all costs in your budget. 9.6 Funds From Other Sources Maximum 1 page Indicate any counterpart contributions made by the company either financially or in-kind to the project. Examples of in-kind contributions are meeting locations, use of information technology, staff time, etc. Also indicate any additional funds from other donors, or in-kind contributions from the community as. All additional funds should be reflected in the budget. Indicate anticipated income related to the project (e.g. sale of materials, fee for service, consultancy services or condom social marketing). Explain how this income will be used to support the programme objectives, and fill in the estimated amounts in the column ‘Funds from other sources’. 9.7 Procurement planning Use format13 Describe how and when you plan to purchase items listed in your proposed budget. 10 Attachments Include with this proposal a copy of each of the following items: 1. For registered Organisations, include documents such as Memorandum and Articles of Association (for micro-enterprise organisations a business license.) 2. Constitution of the organisation 3. List of Board of Directors 4. Most recent annual report 5. Most recent audited financial statement 6. Bank account number and address of bank 7. Letter of support for the project from the Managing Director 13 See Annex 6 15 Proposal Writing Guidelines for Private Sector Companies - Annexes Draft 15.9.2003 Annexes 1. 2. 3. 4. 5. 6. 7. 8. Project Objectives and Activities Format Project Annual Workplan Project Activity Monitoring Format Project Progress Monitoring Indicators Budget Proposal & Summary formats Procurement Planning Format Proposal Review Criteria and Format Checklist for Organisational Appraisal 16 Proposal Writing Guidelines for Private Sector Companies - Annexes Draft 15.9.2003 Annex 1 - Objectives and Activities OVERALL OBJECTIVE What changes are anticipated in the long term? e.g. “# number of employees and family members use (specify!) prevention and care services” “Increased demand for …services” 1.2 SPECIFIC OBJECTIVES What are the specific expected outcomes over the project period? 1. e.g. ACTIVITIES What has to be done to achieve the objectives? 1.1 1.3 etc. 2. e.g. “Improved quality of …. services” 2.1 2.2 2.3 etc. 3. e.g. “Increased capacity of our staff and volunteers” 3.1 3.2 3.3 etc. NOTE: Logical Framework may be used that instead 17 Proposal Writing Guidelines for Private Sector Companies – Annexes Draft 15.9.2003 Annex 2 – Project Annual Workplan No. Activity Responsible Person 1 2 3 4 5 Month 6 7 8 9 10 11 12 18 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 3 – Project Activity Monitoring Format For Activities for THIS MONTH ONLY REPORT DETAILS Report date: Month reporting on Name of Organisation Type of Organisation NAC Grants Management Code Report Compiled by For more information / questions about the report, contact: Name: Tel number: Email: District RD8 Fax: NGO CBO FBO Private Sector Public Sector From: to: RD1 RD2 RD3 RD4 RD5 RD6 RD7 1. INTERVENTIONS FOCUSING ON YOUR OWN EMPLOYEES REPORT ON ACTIVITIES FOR THIS MONTH ONLY Does your organisation have an HIV/AIDS workplace policy? TYPE OF INTERVENTION HIV Prevention WP1 DATA NEEDED Number of interventions this month TYPE OF INTERVENTION Workshops Individual counselling Other (specify) MALE FEMALE YES TOTAL NO Care and Support WP2 WP3 WP4 PERSONS REACHED Total # of current employees & spouses in organisation Number of employees & spouses reached this month Number of employees & spouses reached this month TOTAL 3. INTERVENTIONS FOCUSING ON THE BENEFICIARIES OF YOUR PROJECT/S REPORT ON ACTIVITIES FOR THIS MONTH ONLY a) Information, Education and Communication (IEC) materials IEC1 IEC2 IEC3 IEC4 # new radio / TV programmes this month # IEC materials printed and distributed this month RADIO # Hours aired # TV Hours aired PRINTED # types # printed # distributed # interventions (workshops, counselling sessions and others) # of people directly reached this month through interventions listed in IEC3 Male condoms Female condoms TOTAL b) Socially marketed condoms ABC1 Rural # of condoms distributed to end users this month c) Life skills education ABC2 # of young people aged 15 – 24 exposed to life skills education Urban Rural Urban TOTAL In-school Male Female Out-of-school Male Female 0-24 years Older than 24 d) Prevention of Mother to Child Transmission (PMTCT) 19 TOTAL Guidelines for Private Sector Companies Draft 15.9.2003 PMT1 PMT2 PMT3 PMT4 PMT5 PMT6 # pregnant women who have been seen by provider this month # pregnant women counselled on PMTCT, tested for HIV & receiving serostatus results this month # of pregnant women tested for HIV who are HIV positive this month # HIV positive pregnant women provided with Nevirapine this month # HIV positive mothers provided with replacement infant feeding this month # of HIV positive pregnant women referred for care & support services this month 0 – 12 years Male Female 12+ to 24 years Male Female Older than 24 years Male Female TOTAL e) Voluntary Counselling and Testing (VCT) VCT1 VCT2 VCT3 VCT4 VCT5 VCT6 # clients who receive pre test counselling # clients counselled and tested this month # VCT clients receiving their test results this month # VCT clients who are HIV positive # HIV positive VCT clients referred to care & support services # standalone VCT sites supported f) Community Home Based Care (CHBC) CAR1 CAR2 CAR3 CAR4 # of NEW persons who enrolled for CHBC services in this month TOTAL # persons who received CHBC services in this month # community home based care visits by health care worker/s in this month # community home based care visits by volunteer/s in this month 0 – 15 years Male Female CAR5 CAR6 CAR7 # new persons enrolled at PLWA organisations in this month TOTAL # of persons enrolled at PLWA organisation in this month TOTAL # of persons enrolled at PLWA organisations that received support this month RURAL URBAN TOTAL 15+ to 24 years Male Female Older than 24 years Male Female TOTAL CAR8 CAR9 Total # households with one or more chronically ill adult where your organisation has provided help this month List the types of support that your organisation provides during community home based care visits, and the # of households that has been targeted through each type of support this month TYPE OF SUPPORT # OF RURAL HOUSEHOLDS # OF URBAN HOUSEHOLDS Psychosocial support Nutrition / food support Financial / resource support Medical support Domestic Support g) ARV treatment ARV1 ARV2 ARV3 Total # of PLWA currently on ARV # people started ARV for first time this month # PLWA who fail to adhere this month 0 – 12 years Male Female 12+ to 20 years Male Female Older than 20 years Male Female TOTAL h) Support to orphans and other vulnerable children OS1 List the # of orphans and other vulnerable TYPE OF SUPPORT Psychosocial support 20 # Male # Female Guidelines for Private Sector Companies Draft 15.9.2003 TYPE OF SUPPORT Nutrition Financial Other, please specify # Male # Female h) Support to orphans and other vulnerable children children that received the following types of support: i) Training CB1 # project staff trained this month Subject of training (align with HIV intervention categories # Male # Female CB2 # volunteers trained this month I verify that this information is complete and correct and that I have not misrepresented any information in this report Signed: __________________________________ Designation: ______________________ Date: ____________________________________ 21 Guidelines for Private Sector Companies Draft 15.9.2003 Guidelines for completion of NAC Activity Report Form DEFINITIONS HIV interventions are defined as projects/activities that include one or more of the following: 1. HIV Prevention Information, Education and Communication Promotion of Safe Sex Practices (ABCs) Prevention of Mother-To-Child Transmission (PMTCT) Sexually Transmitted Infections (STIs) Treatment and Prevention Voluntary Counselling and Testing (VCT) 2. HIV/AIDS Treatment, Care, and Support Clinical Care including ARV Community and Home-based Care and Support 3. Impact Mitigation Support for Orphans and Other Vulnerable Children 4. Sectoral Mainstreaming 5. Capacity Building and partnerships Urban is any activities that are implemented in Blantyre city, Lilongwe city, the town of Mzuzu or the town of Zomba. Activities implemented in ALL other geographical areas should be listed as rural. Beneficiaries within the context of this report are defined as those individuals/ communities/ clients/ customers who directly benefit through the project or the work that your organisation does (everyone who is NOT employees, but who benefits from, or is in contact with your organisation) A Health Care Worker is defined as a nurse or a doctor that is medically qualified to provide home-based clinical care to PLWAs Please remember that this form is ONLY for activities that your organisation has implemented Please remember to complete a SEPARATE form for EVERY district where your organisation has provided HIV services this month 22 Guidelines for Private Sector Companies Draft 15.9.2003 HOW DO I COMPLETE THE FORM a) Section 1: Report Details DATA CODE RD1 RD2 RD3 RD4 RD5 RD6 RD7 RD8 DESCRIPTION OF DATA NEEDED Date of report Month reporting on Name of Organisation Type of Organisation NAC Grants Management Code Report Compiled by For more information about the report, contact District COMMENTS / NOTES This is the date that compilation of the report was completed by the implementer This is the month for which statistics is provided in the report. The specific dates should be listed – for example: 2 January 2003 to 29 January 2003. All the data that you provide, will ONLY be for this month. This is the name of your organisation. Please list if this is a branch office or a head office completing this form. Indicate a tick next to the type of organisation – if you are working for government, it is public sector, if you work for a private company, it is private sector or if you work for civil society, it is either an NGO, CBO or FBO. This is ONLY applicable if your organisation is receiving a NAC grant. If your organisation did not receive funding from NAC for its HIV/AIDS activities, do NOT complete this section This is the name of the person who filled in the information on the report This is the name, telephone number, fax number and email address of the person who NAC should contact if they have any questions about what was completed on the report Complete this for the DISTRICT where your project is based. Complete ONE form for EVERY district that your organisation has provided HIV services this month. If your organisation has more than one office/branch in one district, combine the results from these branches/offices and sub ONE form for every district. b) Section 2: Data about activities focusing on employees of the organisation This section is ONLY applicable for HIV interventions that focus on EMPLOYEES and their spouses of the organisation completing the form. DATA CODE WP1 Number of interventions DESCRIPTION OF DATA NEEDED COMMENTS / NOTES This is the number of different HIV prevention interventions held at your workplace in the month that you are reporting on. Please separate per type of HIV intervention. An HIV prevention intervention would be, for example, one of the following: A workshop on HIV/AIDS with employees Developing an HIV workplace programme A VCT day at the work place for employees Individual counselling sessions with a trained counsellor Please specify if your organisation has done an HIV intervention that cannot be categorised into one of the main categories listed. This is the total number of employees and their spouses in your organisation for the MONTH that you are reporting on This is the total number of employees who were reached through these HIV prevention interventions. You can get the number of employees by adding up the number that attended each of the different interventions. There might be some double counting if the same people attended more than one intervention, but that is in order. This is the total number of employees in your organisation who are reached through either ARV therapy, treatment for opportunistic infections or through visits by community home-based care workers on a regular basis. Please obtain this data from our organisation, although it might be confidential, without harming the confidentiality of the person who access these services. WP2 WP3 Number of current employees & spouses in organisation Number of employees & spouses reached this month WP4 Number of employees & spouses reached this month 23 Guidelines for Private Sector Companies Draft 15.9.2003 Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information for all your workplace programmes: Date Type of intervention Description of intervention Number of employees involved Male Female Comments c) Section 3: Data about activities focusing on beneficiaries/ customers / clients of the organisation INFORMATION, EDUCATION AND COMMUNICATION (IEC) DATA CODE IEC1 DESCRIPTION OF DATA NEEDED # new radio/TV programmes this month COMMENTS / NOTES This is the amount of different IEC materials that have been produced in the month that you are reporting on. For example – if your organisation has produced 2 new booklets on PMTCT in the last month and have had 40 copies made of each, you will indicate 2 in the data column for this question, because there are 2 new booklets (irrespective of the number that have been printed) This is the amount of IEC materials that your organisation has printed and distributed in the month that you are reporting on. For example, if you have distributed 35 of booklet 1 and 40 of booklet 2, the total number distributed will be equal to 75. This is the number of HIV advocacy interventions that you held this month – including workshops, peer counselling sessions, etc. please count every intervention separately – for example, if you held 3 workshops and 19 peer education sessions, the total number of interventions would be equal to 22 (3 + 19) This is the estimated number of persons that you have reached with the interventions that your organisation held this month. If you have, for example, had attendance of 20 at workshop A, 30 at workshop B and 15 individual peer counselling sessions, the total # of people reached would be equal to 65 (20+30+15). IEC2 # IEC materials printed and distributed # interventions IEC3 IEC4 # of people reached through interventions defined in IEC3 this month Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date Type of IEC material Description of material Number distributed Estimated # people reached Comments PROMOTION OF SAFER SEX PRACTICES (ABCs) DATA CODE ABC1 DESCRIPTION OF DATA NEEDED # of condoms distributed to end users COMMENTS / NOTES This is the total number of socially marketed male and female condoms that have been distributed to end-users. An end user is an individual or couple to whom condoms were distributed, and NOT another organisation. Please note the definition for rural and urban – urban if the condoms was distributed to a person living in Lilongwe, Mzuzu, Zomba or Blantyre, and rural if the person lives in any other area. Please do NOT include any MOHP condoms distributed to end users in these statistics. This is ONLY a count of all socially marketed condoms (currently distributed by PSI and BLM). This is the total number of on school and out of school youth that has been exposed to lifeskills-based HIV education. This includes group workshops and individual peer education sessions, both in school and out of school environments. ABC2 # of young people aged 15 – 24 exposed to life skills education 24 Guidelines for Private Sector Companies Draft 15.9.2003 PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) DATA CODE PMT1 PMT2 DESCRIPTION OF DATA NEEDED # pregnant women who have been seen by ANC provider this month # pregnant women counselled on PMTCT, tested for HIV and receiving their result this month # of pregnant women tested for HIV who are HIV positive this month # HIV positive pregnant women provided with Nevirapine this month # HIV positive mothers provided with replacement infant feeding this month # of HIV positive pregnant women referred for care & support services this month COMMENTS / NOTES This is the total number of women who have attended antenatal services at the health facility in the month that you are reporting on. This is the total number of women, of those that attended the antenatal services, who were counselled on PMTCT, who elected to have an HIV test done and who received their results in the month that you are reporting on. This number cannot exceed PMT1. This is the number of pregnant women at the facility who have been tested for HIV and who are HIV positive this month This is the number of HIV positive pregnant women who received a course of Nevirapine during delivery in the month that you are reporting on. This is a total number of mothers who were given a 3-month supply of infant feeding in the month that you are reporting on. This is the number of HIV positive pregnant women who have been referred to care and support services PMT3 PMT4 PMT5 PMT6 Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date ANC service accessed (Yes/No) For ANC clients, Counselled on PMTCT? HIV test (yes/no) Infant feeding supplied (yes/no) Provided with Nevirapine during delivery? Referred for care & support services (yes/no) (yes/no) You will also need to report this information to your nearest health facility in order for them to capture it onto the HMIS. However, you will need to report to BOTH the HMIS and the NAC activity report form the same data. VOLUNTARY COUNSELLING AND TESTING (VCT) DATA CODE VCT1 DESCRIPTION OF DATA NEEDED # clients who receive pre-test counselling COMMENTS / NOTES This is the number of persons who have come to the facility for pre-test counselling, irrespective of whether they underwent an HIV test or not. This should EXCLUDE pregnant women who attend a VCT service as part of a PMTCT programme. This is the number of clients who were counselled on VCT services, and who received their test results. Please note that this should EXCLUDE pregnant women who come for VCT services as part of PMTCT. This should also EXCLUDE persons whose HIV serostatus are determined without a pre- and post-test counselling process as defined in the national VCT guidelines. Blood donors should be excluded from this count, unless they have undergone a full VCT process. In summary: VCT clients are only reported for all persons who undergo a full VCT process, irrespective of whether they came voluntary, or if they were referred by and in-patient or outpatient department at a hospital. The key to determining whether or not to add the person in the count, is to ask the following questions: Did the person undergo full pre-test and post-test counselling? Was the person provided with a choice whether or not to undergo the HIV test? Was the person given a choice whether or to receive his/her results? If the answer to all 3 questions is YES, then the person should be added to this statistic. VCT3 # VCT clients receiving their test results this month This is the number of clients who have received their serostatus test results for the month that you are reporting on VCT2 # VCT clients counselled and tested 25 Guidelines for Private Sector Companies DATA CODE VCT4 VCT5 VCT6 DESCRIPTION OF DATA NEEDED # VCT clients who are HIV positive # VCT clients who are HIV positive who are referred for care & support services # standalone VCT sites supported COMMENTS / NOTES Draft 15.9.2003 This is the number of patients out of those who were tested in the month that you are reporting on, who were HIV positive. These are the # of HIV positive clients that have been referred for care and support services in the month that you are reporting on This is the number of standalone VCT sites that your organisation has supported/run in the last month Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date Sex Age Counselled? (yes/no) HIV test (yes/no) HIV result Results Received? Referred for care & support? You will also need to report this information to your nearest health facility in order for them to capture it onto the HMIS. However, you will need to report to BOTH the HMIS and the NAC activity report form the same data. COMMUNITY HOME BASED CARE (CHBC) Please note: Since it is not possible to distinguish between chronically ill HIV positive and chronically ill HIV negative patients, no distinction should be made between these 2 types of chronically ill patients. ALL chronically ill patients statistics for THIS month should be reported in this section. DATA CODE CAR1 DESCRIPTION OF DATA NEEDED # of NEW persons enrolled for CHBC services this month TOTAL # of persons who received CHBC services this month # community home based care visits by health care worker/s in this month COMMENTS / NOTES This is the total number of NEW chronically ill patients who enrol for CHBC services with your organisation in the MONTH that you are reporting on. You should add ALL new persons enrolled this month, irrespective of whether they were enrolled with another CHBC organisation in the past. This is the TOTAL number of persons who received CHBC services this month, including the new persons who enrolled for CHBC services and patients from the previous month. This is the total number of times that patients were visited during THIS MONTH for a home-based care visit by a health care worker, and whose visit entailed follow-up and providing appropriate treatment. A health care worker is defined as a person who has a formal qualification as a health worker in a health facility, such as nurses, doctors or health service assistants. Double counting is possible, as follows: This is the number of VISITS, irrespective of the number of patients. If a patient was visited more than once in one month, count every unique and individual visit. If a health care worker and a volunteer visited a patient in the same month but at separate times, count every visit as a separate visit. However, if a health care worker and a volunteer visits a patient at the same time in one month, count it as only ONE unique visit for that month. This is the total number of times that patients were visited during THIS MONTH for a home-based care visit by a volunteer, and whose visit entailed follow-up and providing appropriate treatment. A volunteer is defined as a person who supports your organisation by donating some of their time to provide CHBC services. Such a person may be given incentives, but financial remuneration is not the main compensation that this person receives. Double counting is possible, as follows: This is the number of VISITS, irrespective of the number of patients. If a patient was visited more than once in one month, count every unique and individual visit. If a health care worker and a volunteer visited a patient in the same month but at separate times, count every visit as a separate visit. However, if a health care worker and a volunteer visits a patient at the same time in one month, count it as only ONE unique visit for that month. This is the number of NEW persons that are enrolled at a PLWA organisation that you are aware of in this month. This is a NOT cumulative total of the total number of persons enrolled during this month, but only persons who enrolled in the month that you are reporting on. This is the number of persons that are enrolled at a PLWA organisation that you are aware of in the current month. This is a cumulative total of the total number of persons who are currently enrolled during this month. CAR2 CAR3 CAR4 # community home based care visits by volunteer/s in this month CAR5 # new persons enrolled at PLWA organisations this month Total # of persons enrolled at PLWA organisation in this month CAR6 26 Guidelines for Private Sector Companies DATA CODE CAR7 DESCRIPTION OF DATA NEEDED Total # of persons enrolled at PLWA organisations who received support this month Total # of households with one or more chronically ill adults where your organisation provided help this month List the types of support that your organisation has provided to households in this month COMMENTS / NOTES Draft 15.9.2003 This is the total number of persons enrolled at PLWA organisations that have received support in this month. This is a cumulative total of all the households with one or more chronically ill adult where your organisation has provided help in the month that you are reporting on. Please note that an ADULT is defined as a male or female person that is 18 years or older of age. This should include all households where support is provided as per CAR9 (the total number of households in CAR9 cannot exceed the total number of households listed in CAR8). List all types of support that your organisation has provided to urban and rural households in this calendar month. Examples of types of support include nutrition support, school fee support and psychosocial support. Please remember the definition for rural and urban – urban if the support was provided to households in Lilongwe city, Mzuzu city, Blantyre city or Zomba. For support to households in any other areas, list it as rural. Please note that all kinds of support to households should be added and that double counting is possible – for example if a household has received more than one kind of support, count it under EVERY kind of support. CAR8 CAR9 Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date Patient Age Sex Services provided Comments PROVISION OF ANTI RETROVIRAL (ARV) TREATMNET DATA CODE ARV1 ARV2 DESCRIPTION OF DATA NEEDED # of PLWA currently on ARV # people started ARV for first time this month COMMENTS / NOTES This is the TOTAL number of patients that are currently on ARVs in the month that you are reporting on This is the number of NEW patients who started on ARVs during the month that you are reporting on. This will also include patients who were taken off ARVs in previous months due to drug toxicity, but who have been RESTARTED on ARVs, but on a different treatment regimen to eliminate the drug toxicity problem previously encountered. This is the number of patients who have stopped to be on ARVs for that month that you are reporting on. Reasons for stopping ARVs could include death, side effects and drug resistance. ARV3 # PLWA who fail to adhere Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date Patient Age Sex Date started ARVs Date stopped ARVs Reason for stopping ARVs Comments You will also need to report this information to your nearest health facility in order for them to capture it onto the HMIS. However, you will need to report the same data to BOTH the HMIS and the NAC activity report form. 27 Guidelines for Private Sector Companies Draft 15.9.2003 SUPPORT TO ORPHANS AND OTHER VULNERABLE CHILDREN (OVCs) DATA CODE OS1 DESCRIPTION OF DATA NEEDED List the # of orphans AND other vulnerable children provided with the following type of support COMMENTS / NOTES This should be the number of orphans that have been provided with the specific type of support listed in the NAC Activity Report Form. If one orphan has been provided with more than one type of support, do NOT double count that orphan, but add that orphan to the type of support that was the MOST substantial. An orphan is defined as any person younger than 18 who have lost a mother, or a father, or both parents. An “other vulnerable child” is defined as any person of younger than 18 years of age that has not yet lost a mother or father, but who is affected by a chronically ill patient in the home (for example - the need for more domestic chores by children due to parents’ continuing illness). Psychosocial support is defined as any kind of counselling or other support that is provided to help the orphan develop mentally, intellectually and spiritually. Nutrition support is defined as any kind of nutrition-related support, such as providing food to a household where an orphan is based or advice about nutrition Financial support is defined as any king of financial resources, such as school fees and provision of clothes Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date Name of orphan / other vulnerable child Type of Support provided Support required Comments CAPACITY BUILDING DATA CODE CB1 DESCRIPTION OF DATA NEEDED # staff trained COMMENTS / NOTES This is the number of staff members(persons working on the HIV interventions themselves) who have been trained in one or more aspects of the HIV intervention that your organisation is implementing, in the month that you are reporting on. Please provide detailed information about the subject areas that was covered in the training, and align these subject areas with the categories of HIV interventions. It is important to note that: “Staff” is defined as all the persons, either permanent employees or on contract (full time or part time), who are working on HIV interventions in/for your organisation and who receives financial remuneration as their main form of compensation for work done The purpose of this training of staff is for them to WORK on HIV interventions, and NOT training for advocacy purposes. Double counting can take place if a person was trained in more than one subject in a particular month. This is the number of persons who are NOT project staff, but either volunteers or community members, who were trained to provide support in the HIV intervention/s that you are implementing, in the month that you are reporting on. Please provide detailed information about the subject areas that was covered in the training. It is important to note that: “Volunteer” is defined as all the persons, either full time or part time, who are working on HIV interventions in/for your organisation without financial remuneration as their main form of compensation for work done (although some incentives might be provided). The purpose of this training of volunteers is for them to WORK on HIV interventions, and NOT training for advocacy purposes. Double counting can take place if a person was trained in more than one subject in a particular month. CB2 # volunteers trained Please note that in order for you to be able to complete this section of the form, you are going to have to make sure that your organisation keeps some kind of record about the data that is required above. We suggest that you keep a register with the following information: Date Person name Category (staff/volunteer) Male Female 28 Describe training provided Comments Guidelines for Private Sector Companies Draft 15.9.2003 WHERE SHOULD I SUBMIT THE FORM TO ONCE IT HAS BEEN COMPLETED This form needs to be completed within 2 weeks of the end of the month, and should be approved by the manager/supervisor of your organisation. Once this form has been completed, it should be submitted to: Name: ………………………………………………………. Organisation: ………………………………………………………. Tel Nr: Fax Nr: ………………………………………………………. ………………………………………………………. 29 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 4 - Project Progress Indicators Obj. No Indicator Quarter 1 T A % Quarter 2 T A % Quarter 3 T A % Quarter 4 T A % Annual14 T A % 1 2 3 4 5 T= target, A=Achievement, %= percentage achievement (A:T) Notes/Explanations: 14 Note: fill in the annual column in every quarterly report, to indicate the cumulative progress towards the annual target 30 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 5A - Budget Proposal Description Monthly Budget (MK) Annual Budget (MK) 1 PERSONNEL 1. 2. Etc 3. Etc. TOTAL SALARIES Casual labour Consultants TOTAL PERSONNEL TRAVEL & TRANSPORT Transport Vehicle operating cost TOTAL TRAVEL AND TRANSPORT OFFICE OPERATING COSTS Office rent & utilities Insurance Office supplies Telecommunication, Internet & postage Subscriptions TOTAL OFFICE OPERATING PROGRAMME DELIVERY Activity 1: Activity 2: Activity 3: etc. Medicines TOTAL PROGRAMME DELIVERY CAPITAL ASSETS Office equipment Furniture Other TOTAL CAPITAL ASSETS TOTAL PROJECT BUDGET Funds from Other Sources (MK) 2 Budget Requested (MK) 1 -/- 2 31 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 5B - Budget Summary BUDGET SUMMARY Total Costs (MK) TOTAL PERSONNEL TOTAL TRAVEL AND TRANSPORT TOTAL OFFICE OPERATING COSTS TOTAL PROGRAMME DELIVERY TOTAL CAPITAL ASSETS TOTAL PROJECT COSTS Funds from other sources (MK) Requested Budget (MK) 32 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 5C - Budget Details Description Budget Category/ Cost Centre: Calculation Annual Budget LINE ITEM: TOTAL LINE ITEM: TOTAL Note: Photocopy as many as you need 33 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 6 – Procurement Planning Formats PROCUREMENT PLAN FOR GOODS (MATERIALS, EQUIPMENT, DRUGS AND SUPPLIES) Ref. No. Date Quantity Estimated Procurement when Required cost method needed Goods description Procurement methods: LS – Local Shopping, NB – National Bidding, LB – Local Bidding, DC – Direct Contracting 34 Guidelines for Private Sector Companies Draft 15.9.2003 PROCUREMENT PLAN FOR SERVICES (INDIVIDUALS, NGOS, FIRMS) Date Duration when of needed service Service Provider (Individual, NGO, Firm) Ref. No. Description of Services Estimated cost Procurement method Procurement methods: LS – Local Shopping, NB – National Bidding, LB – Local Bidding, DC – Direct Contracting 35 Guidelines for Private Sector Companies Draft 15.9.2003 PROCUREMENT PLAN FOR WORKS (CONSTRUCTION, REPAIRS, RECONSTRUCTION) Description of Works Date when needed Estimated cost Procurement method Ref. No. Duration Procurement methods: LS – Local Shopping, NB – National Bidding, LB – Local Bidding, DC – Direct Contracting 36 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 7 – Proposal Review Score Sheet Organisation: This score sheet is meant primarily as a review guide to the proposal content, and the scores assigned may not be the final appraisal of the proposal. The proposing organisation will be appraised separately on organisational capacity and financial management capacity. Please indicate assigned points for each category in the space to the left. Project Design 1. Overall strength of the intervention design: intervention strategy and choice of target population 2. Responsiveness of the project purpose to needs of the target population 3. Sensitivity to gender and social inequalities 4. Clarity of purpose and logical link to objectives and intervention activities 5. Quality and adequacy of monitoring and evaluation plan 6. Feasibility: can the stated objectives be achieved within given time plan and budget 7. HIV/AIDS service delivery: technical strength and consistency with best practice Total points for section 1 Sustainability and Collaboration 1. Cost-effectiveness of the intervention 2. Reasonable level of counterpart contribution of the company/organisation 3. Extent to which the proposal articulates a collaboration plan with other organisations/service providers Total points for section 2 Organisational Capacity 1. Current of past experience in HIV/AIDS or relevant projects 2. Adequacy of human and financial resources to implement the intervention technically and administratively 3. Adequacy of overall organisational management Total points for Section 3 TOTAL POINTS FOR PROPOSAL Out of 10 Out of 5 Out of 5 Out of 10 Out of 10 Out of 5 Out of 10 Out of 55 Out of 10 Out of 10 Out of 5 Out of 25 Out of 10 Out of 10 Out of 10 Out of 30 Out of 110 Accepted Accepted conditionally (Give conditions separately) Not accepted 37 Guidelines for Private Sector Companies Draft 15.9.2003 Annex 8 - Checklist for Organisational & Financial Management Appraisal Please use this checklist in consultation with senior staff of the organisation, to identify strong and weak areas, as well as capacity building needs. The project proposal should be used in the appraisal. Factor 1 Governance and management Mission statement of organisation Values re. HIV/AIDS Board of trustees/directors Staffing and organisation Organogram Staff numbers Team work Job descriptions Team skills and experience in: Project management HIV/AIDS prevention & care Capacity building Personnel policy Personnel files present Recruitment policy Written induction programme Staff/team development policy Salary structure and procedures Staff appraisal Record of staff’s work with clients Staff meetings Written code of practice on working procedures Accommodation/office Financial management/systems Registration with Government Accounting systems Separate bank account Other sources of income Financial planning/budgeting Assessment15 2 3 4 5 Key issues 15 1 = poor; 5 = excellent 38 Guidelines for Private Sector Companies Draft 15.9.2003 Assessment15 1 2 3 4 5 Key issues Factor Financial monitoring External audit system Audited accounts of last 3 years Capital assets available Contracting services/consultants Project management Project planning system Performance monitoring system Evaluation/review system Participation of stakeholders External relations With NAC With DACC/DA With other NGOs With private practitioners With community With PLWA Strong points: 1. 2. 3. Conditions for funding: 1. 2. 3. Weak points/ TA needs 1. 2. 3. 39