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.
Years of mechanism: 2008 2009
08.C0617
Opened in 2003, the COE has built the capacity to provide substantial support to the government of
Botswana for scaling up and improving pediatric HIV/AIDS activities nationwide. The advent of the Pediatric
AIDS Corp program in 2006 provided us with the means to substantially extend our support and to create
linkages with important government partners. Key areas of expansion in 2006/2007 include the following:
1. Consistent support of inpatient and outpatient pediatric programs at Princess Marina Hospital (PMH) and
Nyangabgwe Referral Hospital (NRH). 2. Regular outreach support to district hospital ARV sites in the
Greater Gaborone and Francistown areas; 3. Linkage with the Ministry of Education (MOE) to support
teacher training workshops aimed at empowering teachers to better support HIV-infected and affected
students; 4. Curriculum development and clinical mentorship of interns in collaboration with the national
referral hospitals, the University of Botswana, and the University of Pennsylvania; 5. Began augmenting
PMTCT linkages with public hospitals and clinics; 6. Expanded services for HIV-infected adolescents
receiving HIV care from both the public and private sectors. 7. Increased activities in the area of TB/HIV co-
infection. 8. Provision of expert support for national guidelines development.
CDC-PEPFAR has supported these efforts through the employment of staff including the training
coordinator, 4 nurses, and the Associate Director as well as through the provision of funds specifically
earmarked for the Pediatric KITSO Training Course. In the last 12 months, the following indicators were
tracked for VCT, ART care, palliative care and health professional training by the Botswana-Baylor team:
The COE requests continued support from USG-PEPFAR for the continuation and expansion of pediatric
patient care and training activities. The COE, in close collaboration with the Department of Paediatrics at
Princess Marina Hospital, will continue to provide comprehensive HIV/AIDS care and treatment to children
and adolescents. We anticipate enrolling approximately 200 new pediatric and adolescent patients for ART
in the coming year. Despite enrolment of new patients, we do not anticipate a substantial expansion in the
COE-based active patient caseload as we will continue to transfer stable patients to newly operational and
expanding government PIDCs which we will support through outreach activities. COE staff are currently
providing outreach support to ARV sites in the Greater Gaborone area and districts around Francistown. In
2008, we hope to obtain the necessary financial support to extend our mentorship program to ARV sites
nationwide. Rollout of the mentorship program will be done in accordance with MOH priorities.
The COE also requests ongoing support for the continued implementation of the Pediatric KITSO Training
course. Currently, two week-long Pediatric KITSO Trainings are planned each month. In 2008, it is
expected that this course will be revised to reflect new national guidelines that are due to be published in
late 2007 or early 2008. The rollout of training in the new guidelines will be essential and will be
implemented by COE staff in accordance with MOH priorities. In addition, updates in the pediatric
component of other national training courses will be made as needed in order to conform to the most
updated national guidelines. COE staff will continue to provide pediatric content in support of the Advanced
KITSO course, KITSO Medication Adherence Counseling Training, Nurse Prescriber Training, National TB
Training, and other programs support by the MOH.
08.C0713: TBD - Pediatric TB/HIV management
The diagnosis and treatment of TB in children is difficult and this more so in HIV-infected children, where TB
is a major cause of disease and death. The new WHO Stop TB Strategy was announced in 2006 with the
aim of ensuring equitable access to care of international standards for all TB patients - infectious and non-
infectious, adults and children, with and without HIV, with and without drug-resistant TB. International
guidance for national TB programs on managing TB in children was released in 2006, with the aim of
addressing this neglected area of TB control.
Botswana has one of the largest pediatric HIV/AIDS treatment programs in the world, an example of
effective partnerships in the provision of ART services to the pediatric population. ART services are being
decentralized to peripheral facilities with the support of outreach visits by specialist pediatricians from PMH,
the Baylor Center of Excellence and NRH. The management of TB in HIV-infected children has not matched
this scale up of quality HIV treatment and care.
PEPFAR funding will be requested to improve pediatric TB/HIV patient care and training activities to raise
the quality of TB care and treatment according to the latest national and international recommendations.
Baylor will work closely with the BNTP and GOB facilities in the southern part of the country (Kgatleng,
Kweneng, South-Eastern, Southern districts) to improve and strengthen the delivery of pediatric TB/HIV
services, to increase access to quality TB/HIV care and treatment of children and to train non-pediatrician
health care workers in the care of TB/HIV infected children according to the national guidelines.
The selected organization will create a referral service center which will deal with complicated TB/HIV
disease and multidrug-resistant TB (MDR-TB) in children, and will implement a mentoring/supportive
supervision system with an outreach support component to standardize the approach to pediatric TB/HIV
and MDR-TB management. Baylor will assist hospitals in this region to improve TB screening and diagnosis
of pulmonary TB in children, and will develop appropriate screening algorithms for TB in children.
The selected organization will be charged with reviewing and evaluating pediatric TB/HIV and MDR-TB care
and treatment, and in designing and implementing an information, educational and communication (IEC)
strategy targeting parents of children with HIV/TB disease, and adolescents at high risk of HIV and TB
infection.
08.T1114
The Botswana-Baylor Children's Clinical Centre of Excellence (COE) is a collaborative public-private
partnership between the Baylor College of Medicine International Pediatric AIDS Initiative and the
Government of Botswana. The key objectives of the COE are provision of comprehensive and excellent
care to HIV-infected children and their families and training of health professionals in pediatric HIV care and
treatment. Since its opening in 2003, the COE has built the capacity to provide substantial support to the
government of Botswana for scaling up and improving pediatric HIV/AIDS activities nationwide. The advent
of the Pediatric AIDS Corp program in 2006 provided us with the means to substantially extend our support
and to create linkages with important government partners. Key areas of expansion in 2006/2007 include
the following: 1. Consistent support of inpatient and outpatient pediatric programs at Princess Marina
Hospital (PMH) and Nyangabgwe Referral Hospital (NRH). 2. Regular outreach support to district hospital
ARV sites in the Greater Gaborone and Francistown areas; 3. Linkage with the Ministry of Education
(MOE) to support teacher training workshops aimed at empowering teachers to better support HIV-infected
and affected students; 4. Curriculum development and clinical mentorship of interns in collaboration with
the national referral hospitals, the University of Botswana, and the University of Pennsylvania; 5. Began
augmenting PMTCT linkages with public hospitals and clinics; 6. Expanded services for HIV-infected
adolescents receiving HIV care from both the public and private sectors. 7. Increased activities in the area
of TB/HIV co-infection. 8. Provision of expert support for national guidelines development.
