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.
Background
This project was initially planned to be implemented by the Ministry of Local Government. Given the role of Ministry of Health in formulating health related policies and its important role in the care and management of HIV/AIDS, a decision was made to move this activity under the Ministry of Health.
The HIVQUAL program in Botswana is now executed under the leadership of MOH and in close collaboration with MLG as partner and HHS/CDC/BOTUSA for program management and technical support. This activity complements other quality assurance activities supported by the USG in Botswana, focusing on facility-level data collection and data management, feeding directly into these other activities for monitoring and evaluation and quality assurance, under the stewardship of the MOH.
Strategy and Sustainability
The HIVQUAL philosophy is based on the concept that quality management programs should reflect a balance between quality improvement and performance measurement and be built upon a foundation of programmatic support and infrastructure. This organizational approach to quality management emphasizes the development of systems and processes to support quality improvement activities involving clinic staff and consumers with support from agency leadership. These structural features are designed to be sustainable even when staff turnover is high or organizational affiliations change.
Four principles guide the methodology of the HIVQUAL Project: 1) ongoing quality improvement activities improve patient care; 2) performance measurement lays the foundation for quality improvement; 3) infrastructure supports systematic implementation of quality improvement activities; 4) indicators to measure performance are based on clinical guidelines or formal group decision-making methods.
The program will be piloted in a sample of 12-20 clinics and hospitals providing HIV care and ART, encompassing a diversity of care models and patient load sizes. Capacity-building will involve building skills for a) data management focusing on clinical information; b) chart abstraction or use of existing databases. Quality improvement trainings will be conducted with interactive sessions involving hands-on application of QI tools and techniques that are immediately transferable to the clinic setting. Organizational assessments are conducted of the facility-based quality management program to facilitate development and implementation of processes and structures that will support sustainable ongoing quality management. Activities will result in strengthening systems for documentation of clinical care.
Project Outcome
Ministries will use data to develop a national quality management plan to champion quality, monitor performance among HIV clinics and districts through development of benchmarking reports, development of capacity for conducting QI training and promoting sharing of best practices and regional quality management groups for developing a sustainable network of quality management.
USG funding will support travel of the US team for mentoring of in-country program staff and to coach the team in provision of technical assistance to providers. Training will be provided as well as study-tour to the US for the national HIVQUAL team.
