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
Cote d'Ivoire (CI) has the highest national HIV prevalence in West Africa, estimated at 3.9% among adults
(UNAIDS 2008), with both HIV-1 and HIV-2 viruses present. Data from the 2005 National AIDS Indicator
Survey describes a generalized epidemic marked by gender and geographic differences, early sexual
debut, intergenerational and multiple concurrent partnerships, weak knowledge of HIV transmission and
prevention, and low condom use.
The PEPFAR CI team has been working with the Ministry of Health (MOH), the Ministry of the Fight Against
AIDS (MLS), other government bodies, and PEPFAR implementing partners to build national capacity to
provide high-quality HIV/AIDS prevention, care, and treatment activities and services to Ivoirians. At
present, the number and varying quality of service providers limits the ability to scale up quality programs
and coverage. To ensure that in-country partners effectively manage their PEPFAR agreements and
implement appropriate, high-quality programs, the AIDSTAR contractor will focus on strengthening partners'
financial, human resources, and administrative management systems, along with technical capacities to
implement and monitor HIV/AIDS programs. In addition, the AIDSTAR contractor will assist partners to
develop and integrate HIV/AIDS modules into health curricula, develop a cadre of national trainers, and
improve and increase use of the national training database. The primary objectives of these activities, as a
whole, are to build indigenous capacity and to improve and expand quality HIV/AIDS prevention and care
service delivery.
In the program area of PMTCT, the AIDSTAR contractor will help address low coverage and uptake of
PMTCT services. These barriers to life-saving services for women and children are linked to a number of
factors, including a scarcity of services in the northern part of the country, low acceptance of HIV counseling
and testing (CT) in sites where provider-initiated testing is not yet under way, lack of integration of PMTCT
and CT services into clinical care services, and a lack of on-site HIV testing, leading many women to leave
without obtaining their test results.
PEPFAR has supported technical assistance, through JHPIEGO, to the MOH and the National HIV/AIDS
Care and Treatment Program (PNPEC) to coordinate the scale-up of PMTCT services, particularly those
related to the new national PMTCT guidelines and protocols, including revising and adapting the national
training program for PMTCT, revising performance standards for PMTCT to comply with the new national
policy and guidelines, and revising the PMTCT manual.
With FY09 funding, in collaboration the MOH and other national stakeholders, the AIDSTAR contractor will
build on these activities by expanding pre-service education activities to regional teaching institutions. The
targeted institutions include Unite de Formation et Recherche-Bouake (UFR) and Institut National de
Formation des Agents de la Sante (INFAS) in Bouake, Korhogo, and Aboisso. The contractor will work
closely with members of faculty at the various institutions, representatives of other relevant ministries, and
PEPFAR partners to ensure that all pre-service activities are integrated and linked to Cote d'Ivoire's
National Human Resources Strategy and complement other in-country capacity building efforts.
The contractor will collaborate with 10 identified implementing partners to identify appropriate training
modules and materials to correct existing performance gaps. In addition, the contractor will enhance
referrals and linkages between services such as PMTCT, CT, family planning, and reproductive health to
develop clear referral guidelines and protocols for all ART sites, with an emphasis on referrals for HIV-
positive pregnant women. The contractor will work with implementing partners and government entities to
strengthen supply chain and service delivery to ensure that commodities and other supplies are available at
service provision sites.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16763
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16763 16763.08 U.S. Agency for IQC AIDSTAR 7225 7225.08 IQC AIDSTAR $200,000
International
Development
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $80,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Estimated amount of funding that is planned for Education $80,000
Water
Table 3.3.01:
implement and monitor HIV/AIDS programs.
In the program area of HIV prevention through AB methods, the AIDSTAR contractor will be responsible for
managing, administering, and reporting results for sub-grants to at least three indigenous organizations
promoting HIV prevention in FY09. Grants and technical assistance will enable the identified organizations
to execute programs for HIV prevention along with activities promoting reduction of HIV-related stigma and
discrimination, mobilization for counseling and testing, and links to care for people living with HIV and
orphans and other vulnerable children. Subgrantee activities are expected to reach at least 55,000 people
with AB outreach and train 214 people to conduct such outreach by September 2009.
The contractor will establish agreements with local organizations to administer grants, manage funds
transfers, and reinforce financial accountability measures; ensure data quality and compliance with
reporting requirements; and institute supervision and quality assurance processes. Continued support and a
potential expanded number of grantees are subject to funds availability in subsequent years. Management,
technical, and financial capacity building activities conducted by the contractor (described under Health
Systems Strengthening) should result in grantees' improved ability to plan and deliver appropriate HIV
prevention, testing, care, and/or treatment services to the target populations.
Continuing Activity: 19365
19365 19365.08 U.S. Agency for IQC AIDSTAR 8651 8651.08 IQC AIDSTAR $574,000
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Estimated amount of funding that is planned for Human Capacity Development $100,000
Table 3.3.02:
In the program area of Condoms and Other Prevention, the AIDSTAR contractor will be responsible for
managing, administering, and reporting results for sub-grants to at least 12 indigenous organizations
orphans and other vulnerable children. Activities are expected to reach at least 50,000 people with Other
Prevention outreach.
Continuing Activity: 19362
19362 19362.08 U.S. Agency for IQC AIDSTAR 8651 8651.08 IQC AIDSTAR $300,000
Estimated amount of funding that is planned for Human Capacity Development $150,000
Table 3.3.03:
In the program area of HIV counseling and testing (CT), PEPFAR, other donors, and partners have worked
to prioritize and support CT as an essential entry point in the fight against HIV/AIDS. Even so, only 8% of
Ivoirians have ever had an HIV test, and only 7% of women receive CT during routine antenatal visits (AIS,
2005). There are many reasons for the low uptake of CT services. HIV testing services are not routinely
integrated into clinical care sites and services. CT is still primarily offered on an "opt-in" basis and can only
be performed by professional clinicians. In addition, although rapid testing is included in the current national
standard testing algorithm in CI, most hospitals and other health care facilities predominantly use laboratory
-based HIV tests, and many women are unwilling or unable to return for their test results.
PEPFAR has supported technical assistance, through JHPIEGO, in CT training and in building the capacity
of Care International's local CBO/FBO sub-partners to provide quality CT services. In addition, PEPFAR
has supported 19 EGPAF pilot sites (through JHPIEGO) to develop and validate performance standards for
CT in the PMTCT context; train performance facilitators on PMTCT performance standards, including CT
components; train 20 national trainers and 15 advanced trainers in CT and 20 more Care International
project trainers in CT; and provide follow-up and supervision to the 55 national and project trainers to further
enhance their skills.
With FY09 funding, in collaboration with the MOH and other national stakeholders, the AIDSTAR contractor
will work with targeted national institutions - including the Unite de Formation et Recherche-Bouake (UFR)
and Institut National de Formation des Agents de la Sante (INFAS) in Bouake, Korhogo, and Aboisso - to
incorporate training modules into their pre-service education programs. This will ensure that comprehensive
HIV/AIDS curricula are integrated in training facilities and will promote decentralized pre-service training
efforts by focusing on regional faculty and institutions. The contractor will supervise and mentor faculty to
ensure that HIV/AIDS modules are fully integrated into curricula, thus creating a critical mass of highly
skilled faculty capable of implementing future curriculum revisions.
The contractor will provide technical assistance in developing and revising technical components of CT
programmatic work, including curricula, training materials, job aids, and supervision tools related to stand-
alone, provider-initiated, couples, community-based, and conventional CT. All training materials will be
developed in accordance with revised national HIV/AIDS service-delivery guidelines, and training materials
will include a module defining district- and national-level referral systems that describes linkages of CT
services to treatment and care, including OVC care.
Continuing Activity: 17376
17376 10531.08 U.S. Agency for IQC AIDSTAR 7225 7225.08 IQC AIDSTAR $323,000
10531 10531.07 HHS/Centers for JHPIEGO 5323 5323.07 CoAg $80,000
Disease Control & #U62/322428
Prevention JHU UTAP
(JHPIEGO/JHU
Communication)
Estimated amount of funding that is planned for Human Capacity Development $40,000
Estimated amount of funding that is planned for Education $40,000
Table 3.3.14:
In the program area of Strategic Information (SI), PEPFAR has supported, through JHPIEGO, the
development of a Training Information Monitoring System (TIMS) to track training events, participants, and
trainer development for CT, PMTCT, and ART that is applicable to a broader range of training activities.
This database permits senior- and mid-level program managers to monitor and track training from a variety
of perspectives and replaces paper-based reporting. The database was adapted and customized to the
Ivorian context, translated into French, and implemented through training programs targeted to government
officials and implementing partners.
In FY09, in collaboration with the MOH and other national stakeholders, PEPFAR CI plans to accelerate
and expand the use of the training database to all PEPFAR implementing partners and several other
partner organizations. The AIDSTAR contractor will be responsible for supporting staff to manage the
database.
Continuing Activity: 17383
17383 17383.08 U.S. Agency for IQC AIDSTAR 7225 7225.08 IQC AIDSTAR $100,000
Table 3.3.17:
Strengthening Pre-Service Education
Recognizing that pre-service education programs form the foundation of high-quality HIV/AIDS service-
delivery programs, PEPFAR CI has focused heavily on strengthening pre-service education programs. The
USG has supported the successful development, adaptation, and integration of comprehensive HIV/AIDS
training modules into the curricula of the three major teaching institutions in Abidjan: UFR-SMA (for
physicians), INFAS (for nurses and other health agents), and INFS (for social workers). These efforts will
have a substantial downstream effect as medical, nursing, paramedical, and social work students graduate
with the skills to immediately and effectively support HIV service delivery. During FY08, JHPIEGO built on
this foundation to expand these pre-service education activities to select regional training institutions (UFR-
Bouake, INFAS-Bouake, and INFAS-Korhogo).
With FY09 funding, the AIDSTAR contractor is expected to continue, build on, and scale up these efforts to
reinforce HIV/AIDS training capacity within regional institutions. The targeted institutions include UFR-
Bouake, INFAS-Bouake, INFAS-Korhogo, and INFAS-Aboisso. The contractor will reinforce efforts to
decentralize pre-service training to regional institutions through training programs, mentoring, the
development of structured observation tools, and follow-up visits to classrooms, faculty, and training sites.
In addition, the contractor will provide materials for four skill labs and 10 new clinical training sites. The
contractor will focus special attention on PMTCT and CT training, as described in the COP narratives in
those program areas.
Strengthening National Trainer Pools
Since 2004, PEPFAR has supported efforts to build human capacity to deliver quality HIV services in CI.
With assistance from JHPIEGO, several national pools of trainers have been created (PMTCT, HIV
counseling and testing, medical management of PLWHA/ART, OVC), including a national pool of 35 master
trainers among faculty from the three teaching institutions in Abidjan to build institutional capacity and
promote ongoing curricula revisions. Trainers from the national pools have provided training for a number
of PEPFAR partners, including FHI, EGPAF, ACONDA, the National OVC Program, and ANADER. Training
information has been entered into the national training database. In FY08, PEPFAR-funded technical
support was expanded to 25 additional advanced trainers and to 10 health districts to address concerns that
the pool of national trainers is insufficient to meet all implementing partner training needs and that many
trainers are based in Abidjan and are not accessible at regional levels. As a result, there is now a pool of
160 trainers nationally in various HIV program areas, including 40 regionally based trainers located in the 10
health districts.
With FY09 funding, the AIDSTAR contractor will further expand the national and sub-national pools of
trainers in CT, PMTCT, OVC, PC, TB/HIV, and ART to ensure that the pools are adequate to meet
implementing partner training needs both in Abidjan and nationwide. The contractor will continue to monitor
the performance and progress of new and advanced trainers through classroom observation and feedback.
The contractor will also explore the feasibility of introducing innovative learning approaches and media, as
well as the feasibility of developing an HIV/AIDS-specific, electronic-format learning management system
(LMS) as a resource for teaching faculty and service providers. The contractor will ensure that
updated/revised norms, guidelines, and protocols are reflected in revised training curricula and, working in
collaboration with current training institutions and USG implementing institutions, will establish 10 model
clinical training sites.
Strengthening Ivoirian Organizations
The Alliance Nationale Contre le VIH/SIDA (ANS-CI) is a national umbrella NGO that manages sub-grants
and provides financial and technical assistance to sub-grantees, serving as a linking organization between
donors/partners and civil society organizations working at the community level. ACONDA-VS is an Ivoirian
NGO providing HIV/AIDS treatment, care, and prevention services. ANADER (National Agency for Rural
Development) is a semistatal organization providing HIV prevention and care services in underserved rural
areas.
The USG team believes that ANS-CI, ACONDA, and ANADER - all three PEPFAR prime partners - need
technical assistance in organizational capacity development to achieve their objectives and create
sustainable systems. Under AIDSTAR, in FY 2009, the contractor will be responsible for providing
organizational development support to ANS-CI and some of its current or former sub-grantees (community-
based organizations providing USG-financed HIV/AIDS services and information in Cote d'Ivoire) as well as
to ACONDA and ANADER. In future years, it is envisioned that this support may expand to other indigenous
organizations financed by PEPFAR.
Activity Narrative: The AIDSTAR contractor will be responsible for conducting a participatory needs assessment of ACONDA,
ANADER, and ANS-CI and sub-grantees identified by the USG team to determine their level of
understanding of USG and PEPFAR rules and regulations; organizational management practices and
policies; fiscal management practices, including systems and funds tracking; and human resources
management practices. Based on the findings from these assessments, the contractor will develop an
action plan tailored to the organizational development needs of the partners with milestones to monitor
progress toward objectives. The contractor will, as needed, provide training in USG regulations and
requirements and in managing and tracking resources. The contractor will also provide assistance to
establish effective budgeting practices and ensure compliance with audit requirements, and will ensure
adequate record-keeping for program reporting and improvement. The contractor will be responsible for
actively managing, administering, and reporting results for all subgrants given as part of this activity.
Continuing Activity: 17072
17072 10130.08 U.S. Agency for IQC AIDSTAR 7225 7225.08 IQC AIDSTAR $350,000
10130 10130.07 HHS/Centers for JHPIEGO 5323 5323.07 CoAg $150,000
Estimated amount of funding that is planned for Human Capacity Development $300,000
Estimated amount of funding that is planned for Education $60,000
Table 3.3.18:
