Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

CHALLENGE FACILITY FOR CIVIL SOCIETY (CFCS)

Application Form
ROUND 3
Please note: The deadline for receipt of completed proposals, including all
supporting documents1 is 10 February 2010 at 23.59 GMT.
COVER SHEET

NAME OF THE PROJECT

TUBERCOULOSIS ADVOCACY,
COMMUCATION IN VOLTA.

PREVENTION

&

BEHAVIOURAL

CHANGE

NAME OF THE ORGANIZATION

GOSANET FOUNDATION.
COUNTRY IN WHICH THE WORK WILL BE DONE
GHANA

TOTAL AMOUNT REQUESTED (Indicate amount in US Dollars)

TWENTY THOUSAND US DOLLARS (US$ 20,000.00)
TARGET COMMUNITY (people living with TB, HIV/AIDS, MDR-TB, women,
children, poor/neglected communities, or people living in remote rural
areas)
Nabu,Koni,Yeganbo,Ogyeri,Ubanja,Hodzo
,Kodzobi etc.

,Akoefe

Tokor,Avenuie,Gadza,Kpetoe,

Adaklu

OPINION LEADERS, POOR/NEGLECTED COMMUNITIES AND PEOPLE LIVING IN

REMOTE RURAL AREA
1

Former grant recipients must provide a copy of their project completion and financial report for the
previous grant awarded. CSOs that already received 2 grants from CFCS are not eligible to apply.

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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

IMPORTANT: Applicants are strongly encouraged to read the Guidance for

CFCS Applicants - Round 3 before completing this application form.

CHECKLIST
Please indicate whether your Organization has:
documentation to confirm that it is a registered organization,
either nationally or provincially
(Please include it with your submission)

Yes

Yes

been operating for at least one full year

Yes

an overall manager

regular contacts to health care facility(s)

Name: Ho Municipal Hospital
Location: Ho
Nkwanta District Hospital
Nkwanta

Yes

regular funding sources

No

Please indicate annual budget for year 2009: ___us_30, 00___

and year 2010: ____us_89, 00___________.

any outstanding debts. If so, how much: _US$__________

No

Please indicate the number of staff

your organization has

Are you a Stop

TB Partner?

Full-time staff: _3__

Part-time staff: _5__

No

Volunteers: _14__

Has someone from the local, city or regional health authority

(e.g. director of health centre) provided a letter of support for
this application?
(Please include it with your submission)
Page 2

Yes

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

BACKGROUND DETAILS OF THE GRANT APPLICANT

Please type or print clearly.

Name of person from the organization responsible for managing the grant:
SAMUEL YAO ATIDZAH
Mailing address:
GOSANET FOUNDATION
P. O. BOX HP 637
HO. VOLTA REGION, GHANA, W/AFR.
Telephone No(s): +233 208221964 / 244158139 Fax No:
Email address:

gosanetin@yahoo.com

Please use half a page per question when responding the following:
1) What are the mission and objectives of your organization?
To provide opportunities for people who live in circumstances of social and
economic deprivation to eradicate poverty and provide for T.B. and HIV
prevention.
- To create awareness on T.B/HIV Counselling, Testing, Prevention,
Treatments and care services.
- To provide Care and Support for people living with T.B,HIV/AIDS and
orphans vulnerable Children (OVCs)
- To strengthen the socio-economic capacity of families to meet the
challenges of caring for children who become, T.B, HIV/AIDS positive,
disabled and orphaned.
- To help individuals to develop effective communication skills, which will
enable them to educate others about Tuberculosis (T.B) HIV and AIDS,
Malaria and other related diseases.
- To help reduce illiteracy.
- To promote Child education.
- To promote Community Development Programmes.
- To assist Women, Youth, Teenagers, School drop outs, Street Children
in the region to acquire skills.
2) What are the current funding sources of your organization?

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Challenge Facility for Civil Society (CFCS)

Name of Organization:

PROJECT
NBHADA Sensitizing
Programme
Skill Training Workshop
Community Project on
HIV/AIDS
Prevention, Behavior
Change Communication

GOSANET FOUNDATION

DONOR
GOSANET Foundation

IMPLIMENTATION
February 2006

Gosanet Delade women

Group
Ghana AIDS Commission

May 2008

Ghana AIDS Commission

Dec, 2009

August 2008

3) Do you have a track record in capacity building or community engagement at

the grass roots?
Give 3 concrete but short examples (e.g. report the results of an assessment and
say how you used these results to improve your work).
1. Gosanet Foundation organized Training for 2 volunteers each from 13
communities in Ho municipality.
2. Form Anti HIV/AIDS educational club in 10 community schools.
3. Train 25 HIV/TB peer educator at Kpassa in North Nkwanta District.
4) Has your organization been involved with advocacy, communication or social
mobilization efforts related to health in the past?
- Give 2-3 concrete examples. Gosanet Foundation organized Sensitization
Programmes on T.B, HIV/AIDS, Counseling, and Testing to prevent mother
and child transmission in five Ho Municipality. They are Tokokoe, Atikpui,
Nyive, Shia and Akoefe.
-

Ghana Planner, National Black HIV/AIDS Awareness Day(NBHAAD) in

communities in Volta Region since 2006. To create awareness HIV/AIDS
community mobilization effort designed by Strategic Leadership CouncilU.S.A.

Trained 25 peer educator at Kpassa and Sensitized 518 in school youth on

HIV and AIDS, T.B. Prevention and behavior Change Communication, in
Nkwanta North District.

5) How and which part of the Country's Tuberculosis Control Programme (NTP) does
the work of your organization support? If none, please describe another national
health initiative that your organization focuses on.
Gosanet Foundation form and support four different P.L support groups at Ho
Municipal Hospital.
- Care and support services for OVCs and PLWHAs.
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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

Education on T.B. Prevention, HIV/AIDS and Malaria.

Skill Training and capacity building.

6) Do you work with other international or national development initiatives (e.g.

UNDP, NEPAD, ActionAID)?
Yes.
1. Ghana Health Service
2. Ghana Coalition of NGOs in Health.
3. Ghana HIV/AIDS Network (GHANET)
4. National HIV/AIDS Awareness Day.- U.S.A.
5. World AIDS Day Campaign.

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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

FUNDING PROPOSAL
Please type or print clearly. You may attach up to 2 additional pages for this section

1. Introduction (Please provide a brief introduction to the gap/challenge

you are trying to address)
The Tuberculosis disease, deadly as can be image, but curable has a global concern
due to the difficult to eradicate nature of it, especially in developing countries like
Ghana, as a result of lack of knowledge on its prevention. Tuberculosis is destroying
individuals, families, communities and the Nation as whole.
The development agenda of Ghana as it reflects in the Poverty Reduction Strategy
and National Tuberculosis Control Programmes Framework are aimed at preventing
the deadly disease of T.B. in a way of;
- Sensitizing on Tuberculosis to prevent people from contracting the disease.
- Access to testing and treatment.
- Access to care and support
In spite of increased awareness the prevalence rate of infection in Ghana and the
Volta Region is alarming and frightening. If something drastic is not done through
community commitment and comprehensive education, the most vulnerable groupsyouth, men and women will soon, will soon be wiped away. Available statistics have
shown that each year, over 52,00 people suffer from this disease and it is feared that
about half of this number is likely to die without proper treatment.
TUBERCULOSIS CASES DETECTION AT NKWANTA GOVERNMENT HOSPITAL
YEAR
2006
2007
2008

CASES
37
34
54

MALE
21
26
31

FEMALE
16
8
27

3 YEARS

129

78

51

COVERAGE %
43
51
43

UNCOVERED %
57
49
57

TUBERCULOSIS CASES DETECTION AT HO

YEAR
2007
2008
2009

CASES
148
180
153

It is for this reason, that the Ghana Government is concern with public education on
the disease through professional Association and NGO partners.
GOSANET Foundation is one of the functionary groups that have been carry out
public education activities in collaboration with other CSOs in North Tongu, Nkwanta
North, Ho and Adaklu Anyigbe districts of the Volta Region.
This alarming situation is what Gosanet Foundation in collaboration with District
Health Officers and Community Health Workers seeks to salvage by mounting this
project to help in the prevention of the disease in Ghana, when given the opportunity
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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

2. Objectives (Clearly state objectives which are specific, measurable,

achievable and realistic for the timeframe of the project -- max. 3)
To reduce the morbidity of Tuberculosis and HIV in the Ho, North Tongu and
Adaklu Anyigbe Districts.
To enable the activities of NTP and NACP in providing quality care, prevention
and support for the people living with T.B and HIV at risk.
Facilitate curative measures by encouraging the public to avail themselves for
free medication for T.B and HIV patients through public education.

3. Activities (What are the specific activities and interventions you

propose to carry out to deliver on the objectives outlined in 2)
1. Peer Educators Training and Year-long advocacy education.
2. Dialogue and Advocacy promotion with community Elders/Chiefs/Opinion
leaders.
3. Behaviour Change Film shows and Innovative Communication.
4. Comprehensive Information, Education and Behaviour Change
Communication (IE & C/BCC)
5. Inter Schools/Youth groups Competition on prevention and Protection of T.B.
and HIV.
6. Effective Project, Supervision, Monitoring and Evaluation.
7. Care and Support for infected and affected Persons/Communities/Caregivers.

4. Expected Outcomes - grant results

(identify outcome measures / indicators: For each outcome, identify one or
more outcome indicators that could be measured to track progress towards
the outcomes, see Guidance for Applicants)

Outcome 1:
Indicator 1: 4000 Women and adolescent girls reached and demonstrated
changed behaviour
Indicator 2:2000 Men/ drivers/workers/farmers and young adults adopted
responsible behaviour
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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

Outcome 2:20 Schools mobilized and advanced to carry out peer education
on T.B and HIV in target population.
Indicator 3:
Outcome 3: community Elders/peer educators/ behaviour change advocate
trained and engaged in comprehensive Education and counselling.
Indicator 4: Community members are aware of free medication and TB is
curable.
[use "Delete Row" from "Table" menu in Microsoft Word menu bar to delete or add Indicators as necessary]

5. Workplan

[I
You should support your proposal for a Challenge Facility grant by attaching a ns
er
detailed work plan for the duration of the grant (attached as a separate t
annex). The detailed budget for these activities should also be provided in the An
relevant section (11) of this application form.
ne
x
No INTERVENTION SPECIFIC OBJECTIVE
TIME
EXPECTED
na
AREA
FRAME OUTPUT
m
e
of
1
Prevention and 1.Train Peer Educators for
6
50 selected
de
Behaviour
year -long advocacy
months community
change
/Education
leaders/strategic tai
communication
persons selected, le
2.Dialogue and Advocacy
d
trained and
W
promotion with community
engaged in
or
Elders/chiefs/opinion
behaviour change k
leaders.
advocacy.
Pl
an
3.Behaviour change film
6
50
]

shows and innovative

communication

months

communities/villa
ges 6000 people
educated on TB
prevention and
protection.

4.Comprehensive
information education and
behaviour change
community(IE&C/BCC)

6
months

No. Of Posters,
Notice Boards,
fliers developed
and distributed to
20 schools,40
religious groups.

5.Inter School/Youth groups

competition on Prevention
and Protection of TB.

8
months

2000 youth
demonstrated
changed

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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

behaviour through
participation in
prevention
competition.

Treatment
Care and
Support

6.Effective Project
Supervision Monitoring and
Evaluation.

8
months

No. Of M&E
meetings held. No
of field visits
effected progress
report /Feedback
compiled and
comprehensive
project report
written and
delivered on time.

7. Care and support for

infected and affected
persons/community/caregiv
ers.

8
months

No. Of
PLWTB/HIV
identified and
supported with
food, counselling
and welfare
provisions.
No. of
caregivers/affecte
d families
educated.

6. Monitoring
The purpose of monitoring the grant is to follow progress in
implementation, measure performance, inform decisions during
implementation, and help identify problems that need the attention of
managers.
Applicants are requested to describe the monitoring system that will be
used to monitor the grant activities against the indicators defined in 4.
INTERVEN
TION AREA

ACTIVITY

OUTPUT
INDICATOR

MEANS OF
VERIFICAT
ION

Prevention
and
Behaviour
change
communica
tion

1.Peer educators
Training and Year-long
advocacy/Education

Peer Educators
Workshop held

*Attendan
ce records.
*Reports
*Official
observatio

Page 9

[Insert
Annex
name of
Monitor
ing
Plan]

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

n.
2.Dialogue and
Advocacy Promotion
with community
Elders/Chiefs/ Opinion
Leaders.

Peer educator
hold no. Of
education
throughout target
communities.

*Attendan
ce record

3.Behaviour change film

shows and innovative
communication

No. Of
communities/com
munity members
reached with film
shows.

*Pictures

IE&C/BCC
materials
developed and
distributed.

*Observati
on

4.Comprehensive
Information, Education
and Behaviour change
communication

*Reports
*Resolutio
ns

*Communi
ty
feedback
*Reports

*Pictures
*Samples
reports
* No. Of
patients
reporting
to Health
Facilities
with TB.

5.Inter School/Youth
groups competition on
prevention and
protection.

20 schools and
no. Of students.
Youth participate
in prevention
competition.

*Records

6.Effective project
supervision, Monitoring
and Evaluation/Report
writing/submission

Project officers
and
District/Regional
Health officers
engage in
Monitoring of
Project and
Report developed.

*Data

No. Of PLWTB
Identified and
supported with
welfare

*Media
Coverage

7.Care and support for

infected and affected
persons/communities/ca
regivers.

Page 10

*Pictures
*Official
Observatio
n

*Minutes
of
meetings
*Picture
*Reports

*Picture

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

provisions.

*Reports

No. Of caregivers
affected families
educated.

7. Time frame (specify start and completion date of project)

From March 2010 to January 2011

8. Sustainability -- Plan to ensure the sustainability / continuation of

the project activities after this grant:
The object of the stakeholders orientation is also a strategy for institutionalizing
all the findings, best practices and update on TB incidence in the area using the
resolution as a tool for ensuring corporate commitment and sustenance of the
project activities and objectives.
The community and corporate bodies will therefore own the project outcomes, be
guided to sustain all their efforts through the community programs and eagerly in
subsequent initiative by the PMI.

9. Depending on the objective(s) of the grant, explain how the

activities will forge new collaborative work relationships (e.g. with
health workers , district authorities, NTP officers, other NGOs)
Government agents, community leaders/Assembly men/women, District and Local health
personnel, chiefs, family heads, midwives, drug dealers, faith based organization leaders
and other opinion leaders shall be assembled for intensive discussions with professional
resource persons. They will be educated on the new drug policy, TB prevention, use of
health facilities and community participation in TB prevention interventions.

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Challenge Facility for Civil Society (CFCS)

Name of Organization:
GOSANET FOUNDATION

10. Summary Table

Objective

Activity

A 3 day Workshop to
train peer
educators/volunteers

Training of 50 voluntary
local based assistants

Advocacy promotion
with community
leaders/chiefs

Community entry (50

communities)

Behaviour change
initiatives
communication
IE&C/BCC

Film shows, raising

notice boards,
Distribution of fliers in
20 villages/schools

Organize

Sensitize Promote

competition in 20
schools

Care and Support for

infected persons

Monitoring and
Supervision/Report
Writing.

GH

US$

Duration

7,774.50

5183.00

3 DAYS

3,375.00

2250.00

6 MONTHS

3,607.5

2405.00

6 MONTHS

PERFORMANCE INDICATORS
WHO

HOW

WHEN

Protect
Coordinator

Training

One Month

Protect
Coordinator

Public Durbars
Public Forums

April-Dec 2010

Protect
Coordinator

Public Education
Advocacy
Programmes

6 months

Seminars,
Group
discussions in
2010

6 months

Prevention/Protection of
TB.

6,000

4000.00

6 MONTHS

Protect
Coordinator
Volunteers

Treatment, Care and

support.

6,300

4200.00

6 MONTHS

Protect
Coordinator
Volunteers

Provide
Welfare, Food,
counselling

6 months

Monitoring and
Evaluation of Project

2,943.00

1962.00

6 MONTHS

Protect
Coordinator
Stakeholders

Project
monitored

6 months

[use "Insert Row" or "Merge Cell" from "Table" menu in Microsoft

Word menu bar to add as many additional rows, merge or delete as
required]

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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

11. BUDGET DETAILS

Please ensure that your budget reflects an appropriate balance
between salary and activities (75% or more for activities and 25% or
less for salaries)

Objective no.

Specific Activity

& Cost Category

Local
Currency

US$
equivalent

1
1.1

A 3 day Workshop to
train peer
educators/volunteers

Training of 50
voluntary local based
assistants

Advocacy promotion
with community
leaders/chiefs

Community entry (50

communities)

Behaviour change
initiatives
communication
IE&C/BCC

Film shows, raising

notice boards,
Distribution of fliers
in 20 villages/schools

Organize

Sensitize Promote

50 Handout@10.00
each
1.2
Hall rental @ 70.00*3
days
1.3
Hiring Training material
@ 20.00*3
1.4
Feeding of 60
participants @ 12.00*3
days
1.5
T&T refund for 50
participants @ 25.00
1.6
Honorarium for
Resource Persons @
3*80.00*3 days
1.1.1 Writing letter &
Telephone calls @
120.00
1.1.2 Fuel for Personnel
5*50*20
1.1.3 Protocols 20*50
1.1.2 Film show in 30
communities @ 50*30
Raising 5 Notice board @ 40*5
Developing & Distribution of
fliers in 20 schools @
100*20*50
Rentals
Allowance for 50 volunteers

7,774.50

5183.00

3,375.00

2250.00

3,607.50

2405.00

30 Sachet of water @
100*20
200 T-shirts @ 4.50
each
News coverage@ 120.00
Refreshment for 100
Dignitaries @ 5.00*100
Honorarium for
Resource Persons
2*70*20

6,000.00

4000.00

1.3 Welfare services for

estimated 200*15.00
Provision for caregivers 200*10

6300.00

1.2
1.3
competition in 20
schools

Prevention/Protection
of TB.

1.4
1.5
1.6

Care and Support for

infected persons

Treatment, Care and

support.

Page 13

4200.00

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

2
Monitoring and
Supervision/Report
Writing.

Monitoring and
Evaluation of Project

2.1 Per diem for 3 Field

officers@50.00 for 6 months
Fuel for officials @ 70*3
months
Typing, Printing of Reports
90*6

2,943.00

1962.00

2.2
2.2.1
3
3.1 Fuel for Resource
persons/Consultancies

Monitoring Visits

2,100.00

1,400.00

3.2
3.3
Total:

24,403.00

Amount of grant being requested: US$ 20,000.00

ACTIVITY

IMPUTS

CONTRIBUTION
FROM GOSANET

Monitoring Visits

Fuel for Resource

persons/Consultancy
GOSANET

TOTAL
GH
2,100.00

US$

2,100.00

1,400.00

1,400.00

Budget Justification:
If the budget approved, it will be used to implement programmes and activities as
mentioned in the implementation plan.

Page 14

3,400.00

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

Annex I
MID-TERM REPORT
1. Disbursements (Indicate amounts in US Dollars)
US $
A

Approved grant

Funds received

Total amount spent as per budget details

Balance (B-C)

Outstanding payment on receipt of this

report

2. Narrative Report
Please type or print clearly. You may attach up to 5 additional pages for
this section.
2.1 Summary Table
Objective
[use "Insert
Row" or "Merge
Cell" from
"Table" menu in
Microsoft Word
menu bar to add
as many
additional rows,
merge or delete
as required]

Activity

Planned
Output
10 IPCC
trainings

Output
achieved

Baseline
outcome
indicator

11 IPCC
trainings

70% of
patients
satisfied
with the
counselling

Outcome
achieved so far
(if any at this point)

72% of patients
satisfied with the
counselling

2.2 For you, which are the unexpected outcome(s) of the funded grant
(different from 2.1) to this date?

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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

2.3 What have been the challenges thus far with implementing the grant?
[use as much space as required, the boxes can be expanded]

2.4 What have you learned about your program through the data
gathering and outcome tracking process?

2.5 Course of Action: What changes are you considering that might
improve your efforts and your performance?

2.6 How can CFCS staff be helpful in terms of building capacity and going
smoothly through the grant cycle?

3. Please provide the contact details of the main stakeholders to

this grant (e.g. local health authorities)
Stakeholder

Phone number

Email address

4. Please provide a detailed Financial Report

(you may attach it to this report)

Page 16

Location

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

Annex II
COMPLETION REPORT
1. Please provide a copy of the grant budgeting expenses
(you may attach it to this report)
At the end of the financial report, please add a declaration signed by an appropriately
authorised officer of the funded organisation stating the following:

I declare that:

this report is complete and accurate

the expenditure detailed in the financial report has been extracted from the
organisations financial accounting records

a detailed record of income and expenditure at an individual item level is

available

the funds allocated to this project were used in accordance with the contract
and the Application Form, including any variations to the project approved by
the Stop TB Partnership Secretariat in writing.

Signature:
Full name of authorised officer:
Position in the organisation:
Date:

2. Narrative Report
You may attach up to 5 additional pages for this section.
2.1 Summary Table
Objective
Example
Increase
awareness
of the
importance
of
treatment
adherence
among TB
patients in
community
X

Activity
Example
Improve
counselling
services
through
interpersonal
counselling and
communication
(IPCC) training
for health-care
providers

Planned
Output

10 IPCC
trainings

Output
achieved

11 IPCC
trainings

Page 17

Time
span

AprDec
2010

Baseline
outcome
indicator

Outcome
achieved

(pre-test)
70% of
patients
satisfied with
the
counselling

(post-test)
72% of
patients
satisfied
with the
counselling

Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

2.2 For you, which are the most important expected and unexpected
outcome(s) of the funded grant (different from 2.1)

2.3 Did your project encourage community members to take action to

address a health issue? Please explain:

3. Some results (you may add more results related to HIV or MDRTB, as required)
Total number
of persons:
Approximate number of beneficiaries reached in
person:
(e.g. small awareness raising mtgs, house-to-house
visits, etc.)

Approx. number of beneficiaries reached through

other means:
(e.g. radio, media, public events, large meetings)

Approx. number of people that received printed

information about TB:
Number of referred cases:
Number of those resulting in TB diagnose:
Number of defaulters traced:
e.g. Number of people supported through a
community mechanism:
e.g. Number of cases diagnosed with MDR-TB:
e.g. Number of HIV patients tested for TB:
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Challenge Facility for Civil Society (CFCS)

Name of Organization:

GOSANET FOUNDATION

4. Did you find a way to sustain the activities you started with the
grant? Please describe it:

Page 19