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: 2007 2008 2009
• Title: Role of private providers in delivering EP Services
• Time and money :
This is planned as a one year study costing $150,000 over the life of the study.
•Local Co-investigator:
Co-Principal Investigators:
Dr. Anthony Tanoh, MD, EGPAF/Côte d'Ivoire
Dr. Christophe Grundmann, Ph.D., EGPAF/HQ
Ivoirian Social Scientist, TBD
• Project description:
Background: Studies of African health care utilization have shown that between 33% and 66% of the health
care delivery in any country is delivered by private health professionals. EGPAF's program works with
some private providers. But, in general, private providers have not been included in EP activities, though
they provide the most fruitful area for expansion. EGPAF will conduct a study that explores the private
sector, estimates the proportion of the population served by such sites, is able to assess their potential
contribution to EP goals, and offers a plan of action on how to work with them in the future.
• Evaluation question/Hypothese:
1) Private for profit health care practitioners provide a significant proportion of the health care available to
urban residents of Côte d'Ivoire.
2) Private providers can be utilized to further the EP program in Côte d'Ivoire.
• Programmatic importance:
Private providers offer the most fruitful area of expansion for EP services in urban areas, particularly for
PMTCT and Care and Treatment services. But to reach their potential cannot be reached without a better
understanding of their numbers and their current importance in delivering antenatal and curative care
services. With this understanding, one can envision some sort of accreditation strategy that would utilize
private providers to further EP expansion but maintain quality standards.
• Methods:
1) Private provider census in targeted neighborhoods in Abidjan, Abengerou and San Pedro.
2) In depth interviews with a representative sample of private providers in each neighborhood.
3) Household survey on health care utilization patterns.
4) Consultative meetings with PNPEC and Private Providers to return findings and plan future expansion
strategy.
The investigators have all necessary technical expertise. No major ethical issues are foreseen.
• Population of interest:
There are two populations of interest. The first is private providers themselves; these will include
physicians, nurses, pharmacists, and laboratory technicians. The sample size necessary to sample from
this population will be determined by the census that is the first activity proposed. The second population is
composed of the users of private providers. The number of households that will need to be sampled to
understand care-seeking behavior will be directly related by the level of private provider utilization, which
will be estimated after the results of the census are analyzed. But given previous African estimates that
between 33% and 66% of all health care utilization are provided by private providers, sample sizes are not
expected to be particularly large.
• Information Dissemination Plan:
The results from the census and both the provider and household interviews will be formally presented to
stakeholders representing the GoCI, the gamut of private providers, and the major HIV/AIDS donors. It is
envisaged that this can be done through a formal development process that will lead to steps to further
utilize private providers in the EP program.
• Budget justification for Year 1 budget
Salaries/Fringe benefits: $40,000
Equipment: $30,000
Supplies: $20,000
Travel: $25,000
Participant Incentives: $10,000
Laboratory Testing: $0
Other: $25,000
Total: $150,000
PARTNER: EGPAF CENTRAL FUNDS
• Title of study: Evaluation of the Effectiveness of HIV Care and Treatment within Project HEART
• Time and money summary:
The project involves two studies. The first study, funded with $150,000 in carryover money, includes a
retrospective analysis of patient outcomes and a cross-sectional survey of patient and health-provider
satisfaction. It is expected to start in November 2007 upon IRB approval of the protocol and to be completed
by March 2008. The second study, described below, will take two years from protocol development to
completion of the study and will require a total budget of $245,000. FY08 funding requested is $150,000.
• Local Co-investigators:
Dr. Essombo Joseph, EGPAF
Dr. Kouakou Joseph, EGPAF
Dr. Ettiegne-Traoré, Virginie, PNPEC
EGPAF's Project HEART in Côte d'Ivoire has experienced a rapid expansion in the past three years. By
March 2007, 36,641 patients had received ART at 77 sites. While 65% of enrolled patients are women,
enrollment of children is lagging behind at 6% of patients no ART, well below the EGPAF and WHO target
of 15%. The current program strategy is to move toward decentralization and integration of HIV care within
primary-care facilities using a family approach to HIV diagnosis and treatment to increase enrollment and
provision of services to HIV-infected children and improve their health outcomes.
• Evaluation questions
First study:
1. Is the ART program effective in improving patients' health and survival?
2. What are the program characteristics that significantly affect patient outcomes?
3. Are patients and health-care providers satisfied with the program?
Second study:
1. Does routine HIV testing of pediatric patients increase identification of HIV-infected infants and children
and uptake of care and treatment services?
2. What is the impact of family care services at the same facility on treatment and longitudinal follow-up of
HIV-infected children?
Evaluation of the effectiveness of the care and treatment program during initial scale-up is critical to inform
further program expansion. Furthermore, EGPAF is implementing the family-centered model of HIV care at
selected health facilities. There is a need to assess the effectiveness of this strategy in improving access to
care and provision of HIV services to children with HIV infection.
The first phase is a retrospective analysis of data from a sample of patients' medical records to assess their
immunologic status and clinical status, the rate of treatment failure, and the determinants of treatment
failure.
The second phase of the first study is a cross-sectional study at selected sites to assess the proportion of
patients and health-care providers satisfied with the program.
The second study is a prospective cohort study to compare the rate of enrollment and outcomes of children
in selected sites implementing the family HIV care model to the indicators at control sites. The family-
centered model of HIV care is defined as a package of services provided at the same health facility that
includes routine rapid HIV testing for all children at all child-health interfaces, followed by an offer of HIV
testing for all family members of the identified HIV-positive child and provision of cotrimoxazole prophylaxis
and ART to eligible children and family members. The following outcome measures will be assessed at the
intervention and control sites.
1. The proportion of children among patients enrolled into care and treatment
2. The proportion of eligible children on cotrimozaxole prophylaxis
3. The proportion of eligible children on ART
4. The 12-month survival rate
A working group composed of local collaborators and US-based staff will develop the study protocol and
oversee the implemention of the study. The final protocol will be submitted to the local and a US-based IRB
for approval.
• Population of interest: HIV-infected adults and children enrolled in the care and treatment program at
selected facilities in urban and rural health-care facilities in Cote d'Ivoire.
The results of the study will be shared with the Ministry of Health and implementing partners to inform future
program planning.
• Budget justification for Year 1 budget: Detailed budget will be submitted with study protocol
Salaries/ Fringe benefits: $97,714
Activity Narrative: Administrative costs: $24,573
Training: $420
Travel: $11,683
Other cost (incentives, IRB approval, translation, etc.): $19,379
Total: $153,796
NOTE: Track 1 HTXS funding of $300,000 for a study on an EGPA ART pregnancy registry has not been
approved. The USG team does not intend to support the originally proposed study. These funds will remain
in EGPAF's Track 1 HTXS funding (the original source).
Please also see accompanying application for country funding in the same section. Additional country funds
will be added to the central funds available to ensure appropriate implementation and achievement of
intended targets.
Since 2004, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has received USG funds through
Project HEART to provide comprehensive care and treatment services to more than 88,000 PLWHA,
including 40,000 on ART at 77 sites.
In June 2007, 18 sites managed by EGPAF sub-grantee ISPED/ACONDA (and accounting for about 14,000
patients on ART) moved from Project HEART when ACONDA graduated to become a PEPFAR prime
partner. Thus, EGPAF now supports 59 sites with 26,000 patients who have initiated ART. With FY07
funds, EGPAF aims to support 75 sites (including 16 new sites) with 33,000 patients ever receiving ART
and 29,700 patients actively receiving ART.
The objective of the FY08 Track 1 funding is to support complementary country funding to permit EGPAF to
provide ongoing support to the 75 existing sites and 29,700 patients expected to be on active ART by March
2008 as well as to provide services to 25 additional sites, with 35,000 patients on active ART at 100
supported sites by March 2009.
