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.
07-T1113: Rollout of Early Infant Diagnosis-Training.
This activity has USG Team Botswana Internal Reference Number T1113. This activity links to the following: C0613 & C0615 & P0101 & T1101 & T1107 & T1108 & T1109 & T1114 & T1119 & X1301.
In FY07 the roll out of early infant diagnosis of HIV will continue activities begun in FY06. Until recently, most HIV-exposed infants who received services through the government PMTCT program were routinely tested for HIV at 18 months, when an ELISA or rapid HIV test could be reliably performed. Infants who were ill enough to be seen by a pediatrician could be diagnosed earlier if a pediatrician ordered a DNA PCR, as the capability to do phlebotomy and DNA PCR tests does exist in Gaborone.
However, early diagnosis of HIV in infants before they become ill is pivotal for a number of reasons. For HIV-infected infants, early diagnosis makes possible early treatment with ARVs and other therapy for HIV-infected infants; For HIV-negative infants who are being breastfed by HIV-positive mothers, early diagnosis allows an earlier switch to replacement feeding, before the infant acquires HIV. Further, for all HIV-negative infants, early exclusion of HIV infection eases the emotional burden on the mother, and may allow for easier bonding between mother and infant. Finally, for the PMTCT program as a whole, early diagnosis facilitates tracking of program success.
From June - December 2005, a pilot program was conducted to determine if HIV-exposed infants could be routinely screened by nursing staff in public health facilities for HIV using a DBS methodology and DNA PCR test at the age of six weeks.
In the pilot, blood samples were collected by heel stick and placed on filter paper to create a dried blood spot. The pilot evaluation assessed feasibility, quality of results, and cost of the methods employed. In addition, it identified challenges and lessons learned for the implementation of a national early infant diagnosis system. During the six-month period, 1,917 HIV-exposed infants were tested, and 6.7% of the infants were found to be infected with HIV. Operationally, the DBS methodology worked well, was acceptable to staff and mothers, and tests were performed accurately and efficiently in the lab. Based on this successful pilot, a national rollout of early infant diagnosis using DBS and DNA PCR testing was recommended, and started in FY06.
In FY07, work will continue to complete rollout by increasing the capacity of all doctors and nurses throughout the country to make DBS from heelstick blood. In collaboration with the National Health Laboratories, more laboratory technicians will also be trained to perform DNA PCR tests in order to cope with increased demand. All HIV-exposed children attending postnatal clinics will be tested at 6 weeks or during their first postnatal visit. The mothers will be advised to come for the results after two weeks. The child's HIV exposure status will be put on the child's "under-five clinic card" at delivery to help identify and track HIV-exposed infants. Older infants under 18 months of age will be tested using a rapid HIV test and if positive will then have blood collected for PCR testing. This will save money because if the large disparity in testing methodologies.
The second component of this project will be to strengthen supervision of the roll out. PMTCT focal persons and laboratory personnel at the District Health Team (DHT) will conduct supervisory support visits to the antenatal consultation (ANC) clinics to ensure that clinic staff perform DBS collection according to set standards, and that HIV-positive infants are referred for treatment in a timely fashion. Likewise, PMTCT personnel will also carry out regular supervisory visits to the districts.
