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.
The Funding Mechanism will change to a new # as the funds will be awarded to National Institute for Communicable Diseases (NICD) via CoAg U62/CCU022901. The best mechanism to support the continued laboratory accreditation in Botswana has been found to be the National Institute for Communicable Diseases, South Africa as they are the regional experts in this field and they already have an existing CoAg with HHS/CDC.
Table 3.3.13: Program Planning Overview Program Area: Strategic Information Budget Code: HVSI Program Area Code: 13 Total Planned Funding for Program Area: $ 3,483,902.00
Program Area Context:
The national response to the HIV/AIDS in Botswana is multi-sectorial and involves many partners. The National AIDS Coordination Agency (NACA) coordinates and monitors/evaluates the response. The United States Government (USG) team in Botswana had the vision to support the Government of Botswana (GOB) over the past years in establishing one national monitoring and evaluation system. The creation of the Botswana HIV/AIDS Response Information Management System (BHRIMS) at NACA has experienced many delays in the implementation due to lack of human resources and challenges with decentralization efforts. While many challenges remain, significant progress has been made. USG has supported the creation of a BHRIMS Informatics Subcommittee that is in the process of designing the national electronic M&E system (eBHRIMS). An InfoAid was initiated with the HHS/CDC Atlanta Public Health Informatics Fellowship Program for assistance in creating an eBHRIMS data model and data dictionary. Once that is complete this group will analyze gaps in functionality between the eBHRIMS prototype and the requirements to determine the feasibility of adding additional functionality (e.g. program/project tracking) to the prototype. The USG supported a national Information Communication Technology (ICT) infrastructure and use of ICT resources assessment by key health officers during FY06. The final report will be disseminated to key stakeholders for use in planning ICT infrastructure upgrades and ICT training prior to full deployment of eBHRIMS.
Another major strategic information challenge in HIV/AIDS response is the existence of multiple data collection and reporting systems within GOB (especially in the MOH where there are various programs). These systems are not integrated and cannot easily share information among them. In addition, since data definitions are not consistent across systems, data from different systems cannot be aggregated easily. Furthermore, some of these systems are proprietary and the users can not easily access data contained in these databases. A national working group has been created to address strategic issues related to integrating health information systems in Botswana. The main objectives of the working group are to develop an HIV data warehouse to integrate patient level data from HIV and TB programs, design and implement a plan for integrating health information and monitoring systems, and define data confidentiality and security strategies, including standards. Entry number T1111 (Harvard Central) will implement this initiative in FY07 using the Integrated Patient Management System (IPMS) and Patient Information Management System (PIMS) datasets as a start-up. Lessons obtained from this initiative will guide a national HIV data warehouse development.
For the USG office itself, an internal CRIS-PEPFAR monitoring and evaluation system developed by UNAIDS in collaboration with HHS/CDC/Global AIDS Program (GAP) Atlanta and HHS/CDC/BOTUSA is being pilot tested in Botswana. This system, once operational, will enable in-house electronic data capture and reporting of indicators and programmatic data. The system is based on the same platform as the national BHRIMS. Therefore the exchange of data to and from and the national system could be simplified.
Pertaining to program monitoring and evaluation (M&E), the USG provides regular technical support in program evaluations, funded a national service provision assessment survey in FY06, and supported two rounds of M&E training in fiscal year (FY) 05 and FY06. Few of the success stories from the USG's technical support included active participation in the evaluation of the Total Community Mobilization project, economic and demographic evaluation of HIV/AIDS impact in Botswana, and BAIS (Botswana AIDS Impact Survey) II report writing and secondary data analysis. During FY07, the USG will in collaboration with NACA) and Central Statistics Office (CSO) begin the planning process to undertake BAIS III in FY08. BAIS III is expected to provide another set of population-based data on HIV prevalence and the outcome/impacts of HIV/AIDS response on sexual behavior. In the meantime, Botswana will continue to undertake the ANC sentinel surveillance annually which has recently included antiretroviral (ARV) resistance testing (FY05 and FY07) and HIV incidence estimation (FY05, 06 and 07). USG funds will help disseminate and follow up of recommendations of the health facility survey in collaboration with Ministry of Health (MOH) and Ministry of Local government (MLG) during FY07.
Technical Work/Services In the area of surveillance, USG in FY07 will support 1) antenatal sentinel surveillance on HIV prevalence, incidence and ARV drug resistance; and 2) annual behavioral surveillance survey among the students aged 15 to 24 years in selected grades to compliment the behavioral data collected by the BAIS in collaboration with Ministry of Education (MOE).
Targeted evaluations (TE) During FY07 there will be 12 targeted evaluations in prevention program area (P0105, P0203/P0512, P0501, P0506, P0507, P0508, P0513), palliative care (C0612), counseling and testing (C0904, C0910) and in strategic information area (X1301, X1303, X1304). Results of the routine HIV testing (RHT) program evaluation (C0910) and assessment of the implementation of post-exposure prophylaxis provision post-rape (P0507) will guide the MOH in improving and scaling up the two programs in the country. The HIV prevention needs assessment of men having sex with men (MSM) (P0508) and the situation analysis of care and support services for people living with HIV/AIDS (PLWHA, C0612) will provide vital information for the implementation of effective and efficient HIV prevention and care programs for these subgroups in Botswana. Activity X1303 will explore the plausible explanations for the recent decline of HIV prevalence among young pregnant women and guide the development of evidence-based HIV prevention and care strategies. PMTCT program in Botswana has a national coverage and generates nationally representative data which could be useful for HIV prevalence surveillance. This TE will explore the utility of PMTCT data for HIV surveillance (X1304) while TE X1301 will focus on validation of mortality data to assess the impact of ARV therapy on childhood mortality. All these TEs will abide to all the ethical requirements as per the Botswana Human Research Development Committee HRDC) and the HHS/CDC/Atlnata Iinstitutioal Review Board (IRB). Protocols will be developed in due time.
Policy Human capacity development (HCD) remains a major obstacle to the establishment of an efficient strategic information system in the country. During FY07, USG will collaborate with the International Training and Education Center on HIV (I-TECH) to support 56 positions at central ministry level. These positions include one chief health information officer, one principal systems analyst I; and one senior systems analyst for MOH's Department of Policy Planning and Monitoring and Evaluation (DPMME); one data manager, two data clerks, and one public health specialist for MOH's Department of HIV/AIDS Prevention and Care (DHAPC); and one M&E officer and one data manager for the MLG's Department of Primary Health and Primary Services. Another senior strategic information/systems specialist and an epidemiologist/surveillance specialist will also be recruited to work for the MOH's DHAPC. These two positions will be contractual advisors to the MOH and will not be absorbed in the public service. 45 Information Management Officers will be recruited to work for the District AIDS Coordinating (DACs) Office (21 of them) and District Health Team Offices (25 of them). These officers will be given job-induction training and M&E trainings before and right after assuming their positions. In-service training and supervisory support will also be provided by I-TECH.
Program Area Target: Number of local organizations provided with technical assistance for strategic 9 information activities Number of individuals trained in strategic information (includes M&E, 222 surveillance, and/or HMIS)
Table 3.3.13:
