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: 2013 2014 2015 2016
The goal of the HRSA Global Nurse Capacity Building Program is to strengthen the knowledge, skills, and abilities of nurses to deliver high-quality care to people affected and infected by HIV/AIDS and co-morbidities, as well as to build the capacity of in-country nurse leaders, organizations, and institutions in African countries. The PEPFAR Cote dIvoire program will provide COP 2013 country funds to this mechanism to support:
1. Ongoing activities started with central funds and focused on nurse training and capacity building, including a baseline assessment, expansion of pre-service and in-service training capacity, and strengthening of leadership and management capacities of nursing and midwifery associations.
2. Capacity building of health extension workers to improve community-level health outcomes, including HIV/AIDS service uptake and retention within a continuum of care.
CDC and HRSA plan to share oversight of these activities by implementing partner Columbia University, with CDC providing in-country day-to-day oversight and workplan review/monitoring, HRSA fulfilling Project Officer responsibilities, and the two agencies conducting conference calls at least bi-monthly.
COP 2013 funds requested in the OHSS budget code will support:
1. Ongoing activities started with central funds and focused on nurse training and capacity building, including a baseline assessment, expansion of pre-service and in-service training capacity, and strengthening of leadership and management capacities of nursing and midwifery associations. These activities are described under the MTCT budget code.
2. Capacity building of health extension workers (HEWs) to improve community-level health outcomes, including HIV/AIDS service uptake and retention within a continuum of care. This component is designed to help address Cote dIvoires challenges in ensuring adequate human resources for community-level health care and health promotion, especially in parts of the country (Northwest, West, Southwest) marked by disproportionate violence and deterioration of health and social services during the recent civil war and, according to preliminary DHS data, reporting increased HIV prevalence rates.
This program component will be based on the Ethiopia health extension program (HEP) model, with four health subprograms: disease prevention, family health, environmental hygiene and sanitation, and health education and communication.
Any community or group of communities with more than 1,000 households will be eligible to nominate a female member who has completed 10th grade as a HEW. The program will train selected candidates for one year, after which they return home as salaried frontline health-care staff.
Newly trained HEWs will recruit three to five voluntary community health workers. This Community Health Extension Team (CHET), led by the HEW, will be the first point of contact of the community with the health system, delivering integrated preventive, promotive, and curative health services, with a focus on maternal and child health.
The CHET will work to increase knowledge and skills of communities and households to deal with preventable diseases and access clinical services. Its official package of services will be determined with the Ministry of Health and AIDS (MSLS) but could include supervision of Directly Observable Treatment-Short Course (DOTS) for TB, rapid testing and supervision of antiretroviral treatment for HIV/AIDS, rapid testing and administration of treatment for malaria, attendance at non-complicated childbirths, referral of patients to nearby health centers, and collection of vital statistics.
With COP 2013 funds, four preparatory steps will be completed:
1. Mobilize stakeholders (PEPFAR, UNICEF, MSLS directorate of community health, people living with HIV, governmental and non-governmental entities supporting community health workers in western CI).
2. Collect and organize data. Working groups will gather quantitative and qualitative data on mortality, morbidity, community opinions, and behaviors in targeted zones, to be analyzed and used during the planning phase.
3. Define the package of services to be offered. Collected data will be paired with national policies and guidelines to help define a limited number of priorities that are likely to impact disease, death, disability, and injury rates.
4. Develop a comprehensive five-year HEW plan for CI. The first two years will focus on planning, communication with communities, recruitment and training HEW, and deployment of CHETs. Once finalized, the plan would be expected to be adopted by the GoCI for fund raising and implementation, with PEPFAR support.
HRSAs Nursing Capacity Building Program (NCBP) has been working since 2006 to strengthen the knowledge, skills, and abilities of nurses to deliver care to people affected and infected by HIV/AIDS and co-morbidities, as well as the capacity of in-country nurse leaders, organizations, and institutions in African countries. The projects general nursing capacity building component has (1) conducted assessments to identify capacity building and technical assistance needs of nurses providing HIV/AIDS care, treatment, and prevention services; (2) provided pre-service and in-service HIV/AIDS training to nurses, nurse educators, and students, both through on-site clinical and on-campus didactic mentoring and through curriculum review and development; (3) developed wellness programs and centers for health workers infected or affected by HIV/AIDS and co-morbidities; (4) facilitated networking of nurses across institutions and countries; (5) supported development of national nursing strategy; and (6) advocated for nursing leadership, visibility, and nursing issues.
Under a five-year grant (2012-2017), ICAP Columbia University will implement the NCBP with a goal of having a sustainable effect on the prevention, care, and treatment of HIV/AIDS and co-morbidities in at least 12 PEPFAR-supported countries, including Cote dIvoire, by strengthening nursing and midwifery education systems, enhancing nursing and midwifery professions through multi-level capacity building activities, and increasing the number of professionally trained nurses, in partnership with the Ministries of Health (MOH), country stakeholders, and in-country USG teams.
Requested COP 2013 funding in MTCT will be used to:
Conduct a baseline capacity assessment of CIs three public nursing/midwifery schools, as well as of nursing and midwifery associations. Assessment of private and faith-based nursing schools is under discussion. The assessment will include regulation of nurses and midwives to ensure that standards and policies are in place at the Ministry of Health and AIDS (MSLS) central and decentralized levels; training curricula, which currently do not include HIV care; and policy changes needed to authorize nurses to prescribe ART.
Work with the MSLS to develop HIV curricula and tools and to incorporate HIV care into training school curricula
Work with the MSLS to ensure that nursing/midwifery students receive proper training prior to working professionally on the ground.
Strengthen the leadership and management capacity of nursing and midwifery associations.
