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.
I. Comprehensive Goals and Objectives:
The Integrated Health Services Project (Project AXxes) is a three-year $42 million dollar USAID-financed primary health care project designed to revitalize health zones across the DRC. Implementing Partners include IMA World Health (IMA) as prime recipient for AXxes collaborates with three implementing partners: World Vision (WV), The Protestant Church of Congo (ECC) and Catholic Relief Services (CRS). The main goal of AXxes is to provide integrated development assistance for primary health care health systems strengthening based on the "Appui Global" strategy of the Ministry of Health. (expanded below)
II. Geographic coverage and Target Population: The project assists fifty-seven (57) health zones in four provinces of eastern and southern DR Congo (Kasai East, Kasai West, Katanga, and South Kivu) with a catchment population of 8.2 million persons.
III. Expanded Objectives (A) and Key Contributions to Health Systems Strengthening (B,C) AXxes provides health zone development assistance through three major components: Component A: (Increase access to, quality of, and demand for multi-sectoral, integrated PHC): Component A or AXxes assistance to 57 health zones includes the MOH priority package of PHC interventions, e.g., the Minimum Package of Activities. This includes reinforcement of vaccination services, provision of pharmaceuticals and supplies to hospitals and health centers, provision of a full complement of maternal and child health services including family planning, PMTCT and newborn and postpartum care, vitamin A and Zinc supplementation, prevention of HIV/AIDS and STIs, malaria diagnosis and treatment and prevention, nutrition support, management of re-emerging diseases such as tuberculosis, and elaboration of water, sanitation. Support systems on the national, provincial, and health zone level include planning and management, health facility rehabilitation, training and supervision, supply line and cost recovery, and information and surveillance systems.
Component B: (Increased Capacity of Health Zones and Referral System) Component B of Project AXxes targets the reinforcement of Health Zone support systems that are essential to the provision of primary health care services and long-term program sustainability. Two areas of particular emphasis are 1) improved health zone planning, governance, transparency and accountability and 2) improved health zone support systems.
Component C: (Increased capacity of national health programs & Province/Districts) Component C provides technical assistance and support at the national and intermediary levels (provincial and district) to increase the capacity for planning, supervision, and monitoring the delivery of primary health care services.
IV. Cross -Cutting Areas
Section IV above discusses the key components of this primary health care project. In addition the following (cross cutting) components, funded in part with Child Survival (USAID) and PEPFAR monies, are attributes of both the HIV-related PEPFAR activities and the larger clinical components of this project
1. Human Resources for Health: Current FY 10 includes training of health zone clinical and management staff in cross cutting areas such as: Integrated Management of Childhood Illnesses, data collection (SNIS), PMTCT updates, management of HC resources, techniques in safe motherhood and newborn care, use of micronutrients, prevention of gender-based violence (GBV) through integration into 'minimum package of activity' and funding of local HZ NGOs, Communication for change (health facility and community promoter levels) and quarterly reviews of family planning and PMTCT clinics. 2. Construction/Renovation: REDACTED. 3. Food and Nutrition: Roll out of Vitamin A and Zinc use in the DRC health facilities is a new and cross cutting intervention in maternal and child health. A total of REDACTED has been allocated per health zone for support of treatment campaigns and routine use of micronutrients in the management of key diseases. 4. Water: Provision of clean and potable water improves significantly the health and livelihood of women and children in the DRC. Current FY 10 funding (total REDACTED per HZ) will provide clean water sources (capped springs), cisterns, filtration systems, and support sanitation and environmental support such as latrines and certification of clean villages. 5. Gender: The prevention and management of GBV and integration of strategies into the routine health system is a key and cross cutting component. Current FY funding (REDACTED per HZ) includes media campaigns, training, provision of medicine for treatment of STIs, and direct support for treatment for fistula prevention and care (surgery).
V. Enhancing Sustainability
In the context of ongoing conflict, failed states, staggering morbidity and mortality rates, and lack of infrastructure, the concept of sustainability is far-reaching though attainable. Project AXxes implements this project through over 5000 health care workers, all employed by the DRC government but trained and supplied (tools) by the project. By strengthening personnel and intuitions, developing guidelines, protocols, and strategies, along with the establishment of supply-chain structures (CDRs) concrete steps are being taken to develop both competence and sustainability
Project AXxes also funds self capacity NGOs (promising partner grants) that have showed capacity of sustainability and delivery of project supported health services to our target population. PEPFAR funding is used in all of these endeavors.
VI. M/E and Program Performance Indicators
The AXxes project is an integrated health project and as such works with the DRC government in recording and attaining health indicators. Project consultants (JHU and HISP) have worked extensively with project personnel, implementing partners, and the MOH to implement an M/E dashboard and data collecting system to evaluate program performance. Project indicators are reviewed, analyzed, and presented quarterly.
Overall Goals and Objectives:
Project AXxes supports 130 PMTCT clinics in 40 of its 57 health zones.
Target Population:
The project targets pregnant women who attend prenatal clinics in select project-supported sites. All women who enter antenatal care are offered HIV counseling and screening and those who are serapositive, confidential entrance into a PMTCT program. In the previous four quarters 70,164 women presented to prenatal clinics offering PMTCT services. Out of those, 56.012 received HIV counseling and 53,093 agreed to testing (did not opt-out).
Mechanisms of Assistance
PMTCT assistance supported by PEPFAR funding includes:
1. Training of Ministry of Health personnel in the implementation and monitoring of PMTCT sites. 2. Training of health care workers in counseling, testing, delivery of services, and monitoring and evaluation. 3. Provision of supplies to PMTCT sites including needles, gauze, alcohol, HIV testing material, treatment of STIs, provision of ARV and prophylactic drugs such as cotrimoxazole , multivitamins, etc. 4. Supply chain and drug stock management. 5. Data and record collection. 6. Supervision of laboratory testing (rapid testing). 7. 'Waste management. 8. Monitoring, evaluation, and reporting. 9. Counseling and provision of family planning commodities post delivery. 10. Counseling and testing of partners.
