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: 2007 2008 2009
The goal of the Making Medical Injections Safer (MMIS) project is to provide a rapid response to prevent the
transmission of HIV and other blood borne diseases by improving the safety of medical injections. In Côte
d'Ivoire, the MMIS implementation environment is marked by a political crisis dating back to September
2002 and the resulting disruption of the national health system with a sometimes precarious security
situation. Despite these security concerns, the program is expanding in scope. In 2007, the political and
social environments became more favorable for national implementation since the signing of the "Ouaga
Settlement" in Burkina Faso. To date (July 2007) 34 districts representing 40% of the country's total
districts are covered by MMIS activities. The program benefits from a collaborative work environment with
local partners and responsive technical support from MMIS/Washington as well as USG technical staff in
country. MMIS works with WHO, UNICEF, and other partners to complement safe injection activities
implemented by the Ministry of Health. Project achievements from 2004 are as follows:
Capacity Building: 5225 health workers and waste handlers were trained in injection safety and waste
management (ISWM) from October 2004 to July 2007 representing 74.4% (5225/7027) of HCWs and waste
handlers in the 816 MMIS covered public sector health facilities in 34 districts and 1 Teaching Hospital.
Logistics Management: To date 34 districts have been supplied with safety syringes (auto-disable and
retractable types) and safety boxes. The program works through the MOH supply distribution network which
is managed by the Pharmacie de la Santé Publique (PSP).
Behavior Change and Communication: Job aides and other communication aides for healthcare workers
were produced, tested and disseminated in all program intervention districts. Field visits were conducted in
districts to promote behavior change among HCWs and to advocate for the allocation of resources for
building incinerators. Discussions and sensitization sessions were organized for media professional and
leaders of heath workers associations. Radio/TV messages for behaviour change in communities were
drafted and tested.
Waste Management: MMIS assisted MOH in updating the National Waste Management Strategic Plan 2008
-2010. The Project also supplied waste handlers with personal protective equipment in 24 districts (68.5%)
and supported 3 districts in repairing incinerators.
Monitoring and Evaluation: Supervision visits were conducted with district supervisors in covered districts,
focusing on key indicators.
NB: in 2007 MMIS started activities in 2 districts of the country's areas controlled by ‘‘Forces Nouvelles'' in
the North.
The COP08 is consistent with MMIS' 2005-2009 strategic plan. With expected funding for the period from
March 2008 to September 2008, MMIS will expand to nationwide coverage, build on the project's
successes, and implement interventions that will continue beyond the life of the project. The project will
continue to focus on coordinating activities with key IS partners at the national, district and local levels.
Collaboration with the USG and other PEPFAR partners remains a priority and will be achieved through
regular meetings. MMIS strategies and major activities for the funding period are:
Expanding project coverage
Ongoing progress in Injection safety, waste management, and infection prevention will be expanded to one
additional district and one university teaching hospital with PEPFAR support. In these 2 additional areas,
MMIS will support the development of injection safety and waste management microplans.
Training and capacity building
MMIS expects to train at least 150 health care workers in the target district and 500 individuals in the
university teaching hospital (health care facilities managers, prescribers, frontline health care service
providers, supply managers and level logistics officers, facility waste handlers). Training sessions will
continue addressing phlebotomy issues. Capacity building activities will also include supervision of
individuals who were trained at districts and facilities levels since 2004.
Logistics and procurement
MMIS will continue to ensure the procurement of injection safety supplies at the central level through
coordination with PATH and PSP. MMIS, jointly with PSP will organize the distribution of safe injection
equipment and supplies at service delivery points (health districts and facilities).
In order to contribute to the sustainability of safe injection commodity procurement and distribution, MMIS
will liaise with injection safety partners including private sector distributors to sensitize and advocate quality
control and appropriateness of products imported in regards to international norms and guidelines.
MMIS will also work with partners (DIPE, JSI/R&T-MEASURE, PSP) to integrate safe injection indicators in
national health data management systems. This includes consumption data. Advocacy meetings targeting
private sector distributors will be held for the procurement and distribution of safety boxes and safety
syringes (AD, retractables) in private health facilities.
Behavior change communication and advocacy (for reduction of unnecessary injections)
JSI/R&T-MMIS Behavior change and advocacy activities will focus on the organization of field visits to
sensitize local authorities on ISWM issues in order to expand project activities in one additional health
district, one university teaching hospital. Sensitization of communities started with the production of
TV/radio messages will be reinforced by MMIS through the development of specific BCC materials such as
"boîte à images" which is an important tool used for sensitization sessions in health facilities and
communities (homes and workplaces visits).
Waste management
MMIS will support the MOH to bring partners (Ministry of Environment, WHO, the World Bank, GAVI and
others) together to discuss and update the National Health Care Waste Management Plan developed in
2005.
MMIS plans to continue working to improve a segregation system for health care waste in two pilot health
facilities where the project has successfully introduced safety boxes and waste management training. The
results of this pilot will serve as a model for other health facilities for the sustainability of good practices in
health care waste management.
MMIS will also support districts in the promotion of good practices in waste management including
incinerator operation, repair, and maintenance. In order to reinforce waste management activities started in
Treichville University Teaching Hospital, MMIS will promote waste handlers' protection by providing
personal protective equipment. In collaboration with the MOH and national partners involved in health care
waste management activities, JSI will advocate for the building of incinerators (with 2 chambers) in health
districts.
Monitoring & Evaluation
Activity Narrative: MMIS monitoring and evaluation activities will consist of:
Monitoring of procurement activities and availability of commodities in MMIS districts, supporting periodic
(quarterly) meetings of the Injection Safety Technical Task Forces (BCC, WM, Logistic task forces). M&E
will also include writing of quarterly, semi-annual and annual reports to document project implementation,
working sessions to prepare for prescription record reviews to document the behavior changes among
prescribers, and project participation in meetings for national PEPFAR activities coordinated by the local
CDC office.
