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: 2011 2012 2013 2014 2015
The Nicaraguan Military population is characterized as at increased risk for HIV and other STIs. Nicasalud will provide technical assistance to support sexual prevention, counseling and testing and system strengthening activities in the Nicaraguan military. The Prevention program will emphasize expansion and enhancement of existing combination prevention activities.
Nicasalud will also support Health Strengthening in Nicaragua. Activities will expand and improve in-service training for military health care providers in a wide variety of fields, including the diagnosis and management of STIs, Opportunistic Infections, TB and mental health disorders as well as training in the provision of ARVs, and the assessment and management of care for HIV infected persons.
Primary achievements have been in the area of capacity enhancement for partner militaries. Nicasalud has provided extensive support to the Nicaraguan military in its implementation of counseling and testing and HIV prevention. With this support the military has increased its capacity to lead these vital programs. Host militaries will be called on to incrementally increase cost sharing in support for counseling and testing services.
Cost efficiency and quality will be improved by increasing the capacity of military healthcare workers to conduct trainings internally, leverage partnerships with local organizations, and share best practices across militaries in the region. The program will incrementally increase the financial and human resource contribution of the host country military.
Program monitoring and evaluation will be carried out according to national health standards, utilizing mechanisms provided by or recommended by the Ministry of Health and/or National AIDS coordinating body.
This activity will strengthen the capacity of the Nicaraguan Armed Forces to plan, manage, and implement HIV programs. Referral networks and service integration will be strengthened for HIV/STI/TB care and treatment. Strategies for improving partnerships with other governmental organizations, NGO, and private entities working on HIV and health will be emphasized. Program activities will seek to secure military leadership endorsement and support of interventions addressing gender norms, substance abuse, and confidentiality, among others. TA will be provided to improve treatment adherence, psychosocial support services and diagnosis and treatment of mental health problems for the HIV + personnel and civilians receiving treatment and care at military health sites. Efforts will be made to strengthen military protocols that reduce stigma and discrimination and strengthen military commitment to support HIV-positive members and HIV programs.
Financial management mechanisms will be improved and training will be provided for military leadership in financial management for HIV programs. The development of mechanisms for leveraging resources and creating greater resource efficiencies will be encouraged.
Opportunities to strengthen in-service training will be expanded and improved for military health care providers in multidisciplinary fields, including STIs, ART management, psychosocial counseling, and substance abuse will be pursued. Service guidelines will be developed or disseminated and quality assurance mechanisms will be established. Military personnel will also be trained on HIV surveillance and strategic information.
Opportunities for military to military exchange training programs and professional exchanges to share program best practices and foster regional collaborations will be explored. TA will be provided for the development of strategies to encourage staff retention, performance and promotion for healthcare staff providing HIV/AIDS related services.
Activities will support the retention of healthcare personnel and uptake of clients by improving the workplace environment through minor refurbishment of work sites, including counseling and testing centers, labs and clinic settings.
Activities will strengthen the capacity of the Nicaraguan Armed Forces to provide accessible, confidential, and quality testing and counseling services. Testing and counseling will be integrated into existing medical health services and routine medical care through provider-initiated testing and counseling (PITC). TC opportunities for military personnel will be expanded (i.e. on bases, pre/post deployment, and temporary assignment) and activities will link with other prevention activities as well as provide access to other support services. TC activities will link with prevention sensitization activities to educate participants and access other support services.
As the military increase their capacity for managing TC activities, couples TC will be promoted among military personnel and their partners in order to identify serodiscordant couples and encourage safe sex practices and other preventive behaviors. Couples TC will promote gender equity and facilitate safe, mutual disclosure of HIV test results. Enhanced risk elucidation and risk reduction planning will be incorporated into post-test counseling encounters.
The Military will work with national supply chain mechanisms to ensure TC sites have sufficient supplies, adequate and secure storage facilities, as well as inventory monitoring and tracking systems for HIV test kits. TA in the provision of quality HIV TC services will be provided to military TC providers. Counseling will be performed in accordance with national guidelines and will include targeted prevention messages, emphasizing the reduction of risk behaviors, and address issues surrounding stigma and discrimination.
Building on previously funded trainings, training and refresher training of counselors will begin to focus on management and supervision and advanced TC skills such as couples counseling. Mechanisms to maintain confidentiality of those tested will be established. A monitoring and evaluation system will be implemented through i.e. standardized logbooks, client data forms, monthly reporting forms, and other methods that comply with the national reporting systems and requirements.
NicaSalud will support the Nicaraguan Armed Forces in the implementation of HIV prevention activities with military members and their families. Drivers of the Nicaraguan epidemic in military members , families and community is the focus of this program. Military members and families will be provided the necessary skills to change behaviors, engage in safe sex practices, decrease other risk behaviors and learn HIV status. By targeting military personnel, activities will support the Partnership Framework prevention goal of increasing healthy behaviors among MARPS to reduce HIV transmission. The support of prevention programs leveraging the existing military institutional structures will lay the foundation for sustainable programs. Technical assistance will build internal capacity of the partner military to direct and maintain HIV prevention efforts. Technical assistance will be provided for the provision of evidence based interventions in areas such as correct and consistent condom use (including minimizing stigma surrounding accessing condoms), promoting condom negotiation skills with partners, decreasing sexual risk behaviors, mitigating the influence of alcohol on sexual risk taking behaviors. Prevention activities will promote sexual health and reduced HIV risk by communicating the risks associated with overlapping or concurrent sexual partnerships. Health seeking behaviors and access to services will be promoted.
Interventions will be delivered through individual one on one and small group sessions, campaigns, and through trainings integrated into military institutions. Peer educators will be trained in risk reduction counseling and equipped with risk reduction supplies (i.e. penile models, condoms). Master trainers will implement and train others on how to implement educational outreach and community mobilization activities and provide supportive supervision of peer educators. Selection criteria will be established for peer educators, and retention and incentive strategies will be developed with militaries to encourage sustainable programs.
Operations research will be conducted to determine the efficacy of these interventions on key behavior and health outcomes. Interventions will be compared across and between countries to refine intervention efficacy.
