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 2012 2013 2014 2015
Health Alliance International (HAI) supports the Ivoirian Ministry of Health (MOH) to expand access to comprehensive HIV/AIDS care, treatment, and prevention services while building the capacity of national structures and contributing to sustainable service delivery within the health sector in Côte d'Ivoire.
HAI began activities as PEPFAR Cote d'Ivoire's fourth HIV/AIDS care and treatment prime partner in September 2009. With FY2009 funding, HAI is working to provide PMTCT, HIV testing and counseling (TC), adult and pediatric care and support, adult and pediatric ART, HIV/TB, and AB prevention services in five health facilities in three northern regions of the country (Vallée du Bandama, Zanzan, and Les Savanes).
With FY 2010 funding, HAI will continue, strengthen, and expand these activities, serving 15 clinical sites (with 2,360 adults and children on ART) in the same geographic zones by September 2010.
HAI promotes routine provider-initiated TC and TB screening at all supported health facilities. ART services are initiated at health facilities where there is at least one medical doctor, according to the national guidelines, and PMTCT services are offered at participating antenatal clinics. ART services are provided by multidisciplinary teams of providers using a family-based approach. HAI provides subgrants and technical assistance to several subpartners (private and faith-based clinics) to implement HIV/AIDS care services. Through contracts with local NGOs and PLWHA associations, HAI strives to improve outcomes for care and treatment through improved adherence and reduced rates of loss to follow-up.
At all sites, HAI works through counselors dedicated to providing a comprehensive package of HIV prevention and TC interventions for all clients and effective referrals for people living with HIV/AIDS (PLWHA) and their children, creating linkages to OVC, PMTCT, ART, TB, family-planning, and community-based care and support services. Counselors provide HIV prevention interventions in small-group sessions for up to 80 HIV-negative clients, as well as prevention with positives services and referral to OVC and community-based care and support services in individual sessions for up to 10 HIV-positive clients.
HAI works to support sites to shift the organization of their facility from a traditional episodic model of care to a chronic model of care for HIV patients. HAI emphasize the involvement of PLWHA in programs through peer-support interventions and strong linkages to community resources. The partner's capacity-building approach, focusing on district- and facility-level systems strengthening and provider training and mentoring, is designed to help ensure sustainability.
High-quality, timely, and sustainable monitoring and evaluation (M&E) activities are a high priority. HAI engages in a collaborative effort with local, national, and international partners to routinely collect, analyze, and disseminate data to assess program quality as well as program impact within and across sites. HAI uses nationally approved M&E systems and tools, including harmonized patient monitoring tools. HAI reports quarterly program results to the USG strategic information team and furnishes program data on an ad hoc basis.
HAI's activities contribute to the key issues of TB, malaria, safe motherhood, and child survival through its clinic-based HIV/AIDS services and its emphases on effective linkages with other health programs (e.g. TB, malaria, MCH). An evaluation of project implementation and impact is planned.
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Health Alliance International, the newest of four PEPFAR Cote d'Ivoire care and treatment partners, will use FY 2010 funds to continue and improve the quality of its care and support activities for OVC. PEPFAR CI care and treatment partners provide support to OVC in two ways: 1) by identifying OVC at partner-supported sites, providing medical care, and referring them to community-based care and support, and 2) by providing subgrants to community-based organizations providing OVC services in the geographic zones around partner-supported facilities. All care and treatment partners are receiving increases in funding in FY 2010 (substantial in percentage terms, though modest in absolute terms), in large part to provide subpartner funding to local NGOs providing the direct OVC services. HAI activities will support at least 1,500 OVC by September 2010.
All HIV-positive clients presenting at supported sites are offered information about and referrals to specific community-based OVC care and palliative care services tailored to their individual needs. In individual sessions, counselors seek to obtain contact information (e.g. address, telephone number) for the clients and briefly assess the clients' needs and resources. Counselors provide the clients with a brochure or other illustrated materials showing what the palliative care and OVC care services might include, such as clean water and bed nets for palliative care and educational, medical, nutritional, legal, and psychosocial support for OVC. The counselors then ask the clients whether they would like to provide the names of people in the household who might need referral to such services.
HAI will work with other stakeholders to ensure that community-based services capable of meeting these needs are identified. HAI will be responsible for monitoring and reporting on referrals according to a nationally standardized referral system. Health workers will be trained in pediatric HIV/AIDS management and care, and will be encouraged to facilitate access to OVC services in the partner-assisted regions. HAI will promote uptake of early infant diagnosis and provision of cotrimoxazole prophylaxis.
Health Alliance International (HAI) supports the Ivoirian Ministry of Health (MOH) to expand access to comprehensive HIV/AIDS prevention, care, and treatment services while building the capacity of national structures and contributing to sustainable service delivery within the health sector in Côte d'Ivoire.
HAI began activities as PEPFAR Cote d'Ivoire's fourth HIV/AIDS care and treatment prime partner in September 2009. With FY2009 funding in the HVCT budget code, HAI is working to promote routine provider-initiated HIV testing and counseling (TC) services in five health facilities in three northern regions of the country (Vallée du Bandama, Zanzan, and Les Savanes).
With FY 2010 funding, HAI will continue, strengthen, and expand these activities in the same geographic zones. Activities are expected to support testing at least 15,000 individuals at 29 sites by September 2010, with training for at least 65 providers. HAI will work to ensure that TC services are available at sites through regularly scheduled TC days and available trained counselors, as well as "opt-out" provider-initiated testing.
TC will become part of the continuum of HIV care for patients at sites. HAI's capacity building approach, focusing on district- and facility-level systems strengthening and provider training and mentoring, will help ensure long-term sustainability. Interventions will include:
Training and on-site mentoring for implementation of the new rapid-test algorithm to improve turn-around time for test results and limit dependence on laboratory staff, thus making point-of-service counseling and testing easier
Support for facilities to expand TC and improve quality and linkages to care and ART services.
Strengthening of providers' counseling skills, including those related to HIV prevention and couples counseling.
Promotion of the use of routine opt-out models in clinical settings such as ANC, TB, and STI clinics, and for adult and pediatric inpatient and outpatient settings to facilitate diagnosis and referral for enrollment and entry into treatment programs. HAI will support sites to develop standard operating procedures related to routine testing within the facility and will train appropriate staff.
Development of tools, instruments, and databases to track TC activities, including linkages to HIV care and treatment.
Support for TC services in all prisons and school infirmaries (SSSU) in the three supported regions.
Support for facilities to establish strong linkages with PLWHA organizations, OVC services, faith-based groups, and community-based NGOs to reduce stigma surrounding HIV testing, promote TC, and ensure that those who test HIV-positive are offered the opportunity to access care and treatment services.
Collaboration with SCMS and the Public Health Pharmacy (PSP) to ensure effective forecasting of test kits and timely delivery and management of stock.
At all sites, HAI will provide either through direct hire or by contracting with individuals or local organizations counselors dedicated to providing a comprehensive package of HIV prevention interventions for all clients and effective referrals for persons living with HIV/AIDS and their children. All clients who test HIV-negative will be referred (on an opt-out basis) to a counselor for behavior-change communication interventions, delivered individually or in small groups, focusing on risk reduction through abstinence and fidelity, with correct and consistent condom use for those engaged in high-risk behavior, as well as partner testing and STI prevention and care.
HIV-positive clients will be referred (on an opt-out basis) to a counselor for individual counseling that will include HIV prevention interventions and referral to community-based OVC and palliative care services to address family and individual care needs. Where possible, family-planning counseling and services will be provided to
patients and their partners through wraparound programming by non-PEPFAR funded partners, and condoms will be provided free of charge.
With assistance from the National OVC Care Program (PNOEV) and the PEPFAR in-country team, HAI will ensure that community-based services capable of meeting these needs are identified, and will be responsible for monitoring and reporting on referrals according to a nationally standardized referral system.
HAI will continue to support sites to implement patient record keeping and data quality assurance systems. There will also be an ongoing collaboration with districts to support CT services, including supervision, quality improvement, and linkages to HIV care and treatment.
Facility-based health services represent a critical opportunity to impact client behavior through clear, authoritative health messages delivered in one-on-one or small-group settings, as well as to connect clients effectively with community-based care services. To use the opportunity to reduce risk behavior and thus HIV transmission, all PEPFAR care and treatment partners support community counselors to ensure that the package of services offered to HIV-positive and HIV-negative clients at supported sites includes, as appropriate, HIV prevention behavior-change communication (BCC) interventions promoting risk reduction through abstinence, fidelity, correct and consistent condom use, status disclosure, partner testing, and STI prevention and care. In addition, they strive to ensure that all HIV-positive clients are offered effective, monitored referrals to community-based OVC and palliative care services.
HVAB funding allows all clients who test HIV-negative to be referred (on an opt-out basis) to a community counselor for appropriate BCC interventions, delivered individually or in small groups. Prevention with positives activities are supported through funding in the HBHC budget code.
HAI began activities as PEPFAR Cote d'Ivoire's fourth HIV/AIDS care and treatment prime partner in September 2009. With FY2009 funding in the MTCT budget code, HAI is working to provide PMTCT services in five health facilities in three northern regions of the country (Vallée du Bandama, Zanzan, and Les Savanes).
With FY 2010 funding, HAI will continue, strengthen, and expand these activities in the same geographic zones. Activities are expected to test 12,208 women, provide ARV prophylaxis for 500 women, and train 35 providers at 20 PMTCT sites by September 2010.
HAI supports sites to provide family-centered PMTCT services, using antenatal care (ANC) and other maternal and child health (MCH) services as key entry points. HAI's capacity-building approach, focusing on district- and facility-level systems strengthening and provider training and mentoring, is designed to help ensure long-term sustainability.
Key PMTCT activities in FY 2010 will include:
Develop an annual work plan in collaboration with the MOH and district authorities to improve PMTCT services according to national guidelines
Provide training and on-site mentoring in PMTCT for nurses, midwives, social workers, counselors, and physicians
Support sites to provide quality group and individual pre- and post-test counseling to maximize testing consent, receipt of results, and enrollment in and adherence to the PMTCT program
Provide TC to pregnant women presenting to the facility for the first time during labor
Support sites to develop systems ensuring that HIV-infected pregnant women are promptly assessed for eligibility for ART, receive routine CD4 cell count testing, and are provided with the clinical and social services appropriate to their disease stage
Support health care sites to provide enhanced counseling on disclosure, couples counseling, prevention, family planning, nutrition, infant feeding, and treatment adherence
Develop systems for linking PMTCT, care, and ART services to ensure that all pregnant women testing HIV-positive are enrolled in HIV care and treatment and receive ongoing care after delivery
Support facilities to establish systems for identifying and tracking women lost to follow-up and supporting adherence to ART, including linkages to organizations of people living with HIV/AIDS (PLWHA)
Ensure effective HIV-exposed infant follow-up, including initiating exposed infants on cotrimoxazole and conducting early infant diagnosis using DNA PCR
At all PMTCT sites, HAI will contract with local organizations to provide counselors dedicated to support for a comprehensive package of HIV prevention interventions for all clients and effective referrals for PLWHA and their children.
All clients who test HIV-negative will be referred (on an opt-out basis) to a counselor for BCC interventions focusing on ABC methods of risk reduction, as well as partner testing and STI prevention and care. HIV-positive clients will be referred (on an opt-out basis) to a counselor for individual counseling that will include ABC prevention interventions (including disclosure, partner and family testing, and STI prevention and care) and referral to community-based OVC and palliative care services to address family and individual care needs. Where possible, family-planning services will be provided through wraparound programming by non-
PEPFAR funded partners, and condoms will be provided free of charge.
HAI will ensure that community-based services capable of meeting these needs are identified and will be responsible for monitoring and reporting on referrals according to a nationally standardized referral system.
HAI will continue its collaboration with nutrition partners (National Nutrition Program, PATH) to improve nutrition assessment, counseling, and support services for pregnant and lactating women and exposed infants, according to national guidelines. All HIV positive pregnant women, before delivery, will receive individual counseling regarding infant feeding, according to national and international (WHO) guidelines.
HAI will continue to support sites to implement patient record keeping and data quality assurance systems and will collaborate closely with health districts for supervision and quality improvement.
