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
Expanding PMTCT Services in Private Health Sectors in Ethiopia
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
In FY 09, the Ethiopian Public Health Association (EPHA) will continue prior-year activity by serving as the
prime PEPFAR partner implementing expansion of PMTCT services in private health institutions. EPHA will
subcontract with the Ethiopian Society of Obstetricians & Gynecologists (ESOG). In FY 09, ESOG will
continue supporting expansion of PMTCT services in hospitals and special clinics with maternal-child health
(MCH) services in Addis Ababa and other major towns in the country.
In FY08 ESOG had assessed knowledge, attitude and practice of PMTCT among health professionals
working in the private health facilities in Addis Ababa. A tripartite MOU between ESOG, JHU and Addis
Ababa Regional Health Bureau was signed to implement PMTCT in private health facilities. So far, the
society has conducted 3 rounds of training on the new PMTCT Guidelines for 52 private health workers
trained, in preparation to implement the PMTCT program.
ESOG is a nonprofit professional organization that claims nearly all obstetricians and gynecologists in the
country as its members. Previously, the society has effectively implemented several safe-motherhood and
reproductive health projects, in collaboration with both national and international organizations, including the
Federal Ministry of Health (MOH), the International Federation of Gynecology and Obstetrics (FIGO),
IntraHealth/USAID, and the David and Lucille Packard Foundation. Currently, the society is also engaged in
several nationwide efforts to reduce maternal and newborn morbidity and mortality. Because several ESOG
members are providing MCH services in the private sector, ESOG has a comparative advantage to
implement and expand PMTCT services in private health facilities, particularly in urban settings where the
HIV seroprevalence among pregnant women is very high. Furthermore, as a professional organization,
ESOG can play an advocacy and leadership role to scale up PMTCT in Ethiopia.
In COP08, the number of service outlets providing the minimum package of PMTCT according to national
and international standards will be increased from 25 to 30, and 180 health professionals in these
institutions will be trained to provide VCT service to 9,450 pregnant women and provide a complete course
of ARV prophylaxis to 1,080 HIV-positive pregnant women.
In FY 09, the number of private facilities providing the minimum package of PMTCT according to national
and international standards will be increased from 30 to 40, and 150 health professionals in these
institutions will be trained to provide PMTCT service to 12,660 pregnant women and provide a complete
course of ARV prophylaxis to 1,440 HIV-positive pregnant women. Referral linkages among health facilities
will be established and supportive supervision will be provided for the effective implementation of PMTCT.
EPHA/ESOG will continue a strong collaboration with the Addis Ababa Health Bureau, JHU/TSEHAI and
associations of private health workers to implement the PMTCT program in the private health facilities.
Furthermore, EPHA/ESOG will closely work with ABT Associates (a private-sector partner) and other
PEPFAR PMTCT implementing partners in order to harmonize and avoid duplication of efforts in
implementing PMTCT services in the private health facilities.
EPHA will support institutional capacity building of ESOG so that it can be more responsive to the high
demand for PMTCT services in the country.
COP08 ACTIVITY NARRATIVE
In FY08, the Ethiopian Public Health Association (EPHA) will continue prior-year activity by serving as the
prime PEPFAR partner implement expansion of PMTCT services in private health institutions in the city of
Addis Ababa. EPHA will subcontract with the Ethiopian Society of Obstetricians & Gynecologists (ESOG). In
FY08, ESOG will continue supporting expansion of PMTCT services in hospitals and special clinics with
maternal-child health (MCH) services in Addis Ababa.
In order to facilitate implementation of PMTCT, in FY07, ESOG identified training needs by assessing
existing knowledge, attitudes, and practices on
PMTCT among health professionals working in private health facilities. The findings will also be
disseminated using the Society's publication, The Ethiopian Journal of Reproductive Health. Based on the
needs revealed in the assessment, 150 health professionals will be trained, and 25 health institutions
strengthened to enroll 7,875 pregnant women in voluntary counseling and testing (VCT) and provide a
complete course of ARV prophylaxis in a PMTCT setting to 900 pregnant women. ESOG will provide
continuing supervision support to these health professionals, as well as technical support to MOH and the
Addis Ababa Administrative City Health Bureau.
In FY08, the number of service outlets providing the minimum package of PMTCT according to national and
international standards will be increased from 25 to 30, and 180 health professionals in these institutions will
be trained to provide VCT service to 9,450 pregnant women and provide a complete course of ARV
prophylaxis to 1,080 HIV-positive pregnant women. Referral linkages among health facilities will be
Activity Narrative: established and supportive supervision will be provided for the effective implementation of PMTCT. ESOG
will continue a strong collaboration with the Addis Ababa Health Bureau, associations of private health
workers, ABT Associates (a private-sector partner) and PEPFAR-supported PMTCT implementing partners
in order to harmonize and avoid duplication of efforts in implementing PMTCT services in the private and
nongovernmental sectors.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16648
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16648 12242.08 HHS/Centers for Ethiopian Public 7489 674.08 Improving $250,000
Disease Control & Health Association HIV/AIDS/STD/T
Prevention B Related Public
Health Practice
and Service
Delivery
12242 12242.07 HHS/Centers for Ethiopian Public 5491 674.07 $150,000
Disease Control & Health Association
Prevention
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
APRIL 2009 REPROGRAMMING
MSM and HIV Prevention
As a result of the Prevention Portfolio Review, we have determined this activity to have 90% OP component
from the previous 100% OP activity.
MSM & HIV Prevention Activities - Disseminate the results of the first MSM assessment in Ethiopia.
Ethiopian Public Health Association (EPHA) will work with local partners to improve access to correct and
consistent use of condoms & lubricants. Linked with HCT and STI services with the support of peer
outreach.
In FY09 the following activities will continue 1) Technical assistance support on HIV interventions among
MSM as a hidden population 2) Strengthening of interventions reaching the MSM network with promotion of
condoms and counseling and HIV testing. 3) Training of health workers on counseling and working with
MSM as a hidden population (in the Ethiopian context) 4) Development and distribution of educational
materials adapted to the needs and contexts of MSM. 5) Ensure access to condoms and lubricants. 6)
Strengthening referral system for STI and linkages to HIV counseling and testing. This is a continuation
activity following on from a formative assessment completed by the Ethiopian Public Health Association
(EPHA) in FY07 on men who have sex with men (MSM) and HIV. Sex between men occurs all over the
world. In Europe, the Americas, and Asia, the lifetime prevalence of MSM ranges between 3% and 20%.
Recent evidence highlights increasing risk levels and vulnerability in this group in developing countries. Due
to stigma and discrimination, male-to-male sex is frequently denied, forcing the HIV epidemic underground
and threatening the health of MSM, and their male and female partners. Studies in certain developing
countries indicate prevalence of HIV and sexually transmitted infections (STI) among MSM as high as
14.4% and 25% respectively. Few epidemiological studies exist on HIV and vulnerability to sexually
transmitted infections among MSM in sub-Saharan Africa. In Ethiopia, before this recent assessment on
MSM, there had been very little information about MSM and their HIV risk behavior. As in most developing
countries, MSM tend to congregate in cities, in places frequented by expatriates, and along major tourist
travel corridors and destinations. A recent pilot study of MSM in Addis Ababa confirms that this population
has long existed covertly. The assessment showed that MSM have an early age of sexual debut, and male-
to-male sex appears to be on the increase. MSM were found to have misconceptions about HIV risk; some
believe sex with men carries a lower risk of infection than heterosexual sex. In FY08, EPHA will conduct
the following activities: 1) Dissemination workshop on the result of the assessment of MSM conducted in
FY07, where all regional HAPCO representatives and responsible persons will be in attendance 2)
Technical assistance support on HIV interventions among MSM in a hidden population 3) Strengthen
interventions reaching the MSM network with promotion of condoms and counseling and HIV testing 4)
Studies of STI and HIV prevalence among MSM. 5) Developing training manuals on MSM behaviors and
MSM/HIV prevention for counselors and health workers 6) Training of 40 health workers on counseling and
working with MSM in a hidden population (in the Ethiopian context) 7) Participatory community assessment
on identification of MSM-network meeting places 8) Experience-sharing visit to Kenya and Ghana to look at
successful program interventions on MSM and HIV 9) Development and distribution of educational materials
adapted to the needs and contexts of MSM 10) Procurement and provision of condoms and lubricants 11)
Creation of a referral system for STI and linkages to HIV counseling and testing.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.02:
The activity title is renamed to better indicate the acomplishements of the program - and hence is renamed
"One Love Campaign" - Reduce Multiple Concurrent Sexual Partnership (MCSP)
"One Love Campaign" - Reduce Multiple Concurrent Sexual Partnership (MCSP); includes formative
assessment and pilot intervention-Experience from South Africa; pilot in Addis Ababa; Mass media
combined with reinforcement at the individual level through outreach (print materials, drama, discussion
forums).
2/3rd of the budget has been allocated to B-focused AB and the OP budget has been reduced.
Youth Leadership in Multi-sectoral Approach to reduce multiple concurrent sexual partnerships: Community
Mobilization and Outreach; "One Love" Campaign
This is a new activity for FY09.
A fundamental goal of HIV prevention is to change the behavior that puts individuals at risk of infection. For
the past two and a half decades, HIV prevention has been dominated by individual-level behavioral
interventions that seek to influence knowledge, attitudes, and behaviors, such as promotion of condom use,
or sexual-health education, and education of injecting drug users about the dangers of sharing equipment.
Lessons learned from the successes in reducing population-level HIV prevalence in countries such as
Uganda may prove useful for prevention programming. It seems that the Ugandan response stimulated
personalization of risk in a way that fostered community mobilization for behavior change, without
increasing stigma. Second, the intensive use of a coordinated multilevel approach, involving clear and
consistent risk-avoidance messaging at all levels, assisted in changing societal norms of behavior. And
third, it seems that focusing such efforts for risk avoidance and partner reduction on adult men was key to
reducing the sexual networks that fuel HIV transmission in high prevalence countries.
Goals for behavioral strategy involve knowledge, stigma reduction, access to services, and delay of onset of
first intercourse, decrease in number of partners, increases in condom sales or use, and decreases in
sharing of contaminated injection equipment. A multilevel approach that encompasses behavioral strategies
must be taken— behavioral HIV prevention needs to be integrated with biomedical and structural
approaches, and treatment for HIV infection.
Concurrent sexual partnerships, which create interlocking sexual networks through which
HIV can spread rapidly, are emerging as a key driver in generalized and "hyper" epidemics. However,
efforts to address concurrency within HIV prevention programs are still fledgling.
Emerging themes which are common in all countries includes: MCPs are a common practice (youth and
adults); dissatisfaction in relationships; lack of communication in relationships; culture and social norms
influence MCPs; alcohol; money and material possessions; Perception of HIV risk and lack of condom use
fuels the practice of MCPs among youth in Ethiopia.
Through a campaign "One love" making billboards, posters, radio dramas, and adverts as a communication
channel, the program focus on increasing perception of risks associated with partners' unknown HIV status
and sexual behaviors; Increase consistent and correct condom use in concurrent relationships; Increase
individuals' communication and negotiation skills and perceived self-efficacy to prevent infection; Increase
fidelity in long-term partnerships; Reduce the number of partners people have, especially concurrent
partners; Change social and cultural norms (especially gender norms) that encourage/perpetuate MCPs;
Increase livelihood options for women and girls to provide alternatives to transactional sex. The activities
will be reinforced with outreach activities. The campaign will be for the general population and will target
married and unmarried men and women groups aged 15-49 using HIV workplace education programs
strategies. Older sexually active youth groups will be among prime focus groups and at the front seat to
implement activities.
Programmatic Approaches:
•Incorporate MCP messages into all existing prevention programs (including clinic-based services such as
CT)
•Develop new initiatives with MCP as a primary focus-media campaigns
•Both require increased attention to the content/messages delivered by prevention programs
•Community Mobilization and Outreach
In FY 09 the Multi-sectoral approaches to reduce multiple concurrent sexual partnerships: Community
Mobilization and Outreach; "One Love" Campaign activities include:
•Bringing together multi-sectoral community organizations and leaders to raise awareness and change
attitudes of the need to change norms and behaviors
•Support for a participatory process to assist communities in identifying key issues and solutions
•Interventions may include a range of communication approaches and tools, e.g., community meetings and
dialogue, theater, workshops, traditional media
•Develop message, design, pretest the message and select the appropriate communication channel to
reach the audience including but not limited to bill boards, posters, TV ads, radio snaps.
This activity will be implemented by Ethiopian Public Health Association (EPHA) through Save Your
Generation Ethiopia (SYGE). EPHA was supplemented in COP08 a funding to build the capacity of the
national Health Extension and Education Center in strategic Health Communication. As a continuation of
this, EPHA will implement through SYGE this youth lead activity. SYGE is among the pioneers of youth
organizations in Ethiopia since the emergence of HIV/AIDS in Ethiopia. SYGE as s sub-partner will work
with this multi-faceted activity mobilizing various sectors including other youth associations. SYGE will also
standardize approaches around multiple concurrent sexual partnerships in collaboration with EPHA.
* Addressing male norms and behaviors
Estimated amount of funding that is planned for Human Capacity Development $50,000
Table 3.3.03:
Standardizing Basic Care Package and Care and support program
This activity has been funded through COP07 supplemental funding to evaluate the Ethiopian basic care
package program. Ethiopian Public Health Association (EPHA) participation in the baseline evaluation was
not possible due to delayed implementation of the Basic Care Package Provision program. A baseline
evaluation will be carried out by CDC-Ethiopia before implementation. The delay in the implementation is
partly due to the fact that in Ethiopia, specific elements of preventive care package are not well defined.
There are ongoing efforts to define the menu of services for people with HIV and their families. Planning for
the basic care package implementation is underway. With this background this activity has two
complimentary parts.
The first part of this activity is linked to Basic Care Package Provision Program. In this part EPHA will
conduct a systematic, quantitative mid-term and final program evaluation of the implementation of the basic
care package in Ethiopia. The goal of this evaluation is to determine the extent to which the basic care
package has been provided to persons enrolled for HIV care in Ethiopia.
CDC-Ethiopia will work closely with CDC-Atlanta and EPHA to design and conduct programmatic evaluation
through a multi-stage scientific sampling process that will establish a study population representative of all
patients enrolled for HIV care in Ethiopia. Trained study staff will interview patients, conduct chart reviews
and make home visits to collect water samples and observe usage of items at home to establish the extent
to which the basic care package is being used within the study population. The data from the baseline, mid-
term and final evaluations will be analyzed to project an overall utilization rate for each element of Ethiopia's
basic care package.
The analysis will allow identification of factors associated with incomplete or with full implementation of the
basic care package; further it will identify gaps in the use of various commodities necessary for the basic
care package, or inadequate facility-level promotion of its use, and identify ways to improve program
implementation. Finally, this project will build capacity for program evaluation within Ethiopian Public Health
Association.
The second part of this activity concentrates on defining and describing basic care package for Ethiopian
context. This part will very much depend on the first part. In other words, the evaluation would be an input in
refining the elements of the Basic Care package.
In the past years, PEPFAR Ethiopia worked to ensure all HIV positive clients benefited from basic HIV
prevention and care, including a core set of evidence based effective interventions that are simple, relatively
inexpensive, can improve the quality of life, prevent further transmission of HIV, and for some interventions,
delay progression of HIV disease and prevent mortality. Toward that end, EPHA will sponsor national level
activities directed toward revising implementation guidelines with a view to define a set of preventive care
interventions for the Ethiopian context. Recently, World Health Organization develops guideline on Essential
prevention and care interventions for adults and adolescents living with HIV in resource-limited and through
this activity EPHA will ensure that all those interventions are defined nationally. These WHO guidelines
outline evidence-based interventions that, in addition to or prior to the initiation of ART, promote health,
reduce the risk of HIV transmission to others, and address diseases that most impact the quality and
duration of life of adults and adolescents with HIV. The recommended interventions will be those focusing
on prevention of initial illness or episodes of opportunistic infections and malignancies rather than treatment
or prevention of recurrence. Most interventions considered in the WHO and OGAC guidance is delivered by
staff in health-care facilities, some are best delivered in households, such as point-of-use interventions to
improve water safety which make the interventions more practical for our context.
Table 3.3.08:
Laboratory Capacity Development
EPHA will focus on the supporting local laboratory professionals, policy and advocacy. EPHA will provide
assistance in pre-service training but not in in-service trainings.
This is a continuing activity whereby Ethiopian Public Health Association (EPHA) supports local capacity
development in partnership with Ethiopian Public Health Laboratory Association (EPHLA).
In FY09, EPHA will continue supporting local organizational capacity development through laboratory
education, workplace HIV/AIDS interventions, publications, dissemination of research findings, and
strengthening of public health laboratory systems in Ethiopia. In partnership with the Associations of Public
Health Laboratories/USA, EPHA will continue supporting local professional associations through annual and
review meetings related to related to laboratory services supporting HIV/AIDS prevention, care and
treatment program
EPHA will also support continuing education of laboratory processionals to improve the clinical laboratory
services with emphasis HIV/AIDS care and treatment program. EPHLA will provide technical support to
National laboratory system in implementing national laboratory policy. This includes development of
technical guidance and advocacy.
Continuing Activity: 16650
16650 5612.08 HHS/Centers for Ethiopian Public 7489 674.08 Improving $90,000
10593 5612.07 HHS/Centers for Ethiopian Public 5491 674.07 $75,000
5612 5612.06 HHS/Centers for Ethiopian Public 3772 674.06 $50,000
Table 3.3.16:
April 2009 Reprogramming:
Amhara MARPS size estimation and integration of Size estimation to other regions MARPS study
This is a new activity: Quantification/size estimation of Most At-Risk Populations (MARPS) has a
paramount importance in the design of appropriate intervention programs as well as to monitor and evaluate
the effectiveness of prevention and control programs targeting these populations. A recent survey done in
selected hotspots of Amhara region on various MARPs has shown a consistently high prevalence (11.6%
to 37%) of HIV infection. The result is 5-18 times higher compared to the national single-point HIV
prevalence estimate of 2.1%; and 2 to 7 times higher than the 5.5% HIV prevalence documented for urban
Ethiopia in the 2005 DHS. Moreover, these MARPS appear to have exhibited high-risk behaviors, as
depicted by high sexual partner change, concurrent sexual partnerships, high exposure to STIs, and low
and inconsistent condom use. These MARPS also showed a high sexual network among themselves and
the general population acting as a bridging population for HIV transmission to the wider public. The Amhara
region is planning a targeted intervention of HIV/AIDS control in the various MARPS identified in the region.
Other regions will also follow the same action once the national MARPs study is done. However, there was
no data on the size of these MARPs in the in Ethiopia so far. To effectively target appropriate HIV control
prevention efforts to the MARPS, a detailed estimation of size of the various MARPs in the regions is a
critical step.
Ethiopian Public Health Association (EPHA), with support from PEPFAR, has conducted a study on the
magnitude of and risk factors for HIV infection among selected MARPs in Amhara region. This year similar
studies will be conducted at national level.
In COP 09, EPHA will support the estimation of various MARPs groups including female sex workers, Daily
Laborers, Students, Mobile Merchants, Long Distance Truck Drivers and other locally relevant MARPs in
Amhara and other regions of the country. Data from this study will provide the Government of Ethiopia and
its HIV/AIDS control partners including PEPFAR implementing partners with the necessary data to design
appropriate control and prevention measures for HIV/AIDS in these populations.
Table 3.3.17:
Capacity Building for Evidence-informed Decision Making, Generation and Dissemination of Strategic
Information
In FY06, with PEPFAR support, the Ethiopian Public Health Association (EPHA) began to support the Addis
Ababa Mortality Surveillance Project (AAMSP) to monitor the population impact of ART via analyses of age
and sex-specific trends in AIDS mortality. In FY07, PEPFAR Ethiopia supported the expansion of EPHA's
AIDS Mortality Surveillance to four rural project sites, namely, Butajira, Gilgel Gibe, Dabat and Kersa, which
sites are run by Addis Ababa, Jimma, Gondar and Haramaya Universities, respectively. In addition, the
AAMSP continues. These five project sites have established a network for strengthening the generation of
usable information on the impact of AIDS and ART intervention for national level policy- and decision
makers.
In FY08, EPHA supported the conduct of AIDS Mortality Surveillance activities in five demographic and
health surveillance (DHS) sites run by local universities. The program was also expanded to include two
more DHS sites run by Mekelle and Arbaminch Universities. This expansion helped the AIDS Mortality
Surveillance program to produce more representative data to be used by the Federal Government of
Ethiopia and other partners engaged in ART intervention efforts in reducing the impact of AIDS. EPHA had
also provided technical assistance together with CDC that helped to strengthen the networking of the
project sites and training of university staff members and project-site coordinators, critical supports required
to ensure quality of the data generated. Since the surveillance sites are linked to governmental universities,
this local capacity building has created fertile ground that will ensure continuous and sustainable generation
of information for decision-makers even after the phasing out of the fund.
In COP07, EPHA, in close collaboration with the Federal Ministry of Heath (MOH), regional health bureaus
(RHB), CDC Ethiopia, and CDC Atlanta, conducted a one-year Leadership in Strategic Information (LSI)
training program for leaders from five regions. Sixteen trainees from these regions completed the course
including one staff member from the AAMSP. In COP08, the program was evaluated and findings from the
evaluation showed that the training had enabled program managers to critically evaluate and use data for
decision-making and designing and implementing evidence-informed programs. Based on the identified
needs of the government organizations that participated in the training and its evaluation, the LSI training
program was expanded to Jimma University in FY08 and trainings were initiated for HIV/AIDS program
managers at zonal and district levels. To increase the sustainability of trainings, human-resource capacity,
and continuity of evidence-informed decision-making in HIV/AIDS programs, EPHA, in collaboration with
MOH and with the support of CDC, has developed a two-year, field-based, service-oriented master's degree
program in advanced analytic epidemiology, public-health program management, laboratory management,
and communications. The program enrolled ten leader trainees at the end of 2007. The two-year training is
based at Addis Ababa University and benefits from the full support of MOH. This activity continued in
COP08, and support was extended to the students enrolled in COP07 while they were attached to regions
and health facilities to gain field level experiences. The activity also supported the enrollment of 15 second
batch trainees.
EPHA also supported the generation and dissemination of strategic information through the EPHA annual
conference, master's theses extracts, and publications for scientific communities, policy-makers, health-
service providers, and the general public. PEPFAR support was also extended to efforts for strengthening
the leadership, technical, and managerial capacity of EPHA. This support helped EPHA adequately respond
to the increasing needs for evidence-based information for policy- and decision-making on HIV/AIDS in
particular, and public health in general.
In COP09, EPHA will support the seven AIDS Mortality Surveillance system by collecting generating,
analyzing, interpreting and disseminating relevant information.. Existing sites will be strengthened, and two
additional universities (Awasa and Bahir Dar) will be added in the network of mortality surveillance. This will
increase representation from corners of the country previously not involved in SAVVY (Sample Vital
Registration with Verbal Autopsy) network sites. This will also provide capacity building trainings to project
and scientific site staff and ensure appropriate timely use of mortality data. Experience sharing visits to
networked mortality surveillance programs in Tanzania or other African countries will be supported.
Capacity Building for Evidence-Informed Decision making activity will continue with the training in
Leadership in Strategic Information (LSI) in Addis Ababa University and Jimma Universities to 35
candidates. It will also support the Field Epidemiology and Training Program in Addis Ababa University for
13 students and support the program cost of the course. It will support the experience sharing travels of
trainees and related staff to international field epidemiology training networks including the African Field
Epidemiology Network (AFENET) and TOPHINET). Candidates for both programs will be selected from
surveillance and lab officers currently servicing in related activities. The trainees will collect and make use of
data related to their regions and will continue to serve in their respective regions after the completion of
training.
Generation of Strategic Information and Institutional Capacity Building will continue to be supported. In
addition, EPHA will also undertake a survey in Gambella region to understand the causes of high HIV
Prevalence and heterogeneity of the epidemic in priority populations. Appropriate survey protocol related to
this will be developed and implemented.
COP08 NARRATIVE
I. AIDS Mortality Surveillance ($910,000)
Ababa Mortality Surveillance Project (AAMSP) to monitor the population impact of ART via analyses of age-
usable information on the impact of AIDS and ART intervention for national level policy- and decision-
In FY08, EPHA will support two more new AIDS Mortality Surveillance sites, which will be run by Mekelle
Activity Narrative: and Arbaminch Universities. This will be a step toward ensuring that the data generated by AIDS Mortality
Surveillance projects is nationally representative so that it can be used by the Federal Government of
Ethiopia and other partners engaged in ART intervention efforts and reducing the impact of AIDS. EPHA will
also strengthen the networking of the project sites and training of university staff members and project-site
coordinators, critical supports required to ensure quality of the data generated. Since the surveillance sites
are linked to governmental universities, PEPFAR support will ensure continuous and sustainable generation
II. Capacity Building for Evidence-Informed Decision making ($920,000)
In FY07, EPHA, in close collaboration with the Federal Ministry of Heath (MOH), regional health bureaus
training program for leaders from five regions. Sixteen trainees from these regions completed the course,
including one staff member from the AAMSP. The need for this type of training had become evident, as it
enabled program managers to critically evaluate and use data for decision-making and designing and
implementing evidence-informed programs. Certificates were awarded for those who completed the course.
To meet the increasing need for the course, the LSI training program is to be expanded to Jimma University
in FY08 so that HIV/AIDS program managers at zonal and district levels can also be trained. The current
course capacity can accommodate only those from the regional level who are capable of serving as field-
site supervisors to the trainees of the Field Epidemiology Training Program.
To contribute to the sustainability of trained, human-resource capacity and continuity in the use of evidence-
informed data for decision-making in HIV/AIDS programs, EPHA, in collaboration with MOH and with the
support of CDC, has developed a two-year, field-based, service-oriented master's degree program in
advanced analytic epidemiology, public-health program management, laboratory management, and
communications. The program enrolled ten leader trainees at the end of 2007 for the two-year training,
which is based at Addis Ababa University and which enjoys the full support of MOH. This activity will
continue in FY08, during which the students will be attached to regions and health facilities to gain field-
level experiences.
III. Generation of Strategic Information and Institutional Capacity Building ($600,000)
EPHA is uniquely positioned in Ethiopia to assist in strategic-information generation and dissemination
activities because of its ongoing involvement in HIV/AIDS and related programs, supported particularly by
PEPFAR Ethiopia. In FY07, EPHA supported the generation and dissemination of strategic information by
supporting targeted evaluations and postgraduate theses in the areas of HIV/AIDS, sexually transmitted
infections, and tuberculosis to enhance the monitoring and evaluation capacity of the public health sector.
EPHA also disseminated surveillance data, best practices, and research findings through its annual
conference and sisterly professional associations, its website, and both regular and special publications
throughout the year.
During FY08, EPHA will continue supporting generation and dissemination of vital strategic information
through the EPHA annual conference, master's theses extracts, and publications for scientific communities,
policy-makers, health-service providers, and the general public. EPHA and its members will also engage in
operational studies and targeted EPHA-CDC project-evaluation activities. Another component of this activity
will be strengthening the leadership, technical, and managerial capacity of EPHA itself, so that it can
adequately respond to the increasing needs for evidence-based information for policy- and decision-making
on HIV/AIDS in particular, and public health in general.
Continuing Activity: 16651
16651 5611.08 HHS/Centers for Ethiopian Public 7489 674.08 Improving $2,430,000
10450 5611.07 HHS/Centers for Ethiopian Public 5491 674.07 $1,650,000
5611 5611.06 HHS/Centers for Ethiopian Public 3772 674.06 $400,000
Estimated amount of funding that is planned for Human Capacity Development $600,000
