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 2012 2013 2014 2015 2016 2017
The MOH employs approximately 57,000 health and administrative workers. Additional health staffs are employed by the Dominican Armed Forces (DAF), the Social Security Institute (IDSS) and the Teachers Health Insurance System (SEMMA), and the private for-profit and non-profit Sectors. The GODR estimates that 6 percent of its 57,000 workers are in the process of retiring (some are over 80 years old) and the government doesnt know where another six to seven percent of its employees are. In addition, a comparison of different MOH payrolls showed that 40% of all health workers appear on at least four payrolls and another 30% on at least three. This may explain the significant staff shortages found in remote or rural health services. Conversely, health facilities in and around the major cities have staff surpluses. A recent study on use of staff time in hospitals found that doctors who are contracted and paid for six hours of services, in fact only provide two hours. USAID/DR provides support to the MOH to develop a HR system needed to manage its workforce to perform effectively. This work includes developing new legislation to create a public health career and health worker career paths. This legislation was developed, with the support of the Ministries of Public Administration and of Public Health, and was discussed in a forum attended by representatives from 87 organizations, including members of Congress. This addresses the health sectors human resources as a means to ensure good governance. The law approved by the Senate is awaiting approval by Congress. In addition, Capacity Plus provides TA to develop HR policies, HR structures at all levels, position descriptions for staff at each hospital level and the corresponding salary scales.
During 2013 CAPACITY Plus will continue to reinforce the importance of country-led implementation, provide TA and other support to the MOH to implement the new Public Health Career Law, and support the MOH to develop the HR departments needed at the central level and in least in three regions. It will also support the MOH to increase transparency in the payroll system, unify the different payrolls and implement a Human Resource System that will include the elemental HR functions, such as position descriptions, salary scales, supervision and evaluation, training plans and promotions to ensure health worker retention, transparency and accountability. All of this will translate into better access to care and improved health outcomes.
The CAPACITY PLUS local office will also train the HR staff at the various levels, so they will have the necessary tools and knowledge to implement the Human Resource System.
To ensure that the impact of strengthening human resource management is felt directly in improvements to HIV service delivery, the project will work with the MOH on the design and rollout of supportive site supervision with the 16 hospitals prioritized in the national strategy for elimination of mother to child transmission of HIV and congenital syphilis. The consultation report by the PEPFAR PMTCT TWG visit in January 2013 recommended that supportive site supervision is a critical gap that PEPFAR could help to fill. Benefits of investing in supportive supervision include: (1) Improvement in service quality; (2) Improvement in data quality; and (3) Standardized way to provide routine feedback on program performance.
