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: 2008 2009
Development of Model Voluntary Counseling and Testing Services
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS
In FY09 OSSA will add another 50 service outlets, bringing the total number to 70 to serve ART client's in
the hospitals. According to the June 2008 report, of255, 313 clients ever enrolled for care in the country,
78% of patients are enrolled in hospitals. Although we are working to off load patient to health centers, it is
critical that we have to arrange community care for those attending hospitals. OSSA would give family-
centered care and support to 60,000 clients through these 70 service outlets and home-based care.
In FY09 OSSA will closely work with University of Washington to complement and strengthen the prevention
with positives efforts at facility level. Recruit PLWH and sponsor the training of PLWH in prevention with
positives; assist HIV-positive clients to disclose test results to sexual partners and family members and
encourage HIV testing for couples and families; provide preventive and supportive posttest services for
concordant HIV positive and discordant couples; provide care for terminally-ill patients at their home and
support family members to prepare for loss.
In FY09, the Addis Ababa City Government's HIV/AIDS Prevention and Control Office (AAHAPCO) will
continue prior years' activity by serving as the prime partner subcontracting to the Organization for Social
Services for AIDS (OSSA) to implement and expand HIV/AIDS palliative care programs support to clients
enrolled at hospitals nationwide, in collaboration with US university partners.
COP 08 ACTIVITY NARRATIVE:
OSSA have many years of local experience and linkage mechanisms in providing care and support for
PLWH. Nearly all hospitals providing ART have limited capacity, resources, and space to address the full
spectrum of comprehensive care services for people living with HIV (PLWH), especially on a long-term
basis. OSSA will continue to work with hospitals to fill this gap and alleviate the increase in workload
imposed at facilities by providing long-term care and support.
In FY07, OSSA provided palliative care to PLWH and family members referred from hospitals and trained
community health workers through 14 service outlets and home-based care programs. In FY08, OSSA
expanded its capacity and establish six new service outlets, bringing the total number of such outlets to 20.
Although OSSA has stated to meaningfully support the hospital by offering PLWH in hospitals with range of
care and support services, it is becoming more evident that expansion of the service is needed. In FY09
OSSA will add another 50 service outlets, bringing the total number to 70 to serve ART client's in the
hospitals. According to the June 2008 report, off 255,313 clients ever enrolled for care in the country 78% of
patients are enrolled in hospitals. Although we are working to off load patient to health centers, it is critical
that we have to arrange community care for those attending hospitals. OSSA would give family-centered
care and support to 60,000 clients through these 70 service outlets and home-based care.
OSSA will continue to support ART provision in hospitals in the following key activity areas:
Support 80% of ART hospitals by making 70 community service outlets operational.
1)Each of these service outlets will be the community support end for two to three ART hospitals. All clients
will be offered the following services depending on their need: adherence counseling, link to PLWH support
group for psychological support and education on safe water and basic sanitation, as well as nutrition
counseling.
2)Trace patient lost from follow up and assist critically ill patients to access different services within the
hospital and link patients with home based care run by OSSA at discharge. Provide care for terminally-ill
patients at their home and support family members to prepare for loss.
3)Establish patient peer-support groups in close collaboration with the hospitals to support adherence to
care and treatment. Use patient support group to distribute and replenish basic preventive care package.
4)Distribute patient education materials and translate some into local languages.
5)Link all patients needing long-term community care service to OSSA's care and support program and
other community-based programs to increase access to counseling on positive living, and other preventive
care like safe water usage, hygiene, mosquito nets, nutrition, cotrimoxazole and INH prophylaxis, home
based care services.
6)In FY09 OSSA will closely work with University of Washington to complement and strengthen the
prevention with positives efforts at facility level. Recruit PLWH and sponsor the training of PLWH in
prevention with positives. Assist HIV-positive clients to disclose test results to sexual partners and family
members and encourage HIV testing for couples and families. Provide preventive and supportive posttest
services for concordant HIV positive and discordant couples.
7)Provide support to PLWH and family members (including orphans) to maintain their living through income
generating activities. Prioritize woman and girls for income generating activities and vocational training.
Encourage house hold to keep young girls in school by compensating for lost family income through giving
priority to participate on income generating activities. Recruiting and training more male on care for PLWH
at home.
8)Work closely and link PLWH with major religious organizations that provide spiritual care & support for
HIV/AIDS patients. Organize forum with religious organization in effort to reduce stigma and discrimination.
All of these activities will contribute to the capacity-building of a crucial indigenous organization, OSSA, to
undertake service expansion and increase coverage of palliative care services, thus establishing a firm
ground for more sustainable program implementation in the country.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16694
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16694 10549.08 HHS/Centers for Addis Ababa 7508 651.08 Development of $600,000
Disease Control & Regional Model Voluntary
Prevention HIV/AIDS Counseling and
Prevention and
Testing Services
Control Office
in the
Democratic
Republic of
Ethiopia
10549 10549.07 HHS/Centers for Addis Ababa 5526 651.07 $534,400
Disease Control & Regional
Prevention HIV/AIDS
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.08:
ACTIVITY UNCHANGED FROM FY2008
COP 08 Narrative:
Activity Narrative: Strengthening National Model VCT Sites & Expansion of Mobile VCT Services
This is an ongoing activity and relates to activities in basic palliative care (ID10549), ABT associates
(ID10538) and HCT activities implemented by partners.
Strengthening National Model VCT Sites and Expansion of Mobile VCT Services:
In FY09, Addis Ababa City Government HIV/AIDS Prevention and Control Office (AA/HAPCO) plans to
strengthen the existing national model and mobile voluntary counseling and testing (VCT) services based
on the experiences gained. In FY08 AAHAPCO launched 11 mobile VCT services in eight regions and were
able to reach the high risk groups and underserved rural population. Currently the mobile VCT is operational
in Amhara, Oromiya, SNNPR, Tigray, Benshangul and Gumuz, Afar, Somali and Addis Ababa. Home based
VCT (HBVCT) piloting started in Addis Ababa and will continue through January 2009. Local community
conversation leaders become promoters and models of the implementation of HBVCT in their areas.
Major challenges faced during the implementation of HBVCT include maintaining confidentiality in the home
environment, transportation and the ensuring quality of HIV testing.
In COP09 AAHAPCO has two continuing activities. The first component is to maintain the existing national
model VCT sites and mobile units in Addis Ababa. In FY09, the model sites will continue to provide VCT
services at the two national model centers, mobile unit, satellite sites, and home-based VCT services
through home-to-home visits. Activities of this component include:
1) Supporting model sites to provide same-hour VCT service to the general community, with special
emphasis on couples, family, and child counseling
2) Strengthening satellite VCT sites that have good performance records for reaching students and
company workers
3) Providing VCT services using a mobile truck in schools, business/commercial places, work places, and
markets in Addis Ababa
4) Strengthening and expanding home-based VCT services
5) Supporting the national Millennium AIDS Campaign to meet the counseling and testing target and create
demand for HIV testing using available channels during special events (e.g., World AIDS Day, National VCT
day)
6) Continuing to provide VCT services to disabled people (hearing impaired, visually impaired, etc)
7) Improving the competence of community counselors to deliver VCT at static sites, satellites, and mobile
VCT units through mentorship
8) Strengthening the management system of the project, mainly focused at the site level
9) Conducting regular case conferences twice a month, burnout management conference twice a year, and
refresher training quarterly
10) Supporting sites to maintain data quality management through close follow-up and training
11) Conducting regular VCT promotion using different media and allowing participation by key informants
and prominent people, who can promote and increase uptake of services
12) Documenting best practices and experiences from the implementation of the two model VCT sites and
sharing with other relevant organizations who are offering the same services
13) Building the capacity of managers, VCT project coordinators, and counselors through short-term training
(onsite and regional)
14) Strengthening the existing post-test clubs in the sites
15) Strengthening the existing VCT network and referral linkages and initiating ongoing counseling
16) Strengthening the role of community VCT promoters in VCT services
17) Conducting impact-assessment surveys on sexual behavioral change of clients tested in different VCT
sites.
The second component of this activity is support for consolidating the expansion of VCT mobile units. These
mobile units improve access to HIV/AIDS services in rural communities including mobile workers on big
farms and uniformed personnel in camps and barracks. The mobile units also assist in delivering community
education to promote safer sexual behavior, stigma reduction, and promote community care service to HIV
infected and affected individuals and families. The service will be provided through well-trained community
VCT counselors (lay counselors).
During FY09, AA/HAPCO will continue providing VCT services to rural populations, with an emphasis on
most-at-risk populations (MARPs), such as mobile workers, truckers, commercial sex workers (CSW),
traders, and uniformed personnel. As a special service, premarital couples' counseling and testing services
will be provided during wedding season.
The mobile unit will introduce night services to capture truckers and CSW and their clients along the main
highway routes and stopover sites. In addition to the VCT services, the unit will conduct health education to
reduce transmission of HIV and sexually transmitted infections, and reduce the effects of drugs (alcohol,
khat, and cannabis) on individual health.
Referring HIV-positive individuals for care and treatment is one of the shortcomings of mobile VCT service.
To overcome this major challenge, the Organization for Social Services for AIDS plans to establish a
support group which consists of people living with HIV, teachers, health extension workers, traditional
healers, and other community agents. After appropriate training, the support group will provide post-test
services, including ongoing preventive and supportive counseling, adherence counseling, and education on
prevention and basic care packages. It also links mobile VCT activities with the health network model in
particular catchment areas.
In FY09, the mobile unit will continue screening of syphilis using rapid plasma reagent (RPR). Clients who
are RPR-positive will receive referral for treatment and education. The patients will be encouraged to notify
Activity Narrative: their partner(s).
The mobile units will work in close collaboration with PEPFAR partners
Continuing Activity: 16695
16695 5667.08 HHS/Centers for Addis Ababa 7508 651.08 Development of $1,350,360
10547 5667.07 HHS/Centers for Addis Ababa 5526 651.07 $2,452,000
5667 5667.06 HHS/Centers for Addis Ababa 3769 651.06 $325,000
Table 3.3.14:
