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
09.C.AC10: Tebelopele - Prevention with Positives
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
As part of its Prevention with Positives (PWP) program, Tebelopele will expand its current Supportive
Counseling and Post Test Club package of services, which includes TB and STI suspect screening, by
expanding its focus to prisons and construction camps.
Referral systems will be modified to improve referrals for patients with TB to IPT programs and mothers to
safe motherhood, including PMTCT, programs. An improved referral system as well as involvement of male
partners could improve acceptance and uptake of the Prevention of Mother to Child Transmission (PMTCT)
program; therefore, part of our prevention with positives (PWP) package will be assisting in education and
involvement of partners.
Family planning remains a vital part of the PWP package to ensure minimum risk, including sexually
transmitted infections (STIs) to HIV- positive partners. PWP will include empowering would-be mothers to
consult medical practitioners in their family planning concerns and intentions.
Male Circumcision will be incorporated into the PWP as a prevention mechanism in the reduction of STI
acquisition among HIV-positive male clients. Linkages will be created with the ‘See and Treat" (SAT) clinics
to encourage HIV-positive women to be screened in the cervical cancer prevention program.
In FY2009, Tebelopele will incorporate PWP into five of its youth friendly counseling outlets to address PWP
youth. Training will be required to build the capacity of counselors to administer the PWP services to youth,
including Post Test Clubs, support for positive living and advocacy for HIV-positive youth.
PEPFAR funds will support the training of counselors through the Tebelopele Resource and Training Centre
in partnership with the TWININGS program.
From COP08:
Tebelopele engaged the District Multisectoral AIDS Committees (DMSACs) in building strong referral
linkages at all their center locations in the country. They continued use of the referral form, track of referrals,
and hold regular referral network meetings with service providers in each district. Screening of all clients for
TB using a questionnaire was introduced in 2007. Any clients reporting any of the TB symptoms were
referred to government clinics for evaluation. In addition, post-test clubs and supportive counseling were
introduced.
FY08 plans:
Referrals and linkages will be augmented by using Post-Test Clubs and the Youth Against Aids (YAA)
Volunteers to track clients tested at Tebelopele and referred for services. Tebelopele will work with HPP to
create community-based referral linkages, and to continue the involvement of traditional and spiritual
healers in prevention and referrals. Pregnant women will be referred to the Cervical Cancer Unit and to the
PMTCT program.
The Tebelopele VCT centers will continue to role out the Supportive Counseling program initiated in
FY2007, by providing Post Test and Supportive Counseling Services to those who test negative and
positive, both at Tebelopele VCT sites, as well as Provider Initiated Sites. Tebelopele now provides
supportive counseling at its fixed sites, with a package of services that includes TB suspect screening,
testing of family members, disclosure, discordant couples, education and prevention for positives.
To strengthen capacity and improve quality of services, Tebelopele will train its counselors and VCT site
managers in various aspects of Supportive Counseling, and in particular couples counseling.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17567
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17567 10294.08 HHS/Centers for Tebelopele 7807 1345.08 U62/CCU25113: $400,000
Disease Control & Expanding and
Prevention Enhancing
Voluntary
Counseling and
Testing Services
10294 10294.07 HHS/Centers for Tebelopele 5289 1345.07 CoAg # $215,000
Disease Control & U62/CCU25113
Prevention
Emphasis Areas
Health-related Wraparound Programs
* Family Planning
* Safe Motherhood
* TB
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $300,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.08:
09.C.CT01: Tebelopele - VCT Network
Tebelopele has increased the number of direct service delivery outlets from 31 in FY2008 to 41 in FY2009.
The additional outlets include prisons, which will eventually be phased out when more non-governmental
organizations (NGO), community-based organizations (CBO), and faith-based organizations (FBO) are
trained to provide direct voluntary counseling and testing (VCT) services to those groups.
Tebelopele is dropping the Dialogue Group as an advertising company because they (Tebelopele) will carry
out the social marketing and community mobilization in collaboration with existing community-based
organizations, such as Humana People to People and BOCAIP. Similarly, Tebelopele is dropping the
Academy for Educational Development (AED) as sub-partner, but plans to solicit technical assistance from
them by engaging short-term consultants on an as-needed basis.
Tebelopele's Outreach Program is being reduced by 50% with the plan to build the capacity of community-
based organizations in hard to reach areas to provide the direct services that they were previously providing
through outreach, which will contribute to the sustainability of the program.
Male circumcision (MC) activities will be introduced into VCT by, for example, referring uncircumcised males
to sites that provide that service, providing prevention counseling pre- and post-circumcision, participating in
the MC committees at various levels for the development of guidelines and communication strategies, and
working with the Zebras National Football players to promote male circumcision, in general.
Additionally, Tebelopele would like to participate in the multi-country
Public Health Evaluation (PHE) for Maximizing the Prevention Effectiveness of HIV Testing and Counseling,
if Botswana's participation is approved by Office of the Global AIDS Coordinator (OGAC) PHE Team.
2007 Accomplishments
In January 2007, Tebelopele transitioned from a completely anonymous to confidential VCT services
delivery, with an option for anonymous services, for those who preferred it. By time of writing this COP, 75%
of clients were receiving confidential services. In 2006, Tebelopele counseled and tested 110,000 clients
(73% of whom were first-time testers) through 31 service delivery outlets. This number is expected to
increase by at least 12% in 2007. The GOB provided rapid HIV test kits and supplies including condoms.
Tebelopele used USG funds to procure back up stock of test kits to assure a steady supply.
linkages at all their center locations in the country. They continued use of the referral form, tracking of
referrals, and holding regular referral network meetings with service providers in each district. Screening of
all clients for TB using a questionnaire was introduced in 2007. Any clients reporting any of the TB
symptoms were referred to government clinics for evaluation. In addition, post-test clubs and supportive
counseling was introduced. CD4 cell counting at the VCT centers was not approved by GOB, and therefore
not implemented.
Community mobilization and social marketing continued in partnership with community based organizations
like Humana People to People (HPP) and BOCAIP, and through print and electronic media. Specific
campaigns targeting men were implemented, like the Zebras for Life, Test for Life. In this campaign,
Tebelopele worked with the Peace Corp Volunteers in various communities to mobilize people, especially
men, for testing.
From 2004 through 2007, Academy for Educational Development (AED) worked to build Tebelopele's
capacity to run as an independent NGO. Tebelopele is now able to also build the capacity of smaller NGOs
and CBOs. In 2007, Tebelopele worked with HPP and BOCAIP, providing support in M&E, reporting and
financial management.
With technical assistance from AED, Tebelopele established a sustainable organization from a systems and
procedures standpoint. Becoming a financially sustainable organization is an ongoing priority for
Tebelopele. In FY 2007, a Sustainability Plan was developed, focusing on: GOB to supply test kits and
supplies; creation of a counselor training unit for capacity building and for income generation; partnership
with private companies e.g. Medical Rescue International to support with some resources; increased use of
volunteers; fund raising; exploring fee for service, e.g. charging private companies for workplace VCT;
soliciting funds from other donors - an award of $600,000 was received from African Comprehensive
HIV/AIDS Partnership (ACHAP) (Gates Foundation, Merck and GOB Partnership).
To improve data quality, the use of electronic data capturing technology (Personal Digital Assistant - PDA)
was introduced. This has improved the timeliness and accuracy of VCT data and reporting.
Plans for 2008
Tebelopele will continue to provide high quality confidential and anonymous VCT services with same-visit
results, through 31 service outlets throughout Botswana. This activity will support 220 locally employed
staff including 104 HIV/AIDS counselors, other technical staff like lab technicians, community outreach
technicians and management staff who are responsible for providing VCT services on a daily basis. In
addition to its 31 directly managed sites, Tebelopele will support 32 additional civil society sites to provide
VCT services through training, mentoring and development of VCT service delivery systems. By building
the capacity of community-based organizations, it is expected that testing numbers will increase by 20%,
from 125,000 in 2007 to 150,000 clients (75% of whom will be first time testers).
Activity Narrative: Referrals and linkages will be augmented by using Post-Test Clubs and the Youth Against Aids (YAA)
PEPFAR funds are also requested to support the hiring of additional 40 lay counselors to enhance outreach
to specific target groups such as men, CSW, clients of CSWs, truck drivers, women and girls in cross
generational/transactional sex, through "mobile moonlight" VCT services. Tebelopele also plans to reach
more youth by advocating for the reduction of the age of consent for testing from 21 to 16 years, and by
youth outreach activities in schools and other locations. Through promotional events, such as Valentine's
month of Love in February, couples counseling and testing will be scaled up. The strategy of addressing
couples at the District Commissioner's office as they wait for the marriage ceremony was found to be
successful, and will be scaled up in 2008.
To promote and sustain a high demand for services, The Dialogue Group, Tebelopele's advertising agency,
will continue with the print and outdoor media production and placement, and the design and production of
all Tebelopele VCT information, education and communication (IEC) materials.
Funds are also requested for Tebelopele's continued collaboration with AED: strengthening utilization of
data and technology for more effective VCT services. In many activities Tebelopele is breaking new ground,
a factor that has not been documented for best practice or lessons learned in leading journals; supporting
new and expanded approaches to VCT. AED will work with Tebelopele and HPP to develop and implement
an effective strategy to provide VCT for CSWs and truck drivers in selected "high-risk locations". This
activity will be further supported by the HHS/CDC/BOTUSA BCC/prevention section, to augment
mobilization, prevention messages, and C&T outreach to these groups. Approaches will include cost-
effective, door-to-door VCT; providing technical assistance (TA) to Tebelopele as it develops its supportive
counseling service; mentoring Tebelopele in its expansion of NGO service provision; and ongoing support
for sustainability of Tebelopele in the areas of Board Governance, diversification of services and funding
sources, a Fee-For-Service, and establishing a clear memorandum of understanding (MOU) with GOB for
supplies from CMS.
Continuing Activity: 17568
17568 4857.08 HHS/Centers for Tebelopele 7807 1345.08 U62/CCU25113: $5,300,000
9831 4857.07 HHS/Centers for Tebelopele 5289 1345.07 CoAg # $2,607,711
4857 4857.06 HHS/Centers for Tebelopele 3503 1345.06 Technical $3,539,000
Disease Control & Assistance
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Table 3.3.14:
