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.
This will be a new partner in Botswana.
Overall Goals and Objectives: The Health Systems 20/20 (HS 20/20) project is a Leader with Associates Cooperative Agreement awarded by USAID for the period September 30, 2006 to September 29, 2011, with a total potential value of $125,000,000. The HS 0/20 cooperative agreement helps USAID-supported countries address health system barriers to the use of life-saving priority health services. The goal of HS 20/20 is to strengthen health systems through integrated approaches to improving financing, governance, and operations, and building sustainable capacity of local institutions. The project's results framework calls for improvements in these areas primarily Sub-Saharan Africa, while also working in Latin America, South and East Asia, as well as the Middle East and North Africa.
The project team brings together an exceptional pool of professionals with depth and experience in the project's intermediate results areas plus significant field presence and experience to link health system improvements to increased service access and use. Abt Associates Inc., the prime recipient, is joined by the Aga Khan Foundation USA, Deloitte Consulting, LLP, Bitrán y Asociados (Chile), BRAC University (Bangladesh), Broad Branch Associates, Forum One Communications, RTI International, Training Resources Group, Inc. (TRG), and Tulane University's School of Public Health.
The HS 20/20 project shares the vision of the Office of the Global AIDS Coordinator (OGAC) and USAID to harness political will and resources across the public and private health sectors to build innovative, replicable, quality, and sustainable HIV/AIDS services as well as to build requisite support systems for laboratory and HIS. The PEPFAR I initiative has produced significant results in prevention, treatment, care and support of HIV/AIDS services in the focus countries in a relatively short period. PEPFAR II will increasingly focus on Health Systems Strengthening and the sustainability and integration of the USG program into the national program.
HS 20/20 will provide technical assistance to the Government of Botswana and its development partners in the area of health system strengthening by applying the National Health Accounts (NHA) tool to clarify expenditures and resource allocations. We will make our activities in the country more cost-effective over time by involving local and regional consultants and experts, and investing in Ministry capacity building. HS 20/20 will work to incorporate partnerships in their activities. As each activity continues the process of cost sharing, program coverage and depth will increase at lower costs.
Target Population and Geographic Coverage: The target population will be primarily the Department of Policy, Planning, Monitoring and Evaluation (DPPME) in the Ministry of Health headquarters.
Cross-cutting Areas: Abt Associates will focus on building the capacity of headquarters staff (human resources for health) in DPPME to undertake National Health Accounts.
Enhancing Sustainability: The project will be designed to build capacity within the country such that NHAs can be undertaken in future without outside technical assistance.
Monitoring and Evaluation: At its onset, HS 20/20 drafted a set of program indicators to benchmark its performance. We will apply them to each of the activities proposed for Botswana in order to both monitor and evaluate performance and create opportunities for learning.
National Health Accounts are a powerful tool used to improve the capacity of decision makers to identify health sector problems and opportunities for change and to develop and monitor reform strategies. National Health Accounts (NHA) measures total public (all relevant sectors), private (including households, enterprises, NGOs) and donor health expenditures.
Technological advances, demographic transitions, rapid changing patterns of morbidity and mortality, and the emergence of public health problems such as HIV/AIDS, all call for a more efficient use of resources; therefore the need to conduct an NHA study is vital to depict the current use of resources in the health system, an essential element in health care monitoring and evaluation. Botswana conducted its first NHA in 2006.
The Ministry of Health is striving to cultivate an evidence-based decision-making culture in the health sector that will create demand for health information. The vision is for health systems managers (public and private) at various levels to be responsible for generating evidence and information (including NHA) for use in decision-making and planning.
The MOH would like to institutionalize NHA that would be undertaken on a regular and sustained basis. Institutionalization is an ongoing process in which NHA activities, structures, and values become an integral and sustainable part of the government operations. With institutionalization, a department or a unit is designated to oversee the collection, analysis, and reporting of health expenditure data in a routine and systematic fashion. MOH would integrate the NHA data collection within the national health information management systems. There will be a need to strengthen the capacity of the unit responsible for undertaking NHA.
The last NHA report was published in 2006 with the data for the years 2000/2001, 2001/2002, and 2002/2003. This proposal is to conduct a NHA in 2010 which would cover data for the financial years 2007/2008, 2008/2009 & 2009/2010. It will be necessary to strengthen the existing set of data collection instruments for use among sources, financing agents, health care providers (including functions and inputs) and critically important to ensure that all relevant data (e.g. expenditures from all sources, flow of resources from sources to: financing agents, providers of health services, public health functions, and inputs), some of which was missed in the first NHA exercise, is collected.
An outside technical assistance provider will be engaged to assist in developing NHA tools (questionnaires) and the quality control of data collection, analysis and report writing. Officials of the Ministry of Health, Ministry of Local Government and other stakeholders will be capacitated during the process to enable them to undertake NHA in future.
