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
Nutrition support, an important aspect of comprehensive HIV/AIDS prevention, treatment, and care services, has been limited in many PEPFAR-supported programs. In an effort to develop and implement a nutrition strategy and services for PEPFAR-supported HIV/AIDS programs in Cote d'Ivoire, the USG team significantly increased its investments, starting with FY 2007 plus-up funds, to strengthen this area of work. All care and treatment partners provide some nutrition-related services. Major partners focusing on nutrition are IYCN/PATH and AED/FANTA for technical assistance, the World Food Program, and the Ministry of Health's National Nutrition Program (PNN).
IYCN/PATH receives funding in the HKID, PDCS, and PMTCT budget codes to help strengthen national capacity to provide high-quality nutritional assessment, counseling, and support to HIV-infected and -exposed infants and other OVC as well as to pregnant/lactating women, in collaboration with national programs (PNN, HIV/AIDS care and treatment (PNPEC), child health (PNSI), OVC (PNOEV), reproductive health (PNSR), public health (INSP)) and PEPFAR implementing partners. PATH's technical assistance consists of building the capacity of the government, partners, and health and social workers at PMTCT, pediatric ART, and OVC sites (social centers) to provide:
? Appropriate planning, implementation, coordination, and monitoring of nutrition support, based on up-to-date policies, practices, and tools.
? High-quality infant feeding counseling, support, and follow-up for all HIV-exposed infants and mothers, along with a package of child-survival and reproductive-health interventions with linkages to HIV prevention, treatment, and care services.
? Nutritional assessment, counseling, and support as an integrated part of care at clinics, at home, and at social centers, including routine assessment of anthropometric status, nutrition-related symptoms, and diet, with therapeutic or supplementary feeding support for malnourished clients.
? Linkages to food aid and social services that can assist in the assessment and support of household food security.
? Training and coaching for health, social, and community workers, as well as OVC caregivers
? Wrap-around nutrition support.
PATH works at the national level, to help ensure appropriate policies and materials, as well as at the health district and site levels nationwide. In coordination with the national programs, PATH will support at least 154 PMTCT sites (up from 124 as of September 2009), 10 pediatric care sites, 30 UNT/CNT sites (up from 20), and 40 social centers providing "platform" services for OVC (up from 28) by September 2010.
With FY2010 funding, PATH will continue FY 2008-2009 work with the PNN, PNPEC, PNOEV, and implementing partners to scale up integrated nutrition services as an essential component of PMTCT, pediatric HIV/AIDS care and treatment, and OVC care. Between October 2010 and September 2011, PATH activities are expected to support nutritional assessment and counseling for at least 240 HIV-positive children, therapeutic or supplementary feeding (with food provided through other partners) for at least 80 HIV-positive malnourished children, and training in nutritional assessment and care for at least 90 health care providers and 130 OVC caregivers. Major activities will focus on:
Strengthening the capacity of Ministry of Health (MOH) district offices to integrate and scale up infant feeding and nutrition activities, with a streamlined training plan and follow-up coaching and monitoring.
Helping to implement the national document on minimum standards for equipment (e.g. measuring ribbon, infant feeding cup, weight measure, materials for dietary demonstrations, therapeutic food) for PMTCT sites, OVC social centers, rural health centers, and community workers
Revising guidelines, policies, training curricula, job aids, and IEC materials as needed on therapeutic care for malnourished infants
Strengthening the capacity of government therapeutic nutritional centers (UNTs and CNTs), in collaboration with national programs and international partners (UNICEF,WHO)
Promoting guidelines for the identification of malnourished infants in the community, as well as referral systems for appropriate clinic-based therapeutic care
Strengthening the capacity of national trainers in Nutrition and HIV
Promoting recipes appropriate for OVC ages 6-24 months developed during through food mapping by region.
Working with the PNN, PNPEC, and RIP+ (national network of PLWHA organizations) to promote the creation of HIV/AIDS support groups and use of monthly discussion topics with messages about the importance of routine follow-up, delivery at health facilities, immunization, cotrimoxazole prophylaxis, nutrition, and disclosure of HIV status to partners.
PATH works to build national ownership and capacity through support for training of national and district program staff as well as health workers, social workers, and community workers from the public and private sectors; integration of HIV and Nutrition into pre-service training curricula for health providers and social workers; and the elaboration of strong national policies, guidelines, and tools. PATH works to strengthen national and district-level technical groups and coordination bodies. PATH uses its M&E system to provide timely, accurate reports to national authorities and the USG strategic information team, takes part in quarterly SI meetings, and participates in the process of integrating nutrition indicators in the national management information system to improve access to data for decision-making.
PATH's work to improve nutrition and related care for pregnant women, mothers, infants, and children contributes to the key issues of child survival, safe motherhood, and increasing gender equity.
None
IYCN/PATH receives PEPFAR funding in the MTCT budget code to help strengthen national capacity to provide high-quality nutritional assessment, counseling, and support to HIV-infected and -exposed infants and pregnant/lactating women at PMTCT sites. Working in support of the national programs (nutrition (PNN), HIV/AIDS care and treatment (PNPEC), child health (PNSI), OVC (PNOEV), reproductive health (PNSR), and public health (INSP)) and in collaboration with the International Baby Food Action Network (IBFAN-CI), Stratégie Accélerée pour la Survie et le Développement de l'Enfant (SASDE), and PEPFAR implementing partners, PATH provides technical assistance to build the capacity of the government, partners, and health workers to provide:
? Nutritional assessment, counseling, and support as an integrated part of care, including routine assessment of anthropometric status, nutrition-related symptoms, and diet, with therapeutic or supplementary feeding support for malnourished clients.
? Training for health workers.
? Wrap-around nutrition support provided as part of PMTCT.
With FY 2009 prime-partner and subpartner funding, PATH is working to provide nutritional care and support at 30.8% of PMTCT sites (124/402) and training for 316 health workers by September 2010 with the WHO integrated six-day course, as well as shorter on-site training for more than 805 health workers. PATH is working to strengthen the capacity of health districts to integrate and scale up infant feeding and nutrition activities, moving from demonstration activities at a limited number of sites to support scale-up at existing PMTCT sites and integration of infant feeding and nutrition care at new sites. In five zones, PATH is working closely with the district health team to plan, implement, and coordinate nutrition activities as part of district micro-plans and to implement a streamlined training and equipment plan for care providers.
With national programs and implementing partners, PATH will also provide technical assistance to PNN to integrate HIV and Nutrition in pre-service training curricula for midwives and nurses as needed; to adapt national minimum standards for equipment for PMTCT services to monitor infant growth (measuring ribbon, infant feeding cup, weight measure, materials for diet demonstrations) and to equip 50 PMTCT sites; and to develop guides to creating HIV/AIDS support groups and to monthly discussion topics with messages about the importance of routine follow-up, delivery at health facilities, immunization, cotrimoxazole prophylaxis, nutrition, and disclosure of HIV status to partners.
PATH's significant funding increase in FY 2010 reflects both the USG team's commitment to improving and scaling up nutrition support in PMTCT and the fact that unlike in previous years, PATH's work will be supported mostly through direct prime-partner funding instead of relying in part on subgrants from care and treatment partners.
Continuing and building on FY 2009 activities, PATH's FY 2010 activities will include technical assistance to the PNN and PNPEC to:
? Extend the nutrition-support package to 30 additional PMTCT sites by September 2010, reaching at least 38.3% coverage of PMTCT sites.
? Evaluate and support health districts' micro-planning for integrating nutrition and HIV activities
? Train and equip 20 regional trainers in Nutrition and HIV to promote and coordinate nutrition activities in their intervention zones (situational analysis, on-site training, and follow-up)
? Identify and meet training and equipment needs of at least 50 PMTCT sites
? Provide regular monitoring and supervision of Nutrition and HIV activities at all supported PMTCT sites, including support for HIV/AIDS support groups at 154sites as needed
