PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions 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. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Activity links with C0906 & P0510 & C0905
Recent studies indicate that unsafe injection practices account for a substantial proportion of transmissible infectious diseases such as HIV and viral hepatitis. With funding from the EP, JSI and its subcontractors, PATH and AED are supporting the GOB through the MOH to strengthen the existing injection safety systems and promote safety of healthcare workers, patients, and the community.
This activity is a continuation from FY05 and FY06. The MMIS program is working in four districts, including Kgatleng, Lobatse, Kanye/Moshupa and Gaborone, covering 103 health facilities comprised of 5 hospitals, 62 clinics, and 36 health posts, and serving approximately 380,000 people.
1. Capacity building, support, and training:
By July 31, 2006, a total of 2,350 healthcare workers including nurses, doctors, laboratory and dental staff, pharmaceutical staff, lay counselors, environmental health staff, healthcare waste handlers had been trained in infection prevention and control and injection safety. MMIS will continue to provide trainings to improve the IPC/IS knowledge, competency and skills of healthcare workers.
In FY07, JSI will target 5,000 additional healthcare workers in the expansion districts (Jwaneng, Mabutsane, Good Hope, South East, Kweneng West, Mahalapye, Kgalagadi North, Tutume, Boteti) and Chobe districts. The health care workers will receive in-service training to provide them with skills in injection safety practices.
2. Logistics and injection commodity management:
In FY06, the primary focus for this intervention was in the Lobatse and Kgatleng districts where the MOH and MMIS are implementing the use of retractable syringe technology for one year to evaluate if its use can reduce the number of needle-stick injuries. In September/October 2006, MMIS will conduct an assessment on the use of retractable syringe technology during the previous 12month period.
In FY 07, MMIS will focus on establishing a state-of-the-art management information system at the district level to assist districts and CMS with effective management and utilization of medicines and injection equipment. MMIS will also support BEDAP, CMS. MMIS, with its partners (BEDAP, DMU and CMS will finalize the revision of "The 2000 Botswana Drug Management Guidelines."
3. Advocacy, behavior change and communications:
During FY06 several IEC materials were developed with injection safety messages targeting healthcare workers, patients and the community. Estimates suggest that 200,000 people were reached through various channels of BCC and advocacy messaging in the four districts.
For FY 07, with its partners MMIS will develop a multi-year BCC and advocacy strategy to guide scaling-up of injection safety messages. This will include an expansion of the scope of communication and advocacy efforts targeting the general public through strategically sequenced activities. MMIS will also discourage demand for unnecessary medical injections from patients, and encourage decision makers to adapt IPC safety measures for healthcare workers and patients.
4. Health care waste management:
In FY06, MMIS has primarily been supporting the GOB through MOH, MLG and Ministry of Environment, Wildlife and Tourism to enforce its "1996 Code of Practice for Clinical Waste Management Healthcare Waste Management."
During the FY 07 implementation period, MMIS will finalize the revision of the Code of Practice for Clinical Waste Management, which has been in development since 2004, which was the initial phase of the program. MMIS will work with partners to identify
methods of leveraging resources and strengthening healthcare waste management efforts.
5. Health care worker safety:
In conjunction with NISAG and other partners, MMIS developed a national policy on infection prevention and control focusing on injection safety and sharps waste management. The policy is currently under review by healthcare workers in the country.
MMIS will finalize the IPC/IS policy during FY 07, and advocate for institutional administrative procedures, and IPC guidelines to improve healthcare worker safety.
6. Informal sector:
A substantial proportion of Batswana seek medical services from traditional healers whose services sometimes result in skin punctures. To extend safety to all health providers, MMIS will work with the MOH's DHAPC - Traditional Health Practitioners' Program to raise awareness and train traditional health practitioners on safe medical practices. Linkage with activity C0906
7. Monitoring and evaluation:
in Sectember 2006, MMIS will conduct a follow-up health facility assessment in the pilot districts to gather information on the effectiveness of retractable syringe use. A baseline and follow-up assessment in the expansion districts is also planned for scale-up of program activities. Supervision visits are crucial to the evaluation of MMIS interventions and will be conducted on a quarterly basis with results reported quarterly to HHS/CDC/BOTUSA, MOH, and MMIS/HQ. Other M&E activities include conducting an evaluation of BCC efforts through a community survey as well as a drug utilization study (prescription record review) to look at injection use.
Scaling-up:
MMIS is planning to scale-up its interventions to ten new health districts [Jwaneng, Mabutsane, Good Hope, South East, Kweneng West, Mahalapye, Kgalagadi North, Tutume, Boteti and Chobe districts] by September 2007. MMIS will also extend its services to the BDF Health Corps starting from October 2006.
Sustainability: MMIS implements its activities using consultative and multi-disciplinary approach to sustain the interventions. During FY 07 MMIS will finalize the sustainability strategy and submit it to MOH. The sustainability strategy outlines how MMIS interventions will be integrated into government departments and programs at the end of September 2009.
