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 PHE activity, 'Models for Improving Loss-to-Follow-up in the DRC,' was approved for inclusion in the
COP. The PHE tracking ID associated with this activity is CD.09.0224.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Human Capacity Development
Public Health Evaluation
Estimated amount of funding that is planned for Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Program Budget Code: 10 - PDCS Care: Pediatric Care and Support
Total Planned Funding for Program Budget Code: $131,508
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
Pediatric Care and Support
Overview
Overall, the coverage and quality of HIV pediatric care and treatment in DRC is inadequate. The EPP-Spectrum analysis (2006)
estimated that 233,340 HIV positive children needed cotrimoxazole, in 2007, the PNLS reported only 2,603 children receiving
cotrimoxazole prophylaxis. As of October 2008, approximately 4,000 children were receiving cotrimoxazole. The EPP-Spectrum
analysis (2006) projected that 43,920 children will be eligible for ARV in 2009. However, in 2007 the MOH estimated that 1,485
were enrolled in ARV treatment or 3% of those eligible. As of October 2008, more than 3,000 children were receiving ARVs.
Challenges
Barriers to effective HIV pediatric care include: the retention of children after birth in clinics, malnutrition, TB, ARV dosing, and the
socio-economic cost of care. Barriers to scale-up are primarily due to challenges with case identification. Contributing factors
include home delivery and limited testing capacity at health facilities where children are born.
Leveraging and Coordination
Due to the special needs of pediatric AIDS cases, the USG plans to leverage the Clinton Foundation's new pediatric treatment
and care program in the DRC. The Clinton Foundation is working in Kinshasa, Lubumbashi, Kisangani, Mbuji Mayi, Bukavu,
Matadi, Kananga and Goma with a goal of enrolling 2,000 children in ART and related HIV care programs. The USG's PMTCT
plus program in both urban and rural areas will seek to link to pediatric care services, including those provided by Clinton
Foundation. The USG OVC program in Bukavu, Matadi and Lubumbashi also refers children to available pediatric AIDS services
in each of the locations.
Current USG Support
The USG funded Pediatric Care and Support services run by UNC at the Kalembe Lembe Pediatric Hospital in Kinshasa provides
care and support to HIV children and their first-line family members. The Clinton Foundation provides ARVs and other needed
supplies to selected health facilities that provide care to HIV positive children. The USG has assisted the Clinton Foundation to
train lab technicians on Dried Blood Spot for Early Infant Diagnosis in Kinshasa and in Lubumbashi. These collaborative efforts
increased the number of children diagnosed and who receive disease monitoring and ARV 1,475 in FY 2008 to an estimated
2,000 in FY 2009. With USG support, UNC has established at Kalembe Lembe Hospital a new service for follow up of HIV positive
pregnant women diagnosed at nearby PMTCT sites and their newborns and first-line family members.
The USG also through UNC funds community-based HIV support groups for families of infected children in Kinshasa. HIV positive
children are vulnerable to infectious diseases, stigma and discrimination. Many schools refuse to enroll children with facial rashes.
Activities for home visits targeting orphans, HIV positive and vulnerable children include: follow-up for missed appointments,
assessments of adherence to ARV treatment regimens, linkages to available social services, and instructions on home-based
health care. Psychological support is provided on coping with illness and care-giving, as well as the grieving process following the
death of a family member. Participant-centered support groups provide opportunities for individuals to meet and discuss coping
mechanisms with trained community outreach workers. Disclosure support is provided to parents or caregivers of HIV positive
children and adolescents who will receive counseling and support throughout the process of disclosing serostatus to family
members.
USG FY09 Support
FY09 funds will continue to provide Pediatric care and support to Kinshasa Pediatric Care and Support activities run by UNC to
HIV positive children and their immediate family members. Community-based psycho-social support activities in conjunction with
palliative and ART health facilities will also be supported through support groups. Follow up of HIV positive pregnant women
identified in PMTCT sites and their newborns and linkages to ART for those who are eligible will continue in two sites in Kinshasa.
The USG, along with UNICEF and Clinton Foundation, will provide TA and support to the PNLS Referral Laboratory for Early
Infant Diagnosis.
Support groups are very popular and in great demand, with more than 200 people attending one meeting at the Pediatric Hospital.
Discussion topics include disclosure, financial problem-solving, staying healthy, positive prevention, self-esteem, and sharing
experiences with others. Decentralization of support groups based in the community will continue with FY09 funds.
FY09 funds will support the expansion of the Lubumbashi HIV program through the new HIV bilateral program (mechanism TBD)
in Kasumbalesa, Kolwezi, Kipushi and Likasi and pediatric care and treatment will remain a component of this USG's integrated bi
-lateral HIV program. This new program will be designed and awarded by September 2009. These cities are located outside of
Lubumbashi at the Zambia border and along a major trucking route which starts in South Africa and travels north through
Zimbabwe and Zambia into Lubumbashi through Kasumbalesa. PICT and finger prick techniques will be implemented in CT
services using the family centered approach and a functioning referral system will be established to increase access to
comprehensive care and treatment for both HIV positive children and their parents. FY 09 funds will sustain a more
comprehensive program and improve care services articulated by the MOH. This model program envisions comprehensive health
care at the site level, linkages to strengthen the continuum of care between health facilities and the communities that they serve.
The PEPFAR team will also coordinate with Global Fund and Clinton Foundation activities to fill gaps in the existing package of
services available especially for pediatric ARV drugs and laboratories. Having one prime partner providing such comprehensive
prevention, care and treatment services will avoid duplication of activities. *
Program Area Downstream Targets:
6.1 Number of service outlets providing HIV-related palliative care (including TB/HIV): 199
6.2 Number of individuals provided with HIV-related palliative care (including TB/HIV): 2,177
Male: 830
Female: 1347
6.3 Number of individuals trained to provide HIV palliative care (including TB/HIV):1386
11.1 Number of service outlets providing antiretroviral therapy (FY07 said includes PMTCT sites): 27
11.2 Number of individuals newly initiating antiretroviral therapy during the reporting period (FY07 said includes PMTCT sites): 97
Male (0-14) : 50 ; Male(15+) : 0 ;Female (0-14): 47; Female (15+): 0 and pregnant female (all ages): 0
11.4Number of individuals who ever received antiretroviral therapy at the end of the reporting period: 600 Male (0-14): 286; Male
(15+) : 0; Female (0-14): 324; Female (15+): 0 and pregnant female (all ages): 0
11.4 Number of individuals receiving antiretroviral therapy at the end of the reporting period: 427; Male (0-14): 212; Male(15+): 0;
Female (0-14): 215; Female (15+): 0 and pregnant female (all ages): 0
11.8 Number of health workers trained to deliver ART services, according to national and/or international standards : 197
11.9 Number of individuals receiving ART with evidence of severe malnutrition receiving food and nutritional supplementation
during the reporting period: 66
Table 3.3.10:
