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AND AFFECTED BY, HIV/AIDS 1. Please identify your organization: ____________________________________ 2. Please specify the country where you work ____________________________ 3. Your organization is best described as a: ( ) National NGO ( ) International NGO ( ) Community-based NGO ( ) National affiliate of an international NGO ( ) Coalition ( ) National affiliate of global coalition ( ) Other ____________________________________________________________________ 4. What percentage of your organization’s work is with children and HIV/AIDS? ( ) 0–20% ( ) 21–40% ( ) 41–60% ( ) 61–80% ( ) 81–100% 5. The HIV/AIDS programming of your organization is in the following area(s): (Please check all applicable) ( ) HIV/AIDS counseling and testing ( ) Administration of anti-retroviral (ARV) treatment ( ) Administration of non-ARV treatment (e.g. prophylaxis against opportunistic infections, nutritional support) ( ) Home-based care for people living with HIV/AIDS ( ) Prevention of parent-to-child transmission (e.g. prevention counseling, administration of ARV prophylaxis to infants) ( ) Community-based awareness raising (regarding prevention, testing, availability of treatments, reducing stigma and discrimination etc.) ( ) Sexual health education in schools ( ) HIV/AIDS outreach sexual health education ( ) HIV/AIDS fund-raising ( ) Providing services for AIDS orphans and vulnerable children (“OVC”) ( ) Other ___________________________________________________________________________ 6. If your organization provides services to AIDS orphans and vulnerable children, please indicate if these services are in any of the following areas and estimate how many children are reached per year: Type of Service Estimate of OVCs Reached Per Year ( ) Basic care; shelter, clothing and nutrition ____________ ( ) Medical care ____________ ( ) Financial support ____________ ( ) Schooling ____________ ( ) Helping mobilize community support networks ____________ ( ) Advocacy for protection of children’s rights (e.g. property rights) ____________ 7. With respect to children and HIV/AIDS in your country, UNICEF: ( ) is a major actor ( ) is a minor actor ( ) is currently inactive/has no role ( ) UNICEF’s role in my country is unknown 8. Does your organization collaborate with UNICEF in its HIV/AIDS work? ( ) Yes ( ) No ( ) Don’t know 9. Does your organization collaborate with other NGOs in its HIV/AIDS work? ( ) Yes ( ) No ( ) Don’t know 10. If yes, please identify the organizations with whom you collaborate: _____________________________________________________________________ 11. Has your organization been involved with any regional networks addressing the issue of children and HIV/AIDS? ( ) Yes ( ) No ( ) Don’t know 12. If the answer to Question 11. is “Yes”, has UNICEF been involved with these networks? ( ) Yes ( ) No ( ) Don’t know 13. Does your organization engage community participation in HIV/AIDS program planning? ( ) Yes ( ) No 14. If the Answer to Question 13. is “Yes”, does the community participation include youth representation? ( ) Yes ( ) No 15. Please indicate the source(s) of funding for your HIV/AIDS program, by numbering the following sources from 1 to 9 (with 1 being the largest source of funds). Please leave blank if not a source of funding for your HIV/AIDS program. ( ) Bilateral Government grants from _____________________ (please specify donor) ( ) Grants from multilateral donor organizations (e.g. EU) _____________________ (please specify donor) ( ) Global Fund to Fight AIDS, Tuberculosis and Malaria ( ) World Bank ( ) UNICEF ( ) Other UN bodies (e.g., UNHCR, WHO etc) ( ) Private Donations ( ) Initiatives by HIV/AIDS-affected Communities ( ) NGO partners 16. Please select from the list below what you would consider to be the top three (3) priorities in your country with respect to children and HIV/AIDS (Please select only three) ( ) HIV/AIDS counseling and testing ( ) Administration of ARV treatment for AIDS ( ) Non-ARV treatment for AIDS (e.g. prophylaxis against opportunistic infections, nutritional support) ( ) Home-based care for people living with HIV/AIDS ( ) Ensuring treatment programs are accessible and sustainable ( ) Prevention of parent-to-child transmission (e.g. prevention counseling, administration of ARV prophylaxis to infants) ( ) Protecting the institution of breast-feeding ( ) Community-based awareness raising ( ) Sexual health education in schools ( ) HIV/AIDS fund-raising ( ) Basic care (shelter, clothing and nutrition) for AIDS orphans and vulnerable children ( ) Providing support for caregivers ( ) Community participation in program planning ( ) Child participation in program planning ( ) Integrating HIV/AIDS programming into emergency responses ( ) Improving health outcomes ( ) Other(s) (please specify)_____________________________________________________________ Due date: April 30, 2004 BY E-mail: JPFCM@att.net By mail: Joseph Foley, C.M. 80-14 217th Street Queens Village, New York 11427 USA | What Everyone Should Know about HIV/AIDS | UNICEF's Aims and Priorities | What can we do? | Suevey: Children and HIV/AIDS | | Global Summaey: Children and HIV/AIDS 2004 | The Search for Peace (A) | The Search for Peace (B) | POVERTY ERADICATION (A) | Poverty Eradication (B) | Social Development | A Human Rights Approach to Issues (A) | | News Center | Vincentian Issues 2004-2005 A | Vincentian Issues 2004-2005 B | Jeff Sachs -Meeting the MDG's | The Whole World Knew | Anglicans - Water | | Return Home | About Us | What's New | Current Focus | Articles | Great Links | E-mail | |
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