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 is a new implementing mechanism which is a follow-on training program for the Caribbean (CHART II) to be implemented under HRSA. This award is in alignment with the health sector strengthening, human capacity development and sustainability objectives of the Caribbean Regional Partnership Framework. The focus of this award will be on continuing professional development programs via collaboration with regional stakeholders and institutions including CHART RCU, the National Training Centers, the CHART Training Coordination training hub housed in the OECS \par HAPU, related Caribbean Universities, training institutions, health professional associations and relevant health professional accreditation and licensing boards. It will support CHARTs on-going work with in-service training, curricula design, and entry into pre-service training. This mechanism will provide technical assistance to enable CHART to closely coordinate its in-service and proposed pre-service work with relevant stakeholders. The goal of CHART II is to improve HIV/AIDS related health service delivery outcomes in the twelve (12) Caribbean Regional Partnership Framework countries through the development of continuing education programs integrating pre-service and in-service of the health workforce.
Partnership Framework: This mechanism encompasses a broad range of activities described in the Partnership Framework. Specifically the 5 strategic objectives described in the Human Resources for Health Goal Area
Coverage: The activities under this mechanism are regional in scope. The targeted populations include: doctors, nurses, enrolled nurses/midwives, pharmacy assistants, community workers and laboratory workers.
Health System Strengthening: The key contributions of this mechanism relate to in-service and pre-service capacity development of health care workers. This mechanism contributes to the global PEPFAR goal of training 140,000 new health care workers. This mechanism supports building the capacity of CHART for long term sustainability.
Cost Efficiency: CHART will become a sustainable training network that will be able to provide training and clinical mentoring to health care providers in the Caribbean. Special emphasis will be given to cost efficient strategies such as Training of Trainers, distance learning, training of community volunteers and inclusion of PLWHIV.
Monitoring and Evaluation Plan: The monitoring and evaluation of this mechanism includes PEPFAR indicators and the TBD partner will have to submit a more detailed M&E plan for the period of the award to measure outputs and outcomes of capacity building.
Cross-Cutting/Key issues
This mechanism will contribute to human resources for health professionals. Cross cutting technical assistance supported by this mechanism will emphasize health care worker training, collection of human resource data available through the MOH, and collection and analysis of information linking training to health services delivery outcomes.
Adult Care and Support trainings will continue to be provided by CHART to multidisciplinary groups of health care workers in the ten countries in this region in support of each countrys Human Resources for Health plan and as relevant to their individualized training plans.
CHART will continue to sponsor trainings in this region of the Caribbean which focus on testing, including provider initiated testing and counseling (PITC), rapid testing, as well as voluntary counseling and testing (VCT).
CHART will begin to provide in-service training to targeted groups of health care workers and para-professionals in Antigua, Barbados, Belize, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname and Trinidad and Tobago. Further development of pre-service materials and plans for roll out will also occur in conjunction with local universities and other continuing education institutions.
Targeted technical assistance will be provided to the Ministries of Health in Antigua and St. Lucia to assess and plan for the implementation of the revised Caribbean TB Guidelines.
Clinical consultation participants from Suriname, Trinidad and Tobago, and other Eastern Caribbean countries will be supported in attending the March 2011 IUATLD-NAR meeting in Vancouver, Canada to build additional TB/HIV capacities and provide networking opportunities for these clinicians.
The CHART National Training Centres in Trinidad and Tobago and Barbados will continue to provide ART training via in-person didactic and skill-building sessions, distance learning courses, preceptorships and onsite clinical mentoring for physicians, nurses and pharmacists. Additionally, the CHART RCU and TBD partners for relevant training programs in Suriname, Belize and six OECS countries (Antigua, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines), will deliver targeted ART training and technical assistance to expand the capacity of clinics and hospitals in these countries to provide quality HIV care and treatment.
These activities will complement the training activities funded under HRSA in support of decentralized and integrated HIV care and treatment in Jamaica and the Bahamas.
Activities and support for laboratory strengthening in the eastern and southern Caribbean regions need to be clarified and coordinated among national and regional partners. The CHART National Training Centres, with leadership from the CHART RCU and TBD partners, have the training coordination infrastructure to provide laboratory staff training as well as access to technical assistance for systems strengthening. A coordinated training program led by the CHART Network will also support the efforts begun by CHART and the Caribbean Cytometry and Analytical Society (CCAS) in 2009 to strengthen relationships and coordination of care between HIV clinicians and laboratorians in Antigua, Barbados, Belize, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname and Trinidad and Tobago.
The CHART Network will contribute to Health Systems Strengthening across the region by continuing to provide high quality and cost-effective in-service training to a wide audience of health care workers in several southern and eastern Caribbean countries, including: Antigua, Barbados, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago. Additionally, new training partnerships and collaborations will be pursued in Belize and Suriname, two countries in the region who have benefited minimally from CHART regional trainings in the past and who do not themselves have a CHART National Training Centre. Training plans will be developed in conjunction with local partners in Belize and Suriname based on needs assessments and Human Resources for Health plans.
The CHART Network will continue to strengthen the provision of care for people living with HIV and AIDS, tuberculosis, and sexually transmitted infections by assessing and making recommendations for improvements to service-delivery systems. Clinical mentors will assist in developing tools, algorithms, and guidelines that help providers offer quality care. CHART mentors will also apply quality improvement strategies such as Plan-Do-Study-Act (PDSA) cycles to construct improvement goals, test proposed changes, and implement adjustments that lead to increased quality of operations, service delivery, and care.
Technical assistance will also be provided to Ministries of Health in the ten countries identified in this grant for national level adaptations to the Caribbean Regional Treatment Guidelines as needed and relevant. Training curricula will reflect these regional or country specific guidelines to ensure consistent messaging to health care workers and systems of care. Efforts will be made to strengthen linkages between core competency-based in-service training and updated job responsibilities with related performance measures.
The administrative, fiscal and grants management capacities of the CHART Regional Coordinating Unit will be strengthened via technical assistance from UWI in order to prepare this unit to become the primary recipient of funds for the CHART Network. An initial assessment will be performed to clearly identify the technical assistance needed toward effective and efficient grants management; goals, objectives and milestones for sustainability will be developed and agreed to by all parties; an action plan will be identified and implemented to address any shortcomings or further strengthen capacities as required.
These activities will complement the Health Systems Strengthening strategies undertaken by the CHART Regional Coordinating Unit (RCU) and the National Training Centres in Jamaica and the Bahamas funded by the HRSA CHART grant.
Collecting and utilizing training data to evaluate knowledge and skills helps to ensure that health care workers are appropriately trained to provide care and support to PLHIV. Under CHART II, the CHART RCU will support training centers and Ministry staff in ten countries in order to collect training data and evaluate training outcomes. These ten countries are Antigua, Barbados, Belize, Dominica, Grenada, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Suriname and Trinidad and Tobago.
Given the relatively high level of internet connectivity in a number of countries, like Trinidad and Tobago, the CHART RCU will work with training centers to explore on-line evaluation techniques such as follow-up surveys to participants that include knowledge questions. In addition, the RCU will scale up utilization of the TrainSMART database, which is currently used by training centres in Trinidad and Tobago and Barbados, for evaluation purposes. These activities will compliment the customizations to TrainSMART and the workshop on outcome evaluations that will be funded by HRSA.
