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: 2011 2012 2013 2014 2016
Due to space limitations all areas cannot be fully explained in this section. Additional information is included under the budget code narrative for each setionGoal: To strengthen the DRs Ministry of Health Capacity in the Areas of Epidemiology, Monitoring and Evaluation, Tuberculosis, Blood Safety, Prevention and Laboratory
Objectives:Create a pool of skilled trainers, with high motivation and plans to retain staff as needed.Design and implement a national blood donor program which encourages the general population to increase volunteers blood donationTrain health care providers in a client centered model and how to collect data from patients at selected sites.To implement electronic platform at central, regional and local level in 150 selected TB sites provincesIncrease the number of health establishment that notify cases of HIV/AID pediatric and PMTCT from 25% to 50% using electronic notification system and the alignment form official tool
Geographic Coverage & Target Population: The MOH plan will cover the entire country.
Cost Effectiveness: Trained personnel will be able to create a much stronger, better prepared and empowered work force to conduct the public health role.
Transition: All training and related activities will be prepared jointly and delivered sole by the Ministry of Health.
Monitoring and Evaluation: Technical working groups will be established to guide and evaluate the proposed activities.
Global Fund / Programmatic Engagement Questions
1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? No
Goal: To strengthen the epidemiological surveillance within the operational information and epidemiological system of the National Tuberculosis Control Program (NTCP).
Objectives:To implement electronic platform at central, regional and local level in 150 selected TB sites provincesTo train 80 health workers (facilitators), technical staff or others in the Provincial and regional Health Directory and the National TB and HIV ProgramsTo support in establishing research epidemiological trends of co-infection TB and HIV and support in the formulation of the national plan relating to the subject.
Geographic Coverage: The surveillance system will be implemented at multiple levels including the central, regional (0, I, II, IV, V, VII) and local levels in 150 selected TB sites.
Cost effectiveness: Epidemiological surveillance will become more cost effective over time with the implementation and use of a harmonized TB case detection system.
Transition: This project is building capacity for a sustainable surveillance program within the operational information and epidemiological system of the National Tuberculosis Control Program (NTCP).
M&E: 100% of the TB sites selected will perform monitoring and evaluation following the harmonized TB and HIV M&E national plan.
CDC will continue to provide support for the implementation of a national TB information system assessment. This assessment will allow the MoH to analyze data from key source such as routine testing, care, treatment and referral of TB patients from TB clinics, hospital and pediatric TB/HIV. This system has the opportunity to significantly contribute to the development and better understanding of the TB/HIV burden in the country. It will also provide reliable and timely information for the collaborative activities at TB and HIV national programs.
Goal: Develop and implement a National Laboratory Strategic Plan that provides sustainable, quality laboratory systems, with a trained workforce and the resources needed.
Objectives:Continue to strengthen, expand, implement and support the National Quality Management System (QMS) for prioritized clinical laboratories from MOH hospitals towards accreditation.Create a pool of skilled trainers, with high motivation and plans to retain staff as needed.Provide TA to the MoH for the Equipment Maintenance and Calibration PlanAssist MoH to disseminate and implement a program to update Biosafety, and management of contaminated and toxic waste norms and guidelines.
Geographic Coverage: Will focus on the national Reference Laboratory and targeted province and regional laboratories within the Dominican Republic.
Cost Effectiveness: Trained personnel will be able to support the Province and Regional Heath Center Directors on QMS
Transition: Joint planning and training will help ensure host country ownership and sustainability of quality laboratory systems, creating a pool of highly trained mentors and tutors to work simultaneously at regional training hubs, which will reach out to NGOs and private sector labs as well.
M&E: A technical working group will be established to guide activities outlined in the National Laboratory Strategic Plan.
The MoH will support the implementation of a National Laboratory Strategic Plan that provides sustainable, quality laboratory systems, with a trained workforce and the resources needed for oversight to maintain quality national laboratory programs. A technical working group, lead by the MoH, will coordinate roadmaps towards prioritized goals with a general vision for Dominican laboratories, bringing together MoH/NRL, the different vice ministries of Health, Education, Finances, Academics, professional and research institutions, NGOs as well as supporting agencies to make long lasting changes.
Having both Quality and Biosafety/Contaminated and Toxic waste management updated norms and guidelines, efforts will be made to disseminate and implement them at all levels by the MoH laboratory middle managers give constant capacitating supervision.
Goal: To develop and monitor guidelines for mandatory disease surveillance and the training of epidemiological personnel within the public health system nationwide.
Objectives: 1) Increase the number of health establishment that notify cases of HIV/AID pediatric and PMTCT from 25% to 50% using electronic notification system and the alignment form official tool. 2) Implement a rapid EID in 100% of the maternity facilities and sites selected.
Geographic Coverage: 75% of the PMTCT/EID sites in select provinces with seven Health Regions (0, I, II, III, IV, V, VII).
Cost Effective: This strategy will allow the use of a standardized tool and procedures for PMTCT/EID notification in order to validate the guidelines for use of DNA-PCR in the select provinces. Through the use of standardized procedures and a facilitator to train new health providers on site, the notification should become more cost efficient over time.
Transition: The implementation strategy is conducted and lead by the MoH and other stakeholder at various levels within the health system. Thematic epidemiological surveillance groups are being developed to strengthen the local TB and STI/HIV/AIDS services under a new data flow guideline.
M&E: Follow-up visits to local level facilities by MoH will be conducted to assess progress towards achieving targets.
CDC will provide a technical assistance to the MOH to strengthen the PMTCT/EID components in order to develop a routine strategic flow of DBS data from maternity hospital to the National Reference Laboratory and vice versa. This system will greatly enhance exiting early infant diagnostic surveillance system and will contribute to improve our understanding of the HIV epidemic among the pregnant women in Antenatal care clinics (ANC). CDC will also provide capacity building to the DR MoH in order to improve the collection, analysis, monitoring and dissemination of accurate PMTCT/EID data.
The existing data and sample form PMTCT/EID will be analyzed in order to evaluate important variables regarding the HIV epidemic in the pregnant women and newborn.
Goal: Develop and implement a National Safe Blood Plan to guarantee access to sufficient, prompt and quality blood components
Objectives:Develop and implement the National Blood Services plan in the most important Health Centers in Dominican RepublicDesign and implement a national blood donor program which encourages the general population to increase volunteers blood donationDesign an information system and implement the system for 10 prioritized blood services
Geographic coverage: Will focus on targeted province and regional areas within the Dominican Republic.
Cost Effectiveness: To ensure cost effectiveness, improve efficacy and minimize service interruption staff will be training at each of the participating sites.
Transition: joint training and activities will help ensure host country ownership and sustainability of a quality management system in blood safety. This will help to ensure the continuity of blood safety after PEPFAR, including accurate and efficient costing of blood products.
Based on the population of the Dominican Republic, there is the demand for approximately 280,000 blood units per year. In 2010, only 94,884 units were collected, a shortfall of approximately 66%. Of the units collected, 19% came from volunteers and 58% came from relatives or replacement donors. This situation opens up a gap for the transmission of infectious and contagious diseases through blood transfusion.
Some of the objectives are to continue to strengthen the capacity of the Ministry of Health to provide blood safety services that will guarantee access to sufficient, prompt and quality blood components. The specific activities include developing and implementing a National Safe Blood Plan including the:- Collection of blood only from voluntary, non-remunerated, low-risk blood donors- Universal blood screening for HIV, Hepatitis B and Hepatitis C viruses and Syphilis- Appropriate clinical use of blood- Installation of Blood Bank Information System to improve data management in blood services- Design and implement a monitoring and evaluation system to verify compliance with the National Strategic Plan in Blood Safety.
Goal: An effective sustainable sentinel surveillance system with emphasis on the collection, analysis, dissemination and appropriate use of data targeting the general population and vulnerable groups.
Objectives:Train health care providers in a client centered model and how to collect data from patients at selected sites.Implement two Prevention interventions integrating a community liaison and covering biomedical component (laboratory diagnosis of STD), the change of behavior and the use of condomsDevelop and implement a VICITS national protocol to be implemented in the STI/HIV services.
Geographic Coverage: VICITS will be implemented in two provinces (Santo Domingo y La Vega) Health Regions 0 and VIII. The primary target populations will include male and female sex workers, men who have sex with men and drug users who are seeking STD and HIV services.
Cost Effectiveness: VICITS will analyze the first year data for lesson learned in order to improve the program for the second year. This will allow the health department to become more cost efficient over time.
Transition: The project is currently been conducted by the MoH and their staff has been train to conduct the intervention independently.
M&E: 100% of the establishments selected will perform monitoring and evaluation of VICITS activities as specified in the harmonized M&E national plan.In FY2012 the CDC/GAP-DR will continue to provide support to the MoH for the development and implementation of a STD/HIV surveillance sentinel service in most at risk population (MARPs) which include MSM, FSW, DU). We will be implementing a model called VICITS which has been very successful in Latin America.
Funds under this mechanism will be used to strengthen STD detection services in the country by providing training and technical assistance to clinical staff, advocating for policy change and improving linkages with other prevention, care and treatment services.
CDC will also provide a capacity building to MoH staff on the use of existing STD/HIV/AIDS data. This process will seek to improve the collection, analysis, monitoring and dissemination of accurate epidemiology information.
