November 2012
This publications was produced request of the United States Agency for International at the Development
independently by Ishrat Husain, Rachel Macharia, Mary O’Grady and Billy Pick
2
Final Evaluation Report on the ROADS to a Healthy Future 
(ROADS II) Project in East and Southern Africa 
Mary O’Grady, Independent Consultant and Team Leader 
Ishrat Husain, USAID/Washington 
Rachel Macharia, Independent Consultant 
Billy Pick, USAID/Washington 
DISCLAIMER: 
The contents of the following report are the responsibility of the authors and the opinions 
expressed herein are those of the authors only. 
Cover Photo: Boda Boda operators (cyclists) ferry passengers and goods in front of the 
ROADS SafeTStop Cente in Busia, Uganda.
3
ACKNOWLEDGEMENTS  
This report is dedicated to the people of East, Central and Southern Africa. The ROADS II 
Evaluation Team wishes to thank all the organizations, community clusters, governments, 
private sector entities, and individuals, especially at USAID and FHI 360, who provided 
assistance and support to the Team during the evaluation, conducted from May through 
September 2012. 
4
TABLE OF CONTENTS 
List of Abbreviations and Acronyms ……………………………………..………...6 
Executive Summary………………………………………………………..…..…..…8 
ROADS II Project Objectives and Introduction…………………………..………12 
Main Evaluation Findings………………………………………………..…............13 
Extension of Coverage………………………………………...………..….....13 
Capacity Strengthening……………………………………..…………….......16 
Innovation and Diffusion…………………………………..…………..…..…19 
HIV Prevention……………………………………………………………… 22 
Administration and Management……………………..………………....……23 
Lessons Learned………………………………………………..……………………28 
Conclusions and Recommendations………………..…………………………..…..31 
Economic Strengthening……………………..…………………………………..…36 
ROADS II Responses to Recommendations of ROADS I Evaluation in 2008…..45 
Annexes
Annex A: Scope of Work for the Evaluation………………………………...…....58 
Annex B: Evaluation Methodology………………………….................................62 
Annex C: Limitations of the Evaluation…………………………….………….....64 
Annex D: List of Individuals Met or Interviewed………………….……………..66 
Annex E: Evaluation Site Visit Schedule…………………………….…………...80 
Annex F: List of Documents Reviewed……………………………….…………..85 
Figures and Tables
Table 1: ROADS II Results, Targets and Percent of Targets Achieved...….……...13 
Figure 1: ROADS II Site Locations in East and Southern Africa, May 2012….….14 
Figure 2: Total Number of ROADS Site from 2006-2012………………………....14 
Figure 3: Growth of ROADS II Sites, Obligations and Expenditures FY09-12…...15 
Table 2: ROADS II Budgets and Obligations Summary by Country, May 2012….15 
Table 3: ROADS Training Data FY2006-FY2012………………………………...17 
Figure 4: Group Savings and Loan Association (GSLA) Results, May 2012……...18 
Figure 5: Community Clusters and Groups Growth from FY2006-FY2012……....20 
Table 4: Community Clusters by Site in Rwanda, March 2012…………………....21 
Figure 6: Djibouti USAID-Dubai Ports World-FHI 360 Partnership……………....22 
Figure 7: Innovations and Best Practices of Corridors of Hope in Zambia…….…..22 
Figure 8: Materials Developed by ROADS in Kenya on Alcohol and Anal Sex......23 
Figure 9: ROADS LWA Bilateral Mission Buy-Ins FY2006-FY2012…………….24 
Figure 10: ROADS Conception of Linkages among Issues, Behaviors and Impact.25 
Table 5: ROADS Maternal, Neonatal, and Child Health Achievements, Rwanda...26 
Figure 11 ROADS Results in Burundi Showing Cotrimoxazole Prophylaxis…...…26 
Table 6: ROADS Economic Strengthening Activities by Country & Location……38 
Table 7: GSLA Results in Mozambique, Rwanda, Tanzania and Zambia………….39 
Figure 12: Volunteers Trained by ROADS in Rwanda Currently Active………….42 
Figure 13 Comparison of GSLA Membership & Volunteers in Tanzania………….42 
Figure 14: Comparison of GSLA Membership in Tanzania and Rwanda……….…43 
Figure 15: Grassroots Capacity Building through Learning Approaches…………..43 
Figure 16: Progression of ROADS M&E System……………………………....…..47 
Figure 17: Diagram of ROADS Data Collection and Outputs………………….…..48 
Figure 18: Data Use Flow Chart by STI Team for Sex Workers in Rwanda……….49 
Figure 19: Organogram Showing ROADS Organizational Evolution…………...….50 
Figure 20: ROADS Tanzania Team Organogram…………………………………...51 
Table 8: Representation by ROADS on National Planning Bodies by Country….…53 
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ABBREVIATIONS AND ACRONYMS 
AOR Agreement Officer’s Representative (USAID) 
APHIA AIDS Population and Health Integrated Assistance (in Kenya) 
ARC American Refugee Committee 
ART Antiretroviral therapy 
ARVs Antiretrovirals 
BCC Behavior change communication 
BMS Behavioral monitoring survey 
BSS Behavioral surveillance survey 
CCP Center for Communication Programs of Johns Hopkins University 
CDC US Centers for Disease Control and Prevention 
CRS Catholic Relief Services 
DAI Development Alternatives, Inc. 
DFID UK Department for International Development 
DRC Democratic Republic of the Congo 
EAC East African Community 
ECSA East, Central and Southern Africa 
ES Economic strengthening 
FHI Family Health International 
FP Family planning 
FGD Focus group discussion 
FSW Female sex worker 
FY Fiscal year 
GBV Gender-based violence 
GHI Global Health Initiative 
GSLA Group Savings and Loans Associations 
HMIS Health management information system 
HTC HIV testing and counseling 
IGAs Income-generating activities 
INGO International non-governmental organization 
IOM International Organization for Migration 
IP Implementing partner (organization) 
IRC International Rescue Committee 
ISN Immediate social network 
Jhpiego Johns Hopkins Program for International Education in Gynecology 
and Obstetrics 
LAPM Long-term acting or permanent methods (of FP) 
LIW Low-income women 
LQAS Lot quality assurance sampling 
LWA Leader with associates 
M & E Monitoring & evaluation 
MARPs Most-at-risk populations 
MCP Multiple and concurrent sex partners 
MMC Medical male circumcision 
MNCH Maternal, neonatal and child health 
MOH Ministry of Health 
NACC National AIDS Control Council (Kenya) 
NASCOP National AIDS & STI Control Programme (Kenya) 
NGO Non-governmental organization 
NSP National Strategic Plan 
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OGAC Office of the US Global AIDS Coordinator 
OHA Office of HIV/AIDS (USAID Washington) 
OR Operations research 
OVC Orphans and Vulnerable Children 
PACE Pharmacists and Continuing Education of Howard University 
PATH Program for Appropriate Technology in Health 
PHDP Positive health, dignity and prevention 
PLHIV People Living With HIV/AIDS 
PHN Population, Health, and Nutrition 
PHSC Protection of Human Subjects Committee 
PLACE Priorities for Local AIDS Control Efforts 
PMP Program monitoring plan 
PSI Population Services International 
PwP Prevention with Positives 
ROADS Regional Outreach Addressing AIDS through Development 
 Strategies 
ROADS II Roads to a Healthy Future Project 
SADC Southern African Development Community 
SBCC Social and behavior change communication 
SCM Supply chain management 
SDM Standard days method (of FP) 
Sida Swedish International Development Cooperation Agency 
SOTA State-of-the-art 
SRH Sexual and reproductive health 
STI Sexually transmitted infection 
TA Technical assistance 
USAID/EA United States Agency for International Development/East 
 Africa 
USG United States Government 
VCT Voluntary counseling and testing 
WHO World Health Organization 
  
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EXECUTIVE SUMMARY 
The ROADS to a Healthy Future (ROADS II) Project is a five-year Leader with Associates 
(LWA) award with funding from USAID/East Africa (EA) starting on August 1, 2008 that also 
includes bilateral funding from USAID Missions and will end on July 31, 2013. This initiative 
was a direct follow-on program to the ROADS Project that began in 2005. In mid-2012 The 
ROADS II project is operational in the following countries in East, Central and Southern 
Africa: Burundi, Djibouti, Kenya, Mozambique, Rwanda, Tanzania, Uganda, and 
Zambia. Countries with previous ROADS programming included: Democratic Republic of the 
Congo (DRC), South Sudan, and Ethiopia. The objectives of the project are to: (1) Extend HIV 
and broader health services to underserved, most-at-risk mobile and community populations 
along the East, Central and Southern Africa (ECSA) transport corridors and waterways; (2) 
Build the capacity of indigenous partners to design, implement and manage programming of 
their own design over the long term, in line with USAID’s Global Health Initiative (GHI); and, 
(3) Identify, test and diffuse innovations throughout sub-Saharan Africa. ROADS II is 
managed by Family Health International (FHI) 360 with the following sub-partners: 
Development Alternatives, Inc. (DAI), Howard University/Pharmacists and Continuing 
Education, Jhpiego, Johns Hopkins University/Center for Communication Programs, North 
Star Alliance, Program for Appropriate Technology in Health (PATH) and Voice for 
Humanity. 
The ROADS Project is focused on developing and instituting African-led and African-owned 
response to health and development needs by targeting transport corridor communities. As a 
result, ROADS hopes to build effective programs in HIV/AIDS and health to increase the 
number of people served, innovate and use promising new practices and approaches to improve 
outcomes in health and HIV/AIDS and build African capacity to respond to future health and 
development challenges. To meet these expected results, ROADS carries out a portfolio of 
activities, including: economic empowerment, community based services and activities, 
clinical health services and SafeTStops. Key to this programming are program features such 
as integration of health services, community engagement with new and innovative models such 
as the community clusters, collaboration with government and private partners, use of a 
regional platform to test, diffuse and scale up innovations and then documenting and 
disseminating these interventions. 
The final, independent evaluation of ROADS II was conducted from late May through 
September 2012 by Ishrat Husain, Rachel Macharia, Mary O’Grady, and Billy Pick, all of 
whom have experience evaluating health and development programs in Africa. The purpose of 
this evaluation was to assess overall project performance and to obtain recommendations for 
the re-design of the project. In order to do this, the evaluation assessed the outcomes of both 
the ROADS I and II projects in strengthening the response to HIV/AIDS in vulnerable mobile 
and transient populations along transport corridors in East, Central and Southern Africa. It is 
important to note that the overall evaluation, while focused on ROADS II took the entirety of 
ROADS programming into account and are reflected in the evaluators overall findings. 
Conclusions, lessons learned and recommendations will provide information for decisions 
made about ROADS program components of a follow-on project and the potential scale-up of 
these components by USAID/EA and bilateral programs in the region. Evaluations of new 
innovations designed and implemented by ROADS, such as the community cluster model and 
the regional platform approach to cross-border health issues, will serve not only to inform the 
future re-design of the ROADS project, but to inform the design of broader services in the 
region. 
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The ROADS II Evaluation Team found that the project largely met or exceeded its targets 
across the program areas and interventions, both for the mobile populations it has served and 
the local community members, by mid-2012. The two monitoring and evaluation (M&E) 
indicators where targets were exceeded included sexual and reproductive health and family 
planning (SRH/FP) counseling services provided, which exceeded the target by 253%, and 
training to provide SRH/FP services, which exceeded its target by more than 100%. Both 
program areas were added to the HIV prevention program interventions originally designed to 
be covered by the ROADS project. Two indicators where targets were below 70% in mid-2012 
included positive health, dignity and prevention (PHDP) or prevention with positives (PwP) 
interventions for people living with HIV (PLHIV), a newer HIV prevention and care 
intervention emerging internationally over the last few years, and delivering core care services 
to eligible adults in the target areas. Another indicator where ROADS II did not reach the target 
was delivering essential services to orphans and vulnerable children (OVC), where 78% of the 
target was met. However, comprehensive OVC programming requires more intensive and 
potentially daily service provision and support across a wide range of health and development 
sectors. 
ROADS also added interventions to its original programmatic purview, thus extending the 
range of health and development services provided, including gender-based violence (GBV) 
prevention, alcohol abuse counseling and support groups, nutritional support to families and 
individuals through the innovative design and training provision of community gardens and 
bio-intensive gardens. Importantly, ROADS provided economic strengthening through the 
creation, training, and support of local Group Savings and Loan Associations (GSLAs), a key 
development model that strengthens the economic resilience of communities, families, and 
individuals, with savings enabling greater access to health services. In mid-2012 5,800 
individuals were members of sustainable GSLAs in four countries with savings to date totaling 
nearly $184,000. 
In terms of the capacity building of indigenous organizations to design and manage their own 
programs on a sustainable basis, ROADS largely exceeded its cumulative targets over the life 
of the project by mid-2012, a year before the project is set to end. Eight of the ten training 
targets have been exceeded by ROADS, with a few exceeded at nearly 200% or more of the 
target. As well as the training targets exceeded in the technical intervention areas, the number 
of individuals trained in strategic information exceeded the target by 170%, and the number of 
individuals trained in community mobilization exceeded the target by 190%, showing 
significant focus on building the capacity of communities to launch and monitor programs they 
have identified themselves as important to implement. 
ROADS has shown substantial leadership on and even foreshadowed the principles of the US 
Government’s GHI and USAID Forward. The project’s focus on country ownership and 
leadership, gender equity, and capacity building, including technical training and programmatic 
design and leadership, financial and grants management, and M&E is a forerunner of such 
approaches, which over the last few years have become a priority for USAID. Some 84% of the 
1,307 indigenous volunteer groups that have worked through the ROADS’ ‘community cluster’ 
model over the life of the project had never participated in a donor-funded program prior to 
ROADS. Moreover, in FY2012, ROADS II allocated US$12,747,733 in sub-awards, with 82% 
($10,467,587) going directly to communities through cluster sub-agreements; and, 18% 
($2,280,147) going to international NGO (INGO) partners. 
9
In addition to the economic strengthening model successfully developed by ROADS, the 
aforementioned community cluster model, also developed and promulgated by ROADS, is at 
the forefront of the innovations designed by the project, totaling 114 clusters across the 
ROADS countries as of mid-2012. The use of the cluster model by ROADS has contributed to 
an improved quality of life of the cluster members individually and at an organizational level. 
Through this approach ROADS has provided a unique model of development, which builds 
capacities at the grassroots level through horizontal and vertical learning processes, utilizing 
immediate social networks that previously were informal, and strengthening organizational and 
leadership skills to implement what formerly were ad hoc responses by communities to address 
their needs. The clusters show a significant range in their membership, including: low-income 
women’s clusters, men’s clusters, youth clusters and PLHIV clusters. Moreover, the cluster 
model has proven successful in mobilizing communities sustainably through the life of the 
project, as the Evaluation Team found that the clusters formed since the project initiated them 
were still in existence in 2012. 
The LWA award, the program funding mechanism used by USAID for ROADS II, was found 
by the Evaluation Team to be a robust and flexible model for a regional program. The LWA 
mechanism has enabled USAID Missions to buy into a high-quality program crossing borders 
and fostering community health and economic development. Although the LWA model of 
ROADS has been acknowledged as a substantial value-added mechanism in most countries, it 
has not been integrated into every bilateral program where it started. Likewise, the funding 
levels of ROADS by country have varied greatly, from $100,000 for a one-year program in 
Ethiopia to $25 million for five years in Zambia. A lesson learned evident to the Evaluation 
Team was that providing only one year of funding or funding on a very limited level, for a 
complex program will achieve little or no impact. 
Given this lesson learned, continuation of the ROADS II model for five years is strongly 
recommended by the Evaluation Team. Continuing the regional concept of the ROADS model 
will serve to advantage nationally in most countries and result in continuing regional impact, 
with a greater focus on relevant regional and national policy advocacy added to the model in 
the future. 
The rationales for continuing this important multisectoral and multidimensional health and 
development initiative in the medium term include the following: (1) Public Health 
Rationale: ROADS target groups are at the highest risk of HIV infection and for onward 
transmission of HIV/STIs nationally and internationally. (2) Human Rights Rationale:
ROADS target groups remain underserved by all health services, and these groups are 
generally socially marginalized and stigmatized. (3) GHI Rationale: The ROADS approach is 
the GHI approach, encompassing HIV/STI, TB, malaria, maternal and child health (MNCH) 
and FP as an integrated program under one umbrella, which has adaptable intervention 
priorities based on the programmatic flexibility to address local needs, as well as local 
ownership by communities with an intensive focus on capacity building and sustainability. (4) 
Sustainable Development Rationale: ROADS uses a holistic development framework for 
programming, including economic strengthening, which is increasingly recognized as essential 
to overcome the inferior health conditions and socioeconomic vulnerabilities in sub-Saharan 
Africa. (5) Gender Rationale: ROADS takes a gendered approach to its interventions and 
prioritizes gender equity, increasing the access to essential services for women and men and 
increasing individual and community understanding of the related socio-cultural issues, 
including GBV, alcohol and substance use, and other behaviors increasing individual and 
community vulnerability to ill health and socioeconomic dissolution. (6) Structural Change 
Rationale: ROADS strengthens existing community structures, including CBOs and local 
10
associations, to build and maintain social networks to support health, economic development, 
food security, and healthy behavioral and social norms as well as enforce laws and provide 
legal support, where needed. (7) Globalization Rationale: An adequate supply of food 
continues to be the single greatest need in many countries in sub-Saharan Africa, especially 
among PLHIV and people affected by HIV/AIDS. That ROADS II has increased its focus on 
food supply and nutritional support through a variety of initiatives, such as the bio-intensive 
individual and community gardens, highlights its flexibility as an initiative capable of 
encompassing a wider array of development options within the present global situation of 
rising food prices based on drought in many areas. (8) Humanitarian Rationale: In several 
ROADS countries, the number of refugees, another mobile population using transport 
corridors, is increasing. Future corridor initiatives also should recognize the current or potential 
need, where relevant, to create linkages with or incorporate humanitarian-focused 
programming into the overall response and intervention mix to be able to have a greater 
positive impact on the communities and individuals served. 
In the remaining year of ROADS, it would be helpful for the program partners, the bilateral 
programs, and USAID/ EA to work together to increase the program documentation and 
disseminate more widely the program’s best practices and lessons learned, including its most 
successful management approaches, enabling USAID as a whole, other donors, and mobile 
population and community-based programs to gain from the experience of ROADS. Lastly, 
ROADS should develop a viable exit strategy to transition community initiatives over the next 
year to be more sustainable, whether or not a related or the same mechanism will continue in 
the future; and, actions taken as part of this process should be documented. 
 
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INTRODUCTION 
The ROADS II Project is a five-year LWA award funded by USAID/East Africa and bilateral 
USAID Missions in East and Southern Africa on August 1, 2008 and ending on July 31, 2013. 
This activity was a direct follow-on to the ROADS Project, whose ceiling was exceeded before 
its completion date due to significant participation from various bilateral USAID missions. 
ROADS II picked up from the mid-point of the previous ROADS Project. The midterm 
evaluation conducted in January 2008 informed the ROADS II Project design. 
In FY 2004, USAID/East Africa (EA) issued a Request for Applications for “Strengthened 
HIV/AIDS Program in the Region,” also referred to internally as the Transport Corridor 
Initiative. The proposed program was designed to reduce HIV transmission, improve care for 
people living with HIV and AIDS, and to reduce the impact of this disease on the communities 
and mobile populations along the region’s major transport corridors by harnessing the 
resources, imagination and commitment of communities and the private and public sectors. On 
August 5, 2005, USAID/EA signed Cooperative Agreement No. 623-A-00-05-00320-00 with 
FHI entitled “Technical Assistance for Strengthening USAID/EA Response to the HIV/AIDS 
epidemic in East and Central Africa.” This project was referred to as the “Regional Outreach 
Addressing AIDS through Development Strategies (ROADS I) Project” and was branded 
“SafeTStop.” 
ROADS I implemented HIV prevention and AIDS care and support services in “hot spot” 
communities linked by major transport routes across nine countries in East and Central Africa: 
Burundi, the eastern Democratic Republic of the Congo, Djibouti, Ethiopia, Kenya, Rwanda, 
South Sudan, Tanzania and Uganda. Beyond building health services and community 
mobilization structures to promote increased use of HIV/AIDS and health services, a critical 
component of the project was economic strengthening to address vulnerabilities of the local 
communities through partnership with local and international businesses called “LifeWorks.” 
The ROADS II Project, a five-year LWA award was a direct follow-on program to the ROADS 
Project. In mid-2012 the ROADS II project is operational in the following countries: Burundi, 
Djibouti, Kenya, Mozambique, Rwanda, Tanzania, Uganda, and Zambia. Countries with 
previous ROADS programming included: Democratic Republic of Congo (DRC), South 
Sudan, and Ethiopia. Led by FHI 360, the ROADS strategic partners include DAI, Howard 
University/Pharmacists and Continuing Education, Jhpiego, Johns Hopkins University/ CCP, 
North Star Alliance, PATH and Voice for Humanity. 
The Roads to a Healthy Future (ROADS II) Project Objectives: 
• Extend HIV and broader health services to underserved, most-at-risk mobile and 
community populations along the ECSA transport corridors and waterways. 
• Build the capacity of indigenous partners to design, implement and manage 
programming of their own design over the long term, in line with the GHI. 
• Identify, test and diffuse innovations throughout sub-Saharan Africa. 
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MAIN EVALUATION FINDINGS 
EXTENSION OF COVERAGE 
Program Indicator Targets: The program targets largely have been met or have been 
exceeded annually and over the life of ROADS in some cases. The following table shows the 
ROADS II results against the targets from fiscal years 2009 to 2012, including six months of 
results for FY12. 
Table 1: ROADS II Results, Targets, and Percent of Targets Achieved 2009-2012 
PEPFAR Indicators and ROADS II Results and 
Targets Reached 
FY09-FY12 
Results 
FY09-FY12 
Targets 
% Target 
Achieved 
 Number of pregnant women with known HIV status 
(includes women who were tested for HIV and received 
their results) 
185,131 214,602 86% 
 Number of PLHIV reached with a minimum package of PwP 
interventions 
26,784 57,358 47% 
 Number of the targeted population reached with individual 
and/or small group level HIV prevention interventions that 
are based on evidence and/or meet the minimum standards 
required 
3,977,392 3,968,514 100% 
 Number of MARPs reached with individual and/or small 
group level preventive interventions that are based on 
evidence and/or meet the minimum standards required 
320,532 342,242 94% 
 Number of individuals who received HTC services for HIV 
and received their test results 
700,328 768,182 91% 
 Number of eligible adults and children provided with a 
minimum of one care service 
61,289 112,504 54% 
 Number of OVC provided with a minimum of one CORE 
care service 
29,732 38,037 78% 
 Number of eligible clients who received at least 1 PLHIV 
care and support service 
46,866 51,988 90% 
 Number of people trained in FP/RH with USG funds 1,692 1,443 117% 
 Number of counseling visits for RH/FP as a result of USG 
assistance 
43,065 17,000 253% 
 Number of people who have seen or heard a specific USG￾supported FP/RH message 
108,900 133,500 82% 
The two M&E indicators where targets were exceeded were related to RH/FP which was an 
addition to the program interventions originally designed to be covered by the ROADS project. 
The targets were exceeded for the number of individuals who were trained to provide sexual 
and reproductive health/family planning services and the number of counseling sessions/visits. 
13
The indicators where the percent of targets were the lowest, with both below 70%, were PHDP 
or PwP interventions for PLHIV, a newer HIV prevention and care intervention developed over 
the last few years, and delivering core care services to eligible adults in the target areas. 
Another indicator where ROADS II did not reach the target was in delivering essential services 
to OVC where 78% of the target was met. One explanation for this may be that, in 
interventions for OVCs, the delivery of services to these children is often needed on a daily 
basis, thus involving more intensively trained staff and wider community support, as well as 
extensive resources. Whether ROADS is the best possible mechanism to provide care and 
support to OVC should be made on a case-by-case basis depending on the country, the level of 
need, available expertise, local community capacity, and the overall adequacy of resources. 
Site Coverage: The ROADS II model in its current capacity has extended HIV-related and 
other health and development services to the underserved and most-at-risk and vulnerable 
populations (MARPS) and communities along transport corridors, waterways, and in other 
locations where the project works. 
Figure 1: ROADS II Site Locations in East and Southern Africa in May 2012 
ROADS Sites 
May 2012
As a result of funding increases, ROADS II sharply increased its site coverage as shown in 
Figure 2. The number of ROADS sites increased from 30 to 50 from FY 2009 to FY 2010 and 
then stabilized in subsequent years. 
Figure 2. Total Number of ROADS Program Sites from 2006-2012 
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Resource Utilization: ROADS II has been efficient in the use of resources, as shown in Figure 
3 below. More in-depth analysis should be conducted to identify whether improvement is 
needed in linking expenditures to results-based management and/or target coverage. 
Figure 3. Growth of ROADS II Sites, Obligations and Expenditures: FY2009-FY2012
Table 2, below, summarizes the ROADS II budgets and obligations by country from the start of 
the LWA award by USAID/EA in August 2008, including the bilateral Associate awards, 
through September 2014. The list shows a vast range in commitments, varying from $100,000 
in Ethiopia for one year of programming to $25 million for five years of programming in 
Zambia, illustrating that some USAID Missions considered ROADS to be a more important 
programmatic opportunity than others. 
15
Table 2. ROADS II Budgets and Obligations Summary by Country, May 28, 2012 
USAID 
Mission 
Start Date End Date Total 
Commitment
Total 
Obligated 
Obligation 
Mortgage 
LWA Total
East Africa 1 Aug 08 31 July 13 $17,000,000 $8,301,789 $8,698,211 $183,000,000
Tanzania 6 Oct 09 30 Sep 13 $18,493,169 $10,989,741 $7,503,428 $164,506,831
Tanzania 29 Sep 08 31 Dec 09 $3,593,286 $3,593,286 $0 $160,913,545
Burundi 29 Sep 08 30 Sep 13 $15,351,804 $13,507,713 $1,844,091 $145,561,741
Rwanda 29 Sep 08 30 Sep 13 $14,900,000 $11,644,467 $3,255,533 $130,661,741
DRC 29 Sep 08 31 Dec 09 $800,000 $800,000 $0 $129,861,741
Ethiopia 30 Sep 08 31 De 09 $100,000 $100,000 $0 $129,761,741
Uganda 2 Oct 08 30 Nov 10 $4,685,000 $4,685,000 $0 $125,076,741
Sudan 21 Nov 08 31 Dec 09 $2,701,000 $2,701,000 $0 $122,375,741
Zambia 11 Sep 09 10 Sep 14 $25,000,000 $13,596,972 $11,403,028 $97,375,741 
Mozambique 1 Sep 10 31 Aug 14 $14,059,026 $6,254,387 $7,804,639 $83,316,715 
Kenya 1 Sep 10 31 Aug 14 $1,000,000 $1,000,000 $0 $82,316,715 
TOTALS $117,683,285 $77,174,355 $40,508,930 $82,316,175
Framework: The use of a consistent framework by ROADS II to focus on mobile populations 
at high risk of HIV infection across countries has provided a basis for replication of the 
program activities and has increased the sharing of innovations and best practices across the 
project sites. ROADS’ SafeTStop Resource Centers are alcohol-free and provide HIV 
prevention, counseling and testing, STI diagnosis and treatment services, linked with public 
health systems, men’s discussion groups on these topics, and road safety, alcohol abuse, men as 
partners, financial literacy, and offer satellite TV, pool, and Internet access. 
Stakeholder Collaboration: ROADS II has prioritized collaboration with a variety of 
stakeholders across sectors, including national and local government bodies, unions, clinics, 
community-based organizations (CBOs), local associations, etc., enabling wider geographic 
coverage of interventions and population groups nationally and enhancing local buy-in, thereby 
ensuring high-quality standards and increasing the possibility for sustainability. 
Alignment with USAID Initiatives: ROADS has achieved greater Programmatic Coverage 
and Alignment with USAID Forward and GHI: 
 ROADS is aligned with and foreshadowed USAID Forward and the Global Health 
Initiative (GHI) with its focus on country ownership and leadership, gender equity, and 
capacity building focusing on technical training and programmatic leadership, as well 
as financial and grants management. 
 Some 84% of the 1,296 indigenous volunteer groups that have worked through 
ROADS’ Community cluster model over the life of the project had never participated in 
a donor-funded program prior to ROADS. 
 In FY 2012, ROADS II allocated US$12,747,733 in sub-awards, with 82% ($ 
10,467,587) going directly to communities through cluster sub-agreements; and, 18% 
($2,280,147) going to international NGO (INGO) partners. 
CAPACITY STRENGTHENING
Community Involvement and Ownership: ROADS II has been largely community-driven. 
Community beneficiaries have described how the training they have received by ROADS and 
16
the related activities they have implemented have changed their mindset, providing hope for 
the future. 
Table 3, below, shows the ROADS training results achieved to date and the percentages against 
the targets. Several training areas have exceeded the targets set, including: the number of 
individuals trained to provide prevention of mother-to-child transmission (PMTCT) of HIV at 
190%; the number of individuals trained to promote HIV prevention (through abstinence and 
faithfulness messages and general prevention messaging) at 129%; the number of individuals 
trained to provide care for OVC at 104%; the number of individuals trained in collecting 
strategic information at 170%; the number of individuals trained in SRH and FP service 
provision at a whopping 225%; and, the number of individuals trained in community 
mobilization at 190%. One area where additional effort undertaken in the final project year 
could make a difference is training focusing on care of PLHIV, where the project has met less 
than 50% of its target. 
Table 3. ROADS Training Data FY2006-FY2012 
Program Area/Indicators Cumulative 
Actual 
FY06-12 
Cumulative 
Targets 
FY06-12 
 Results 
Achieved 
Against 
Targets (%) 
Number of Individuals trained in PMTCT 580 305 190% 
Number of Individuals trained to promote HIV 
prevention messages through Abstinence 
and Being Faithful (AB) 13,281 10,334 129% 
Number of Individuals trained to promote HIV 
prevention beyond AB ( MARPs/sexual 
prevention for general population) 13,521 9,291 146% 
Number of Individuals trained to provide care 
and support for PLHIV 4,784 11,240 43% 
Number of Individuals trained to provide care 
and support for OVC 2,092 2,020 104% 
Number of Individuals trained to provide HIV 
testing and counseling 1,264 1,840 69% 
Number of Individuals trained to provide ART 
services 256 n/a 
Number of Individuals trained in strategic 
information 4,604 2,710 170% 
Number of Individuals trained in stigma 
reduction 389 n/a 
Number of Individuals trained in FP/RH with 
USG funds 2030 903 225% 
Number of Individuals trained in community 
mobilization 8,824 4,640 190% 
Total Number of Individuals Trained 56,110 46,274 121% 
Furthermore, ROADS II is a robust model to instill community ownership of economic 
strengthening, forming a strong basis for financial sustainability although this area needs 
further exploration and development as time passes. The economic strengthening component of 
ROADS II was considered a major strength of the project by the Evaluation Team. Figure 4 
shows the results of the economic strengthening activities undertaken by ROADS II by through 
establishing GSLAs as of May 2012. 
17
In programming for economic strengthening, ROADS II has incorporated their lessons learned 
into new or different approaches, achieving greater programmatic effectiveness, i.e., focusing 
on GSLA rather than continuing to create some larger private sector-focused and less 
sustainable income-generating activities (IGAs) initiated by LifeWorks under ROADS I. 
Though the GSLA approach promises to continue the economic strengthening of communities, 
it remains to be seen whether health program interventions will continue to be implemented by 
communities after ROADS II ends. 
Figure 4. Group Savings and Loan Association (GSLA) Results, May 2012 
Examples of other areas in which ROADS II has increased NGO/CBO capacity through 
capacity building and the involvement of communities in identifying priorities for intervention 
support include: 
 Prevention of GBV was initiated in many communities by ROADS II. Since GBV and 
gender-focused initiatives are a prominent new and growing focus of the US 
Department of State and USAID, this is an important achievement of ROADS II, which 
should be continued as additional gender-focused funding is made available. 
 Alcohol use can be linked to GBV and the practice of high-risk behaviors related to 
HIV transmission. Consequently, alcohol and substance abuse and the related 
counseling and support groups were an intervention priority identified by communities 
and ROADS II; these programs are supported by ROADS II in three countries. 
 Magnet theatre for community and peer education on various issues has become a 
mainstay intervention approach for social and behavior change communication (SBCC) 
on health issues in many communities supported by ROADS. It is important to 
underscore this successful approach as currently the value of SBCC programming is 
being questioned internationally. Yet many ROADS II community members 
18
emphasized how important magnet theatre as a communication medium to foster social 
norm change has been to them. 
 Nutrition initiatives developed through ROADS training and support have been adopted 
by communities in several countries, strengthening individual, couples, and family 
health outcomes through bio-intensive gardening. 
GSLA member in her bio-intensive garden in Makambako, Tanzania 
 Family planning was enhanced at district hospitals and clinics in Burundi, Rwanda and 
Tanzania by training health care workers and making referrals; and, in some Rwandan 
communities, FP/RH services were initiated where Catholic clinics were not providing 
FP services. 
 Community participation has been utilized in developing relevant HIV prevention 
messages based on community identification of their specific needs and the development 
of ideas on how to make messages resonant to other community members, enhancing the 
quality of these interventions. 
 The capacity of health staff, community clusters, and peer educators to make referrals by 
developing referral systems, networks, and processes, including ‘back’ referrals. 
 Most training provided by ROADS has been fully collaborative with government, 
resulting in local capacity enhancement and increased national capacity, with greater 
likelihood of programmatic sustainability in the future. 
 The capacity of community members to gather and report data on a monthly basis has 
been built by ROADS and electronic M&E systems have been developed nationally, with 
ROADS II sites feeding data to district, provincial, and national health management 
information systems (HMIS), as well as to ROADS HQ and USAID. 
INNOVATION AND DIFFUSION 
19
The cluster model using volunteers appears to be more sustainable than using paid staff to 
manage programs or providing incentives to community members to organize and undertake 
programmatic activities, a more common development approach. 
ROADS has been effective in delivering services through the cluster model, a holistic and 
flexible approach beneficial at the individual, community, and/or national levels. While 
utilizing the community cluster model for development was an innovation in ROADS I, the 
further evolution of this participatory approach for development has enabled: 
 The integration of various program areas, including tuberculosis (TB) and malaria, 
GBV, SRH and FP, and maternal, neonatal and child health (MNCH) 
 The ability to focus on special issues identified by communities for programmatic 
attention, including alcohol and substance use 
 The destigmatization of previously marginalized community members (PLHIV and sex 
workers). 
Figure 5 shows the number of ROADS community clusters from FY 2006 to FY 2012 (to date) 
and the number of groups involved in these clusters across the same period. 
Figure 5. Community Clusters and Groups Growth from FY2006-FY2012 
The use of the cluster approach has contributed to an improved quality of life of the cluster 
members individually and at an organizational level. This unique model of development, which 
builds capacities at the grassroots level through horizontal and vertical learning processes, 
thereby utilizing immediate social networks that previously were informal and strengthening 
organizational and leadership skills to implement what formerly were ad hoc responses by 
communities to address their needs. Moreover, the cluster model has proven successful in 
mobilizing communities sustainably throughout the life of the project as the Evaluation Team 
found that all clusters formed in their respective country since project inception in 2006 were, 
for the most part, still in existence. 
Enhancing the understanding, acceptance, and inclusion of previously marginalized community 
members, such as PLHIV, into the community clusters has resulted in wider access to services 
by these community members. Moreover, in some areas they have been recognized as 
community assets, with the group and individual PLHIV no longer marginalized within the 
20
community. This example highlights how ROADS management and support for the inclusion 
of a generally marginalized group based on a highly sensitive issue into the overall community 
has benefitted the community as a whole. 
An example of the clusters formed in Rwanda in Table 4, below, shows the types created, their 
locations, and the number of individuals involved, nearly 32,000 in 5 provinces. 
Table 4: Community Clusters by Site in Rwanda, March 2012 
Sites # of organizations/groups involved
Cluster LIW Youth PLHIV Union Fishers Church Total 
Kigali 3 22 15 30 24 0 0 91
Gatuna 3 127 51 13 0 0 1 192
Rubavu 4 4 1 30 0 7 0 42
Bugarama 3 16 19 11 0 0 0 46
Rusizi 4 22 14 20 0 9 0 65
17 191 100 104 24 16 1 436
# Members 9,054 8,048 5,743 7,881 1,178 4 31,908
A total of 60 community cluster steering committees (representing community memberships, 
including many women) have driven decision-making on programming US$10,467,587 in 
USAID funding, with ROADS providing the technical support to the clusters. 
Partnerships: Partnerships with a variety of stakeholders, including various levels of 
government, faith-based, gender-based, age-based and work-based networks and community￾based organizations, have played a key role in the success of the ROADS project. In Djibouti, 
ROADS has established an important partnership with the Government of Djibouti, USAID, 
and Dubai Ports (DP) World, which manages the Port of Djibouti. The port serves as sea access 
for Ethiopia, with some 1,000 trucks from Ethiopia passing through each day, transporting 
goods from Addis Ababa to and from the port, and supporting workers from Djibouti, Ethiopia, 
Somalia, and other countries. The alliance is the first of its kind in Djibouti, formed to protect 
the health of these workers and their families through the establishment of a SafeTStop 
Community Center. This partnership is now serving as a model for other ports such as 
Maputo, Mozambique and Dakar, Senegal. 
21
Figure 6: Djibouti USAID-Dubai Ports World-FHI 360/ROADS Partnership 
HIV PREVENTION
Medical male circumcision (MMC): MCC, an HIV prevention strategy that has been 
incorporated into the ROADS programming through the transport corridor project in Zambia, 
This is shown in Figure 7, below, which outlines the way in which MMC is incorporated into a 
large portfolio of interventions and best practices in Zambia. This MMC programming may 
serve as a model for replication in other countries. 
Figure 7: Innovations and Best Practices by Corridors of Hope III in Zambia 
Behavior Change Communication (BCC): For BCC messaging ROADS II in Kenya initiated 
a collaborative process with the National AIDS Control Council (NACC), the Ministry of 
Health (MOH)/National AIDS & STI Control Programme (NASCOP), and USAID-funded 
AIDS, Population and Integrated Health Assistance (APHIAplus) implementing partners to 
develop messages on the topics identified by target group members related to risk behaviors 
forHIV transmission, including: unprotected sex, fear of HIV testing and counseling (HTC), 
practicing anal sex without using condoms or appropriate lubricant, using alcohol and drugs, 
and, having multiple and concurrent sex partners (MCP). 
The messages were pretested at two ROADS sites, including Malaba and Mariakani, and at two 
non-ROADS sites, Machakos Junction and Salgaa, and were approved by the MOH, 
Department of Health Promotion, NASCOP and the NACC prior to dissemination. ROADS 
trained the APHIAplus partners to disseminate the messages and built their capacity to develop 
their own contextual messages in the future. Figure 8, below, shows two messages developed 
• DP World demonstrates long-term commitment to the health development
 of its host countries.
• Establishing a SafeTStop Community Center near the port:
 DP World: contributing US$100,000 to establish the Center
 USAID: funding technical and management support through ROADS
 FHI 360: preparing site for construction 
 Government of Djibouti: providing health care workers; will take on full 
management within 2 years
• Offer an array of health and social services:
 Malaria, TB, respiratory infections, first aid, HIV education, counseling and 
testing, linkages to other health and social services
 Training for personal and professional development (e.g., language classes, 
computer literacy)
 Recreation (e.g., satellite TV, billiards)
• ROADS partners adapting model at ports of Maputo, Mozambique, and Dakar, Senegal.
 Quality improvement for referral system for ART in Livingstone, Kazungula and 
Kapiri Mposhi sites
 Training and involvement of volunteer lay counselors to provide psycho-social 
counseling 
 Design and implementation of Community Radio Programs in partnership with 
communities
 Introduction of door-to-door HTC
 Integration of FP/RH services in HTC service delivery
 Incorporation of male circumcision at selected COH sites through partnership with 
Society for Family Health 
22
collaboratively by ROADS in Kenya, highlighting innovative and relevant BCC messages for 
the African context, promoting awareness of HIV transmission through anal sex, a very high￾risk behavior for HIV and a culturally sensitive topic, and alcohol use. 
Figure 8: BCC Materials Developed by ROADS in Kenya on Alcohol Use and Anal Sex 
Gender Equality: A total of 441 (51%) of the cluster steering committee members (867) are 
women, indicating equitable decision-making in ROADS II program design and 
implementation and highlighting women’s leadership. This is a real achievement by ROADS 
focusing not only on gender inclusion, but on gender equality as many communities in sub￾Saharan Africa still engage with each other using a patriarchal and hierarchical structure, 
positioning men in most of the leadership roles. 
ADMINISTRATION AND MANAGEMENT 
The LWA award is a robust and flexible model for a regional program, enabling USAID 
Missions to buy into a high-quality program crossing borders and fostering community health 
and economic development. Although the LWA model of ROADS has been acknowledged as a 
substantial value-added mechanism in most countries, it has not been integrated into every 
bilateral program where it started. Figure 9, below, shows the extent of the bilateral buy-ins on 
an annual basis. 
Monitoring and Evaluation (M&E): ROADS II has developed a state-of-the-art M&E 
system, effective in tracking project results on the community, district, provincial, and national 
levels with future plans for additional improvements to their national M&E systems in 
countries and the project’s M&E system and databases. An unusual aspect of ROADS’ M&E 
system is the emphasis on data capturing by community-level data collectors, who, after 
training, have appreciated their new and important roles, becoming engaged with the process 
and involved with achieving the programmatic results. 
23
Figure 9. ROADS LWA Bilateral Mission Buy-ins FY2006-FY2012 
Decentralization: The LWA award model has worked well after the ROADS country teams 
were decentralized from ROADS HQ in Nairobi. The results have included the strengthening 
of partnerships with government and local organizations, resulting in stronger national and 
local responses to the health and development needs on the ground in countries, and increased 
communication across countries, and with USAID regionally and bilaterally. 
Leadership: The management structure of ROADS II is strong and has provided adequate 
leadership across countries, using mostly African and local expertise in management and 
technical areas. See the ROADS II management organogram on page 47 showing the changes 
made by ROADS based on the recommendations made by the Evaluation Team in 2008. 
In addition, some 97% of the ROADS II staff of 184 people in the country programs are 
national staff. Of the 3% of ROADS II staff who are not national staff, one-half are African, 
including the former Rwandan Country Manager in Tanzania; a Rwandan Country Manager in 
Burundi; and, the Kenyan STO/BCC officer in Mozambique. Consequently, while the 
multinational ROADS project is managed by a US-based non-governmental organization, FHI 
360, the program is managed on the ground largely by Africans for Africans, embodying GHI 
and USAID Forward principles. Furthermore, some 94% of all the technical assistance 
provided through ROADS II is South-South, an important management decision and direction 
taken by ROADS management, which also is a growing focus for USAID. 
Program Integration: ROADS II serves as a model for program integration by integrating 
new or additional HIV prevention and other health and development program areas Figure 10, 
below, displays the linkages of various contextual issues and behaviors and emphasizes why 
program integration is so important to enhance and deliver much-needed services and to 
foment understanding of the need for individual, couples, and community behavior change and 
the adoption of healthier social norms. 
4.50 2.80 2.30 1.90 2.50 2 1.80
3.80
4.80
9.40
15.30
16.40
19.5 21.20
0.00
5.00
10.00
15.00
20.00
25.00
2006 2007 2008 2009 2010 2011 2012
US$ millions by fiscal year
Associate Award
(Bilateral Mission)
24
Figure 10. ROADS Conception of the Linkages among Contextual Issues, High-Risk 
Behaviors, and Individual, Familial, and Societal Impacts 
*Evidence in ROADS sites indicates that girl children rarely "drop" out of school of their own 
accord, but rather are "pulled" out of school by parents/guardians, often for economic or 
gender-related reasons. 
Table 5 shows the ROADS II MNCH results in Rwanda, one of many programmatic foci by 
ROADS. In Rwanda, ROADS has had a direct impact on strengthening MNCH programs in 
the country through a combination of increasing the related services delivered and the training 
provided by as much as eight-fold or more. As illustrated in the table, ROADS has succeeded 
in overall program management, training provision, and technical service delivery of the 
MNCH program through program integrations. 
Ensuring these programs are not only integrated with one another, but with the greater service 
provider networker, has also proven successful. Establishing local clinics providing FP 
services where they previously have been unavailable or adding these services to existing 
clinics has filled a much-needed service gap, which has benefitted many women, adolescent 
girls, families, and PLHIV in these communities. ROADS was lauded by nursing staff and 
community members at one of the new community clinics visited by the Evaluation Team in 
Rwanda, both for initiating the service and the management finesse shown in gaining the 
acceptance of the new clinic in the area by the older, more established clinics unable to provide 
family planning services. 
25
Table 5. ROADS Maternal, Neonatal and Child Health (MNCH) Achievements in Rwanda 
District # New ANC visits
at facility
# of 4 standard
ANC visits
# people trained
in MNCH
# deliveries by
SBA
# children < 12
months received
DPT3
# children < 5
received Vitamin A
Before Current Before Current Before Current Before Current Before Current Before Current
GASABO NA NA NA NA NA NA NA NA NA 457 NA 69
GICUMBI 316 1,183 20 44 0 2 197 681 543 1,022 62 7,199
KICUKIRO NA NA NA NA NA NA NA NA NA NA NA NA
RUBAVU 2,724 3,065 841 1,111 0 0 1,880 1,894 3,213 3,457 652 13,175
RUSIZI 3,686 8,979 465 3,686 0 8 2,087 5,029 1,801 10,450 913 38,429
Total 6,726 13,227 1,326 4,841 0 10 4,164 7,604 5,557 15,386 1,627 58,872
Another success of program integration lies in Burundi, where pregnant women testing HIV￾positive are initiated on ART for life, unlike many other countries, and as a ‘PMTCT plus’ 
country, a package of HIV prevention, treatment, care, and support interventions is provided to 
mothers, their children, and their families. When ROADS started in Burundi, only 14 PMTCT 
sites existed; yet by 2011 PMTCT services were offered at 82 health facilities, with 17 newly 
launched. Officials lauded ROADS for their management and capacity building of the 
government’s PMTCT teams, the Burundi Ministry of Health’s (MOH) main priority. Within 
its PMTCT minimum package in Burundi, ROADS provides preventive therapy using 
cotrimoxazole to infants exposed to HIV, with achievements shown below11. 
Figure 11. ROADS Results in Burundi Showing Cotrimoxazole Prophylaxis Management 
# of people who on cotrimoxazole prophylaxis:
2006‐2012
1,130
2,041
3,606
4,972
6,210
8,105
9,525
0
2,000
4,000
6,000
8,000
10,000
12,000
2006 2007 2008 2009 2010 2011 2012
Individuals on cotrimoxazole
Program integration reaches beyond health to such areas as economic strengthening, which has, 
in an initiative focused primarily on health, and even more narrowly HIV/AIDS, has enhanced 
26
the asset value of ROADS II programs within communities, making them more appreciated 
and locally sustainable as well as strengthening health programs themselves. 
“Estradas” (ROADS) Project Youth Cluster member in Munhava, Mozambique 
LESSONS LEARNED 
27
Organization, Networking and Planning 
 Long-term Planning: Comprehensive programming requires strong country leadership 
and planned technical support, which should be flexible to enable evolution as needs 
change. Comprehensive programs are likely to show little impact with funding for only 
one or two years. 
 Government Involvement: Government engagement and ownership works best when 
ideas and initiatives begin at the community level rather than through external program 
initiation. In addition, strong community commitment and government support and 
coordination at the local level is key, e.g., holding quarterly review team meetings with all 
implementing partners (IPs). 
 Partner Networks: Establishing strong networks with local implementing partners, 
including government agencies, NGOs, CBOs, and community clusters is essential not 
only for comprehensive program implementation and coverage, but also for state-of-the-art 
training provision and necessary refresher training using locally adapted materials 
translated into the common local languages, and for overall initiative sustainability in the 
future. 
 Creative Partnerships: Bringing ‘non-traditional’ program partners together adds 
creativity and dynamism to programming, including peer education through cross-training 
and the design and development of resonant social and behavior change communication 
(SBCC) messaging. 
 Organization of Key Groups: Through the cluster approach, the anchor organization that 
is elected by the different cluster organizations as the cluster network center facilitates a 
Steering Committee with representatives from each organization. Selected members from 
each organization are trained to build the capacity of their other members in their 
communities. Taking this approach has worked very well for ROADS, one of its most 
important programmatic features that should be continued and replicated in the future. 
 Social Networks: Using the immediate social networks (ISNs) in addition to the classic 
peer education model and the ongoing peer education provided by CBOs and community 
clusters has resulted in reaching out to people who were not initially targeted, increasing 
program coverage. The ISN channel has proved to make learning more retentive as the 
learners, in turn, become coaches and mentors to those in their own ISN. 
28
Truck drivers and their assistants discuss their programming needs and issues while 
awaiting government clearance at a SafeTStop Centre in Rusizi, Rwanda. 
Program Approaches 
 Branding: The ROADS branding of the SafeTStop Resource Centers has been critical to 
the establishment of these dedicated health provision, information dissemination, meeting 
place and leisure facilities catering to transport workers, other mobile population members, 
and local communities. Moreover, the SafeTStop branding across national borders has 
enabled international recognition of these sites as safe havens and rest stops for mobile 
populations as well as community HIV/STI/alcohol prevention centers. 
 Training: The shift by ROADS from classroom training to mentoring and coaching gave 
more favorable learning results as it is more participatory and encourages creativity and 
initiative within the community. Utilizing both cascade and horizontal learning approaches 
provides quicker and longer-lasting impact. 
 Strategies for Involving Youth: Young people are responsive to music and theatre as a 
way of awareness rising. More ideas need to be sought on innovative strategies that will be 
attractive to youth to build greater awareness of sexual and reproductive health issues, 
including HIV and STI prevention. 
 Information Dissemination: Information dissemination is crucial so that good practices 
and innovations can be shared and replicated, or refined, so that each project does not have 
to build from scratch using trial-and-error approaches. 
29
Peer educators interact at a SafeTStop Centre in Tunduma, Tanzania 
 Motivation: Some households have moved up on the economic ladder through GSLAs. 
They advanced from households previously unable to respond positively to any external 
shock without reducing their levels of consumption, to households that had developed a 
financial safety net and were able to level out consumption peaks and troughs. This change 
provided encouragement for moving towards greater levels of risk management in their 
economic decision-making. Members reported feeling more confident in their economic 
future than their neighbors who had not formed a GSLA. Moreover, confidence is a key 
motivator for future investment to provide income growth opportunities. Another GSLA 
cluster of HIV post-test club members had improved their health status due to better 
nutritional and financial security, and they were thrilled with the contribution of the 
project. 
 
30
CONCLUSIONS AND RECOMMENDATIONS 
Conclusions 
Continuing the regional concept of the ROADS model over the next five years will serve to 
advantage nationally in most countries and result in continuing regional impact. The rationales 
for continuing this important multisectoral and multidimensional health and development 
initiative in the medium term include the following: 
 Public Health Rationale: ROADS target groups are at the highest risk of HIV infection 
and for onward transmission of HIV/STIs nationally and internationally. 
 Human Rights Rationale: ROADS target groups remain underserved by all health 
services, and these groups are generally socially marginalized and stigmatized. 
 GHI Rationale: The ROADS approach is the GHI approach, encompassing HIV/STI, TB, 
malaria, MNCH, SRH and FP as an integrated program under one umbrella, which has 
adaptable intervention priorities based on the programmatic flexibility to address the local 
needs, as well as build local ownership by communities and a more intensive focus on 
capacity building and sustainability. 
 Sustainable Development Rationale: ROADS uses a holistic development framework for 
programming including economic strengthening, which is increasingly recognized as 
essential to overcome the inferior health conditions and socioeconomic vulnerabilities in 
sub-Saharan African countries. 
 Gender Rationale: ROADS takes a gendered approach to its interventions, including 
gender equity, increasing the access to essential services for women and men and 
increasing individual and community understanding of the related socio-cultural issues, 
including GBV, alcohol and substance use, and other behaviors increasing individual and 
community vulnerability to ill health and socioeconomic dissolution. 
 Structural Change Rationale: ROADS strengthens existing community structures, 
including CBOs and local associations, to build and maintain social networks to support 
health, economic development, food security, and healthy behavioral and social norms as 
well as enforce laws and provide legal support, where needed. The lack of addressing the 
relevant structural obstacles and issues remains a major impediment to increasing HIV 
prevention practices and gender equality and decreasing poverty in sub-Saharan Africa. 
 Globalization Rationale: In 2012 food prices are rising because of serious drought in 
many locations, having a direct impact on the availability of staple crops. Food supplies 
may become less secure in the foreseeable future based on this situation. Moreover, an 
adequate supply of food continues to be the single greatest need in many countries in sub￾Saharan Africa, especially among PLHIV and people affected by HIV/AIDS. That 
ROADS II has increased its focus on food supply and nutritional support through a variety 
of initiatives, such as the bio-intensive individual and community gardens, highlights its 
flexibility as an initiative capable of encompassing a wider array of development options 
in partnership with other entities―governments, non-governmental and community-based 
31
organizations, and the private sector―depending on the needs locally, provincially, 
nationally, or regionally. 
 Humanitarian Rationale: In several of the ROADS countries, the number of refugees, 
another mobile population using transport corridors, is increasing. Future corridor 
initiatives also should recognize the current or potential need, where relevant, to create 
linkages with or incorporate humanitarian-focused programming into the overall response 
and intervention mix to be able to have a greater impact on the communities 
served―whether they are local community members or mobile individuals, families, and 
groups transiting program areas for political or economic reasons, or to access basic 
human needs and services for survival. 
Recommendations 
Continuation in Programming 
 ROADS has successfully integrated various components into the project. Whereas HIV 
prevention, care, and support are the main foci of the project, ROADS has successfully 
managed to add supportive strategies such as economic strengthening through 
formation of GSLAs, FP, MNCH care, and addressing social problems, such as alcohol 
and substance abuse and GBV that contribute to risk behaviors and HIV transmission. 
It is important to continue this wide ‘umbrella’ approach in the future as conditions on 
the ground evolve re: specific intervention needs and HIV prevention and other 
interventions also evolve. 
 The use of the cluster model as a vehicle to respond to shifting priorities in HIV 
prevention, e.g., MMC, or for provision of ART refills at SafeTStop Resource Centers, 
or to incorporate new program areas such as MNCH, SRH and FP, GBV, and alcohol 
and substance abuse counseling not only can mobilize communities to design and plan 
community responses, but also increase awareness and create demand for greater 
service utilization. 
 The use of GSLAs as a cost-effective development foundation is promising for long￾term efforts to establish economic resilience and move towards income growth. The 
GSLAs also can be expanded and improved. They have been shown to make a 
difference in the lives and livelihoods of individuals and communities by fostering 
economic growth and helping to reduce the stigma associated with poverty or ill health. 
Of particular interest to the Evaluation Team was that the GSLA mechanism for 
economic strengthening has led to considerable reduction in the stigma associated with 
one’s HIV status for PLHIV involved in GSLAs in rural Rwanda. Thus the approach 
appears to be an entry point worth trying in other locations in sub-Saharan Africa to 
lessen stigma toward and discrimination against PLHIV, which exists more or less 
worldwide, and its more central positive outcomes of community mobilization, 
partnership, economic strengthening, and self-reliance. 
 The approach taken by ROADS ensures that entry into a GSLA is accomplished 
through self-selection of like-minded persons, who are known and trusted to be safe 
savers and who are reliable. Thus a member’s identity is less connected with the 
person’s association to the HIV prevention or other program element and based more 
32
on the mutual desire for economic self-reliance and sharing information on sustainable 
economic activities. 
 The horizontal and vertical learning processes used by ROADS have the potential to 
build capacity at the grassroots level and can be adopted as a capacity strengthening 
approach to use in the project activities where relevant. In terms of sustainability, the 
economic strengthening approach used by ROADS is developing lower-cost delivery 
approaches, positioning the provision of training and mentoring within the environment 
of the learner, rather than venue-based traditional classroom teaching. The horizontal 
approach of encouraging GSLA members to share their own best practices, identify 
additional good practices in their own communities, and learn from each other not only 
promotes ownership and reduces the reliance on external ‘experts,’ but builds 
sustainability of the knowledge transfer process and the initiative itself. At the same 
time, ROADS II has recognized that some specific and carefully focused technical 
support is still required to build on local knowledge as it develops and to introduce new 
thinking and techniques where appropriate. This mix of vertical and horizontal learning 
is a key strength of ROADS. 
Future Shifts in Programming 
 The use of communication technology (text messaging on cell phones) will strengthen 
the communication links between mobile men and their families and could be used to 
engage with youth creatively regarding youth-focused programs. Cell phones already 
are used in a few countries in Africa to share treatment information with healthcare 
providers, including updates on drug side-effects, the latest protocols to follow, and 
individual patient information on a confidential basis after implementing an ‘informed 
consent’ process with the patient. Using this type of technology, as well as networked 
laptops, with mobile population group members for healthcare access is not new. 
However, it generally has been implemented on a local or national basis, where it is 
available, and the technological configurations should be analyzed as potentially very 
important cross-border tools. 
 The pharmacy component of ROADS appears not to be an integral aspect of the 
program; it may be better suited to provision by government, or a health-system 
strengthening mechanism, depending on the location and the existing local capacity and 
resource availability. 
 There should be a focus in the future on a regional policy initiative in conjunction with 
a corridor program, using a regional body to initiate or change related policies with 
additional support and advocacy from the regional health community and NGOs. 
Monitoring and Evaluation 
 A number of studies are being undertaken during the current project to document the 
impact of the project. These studies include the study of cost-effectiveness of activities, 
the impact of economic strengthening activities on sexual behavior and health status, 
the study of the community cluster model, and population size estimations of ROADS 
target groups for coverage percentage determinations. Such studies should be continued 
as they provide information useful not only to this project, but also provide much￾needed information for other programs nationally and internationally. 
33
 The ROADS approach using volunteers rather than paid staff theoretically should result 
in a cost-effective program. Yet the upcoming study on the cost-effectiveness of 
ROADS across program areas, taking into account that costs differ by location and 
other relevant factors affecting costs, will be able to make a more comprehensive 
determination on cost effectiveness than achievable through this program evaluation. 
‘Cost-effectiveness’ determinations involve a wide range of issues. For example, if 
using volunteers is unsustainable, such an approach will not be a cost-effective 
approach over the long term―if a programmatic objective is to build the capacity of 
communities to sustain programs on their own in the future. 
 Regional programs that cross national boundaries must be flexible and adapt to specific 
country contexts, targeting the highest priority needs in the country or the regions of the 
country where the program will be operational. Not only should there be a situational 
analysis conducted to determine the greatest needs and the current response, but 
baseline data should be collected to be able to gauge appropriate M&E annual and life￾of-program targets, specific and measurable indicators, and establish a results-based 
management approach using systematic M&E design and implementation methodology 
including the capacity to measure change. 
 In the remaining year of ROADS, it would be helpful for the program partners, the 
bilateral programs and USAID/EA to work together to increase the program 
documentation and disseminate more widely the program’s best practices and lessons 
learned, enabling other donors and mobile population and community-based programs 
to gain from the experience of ROADS. 
An evaluation should be conducted two years after ROADS ends on the impact of the 
program in building the capacity of communities to continue the various intervention 
areas without external support and a determination made of the reasons why or why not 
the continuation of specific interventions was possible. 
Sustainability
 Where the decision needs to be made between intensifying current programmatic 
coverage versus adding more sites before the end of ROADS II or transitioning to a 
potential ROADS III, the determination should be made based on potential epidemic 
impact, prioritizing both locations and interventions based on the need for either 
increased geographic coverage or a more intensified response at existing sites. 
 ROADS should develop a viable exit strategy to transition community initiatives over 
the next year to be more sustainable, whether or not a related or the same mechanism 
will continue in the future; actions taken as part of this process should be documented. 
 The unique sustainability aspects of ROADS II can be replicated: the economic 
strengthening components all have sustainability elements, including financial, 
manpower, and organizational structure. These components mobilize domestic 
resources; rely on local capacity development and volunteerism, and the cluster model 
shows substantial resilience for enhancing community leadership and fostering new 
community initiatives. The three aspects working together increase the chances of 
sustainability, which needs further review and contextual exploration. 
34
Community Cluster meeting in Kayanza, Burundi 
Low-income women’s group in Kamambe, Rwanda 
35
Youth Cluster dancers, Munhava, Mozambique 
ECONOMIC STRENGTHENING 
Of all the ROADS II interventions reviewed and visited, the Evaluation Team was most 
impressed with the economic strengthening component and the approach used. Thus this 
special section of the evaluation report specifically highlights this intervention approach as an 
example to adapt and replicate in the future. The ROADS II economic strengthening approach 
provides a foundation for building the internal capacity of individuals, households, and 
communities to build, strengthen, and maintain their livelihoods through entrepreneurial 
activities, resulting in better individual and community health outcomes, including a stronger 
focus on the need for HIV/STI, malaria, and TB prevention, as well as less socioeconomic 
vulnerability. 
ROADS II rightly has made the improvements in economic status of the household as one of 
the key areas of its work. Secondly, the project has responded to some key recommendations of 
the evaluation in 2008 relating to the strategic direction of any economic strengthening 
component of the project. These activities have been innovative and effective in terms of 
impact, and they have been organized and implemented with cost-consciousness to ensure 
sustainability. The following information summarizes the approach of ROADS II to economic 
strengthening, the participants, geographical coverage and key activities, describes the status of 
the economic activities and provides comments on them. 
Approach: The project follows PEPFAR guidelines for economic strengthening. It lays down 
a pathway where households move from activities that decrease their vulnerability to those that 
improve quality of life and contribute to economic growth. Thus, the project has three 
components of economic strengthening: 
 Developing a financial safety net: mobilizing internal funding, developing social 
capital and governance and promoting savings discipline through the formation of 
savings and loan groups 
 Undertaking household production for consumption and the local market 
 Expanding production for the commercial market. 
36
ROADS II undertakes the assessment of household vulnerabilities based on 65 question tools 
to determine the kind of activities required to improve the economic status. Development 
Alternatives Inc (DAI) and FHI 360 provide technical assistance to the local implementing 
partners in implementing economic strengthening activities. 
ROADS has a well-defined strategic framework for economic strengthening (ES), which offers 
a portfolio of interventions reflecting differing levels of household economic vulnerability 
among participants, as well as their differing capacities to manage risk, and move towards 
income growth. 
The implementation approaches vary in different countries, from direct implementation by FHI 
360 technical officers (Tanzania); capacity building of national implementing partners 
(Zambia); and, capacity building of site-level local implementing partners (Rwanda and 
Mozambique). In all the countries where ES programming is evident, ROADS is shifting to 
more capacity building of implementing partners and away from direct implementation. The 
ROADS technical officers carry out regular monitoring and supervision of IP staff and conduct 
rapid evaluation and program reviews at 
community and household level.
The main participants are: 
 Low-income women (LIW) 
 Youth (18-24) 
 Orphan and vulnerable children caregivers 
 Sex workers 
 Fishermen 
 People living with HIV/AIDS (PLHIV) 
 Men 
Men’s Cluster, Beira, Mozambique 
Community clusters based on the groupings mentioned above provide the platform for 
organizing economic activities. Economic activities are cross-cutting as they draw on members 
from different clusters on the basis of their interest in economic activities. For example, 
ROADS II Provides assistance to HIV/AIDS‐
affected individuals and households focusing on
strengthening the conditions that underlie
coping strategies, particularly:
 Level of savings
 Access to and availability of food
 Diversity of income
 Volume of income
37
members engaged in savings and loan or other economic activities may belong to multiple 
clusters such as PLHIV, low income women, or sex workers. 
Geographic Coverage: ROADS II has economic strengthening activities in four of the 
countries. In Kenya the economic strengthening activities started in Mariakani under ROADS I 
are continuing with technical assistance from ROADS. The Burundi program is focused 
mainly on clinical service provision augmented by HIV prevention and community support 
activities. Djibouti does not have an economic strengthening program yet, but it is under 
discussion. Uganda benefitted from limited ES interventions under ROADS 1, which were not 
included in the reduced ROADS II award for Uganda. The ES work in Mozambique is still 
developing and shows promise so far. The economic strengthening sites in four countries are 
listed below in Table 6. 
Table 6. ROADS Economic Strengthening Activities by Country and Location 
Rwanda Tanzania Zambia Mozambique 
Kigali Kahama Chipata Beira 
Rusizi Makambako Solwezi 
Bugarama Tunduma Kapiri-Mposhi 
Rubavu Port of Dar Livingston
Gatuna Kazungula 
 Nakonde 
 Chirundu 
ROADS conducts a Household Economic Assessment at sites prior to implementation, using a 
fixed choice questionnaire on the key aspects of the household income sources, asset levels, 
experience of hunger, access to savings and credit, access to farm land and utilization of that 
land, and access to health and education services. Focus group discussions on these issues build 
a more complete picture of the economic profile of ROADS beneficiaries. There are no data to 
determine population coverage at the site level. 
Activities: Based on the PEPFAR guidelines stressing an ‘economic pathway’ approach to 
developing household economic resilience, the three main activities mentioned below range 
from simple saving mobilization to expanding businesses on a large scale: 
 
 Formation of Group Savings and Loan Associations (GSLAs) 
 Small businesses start-up 
 Expansion of businesses on a commercial scale. 
The details of each of these activities are summarized below: 
 Mobilizing Financial Safety Nets through Savings ROADS’ support specifically focuses on 
empowering beneficiaries and their families to build group savings-based safety nets in 
partnership with trusted friends and relatives. The GSLAs are the focal point for all FHI 360 
economic livelihoods programs and the hub for the majority of all community-level economic 
discussions and capacity building. Access to training and advanced levels of technical support 
depend on the commitment of the GSLA members to form and effectively manage their GSLA 
group. Using an adaptation of an international standard manual developed by VSL Associates, 
ROADS trains focal persons from implementing partners in the methodology. After training, 
the trained focal persons provide a modular training course to groups of between 15 and 30 
people, meeting within the household environment rather than through venue-based training. 
The training program includes governance, record-keeping, and managing savings and loans 
procedures. The ROADS technical officers thereafter support the focal persons to collect 
38
financial data and to analyze the financial performance on each group, as well as to monitor 
individual groups’ adherence to the agreed procedures. 
Considerable progress has been made in the formation and sustaining of GSLAs especially 
during the last two years in four countries as shown in Table 7: 
Table 7. GSLA Results in Mozambique, Rwanda, Tanzania and Zambia 
Category Mozambique Rwanda Tanzania Zambia Total 
Number of GSLAs 10 134 96 49 289 
Number of Members 216 2,936 1,743 905 5,800 
Savings $ 10,495 124,498 38,711 17,359 183,746
Value of Outstanding 
Loans $ 
n/a 39,428 34,694 10,042 84,164 
Loans 135 1,246 855 264 2,365 
GSLAs started in Tanzania in April 2010; in Zambia in February 2011; and, in Rwanda in May 
2011. They have started more recently in Mozambique. 
GSLA meeting, Bugarama, Rwanda
 Maximizing Household Production: By instilling a performance-based culture into 
programming, ROADS provides both direct technical support in the areas of common 
economic activity, including small plot horticulture, small livestock, and small business 
/income generating activities (IGAs) to GSLA members who are adhering to their group 
processes, saving regularly, and utilizing loans with appropriate repayment. 
ROADS uses standard adult-learning approaches that ensure short repeated learning opportunities 
based within the environment of the learner, rather than through classroom-based ‘top-down’ 
teaching. Consequently, ROADS encourages the trainees to make the best use of the assets 
39
available to each of them. This approach is a vital precursor to more income growth-oriented 
activities. Through the use of modified best practices in behavior change and peer education, the 
cluster members learn skills on how to engage in livelihoods-focused community dialogues, 
emphasizing the values of peer accountability to adopt productive behaviors for stabilizing and 
expanding food security and household resilience. Most importantly, the households learn how to 
identify and better utilize their household surplus, their savings and their assets to improve land, 
care for livestock and engage in petty trading outputs. Once the GSLA is consolidated and 
functioning smoothly, ROADS provides additional technical assistance on more advanced 
foundation economic livelihoods areas. 
 Increasing Market Readiness: As production improves and households consider more 
advanced commercial activities, ROADS provides technical support to help interested and 
motivated project beneficiaries gain skills in business initiation (through the concepts of market 
dynamics and the analysis of commercial risk) and prepare, plan, and improve their access to 
local markets. Although only some of ROADS’ beneficiaries will be able or wish to participate 
in more market-oriented commercial activities, it is important that clusters learn the basic skills 
and knowledge to allow them to make solid commercial choices. 
 The GSLAs have contributed to accessing informal financial services: In all the 
discussions with the stakeholders mentioned above, the Evaluation Team members received 
a clear and unanimous message that the GSLAs are fulfilling a useful function by providing 
internally sourced access to credit for economic activities by and stronger financial security 
for vulnerable populations. Thus the GSLAs contribute to the long-term goal of lifting 
these community members out of poverty. Most of the GSLA members had access to 
financial services for the first time through the formation of a GSLA. Further, the GSLA 
approach introduced the orientation of developing a savings discipline, a key behavior 
change necessary for subsequent movement towards income growth. The GSLAs also 
equip individuals to understand and access formal microfinance and/or banking systems 
where they exist locally. 
The GSLAs have been the main source for funding businesses by the members of GSLAs. The 
anchor or coordinator provides guidance to the members on organizing income-generating 
activities (see examples in the section on businesses). 
A critical component of the GSLA methodology is its accountability to all the GSLA members 
and the transparency of record-keeping. On a visit made by the Evaluation Team to a Youth 
Cluster steering committee in Kigali, the anchor organization president said, “When we started 
the GSLA some of the members were skeptical. Now that we have closed the first phase, there 
is such high demand [to become members] by the whole general population.” 
Mobilizing Savings: Impoverished community members, including unemployed youth, low 
income women, sex workers, and others are saving and borrowing money as part of GSLAs. 
The ROADS II experience shows that even impoverished people can save some amount of 
money if proper mechanisms are available. Thus, GSLAs can be an important source of 
mobilizing domestic savings and reducing dependence on outside assistance. In addition to the 
focus on savings, the GSLAs have inculcated a culture of asset-building. 
In the FSW group in Rusizi, Rwanda, the 25 members started by contributing as little as $0.3 
per person. At the time of the evaluation, the minimum individual savings total was reported to 
be USD$36.70, while the maximum individual savings total was $78.50. The PLHIV GSLA in 
Bugamara, Rwanda, reported their savings for one year, which totaled $349, and they had 
made loans to 12 members, each borrowing $25 at an interest rate of 15%, from which these 
40
individuals had started their own small and growing businesses. The GSLA members apply for 
a loan, discuss the purpose of the loan with the other GSLA members, and are subject to a 
review of any previous loans and repayment history by their peers before any new loan is 
issued. The Evaluation Team learned that non-PLHIV community members wanted to join the 
PLHIV GSLA because it was thriving. Thus the success of the PLHIV GSLA had lessened the 
usual stigmatization and discrimination by the community toward PLHIV. 
Introducing Democracy, Transparency and Accountability at the Grassroots Level: The 
GSLAs, which have between 15 and 30 members, are organized and run democratically, with a 
governance structure and the use of transparent procedures. The GSLA members can be sex 
workers, PLHIV, or unemployed youth, etc. A key aspect is the self-selection, whereby 
members join the GSLA after a personal self-assessment for suitability and the selection of 
other members with which to save. Thus one’s HIV-status or other identity becomes secondary 
to the identity of a saver/loanee, reducing both stigma and organizational hierarchy and 
fostering equality. 
Every month the accounts are discussed with the GSLA members and their views are taken into 
account for improving the system. The cash is put in a box with three persons holding separate 
keys, ensuring that the money cannot be accessed easily by any individual. The procedures for 
dealing with default or inadequate meeting attendance of members also are in place. Part of the 
savings plan is a social welfare contribution to cater for emergencies and death. 
In Makambako, Tanzania, the Evaluation Team visited a GSLA that was sharing their funds 
after a completing their savings cycle, which lasts from 9 to 12 months as decided by the 
members. The members agree individually whether to start another savings cycle or to 
withdraw from the group. The current GSLA evidence from ROADS shows a retention rate of 
more than 95%, indicating a sustainable demand for the financial services offered within the 
groups. In Makambako, the GSLA members sat in a circle and referred to a common sheet of 
paper with the summary of each individual’s savings and loans through the year. A member’s 
name would be called, and s/he would go to receive their money at the center of the circle 
where the cash box was placed and the three key holders sat. When receiving his or her money, 
each member would tick the summary sheet; and, the savings and loans booklet of each 
respective member would be updated accordingly. 
Promoting and Sustaining Volunteerism: The functioning of GSLAs is based on 
volunteering by members of the group. The members have a sense of shared goals and purpose, 
understanding the benefits of their efforts. In both Rwanda and Tanzania, the Evaluation Team 
found very high retention rates as shown in Figures 12 - 14, below. 
 
41
Figure 12. Volunteers Trained by ROADS in Rwanda Currently Active 
Further, the GSLA monthly meeting attendance rates, an ongoing indicator of members’ 
interest, has been high. The Evaluation Team observed that for the groups that had GSLAs and 
economic empowerment activities, the issue of sustaining the volunteerism was not a key 
concern emerging in discussions the Team had with GSLA members. 
Figure 13. Comparison of GSLA Membership with Community Volunteers in Tanzania 
Introducing Low-cost Learning and Capacity Building Processes: ROADSII has adopted a 
low-cost and decentralized training approach, using ROADS technical officers at each site to 
42
train the focal persons for GSLAs on how to organize financing and provide information to 
members on business activities. The focal person arranges for a visit of members to a 
successful GSLA site to learn about and adapt the approach to their community. 
Figure 14. Comparison of GSLA Memberships in Tanzania and Rwanda 
The household production vertical and horizontal learning process is shown in Figure 15, 
below. 
Figure 15. Illustration of Grassroots Capacity Building through Learning Approaches 
Through the innovation of ROADS’ Household Production Guide, the GSLA members are 
provided with a series of simple worksheets, based on best practices in land use, animal 
husbandry, water use and small business performance. The selected facilitators encourage 
GSLA members to identify, discuss, and adopt key ‘productive behaviors’ that are aimed to 
43
maximize the utilization of household assets. Each GSLA group discussion encourages the 
organic adoption of productive behaviors at the household level. These productive behaviors 
guide the households in determining their own solutions and empowering both individuals and 
GSLA groups to adapt the available guidance to the local context and their own needs by 
identifying local resources and the means and available assets to systematize the economically 
productive behavior over the long-term. Such a peer-driven process instills a mindset in the 
group and within communities that technical assistance and solutions to common household￾related problems can be found within, decreasing the reliance on external inputs, expertise, and 
funding. 
Starting Small Businesses Improves Nutrition and Social Status of Vulnerable Groups: 
The evaluation team visited two households that have started kitchen gardening on the basis of 
learning the best practices through the ROADS II GSLAs. 
ROADS Economic Strengthening Adding to the Household Food Basket 
Peninah has a kitchen garden, growing Chinese (green leafy vegetables) from which she earns an 
income of $3.20 per week. She bought three chickens from some of her GSLA income, and she 
bought a pig from another source of income. Peninah sees the benefits of this GSLA activity and is 
preparing another piece of land to start a kitchen garden. According to Peninah, the food is nutritious 
and organic. She uses manure, no fertilizers, and grows a weed with the vegetables that keeps away 
the pests and insects. 
In another household, the GSLA member had several kitchen gardens growing different vegetables. 
She had delivered a baby the previous day and was home with her husband. Her husband said he 
was happy helping her with the chores, as the earnings helped her to become somewhat 
economically independent, and she was contributing to the family income. She said most of her 
produce was bought by her neighbors, and her earnings totaled $1.70 per week. Some of her 
neighbors started kitchen gardening after seeing how she productively utilized the little gardening 
space she had. 
The PLHIV GSLA group in Bugarama, Rwanda, has been in existence for a year. The group had 
saved $350.00 and issued loans of about $300.00. One of the group members, a widow with six 
children, said, “After being trained in the kitchen gardening, I started growing vegetables that we eat. 
We sell the surplus, and every week I earn RwF2000 from the vegetables. I managed to save $30.00, 
and I bought a goat for $27.00 and used the remaining $3.00 to buy food.”
Commercial Businesses Are Emerging, Contributing to Improvements in the Quality of 
Life: The team visited one of the households in Makambako, Tanzania, that is ready to take its 
poultry business to scale starting from a very small scale. 
Albertina’s Story 
Albertina has tried various businesses in the past. Initially, she was an illicit alcohol brewer. Next she 
tried sunflower seed pressing to extract oil. According to Albertina, the pressing involved too much 
work for too little return. On joining the ROADS II LIW Cluster, Albertina was trained in kitchen 
gardening and poultry rearing. Shortly afterward she joined a GSLA and opted to start rearing 
chickens, which was her preference. Albertina borrowed $38.00 from the GSLA and pays back $1.20 
on a weekly basis. Currently, she has 66 chickens and sells two trays of eggs daily, earning $3.20. 
Regarding record keeping for her business, Albertina said her records are not up-to-date in her books 
yet. But they were clear in her mind, and she would write them down as soon as she had settled her 
crying child and finished the evening chores. 
44
The Evaluation Team also visited an impressive LIW Cluster meeting in and using a small 
warehouse opposite a truck stop outside Kigali, Rwanda, which has started international 
exporting of their handsome, well-made, wide range of handicraft products. It is important to 
note that this space was donated to the community by the Government of Rwanda and for the 
use of the Community Clusters. 
Basket Weaving by Women outside Kigali, Rwanda 
A women’s sector leader linked a local women’s group to ASOFERWA, which is an NGO and an anchor 
organization for ROADS in Kigali. The women’s group joined the ROADS Women’s Cluster, and 
ASOFERWA helped them to achieve quality assurance in weaving beautiful baskets and creating other 
handmade products to sell in overseas markets. So far, with ASOFERWA’s assistance, the cluster has 
established markets in Japan and the USA. Moreover, the Government of Rwanda is helping them set 
up a factory to produce high-quality paints to use on their baskets and other crafts products. ROADS II 
has contributed by training the women in HIV/STI prevention, which is important because of their 
workshop base across from a heavily trafficked truck stop, and GSLA methods for economic 
strengthening of them individually and of their business enterprises. 
The cluster members said the training they had received from ROADS has changed their perceptions, 
enhancing their self-efficacy and opening their minds to other healthier options. The cluster 
spokeswoman informed the Evaluation Team that the financial returns from the weaving depended on 
personal diligence: “The more you weave, the more you make.” The earnings of the cluster averaged 
between $133.00 and $166.00 per month. To date, the cluster reported to have saved $4,160.00 
through their GSLA and earnings of $4,660.00 from their weaving. While their weaving business is 
designed to make money, they said they have learned new skills from ROADS, which has helped them 
in various ways and has made them feel dignified. Fifteen of the women reported they had stopped 
practicing sex work, and they were concentrating on weaving and their GSLA for economic 
empowerment. “Money is important, but we have received a lot of other good education on our self￾worth and dignity,” said the women. 
 
45
ROADS II RESPONSES TO KEY AREA RECOMMENDATIONS FROM 
the ROADS I EVALUATION IN 2008 
During the ROADS I Project evaluation conducted in January 2008, the Evaluation Team 
identified key areas where they felt the project could focus additional effort and recommended 
actions to be taken during the final two years of the project. These recommendations were 
aimed at establishing that the project activities outlined in the annual workplans would be able 
to demonstrate a significant impact on the target populations, as well as being sustainable, 
replicable, and capable of being expanded during the next phase of the project. The ROADS II 
Evaluation Team reviewed the extent to which these recommendations were addressed by the 
ROADS II Project in the period since the last evaluation. 
The key areas that were deemed to require immediate action by the 2008 team are highlighted 
below. Recommendations were made and these are also addressed in the relevant key area 
sections. Several of the recommendations made by the previous Evaluation Team were 
addressed structurally when the ROADS II project procurement mechanism changed from a 
Cooperative Agreement managed by a single Agreement Officer Representative (AOR) in 
Nairobi, Kenya, to become a Leader with Associates (LWA) award with bilateral USAID 
Mission AORs having greater management and oversight responsibilities. Other recommended 
actions remained relevant to the successful delivery of activities under the current iteration of 
the ROADS project and are addressed below in the Responses. 
Key Area Recommendation 
The first key area identified for action by the 2008 Evaluation Team was the need to 
scientifically verify the basic premises of the project. The team determined that the premises 
for the project design needed to be verified with solid qualitative and quantitative evidence. 
The project’s premises at that time posited that: (1) a comprehensive set of services provided at 
the branded SafeTStops would help change the behavior of truckers and other target 
populations and that these services would be synergistic and cost-effective; (2) the cluster 
model of community mobilization would be organizationally sustainable being based on the 
views and voices of the target communities; (3) the model would also be financially sustainable 
as peer educators would earn income through Lifeworks, thereby mitigating the need for 
regular funding commitments; and, (4) that LifeWorks itself would become self-sustaining 
over a defined period of time due to its grounding in core business principles, and that further 
income and employment generation would help reduce high-risk behaviors among target 
groups and lead to improved treatment and care outcomes. 
In order to collect and analyze data to establish the evidence base for the project’s activities, 
the Team recommended that the ROADS project strengthen and expand its system for 
monitoring and evaluation (M&E) to be able to measure project outcomes and impact on the 
target communities and populations. It was felt that increased capacity to analyze data related 
the various aspects of the program also would provide evidence to inform scaling up and 
expansion of the program to other sites in additional countries. At the time of the first ROADS 
evaluation, there had been no systematic collection of quantitative baseline-indicator data prior 
to the implementation of project activities in individual countries. Therefore, the team 
identified the need to strengthen the collection of baseline quantitative data for both new 
activities and in new countries. Similarly, outcome monitoring for determining which 
objectives had been met was not available, limiting the ability of program managers to improve 
ongoing program performance. 
46
The Evaluation Team recommended that the ROADS Project enter into a contract with a 
reputable operational research institution to design and carry out studies that could provide 
qualitative and quantitative evidence for program effectiveness. An additional technical 
recommendation was made for the ROADS team to consider the use of outcome monitoring 
surveys that use Lot Quality Assurance Sampling (LQAS). The advantage of LQAS is that it 
requires smaller samples and is less expensive. 
As a corollary to the M&E recommendation, issues of data quality were identified for some 
PEPFAR indicators. For instance, in 2008 in countries such as Burundi and Rwanda, there 
were systems at the facility level to track and monitor clients on ART, but there were no 
systems to track the number of people who were lost to follow-up or died. The M&E data that 
flowed upward from the project sites to the FHI office in Nairobi was neither site-specific nor 
disaggregated by sex. Furthermore, data was not readily available at the headquarters for 
clients who were referred by the project. 
The Evaluation Team also recommended that training should continue to be provided to 
members of the M&E steering committees of the clusters to update their knowledge on the 
definition of indicators and the processes of collecting, analyzing, and reporting data from the 
activities implemented. 
Response 
One of the most notable successes of the ROADS II Project has been the strengthening of the 
Strategic Information team and the emphasis on improving M&E structures and systems. The 
project has conducted an analysis of past, present, and future M&E needs as articulated in 
Figure 16, below, for ROADS/Rwanda. Each ROADS country office now has dedicated M&E 
Officers. Selected countries also have Data Managers based at individual sites to provide 
regular and immediate support to local Implementing Partners (IP), or based at the country 
office to maintain databases and collect information for national and regional reporting. In 
addition, ROADS II has strengthened its IP M&E systems through the training of staff and 
deployment of Data Management staff. 
Figure 16. Progression of ROADS M&E System 
47
Despite not partnering with an outside institution to conduct operations research (OR), 
ROADS’ research agenda has been strengthened significantly. It is quite possible that the 
project’s decision to utilize FHI360’s existing resources and develop ROADS in-house 
capacity for research may result, in the long term, in greater local capacity to conduct 
operations research and program evaluation. This, however, is a longer term, secondary gain in 
capacity building that remains to be seen. As part of the project’s scientific research agenda, 
ROADS II has strengthened its site and technical assessment tools and conducted qualitative 
and quantitative studies to address the scientific validity of the project’s premises and inform 
ongoing programming. 
The project has conducted behavioral monitoring surveys (BMSs) in several countries, which 
provide a baseline to estimate project contributions to observed outcomes, as well as site-level 
outcome data for use by all stakeholders. Each country has developed assessments/operations 
research/evaluations relevant to the activities specified in the Associate awards. For instance in 
Burundi, these activities consisted of OR on the Rationale of ART drug use (2009); an 
MCH/FP baseline assessment (2009); a Standard Days Method (SDM) evaluation (2010); a 
PMTCT quality evaluation (2011); and, a BSS baseline among FSWs in Karusi (2012). In 
addition, there is multi-country OR, such as the ongoing assessment of the cluster community￾organizing model being conducted in four countries. 
The project has developed a regional integrated database replacing the multiple formats 
previously used. The database has been designed to meet the data needs of this complex, multi￾faceted project, yet also has been proven easy to use at the IP level. The Strategic Information 
team is populating the database with service statistics to better correlate inputs and outcomes. 
The project has revised M&E plans and developed country-specific program monitoring plans 
(PMPs) in response to the ROADS I recommendations and emerging data needs. This has 
included revision of tools and development of new tools and guidelines. Figure 17, below, 
provides an example of the database source flow. 
Figure 17. Diagram of ROADS Data Collection and Outputs
48
The project’s M&E team has strengthened its data quality assurance mechanism through 
development of a participatory data quality assessment checklist and guide. These are used 
periodically to assess the quality of data at the IP level. The IP skills in data quality assessment 
have been strengthened for routine data-quality assessments during implementation. Figure 18 
illustrates the flow for an IP working with FSWs and STI management at a health facility in 
Rwanda. 
Figure 18. Flow Chart of Data Use by STI Intervention Team for SWs in Rwanda 
Discussions are ongoing with the internal FHI 360 ethics committee (PHSC) on ways to 
routinely use LQAS through less time -demanding processes (without compromising ethical 
requirements) to effectively measure project outcomes. Among the evaluation activities 
pending IRB approval, there is one designed that will use LQAS. In addition to the efforts 
related to utilizing the LQAS methodology, the ROADS team has been using the PLACE 
method to identify locations and circumstances determining high-risk behaviors (meeting new 
sex partners or having risky sex) that occur among fisher folk in Mwanza, Tanzania. The 
Behavioral Monitoring Surveys (BMS) conducted to date have been cross-sectional, 
descriptive studies among selected project target populations, including truckers, FSWs, youth 
and women in low-income settings/households. Repeat studies have been conducted in Zambia, 
and the team plans to repeat the Tanzania BMS in the five sites where the baseline study was 
conducted. 
Key Area Recommendation 
During the previous evaluation, the team found that Health Officers working in bilateral 
USAID programs felt that there was inadequate interaction and communication between 
the Nairobi-based ROADS I project staff and the bilateral Missions. The team felt that two 
factors contributed to the problem. The first factor was the absence of dedicated ROADS 
Project field staff at FHI country headquarters offices in the capital cities. At the time, the 
ROADS Project had only recently hired staff in South Sudan. In the DRC, while ROADS had 
staff in the FHI field office in Bukavu, the ROADS Project did not have a staff member in the 
FHI country office in Kinshasa who was capable of interaction with USAID Mission staff. At 
the time of the 2008 evaluation, the process of posting staff in Kampala and Dar es Salaam was 
still ongoing. Second, bilateral Missions felt that simply having staff present was adequate. In 
49
the case of Kenya; the ROADS Project was headquartered in Nairobi and yet communication 
with USAID/Kenya remained challenging. This was often due to a heavy workload of Health 
Officers, especially in the larger PEPFAR focus countries. In these countries, the ROADS 
Project constituted a tiny portion of a much large portfolio, and it was perceived to be difficult 
for a busy Health Officer to give time and attention to a small program over which they had no 
managerial oversight. 
The Evaluation Team identified the need to increase interaction with the Health Officers and 
national IPs. ROADS was enjoined to find ways to enhance interactions with Missions and IPs. 
The recommendations emerging from the discussions with the Health Officers and other 
concerned parties included: 
 Organize a meeting of Health Officers and HIV point persons to report on and discuss 
ROADS and regional health issues at a time when both would be available to attend it, 
e.g., at a SOTA or PEPFAR Implementers Meetings. 
 Prepare a short progress report focused on each country and send it via e-mail to the 
Health Officers and the point persons. 
 Appoint a focal person in all FHI country offices that have substantial ROADS project 
activities in order to maintain regular contact with the Missions. 
 Have ROADS staff be represented at all Population, Health, and Nutrition (PHN) 
Implementers meetings and also at thematic group meetings (e.g., for OVC, family 
planning) at the various USAID Missions. 
Response 
The advent of the LWA awards under ROADS II allowed bilateral USAID Missions to address 
the communication issues through increases in ROADS national staffing and having bilateral 
Agreement Officer Representatives (AORs). As part of the LWA, ROADS has expanded its 
staff from 58 in 2008 to 184 in 2012, decentralizing key functions to fully staffed country 
teams (technical, program, finance) linked through the regional platform. ROADS Country 
Managers liaise regularly with USAID AORs and other USG staff and partners via monthly 
and quarterly meetings, site visits, etc. While the LWA award is still managed at USAID/EA in 
Nairobi, Kenya, the change provided more opportunities for communication, giving the 
bilateral AORs more oversight responsibility via the Associate awards. Figures 19 and 20 
illustrate the evolution of the decentralized structure of ROADS. 
Figure 19. Illustrative Organogram Showing ROADS Organizational Evolution
50
Figure 20: ROADS Tanzania Team Organogram
The FHI360 ROADS management team also organized annual AOR meetings to bring together 
USAID counterparts from across the region to discuss lessons learned, best practices, and new 
horizons (Dar es Salaam, 2010; Kigali, 2011). 
Key Activity Area 
The Evaluation Team felt the Project should increase advocacy for the adoption of regional 
policies and initiatives for addressing the needs of mobile, transnational populations and 
the communities through which they pass (e.g., the regional adoption of ROADS models). 
The ROADS I Evaluation Team felt that Project staff needed to conduct more thorough data 
analysis to help stakeholders to better understand the implications of regional transport 
networks on their national HIV programs and to demonstrate how the transnational nature of 
the ROADS Project impacts the local HIV transmission factors. Close contact and/or 
collaboration with in-country partners to share experiences and coordinate program activities 
were determined to be extremely important. The team felt that the ROADS I project was trying 
to develop these contacts, but more had to be done on a systematic and regular basis. 
At that time, although there had been several activities aimed at enacting regional policies (e.g. 
HIV prevention and alcohol abuse, alcohol abuse, and ART adherence), the ROADS Project 
primarily and appropriately focused on country-level activities. The team believed that the 
project had generated enough experience to disseminate lessons learned across borders and 
should begin sharing experiences among various clusters and associations to improve quality 
and effectiveness. In addition, they recommended that the project should strengthen cross￾country activities, such as joint trainings, exchange of best practices such as SafeTStop 
branding, and cross-country visits by the field staff and volunteers. 
In a related recommendation, the team also felt that the project should be getting the stories 
out more vigorously and rapidly. The team felt that the ROADS Project staff could devote 
more effort to timely documentation and dissemination of its experiences. The ROADS Project 
would benefit from visibility as its activities and experiences were perceived as valuable for 
51
strengthening the HIV/AIDS prevention activities in communities with mobile populations. 
They recommended linking with the local and international media to share the experiences with 
the general public in addition to professionals and program planners. 
Response 
ROADS has continued to work with the East, Central and Southern Africa Health Community 
(ECSA-HC). The project participated in a Health Ministers Meeting in Mbabane, Swaziland, in 
February 2009, presenting on alcohol and ART loss-to-follow up resulting in passage of 
resolutions on each issue. They also participated in a GBV Technical Experts Meeting in Dar 
es Salaam, Tanzania, in September 2009 and an M&E Technical Experts Meetings, also in Dar 
es Salaam in August 2011. The project was enlisted by USAID/Southern Africa to participate 
in a Southern African Development Community (SADC) donor meeting to share project 
approaches in transport corridor programming in September 2011, attended by Sida, DFID, the 
World Bank and IOM. ROADS also participates in East African Community (EAC) Regional 
HIV and AIDS Partnership Forums (2009-2011). The project continues to collaborate with the 
private sector, including Dubai Ports World (Djibouti), General Motors (Kenya with potential 
expansion in Southern Africa), Equity Bank (Kenya, Tanzania) and Airtel (Kenya). ROADS 
has also received other donor funding, e.g., UNICEF funding in Djibouti to conduct youth￾focused programming in PK 12 and Balbala. 
ROADS also organized cross-country exchange visits to accelerate shared learning: 
• In September 2011, a Government of Mozambique delegation visited ROADS II 
Rwanda sites to examine community-led and -owned programs (Provincial Health 
Director, Sofala Province; Deputy Health Director, Maputo City; Chair; Ministry of 
Transport HIV Committee) 
• In August 2009, local partners from four Tanzania sites visited Busia, Kenya, to 
examine the community-based alcohol counseling programming 
• In October 2008, representatives of South Sudan partners PSI, IRC and ARC visited 
Busia and Malaba, Kenya-Uganda to examine community organizing thru clusters. 
 
Also, as mentioned earlier in this report, 94% of all technical assistance through ROADS II is 
South-to-South. 
Community partners attend ROADS regional meetings and are supported by the project to 
attend donor forums (e.g., a Busia, Kenya, IP presented at the PEPFAR Southern and Eastern 
Africa Technical Consultation on Alcohol and HIV Prevention, April 2011). ROADS II has 
developed various ways to disseminate program accomplishments. For instance, a SafeTStop 
exhibit was organized at the US Embassy/Nairobi in May 2012, which was attended by the 
Ambassador and other USG officials. The project has generated and presented abstracts and 
presentations at national and international forums, including: 
 “Strengthening Broad-based Community Engagement in HIV Service Delivery,” 
AIDS 2012, Washington, July 2012) 
 “New Directions in Transportation and Development in Africa,” Africa House 
Lecture Series, New York University, December 2011 
 “Capacity Building to Promote Locally Driven, Sustained Action in Historically 
Underserved Transport Corridor Communities,” (OHA Partners Meeting, 
Washington, DC, September 2011) 
 “Behavior Change for Key Agricultural Practices to Promote Improved Quality of 
Life for Vulnerable Persons,” 6th International Conference for Exchange and 
52
Research on HIV and AIDS, Kigali, Rwanda, June 2011 (awarded Best Abstract, 
Category C, Socioeconomic Impact and Socio-Economic Support). 
ROADS II has integrated itself into a range of national planning bodies, including MOH, 
Transport, Gender and PEPFAR TWGs as shown in Table 8, below. 
Table 8. Representation by ROADS on National Planning Bodies by Country 
As part of ROADS II, the project team has formalized the branded ROADS package for easy 
adoption and franchising along the corridors. The Kenya Ministry of Transport has adopted 
SafeTStop branding and replicated it along key roads and highways in the country. The 
SafeTStop logo has been translated into French, Portuguese, and Amharic (an Ethiopian 
language) in order to be recognizable to populations across countries. 
The SafeTStop Resource Center model has been replicated across transport routes. For 
instance, Dubai Ports World is in the process of working with FHI360 and the Government of 
Djibouti to establish a SafeTStop Community Center in Djibouti, with plans to expand an 
adapted model in ports in Mozambique and Senegal. 
Key Area Recommendation 
One of the most pressing issues that the 2008 Evaluation Team identified was the prospect of 
whether to expand the project to new sites/different corridors or to consolidate program 
activities at the existing sites. The Team felt that the ROADS Project should consolidate the 
model and demonstrate impact before undertaking expansion to new sites. This would allow 
for the development of a functional model that could be replicated/franchised elsewhere based 
on evidence that the model had an impact on HIV transmission, access to care and treatment, 
and mitigation of the disease on affected populations. The team felt that there were still many 
53
challenges with the existing sites and, therefore, that it might be prudent to solidify the program 
at the existing sites over the following two years, document the successes of ROADS methods, 
and consider geographic expansion and replication during the next phase of the project. 
 
The Evaluation Team found that the ROADS Project had functioned best in countries where: 
(i) it was able to hire an adequate number of expert field staff commensurate with project 
activities, as in Rwanda, Burundi, and Kenya; (ii) where missions have provided appropriate 
resources to fund the project activities, as in Tanzania, Burundi, Rwanda, and Uganda; and, 
(iii) where the ROADS Project implemented its core set of activities, i.e., prevention with 
MARPs, such as truckers and LIW/FSW, linkages to voluntary counseling and testing 
(VCT)/STI/ART services through the SafeTStops, community empowerment through the 
cluster model, and LifeWorks. 
The Evaluation Team also felt that the ROADS Project staff should rethink implementation in 
countries where factors were not in place to adequately roll out the model. For example, in 
countries with small amounts of funding, such as Ethiopia, supporting discrete elements of the 
ROADS model would not contribute to demonstrating impact of the model overall. In South 
Sudan where the ROADS Project received extensive funding, the Team felt efforts should be 
made to provide resources for staff commensurate with activities, as well as to have discussions 
with the USAID Mission to refocus on the core ROADS model activities (HIV prevention, 
SafeTStops, cluster models) as opposed to overseeing HIV activities implemented through sub￾grantee programs, such as Population Services International (PSI), International Rescue 
Committee (IRC), American Refugee Committee (ARC). 
The Evaluation Team recommended that the Project work with USAID/EA to discuss with 
bilateral USAID Missions in Kenya, Rwanda, Burundi and Uganda the feasibility, funding, and 
result expectations for expansion of activities during the last two years of the ROADS I project. 
They also recommended that ROADS should consider the possibility of limiting its activities in 
Ethiopia and Djibouti after discussions with the Missions and management.
Response 
As mentioned above, the shift from a Cooperative Agreement to a Leader with Associates 
award significantly changed the approach that bilateral USAID Missions took when 
considering the ROADS model. The ability of the ROADS project to scale-up the entire 
package of activities was limited to a certain extent by country-specific PEPFAR strategies. 
Some Missions continued to utilize the ROADS II LWA mechanism, while others decided to 
provide similar services through bilateral mechanisms. For instance, the ROADS-II Project 
Associates Award between USAID/South Sudan and FHI/360 lasted just over one year from 
November 21, 2008 to December 31, 2009. While the ROADS II Project in South Sudan 
promoted peer education and community mobilization activities, and generated significant 
uptake of HIV services, including HIV counseling and testing in Juba and Greater Yei, the 
Mission decided to issue a bilateral procurement that included many of the ROADS I activities. 
The bilateral was awarded to FHI360, so there was some continuity. Yet the same cannot be 
said for USAID/Uganda where ROADS II did not receive significant ongoing support, nor has 
USAID/Ethiopia seriously engaged the project. On the other hand, bilateral USAID Missions 
in Rwanda, Burundi, Tanzania, Zambia, Mozambique, and the DRC (in process) have made 
substantial buy-ins through the LWA award, as shown earlier in this report in Table 2. Djibouti 
has continued to receive assistance from USAID/EA through ROADS II and now has 
additional PEPFAR funding to expand the scope of ROADS activities. 
 
54
In some cases, the scope of work for ROADS through the Associate awards has departed from 
the SafeTStop and cluster models. For example, a central component of the current LWA 
award for ROADS/Kenya is the national level development of BCC messages for vulnerable 
groups in collaboration with NACC, MOH/NASCOP and APHIAplus partners. 
ROADS/Kenya has developed messages with focusing on specific risky behaviors identified by 
the target groups during the rapid assessment including unprotected sex; fear of HIV testing 
and counseling (HTC); anal sex without condoms and appropriate lubricants; alcohol and drug 
abuse; and multiple and concurrent sexual partnerships (MCP). Many other components of 
ROADS model have been devolved by the USAID/Kenya Mission to the APHIAplus partners 
in each province. 
The ROADS Project team’s response to the Evaluation Team’s recommendation to consolidate 
and improve the evidence base has been discussed above, but ROADS II also made technical 
and programmatic changes based on assessments and epidemiology. These include improved 
targeting of risk and vulnerable groups, particularly young women. Under ROADS I, youth 
clusters reached significant numbers of young people, but not necessarily those most at risk. 
Under ROADS II, the project has made a more concerted effort to identify and reach most-at￾risk young people, particularly younger, highly vulnerable female sex workers (Burundi, 
Rwanda, and Tanzania). Adapting strategies from the Avahan program in India, ROADS II 
Rwanda has increased the number of “hidden” FSW reached with prevention, care, and support 
services from 596 in 2009 to 2,139 in 2011, showing more than threefold growth. 
In another technical area, ROADS also has tried to negotiate with government, regional, and 
donor programs to address continuity of ART provision for truckers transiting through multiple 
countries in order to avoid missed doses, ensure adherence and prevent drug resistance. In the 
current ROADS II Kenya Associate Award, FHI 360 has negotiated with MOH/NASCOP and 
USAID to pilot ART refills and other selected clinical HIV services at two SafeTStop 
Resource Centers in Rift Valley Province. This pilot is the first of its kind in East and Central 
Africa and will be evaluated for cost, adaptation, and scale-up in Kenya and elsewhere, 
working closely with the EAC. ROADS II is also negotiating with Reach Out Mbuya, a 
USAID/Uganda clinical partner, to provide ART re-supply at the SafeTStop Resource Center 
in Mbuya-Kinawattaka, Kampala. 
Key Area Recommendation 
In 2008, the Evaluation Team recognized the need to undertake a financial analysis on the cost 
of the comprehensive SafeTStop model and of the various individual components (e.g., 
branding, cluster formation, income generation, counseling and testing outreach). While the 
Team recognized that it may have been somewhat early to undertake a financial analysis of the 
program model based on having only recently been established in many sites, they felt there 
was a critical need for making a case for program expansion during the next phase. The USAID 
Missions that proposed funding the ROADS II Project needed to be able to make budget 
decisions based on appropriate information. They recommended that this financial analysis 
should occur within the final two years of the ROADS I project. 
Response 
For a variety of reasons, including the early transition in mechanisms from ROADS I to 
ROADS II, and the ensuing revamping of the decentralized project staffing and expansion to 
additional countries, e.g., Mozambique, a formal financial analysis did not occur. Nonetheless, 
the ROADS II Project has undertaken efforts to document cost aspects of the model to enhance 
reliability. The team tracks programming costs, including costs of establishing and supporting 
clusters. Currently, the ROADS SI team and an FHI 360 health economist are developing a 
55
cost-tracking system for specific services supported by the project. New sites in Tanzania 
(Chalinze, Ilula) will serve as baseline sites to launch the cost-tracking system in FY 2012. 
Key Area Recommendation 
The 2008 Evaluation Team also recommended strengthening the employment generation 
component of the project: They felt that LifeWorks had been successful and in high demand 
among the target populations due to extreme poverty in their communities. The Team 
recommended that LifeWorks consider expanding local entrepreneurship activities, particularly 
among the vulnerable members of the youth cluster, especially in countries with a limited 
private sector. The team also recommended that the project could possibly apply for some of 
the increased funds being made available by the US Congress for micro-enterprise activities; 
intensify the search for local and international markets; and, conduct a cost-effectiveness 
analysis of its operations and determine the impact of economic activities on the high-risk 
behaviors among the vulnerable groups. Most importantly, the project needed to determine the 
applicability of the LifeWorks approach in multiple contexts beyond Kenya. 
Response 
The ROADS Project management team undertook a strategic review of LifeWorks in FY 2009. 
The review found that the LifeWorks Shukrani Production Facility in Mariakani was an 
opportunity unique to that site. The company has since transitioned from being an NGO sub￾grantee to an independent registered private company, with a strategic partnership that is being 
developed with an allied company for sustainability. More importantly, the review led to 
adaptation of USAID’s Economic Strengthening pathway approach to working with HIV￾affected households, based on: (i) strengthening internal savings and loans; (ii) maximizing 
household production; and, (iii) preparing for commercial readiness. This transition was 
described in greater detail in the previous Economic Strengthening section of this report. 
Key Area Recommendation 
Finally, the Evaluation Team felt that ROADS should make use of new information technology 
for program improvements. New information technologies, such as cell phones and solar 
computers, were seen as presenting new opportunities to strengthen employment and income￾generation, as well as health programs. The ROADS Project was asked to explore increased 
linkages across USAID sectors, such as trade and economic growth as well as collaborations 
with other donors. Also, the ROADS Project was enjoined to develop the interest and 
understanding of youth clusters in information technology. 
Response 
The ROADS project has made use of IT in many areas of the project. The majority of 
SafeTStop Resource Centers visited by the team had Internet access on site both as a way to 
attract clients and to disseminate HIV prevention, care, and treatment information and health 
messages. For example, through the partnership with Dubai Ports World, the SafeTStop 
Resource Center in Djibouti has been equipped with a solar internet kiosk to help mobile 
workers stay in touch with their families while away from home. 
ROADS II has developed virtual technical teams (HIV prevention, economic strengthening, 
M&E) to rapidly share critical information, standards and tools with transport corridor 
communities across countries. In Rwanda, the IP M&E teams use iPads for service provision, 
and iPads and PDAs for research and evaluation. 
56
As part of the LWA award, ROADS also has supported the redesign of the AfriComNet web 
site, now highly interactive receiving 77,000 hits per month on average. Under guidance from 
the Board, the network continues to send weekly e-updates and other electronic features. 
 
57
ANNEX A. SCOPE OF WORK FOR THE EVALUATION 
I. BACKGROUND 
In FY 2004, in response to the needs of these vulnerable and underserved populations,
USAID/East Africa (EA) issued a Request for Applications for “Strengthened HIV/AIDS 
Program in the Region”, also referred to internally as the Transport Corridor Initiative. The 
proposed program was designed to reduce HIV transmission, improve care for people living 
with HIV and AIDS, and to reduce the impact of this disease along the region’s major transport 
corridors by harnessing the resources, imagination and commitment of communities, the 
private and public sectors. On August 5, 2005, USAID/EA signed Cooperative Agreement No. 
623-A-00-05-00320-00 with Family Health International (FHI) entitled “Technical Assistance 
for Strengthening USAID/EA Response to the HIV/AIDS epidemic in East and Central 
Africa.” This project was referred to as the “Regional Outreach for Addressing AIDS through 
Development Strategies (ROADS I) Project” and was branded “SafeTStop”. 
ROADS I implemented HIV prevention and AIDS care and support services in “hot spot” 
communities linked by major transport routes across nine countries in East and Central Africa: 
Burundi, the eastern Democratic Republic of the Congo, Djibouti, Ethiopia, Kenya, Rwanda, 
South Sudan, Tanzania and Uganda. Beyond building health services and community 
mobilization structures to promote increased use of HIV/AIDS and health services, a critical 
component of the project was economic strengthening to address vulnerabilities of the local 
communities through partnership with local and international businesses called “LifeWorks.” 
The Roads to a Healthy Future (also known as ROADS II) Project, a five-year Leader with 
Associates (LWA) award funded on August 1, 2008 and ends on July 31, 2013. This activity 
was a direct follow-on to the ROADS Project whose ceiling was exceeded well before its 
completion date due to significant participation from bilateral USAID missions. Roads to a 
Healthy Future picked up from the mid-point of ROADS and the mid-term evaluation 
conducted in January 2008 informed the ROADS II design. The ROADS II project is currently 
in the following countries: Burundi, Djibouti, Kenya, Mozambique, Rwanda, Tanzania, 
Uganda and Zambia. Countries with previous ROADS programming included: Democratic 
Republic of Congo (DRC), South Sudan, and Ethiopia. However, since a mid-term 
evaluation was conducted in January of 2008 for ROADS I, the bulk of this evaluation will 
focus on ROADS programming from that date forward, but should strive to see the project as a 
holistic project, since 2005. 
II. PURPOSE OF EVALUATION 
The main objectives of this evaluation were to assess overall project performance, and to obtain 
recommendations for the re-design, or follow-on of this project. The evaluation assessed the 
outcomes of the ROADS I and II projects in strengthening the response to HIV/AIDS in 
vulnerable mobile and transient populations along transport corridors in East, Central and 
Southern Africa and the additional value in integrating Family Planning/Reproductive Health 
(FP/RH), Maternal and Child Health (MCH) and nutrition interventions into the ROADS 
projects. 
Conclusions, lessons learned and recommendations will provide information that will allow 
USAID/East Africa to: (i) make decisions about the design and specific components of a 
follow-on project, and, (ii) determine what aspects of the project can be scaled-up by 
USAID/EA and bi-lateral programs in the region. Specifically, the evaluation will identify 
ideas on potential models, approaches, activities, and even options for mechanisms. 
58
It is important to note that the ROADS project evaluation looked specifically at the 
achievements of ROADS, the challenges the components of the model and made 
recommendations for continued programming and re-design. Other studies are being 
undertaken by ROADS and USAID/EA that are critical pieces of both the ROADS Project and 
HIV/AIDS and broader health and development needs along the transport corridors. 
One such study will be ROADS’ internal evaluation of their community organizing model (the 
community cluster approach), and this evaluation will evaluate the role of the community 
cluster organizing model in creating and sustaining community ownership of interventions that 
increase demand and access to HIV prevention, care and treatment in ROADS II project sites 
in 4 selected countries. 
Another critical assessment is one that USAID/EA in collaboration with EAC and through 
AIHD, a regional research institution, is implementing will more thoroughly document 
services and needs along the wider transport corridor in and around the 5 EAC countries. 
Specifically, the aim is to document and provide a regional perspective on HIV prevalence and 
provision of integrated health, HIV/AIDS and reproductive health services at cross-border 
communities within Eastern Africa. 
The results of both of the evaluation and the AIHD studies will be integral to design and 
implementation of broader services in the region, will help inform and shape specific aspects of 
ROADS and any future re-design and programming, as well as address some critical questions 
vis à vis sustainability and a locally/regionally owned program/activities/response. 
Dates of the evaluation site visits and meetings were from Monday May 28th – July 15th, 2012 
(with the evaluation report development extended by the ROADS II AOTR through September 
2012 due to previously scheduled team members’ schedules). 
The specific questions to be addressed by this evaluation included (updated with peer review): 
1. As a regionally planned and targeted set of activities, in which areas has the ROADS 
project contributed the most and what key lessons have been learned, both positive and 
negative? 
2. Integration: What was the value-added of the integration components of various project 
components (FP/RH, MCH, nutrition, economic strengthening etc.) and the lessons 
learned? 
3. To what extent has the ROADS II project increased capacity of local and CBOs to 
ensure sustainability without project support? 
4. To what extent did the ROADS project collaborate with local and other relevant 
government authorities and with what results? 
5. What lessons have been learned in the expansion of the ROADS II project that can 
inform what aspects of the project can be scaled up or replicated at a bilateral and/or 
regional level? 
59
6. What can available secondary data and epidemiological analyses on the dynamics of the 
HIV/AIDS epidemic in the region tell us about the strategic role of the ROADS 
Project? 
7. What are some specific ways in which the project has harnessed and utilized innovative 
approaches and methods in their work and with what results? 
8. How effective is the Regional Leader with Associate award model, including but not 
limited to the following areas: 
a. Management: Has the implementing partner provided adequate leadership to the 
Associates to meet country specific needs? 
b. Communication: What has been the experience regarding sharing and 
dissemination of best practices and lessons learned between the leader and 
associates? 
c. Program: What is the value-added for the bi-laterals of this mechanism? 
d. Monitoring and Evaluation: What systems and practices are being utilized and 
how effective have they been in tracking project results and informing future 
programming? 
9. What are the key recommendations for future programming? 
The Evaluation Team made changes to the specific evaluation questions in a team discussion 
meeting held to review, clarify, and simplify some of the wording. Also, because the relevant 
epidemiological data is so sparse or non-existent in the countries where most of the ROADS 
sites are located, there currently is no way to determine the local or national epidemiological 
impact of ROADS on a location by location or a country by country basis. Thus the Evaluation 
Team decided to eliminate the original question 6. as a key evaluation question, as it is largely 
unanswerable without substantial additional epidemiological data on the national, provincial, 
and local levels and relatively accurate population group size estimates, which currently do not 
exist for any of the relevant countries. The evaluation report nonetheless addresses the strategic 
role of ROADS regionally and within countries where relevant, including in the 
Recommendations section. The following are the questions refined and used by the Evaluation 
Team that were disseminated during the evaluation: 
1. What have been the major contributions of the ROADS project? 
2. Which approaches or methods used by ROADS have been innovative? What have been 
the results? 
3. What key lessons have been learned in ROADS implementation, both positive and 
negative? 
4. To what extent has ROADS: 
 Increased the capacity of local NGOs and CBOs to ensure programmatic 
sustainability? 
 Collaborated with national, provincial or local government authorities? 
5. How useful is the ROADS cluster model for: 
 Integrating various program areas with HIV prevention to add value, such as: 
 FP/SRH? 
 MCH? 
60
 Nutrition? 
 Economic strengthening? 
 Integrating other program areas in the future (e.g., MNCH, etc.) or other human 
rights issues (e.g., MSM)? 
 Delivering cost-effective interventions? 
 Ensuring program sustainability? 
6. How effective is the Leader with Associate (LWA) award model in the following (or 
any other) areas: 
 Management: Has FHI 360 provided adequate leadership to the associates to 
meet your country-specific needs? 
 Program: What has been the value-added of this mechanism in your country? 
 Communication: What has been the experience regarding sharing and 
dissemination of best practices and lessons learned across the program area? 
 Monitoring and Evaluation: What M&E systems and practices are being 
utilized, and how effective have they been in tracking project results and 
informing program implementation? 
7. What are your key recommendations for future programming? 
 
61
ANNEX B. EVALUATION METHODOLOGY 
This was a descriptive evaluation that included the following activities: 
Team Briefing: The Evaluation Team held a preliminary briefing with the USAID/EA/RHH 
Office staff in Nairobi to review the statement of work, revise the SOW and/or develop 
additional key assessment questions as necessary, and finalize the schedule. The Evaluation 
Team also held an interview with the RHH Director to discuss the main priorities for the 
evaluation and expectations for future planning. The ROADS II AOTR on the RHH team 
joined the Evaluation Team for the site visits, meetings, and interviews held in Burundi, 
Kenya, and Mozambique. 
 
Document Review: The RRH staff provided the Evaluation Team with a package of briefing 
materials related to the ROADS Projects, both the Leader and Associate awards. The Team 
members also collected additional documents and materials during the sites visits to the various 
countries, and the RHH ROADS II AOTR was copied electronically on many of the documents 
submitted to the Evaluation Team for their review. (A comprehensive list of background 
documents is included as Attachment 3 and will be updated as a comprehensive list in the final 
Evaluation Report.) Examples of such documents include: Semi-annual performance reports, 
special presentations, country and technical briefs, technical frameworks, site assessment 
briefs, training materials and toolkits, as well as documented best practices. 
FHI360 Briefing: The Evaluation Team held in-depth preliminary meetings with the ROADS 
Team, which includes FHI360 as the Prime and key consortium members. The first meeting 
was held with the Nairobi-based FHI360/ ROADS II Team and consortium members. 
Subsequent preliminary meetings were held with country-specific ROADS II implementing 
teams. FHI360 compiled a packet of relevant materials, including the M&E framework and 
tools, site assessment reports, studies, BCC/messaging materials, ROADS country program 
descriptions, and photos of relevant project aspects. The ROADS II Team was requested to 
meet or communicate with the Evaluation Team as needed. 
Other Key Informant Interviews: The Evaluation Team met key stakeholders (a preliminary 
list of key stakeholders is included below and will be included as Attachment 5 as it is 
developed by the evaluation team) to conduct qualitative, in-depth interviews. The interviews 
were loosely structured but followed a list of key discussion issues and questions as a guide. 
Whenever possible, the interviewers were conducted face-to-face informants and interview 
notes were taken. In addition to interviewing the key stakeholders, various USAID and 
ROADS staff were included in the country visits to conduct interviews with key informants, 
community members, and government and community stakeholders. As it was impossible to 
interview all key stakeholders in person in ten countries, the Evaluation Team conducted 
telephone interviews with informants in the countries/sites not visited. 
Country Site Visits and countries of focus: 
 The ROADS evaluation shall include three different types of programming of the ROADS 
project: 
 Project activities directly funded by USAID/East Africa: Djibouti, Uganda, Burundi 
(FP/RH), and Tanzania (FP/RH). 
 Programs managed through USAID bilateral (country) missions: Tanzania, Kenya, 
Rwanda, Burundi, Mozambique and Zambia. 
 Project sites that began as ROADS I but have since been subsumed under bilateral 
country programs (Uganda, Kenya, DRC, and South Sudan). 
62
 USAID/EA in collaboration with the bilaterals selected 1 or 2 countries from each type of 
program described above, and the evaluation team shall look at these countries more in￾depth than the others and this shall include site visits as well. 
 The selected countries to be visited by the Evaluation Team were: Burundi, Kenya, 
Mozambique, Rwanda, and Tanzania (one-half of the Evaluation Team went to 
Mozambique, and one-half went to Tanzania due to time constraints). 
 In addition to interviews with USAID staff and other key national stakeholders in these 
countries, the Evaluation Team was expected to visit at least two to four overall ROADS 
sites as stated above to assess the implementation of activities and to interview local 
participants (including the beneficiaries of the program) and stakeholders. The sites were 
selected in consultation with the USAID/EA and the ROADS team. 
Stakeholders are broadly defined to include (but not limited to): relevant USAID bi-lateral 
and regional Mission staff, relevant regional bodies, government counterparts (national and 
district levels), representatives from community based organizations, ROADS Project staff, 
community members, health care workers, and beneficiaries of the program and 
representatives from key target populations. 
 
63
ANNEX C. LIMITATIONS OF THE EVALUATION 
There were several limitations associated with this evaluation: 
 The qualitative nature of the evaluation meant that the impact of the project can only be 
determined through inference based on the available data, which is limited, the feedback 
from USAID and relevant government staff in the countries visited or through 
teleconferences or email with USAID staff in the countries the Team was unable to visit, 
and impressions gleaned during the site visits, which were very limited given the wide 
geographic coverage of the program. Moreover, the lack of an overall project baseline 
study by location precluded the use of more rigorous study methodologies. However, the 
availability of some site-specific assessments previously undertaken by the program, some 
behavioral monitoring surveys, and some feedback from population group members 
themselves permitted limited investigation and review of the impact of the project on the 
target populations. Consequently, the Evaluation Team recommends that a separate impact 
evaluation be undertaken in the future if the AIHD study, mentioned above, does not elicit 
adequate impact information. 
 Additional limitations include the complexity and size of the program; the number of 
countries involved (ten) and the inability to visit most of the project sites, even in the 
limited number of countries the team was able to visit; the language barriers across the 
countries; the very limited time allotted for the assessment with Evaluation Team members 
working together (three weeks); and, the various logistical challenges involved in any 
evaluation, and especially this one given the very short time frame, the range of program 
interventions, the broad spectrum of the target groups, and the large geographic spread. The 
logistical imitations included: travel, such as limited flight availability and duration of 
travel to disparate and far-flung project sites via air to cities and/or by road to rural areas; 
the costs due to the types of travel and accommodation needed for ten or more people at 
times; the availability of USAID program, government, and ROADS II program and 
implementing partner staff and target group members for meetings, interviews, 
international conference calls, etc). 
 Comparisons between country programs, including the impact and strategic role of the 
project within or compared to bilateral country programs was not possible to determine in a 
systematic way or based on the data and the amount of information available about each. 
Each country program is different across the ten countries where the project is or has been 
operational, and each ROADS program in each country differs somewhat from the other 
countries due to the range of interventions implemented, the specific needs by location, 
range of geographic coverage, provincial prioritization based on government buy-in and, 
indeed, differing national priorities. Moreover, the project started at different times, 
including in different years in the countries. Thus there was an inability to determine the 
strategic role of the project in each of the ten countries in an in-depth, accurate, and fair 
manner, while basic agreement was reached on the strategic role of the project in some of 
the countries through meetings, discussion, information and data review, and basic analysis. 
 The evaluation took place a year before the projected end of the program; thus, final data 
was not available for any aspect of the program in the countries where implementation 
continues. 
 The Evaluation Team requested a significant amount of additional data and information 
than was initially provided to the Team. The additional data and information required 
64
extensive time and effort to compile by various ROADS II staff members in the countries 
and at ROADS HQ. Thus the additional data and information gathering and compilation 
time extended the amount of time needed for data and information analysis off-site and 
individually by the Evaluation Team, beyond the initial expectation for the end of the 
evaluation and the submission date of the final report. 
 
65
ANNEX D. LIST OF INDIVIDUALS MET OR INTERVIEWED BY THE 
EVALUATION TEAM 
Organization Name Title/position 
US Agency for International Development/East Africa and USAID/Kenya 
USAID Kristen Ruckstuhl Prevention Advisor, USAID/EA 
Julia Henn Health Team Director, USAID/EA 
John Power Deputy Mission Director, USAID/EA 
Wairimu Gakuo Strategic Information Advisor, USAID/EA 
René Berger HIV/AIDS Team Leader, USAID/Kenya 
Emma Mwamburi Prevention Advisor, USAID/Kenya 
 
Organization Name Title/position 
Burundi 
FHI 
360/ROADS 
Dr Antoine Barutwanayo Family Planning/Gender-Based Violence 
(FP/GBV) Program Officer 
Dr Bède Matituye Clinical Services Program Officer 
Didace Ngabonziza Program Assistant 
Dr Martin Ngabonziza Country Director 
Eslon Nduwayo Executive Assistant 
Emmanuel Nikoyagize Community Program Officer 
Thierry Nininahazwe FP/GBV Program Assistant 
Majoric Nshimirimana M&E Technical Officer 
Kayanza 
Province 
Concilie Gahungere Technical Advisor of the Provincial Committee 
for the Fight against AIDS 
Jean Claude Mpawenimana Governor of Kayanza Province 
National 
Council for 
the Fight 
against 
AIDS 
(SEP/CNLS) 
Appolinaire Kavungerwa Monitoring, Evaluation and Planning Expert 
Consolate Nduwarugira Civil Society Reinforcement Expert 
Dr Damien Nimpagaritse Technical Director 
Thérèse Ntahompagaze Prevention/PRIDE Project /Global Fund 
Expert 
Albert Ntiringaniza Pharmacist 
Alexis Nzeyimana Civil Society Expert 
Dr Jean Rirangira Executive Secretary of the National Council 
for the Fight against AIDS 
Kayanza 
Health 
Center 
Bénigne Bashushana Laboratory Technician 
Spès Mbonabuca Head of Kayanza Health Center 
Consolate Nduwayezu Head of FP Services 
Tétine Solange Niyibizi Antenatal Care Provider 
Kayanza 
Health 
Center 
Gender￾Based 
Espérance Bantegeyahaga Provincial Coordinator of Family Development 
Center 
Marie Goreth Gakobwa GBV Community Volunteer 
Sabine Habiyambere GBV Community Volunteer 
Marie Goreth Kayobera GBV Community Volunteer 
66
Organization Name Title/position 
Burundi 
Violence 
Unit 
Sylvie Kayobera GBV Community Volunteer 
Marie Goreth Minani GBV Community Volunteer 
Lucie Niyibaruta GBV Community Volunteer 
Gertrude Niyibigira GBV Community Volunteer 
Pélagie Ntawe GBV Community Volunteer 
Domitile Ntuyahaga GBV Community Volunteer 
Immaculée Singirankabo GBV Community Volunteer 
Kayanza 
Health 
Center 
Family 
Planning 
Unit 
Anne Marie Citegetse FP Community Health Worker 
Siméon Hakizimana FP Community Health Worker 
Bernadette Nahimana FP Community Health Worker 
Eugénie Niyonsaba FP Community Health Worker 
Marie Nsaguye FP Community Health Worker 
Richard Sindihebura FP Community Health Worker 
RBP+ 
Kayanza 
Evelyne Bigirimana HBC Community Volunteer 
Christine Bizimana Care Services Officer 
 Joséphine Bucumi HBC Community Volunteer 
Marcienne Bucumi HBC Community Volunteer 
Oscar Ciza HBC Community Volunteer 
Abel Hicumusi HBC Community Volunteer 
Daphrose Hitimana HBC Community Volunteer 
Mariane Hatungimana HBC Community Volunteer 
Elie Kabonetse Chief of RBP + Kayanza provincial office 
Concilie Kayobera HBC Community Volunteer 
Aline Mukeshimana HBC Community Volunteer 
Ancile Mukeshimana HBC Community Volunteer 
Béatrice Mukeshimana HBC Community Volunteer 
Savela Nahabandi HBC Community Volunteer 
Emmanuel Ndayizeye Accountant 
Azela Ndereyimana HBC Community Volunteer 
Sostène Ndereyimana Project Supervisor 
Julienne Nganyirimana HBC Community Volunteer 
Cyprien Nibaruta HBC Community Volunteer 
Spéciose Ninteretse HBC Community Volunteer 
Caritas Ntahonkiriye HBC Community Volunteer 
Celestin Ntakarutimana HBC Community Volunteer 
Josélyne Ntakirutimana HBC Community Volunteer 
Anastasie Ntanyungu HBC Community Volunteer 
Agnès Nyabenda HBC Community Volunteer 
Floride Nyabenda HBC Community Volunteer 
Elie Nyandwi HBC Community Volunteer 
67
Organization Name Title/position 
Burundi 
Goreth Nyandwi HBC Community Volunteer 
Vénérande Nyanzira HBC Community Volunteer 
Aloys Nzigamasabo HBC Community Volunteer 
Samuel Sebaganji HBC Community Volunteer 
Marie Rose Tangishaka HBC Community Volunteer 
Organization Name Title/Position 
Kenya 
Nairobi 
FHI 360/ROADS Chris Degnan Associate Director - Private Sector 
Initiatives 
Leanne Kamau Associate Program Officer 
Boniface Kitungulu Associate Director - Strategic Information 
Dorothy Muroki Project Director 
Patrick Muthee Associate Director - Contracts and 
Grants 
Eunice Mutisya Behaviour Change Communications 
Officer 
Missie Oindo Senior Program Officer 
Tom Owaga Associate Director - Finance 
Robert Ritzenthaler Deputy Project Director 
PATH John Waimiri Project Director, Operation ARIFU, 
Uniformed Services 
Daniel Were Technical Advisor 
Howard University Andrew Maranga Regional Field Coordinator 
DAI Eliud Wakwabubi Livelihoods Advisor 
Mariakani 
FHI 360/ROADS George Dzombo Program Officer 
Ministry of Health Hussein Dima District AIDS and STIs Coordinator 
(DASCO) 
Dr. Lizzy Gathua District Pharmacist 
Dr. David Mang'ongo District Medical Officer of Health (DMOH)
Wellington Mulewa Pharmacist 
Edward Mwamuye District Health Education Officer 
Ray Vespus Pharmacist 
APHIA Plus partners 
Mariakani Youth 
Centre Sadik Chimera Coordinator 
Solidarity with 
Women in Distress 
(SOLWODI) 
George Odhiambo Coordinator 
PSI Sila Mulwa Coordinator 
Mariakani Magnet 
Theatre 
Salim Swaleh Coordinator 
68
Organization Name Title/position 
Burundi 
Pharmacies 
Immam Chemist Mariam Ibrahim Pharmacist 
Mariakani Boaz Obote Pharmacist 
Venture land Matano Maraga Pharmacist 
Immam Chemist Rose Samba Pharmacist 
Kenya 
Name Title/position 
Palm Land Chemist Joyce Wambui Pharmacist 
ROADS 
implementing 
partner - Kenya 
Long Distance 
Truck Drivers 
&Allied Workers 
Union (KLDTDAWU)
Romano Gichinga Assistant Coordinator 
Abubakar Kabocha Truck driver 
Joseph Kahindi Truck driver 
Ruth Karanja Coordinator 
Paul Mwangi Truck driver 
Jorum Mwaura Truck driver 
Salim Mwero Truck driver 
Athman Nganga Truck driver 
Tonny Nganga Truck driver 
Fed Salim Truck driver 
Felix Senja Truck driver 
John Wamalwe Truck driver 
Volunteers trained 
in general peer 
education 
Maria Akinyi Community Volunteer 
Sammy Charo Community Volunteer 
Jemmimah Kilonzi Community Volunteer 
Mutuku Kitili Community Volunteer 
Omar Komu Community Volunteer 
Felister Mbula Community Volunteer 
Matano Mthami Community Volunteer 
Lucy Mwendee Community Volunteer 
Rehema Ndzame Community Volunteer 
Esther Njoki Community Volunteer 
Mutisya Wambua Community Volunteer 
Edith Wangari Community Volunteer 
Grace Wendy Community Volunteer 
Volunteers trained 
in Alcohol and 
Substance Abuse 
Hermissi Abubakari Community Volunteer 
Maria Akinyi Community Volunteer 
Salama Chuda Community Volunteer 
Patrick Chitty Community Volunteer 
David M Dalu Community Volunteer 
Hamza Juma Community Volunteer 
69
Organization Name Title/position 
Burundi 
Jemmimah Kilonzi Community Volunteer 
Joyce Mkalu Community Volunteer 
Agnes Mtua Community Volunteer 
Charles Munene Community Volunteer 
Ali Nyota Community Volunteer 
James N. Nyota Community Volunteer 
Abubakari M.Tayari Community Volunteer 
Organization Name Title/Position 
 Mozambique 
Maputo 
FHI 360 Paulo Ambasse M&E Assistant 
FHI 360/ROADS Paulo Araújo Program Officer 
Dr. Jorge Blanco Country Director 
Caximo Caximo M&E Officer 
Shirley Ko Roads Country Manager 
Maltez Mabuie Community & Mobilization 
Officer 
Daniel Mamberro Site Coordinator – Munhava 
Stella Manjate Site Coordinator – Luis Cabral 
and Trevo 
Julião Matsinhe Economic Strengthening 
Officer 
Nilton Mazitemba Site Coordinator – Ressano 
Garcia 
Stephen Mucheke Senior Technical Officer - BCC 
Ana Paula de Sousa Gender Officer 
Maria Isabel Torres Clinical Officer 
Ministry of Health Dr Marina Kangenge Provincial Director of Health - 
Sofala 
Ministry of Transport 
Luis John Department of Transport 
Cordinator, Chief of AIDS 
Department - Sofala 
Munhava-Beira 
Youth Cluster Margarida André Peer Educator 
Zito Costa Peer Educator 
Armais Draiva Coordinator, Videc Youth 
Group 
Ancha Emilia Peer Educator 
Luis Francisco Peer Educator 
Claudina Frijão Accountant 
José João Peer Educator 
Isabel Joaquim Peer Educator 
70
Organization Name Title/Position 
 Mozambique 
Parafino José M&E Assistant 
Izequiel Lavo Peer Educator 
Helena Luís Peer Educator 
Mário Mavundo Peer Educator 
Zelia Silva Peer Educator 
Arminda Victor Peer Educator 
Women’s Cluster Feliciana Alberto Peer Educator 
Rosa Antonio Peer Educator 
Cristina Chane Peer Educator 
Alcinda Chiposse Peer Educator 
Quinita Fernando Peer Educator 
Joana Filipe Accountant 
Maria João Peer Educator 
Felizarda José Peer Educator 
Cristina José Peer Educator 
Claudina Luisa Peer Educator 
Paulo Simango M&E Assistant 
Pedro Viajeiro Coordinator, Luis na 
Comunidade Group 
Accumulating Savings 
and Credit Associations 
(ASCAS) 
Ana Maria Antóno Member 
Maria Berta Member 
Inácia Ferrão Member 
Dominga João Member 
Paulina Lourenço Coordinator, Luis na 
Comunidade Group 
Rita Merça Member 
Elisa Luis Pereira Member 
Naquene Paulina Member 
Isabel Sebastião Member 
Mariana Francisco Soares Member 
Maria Verónica Member 
People Living with HIV 
(PLHIV) support group 
Ana Maria António Peer Educator 
Vitor João Amade Peer Educator 
Olga Bizique Peer Educator 
Ermelinda Fernando Peer Educator 
Inácio Ferrão Foia Coordinator, Grupo de Apoio 
Luisa Fernando Peer Educator 
Maria José Peer Educator 
Flora José Peer Educator 
Cristina José Peer Educator 
71
Organization Name Title/Position 
 Mozambique 
Amélia Nhamato Peer Educator 
José Roque Peer Educator 
Men’s Cluster Isabel Alberto Coordinator, Fambizanai Mens 
Group 
Santos Alberto Peer Educator 
Chico Arnaldo Peer Educator 
Alberto Charles Peer Educator 
José Charles Peer Educator 
António Dango Peer Educator 
Imen Fred Accountant 
José Manuel Peer Educator 
Soia Manuel Peer Educator 
Victor Manuel Peer Educator 
Lourenço Sola Peer Educator 
Maria Vicente Peer Educator 
Trevo 
Women’s Cluster Nomelia Mazuze Coordinator, Capaz Women 
Group 
Leila Abdula Peer Educator 
Albertina Abilio Peer Educator 
Rosa 
DeolindaDeolinda 
Peer Educator 
Francisco Domingos Accountant 
Rosita Guambe Peer Educator 
Palmira Jeremias Peer Educator 
Elsa Macuacua Peer Educator 
Isaura I.Monica Peer Educator 
Abel Mungoi Peer Educator 
Rosa Namburete Peer Educator 
Izidro Nhangala M&E Assistant 
Beatriz Novele Peer Educator 
Alzira Sebastiao Peer Educator 
Hortencia Upiliamo Peer Educator 
Julia Vasco Peer Educator 
Lucrencia 
Vasco 
Peer Educator 
Verginia Zita Peer Educator 
Youth Cluster Albino Mondlane Coordinator, Ajota Pejota 
Youth Group 
João Vilanculos M&E Assistant 
Narciso Zavala Accountant 
72
Organization Name Title/Position 
Rwanda 
Kigali 
FHI 360/ROADS Anne Marie Ayinkamiye Technical Officer - Community-Based 
Prevention and Mitigation 
Jean Paul Balinda Technical Officer - Community-Based 
Prevention 
Didier Rukabu Kamali Country Manager 
Jean Baptiste Mugabo Technical Officer - Economic 
Strengthening 
Protais Ndabamenye Chief of Party and Francophone 
Countries Coordinator 
Phocas Ntahorugiye Technical Officer - Nutrition 
Anastase Nzeyimana Technical Officer - FP/MCH 
Rwanda Bio-medical 
Center (RBC) 
Dr. Anita Asimwe Deputy Director General 
Florida Mutamuriza In charge of Private sector and Civil 
Society Organizations (CSOs) 
Dr. Sabin Nsanzimana Head of HIV/AIDS,STIs and other 
Blood Borne Infections Division 
Program Coordinator 
Mr. Emmanuel Rusine Coordinator for Regional Project and 
Great Lakes Initiative on AIDS (GLIA) 
Focal Person 
Kicukiro District Emmérence Gatera Head of the Health Unit 
 Jean Damascène 
Kayiranga 
Executive Secretary of Kanserege 
Cell 
Theophile Niwemutoni Social Affaires in Charge in Kigarama 
Sector 
Clauthilide Mukamanzi District HIV Activity Coordinator 
Florence Uwayisaba Vice Mayor - Social Affairs and Health 
ROADS implementing partners 
ASOFERWA (Low 
Income Women’s 
Cluster) 
Flavie Kanyemera Technical Assistant in charge of Care 
and Support 
Chantal Kwizera Technical Assistant in charge of 
Prevention 
Joy Kwizera Economic Strengthening Focal 
Person 
Claudette Muhimpundu Director of Administration and finance 
Cassilde Mukamakombe Technical Assistant in charge of 
Prevention 
Jacques Niyonshuti Accountant 
Appolinaire 
Nshimiyimana 
Managing Director 
Livin Rurangwa Technical Assistant in charge of M&E 
73
Organization Name Title/Position 
Rwanda 
Ngabo J.M Rwurira- Economic Strengthening Focal 
Person 
Louise M Tuyisenge Technical Assistant in charge of MVC 
Program 
Association des 
Démobilisés pour le 
Développement, la lutte 
contre le SIDA et la 
Promotion de la Culture 
Rwandaise (ADSPCR) 
Youth Cluster 
Said Mazimpaka Mechanics Association representative 
Gloriose Mukeshimana Economic Strengthening Focal 
Person
Sandra Mutabazi Peer Educator 
Mariam Nikuze Membre du club des jeunes filles 
Jonathan Niyonzima ADSPCR Coordinator 
Adele Nyirabititaweho Cashier 
Simon Turikunkiko ADSPCR Representative 
Gikondo FP Post Naomie Musabirane In charge of the Secondary post 
Violette Kantamati Representative of Community 
Volunteers
Pascal Muyango 
Kayitaba 
FP Supervisor 
Marie Aimée Umutesi FP Provider 
Gatsata Community 
Center 
Philbert Romanus 
Mlyuka 
Truck drivers representative 
Sandra Mutabazi Peer Educator 
Chantal Nyakubyara Peer Educator 
Goretti Nyirabarigira M. Low Income Women Cluster Steering 
Committee 
Rusizi 
District Authorities Marie Alice Batamuriza Kamembe Sector Social Affairs 
Patrick Muturutsa Data Manager of District Health Unit 
Emmanuel Ndamuzeye Head of District Health Unit 
Françoise Nirere Vice Mayor - Social Affairs 
Peter Pokezi Tara Cell Executive Secretary
Herman Rwagasine Muganza Sector Social Affairs 
Coopérative des Femmes de Mururu (COFEM) - ROADS implementing partner 
Low Income Cluster Jeanne D'arc 
Mukakayijuka 
Technical Assistant in charge of MVC 
Program 
Innocent Niyonsenga 
Technical Assistant in charge of 
Prevention 
Fabien Ntagwabira Program Coordinator 
Djohari Nyiraneza 
Economic Strengthening Focal 
Person 
Antoinette Nyirazaninka COFEM Representative 
Abishizehamwe (PLHIV 
Cluster) Jean Minani 
Technical Assistant in charge of MVC 
Program 
Phenias Mutabazi Program Coordinator 
Jean Damascene Economic Strengthening Focal 
74
Organization Name Title/Position 
Rwanda 
Ndayizeye Person 
Beatrice Nyiranzeyimana Twizigamire GSLA President 
Ibrahim Uwimana Tinyuka Cooperative Representative 
Gihundwe HC 
Desiré Baritonda Data Manager 
Imelde Imaniliho Head of the Health Center 
Bugarama Islamic Health 
Center 
Shamilla 
Nyirandagijimana 
Deputy Head of Health Center 
Rusizi Health Center Ferdinand Macumu Deputy Head of Health Center 
Vestine 
Nyirandikubwimana 
Health Provider at Tara Secondary 
Post 
Organization Name Position/Title 
Tanzania 
FHI 360/ROADS 
Abdallah Mkumbwa 
Site Coordinator - Port of Dar es 
Salaam 
Melchiade Ruberintwari Country Manager 
Fredrick Ogenga Technical Officer - Economic 
Strengthening 
Ministry of Health 
(MOH)/Tanzania 
AIDS Commission 
(TACAIDS) 
Dr Raphael Kalinga Director of Evaluation and Research 
Port of Dar es Salaam 
COTWU (T) Samson Kabana Truck Driver/Peer Educator 
Mariki Kondo Truck Driver/Peer Educator 
Friday Likalala Truck Driver/Peer Educator 
Samson Lussumo Resource Centre Coordinator 
Mrace Mahena Truck Driver/Peer Educator 
Hilda Makene VCT Counsellor 
Magreth Millinga Truck Driver/Peer Educator 
Yusuf Mituka Truck Driver/Peer Educator 
Chisano Mwampashi Truck Driver/Peer Educator 
Nicholaus Mwashala Truck Driver/Peer Educator 
Monica Mwinuka Truck Driver/Peer Educator 
Mwanaharusi Nassoro Truck Driver/Peer Educator 
Bokorani Upendo Bakari Abdul Peer Educator 
Teddy Antoni Community Volunteer 
Hoyce Chabuluma Community Volunteer 
Miski Chaurembo Peer Educator 
Kazumari Chitwanga Community Volunteer 
75
Organization Name Position/Title 
Tanzania 
Stephen Gregory Peer Educator Focal Person 
Hussein Jaha Community Volunteer 
Andrew Jimmy Community Volunteer 
Nuru Juma Peer Educator 
Fidea Kalindaga Peer Educator 
Hamida Kapilima Community Volunteer 
Sybus Kikungwe Coordinator 
Rachel Luhega Community Volunteer 
Warange Marungu Community Volunteer 
Ramadhani Mataluma Community Volunteer 
May Mchomvu Peer Educator 
Ramadhani Mohamed Peer Educator 
Wastara Omary Peer Educator 
Doto Potopoto Peer Educator 
Madina Abdul Qadir Peer Educator 
Zalia Yasini Community Volunteer 
Tanzania Youth 
AIDS Control 
Program (TYACP) 
Youth Cluster 
Ally Abdallah Community-Based Distributor 
Fatuma Fidas Community-Based Distributor 
Shabani Harife Community-Based Distributor 
Tatu Kitenge Community-Based Distributor 
Lilian Magembe Community-Based Distributor 
Rehema Makanjila Peer Educator Focal Person 
Safiel Mgonja Coordinator 
Hafidh Mohammed Community-Based Distributor 
Latifa Moshi Community-Based Distributor 
Hadija Mtegame Community-Based Distributor 
Jamila Nguche Community-Based Distributor 
Pili Rashid Community-Based Distributor 
Pendo Warange Community-Based Distributor 
Khadija Wawa Community-Based Distributor 
Temeke Hospital Cristabella Mwanda Maternal Child Health (MCH) 
Coordinator 
Makambako 
Local 
government 
and 
government 
departments 
Godwin L.Benne Township Executive Officer￾Makambako Township Authority 
Averino M.Chaula District Social Welfare Officer 
Emilia Chiwanga Secretary To The District Medical 
Officer 
Michael K.Haule Council HIV/AIDS Coordinator 
Dr. Maria Lupenza Njombe District Medical Officer 
76
Organization Name Position/Title 
Tanzania 
Nicko Mandele District Community Development 
Officer 
Secilia Maseko District Reproductive and Child 
Health (RCH) Officer 
Tasilo B. Mdamu District AIDS Council Coordinator 
A.S.Mwampanga District Co-operative Officer 
Jonathan Siha Njombe District TB & Leprosy 
Coordinator 
Eng. Steven Siha Ag. District Executive Director - 
Njombe District Council 
Makambako 
Health Center 
Rose Chungu PLHIV HBC Tracking Coordinator 
Ritha Gadau PLHIV HBC Tracking Coordinator 
Hosea Kaguo PLHIV HBC Tracking Coordinator 
Christina Kisakali PLHIV HBC Tracking Coordinator 
Florence Mgaya CTC-Nurse 
Dr. Magreth Msasi Doctor in-charge 
Dr. John Salila Comprehensive Treatment Center 
(CTC) Head 
Mlimani GSLA Raheli Kalinga Chairperson, Evangelical Lutheran 
Church in Tanzania (ELCT) 
Southern Diocese 
Regina Kalinga GSLA member 
Luth Kibiki GSLA member 
Rose Kibiki GSLA member 
Upendo Kibiki GSLA member 
Jester Kigahe GSLA member 
Elizabert Kimbawala GSLA member 
Diana Kinyunyu GSLA member 
Elekia Kinyunyu GSLA member 
Sophia Kinyunyu Secretary, ELCT Southern Diocese 
Janet Kisoso 
 Accountant, ELCT Southern 
Diocese 
Aneda Makweta GSLA member 
Mariam Malega GSLA member 
Bosco Mayanga GSLA member 
Leokadia Mdemu GSLA member 
Blantina Mdugo GSLA member 
Pielina Mfilinge GSLA member 
Rejina Michael GSLA member 
Ester Mkola GSLA member 
Sijali Mkula GSLA member 
Queen Mlamka GSLA member 
77
Organization Name Position/Title 
Tanzania 
Rebeca Mlonganile GSLA member 
Onesmo Myinga GSLA member 
Neema Ndendya GSLA member 
Meck Ngili GSLA member 
Furaha Nyagawa GSLA member 
Jonisia Nyaulingo GSLA member 
Scola Peter Sanga GSLA member 
Frida Simime GSLA member 
PLHIV Cluster Rehema Arone PLHIV cluster member 
Paulina Chaula PLHIV cluster member 
Sophia Chaula PLHIV cluster member 
Rose Chungu PLHIV cluster member 
Asheli Gadau PLHIV cluster member 
Ritha Gadau PLHIV cluster member 
Ayubu Homange PLHIV cluster member 
Hosea Kaguo Chairperson, JUHUDI Post Test 
Club (PTC) 
Frola Kawogo PLHIV cluster member 
Jester Kigahe PLHIV cluster member 
Pelesi Kihungu PLHIV cluster member 
Fednand Kilamlya PLHIV cluster member 
Enelika Kilasi PLHIV cluster member 
Christina Kisakali PLHIV cluster member 
Maria Kiyaulilo PLHIV cluster member 
Tumaini Kunyumba PLHIV cluster member 
Leokadia Kyando PLHIV cluster member 
Eliza Licheka PLHIV cluster member 
Scola Lupande PLHIV cluster member 
Regina Matama PLHIV cluster member 
Venelanda Matandala PLHIV cluster member 
Dominika Mavika PLHIV cluster member 
Chezalina Mawona PLHIV cluster member 
Lozadei Mbata PLHIV cluster member 
Amina Mbogela PLHIV cluster member 
Nazalena Mbugi PLHIV cluster member 
Ainesi Mfilinge PLHIV cluster member 
Agrista Mgaya Accountant, JUHUDI PTC 
Fabiola Mgaya PLHIV cluster member 
Jastine Mhavile PLHIV cluster member 
Scola Mhelela PLHIV cluster member 
Enea Mhepela PLHIV cluster member 
78
Organization Name Position/Title 
Tanzania 
Asha Mlango PLHIV cluster member 
Emelia Mng’ong’o PLHIV cluster member 
Andrew Mpagike PLHIV cluster member 
Ambokile Msigala PLHIV cluster member 
Yusuph Mtelewa PLHIV cluster member 
Grace Mtweve PLHIV cluster member 
Frida Mwakasala PLHIV cluster member 
Venace Ngimbuchi PLHIV cluster member 
Joshua Nyamba PLHIV cluster member 
Duwani Nyome PLHIV cluster member 
Helena Pila Secretary, JUHUDI PTC 
Semeni Salehe PLHIV cluster member 
Amina Sanga PLHIV cluster member 
Hezron Sanga PLHIV cluster member 
Ritha Sanga PLHIV cluster member 
Victoria Sanga PLHIV cluster member 
Miraji Sengele PLHIV cluster member 
Fatuma Tagalile PLHIV cluster member 
Lemija Waya PLHIV cluster member 
Staff and volunteers, SafeTStop, Mariakani, Kenya 
 
79
ANNEX E. EVALUATION SITE VISIT SCHEDULE 
ROADS Project Evaluation: Schedule for Mozambique Site Visit
May 30th ‐ June 3rd, 2012
Time Theme and Activities
Day 1: Wednesday May 30th
07.50 ‐ 10.45hrs Evaluation Team travel to Maputo from Nairobi; hotel check‐in at Serena
Polana Hotel
12.00 ‐ 13:00hrs Briefing with ROADS Mozambique (Estradas); USAID/Mozambique to
attend
13.00 ‐ 14.00hrs Lunch Break
14.00 ‐ 16.00hrs Sexual prevention
Visit to Trevo for discussions with female sex workers and low‐income
women involved in ESTRADAS community cluster organizations
Day 2: Thursday May 31st  
6.45 ‐ 10.30hrs Flight to Beira
11.30 ‐ 12.30hrs ROADS community organizing approaches  and participation of local
leadership  
Meeting with local community leaders at a community center.  
12.30 ‐ 13.30hrs Lunch Break
13.30 ‐ 14.30hrs Sexual prevention cont’d
 Visit Beira SafeTStop Resource Centre   
 Meet and hold discussion with youth cluster committee
14.30 ‐ 15.30hrs Sexual prevention cont’d
Discussion with sex workers  
15.30 ‐ 17.00hrs Immediate  Social Networks
Discussion with women cluster at the cluster office    
Day 3: Friday 1st June  
8.30 ‐ 9.30hrs Government collaboration  
Discussion with  the Direcao Provincial de Saude (Provincial Director of
Health) at Beira Provincial Hospital
9.30 ‐ 11.30hrs Male Involvement
Discussion with the Beira  Men‘s Cluster at the community center
11.30 ‐ 12:45hrs HIV Prevention and Care for PLHIV
Meet and conduct discussion with a PLHIV support group at the
community center
12.45 ‐ 14.00hrs Lunch Break
14.00 ‐ 16.00hrs   Multi‐sectoral involvement of Government of Mozambique  
Discussion with the Ministry of Transport / transport companies Steering
Committee for HIV Prevention  
21.05 ‐ 22.40hrs Flight to Maputo
Day 4: Saturday  June 2nd    
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ROADS Project Evaluation: Schedule for Tanzania Site Visit
May 29th to June 3rd, 2012
Time Theme and Activities
Day 1: Tuesday, May 29th  
22.10 ‐ 23.25hrs Flight Nairobi to Dar es Salaam (Ishrat Hussein)
Day 2: Wednesday, May 30th
9.00 ‐ 10.00hrs Briefing with FHI 360 Tanzania ROADS key staff; country programme
overview
10.30 ‐ 11.30hrs Briefing with USAID Tanzania
11.30 ‐ 13.00hrs Sexual Prevention Strategies ‐  FSW Intervention (regional lessons)
 Discussion with female sex workers in Port of Dar
13.00 ‐ 14.00hrs LUNCH
14.00 ‐ 17.30hrs Sexual Prevention Strategies cont’d… ‐ SafeTstop Resource Center
Visit to Port of Dar Resource Centre: discussion with truckers
Addressing Root Causes: Gender Based Violence,  Alcohol  Abuse  
 Discussions with clusters on GBV and FP
 Discussions with clusters on alcohol counseling  
18.05 – 19.20hrs Flight Nairobi to Dar es Salaam
Day 3: Thursday, May 31st
7.00‐16.00hrs Drive to Makambako
Day 4: Friday, June 1st
9.00‐13.00hrs Care and Support Continuum
 Visit to PLHIV cluster
 Economic Strengthening  
 Visit to Makambako Health Centre
13.00‐14.00hrs LUNCH
14.00‐17.30hrs Collaboration with local leadership, Government of Tanzania  
 Njombe District Headquarters meeting with the ministries of
Health, Community Development / Cooperative Development,
Agriculture and Livestock officials
Day 5: Saturday, June 2nd  
7.00‐16.00hrs Drive to Dar es Salaam
Day 6: Sunday, June 3rd  
08.25 – 09.40hrs Flight to Nairobi (Ishrat Hussein)
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ROADS Project Evaluation: Schedule for Burundi Site Visit
June 3rd ‐ 6th, 2012
Time Theme and Activities
Day 1: Sunday,  June 3rd
11.35‐01.45 Arrival times of USAID team from Nairobi
(KR: 15.30‐17.25) (WP: 23.50‐01.45) (M O’G: 15.30‐17.25) (IH: 10.55‐
11.35)
Day 2: Monday , June 4th
8.00 ‐ 9.00hrs Presentation on ROADS Burundi Program
9.15 ‐ 10.00hrs Briefing with USAID at Burundi Mission
10.15 ‐ 11.00hrs Meeting with Ministry  of Public Health and the Fight Against HIV/AIDS /  
SEP CNLS ( National AIDS Commission)
11:00 ‐ 14:00hrs Travel to Kayanza, Hotel Check‐in and Lunch
14.00 ‐ 16.30hrs HCT, PMTCT, PT, FP/GBV
 Visit to Kayanza Health Center  
 Interact with the community on  FP/GBV at Kayanza Health Center
Day 3: Tuesday, June 5th
8.30 ‐ 9.15hrs Local Collaboration with Government of Burundi
Meeting with Kayanza Province Governor and Head of Provincial Health
Office at Governor’s office.
9.15 ‐ 11.00hrs HIV and Health Service Integration
Visit Kayanza Hospital  
11.00 ‐ 13.00hrs Care and Support and / or FP/RH in the context of GBV
 Presentation on home based care at RBP Plus office
 Interact with PLHIV volunteers in Muruta commune
13.00 ‐ 14.00hrs Lunch at Paradise Hotel , Kayanza
14.00 ‐ 16.00hrs Departure for Bujumbura   
Day 4: Wednesday, June 6th
08.10 – 08.45hrs
12.25 – 16.25hrs
Flight to Kigali (WP + MO’G)
Flight to Nairobi: (KR)
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ROADS Project Evaluation: Schedule for Rwanda Site Visit
June 6th to 9th, 2012
Time Theme and Activities
Day 1: Wednesday, June 6th
08.10 ‐ 08.45hrs
09.35 – 10.45hrs
Flight Bujumbura to Kigali (Billy Pick + Ishrat Hussein)
Flight Nairobi to Kigali (Wairimu Gakuo)
10.00 ‐ 11.00hrs Briefing with FHI 360 Rwanda ROADS key staff; Country Program overview
11.00 ‐ 12.30hrs Briefing with USAID Rwanda
12.30 ‐13.00hrs Government‐led programming
 Visit to RBC: Meeting with RBC Office government  
13.00 ‐ 14.00hrs LUNCH
14.00 ‐ 15.00hrs Government‐Community planning and implementation processes
 Visit to Kanserege Cell Office   
 Discussion with local government officials
 Discussions with clusters in Gikondo  
15.00 ‐ 17.30hrs Integrated services – Family Planning
 Visit to Gikondo Family Planning post
 Discussion with FP clients
 Cluster discussion on lessons from introducing new technical area into
programming
Day 2: Thursday, June 7th
9.00 ‐ 13.00hrs An integrated M&E platform
 ROADS M&E system overview
 Visit to peer educators / Health Centre: data tool development, data
collection process
 Visit to cluster IP office: data entry and analysis processes, examples of
key learning from data analysis and how to use data
13.00 ‐ 14.00hrs LUNCH
14.00 ‐ 17.30hrs Working with MARPs and hidden populations
 Truck driver parking visit
 Visit to HTC service targeting truck drivers and local populations; group
discussion with men
 Visit to Gatsata Youth Cluster: Girls intervention
Day 3: Friday, June 8th
06.55 ‐ 07.30hrs Flight to Rusizi (check‐in by 04.55)
9.00 ‐ 10.30hrs Local collaboration with GoR
Visit to District HQ: Meeting with ministries of Health, Community
Development / Cooperative Development, Agriculture and Livestock
officials
10.30 ‐ 13.00hrs Applying innovation: reaching FSWs
 Discussions with FSW group  
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 Visit to Gihundwe Health Centre
13.00 ‐ 14.00hrs LUNCH
14.00 ‐ 17.30hrs Care and support continuum
Drive to Bugarama:
 Visit to Bugarama Islamic Health Centre
 Economic Strengthening
 Visit to care and support groups (PLHA cluster, OVC)
Day 4: Saturday,  June 9th
9.00 ‐ 12.00hrs Cross border services  
 Drive to Rusizi II border  
 Visit HTC services
 Discussion with truck drivers
12.00 ‐ 13.00hrs LUNCH
15.25 – 15.55hrs Return flight to Kigali
17:00 – 18.00 Evaluation Team Meeting with USAID/Rwanda Mission Director Dennis
Weller
21.55 – 23.30hrs
TBD
Return flight to Nairobi (Billy Pick + Mary O’Grady)
Onward to US (Ishrat Hussein)
ROADS Project Evaluation: Schedule for Kenya Site Visit
June 10th to 11th, 2012
Time Theme and Activities
Day 1: Sunday 10th June
18.30 ‐ 19.30hrs Flight Nairobi to Mombasa
Day 2: Monday 11th June
08.00 ‐ 09.30hrs Travel to Mariakani
09.30 – 11.00hrs Country‐led development process for BCC messages
 Discussion with GoK and targeted community participants in
national message development process
11.00 ‐  11.45hrs Linking with pharmacies and drug‐shops along the transport corridor
 Discussion with pharmacy network members
11.45 – 13.00hrs Adoption of key BCC messages by APHIAplus partners
 Discussion with other USG partners in consistent local utilization of
national messages
13.00 – 14.00hrs Lunch Break
14.00hrs Travel to Mombasa
16.10 – 17.10hrs Flight to Nairobi
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ANNEX F. LIST OF DOCUMENTS REVIEWED 
1. Regional overview brief 
2. Mid-term evaluation recommendations and ROADS response 
3. Country briefing documents 
a. Program briefs (Burundi, Djibouti, Kenya, Mozambique, Rwanda, Tanzania, 
Uganda and Zambia) 
b. Site assessment summaries (Burundi, Djibouti, DRC, Ethiopia, Kenya, 
Mozambique, Rwanda, South Sudan, Tanzania, and Uganda) 
c. UNAIDS Epidemiological factsheets for the relevant countries, as available 
4. Technical proposals 
a. ROADS I 
b. ROADS II 
5. Technical briefing papers 
a. Sexual prevention 
b. HTC 
c. HBC/OVC 
d. PMTCT/ART 
e. FP/RH/GBV and MNH 
f. Economic strengthening 
g. Gender 
h. Alcohol 
i. Capacity building 
6. M&E Building the evidence: ROADS evaluation agenda 
7. ROADS project awards 
1.1 ROADS I technical proposal 
1.2 Mid-term evaluation report and ROADS’ response 
1.3 ROADS II technical proposal 
1.4 LWA 
1.5 Associate Awards (Burundi, Kenya, Mozambique, Rwanda, Tanzania, Uganda and 
Zambia) 
8. Briefing documents 
a. ROADS regional and country briefs 
b. Site assessment summaries (Burundi, Djibouti, DRC, Ethiopia, Kenya, 
Mozambique, Rwanda, South Sudan, Tanzania and Uganda) 
c. Behavior Monitoring Surveillance (BMS) summaries 
9. Selected strategic frameworks 
10. USAID/EA progress reports (FY 2006, 2007, 2008, 2009, 2010, 2011 and semi-annual 
for FY 2012) 
11. Project monitoring and evaluation presentations and documents 
12. ROADS II training and operations manuals 
13. Various ROADS intervention, situational, and technical assessments in specific districts 
in several countries 
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14. ROADS II presentations made to the Evaluation Team by FHI 360 ROADS II staff and 
project implementing partners, including: Development Alternatives, Inc. (DAI), 
Howard University/Pharmacists and Continuing Education (PACE), and the Program 
for Appropriate Technology in Health (PATH) 
15. Status and achievements of country program PP presentations made to the Evaluation 
Team in the countries where site visits were made 
16. Selected abstracts and presentations made to national and international fora 
17. Selected learning stories 
18. Tables and graphs specifically developed at the request of the Evaluation Team 
19. Selected photos and films from ROADS sites, including clinics, interventions, clusters, 
community members, and individual beneficiaries 
20. Various communication materials used by ROADS in the local languages in countries 
to disseminate information and for BCC messaging.