DRAFT WORKPLAN TEMPLATE



Partnership Quarterly Progress ReportResource Partner:Recipient Partner: quarterly report period:date of submission:Submit to:name titleemail addresssection 1implementation planPlease highlight/note activities conducted in the last quarter that contribute to the partnership’s sustainability plan. Objective 1Expected Outcome ActivitiesFY 2014 (Oct 2013 – Sept 2014)Output Indicator or Result Results to DatePerson(s) Responsible for Activity Q1Q2Q3Q41.1Progress this quarter: 1.2Progress this quarter:1.3Progress this quarter:Objective 2Expected Outcome ActivitiesFY 2014 (Oct 2013 – Sept 2014)Output Indicator or Result Results to DatePerson(s) Responsible for Activity Q1Q2Q3Q42.1Progress this quarter: 2.2Progress this quarter:2.3Progress this quarter:Objective 3Expected Outcome ActivitiesFY 2014 (Oct 2013 – Sept 2014)Output Indicator or Result Results to DatePerson(s) Responsible for Activity Q1Q2Q3Q43.1Progress this quarter: 3.2Progress this quarter:3.3Progress this quarter:section 2trainings conducted during reporting periodAccording to the PEPFAR definition, a training event refers to new training or retraining of individuals and assumes that training is conducted according to national or international standards when these exist. A training must have specific learning objectives, a course outline or curriculum, and expected knowledge, skills and/or competencies to be gained by participants.Please list all of the training events conducted this quarter in the table below. For each training event listed in the table, please also attach the following documents:Completed Training Event FormSign-in sheets with all participants listed for each trainingA printable template of the Training Event Form is annexed to this report. Please print it out for use during training events, and send us the completed form for each training event along with this quarterly report. Sign-in sheets should include name, gender, professional affiliation, contact information (when applicable), and signature.Name of TrainingLocationDurationNumber/Type of Individuals Trained123Section 3exchange trips completed during reporting period Please attach relevant trip reports or A3 forms to the PQR. Trip No.DatesPurpose of TripLocationRelates to Objective/Activity No.Title and Names of Travelers 1 23Section 4collaboration with others during reporting period Name of OrganizationCollaboration/ActivitiesAdded Value to the PartnershipPerson(s) ResponsibleSection 5monitoring and evaluation Monitoring FrameworkIn addition to general information about training events and technical assistance provision during the quarter, the Twinning Center also collects partnership-specific data on donor-mandated and “custom” indicators. Please provide the information for the indicators listed during the reporting period in the table below. IndicatorBaseline at Beginning of FY15Target for End of FY15Result at End of the QuarterCumulative Result to DateTimeframe(if different than FY15)Data Source Frequency of Data Collection Responsible person/agencyPEPFAR Indicator 1: PEPFAR Indicator 2: Custom Indicator 1: Custom Indicator 2: Custom Indicator 3: Use and Dissemination of FindingsHow were partnership data and/or relevant information disseminated and used during this reporting period?Are there any changes or updates in the partnership’s original plan to disseminate and use findings from M&E activities?Please list planned activities to use and disseminate findings in the next quarter:Section 6PARTNERSHIP ACTIVITY challengesChallengeHas it been addressed? If so, how? (Include updates from previous reporting period)Timeframe/Deadline (if applicable)Person(s) Responsible (if applicable)Section 7additional accomplishmentsPlease list any additional accomplishments during this review period that were not part of the initial twinning partnership workplan (i.e. reaching additional target populations, obtaining buy-in from key stakeholders)Section 8in-kind contributionsA. Professional Time (volunteer time only)This table collects information about non-budgeted time spent by partners from the lead institution (the one providing technical assistance) working on partnership activities. Please do not include any time spent on partnership activities that are budgeted in and paid for out of the sub-grant from AIHA (e.g., if 20 percent of someone’s salary is covered in the partnership budget, only include time spent in excess of that). NameProfession/ Job TitleOrganization# of HoursActivities CompletedB. Other DonationsCategoryDescriptionEstimated ValueSource/DonorMedical Equipment and SuppliesEducational MaterialsPharmaceuticalsLodgingMeals and Incidental ExpensesOtherOtherSection 10projected activities for next quarterPlease indicate any changes or adjustments to the next quarter’s workplan in response to lessons learned or to accommodate unanticipated changes in the work environment. Please do NOT simply cut and paste from the original workplan. center3937000 Training Event FormPartnershipTitle of TrainingDateAccording to the PEPFAR definition, a training event refers to new training or retraining of individuals and assumes that training is conducted according to national or international standards when these exist. A training must have specific learning objectives, a course outline or curriculum, and expected knowledge, skills and/or competencies to be gained by participants.# Hours Trained: Start Date: End Date: Training of Trainers (yes/no)? Pre-service or In-service Training? Number of Participants Completing Training**:Target Population/Audience:Training Method (more than one method can be selected):Didactic TrainingSkills-Building Workshop Clinical TrainingClinical ConsultationTechnical Assistance Training Objectives: To increased quality health support in home based palliative care services provided to people affected by HIV/AIDSBrief Description of Training Event (Please include the expected knowledge, skills and/or competencies to be gained and any possible next steps): ** Only participants who complete the full training course should be counted. If a training course is conducted in more than one session/training event, only individuals who complete the full course should be counted. All trainings must have authorized sign-in sheets to confirm participant attendance and show gender and professional affiliation. Attached: Sign-in sheets with all participants. ................
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