Cross-Cutting Attributions

Cross-cutting allocations are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully.

There are 16 cross-cutting attribution categories in the database:

Except where noted, the following definitions for the cross-cutting attributions come from Appendix 2 of PEPFAR’s 2015 COP Guidance.

Adolescent Girls and Young Women (AGYW)

Countries should estimate the total amount of funding from their country budgets, not including central funds, which can be attributed to HIV prevention among adolescent girls and young women ages 9 to 24. OUs should include both preventing sexual violence and preventing HIV through avoiding sexual risk activities that focus on helping youth avoid risk before it begins (e.g., preventing sexual violence and any form of coercive/forced/non-consensual sex in the community, preventing early sexual debut, supporting healthy choices, and helping communities and families to surround these youth with support and education – all these activities must be grounded in evidence-based prevention programming), as well as preventing sexual violence and preventing HIV through reducing sexual risk activities that help youth reduce risk (e.g., limiting number of partners, condom use, PrEP, post-violence care).

Condoms: Commodities

This secondary cross-cutting budget attribution is meant to capture the cost condoms procured using bilateral funds including:

Please note: most PEPFAR OUs order condoms through USAID’s Commodity Fund (CF) and do NOT pay for condoms using bilateral funds. Only those few OUs that are not eligible to order condoms through the CF and are therefore purchasing condoms with bilateral funds should be reporting through this secondary cross-cutting budget attribution.

Condoms: Policy, Tools, and Services

This secondary budget attribution should capture all activities with the following components:

Construction/Renovation

These attributions are meant to capture construction and renovation costs. Construction refers to projects to build new facilities, such as a health clinic, laboratory, or hospital annex or to expand an already existing facility (i.e. adds on a new structure or expands the outside walls). Renovation refers to projects with existing facilities intended to accommodate a change in use, technical capacity, or other infrastructure improvements. PEPFAR funded construction projects should serve foreign assistance purposes, will involve facilities that are provided to the partner government (or potentially to another implementing partner) as a form of foreign assistance, and are considered necessary to the delivery of HIV/AIDS-related services.

Importantly, from 2010 to 2012 the Construction and Renovation categories were combined in the COP documents and could not be tallied separately. Thus, when selecting 'Construction/Renovation', the database will automatically include the individual 'Construction' and 'Renovation' categories that exist for 2013 and beyond.

Delivery

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Economic Strengthening

Countries should estimate the amount of funding for each activity that is attributable to economic strengthening activities, including:

Education

Efforts to promote effective, accountable and sustainable formal and non-formal education systems should be included in this secondary budget attribution. In particular, activities focused on basic education, which is defined as activities to improve early childhood education, program area education and secondary education delivered in formal or non-formal settings. It includes literacy, numeracy and other basic skills programs for youth and adults. Activities related to life skills training and HIV prevention education within the context of education programs or settings should also be included in this budget attribution. Please see the Technical Considerations for what can be included as Education.

Food and Nutrition: Commodities

This secondary budget attribution is meant to capture the provision of food commodities through food by prescription, social marketing, school feeding, OVC, PMTCT or other programs, including:

Please note that "safe water" is NOT included in this definition of food and nutrition. It is addressed separately, in the definition for Water.

Food and Nutrition: Policy, Tools, and Service Delivery

This secondary budget attribution should capture all activities with the following components:

Gender: Gender Based Violence (GBV)

This secondary cross-cutting attribution should capture all activities aimed at preventing and responding to GBV, For PEPFAR, GBV is defined as any form of violence that is directed at an individual based on his or her biological sex, gender identity or expression, or his or her perceived adherence to socially-defined expectations of what it means to be a man or woman, boy or girl. It includes physical, sexual, and psychological abuse; threats; coercion; arbitrary deprivation of liberty; and economic deprivation, whether occurring in public or private life. GBV is rooted in gender-related power differences, including social, economic and political inequalities. It is characterized by the use and abuse of physical, emotional, or financial power and control. GBV takes on many forms and can occur across childhood, adolescence, reproductive years, and old age. It can affect women and girls, men and boys, and other gender identities. Women, girls, including men who have sex with men and transgendered individuals are often at increased risk for GBV. While GBV encompasses a wide range of behaviors, because of the links with HIV, PEPFAR is most likely to address physical and sexual intimate partner violence, including marital rape; sexual assault or rape; female genital cutting/mutilation; sexual violence against children and adolescents; and child marriage.

Examples of activities for "Preventing and Responding to Gender-Based Violence" include: Collection and Use of Gender-related Strategic Information: assess differences in power and gender norms that perpetuate GBV as well as gender and societal norms that may facilitate protective actions against GBV and changes in attitude and behaviors; analysis of existing data on different types of GBV disaggregated by sex, age and geography, and in relation the HIV epidemiology in order to identify priority interventions and focus in the context of PEPFAR programs; analysis of treatment, care and referral services data by sex and age to ensure the unique needs of actual and potential victims are being met; employ rapid assessment, situational analyses and other quantitative and qualitative methods to understand norms and inequalities perpetuating GBV:

Activities marked as GBV will now be required to provide additional information on specific acuities supported. Upon ticking the GBV crosscutting attribution box a drop-down menu of activities will appear. Teams should select all that apply.

Gender: Gender Equality

This secondary cross-cutting attribution should capture all activities aimed at ensuring that men and women have full rights and potential to be healthy, contribute to health development and benefit from the results by taking specific measures to reduce gender inequities within HIV prevention, care and treatment programs. This would consist of all activities to integrate gender into HIV prevention, care, and treatment and activities that fall under PEPFAR’s gender strategic focus areas

Examples of these activities include:

Activities marked as GBV will now be required to provide additional information as part of a drop-down menu. Teams should select all that apply.

Gender: Reducing Violence and Coercion

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Human Resources for Health

This attribution includes the following:

Key Populations: FSW

This budget attribution is meant to capture activities that focus on sex workers. Relevant activities include: 1) implementation of core HIV prevention interventions for SWs consistent with PEPFAR guidance on sexual prevention; 2) training of health workers and community outreach workers; 3) collection and use of SI on SWs and clients; 4) conducting epidemiological, social science, and operational research among SWs, their partners, and clients; 5) monitoring and evaluation of SW programs; and 6) procurement of condoms, lubricants, and other commodities essential to core HIV services for SWs.

Activities marked as Key Population: SW will now be required to provide additional information on activities.

Teams should select all that apply and must select at least one tick-box if there is funding in this crosscutting attribution.

Please include the amount of the budget allocated to SW activities and check all of the following boxes that apply:

Key Populations: MSM and TG

This budget attribution is meant to capture activities that focus on gay men, other men who have sex with men including male sex workers, and those who do not conform to male gender norms and may identify as a third gender or transgender (TG). Broader definitions can be found in Appendix ____. These activities may include 1) implementation of core HIV prevention interventions for MSM/TG that are consistent with the current PEPFAR technical guidance; 2) training of health workers and community outreach workers; 3) collection and use of strategic information; 4) conducting epidemiological, social science, and operational research among MSM/TG and their sex partners; 5) monitoring and evaluation of MSM/TG programs; and 6) procurement of condoms, lubricants, and other commodities essential to core HIV services for MSM/TG.

Activities marked as Key Population: MSM/TG will now be required to provide additional information on activities. Teams should select all that apply and must select at least one tick-box if there is funding in this crosscutting attribution.

Please include the amount of the budget allocated to MSM and TG activities and check all of the following boxes that apply:

Motor Vehicles: Leased/Motor Vehicles: Purchased

Countries need to provide the total amount of funding by Implementing Mechanism, which can be attributed to the purchase and/or lease of motor vehicle (s) under an implementing mechanism. The term Motor Vehicle refers to motorcycles, cars, trucks, vans, ambulances, mopeds, buses, boats, etc. that are used to support a PEPFAR Implementing Mechanism overseas.

Public Health Evaluation

Public Health Evaluations (PHEs) were implemented in the 2009 COP cycle and ultimately removed to be funded centrally for the COP 2010 cycle. Per the COP 2010 guidance, the purpose of the PHEs were as follows:

Emphasis will be placed on addressing strategic priority questions of global significance that can inform and improve PEPFAR programming broadly, that PEPFAR is uniquely poised to address, that are of sufficient scale and scientific rigor, that can be addressed in a timely and efficient manner and that take advantage of central coordination and support where appropriate. While we expect that most priority questions will fall into the category of global significance, there may be some exceptions. Therefore, it is recognized that there is a need to allocate some funding to country-specific priority questions that respond to requests of host governments or address locally specific implementation challenges.

Renovation

See Construction/Renovation above

Water

Countries should estimate the total amount of funding from their country budgets, not including central funds, which can be attributed to safe water. Activities include support for availability, access, and use of products to treat and properly store drinking water at the household level or other point-of-use, and promotion of hand washing with soap.