RATN Annual Report FY 2009/2010

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R e g i o n a l AI D S T r a i n i n g N e t w o r k

ANNUAL REPORT

2009/2010



Regional Aids Training Network

ANNUAL REPORT

2009/2010


Our Vision A society with capacity to respond effectively to the HIV and AIDS pandemic

Our Mission To strengthen the capacity of relevant individuals, organizations and other stakeholders to respond to STIs/HIV/AIDS in the Eastern and Southern Africa region

Our Values • • • • • • • •

Tolerance to diversity Mutual respect Involvement of PLWAs Honesty and integrity Equity and fairness Zero tolerance to corruption Transparency and accountability Learning from our past experiences and practices

Cover photo: Graduation, AMREF Kenya


Table of Contents Abbreviations..................................................................................................................... v Chairman’s Message.......................................................................................................... vi Board of Directors............................................................................................................ vii Executive Director’s Message.......................................................................................... viii Executive Summary............................................................................................................ 1 Introduction........................................................................................................................ 2 Sustainable and functioning network of training institutions in ESA region................ 5 Training and Capacity Development................................................................................. 9 RATN responding to demand for quality information on HIV and AIDS in ESA.......... 17 Building strong networks and partnerships for sustainable HIV capacity development.................................................................................................................... 20 Research, Monitoring and Evaluation............................................................................ 24 Reflections and key lessons learnt.................................................................................. 27 Financial and audit report............................................................................................... 29 Annex 1: Summary of Audited Statements.................................................................... 31 List of RATN Member Institutions................................................................................... 34 RATN Governance Structure............................................................................................ 36



Abbreviations ABBA Addressing the Balance and Burden in HIV/ AIDS AIDS Acquired Immune Deficiency Syndrome AIC AIDS Information Centre AMREF African Medical and Research Foundation BOD Board of Directors CAFS Centre for African Family Studies CB Community Based CD Capacity Development CEU Clinical Epidemiology Unit CHIKANKATA The Salvation Army Chikankata Mission Hospital CIDA Canadian International Development Agency COMESA The Common Market for Eastern and Southern Africa CONNECT CONNECT Institute of Systemic Therapy DBL Distance Blended Learning EAC East African Community EANNASO Eastern Africa National Network of AIDS Service Organizations ED Executive Director ESA Eastern and Southern Africa ESAMI Eastern and Southern Africa Management Institute FACT Family AIDS Caring Trust GASD Gender, ARV, Stigma and Discrimination GLIA Great Lakes Initiative on HIV/AIDS GOK Government of Kenya GU Centre Genito-Urinary Centre, City Health Department HBA Human Rights Based Approach HEARD Health Economic and HIV/AIDS Research Division HIT Training Information Hub HIV Human Immune-deficiency Virus HR Human Resource HRD Human Resource Development IA Irish Aid ICASA International Conference on HIV/AIDS and STDs in Africa ICT Information, Communication and Technology IDM Institute of Development Management IT Information Technology JFA Joint Financing Agreement KAPC Kenya Association of Professional Counsellors KARA Kara Counselling and Training Trust Limited KHI Kigali Health Institute KRAs Key Result Areas LFA Logical Framework Analysis

M&E Monitoring and Evaluation MIM Malawi Institute of Management MIs Member Institutions MTR Mid-Term Review NACC National AIDS Coordinating Council/ Commission NARESA Network of AIDS Researchers in Eastern and Southern Africa NBP Nairobi Business Park NDM Network Development Manager NGO Non-Governmental Organisation PCM Partners’ Consultative Meeting PDF Portable Document Format PIs Partner Institutions PMF Performance Management Framework PMTCT+ Prevention of Mother to Child Transmission of HIV RATN Regional AIDS Training Network RC Resource Centre RECs Regional Economic Communities REPSSI Regional Psycho-Social Support Initiative RMF Risk Management Framework RPC Research Program Consortium RTMES RATN Training, Monitoring and Evaluation System SADC Southern African Development Cooperation SANASO Southern African Network of AIDS Service Organisations SIDA Swedish International Development Agency SP Strategic Plan STD Sexually Transmitted Disease STI Sexually Transmitted Infection TASO The AIDS Support Organisation TGNP Tanzania Gender Networking Programme THETA Traditional and Modern Health Practitioners Together Against AIDS TORs Terms of Reference TRG Training Reference Group TRIC Training Reference and Information Centre UN United Nations UNIFEM United Nations Development Programme for Women VAT Value Added Tax

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Chairman’s message

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t the Regional AIDS Training Network (RATN), ending a Financial Year (FY) is not just a calendar event. It is always a moment of deep reflections on our vision towards achieving a society with the capacity to respond effectively to the HIV and AIDS pandemic. During the ending Financial Year (April 2009 – March 2010), RATN has experienced tremendous strides in its journey towards building the capcity of its member institutions to address emerging issues in the HIV and AIDS response. During the year, more effort was invested in building a strong base of staff at the secretariat and undertaking rigorous institutional reforms to commensurate to the tasks ahead. It is appreciable that capacity building for HIV and AIDS responses still poses as a major challenge both at regional and national level with a lot resources invested in this regard. RATN recognizes this development and has redirected its strategy to address the challenge. During this reporting period, RATN has been able to launch its Five Year Strategic Plan (20092014), which will see the organization measure up to the capacity building challenges in the HIV and AIDS response arena. A number of the member institutions have been able to conduct trainings planned for the year in line with our aspirations. One of the strategies in implementing the new strategic plan and deepening capacity building efforts has been to decentralize the implementation roles to the member institution through a granting mechanism. This is expected to strengthen their participation and ownership of RATN programmes. The approach will further enable RATN generate tangible capacity building results from the frontline of HIV and AIDS service delivery.

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Dr. Hizaamu Ramadhan Chair, Board of Directors

I applaud the continuous support of all the Development Partners especially CIDA, SIDA, Irish AID in this time of worldwide economic recession. Considering the increasingly scarce resources, amidst the growing demand for scaling up the HV response in the region, it is only prudent that we maintain our quest to always strategically invest our resources cost-effectively for optimal impact. I have every reason, and without doubt, that with the guidance of the current team of Board of Directors and our strong Secretariat team, RATN is set to build on the successes of this year and make even greater difference in the role of capacity building for effective HIV response. I take this opportunity to thank my fellow Board members, RATN Member Institutions, our Development Partners, and the RATN secretariat staff for making the first year of implementing our new Strategic Plan (20092014) a great success. It is imperative that the reflections and lessons learnt this first year inform us on our strategies and priorities for the next FY 2010/2011.

Dr. Hizaamu Ramadhan Chair, Board of Directors

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Board of Directors

Dr. Hizaamu Ramadhan

Board Chair Traditional and Modern Health Practitioners Together Against AIDS

Dr. Njabuliso Dlamini

Vice Board Chair and Memberof Finance Committee Institute of Development Management

Mr. Kelvin Storey Executive Director RATN

Dr. Raymond Byaruhanga

Mr. Precious Givah

Chair, Programmes Committee AIDS Information Centre

Mr. Dennis Mudede

Chair, Finance and Administration Committee Malawi Institute of Management

Dr. James Dean

Member, Finance Committee Connect Institute of Systemic Therapy

Member, Finance Committee University of Manitoba

Dr Trevor Kaile Member, Programmes Committee

Mr. Zachary Bigirimana Programmes Committee

The Salvation Army Chikankata Mission Hospital

Dr. Walter Jaoko

Member, Programmes Committee University of Nairobi

Kigali Health Institute

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Executive Director’s message

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he financial year April 2009 - March 2010 progressed faster than was anticipated.It has certainly been a very busy and eventful year for most of our stakeholders and partners, as a result of the global financial crisis; but we also had challenging issues specific to our organization. We streamlined the services we offer with the goal of being cost effective yet without compromising the quality of the services.

Kelvin Storey

Executive Director RATN

Similar examples of this altruistic relationship between the RATN and other key stakeholders on HIV capacity building include RATN’s membership of the Technical Team commissioned by SADC HIV Unit to provide oversight on the development of the SADC HIV Capacity Building Framework which is expected to set a new benchmark for prioritization, implementation and monitoring of HIV capacity building activities in the 14 SADC member states.

As you go through the pages of this report, you will see that we have continued to work with the mandate that we have in this region—facilitating capacity building for effective HIV responses through networking. To do so, we continue to work with our 25 Member Institutions in 11 countries within Eastern and Southern Africa. And are pleased to have continued to witness growing interest in the work of RATN as evidenced by more institutions expressing interest to join our network. In October 2009, the Board approved for admission of seven (7) institutions that had met the set criteria to become RATN Members after a comprehensive institutional assessment.

We have managed to run all our programs at no or minimal cost to the beneficiaries, only with the support of our multiple partners. While acknowledging our partners who have made significant contributions to our work, we would like to give special recognition to our main funders this year; Canadian International Development Agency (CIDA), Swedish International Development Agency (SIDA)/ Norwegian Embassy; and Irish AID. We look forward to continuing our good partnership as we work together to effectively respond to the HIV and AIDS pandemic in the region.

Our commitment to the networking and partnerships remains strong, not only within our network members but also working in partnership with other organizations that are focusing on capacity building for effective HIV response in the region. A good example is the June 2009 HIV and AIDS Capacity Building Conference in Kigali, Rwanda, where we brought together key organizations involved in HIV Capacity Building and agreed to make it an annual event. This year’s event will be held in October 2010 where we expect key regional stakeholders in Capacity Building to share their best practices and prioritize on capacity building gaps that should be addressed.

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Kelvin Storey Executive Director RATN

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Executive Summary

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his report provides a progress account of performance of the Regional AIDS Training Network’s (RATN) planned activities both in programme implementation and strengthening the network for sustainability. In order to increase the networks impact in capacity building, the RATN Board approved the admission of six new training institutions as full RATN members surpassing the targeted two Member Institutions (MIs). At the same time, MIs participated in various processes, both in planning and implementing programmes hence exhibiting commitment to the network. To ensure long term financial sustainability, a Board of Trustees was elected to provide leadership advice on management and acquisition of capital assets. The trustees have since developed their strategic plan aligned to RATN’s 2009-2014 strategic plan which will guide their long term strategic direction. RATN managed to achieve full staff complement with the relevant skill mix a prerequisite for effective implementation of the new strategic plan 2009-2014. In a bid to adequately respond to the training and capacity building challenges, RATN facilitated the process of reviewing and developing training curricula targeting member institutions leading to the development of eight new curricula. By the end of March 2010, a cumulative total of 696 participants had been trained through RATN courses across the region. In the year under review, we surpassed our training target for the year by 40%. This was achieved due to our increased attention to quality and innovativeness such as through INSTANT Initiative. Another factor that contributed to the improvement in the quality of our training programmes is the strengthening of our Training Monitoring and Evaluation (M&E) system

known as the RTMES, which tracks participants from entry to exit and also how they are implementing their new skills at their work places. In response to demand for information on training resources, RATN has developed a Training Information Hub (HIT), a web based source of information on HIV and AIDS training. At the same time, RATN embarked on a project to overhaul its website to improve functionality and scale-up and widen content. RATN’s print library was also transformed to an electronic library in order to enhance the effective and timely sharing of quality HIV and AIDS training and capacity building and other related information. In a bid to advocate for effective policy formulation and implementation, RATN, in collaboration with other strategic partners completed two studies focusing on disability and HIV and AIDS. On linkages and strategic partnerships, RATN formalised its relationship with partners by signing Memorandum of Understanding with three strategic partners namely the Great Lakes Initiatives on AIDS, The International HIV/AIDS Alliance and Eastern Africa Network of AIDS Service Organisation. On Financial matters, the 2009/2010 fiscal year saw RATN record an increase of 8.6% in income received. Cost cutting measures and increased efficiency saw a reduction of 14% on expenditure, while increasing the quantity and quality of the services that RATN delivered to its partners.

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1. Introduction

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his report covers the annual programme and Financial Year beginning 1st April 2009 and ending 31st March 2010. It provides an overview of performance of the Regional AIDS Training Network’s (RATN) planned activities both in programme implementation and strengthening the network for sustainability. This report also highlights key achievements, challenges and lessons learnt during the reporting period. Description of RATN and its mandate is highlighted in Section 1, while Section 2 describes activities related to strengthening RATN as a network of members’ institutions and as an effective and sustainable institution. Sections 3 to 7 reports on RATN programmatic performance and key activities that were undertaken in relation to the implementation of the annual work plan. Reflections and lessons leant are highlighted in Section 8, and the financial and related reports are presented in Section 9.

Background Information RATN was founded in 1997 as a network partner constituting training institutions in Eastern and Southern Africa (ESA) to collaborate on training activities related to STDs/HIV and AIDS in the region. RATN’s status changed in April 2003 when it moved from being a project to a registered international/regional Non Governmental Organization with a Secretariat based in Nairobi, Kenya. RATN functions as a facilitator to strengthen the capacities of training institutions and as a forum for the exchange of ideas and experiences. RATN’s Secretariat works with its established network of 25 Member Institutions (MIs) to adapt and develop short term skills upgrading courses targeted at mid-level STD/HIV and AIDS workers, trainers, programme managers and senior policy makers. The broad categories

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RATN functions as a facilitator to strengthen the capacities of training institutions and as a forum for the exchange of ideas and experiences.

of RATN MIs include (a) Non Governmental Organizations (International, National and Local); (b) Management Institutions; and (c) University Departments.

RATN Purpose RATN aims to establish a regional network of training institutions to provide skills training, upgrading, extension services and technical assistance to health and allied workers in the field of HIV/AIDS/STIs in the ESA.

RATN Core Business The core business of RATN is to identify and link institutions with technical capacity to deliver quality training to middle level managers and trainers of HIV and AIDS Programmes. RATN develops the capacity of MIs through specific support for trainees through partial scholarships, advertising and marketing of MI courses to ensure good regional uptake, facilitator exchange and support programmes, support for curriculum development and evaluations, advocacy with Regional Economic Commissions (RECs) such as SADC, EAC, and COMESA, donors and NACs to support its training and capacity development agenda.

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RATN Strategic Plan 2009-2014 The FY 2009/2010 was a first operational year for the new RATN strategic plan 2009-2014, whose focus is in both building foundation blocks and orientation, while implementing annual targeted activities. Thus this reporting period presented an opportunity for reflection on the implementation of the new strategic plan and possible review and strengthening. Towards the end of the FY 2009/2010, RATN reviewed its annual performance against planned targets in the SP 2009-2014, in a bid to refine the key result targets. This being the first year of the new SP, reflections were also done on implementation modalities and institutional arrangements to align resources for effective implementation of the SP 2009-2014. Secretariat and MI capacity to adopt and mainstream results based management principles was strengthened to facilitate effective implementation of the results based SP 2009-2014, and enhance performance monitoring and measurement.

The SP 2009-2014 has been widely disseminated within and without the membership and has thus been a guiding tool for targeting and developing RATN program, both at secretariat and MI levels. Overall, the initial implementation of the SP 2009-2014 has been without challenges and there has been a smooth transition into the new SP, mainly due to high level participation by key stakeholders during development and implementation processes.

The Year under Review (FY2009/2010) The year under review has been of substantial progress, change and transformation for the RATN. A year for RATN that many of our members will recognize that we balanced the need to effectively deliver planned activities with the imperative to understand and plan for the future needs and demands of the membership. Our focus on delivering relevant programs and excellent service has ensured we have continued membership growth, which is on the verge of expansion to 29 MIs, while our

RATN Strategic Objectives (SO) SO 1: Skills and competencies for design and implementation of effective HIV and AIDS interventions at community and workplace levels developed; SO 2: Strengthened capacity for training to develop and deliver training and/or manage quality gender sensitive HIV and AIDS prevention, care, support, and mitigation programs; SO 3: Strengthened exchange of knowledge and information on HIV and AIDS related to training and capacity development SO 4: Strengthened advocacy and capacity of RATN MIs, civil society and other partners to influence policy towards increasing support for developing effective capacity to respond to the HIV and AIDS pandemic in the region; SO 5: RATN strengthened as fully functional and sustainable regional membership-based network organization; SO 6: Monitoring and Evaluation system of RATN and its members strengthened; Page 3

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Photo: RATN

RATN’s strategic objectives include skills and competencies for design and implementation of effective HIV and AIDS interventions at community and work place levels.

operations have continued to be cost effective despite the inevitable impact of the recession. Our effective cost cutting measures have enabled us to deliver more while maintaining quality. To ensure that cost cutting measures are sustainable in the long run, we have taken rigorous action to reduce the overall secretariat administrative cost base and invest in innovative approaches in delivering our programs. The FY 2009/2010 was a first operational year for the new RATN strategic plan 2009-2014, where focus was in both building foundation blocks and orientation, while implementing annual targeted activities. Thus this reporting period presented an opportunity for reflections on the implementation of the new strategic plan and possible review and strengthening. A bulk of activities in FY 2009/2010, were oriented towards laying a foundation not only for the implementation of the new strategic plan but ANNUAL REPORT | 2009/2010 • Page

also for long term institutional reforms and strengthening of the secretariat capacity to carry out its mandate. The secretariat managed to achieve full staff complement, a prerequisite for implementing the new strategic plan. During the last year we have consulted widely with membership, donors and other stakeholders at different program levels. This process has increased our understanding of the landscape, and strengthened relationships and built new networks. RATN has also put in place the building blocks for ground breaking work to advocate for what capacity building for HIV and AIDS ought to be and attempted to explore the future shifts in both regional and global priority areas for effective HIV and AIDS response. That combination of dealing with today, planning for tomorrow, and scanning the horizon to prepare for what the future holds is not only a good indicator of effective capacity building for HIV and AIDS, but also neatly encapsulates our year. 4


2. Sustainable and Functioning Network of Training Institutions in ESA Region The network continues to grow

Kenya has a total of six MIs followed by Uganda with five MIs. Botswana, Rwanda and Swaziland have one MI each. Lesotho has no MI but there are RATN programmes implemented in the country by Institute of Development Management (IDM) through their Maseru campus.

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o increase network’s impact in capacity building for HIV and AIDS response, RATN seeks to expand its outreach and concentration in the programme countries, through expanding the number of implementers.

The increase by six MIs has surpassed the targeted two new MIs for the programme year 2009/2010.

In October 2009, the RATN Board approved the admission of six institutions as full RATN members. Once ratified by the RATN General Council, RATN membership will rise to 29 MIs in Eastern and Southern Africa region.

New member institutions awaiting ratification Infectious Diseases Institute (IDI), Kampala, Uganda: IDI is an institute under Makerere University College of Health Sciences, focusing on the capacity of health workers and researchers in relation to prevention, care, treatment and with a special focus on investigation of HIV and AIDS as well as related infectious diseases. IDI will complement RATN’s critical role of research and clinical investigation, and bring on board specialized expertise and long term experience in designing and delivering training programmes.

Zimbabwe Zambia Uganda

Country

Tanzania Swaziland SA Rwanda Malawi Lesotho Kenya Botswana 0

2 4 Number of MIs

6

Figure 1: Membership by country (including new MIs)

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Zimbabwe Open University (ZOU), Zimbabwe is an institution with a unique focus on distance learning/E-learning and ability to accredit courses. ZOU also focuses on design and delivering quality HIV training programmes that respond to emerging needs at country and regional level which can add value to RATN work.

New Members Infectious Diseases Institute (IDI), Kampala, Uganda; Zimbabwe Open University, Harare, Zimbabwe; Churches Health Association of Zambia (CHAZ), Zambia; Gertrude’s Pediatric Training Centre, Nairobi, Kenya; Liverpool VCT Care and Treatment (LVCT), Kenya; Malawi College of Health Sciences (MCHS), Malawi and PRO-FEMMES/TWESE HAMWE, Rwanda. Page 5

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Churches Health Association of Zambia (CHAZ), Zambia is a network of churches with considerable influence in the Zambian health sector. CHAZ as the Global Fund principle recipient in Zambia has in-depth understanding of the civil society context in terms of capacity building for HIV and AIDS response, a key focus for RATN. Gertrude’s Paediatric Training Centre, Kenya: Gertrude’s Children’s Hospital Training Centre designs and delivers paediatric training programmes targeting medical personnel. The Gertrude’s Children’s Hospital will add value to RATN’s work by bringing on board a unique training area to achieve a comprehensive approach to capacity building for HIV and AIDS response Liverpool VCT Care and Treatment (LVCT), Kenya; LVCT is an institution that provides technical assistance in strengthening responses to HIV prevention, care and treatment for HIV infected persons. The LVCT training division was set up in 1998. LVCT will bring on board extensive experience in HIV and AIDS response, with special skills in working with government ministries and NACs in designing national VCT, HCT, and ART guidelines. LVCT is also experienced in developing national Quality Assurance Strategies for VCT services. Malawi College of Health Sciences (MCHS), Malawi is a training institute designing and delivering a range of training programmes for mid-level health personnel to improve the delivery of Essential Health Care Package (EHP) and Primary Health Care (PHC). Malawi College of Health Sciences is primarily engaged in the training of Health Workers and is a vital component of the Government’s plans. PRO-FEMMES/TWESE HAMWE, Rwanda is a non-profit-making organization which was started in 1992 by 13 Rwandese local associations. Currently, it is made up of 52 member associations aiming at Women Promotion, Peace and Development.

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Increased members’ commitment to the network The year 2009/2010, registered a commendable MI commitment to the network. This was evident through MI participation in various processes, both in planning and implementing programmes. Ninety one percent (21MIs) paid up their member subscription fees in the FY 2009/2010. There was 100% participation in the General Council (GC) meeting in June 2009, held in Kigali, Rwanda. This ensured policy level matters were addressed. MI participation in the GC is a reflection of increased ownership of the network by its members, an indication of MI commitment to addressing policy level matters within the network. During this reporting period, 91% (22 out of 23) of the MIs signed Memorandum of Understanding (MoU) with the RATN secretariat, committing themselves to their roles and responsibilities toward the network and clarifying their expectations as Member Institutions. The MoU enhances commitment to the code of conduct and sets forth a common level of engagement.

Board of trustees embark on official duties In 2008, the RATN General Council elected the Board of Trustees to ensure long term financial sustainability through effective management of resources, exploring investment opportunities, and safe guarding network properties. The trustees are therefore expected to provide, leadership advice on capital assets management and acquisition. In March 2010, the trustees started official operations work through an induction session at the secretariat office in Nairobi, Kenya. The induction process provided guidance to the trustees with regard to trustee roles and responsibilities, clarifying terms and conditions

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Activity: Induction of RATN Board of Trustees Objective: To enhance understanding of the roles, responsibilities and duties of trustees. February 2010

of service as Trustees, highlighting reporting relationships with other RATN members, and understanding relationships with other RATN organs. Through the induction meeting, the trustees agreed on operational matters including election of office bearers and setting commencement date of their term in office. They also developed a comprehensive annual operational plan for FY 2010/2011. The trustees agreed to develop a strategic plan 2010-2014 to guide their long term strategic direction. The trustee’s strategic plan will be aligned to the RATN’s 2009-2014 strategic plan. During the induction, the trustees resolved to raise US$500,000 over the trustees’ strategic plan (2010- 2014).

Strengthened RATN secretariat

Training and capacity building is the core of RATN programme activities. In order to facilitate scaling up RATN programmes, a Training and Capacity Development Coordinator was recruited to provide technical support as well as coordinate training programmes implemented through RATN MIs. This role is expected to help scale-up the quality of RATN training activities. A Finance Manager position, which has been vacant, was also filled. The Finance Manager will play a critical role in streamlining RATN financial processes and policies. The Manager will provide leadership in reviewing and updating RATN finance policies and guidelines to ensure RATN operates within best practices, mitigate risk and ensure effective and timely reporting. The Research, Monitoring and Evaluation Manager is key in providing support to both secretariat and MI to strengthen monitoring and ensure capturing impact of RATN activities through RATN alumni follow-up. This position is also expected to support coordination and provide technical support to the ongoing RATN research projects. The Knowledge and Information Management Manager will provide leadership to enhance management and sharing of strategic information on training and capacity building for HIV and AIDS response. This position is also expected to strengthen the RATN knowledge hub and scale-up RATN role as the regional resource centre.

By the end of the year under review, RATN achieved full staff complement, with the relevant skills mix to effectively implement the 20092014 strategic plan. The changes followed the departure of three staff members who moved on after commencement of the new strategic plan and two other positions not previously filled. The new staff members who joined in line with the strategic plan requirements filled the following positions: Training and Capacity Building Coordinator, Research, Monitoring and Evaluation Manager, Knowledge Information Manager, Finance Manager and Information and Technology Officer.

New staff members: Training and Capacity Building Coordinator; Research, Monitoring & Evaluation Manager; Knowledge and Information Manager; Information Technology Officer

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RATN also brought on board an Information Technology Officer. RATN has been outsourcing this role, and due to expansion, both in terms of staffing and scaling up operations, there is need for a fulltime in-house IT staff. The in-house IT Officer is expected to ensure that RATN benefits from the potential of IT in its quest to scale-up reach and diversity of RATN programmes.

Activity: Organizational Capacity Assessment Objective: To assess RATN’s organisational capacities with the view of identifying organisational gaps for possible intervention

Risk management strengthened RATN is currently expanding its operations, both in terms of increased membership, and taking up more programmes. Increase in complexity of programmes exposes the network to more risks, both internal and external. This has prompted the network to design and implement a comprehensive risk management plan that puts in place structures to monitor and detect risk, and lay down logical steps in mitigating the risk. Key components of the risk management plan include description of roles and responsibilities of different structures

The risk management plan was developed and approved by the Board of Directors in March 2010. Key components of the risk management plan include; description of roles and responsibilities of different structures of RATN from governance to secretariat staff. The plan incorporates self monitoring structures to allow for continues monitoring of risk and assigning roles to different management levels.

RATN organizational capacity assessment In May 2009, SIDA, one of the key donors of RATN, commissioned an organisational capacity assessment aimed at identifying the strengths

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May 2009

and challenges facing RATN as a regional organisation, and identifying existing potentials for RATN to influence regional bodies, such as Economic Commissions, UN agencies, NonGovernmental Organisations and Governments in ESA region. Cognisant of the strategic position of the network in terms of both regional presence and strong membership, it was prudent to unlock its potential to explore the existing opportunities to participate in the regional HIV and AIDS response. The capacity assessment was carried out in Botswana, Kenya, South Africa and Zambia. From the assessment, it was clear that overall RATN is a viable tool with the relevant and appropriate model for its mandate. RATN policy and management practices were found to be strong and effective. Key areas for strengthening included strengthening of RATN external relationships through scaling up of marketing strategies and increasing visibility; strengthening service delivery through increased member participation in network processes and strengthening sustainability strategies and practices through development and implementation of resources mobilisation strategy. The assessment provided specific actionable recommendations. These recommendations and findings were timely as the implementation set the foundation for implementing the RATN new strategic plan 2009-2014.

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Photo: AMREF

One of the key objectives of RATN is to deliver relevant and up to date training programmes in the region.

3. Training and Capacity Development Capacity building for RATN member institutions

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n a bid to adequately respond to the training and capacity building challenges and keep up with a highly dynamic HIV and AIDS epidemic, a virile, dynamic and responsive curriculum is essential. One of the key objectives of RATN is to deliver relevant and up to date training programmes in the region. To achieve this, RATN has facilitated the process of reviewing and developing training curricula. In 2009-2010 RATN developed and delivered a curriculum design and development training, targeting its member institutions. The training programme aimed at creating a cadre of skilled trainers within RATN member institutions equipped with the necessary knowledge, skills and tools to enable them improve the RATN curricula as well as design new courses based on the emerging HIV and AIDS needs in the region.

the skill of programme managers/trainers to review, design and develop curricula; and (b) provide hands on training aimed at developing new curricula and at the same time, review and re-package the existing curricula.

Training Activity: Curriculum design and development Location: Nairobi-Kenya and ManziniSwaziland Target groups: Training focal persons at RATN Member Institutions (MIs) Expected result: A cadre of skilled trainers within RATN member institutions to improve curricula and design

The curriculum design and development training had two key objectives namely; (a) to enhance

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In an effort to mainstream gender in all sectors of intervention, all RATN programmes include gender sensitive curricula and methodologies, while specific gender modules are being offered as well as intergrated into appropriate training components. The training was delivered in two regions between January and February 2010; Eastern and Southern Africa with a total of 19 and 21 participants respectively. The East African region training targeted participants from TASO, AMREF, KAPC, AIC, THETA, CAFS, MILDMAY and KHI. The Southern Africa region training included participants from GU, IDM, MANANGA, REPSSI, FACT, ISTT, KARA, MIM and CONNECT. Key outputs from the two capacity building workshops included the development of eight new curricula with many MIs reviewing and re-packaging their existing course curricula. A total of 40 trainers were trained on curricula design and development.

Training and capacity building strategy RATN training strategy is a key deliverable within the RATN 2009-2014 strategic plan. A milestone that RATN has fast tracked since lack of one affects other processes in delivery and quality assurance of capacity development programmes.

Activity: Development of RATN training and capacity building strategy. Objectives: To guide the implementation of RATN‘s trainings and capacity building priority areas over the next two years

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During the last decade, a vast investment was put in training and capacity building in the sub Saharan Africa. These efforts have not yielded desired results and impact, mainly due to lack of direct participation in planning and execution, duplication of knowledge and implementation of acquired experiences and best practices. As a result, this has led to a crisis of credibility of training and capacity building approaches. Shifting from these trends, RATN has embarked, in 2009-2010, on consolidating its efforts through developing and implementing a comprehensive Training and Capacity Building Strategy founded on the following key pillars; functional support systems, enabling environment, appropriate competencies and adequate participation by key stakeholder. The four key pillars are a prerequisite for realizing strengthened capacity by institutional and implementers in developing and delivering effective HIV and AIDS programmes and services, that respond to the needs of ESA region. Taking advantage of the wealth, knowledge and experience of the MIs, the training and capacity building strategy has adopted a systems approach in its implementation informed by evidence through comprehensive and rapid needs assessments to develop and deliver high quality training and capacity building programmes and structured follow-up and monitoring impact through a network of alumni. The draft RATN training and capacity building strategy was developed through a consultative process, with active participation by Member Institutions in conceptualizing and content building, thus reflecting both individual and common approaches and contexts of MIs. The input and comments from the RATN Board of Directors helped to shape the strategic direction and align the draft Training and Capacity Building strategy to the overall RATN Strategic Plan (2009 -2014). A comprehensive rollout and dissemination plan has been developed that will guide the dissemination process and define a logical implementation process.

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Training courses held

Management, Counseling, Care and Support, Programme Management and Research, Advocacy/Gender/Policy Planning and Adult Education.

In the FY 2009/2010, RATN, through 18 MIs, delivered 42 courses, surpassing the targeted 30 courses planed. This was mainly due to the high demand for some courses that prompted MIs to deliver two courses in the year. Through the INSTANT grant, some MIs were also able to deliver more courses.

Figure 1 shows an analysis of training by thematic area. Counseling accounting for 44% of total courses delivered, with Care and Support accounting for 17%, Adult Education training programme accounted for 2%, while programme management and research accounted for 10% of the total courses delivered.

Overview:

In counseling related courses, RATN also targeted marginalized sub-populations by training the visually and hearing impaired persons. The visually impaired attracted 13 participants (eight male and five female), while the counseling for the hearing impaired persons trained 12 of which six were males and the other six female), with a male to female ration of 1:1.

42 Courses delivered 696 trained 60% trained are female It was also noted that 66% of the total courses were conducted in Eastern Africa, with MIs in Uganda delivering 34% of total courses conducted. Overall, a total of 696 (284 male and 429 female) participants were trained. The trainings attracted 40% male health workers and HIV and AIDS programme implementers.

Some MIs found the FY 2009/2010 busier than others and this is reflected in the number of courses they managed to deliver, with some delivering the same course twice. This can be attributed to improved marketing of courses by some MIs and also popularity of some courses.

The trainings have been categorized into six broad thematic areas as follows; Clinical

Figure 1: Courses offered vs Number of participants 200

Male Female

160 140 120 100 80 60 40 20

Institutional development

Impact mitigation

Treatment care and support

0 HIV Prevention

Number of participants

180

Of the 569 participants that received training in the year 2009/2010, 60% were female. All except courses under the category of Institutional Development attracted more female than male. The highest number of participants was in the HIV prevention with females taking up 64.8%. It was observed that women are more inclined to courses in prevention, treatment and care and support as well as in impact mitigation as opposed to Institutional Development. There is therefore need to find strategies for attracting more males to other courses for optimal participation of males and females in HIV intervention.

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Figure 2: Analysis by gender of participants trained from FY 2005/2006 to 2009/2010

Number of participants

600

Male Female

500 400 300 200 100

2009/2010

2008/2009

2007/2008

2006/2007

2005/2006

0

YEAR

The period between 2005/2006 and 2009/2010 has seen RATN training some 2,895 people. Statistics show an increase

Mildmay Uganda delivered most courses in 2009/2010 followed by KAPC and KARA. TASO partnered with Mildmay as a lead in one course while Mildmay played a lead role in three courses conducted together with TASO. Most MIs delivered one course. In 2009/2010, most courses (14) were delivered in Uganda, followed by nine in Kenya. One course was delivered in both Lesotho and Rwanda. In a nutshell, most courses were delivered in eastern African region (66% of total courses) and the remainder (34%) delivered in Southern Africa region. Activity: Organizational Capacity Assessment Objective: To assess RATN’s organisational capacities with the view of identifying organisational gaps for possible intervention

in the number of participants between the period 2005/2006 and 2007/2008 and a further decline in the period in the year 2008/2009. Overall, course enrollment by gender shows that counseling related courses and the care support have attracted more female participants as compared to the males. Other courses have continued to attract more or less equal numbers of males and females except for the clinical management that attracts slightly more males compared to the females. RATN faces the challenge of making it courses attractive across the gender as opposed to the growing trend of more females being aligned to counseling care and support as males take on clinical and program management.

Highlights of Training Courses Delivered Health and research course RATN identified the University of Nairobi Clinical Epidemiology Unit (CEU) to deliver the Advanced Health Research Methods (AHRM) Course. The course, organized in six modules, has been designed to enable producers and users of research findings design and implement research and translate results into action and policy as well as plan and implement evidence based programmes. The course is aimed at building on principles of epidemiology, biostatistics, health economics and health planning to strengthen skills of health service managers in solving problems of STD/HIV and AIDS and other associated areas of the health system.

May 2009 ANNUAL REPORT | 2009/2010 • Page

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Training Institution: Clinical Epidemiology Unit, University of Nairobi Venue: Nairobi, Kenya Target group: Middle and top level managers of HIV and AIDS programmes; Community based service supervisors and teachers.

Participants were drawn from health-related institutions, most of them working in HIV and AIDS related programs such as training, research and projects management. In addition, participants were guided in writing operations research proposals in area of their interest. At the end of the course, monitoring and evaluation was done using a standard session evaluation, in terms of relevance, clarity of content, use of audio-visual aids and time allocated. This will give the CEU the required information for reviewing the course curriculum and methods for future improvement of content delivery.

Photo: AMREF

Expected results: Strengthened skills of health service managers in solving problems of STD/HIV and AIDS and other associated areas of the health system

Offered annually, the course is the only research course within RATN. In 2009/2010 FY, the course was held in February through March 2010, the sixth time since it was started. It attracted 22 participants, 21 from Kenya and one from Zambia.

The Health and Research course is organized in six modules and has been designed to enable producers and users of research findings design and implement research and translate results into action and policy. Page 13 • ANNUAL REPORT | 2009/2010


The course proved relevant to participants’ needs even though the levels of education and occupational backgrounds were diverse. There is high demand for the course as evidenced by the fact that although the recruitment of the participants was done very late, the course was still able to attract many participants. Training Institution: Kigali Health Institute Venue: Rwanda, Kigali Target group: Professional Counsellors

In collaboration with Kenya Association of Professional Counsellors (KAPC) and Kigali Health Institute (KHI), RATN delivered a postgraduate certificate in professional counselling. The course attracted 10 students, three male and seven female. The course was delivered in Kigali, Rwanda at the KHI campus. The course targeted professional counsellors, and aimed at developing the capacity of health workers in counselling to address the needs in Rwanda and the neighbouring Francophone countries. The participants were drawn from counselling centres in Rwanda, with diverse professional backgrounds like clinical psychology, social work, physiotherapy, VCT, public health, nursing and counselling.

Photo: AMREF

Expected results: Enhanced counselling skills

Post graduate certificate in counselling

The delivery of Advanced Health Research methods includes practice in writing a proposal.

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The demand for this course as expressed by the participants show a growing interest and need for advanced training in HIV and AIDS and counselling in specific. The HIV and AIDS epidemic has become chronic after three decades of existence, and cannot be treated as an emergency but as a problem that calls for long term planning and advanced skills training. This is the only post graduate course offered through RATN and is an indication of RATN’s diverse capacity and commitment to building capacity at all professional levels.

Child and adolescent counselling course Training Institution: The AIDS Support Organisation (TASO) Venue: Kampala, Uganda Expected results: Enhanced competencies to managing emotional needs of children infected and affected by HIV and AIDS

In response to the growing number of orphans and HIV and AIDS positive children in subSaharan Africa, there is an emerging need to train more child counsellors to reach out to the growing number of children in this category. Thus, RATN, in conjunction with The AIDS Support Organization (TASO), designed a course to bridge this gap by developing competencies of trainees in providing psychosocial support to children infected and affected by HIV and AIDS.

In the FY 2009/2010, the ninth course for Training of Trainers in Child Counselling was held incorporating a revised RATN ToT in Child Counselling Course Curriculum. The curriculum had been revised to address emerging issues arising out of the AIDS pandemic. The three-week course was attended by 16 participants from Kenya, Tanzania, Zambia and Uganda. The training covered basic facts of HIV and AIDS concerning children; child counselling process and techniques as well as key counselling concerns for children. Other areas included needs and rights of children, policy issues and professional ethics in handling children. Participants were also taken through the basics of facilitation skills. Training Institution: Kenya Association of Professional Counsellors (KAPC) Venue: Nairobi, Kenya Target group: Visually impaired persons with up to date knowledge of HIV and AIDS. Expected results: Improved access to counselling services for people with disabilities

Counselling for the hearing impaired While numerous campaign programmes have been developed in Africa to deal with HIV and AIDS prevention and treatment, Persons with Disabilities (PWD) such as the visually impaired, and especially women, have largely been left out of these programmes. Most National HIV and AIDS response strategies have

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not effectively targeted this group, turning this sub-population into a high risk group due to lack of relevant HIV and AIDS prevention and related information and inaccessibility to HIV and AIDS services. It is against this background that RATN, in collaboration with Kenya Association of Professional Counsellors (KAPC), held a one month course targeting participants with visual impairment in different professions. The inaugural course, Counselling for Visually Impaired Persons, held in the FY 2009/2010 attracted a total of 13 participants (nine male and four female). Of the 13 participants, seven were totally visually impaired while the rest were partially impaired. The course is an attempt to bridge the gap on the level of HIV and AIDS services and capacity building initiatives targeting the visually impaired. It has been designed to provide the visually impaired with first hand information on HIV and AIDS and eventually equip them with counselling skills to enable them reach other visually impaired in the community. With the right knowledge on HIV and AIDS, the visually impaired group will be able to make informed decisions and protect themselves and others from infections.

Palliative care and rehabilitation for PLWHIVs Training Institution: Mildmay Centre-Uganda

HIV and AIDS in resource-limited settings. It integrates the patient’s family and community at large into the process of understanding and engagement in supporting and caring for the patient. Rehabilitation and palliative care aims to achieve optimal quality of life for PLWHIV and their families while minimizing suffering through mobilizing clinical, psychological, spiritual, and social care throughout the entire course of HIV infection. It also provides the routine monitoring that is essential to determining the optimal time to initiate antiretroviral therapy (ART), and it continues during and after the initiation of treatment. Palliative care includes and goes beyond the medical management of infectious and neurological complications of HIV and AIDS to comprehensively address symptoms and suffering throughout the continuum of HIV disease. It is against this background that RATN, working with Mildmay Uganda, designed and delivered a course, “Rehabilitation and Palliative Care”. The annual course targets health and social workers. In the FY 2009/2010, the course attracted participant from Botswana, Kenya and Uganda. The course aimed at empowering the multi-disciplinary health care providers with knowledge and skills in the provision of effective and efficient holistic care services as a contribution to rehabilitation and palliative care for persons living with HIV and AIDS.

Venue: Kampala, Uganda Expected Results: Improved service delivery in care and support for people living with AIDS.

Rehabilitation and palliative care strategy to AIDS care is a cost effective approach to providing holistic care for people living with

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4. RATN Responding to Demand for Quality Information on HIV and AIDS in ESA Region Revamped website Project activity: Strengthening the RATN website Expected results: Improved access to quality information and sharing of resources on HIV capacity building for RATN stakeholders

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Some of the key features of the new site include expanded marketing section for all RATN course and MIs. A Prospectus with a comprehensive description of MIs’ RATN related courses, providing clear application procedures and tools has been created. Enquiries on courses and related information can now be lodged with ease to complete dialogue box that generate an email to the enquiry desk. This has facilitated real-time response to enquiries. The new site provides for an interactive discussion forum/blog that allows visitors to post comments and inputs on topical issues around capacity building. In addition, News and events sections outline current activities happening within and without the network, providing readers with up

Photo: AMREF

ATN strives to streamline its information management, dissemination, marketing and feedback mechanisms in a bid to achieve effective, user friendly and real time information sharing. In 2009/2010, RATN embarked on

a project to overhaul its website to improve functionality and scale-up and widen content.

The new RATN website incorporates an elaborate inbuilt monitoring system to enhance feedback and monitor the site visitation. Page 17 • ANNUAL REPORT | 2009/2010


to date information on relevant activities, important regional and global news on HIV and AIDS. The RATN newsletter is also uploaded onto the site ensuring wide dissemination of the same at cost effective way. The new site also allows for subscription for the news letter and readers can access previous newsletters.

Photo: RATN

!

RATN’s programme areas are well mapped out making it easy for the users not only to understand who RATN is, but to also know the activities undertaken by each programme area. The site incorporates an elaborate inbuilt monitoring system to enhance feedback and monitor the site utilisation and other network activities. Monitoring traffic visits (hits) to each individual page is enabled and this is cross checked with other components of the site to establish relevance and level of consumption of key information and sections of the site. The next step includes creating a web of training institutions interlinked through the RATN site. So far, the FY 2009/2010 saw eight MIs linked to the RATN site. The target is to have 100% MIs linked to the RATN site.

RATN electronic resource centre Project Activity: Establishing an electronic resource centre Expected Results: Improved knowledge management and access to HIV and AIDS capacity building information

RATN, in the FY 2009/2010 managed to transform its print library to an electronic library (e-library), in line with the 2009 –2014 Strategic Plan. The main objective of this ANNUAL REPORT | 2009/2010 • Page

RATN strives to achieve user friendly information sharing through its electronic resource centre. project is to enhance the effective and timely sharing of quality HIV and AIDS training and capacity building and other related information. This is a cost effective way of obtaining, storing and sharing of information, targeting a wider audience. The publications will be made accessible to all member institutions and the external public. The content shall include electronically acquired documents such as journals and e-books; digital content that’s available on the web; links to free and open content that exists in webpage format; and electronically published original works. Our users’ needs are key to the success of this project; the e-library shall support users with special needs. The content management system will be user friendly and interactive; materials shall be accessible and downloadable through a user’s login system. It shall be accessed through HIT on the RATN website.

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Training information hub (HIT) Project Activity: Development of an information hub for training and information resource Expected results: Improved access to HIV and AIDS capacity building and related information

The training courses listed on the HIT database are sourced for and continuously updated for easy access by our users. Since its inception, in December 2009, HIT has already recorded over 2000 hits. Training Institutions are encouraged to market their training courses on HIT at no cost. The courses uploaded on the HIT database are not only available to members within individual countries but also within the region and beyond. To market training course on HIT one requires to forward to RATN secretariat full listing of their training courses especially those whose curricula is on STI/HIV and AIDS.

Photo: RATN

In response to the demand for information on training resources in ESA region, RATN has developed a Training Information Hub (HIT). The hub is a web-based source of Information on HIV and AIDS training in ESA region. It aims at providing health workers in the STI/HIV

and AIDS sector, managers and policy makers (at community, national and regional levels) with access to information on where and how to access available training programmes on HIV and AIDS in Eastern and Southern Africa region and beyond. The System can be accessed via the RATN website www.ratn.org

RATN has developed a Training Information Hub where Training Institutions are encouraged to market their training courses at no cost. Page 19 • ANNUAL REPORT | 2009/2010


5. Building Strong Networks and Partnerships for Sustainable HIV Capacity Development Establishing linkages and strategic partnerships with regional bodies Project Activity: Building strong networks and strategic partnerships Expected Results: Enhanced coordination and sharing of best practices on capacity building for effective HIV and AIDS response

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apacity building for effective HIV and AIDS response has been elusive in most countries, mainly, because agencies and donors operate quasi-independently of one another, with no integrated capacity development strategies. Where they exist, partnerships are often weak and loose and only exist for short term goals. RATN seeks to establish strong and structured strategic partnerships to provide a platform for sharing information, experiences and best practises as well as to provide a unified voice for advocacy and policy influence. In the FY 2009/2010, RATN formalised its relationships with partners by signing Memorandum of Understanding (MoU) with three strategic partners namely The Great Lakes Initiative on AIDS (GLIA), The International HIV/AIDS Alliance (IHA) and Eastern Africa National Network of AIDS Service Organisation (EANNASO).

ANNUAL REPORT | 2009/2010 • Page

GLIA is an inter-governmental organization established in 2004 following the signing of the GLIA convention by Ministers in charge of HIV and AIDS in the six member states namely; Burundi, Democratic Republic of Congo, Kenya, Rwanda, Tanzania and Uganda. The main objective of GLIA is to contribute to the prevention of new HIV and AIDS infections and improvement of the quality of life of PLWHIVs among selected vulnerable populations in the region. IHA is a global partnership of over 30 nationally-based linking organisations, including an international secretariat (with offices based in the UK, US, Belgium and India and regional representatives), working to support community action on AIDS in developing countries. The Alliance works through linking organisations to help local community groups and other nongovernmental organisations (NGOs) to take action on AIDS, and are supported by technical expertise, policy and advocacy work and fundraising carried out across the Alliance. EANNASO is a regional network of national networks of AIDS Service Organisations operating in 14 Eastern Africa countries. The network supports and enhances the capacity of networks to enable them be functional, sustainable and effective. The MoUs are expected to foster formal and structured relationships, outlining partners’ expectations and responsibilities. They provide a basis for commitment by partners in sharing key information, and building on each other’s mandate and competencies to effectively support national responses.

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MIs also signed the MoUs with the secretariat to strengthen their commitment, clarify expectations and enhance MI participation in RATN processes. Out of 23 MIs, 22 have signed MoUs, and one is expected to sign in the FY 2010/2011.

sharing lessons in addressing challenges and innovations adopted by various players. The forum also managed to develop a joint action plan and a monitoring framework for stronger Capacity Building strategies amongst implementing partners in Uganda.

Strengthening advocacy at country levels

Key issues that came up in the meeting include; challenges in harmonising and standardising national training curricula and enforcing the same. Limited knowledge of who is doing what within the country, which has lead to duplication of activities. The meeting also identified lack of a capacity building model for local NGOs and CBOs targeted for institutional strengthening as a key challenge.

In a bid to enhance capacity of MIs and other

Activity: Uganda HIV and AIDS capacity building partners’ meeting Specific Objective: To share good practices and lessons for coordinating and prioritizing capacity building interventions for HIV and AIDS response

partners and to strengthen capacity building for HIV and AIDS response, and improve sharing and effective coordination of capacity building initiatives, RATN seek to establish functional capacity building reference groups at country level. The reference groups will target national institutions that are in the forefront in designing and delivering capacity building programmes. Government ministries responsible for HIV and AIDS coordination and National AIDS Authorities (NACs) for effective advocacy and policy influence. These groups will provide a forum for sharing capacity building experiences and best practices, and advocate for capacity building issues within the national strategies. In 2009/2010, RATN convened a capacity building forum in Kampala, Uganda, to pilot test the initiative. The meeting brought together capacity building institutions, government representative and Uganda based MIs. The meeting focused on sharing experiences in current capacity building approaches, and

Participating in global capacity building initiatives During the year under review, RATN participated in global events to showcase RATN work and provide support in championing the capacity building agenda at regional level. In November 2009, RATN participated in a global summit for HIV and AIDS capacity building implementers in Washington, D.C, bringing together experts from governments, representatives of capacity building institutions, and field implementers from around the world. The focus for this event was to facilitate sharing of capacity building approaches, success, challenges in the global effort to combat HIV and AIDS. RATN showcased its work during the summit, through a presentation of RATN description, core business and operations. In January 2010, RATN participated in a meeting convened by Southern Africa Development Community (SADC), to bring together Members of Parliament and Civil Society Organisations in the Southern Africa region to work in partnership to support action by government and others to achieve a 50% reduction in new infection in Southern Africa by 2015.

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Photo: PACT

RATN show cased its work at the Global Summit for HIV and AIDS Capacity Building Summit at Washington, DC. In this meeting, RATN conducted a rapid training needs assessment of training needs for both the civil society and policy makers (including parliamentarians), in an attempt to generate information on training gaps among HIV and AIDS implementers.

Greater roles of members in RATN work Project Activity Initiative for strengthening HIV and AIDS training and networking (INSTANT) Expected Results: Strengthening participation of RATN members in the implementation of the Strategic Plan (2009-2014)

ANNUAL REPORT | 2009/2010 • Page

During the year under review, RATN initiated

deliberate efforts to decentralise its operations and facilitate MIs to provide leadership in designing and implementing programmes. One of the programmes aimed at devolving operations and enhancing ownership is the Initiative for Strengthening HIV and AIDS Training and Networking (INSTANT), sub granting programme, through which MIs respond to Request for Proposals (RFP) with comprehensive project proposals. Successful proposals are therefore funded giving MIs the opportunity to utilize their comparative advantages in designing and implementing innovative HIV capacity building projects. RATN is currently implementing the first round of INSTANT projects that commenced in October 2009. A total of seven out of 18 institutions were awarded grants in the first round, most of which are near completion. The application undergoes a vetting process through which strong proposals with clear implementation strategy and targeted impact are approved. The first round of proposals showed a weakness in developing strong and

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concise proposal among the MIs and this gap has been earmarked for strengthening. It is expected that through the process of MIs bidding for projects, and therefore designing and implementing projects informed by the RATN SP, this will ensure that there is optimal utilization of diverse strengths and comparative advantages of MIs. This will also ensure that at any point in time, RATN is implementing multiple projects (around training, advocacy, knowledge management, research and M&E) across ESA region through MIs and therefore guaranteed of achieving more results for any given year than it is currently.

Clustering approach to enhance MI to MI exchange Project Activity: Member institutions clustering for the strategic plan (20092014) Expected results: To build consensus on proposed RATN clustering model, and agree on next steps

Photo: RATN

During the year under review, RATN developed a new networking model, which aims at clustering all network members into small working groups. The clustering model is aimed at increasing MI to MI interaction through creating small groups of MIs within specific thematic areas that work on common projects, and sharing experiences and best practices. As part of planning activities for the new model, RATN held a workshop in August 2009 in Nairobi, bringing together all MIs and the Secretariat. Specifically, the workshop objective was to build consensus on the new model and its implementation. At the end of the workshop, MIs identified their comparative advantages in relation to different thematic areas of HIV response (i.e. HIV prevention, treatment, care and support; impact mitigation and institutional capacity development).

A new networking model, which aims at clustering all network members into small working groups has been developed.

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6. Research, Monitoring and Evaluation Capacity building on results based management Project Activity: Results Based Management (RBM) Training Workshop Venue: Nairobi, Kenya Expected Results: Enhanced capacity of RATN to mainstream RBM principles into program planning and monitoring

RATN secretariat and MIs will thus mainstream RBM into their programmes to ensure implementation of RATN related activities are aligning to the RATN strategic plan in terms of planning, implementation and monitoring for results. Comprehensive RBM mainstreaming activities have been scheduled for the 2010/2011 programme year, which will include MIs focal persons actively involved in programme implementation and reporting. RATN PMF and tools will also be reviewed to ensure they are results focused and embrace RBM principles.

Fifth annual donors’ joint monitoring mission

Target Audience: RATN staff, Board of Directors, Cooperating Partners, and MIs.

Project Activity: Annual joint monitoring mission Achieved Results: Assessment of RATN progress against annual work plan and strategic plan 2009/2014

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he RATN strategic plan, 2009-2014, adapted the RBM principles and approach, with a comprehensive results management framework. To operationalize the RBM oriented strategic plan, RATN delivered a three day capacity building workshop to enhance the capacity of programme staff, managers, RATN Board, MIs, and International Cooperating Partners. This activity aimed at ensuring that the RBM approach is cascaded down to annual programme plan and monitoring. Through the training, RATN managed to establish roles and responsibilities of key RATN structure and levels in delivering the 2009-2014 Strategic Plan based on the RBM principles and framework. These included the Policy and Governance including the Board, the Network Member Institution, the network Secretariat and the International Cooperating Partners; Irish Aid, CIDA and SIDA.

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RATN Partners: International Cooperating Partners; Irish Aid, CIDA and SIDA March 2010

In 2006, the three core RATN donors, Irish Aid, CIDA and SIDA developed and signed a Joint Financing Arrangement (JFA) with RATN to further harmonize their support. As part of this agreement, the donors hold annual joint monitoring mission aimed at supporting RATN’s enhanced project performance by providing timely feedback and constructive advice that can contribute to achieving project results and improving the effectiveness and efficiency of project implementation. 24


The fifth joint monitoring mission team comprised of representatives from Irish Aid, CIDA, SIDA, and the RATN M&E Manager. The team assessed progress made against annual work plans and the strategic plan. The team also visited Member Institutions in Uganda to appreciate the work and involvement of members in RATN work. In summary, the mission found greater ownership of RATN work by member institutions at country level as well as increased participation by MIs in the RATN key processes such as annual planning and governance. Regional exposure and MIs exchange programmes were identified as some benefits of being a RATN member as this creates a platform for sharing and exchanging information and best practices in designing and implementing HIV capacity development programmes. However, the mission recommended that alumni followup and research were some areas that need strengthening to allow for accurate assessment of the value of RATN work in the region.

Innovative training needs assessment In response to the highly dynamic HIV and AIDS sub-sector, RATN emphasises on developing and delivering capacity

Project Activity: Pilot rapid training needs assessment Expected Results: Cost effective tools for understanding changing HIV training needs in ESA region

development programmes that are relevant and reflect the changing needs of the health care workers and HIV and AIDS planners

and programme implementers. In the last three decades, the sector has experienced a numerous HIV and AIDS prevention strategies, ever changing care and treatment approaches and mitigation strategies. This has exerted additional pressure to the already strained health workforce that need continuous training to implement new guidelines and approach in managing HIV and AIDS cases. RATN, in the year 2009/2010, designed and pretested a rapid training needs assessment tool, in a bid to complement the comprehensive needs assessments that are commonly expensive and require long term planning and implementation. The project incorporated two pronged objective implemented through two comprehensive processes; 1) Designing and pre-testing a rapid needs assessment tool. RATN designed, through a consultative process, a one page data collection tool examining eight variables i.e. Sex, Age, Educational Level, Professional Background, Designation, selection of five areas out of the 17 areas designated in HIV and AIDS service provision and programming that they would desire their training needs/skills enhanced. The tool also included information about the recent trainings in HIV and AIDS related areas they had undergone and any other additional training areas they would have desired additional training. A corresponding data entry screen was designed to allow for ease and accurate analysis of data. 2) Assessment of training needs of health workers and HIV and AIDS programmers, targeting 261 respondents during three events; 200 respondents at the World AIDS Day in December 2009 in Kenya; 25 respondents at the University of Nairobi STD-AIDS collaborative meeting in January 2010 and 38 respondents at the South African forum for Members of parliament for HIV prevention. The project adapted a simple, quick and cost effective approach in data collection, and analysis, with minimum disruptions of respondents’ ongoing activity.

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The findings of the pre-test show that the rapid needs assessment approach is both cost effective and generates useful information.

Evidence based programming through research Effective, relevant and sustainable HIV and AIDS capacity development programmes require innovation. RATN is cognizant of the fact that enhancing innovation in HIV and AIDS programming calls for increased focus on research. There is need to generate and share knowledge that can provide clues on the best approaches to HIV and AIDS response.

The RATN studies focused on disability and HIV and AIDS. Limited studies have been conducted in this area, thus there is inadequate or (none at all) statistics on HIV and AIDS prevalence, incidence and impact of HIV and AIDS among this sub-population. RATN disability studies show that persons with disabilities (PWDs) are also sexually active with partners in the general population, thus becoming a bridging population for new infection. In 2009/2010, the following studies were completed and findings presented for peer review by stakeholders; 1) HIV and AIDS prevention among deaf youth in Nyanza and Western Province; and 2) Addressing the balance and burden of HIV and AIDS among PWDs in Addis Ababa, Ethiopia.

Photo: RATN

RATN’s demand for knowledge and evidence is prompted by its mandate to advocate for effective policy formulation and implementation. RATN, working with other strategic partners in the ABBA Research

Program Consortium (RPC), is currently conducting seven studies, which are all at advanced stages of report writing. Findings from these studies will be shared with strategic partners and policymakers to inform policy formulation and HIV and AIDS programming.

RATN is cognizant of the fact that enhancing innovation in HIV and AIDS programming calls for increased focus on research. ANNUAL REPORT | 2009/2010 • Page

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Photo: RATN

RATN recognizes the fact when change process is participatory; it can positively contribute to relization of organization’s potential.

8. Reflections and key lessons learnt

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hange management is a key to growth of an organization: The year under review largely involved transition from old Strategic Plan to New Strategic Plan. The process involved changes in a number of key operations and approaches and programme and management levels. For instance, in order to set a path to achieving the aspirations of the new strategic plan, RATN undertook new initiatives such as changing the staffing and skills mix at the Secretariat ; developed a networking and partnerships strategy; developed a resource mobilization strategy; piloted innovative approaches to programmes implementation through the clustering model and Instant project among others. The fact that all these changes have cumulatively helped to achieve a successful year without major hitches reflects that when change process is participatory, it can positively contribute to realization of organization’s potential.

Consolidating impact of RATN work needs clear framework: Expansive M&E system cutting across all programme areas and all MIs across the Eastern and Southern Africa and diverse MIs with varying own systems calls for a complex framework to address these divergent needs and fit into unique and independent structures. This has been a challenge for RATN that strives to monitor and evaluate activities of MIs with varying structures, contexts and own elaborate systems. Balancing independence of MIs and belonging to a network: Creating a sum of individual institutions to be more than a collection of units means MIs committing the best of them for the common purpose of the network. This is both an opportunity and a challenge considering MIs are independent organizations with independent strategic plans and priorities which also affect the prioritization of the network activities within each member institution. Page 27 • ANNUAL REPORT | 2009/2010


Strategic planning informed by evidence is a key to success: RATN ensures that the evaluation of the last strategic plan (2004-2008) was done back to back with the development of the new strategic plan (2009-2014). The process has shown that it did not only help to ensure that lessons learnt inform responsive and the quality workplans for implementing the new strategic plan but also ensured that the best practices are strengthened and organizational systems are re-aligned to the goals of the new strategic plan. Networking and partnerships need investment and planning: The fact that members join the network does not automatically translate to members working together for a common purpose. Hence the need to create avenues through which the expectations of the network members are addressed and met. Continuous evaluation of these expectations equally keeps ensuring that the network remains relevant to its members. In recognition of this, during the reporting year, RATN developed a comprehensive Networking Strategy to guide how to systematically network members and enable them to work together for a common purpose as well as how network members can work together with other partners at regional and country levels to effectively contribute to building capacity for effective HIV response.

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Creating impact from Training and capacity development needs clear strategy: Training and capacity development has been traditionally in the hands of academics. But with the advent of the HIV the dynamics of ensuring there is adequate capacity requires focus targeting and concise approaches that meets diverse needs and interventions. For instance, capacity building of policy makers such as MPs would clearly be different from needs of community youth counsellors or health workers. RATN has therefore, during the year under review, undertaken two related initiatives. First, a detailed training and capacity development strategy was developed to ensure a systematic and well coordinated approach to targeting designing and tracking the impact of its training and capacity development activities. The strategy will be reviewed bi-annually to ensure that necessary adjustments are made in a timely manner to ensure the strategy remains relevant over the period of the strategic plan. Second, an innovative approach to a training needs assessment was developed and piloted. The tool aims to rapidly collect both quantitative and qualitative training data needs among HIV stakeholders. RATN believes that when this approach works it will not ensure that training institutions have up-to-date information on changing training needs but also drastically reduce the cost of getting similar information using traditional methods.

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9. Financial Management Report RATN has three main funding partners namely, Canadian International Development Agency (CIDA), Swedish International Development Agency (Sida) and Irish Aid (IA) who through a joint funding agreement (JFA) contributed 95% of the budget support for the fiscal year 2009/2010. The total income in the Fiscal year was US$ 2,758,246(table 1) which was an 8.6% increase on the income recorded in the previous financial year of US$ 2,538,197. Table 1 Summary of Grants received by RATN (FY2009/2010) Development Partner

CIDA Sida/Norwegian Agency Irish Aid Others Total

Grant Received (2009/10) US$ 1,151,255 641,813 814,642 150,536 2,758,246

Grant Received (2008/9) US$ 934,571 531,496 755,976 316,154 2,538,197

The total expenditure in the year was US$ 2,051,907 (table 2) which was a 14 % reduction from the amount of US$ 2,381,118 recorded in the previous financial year. The reduction was a result of cost cutting measures and increased efficiency in the operations of RATN. Of these amount 76% was spent on program activities while 24% was spent on administration cost. This represents an improvement of 1% against the previous year’s performance of 75% and 25% respectively. Table 1 shows the summary of financial statements for the year under review. Annex 1 provides the Summary Auditors Report. (Detailed Financial Statements are available as a separate document). Total income received during the year under review was US$2,758,246 compared to US$2,538,197 for the previous year (FY2008/9). This translates to an increase of 8.6%.

Figure 3; Income by source

CIDA 42% SIDA 23% other 5% IRISH AID 23%

Page 29 • ANNUAL REPORT | 2009/2010


Budget versus Actual Analysis Table 2 Program

Budget in USD

Actual in USD

Variance in %

Network Development

540,774

332,589

38%

Training and Capacity Development

964,815

892,163

7.5%

Knowledge and Info. Management

528,886

172,033

67%

Research, Monitoring and Evaluation

286,046

147,349

48%

Secretariat and Administration

651, 796

507,773

22%

2,972,317

2,051,907

31%

Total

Trend in Annual Expenditure vs. budget

activities that were pushed to the coming year due to time constraints.

In the FY 2009/2010, there was a 14% decrease in overall, expenditure. This was mainly due to savings through seeking cheaper service providers while maintaining and even increasing the quality of service and also from delayed

Income (in USD)

3,000,000

However, despite the cost reduction, the outputs for the financial year 2009-10 were significantly higher than the past years. The number of people trained increased from 503 to 696 translating to a 38% increase and therefore surpassing the FY2009/10 annual target of 538 by 21%. Relatedly, the year under review also recorded a 40% increase in courses conducted.

2,500,000 The financial reports were audited by Messrs Wachira Irungu & Associates a firm of Certified Public Accountants of Kenya who gave an unqualified opinion. (Annex 1)

2,000,000 1,500,000 1,000,000 500,000 0 2004

2008

2012

Financial year Total income Expenditure

ANNUAL REPORT | 2009/2010 • Page

30


Annex 1: Summary of Audited Statements REPORT OF THE INDEPENDENT AUDITOR TO THE MEMBERS OF REGIONAL AIDS TRAINING NETWORK FOR THE YEAR ENDED 31ST MARCH, 2010 We have audited the financial statements of the Regional AIDS Training Network which comprise the balance sheet as at 31st March 2010, the income statement, the statement of changes in capital funds, the cash flow statement for the year then ended, and a summary of significant accounting policies and other explanatory notes. BOARD MEMBERS’ RESPONSIBILITY FOR THE FINANCIAL STATEMENTS The Board Members are responsible for the preparation and fair presentation of these financial statements in accordance with International Financial Reporting Standards. This responsibility includes designing, implementing and maintaining internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error, selecting and applying appropriate accounting policies and making accounting estimates that are reasonable in the circumstances. They are also required to ensure that the organisation maintains proper books of account which are in agreement with the balance sheet and income statement. AUDITOR’S RESPONSIBILITY Our responsibility is to express an independent opinion on these financial statements based on our audit. We conducted our audit in accordance with International Standards on Auditing. Those standards require that we comply with ethical requirements and plan and perform the audit to obtain reasonable assurance whether the financial statements are free from material misstatement. OPINION In our opinion, the accompanying financial statements give a true and fair view of the state of financial affairs of the organisation as at 31st March, 2010 and of its income statement and cash flows for the year then ended in accordance with the International Financial Reporting Standards and Kenya’s Non-Governmental Organisations Coordination Act.

Certified Public Accountants P.O. Box 46671 - 00100 NAIROBI DATE:………………………………

Page 31 • ANNUAL REPORT | 2009/2010


REGIONAL AIDS TRAINING NETWORK INCOME STATEMENT FOR THE YEAR ENDED 31ST MARCH, 2010

2010

2009

US$

US$

2,607,710

2,222,043

150,536

316,154

2,758,246

2,538,197

Network development

332,588

306,118

Training and capacity development

892,163

914,587

Knowledge and Information management

172,034

306,125

Research, monitoring and evaluation

147,349

229,361

Secretariat and administration costs

460,015

579,932

2,004,149

2,336,123

754,097

202,074

47,758

44,995

706,340

157,079

Income Grants received during the year Other income Total income Operating expenditure

Total operating expenditure Operating surplus Other expenses Net Surplus for the year

ANNUAL REPORT | 2009/2010 • Page

32


REGIONAL AIDS TRAINING NETWORK BALANCE SHEET FOR THE YEAR ENDED 31ST MARCH, 2010

ASSETS NON-CURRENT ASSETS Property and equipment Intangible assets

CURRENT ASSETS Receivables from donors Trade and other receivables Cash and cash equivalents

TOTAL ASSETS FUNDS AND LIABILITIES CAPITAL FUNDS Capital fund Operating fund

CURRENT LIABILITIES Unspent donor funds Trade and other payables TOTAL FUNDS AND LIABILITIES

2,010 US$

2009 US$

123,315

86,841

6,997

9,995

130,312

96,836

62,338 1,267,083 1,329,421

76,457 140,458 476,596 693,511

1,459,733

790,347

130,312 103,774

96,837 378,600

234,086

475,437

1,178,278 47,369 1,225,648 1,459,733

212,982 101,928 314,910 790,347

The financial statements were approved by the Board of Directors on …………………………………and signed on its behalf by:

………………………………… CHAIRMAN

………………………………… BOARD MEMBER

Page 33 • ANNUAL REPORT | 2009/2010


RATN Member Institutions 1. African Medical and Research Foundation (AMREF), Nairobi, Kenya AMREF International Training Centre Email: amreftraining@amrefhq.org Website: http://www.amref.org

9. Health Economic and HIV/AIDS Research Division (HEARD), University of Natal- KwaZulu, Durban, South Africa E-mail: heard@ukzn.ac.za Website: http://www.heard.org.za

2. AIDS Information Centre (AIC), Kampala, Uganda Email: informationdesk@aicug.org Website: http://www.aicug.org

10. Institute of Development Management (IDM), Gaborone, Botswana Email: directorb@idmbls.com Website: http://www.idmbls.comIn Service Training Trust (ISTT),

3. Centre for African Family Studies (CAFS), Nairobi, Kenya Email:info@cafs.org; Website: http://www.cafs.org

11. In Service Training Trust (ISTT), Lusaka, Zambia E-mail: istt@zamnet.zm Website: http://www.istt.ac.zm

4. Clinical Epidemiology Unit (CEU), Nairobi, Kenya University of Nairobi, College of Health Sciences, Email: nbiceu@uonbi.ac.ke Website: http://www.uonbi.ac.ke

12. KARA Counselling and Training Trust Ltd, Lusaka, Zambia Email: kara@zamnet.zm Website: http://www.kara.org.zm

5. CONNECT Zimbabwe Institute of Systemic Therapy, Harare, Zimbabwe Email: admin@connect.org.zw Website: http://www.connect.co.zw 6. Eastern and Southern Africa Management Institute (ESAMI), Arusha, Tanzania Email: adminbs1@esamihq.ac.tz Website: http://www.esami-africa.org

13. Kenya Association of Professional Counsellors (KAPC), Nairobi, Kenya Email: nairobi@kapc.or.ke Website: http://www.kapc.or.ke 14. Kigali Health Institute (KHI) Centre for Continuing Education, Kigali, Rwanda Email: khi@africamail.com; fidelisca2000@yahoo.fr Website: http://www.khi.ac.rw

7. Family AIDS Caring Trust (FACT), Mutare, Zimbabwe Email address: enquiries@fact.org.zw; Website: http://www.fact.org.zw

15. Malawi Institute of Management (MIM), Lilongwe, Malawi Email: mimexecutive@mim.co.mw Website: http://www.mim.co.mw

8. Genito-Urinary Centre (GU) Harare, Zimbabwe City of Harare – City Health Department Email: hcchd@africaonline.co.zw and health@hararecity.co.zw

ANNUAL REPORT | 2009/2010 • Page

16. Mananga Centre for Regional Integration and Management Development, Mbabane, Swaziland Email: Mananga@africaonline.co.sz Website: http://www.mananga.sz 34


17. Mildmay Uganda The Mildmay Centre Email: misc@mildmay.or.ug Website: http://www.mildmay.org 18. Network For AIDS Researchers in Eastern and Southern Africa (NARESA), Nairobi, Kenya Email: info@naresa.org Website: http://www.naresa.org 19. Regional Psycho-Social Support Initiative (REPSSI), Johannesburg, South Africa REPSSI Regional Office Email: info@repssi.org Website: http://www.repssi.net

21. Tanzania Gender Networking Programme (TGNP), Dar es Salaam, Tanzania Email: info@tgnp.org Website: http://www.tgnp.org 22. The AIDS Support Organization (TASO), Kampala, Uganda The TASO Training Centre Email: mail@TASOuganda.org training@TASOuganda.org Website: http://www.TASOuganda.org 23. Traditional and Modern Health Practitioners Together Against AIDS (THETA), Kampala, Uganda Email: theta@thetaug.org Website: http://www.thetaug.org

20. The Salvation Army Chikankata Mission Hospital, Mazabuka, Zambia Email: Chikankata@zamnet.zm Website: http://www.salvationarmy.org

Page 35 • ANNUAL REPORT | 2009/2010


RATN Governance Structure

Full Members General Council (Voting)

Associate Members (Non-Voting)

RATN Trustees (5 Members)

Board Sub Committees (Programmes and Finance)

RATN Board (9 Members)

Associate Members (Non-Voting)

Partners’ Consultative Meeting

Executive Director

Finance and Administration

Research Monitoring and Evaluation

Advocacy, Partnership and Networking

ANNUAL REPORT | 2009/2010 • Page

36

Training and Capacity Development

Knowledge and Information



For More Information Contact: The Executive Director, Regional AIDS Training Network, The Navigators Building, 3rd Floor, Kindaruma Rd, Off Ngong Road, P.O. Box 16035, 00100 GPO, Nairobi, Kenya Tel: +254-20-3871016, 3872201, 3872129, 3872235 Mobile (Office): +254-734 999975, 724 255849 Fax: 254-20-3872270- Email: ratn@ratn.org

http://www.ratn.org


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