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: 2010 2011
This implementing mechanism is unchanged from last year.
Reproductive Health Association of Cambodia (RHAC)
Overall Goals and HIV-Specific Objectives
Established in 2006, Reproductive Health Association of Cambodia (RHAC) is a Cambodian NGO whose goal is to enable Cambodian people to exercise their right to achieve quality of life through model services, gender-sensitive health communication, and training focused on family health, including sexual and reproductive health, maternal and child health, and HIV/AIDS.
With FY10 PEPFAR funding, RHAC will continue to provide and/or support the provision of Prevention of Mother-To-Child Transmission (PMTCT), Voluntary Confidential Counseling and Testing (VCCT), STI treatment, Post-Exposure Prophylaxis (PEP), ARV prophylaxis for HIV + pregnant women (PW), integrated RH and HIV/AIDS education, OI/ARV prophylaxis and treatment, and Orphans and Vulnerable Children (OVC) support. New activities in FY10 are TB/HIV and cervical cancer screening for HIV+ women.
Target Populations
Target groups for VCCT include sex workers, men who have sex with men (MSM), beer promoters, karaoke, massage workers, waitresses, casino workers, migrant workers [factory workers (FWs), construction workers (CWs), fishermen], youth, and the general public. PMTCT targets PW, HIV+ PW, and their newborns. PEP targets rape victims and RHAC clinical staff. Cervical cancer screening targets HIV + women. Targets for RH and HIV/AIDS education are youth in-school and in villages, migrant workers, married couples and STI clients. Pediatric care and treatment is provided to children infected and affected by HIV/AIDS at Angkor Hospital for Children (AHC). TB patients are targeted for TB/HIV.
In total, 56,874 individuals will receive VCCT; 28,366 PW receive HIV C&T; 175 HIV+ PW will receive ARV prophylaxis; 161 rape victims and RHAC clinic staff will receive PEP; 284,857 individuals will be reached with other prevention (112,241 received STI treatment, 3,736 FWs, 3,091 CWs and fishermen, 74,463 married couples and 91,326 young people); 490 HIV+ children receive ARV; 120 OVC will be supported; and 3,277 TB patients tested for HIV.
Geographic coverage
The 18 RHAC clinics are in 15 ODs in Phnom Penh, Kampong Cham, Siem Reap, Kampong Speu, Battambang, Sihanouk, Takeo and Svay Rieng provinces. The 20 RHAC supported satellite sites are in 6 ODs in Kampong Cham, Kampong Speu, Sihanouk and Battambang. In 2011, 12 of the 18 RHAC clinics will start ARV prophylaxis for HIV+ PW.
Pediatric HIV care and treatment will continue in Siem Reap with some patients coming from other provinces.
RH and HIV/AIDS education for youth will take place in 755 villages and 38 schools in Battambang, Pailin, Siem Reap, Phnom Penh, Kampong Cham and Sihanouk. Programs for migrant workers will occur in eight factories in Sihanouk, 25 construction sites in Sihanouk, Phnom Penh and Siem Reap, five fishing sites in Sihanouk and Siem Reap provinces and 3961 rural villages in Battambang, Pailin, Kampong Cham, Kampong Speu and Sihanouk.
Making the Most of HIV Resources
RHAC applies funds from the Global Fund (GF) for HIV test kits and STI drugs in all of its clinics. It also uses this funding for BCC on HIV/AIDS and RH for MARPs and youth; home-based care (HBC) projects; and Community DOTS (C-DOTS). Additional funding comes from Plan International (PLAN) for BCC for youth and the European Commission (EC) for BCC for FWs in additional provinces.
GF supports HIV education for MARPs in 246 entertainment establishments in Phnom Penh, Sihanouk, Siem Reap, Svay Rieng, Mondulkiry and Kandal; BCC for youth in 511 villages in Takeo, Svay Rieng, Kampong Cham, Mondulkiry; C-DOTS in Takeo and Prey Veng and HBC in Sihanouk, Svay Rieng and Kampong Cham provinces. PLAN supports in 126 villages in Kampong Cham and Siem Reap and EC in 30 factories in Phnom Penh, Kampong Cham and Kampong Speu.
RHAC also uses its HIV funds to improve its extensive MCH and RH programs by integrating programs.
Cross-cutting Areas
RHAC supports the cross cutting areas of gender and human resources for health. RHAC promotes gender equity by having gender-balanced peer educators (PEs) and promoting equal opportunity and rights with regard to training, jobs and roles and responsibilities. RHAC has expanded its program reporting form to collect the number of beneficiaries by gender and will closely monitor gender participation. RHAC will train health care workers and PEs on different HIV/AIDS subjects through pre-service and in-service training in collaboration with relevant national programs of MoH.
Enhancing Sustainability
RHAC collaborates closely with government and private institutions to implement activities and promote sustainability. RHAC works closely with national programs such as National Center for Maternal and Child Health (NMCHC), the National Center for HIV/AIDS, Dermatology and STD (NCHADS) and the National Tuberculosis Program (CENAT) to incorporate RH/FP, HIV/AIDS, and TB activities in national planning, guidelines and training curricula. RHAC actively involves beneficiaries, marginalized groups and government partners in all activities from the start to ensure ownership, commitment and integration of programs within the existing structure.
M&E
RHAC will ensure proper M&E of PEPFAR indicators for all relevant implementing program areas. As RHAC routinely collects program data, it will use this information to inform and shape ongoing project design and implementation. RHAC's monitoring and evaluation plan will thus be programmatically relevant, based upon ongoing inputs and utilizing staff expertise for data collection and data-driven interventions. RHAC will conduct a study to determine risk behavior among migrant workers.
This is a new activity.
Care and support services for people living with HIV/AIDS (PLHAs) refers to cervical cancer screenings provided to HIV+ women at RHAC clinics. RHAC conducts two types of cervical cancer screening tests: VIA (Visual Inspection Acid Acetic) and PAP smear. RHAC has 18 clinics located in 15 Operational Districts (ODs) of 8 provinces of Siem Reap, Battambang, Kampong Speu, Preah Sihanouk, Kampong Cham, Phnom Penh, Svay Rieng, and Takeo. All clinics can perform VIA on-site and collect samples for PAP smear reading, which is performed in Phnom Penh. RHAC will continue to coordinate with other partners and OI/ART sites to refer HIV+ women for cervical cancer screening at its clinics. RHAC will work with NCHADS and the provincial health departments to identify OI/ART sites under its coverage that can refer HIV+ women to RHAC clinics for screening. Cryotherapy service is provided for HIV+ women identified as having pre-cancerous lesions in 12 RHAC provincial and Phnom Penh clinics. RHAC will discuss with relevant national programs (NCHADS, NMCHC) to identify OI/ART/PMTCT sites appropriate to provide cervical cancer screening. It will conduct training for medical staff and monitor HIV+ women referred and screened. Through this activity, RHAC will determine the prevalence of cervical cancer among HIV+ women and share the results with government and other partners to fill knowledge gaps on the issue.
This activity is unchanged from last year.
TB/HIV activities implemented through the RHAC program include: HIV counseling and testing among registered TB patients under RHAC support; Community DOTS; and referral of HIV+ clients identified through RHAC clinics for TB screening by TB units. These activities follow Standard Operational Procedures (SOPs) of NCHADS and CENAT. RHAC implements community DOTS in eight ODs: (Battambang, Sangke, Maung Russey, Kampong Speu, Kong Pisey, Tbaung Khmum, Prey Chhor and Srey Santhor) of three provinces: (Battambang, Kampong Speu and Kampong Cham). In the ODs in which RHAC supports Community DOTS, RHAC collaborates with CENAT to train health center (HC) staff on HIV counseling (training conducted by CENAT). HC staff provide HIV counseling for identified TB patients and take blood for testing at VCCT sites with consent. RHAC pays transportation costs for HCs to take blood to VCCT sites for testing. HC staff provide post-test counseling and refer HIV+ TB patients identified to other services such as OI/ART and home-based care. RHAC-supported TB/HIV activities are linked with the Continuum of Care activities of the Ministry of Health and PHD/OD.
RHAC clinics refer HIV+ clients identified through its VCCT services to TB units for TB screening. The clinics support transportation for referred clients and coordinate with TB units for follow up of clients. TB units will provide treatment for identified TB patients.
RHAC will support ODs and HCs to collect, review and analyze information about the number of TB and HIV patients referred and screened/tested for TB/HIV. It will document prevalence of TB and HIV among these groups. RHAC has developed reporting forms that can track progress indicators, as in the TB/HIV framework and revised indicators, which will ensure data quality and accuracy. In FY10, 2,259 TB patients are expected to receive counseling and testing for HIV and will know their results.
