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3 ~o HID'i:Hl~ruth~lUU1~Bi10EtH~C'13 tmtmj!'i Bi1i'ilHtmi Bi1H8tgi'il1~91iiUt~Hrun~ru~rumHl~Ul~i1!'i~1tiu~u Si1 tt~gioeth~c'13 tbn"~tnb t9jrutm!'itrui1t~m8i'ilh~lmt~ht~runj1thlrumhl~ul~i1!'i~1tiuttubi1ttlmoeth~c'13 ta~rn1h~1~ut~h '1 ~~tum8thi'iln:irunrutfii'il qi1urunrlfij~tithi1i'ilm~h~tfii'ilqi1h~8i'il1luuifij ~ruji'il1t8tfii'ilt~rutsimrutii'il1 ~ru~8 rn1hilu~ruh!'i HIDHUDruth~lUU1~Bi1oEtH~C'13 tmtmji'i Bi1 i'ilhtn~ t8l!'i~i1rqb1fiu1ru1t] '1 ~mi'il1~fi!~i1 y i'il1t i1i;s~tjlmi19jlrutt3rutii~t9ji1qi1i'ilm~1~~tilrlhtlrlji1t8mjjrut~ruh8hlmupm1ruu18t~ru \! ) M~ti 1tltlm~mi1HM rn1tgi'ilnt3l:lmlru y i'ili;tmtifimhtijlumml!'i~i1rqb1fiu1ru '1 ~1SHIDHUDruth~lUU1~Bi1oEtH~C'13 tmtfi!j!'isi1i'ilhm~hltiut]jui'ilm~1~~~lrlhtlrlji1mi1lrqi1 y tt3lrut~l'ilum8tu : I'i mhl~ul~i11'i~1tiuttusi1ttlmoet Ht3C'13tBIl"~tngH8Hlti H~1~U18 ~1m1~Tit~ ruu18ttitl qi1 ~~lrlhtlrlji18: '1 2 mhl~ul~i11'i~1ti U~1 Bi1ttlmoEtHt3C'13 tbn"~~tngu18rntin~bi1html:ii1u~~ruti~tilrl'i:jtlttli1 '1... ~ u_. A.1 t~g...ii.\.lj... ta...,,,q.. fil [looe... '" IIV (L). t~g. lj.l)... ta.~...,.;[l [looe 3

4 "W1nuW1i:dlrnthnLurmdlrnB~MfigmrntlJ~!JnH~rnnU'iil~nmruttlrufmm;tBi~~~uUiIrnlttlsrnHUMta~m~l]f msu~ru~~ttlsrnileiul~~tlthmta~m~~~aum~~~~t~hsmsuqpfi~frut:1a~ yguirnhm~tl fi~lt1t:jtuljtl ts:t9 ~ ~ Local Fund AgentCambodia HFI $ 143,783 SltIJM!ilS ttlsrm LnrtJ~rq81nuuu S~ H~rmdlttlU 4

5 Ministry 1"1\ of Health.. i ~i~\~'<;' National Center for HIV/AIDS, Dermatology and STDs KINGDOM OF CAMBODIA Nation Religion King No...QJ.J.f,)~.NCHADS LETTER OF AGREEMENT FOR HIV/AIDS PROGRAMME MANAGEMENT Between the National Center for HIV/AIDS Dermatology and STD (NCHADS) and the HIV/AIDS Management Team (HAMT) of Kampong Cham Concerning Decentralization of HIVIAIDS Activities Funded under the NCHADS Comprehensive Work Plan 2009 (1)The National Center for HIV/AIDS Dermatology and STD (NCHADS) and the HIV/AIDS Management Team of Kampot (hereinafter known as 'the HAMT'), represented by Dr. Kimsour Phirun, acting in his capacity as Provincial Health Director and the Leader of HAMT, agree that the following special assignment will be carried out with funds provided under the NCHADS Comprehensive Work Plan (2)Task: The HAMT, through its subordinates (primarily the Provincial AIDS Manager), is responsible for implementation of HIV/AIDS and STI activities in Kampong Cham. The National Center for HIV/AIDS, Dermatology and STD/Ministry of Health (NCHADS/MoH) will directly monitor and supervise implementation on technical aspects and supervise the financial management of funds provided. (3)Task Components: The HAMT, through its subordinates and represented by the HAMT Leader, will ensure the completion of the activities approved in the provincial HIV/AIDS and STI Annual Work Plan for the year 2009 attached at Annex 1. (4)lndicators and Outputs: Indicators and outputs for the satisfactory performance of these tasks are: % of activities implemented according to Annex 2 (provincial targets 2009); 2. Accounts satisfactorily maintained, as agreed by the NCHADS Finance Unit; 3. DiagnOSis and management of STI cases appropriate (as judged by NCHADS supervision); 4. Testing and Counseling conducted appropriately (as judged by NCHADS supervision); N245 H, Street 6A, Phum Kean Klang, Sangkat Prek Leap, Khan Russey Keo, Phnom Penh, Cambodia, inio@nchads.org, Website:

6 .,...~. 5. Provincial annual and quarterly work plans submitted on time to NCHADS within one month before next annual work plan began and two weeks before next quarter work plan began. (as Judged by NCHADS PMR Unit) 6. Provincial monthly and quarterly reports submitted on time to NCHADS within 2 weeks after each monthly and quarterly activity work plan ended. (as judged by NCHADS PMR Unit) (5)Term: The HAIVIT shall perform the services specified above during the period commencing on January 1, 2009 and continuing to December 31, This tenn is subject to change upon reasonable written notice agreed by the two Parties. (G)Cost: A total estimated cost of not more than US$ 24, (Twenty four thousand four hundred thirty two point five US Dollars), (GFR7=$ 2,980 and GFR4=$ 21,452.50) as in Annex 1 ; will be provided by NCHADS/MoH as follows. (7)Funding: Funds will be transferred from NCHADS/MoH to the HAMT as an initial advance of $500 for GFR7 which will be reconciled and replenished each month in accordance with NCHADS standard operating procedures, as laid down in the relevant "Procedures for Implementation of Program Activities" with respect to various funding sources, as formally approved. (8)For 2009, funds are allocated from the following sources: GFR7 $ 2,980 GFR4 $ 21, (9)Should further funding become available for provincial activities, the Annual Work Plan at Annex 1, the targets at Annex 2, and this agreement at clause 6 and 8 will be amended by letter of amendment. (10)lt is anticipated that no additional cost will be paid for the work by NCHADS/MoH to the HAMT, unless extra work is requested to be performed. (11 )If expenditures during the year are less than the approved workplan, any balance of funds advanced must be refunded to NCHADS. (12)Audit: The HAMT it accounts will be audited as part of the various relevant audits relating to relevant funding sources. NCHADS/MoH reserves the right to audit the HAMT Account at any time. (13)Any difference or dispute arising out of this Letter of Agreement (LoA), which cannot be amicably settled between the parties, shall be referred to adjudication/arbitration in accordance with the regulation of the Ministry of Health. (14)The NCHADS without prejudice to any other remedy for breach of LoA, by written notice of default sent to the HAMT, may terminate this LoA in whole or in part: (a) if the HAMT fails to perform any other obligation(s) under the Letter of Agreement; (b) if the HAMT, in the judgment of NCHADS has engaged in corrupt or fraudulent practices in competing for or in excluding the LoA.

7 Date: O{C ~ Date:. 0..f..../.. ~.{ Note: In addition to the funding sources above, the national budget, and the following NGO funds and activities identified in the provincial planning process are included in the Annual Comprehensive Plan in Annex 1, but are not covered by the terms or scope of this LOA. FHI $ 143,783 cc: Local Fund Agent in Cambodia Department of planning and information, ministry of health Partners

8 ANNUAL OPERATIONAL COMPREHENSIVE PLAN JanDec, 2009 I. Kampong Cham Work Plan I. PREVENTION PACKAGE IEC Q1 Q2 Q3 Q Events Khmer New Year Water Festival World AIDS day Mobile Shows TV and/radio shows Other (festival, concert..) Subtotal for GFATMR7 $ Subtotal for CHAI $ Subtotal for AHF $ Subtotal for NB $ Subtotal for IEC $ Outreach Q1 Q2 Q3 Q Training $ Curriculum design Training materials Conducting training Mapping & Sensitisation $ Annual mapping PAO $ GFATM R Outreach interventions $ 2, Outreach visit (monthly).annual Mapping Conducted by 14 PWG/OPC Members.4 Meetings with 30 Owners in Kampong Cham Town.4 Meeting with 45 Owners in 3 OD : Tbong Owners meeting PAO $ 2, GFATM R4 Khmum, Ponhea krek, Memot Owners meeting PAO $ GFATM R Peer Education.1 Meetings with 30 Owners in Kampong Cham Town.4 Meeting with 39 Owners in 3 OD : Tbong Khmum, Ponhea krek, Memot Training and refresher training of PSTOP PAO $ GFATM R4.2 Training for PST/OP 8 members (3 days) Refresher training at national level for PSTOP, PWGOPC and DTOP on OPE (2 times/year)

9 In Sevice/refresher training of PWGOPC/DTOP Refresher training for PST/OP on OPE at provincial level (2/prov/y) Technical coordination Technical coordination National TWG/OPC meeting Provincial PWG/OPC coordination meeting $ GFATM R4.14 PWG/OPC Members Provincial PST/OP meeting $ 1, GFATM R4.9 PST/OP Members Provincial PWG/OPC coordination meeting PAO $ GFATM R7.14 PWG/OPC Members Provincial PST/OP meeting PAO $ GFATM R7.9 PST/OP Members Sensitization meeting Consensus workshop Subtotal for GFATMR7 $ 1, Subtotal for GFATMR4 $ 5, Subtotal for Outreach $ 6, % CONDOM USE Q1 Q2 Q3 Q Condom promotion Training Meeting for CUCC/CUWG.4 Meetings will be conducted and 9 members of Provincial CUCC meeting $ GFATM R4 CUCC will attend Provincial CUCC meeting PAO.1 Meetings will be conducted and 9 members of $ GFATM R7 CUCC will attend.36 meetings will be Conducted and 5 members of Provincial CUWG meeting PAO CUWG in Kg Cham Town, 5 members of CUWG in $ GFATM R4 Tbong Khmum and 4 members of CUWG in Memot will attend.2 meetings will be Conducted and 5 members of Provincial CUWG meeting PAO CUWG in Kg Cham Town, 5 members of CUWG in $ GFATM R7 Tbong Khmum and 4 members of CUWG in Memot will attend Techncial coordination Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ 1, Subtotal for CUP $ 1,383.00

10 STI MANAGEMENT Q1 Q2 Q3 Q Training Refresher training PAO $ 6, GFATM R4 Refresher training on STI/RTI syndromic case management for health care providers at 222 selected health centers Supplies Other operational cost Mobile clinic for SWs Mobile service on STI/RTI case management for sex workers to provide onsite care and treatment for sex workers in 10 provinces Technical coordination, etc Semi Annual meeting for strengthening linkage between STI clinic, OPC, VCCT, ANC, FP and NGOs partners Monthly TWG meeting on STI/RTI case manageement Network meetings in five regions for sharing STI/RTI clinical and lab experiences. Regional workshops for sharing experiences in STI/RTI clinical and laboratory management in 5 regions Province.3 Refreshers training for 60 HCs Staff and 10 OD Coor from 10 OD ( 3 days) Coordination meeting between Family Health Clinics and Local MSM networks to promote utilization of HIV/AIDS/STI services Quarterly coordination meeting for health care providers at 03 STI/RTI clinic and all relevant partners PAO $ GFATM R7 Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ 6, Subtotal for STI $ 6, Coordination Meeting for Health care providers at 3 STI/RTI Clinic II. CONTINUUM OF CARE HEALTH FACILITY BASED CARE Q1 Q2 Q3 Q4 Cost Source Target/Expected output Need assessment Guidelines and policies Initial Training Technical coordination PAO $ FHI Clinician network meeting for OI/ART for Adult Counseling network meeting for OI/ART for Adult

11 Pediatricians network meeting for OI/ART Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ Subtotal for FHI $ Subtotal for HFBC $ TB/HIV Activities Q1 Q2 Q3 Q Guidelines and Policies Develop 3Is Framework Training Technical coordination Orientation workshop on TB/HIV collaborative activities Dissemination Collaborative TB/HIV Activities Transport of poor PLHA patients to TB Xray Services at Referral Hospital OD $ 5, FHI OD $ 4, FHI Develop referral mechanism and refer TB pts blood for HIV testing ( Kg Cham,Tbong Khmum,Memot and Cheung Prey OD).Strengthen linkages with HC staff,hbc,vhsg (Monthly Meeting ) in Kg Cham,Tbomg Khmum,Memot and Cheung Prey OD Orientation and networking on TB/HIV Subtotal for GFATMR7 $ Subtotal for FHI $ 10, Subtotal for TB/HIV $ 10, Account code Description 8.HOME BASED CARE and Donor Code Who PLHASG & MMM & Positive Prevention Q1 Q2 Q3 Q4 Activites Technical Coordination $ Technical Coordination Meeting of provincial HBC network Quarterly Meeting of HBC Networks TWG Meetings TWG Meetings for HBC TWG Meetings for Positive Prevention Counselor Monthly Meeting OD $ FHI.Counselor Monthly Meeting (adult,pediatric and AUA staff ) in Kg Cham RH

12 Biweekly Case discussion/death review to improve the quality of services (OI/ART) OD $ 6, FHI Biweekly Case discussion/death review to improve the quality of services in Kg Cham,Tbong Khmum,Memot and Cheung Prey Biweekly OI/ART Coordination meeting OD $ 1, FHI Biweekly OI/ART Coordination meeting (Kg Cham RH) Link OI/ART with HBC OD $ FHI Referral to Service & Improve quality of service OD $ 20, FHI Dissemination Workshop of Guidelins, Policy, and SOP Contracting HBC with NGO $ Contracting HBC with NGOs PLHA Support Groups and MMM $ 12, PLHA Self help group meeting MMM Monhtly meeting OD $ 12, FHI Link OI/ART with HBC to improve lost follow up(perdiem &transport)in Kg Cham,Tbong Khmum, Memot and Cheung Prey OD Referral to Service & Improve quality of service(lab testing OPD) in Kg Cham,Tbong Khmum, Memot and Cheung Prey OD.MMM Monthly Meeting in OD Kg Cham,Memot,Tbong Khmum and Cheung Prey mmm Monhtly meeting OD $ 2, FHI.mmm Monthly Meeting in OD Kg Cham,Tbong Khmum Technical coordination for PLHASG & MMM Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ Subtotal for FHI $ 44, Subtotal for HBCPLHAsSG and MMM. $ 44, Linked Response Activities Q1 Q2 Q3 Q Need Assessement Training initial traininig of LR Refresher training for LR Study tours LR for management teams Mentoring LR for New sites Referral network OD $ 17, FHI.For Lik Response in Tbong Khmum OD Subtotal for GFATMR7 $ Subtotal for FHI $ 17, Subtotal for Linked Response $ 17, Cost Source Target/Expected output

13 Donor Code 11.VCCT Who Q1 Q2 Q3 Q Guidelines/ Regulation $ Revise and printing policy, strategy and guidelines for HIV testing and counseling Training Develop curriculum & Training PAO $ 2, FHI.Positive Prevention Training Initial Counseling training Initial training for VCCT Counselors Initial Laboratory Training Initial laboratory serology Trainings Training VCCT data management Refresher counseling training Refresher lab training Technical coordination meeting Technical coordination meeting PAO $ 2, FHI.Counselor Network meeting Quality Assurance HIV Quality Control (QC for HIV testing) Quality Control for VCCT Quality control for 230 VCCT sits Network meeting (QI) Regional Counselling Network meeting Regional Lab Network Meeting Annual regional VCCT meeting Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ Subtotal for FHI $ 4, Subtotal for VCCT $ 4, Account code Description Donor Code 12.COORDINATION and REFERAL Who Q1 Q2 Q3 Q4 NETWORK of CoC Needs assessment Policy and guidelines $ Continuum of Care Committee Designate CoC committee Monthly CoC committee meeting expenses OD $ 4, FHI Referral network Development of referral network materials Transportation/testing fee for Adult CD4, Technical coordination Subtotal for GFATMR7 $.Monthly CoC cmmittee meeting in Kg Cham,Tbong Khmum,Memot and Cheung Prey OD

14 Subtotal for GFATMR4 $ Subtotal for FHI $ 4, Subtotal for CHAI $ Subtotal for AHF $ Subtotal for CoC $ 4, PMTCT Q1 Q2 Q3 Q4 Cost Source Target/Expected output Need assessment M&E, Network & Assessment PMTCT Policy and Guideline Training Workshop and Training PMTCT $ 2, FHI.Workshop and Training for PMCTC Supplies and drugs Vitamin Supplements Gaps (Iron and Folate) Technical Coordination Miscellaneous Miscellaneous II, redundant procurement Transport HIV positive pregnant women Annual planning workshop/retreat for PMTCT Quarterly Network meeting for PMTCT PMTCT $ 1, FHI.Quarterly Network meeting for PMTCT Provide on site coaching PMTCT staff Provide monitoring, networking and assessment in support of 2 new PMTCT sites Equipment for PMTCT IEC campaign PMTCT Strengthen follow up positif pregnant women, infants exposed to delivery in RH OD $ FHI Support positive womem to delivery in RH OD $ FHI Coordination PMTCT biweekly meeting OD $ 6, FHI Subtotal for GFATMR7 $ Subtotal for FHI $ 11, Subtotal for PMTCT $ 11, Strengthen follow up positif pregnant women, infants exposed to delivery in RH (Kg Cham,Tbong Khmum,Memot and Cheung Prey) Support positive womem to delivery in RH(Kg Cham,Tbong Khmum,Memot and Cheung Prey) Coordination PMTCT biweekly meeting(kg Cham,Tbong Khmum,Memot and Cheung Prey) IV. PROGRAM MANAGEMENT Account code Description Donor Code 16. PLANNING, MONITORING & Who Cost Source Q1 Q2 Q3 Q4 REPORTING Planning, Target/Expected output

15 Annual Planning Workshops Midyear Review Workshop MidTerm & Final evaluation Technical Strategies Strategy Development Printing and documentation Management & Coordination Workshops and coordination meetings PAO $ FHI. Review budget workplan for OI/ART PAO $ 1, FHI Workplan budget development Mission to NCHADS PAO $ GFATM R4. 4 Missions to NCHADS by 1 HAMT Accountant Travel to PP for Drug PMTCT $ FHI. 1 Mission to PP by PMTCT Staff Transportation for Supply Chain Management PAO $ FHI.Transport go to take reagent and material Monitoring, Supervision M & E system Monitoring and Supervision OD $ FHI OD $ FHI OD $ FHI.Transportation to get drug (when the drugs out of stock) for Kg Cham,Tbong Khmum,Memot and Cheung Prey OD.Transport to Kg Cham for Request( Tbong Khmum,Memot and Cheung Prey OD).Blood Transportation fee for HIV testing from HC to RH ( PMTCT Kg Cham RH).PST/OP members will supervise the Outreach PAO $ GFATM R4 Activities in 4 OD PAO.CUWG members will supervise the 100% CU $ 3, GFATM R4 3 OD activities in 3 ODs PAO GFATM R4.PAO Staff Supervise STI Activities 20 HCs $ 1, PAO $ 1, GFATM R4. OD Coordinator Supervise STI Activities 33 HCs PAO $ 1, FHI.PAO Staff Supervise VCCT Activities 10 OD PAO $ FHI.Supervise PMTCT Activities 6 Sites PAO $ FHI.Supervise OI/ART Activities 4 Sites monthly supervision from PST/OP to DTOP in each province OD $ FHI CUWG monitoring of all entertainment services PAO x $ GFATM R7.Supervision from OD to HC ( Kg Cham,Tbong Khmum,Memot and Cheung Prey).CUWG members will supervise the 100% CU activities in 3 ODs

16 Monitoring and supervision from PAOs to 10 operational districts (OD) on STI/RTI prevention and care mangement PAO x $ GFATM R7.PAO Staff Supervise STI Activities 20 HCs Monitoring and supervision from 10 operational districts (OD) to 33 selected health centers on STI/RTI syndromic case mangement OD x $ GFATM R7. OD Coordinator Supervise STI Activities 33 HCs Supervision of health facility staff by provincial Data Management units Reporting.PDMO Team will supervise on Data management System at PAO $ GFATM R7 10 OD Subtotal for GFATMR7 $ 1, Subtotal for GFATMR4 $ 7, Subtotal for FHI $ 5, Subtotal for Planning $ 14, Account code Description Donor Code 18. LOGISTICS & SUPPLY MANAGEMENT Equipment & Furniture Who Q1 Q2 Q3 Q Clinical equipment Furniture and Equipment PAO/OD $ 13, FHI.Furniture for PAO,VCCT,OIART and PMCTC Sevices Electronic equipment provide electronic equipment to 9 new provinical data management units Lab equipment Includes utitlities, maintenance equipment, office supplies for all provincial labs Consumables Consumables Consumables for VCCT Consumables for OI/ART RH $ 3, FHI.Consumable for OI/ART in Kg Cham RH OD $ FHI.PMCTC Material ( Cheung Prey) Consummables and commodities for new VCCT sites Condom supply PAO $ GFTM R condoms will be Supplied Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ Subtotal for FHI $ 17, Subtotal LogMgt $ 18, ADMIN & FINANCE Q1 Q2 Q3 Q4 Cost Source Target/Expected output

17 Administration Administrative costs PAO $ GFATM R4.Office Supply for CUCC PAO 3 OD $ GFATM R4.Office Supply for CUWG PAO $ 1, FHI.Office Supply for VCCT PAO $ 1, FHI.Office Supply for OI/ART PAO $ FHI.Office Supply for PMTCT PAO $ FHI.Office Supply for TBHIV Running cost for 35 STI/RTI clinics PAO 3 OD $ GFATM R7.Running Cost for 3 STI/RTI Clinic Conmmunication costs PAO $ FHI.Phone card ( Adult & Pediatric service) RH $ 2, FHI.Computer for Data entry in Kg Cham HR Renovations Renovation/Construction RH $ FHI Training and Rent Computer in Kg Cham RH RH $ FHI.MMM Room Renovation in Kg Cham RH (if it needed) OD $ 1, FHI Renovation (Memot OD) Consulting services Stipend PAO $ FHI.Stipend for VCCT staff in Dambe HC OD $ 19, FHI.Stipend for PLHA staff in Memot,Kg Cham,Tbong Khmum and Cheung Prey RH( PLHA Counselors,PLHA Cleaner ) Subtotal for GFATMR7 $ Subtotal for GFATMR4 $ Subtotal for FHI $ 28, Subtotal for Admin & Finance $ 28,770.00

18 ,, " II. Summary Budget allocated by Components in 2009 III. Summary Budget allocated by sources in 2009 Sources Budget 0/0 GFATMR7 $ ~~~ ~ GFATMR4 $ 21, FHI $ 143, GRAND TOTAL $ 168, % /6 Date: <z. t 'r:b::> b ~ Prepared by t ~ Dr. CHHUN LYPrCfl