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.AC06: TBD - Health Care Provider Training
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The TBD organization is expected to develop a sustainable training capacity in clinical care and treatment of
HIV/AIDS patients, expand CD4 and Viral load laboratory testing to decentralized laboratories, and
strengthen the Ministry of Health's (MOH) Monitoring and Evaluation (M&E) capacity to monitor the
effectiveness of the national anti-retroviral (ART) program, MASA.
In FY2007 and FY2008, the Clinical Master Trainer (CMT) program trained a total of 492 health personnel
on ART service delivery and 635 on palliative care service delivery. It also supported and mentored 18
hospitals and 39 satellite clinics. The Laboratory Master Trainers have so far been able to train a total 22
laboratory technicians and have supported and mentored approximately 22 facilities, 15 of them
decentralized.
The M&E results indicated that there were 32 sites reached, 59 data entry clerks (DEC) trained, a data
warehouse developed with integration of MASA and DHIS ongoing, and a data security and confidentiality
system with encrypt and decrypt completed.
The TBD organization is expected to have a three pronged approach to using the master trainer model,
which will include Clinical master trainers, Laboratory master trainer and M&E technical advisor.
The Clinical Master Trainers will continue to do:
(1) task shifting: training of nurse dispensers and nurse pre scribers; (2) train Health Care Providers on QAI
and implementation of QA activities at ART site level and QAI training for district/site leadership cadres; (3)
provide CME at district level and telephone site support; 4) continue training material development, SOPs,
guidelines, memos, checklists and other tools for care and treatment sites.
B) The Laboratory Master Trainers will continue to:
(1) support the established CD4, VL decentralized and expand training to include hematology, chemistry
and microbiology support; (2) in collaboration with MOH and HHS/CDC/BOTUSA formalize the training
manuals on CD4, VL, hematology, chemistry and microbiology, including TB; (3) train on LIS issues at
decentralized labs/sites and on lab data management, reagent logistics and quality assurance.
C) The M&E Unit within MASA will continue to:
(1) refine and expand indicators and management tools; (2) replace PIMS (MASA) and roll out new system
to all PIMS locations; (3) integrate functions of (e.g. PMTCT) and integrate with all other national systems,
for example, DHIS;(4) train end users on the new systems; (5) establish a support desk and use DEC to
perform vital roles; and 6) conduct a targeted patient evaluation study on medication adherence.
From COP08:
With PEPFAR support, an organization (TBD) will assist GOB in strengthening the capacity of health care
providers in providing palliative care/ ART services. The organization TBD will put in place a training
program using the Trainer of Trainers Master trainer approach as described below. Three main activities will
be supported by the TBD organization: 1) support and strengthen a clinical master trainer (CMT) program;
2) support and strengthen a laboratory master trainer program; and 3) support and strengthen the M&E
component of the MASA program
A. The Clinical Master Trainer program consists of on-site specific training to bring MLG and MOH facilities
up to standard to prescription and dispensing level. Proper data recording and reporting is another area of
strengthening in the master trainers program. It consists of site assessments, on-site and centralized
training to support task shifting, support and follow up on clinical, laboratory, pharmacy and quality
assurance and improvement activities.
B. The CMT program should also involve a pharmacy training component. Activities should be scaled up to
include training on task shifting for nurse prescribers/ dispensers to support pharmaceutical officers and
prescribers for managing chronically stable patients. By the end of the program, all 32 sites and satellite
clinics should have received coverage. All roll out clinics should l have been supported and > 1,000 workers
trained in short term trainings including, Introduction to AIDS Clinical Care, Nurse Dispensing, Nurse
training for stable patients and facilitated other MoH training initiatives including palliative care.
C. Strengthening the capacity of laboratories through the laboratory master trainers (LMT) has been
instrumental in the decentralization of CD4 and VL testing (infrastructure funded by ACHAP and PEPFAR).
CD4 services were decentralized to 12 laboratories. The LMT program will continue to support the
established CD4, VL decentralized and expanded training to include hematology, chemistry and
microbiology support. All laboratory technicians from the 12 decentralized laboratories will be fully trained in
CD4 & VL, re-trained in hematology, chemistry, and micro and all 12 labs should be fully functional.
Attachment training at the Botswana-Harvard HIV Reference Lab, site support, telephone site support, and
capacity building through development of site-level LMT will continue. The LMT in collaboration with MOH
and HHS/CDC/ BOTUSA will formalize the training manuals on CD4, VL, hematology, chemistry and
microbiology (including TB) The activity will include training in quality issues at decentralized sites and LIS
at roll-out sites. Additionally they will provide training on lab data management, reagent logistics and quality
assurance in COP08.
D. Monitoring and Evaluation (M&E) Unit within the National ARV (Masa) Program will be assisted by the
TBD organization to develop standardized paper-based and electronic monitoring systems to track ARV
patients, specifically, clinical, laboratory and pharmaceutical monitoring systems. This will include
development of indicators and data capture instruments, harmonization of indicators, development of data
flow mechanisms including reporting guidelines and instruments, reporting schedules and routine feedback
documents to the sites. Staff at the ART sites will be trained on the new data capture instruments,
Activity Narrative: indicators, quality and flow. Activities for COP08 will continue in line with the MoH vision of developing a
viable and sustainable monitoring system for the ART program. Long term, the TBD organization will assist
the M&E Unit to do the following: 1) refine and expand indicators and management tools; 2) replace PIMS
(MASA) and roll out a new system to all PIMS locations; 3) Integrate functions of (e.g. PMTCT) and
integrate with all other national systems (e.g. DHIS); 4) Train end users on the new systems; 5) Establish
support desk and using DEC to perform vital role; 6) Unlock data warehouse; 7) Purchase and install
software to develop end user reporting tools for the data warehouse; 8) Establish end-user support (user
registration, user training).
New/Continuing Activity: Continuing Activity
Continuing Activity: 17675
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17675 17675.08 HHS/Centers for To Be Determined 7804 7804.08 New CoAg-
Disease Control & Health Care
Prevention Providers
Training
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.08:
09.T.AT12: TBD - Health Care Provider Training
CONTINUING ACTIVITY UNDER PERFORMANCE PASS:
provide CME at district level and telephone site support; (4) continue training material development, SOPs,
to all PIMS locations; (3) integrate functions of, for example, PMTCT, and integrate with all other national
systems, for example, DHIS; (4) train end users on the new systems; (5) establish a support desk and use
DEC to perform vital roles; and 6) conduct a targeted patient evaluation study on medication adherence.
providers in providing ART services. The organization TBD will put in place a training program using the
Trainer of Trainers Master trainer approach
as described below. Three main activities will be supported by the TBD organization: 1) support and
strengthen a clinical master trainer (CMT) program; 2) support and strengthen a laboratory master trainer
program; and 3) support and strengthen the M&E component of the MASA program
strengthening in the master trainers program. ART site support is designed to provide a sustainable training
capacity for integrated, high quality HIV/AIDS treatment at public sector ART sites in Botswana. It consists
of site assessments, on-site and centralized training to support task shifting, support and follow up on
clinical, laboratory, pharmacy and quality assurance and improvement activities.
clinics should have received coverage. All roll out clinics should l have been supported and > 1000 workers
training for stable patients and facilitated other MoH training initiatives including palliative care. The Master
Trainer Program will expand its clinical support to ARV sites in COP08 through these activities; 1) Training
of nurse dispensers and nurse prescribers for stable patients for ARV roll out; 2) strategies to improve,
integrate, monitor and evaluate services and programs at ARV sites and to increase capacity through
improved integration of programs. This includes training of the Health Care Providers on QAI and
implementation of QA activities at ARV site level and QAI training for district/site leadership cadres; 3)
provision of CME at district level, telephone site support for HIV/AIDS Management , the newly established
failure management phone support to enable clinical and pharmacy staff at all ART sites to obtain advice
on difficult cases, etc. from core Master Trainers and to ensure the best, quickest, and most efficient care &
treatment possible; 4) Development of training materials, SOP's, guidelines, memo's and checklists tools for
ARV sites; 5) seeking editorial and peer review services for developed material
Activity Narrative: microbiology support. All laboratory technicians from the 12 decentralized laboratories will be fully trained in
indicators, quality and flow. Activities for COP08 will continue in line with the MoH vision of developing a
viable and sustainable monitoring system for the ARV program. Long term, the TBD organization will assist
the M7e Unit to do the following: 1) refine and expand indicators and management tools; 2) replace PIMS
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.09:
09.C.PC05: TBD - Masa Expert Patients Support
The Expert Patients Support program has been developed for the following reasons:
HIV-infected children are a vulnerable group with an extremely high morbidity and mortality, if they have not
been identified, tested and received care. It is estimated that about 25% of HIV-infected children would be
dead by the end of their first year of life and close to 50% would be dead at the end of second year. Even
infants who have received prophylactic antiretroviral drugs from the Prevention of Mother to Child
Transmission (PMTCT) program have slipped through the system without getting the full benefit of care.
The Expert Patients Support program will therefore:
-identify and refer children who need testing to health facilities.
-follow up on children from PMTCT and Under 5 clinics who need care and refer them to the point of service
sites for anti-retrovirals (ARV.)
-provide psychosocial support and appropriate referrals, as needed.
They shall be functioning from clinics where children are most often seen and also in the community. They
will link up with community based organizations (CBO) and NGOs in the respective communities to leverage
these resources in carrying out their duties, as there are other community resources that will add value to
child survival.
It is hoped that through this program care will be expanded care to many more children. Currently, less than
10% of the over 100,000 patients on ARVs in Botswana are children. Even though the exact number of
children in need of care in Botswana is not known, because of the high prevalence of HIV, it is expected
that more children will be identified and cared for.
The Clinton Foundation had supported a pilot project to see the feasibility of using Expert Patients for
identifying children in need of treatment. The project yielded promising results. With these results, Masa in
collaboration with the Botswana Harvard Master Trainer program will roll out the Expert Patients project
initially in three districts.
PEPFAR funds are requested for the purpose of training the Expert Patients in counseling, psychosocial
support and stigma reduction.
Health-related Wraparound Programs
* Child Survival Activities
Program Budget Code: 11 - PDTX Treatment: Pediatric Treatment
Total Planned Funding for Program Budget Code: $1,491,624
Total Planned Funding for Program Budget Code: $0
Table 3.3.11:
