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
Preventive Care Package: Access to Home Water Treatment
ACTIVITY UNCHANGED FROM FY2008
This activity was awarded to Population Services International in 2008.
COP 08 Narratives:
This is a continuing activity from FY06 that received FY07 supplemental funding. The supplemental funding
was recently obligated to the partner, and implementation is beginning in late FY07. Funding has been
augmented to increase safe water access for ART, pre-ART and PMTCT clients.
People living in resource-poor settings often have limited access to safe water and basic methods of
hygiene and sanitation. The situation in Ethiopia is no different as only 35.9% of the population has access
to a safe and adequate water supply, and only 29% has access to excretal disposal facilities. The
government is currently addressing this issue through the health extension program where Health Extension
Workers (HEW) and health promoters educate, mobilize, and support communities in constructing safe
excreta disposals and teaching about safe water storage (an activity supported by the USG with non-
PEPFAR funds).
PEPFAR Ethiopia will build on the government's safe water initiative to improve safe water access among
PLWHA. This is important as there is ample evidence that simple safe water interventions radically improve
the quality of life for PLWHA. For instance, a study of HIV-positive persons and their families in Uganda
showed that use of a simple, home-based safe water system reduced incidence of diarrhea episodes by
25%, and the cost was less than $5 per family per year.
This activity strongly supports a safe water program as an element of the preventive care package for
PLWHA in adherence to OGAC guidance. This activity will work closely with PEPFAR Ethiopia partners
operating at hospitals and health centers to build on their safe water efforts and strengthen their links with
community-based initiatives and safe water outlets.
Thirty hospitals and ninety health centers providing ART, PMTCT and HIV/AIDS care services and their
surrounding community networks will be targeted, with particular attention to high prevalence areas with
poor water and sanitation services. It will include: distribution of a locally-produced point-of-use water
treatment, WuhaAgar, which is a diluted sodium hypochlorite approved by Ethiopian authorities, at voluntary
counseling and testing (VCT), ART, PMTCT and postnatal clinics; inclusion of a voucher entitling HIV/AIDS-
affected clients to receive free bottled water disinfectant at a nearby commercial outlet to avoid travel to the
health facility just for the sake of getting WuhaAgar; training of health providers at hospitals and health
centers on hygiene and safe water counseling; consistent supply of WuhaAgar to the facility-based service
outlets; sensitization of commercial providers to the voucher approach; monitoring of the voucher program
at commercial outlets primarily through stock monitoring; support of existing community-based education on
hygiene and safe water by the health extension workers and community health promoters; assessment and
revision of existing teaching materials; and the design of new information, education, communication (IEC)
and behavior change communications (BCC) resources for patient education at facilities and by community
health extension workers and health promoters on personal hygiene, safe water storage, and home water
treatment, including how to use WuhaAgar.
The implementing partner will coordinate with the Ministry of Health HIV/AIDS Prevention and Control Office
(MOH/HAPCO), Health Education Center, AIDS Resource Centers, the non-PEPFAR USG Essential
Services for Health (ESHE) project, and other relevant PEPFAR Ethiopia partners on designing the IEC
materials.
The implementing partners will spearhead the social marketing of WuhaAgar through commercial market
outlets in urban and per urban areas. It will work in partnership with other PEPFAR partners, including the
US universities, the Care and Support Program, IntraHealth, Family Health International, Save the Children-
USA, International Orthodox Christian Charities, World Food Program, and the Partnership for Supply Chain
Management/Supply Chain Management Systems to distribute WuhaAgar to community and facility outlets
providing HIV/AIDS care, treatment and PMTCT services.
The implementing partner will also ensure equity of availability for the product. Those not yet benefiting from
PEPFAR Ethiopia programs or not yet aware of their status will have access to the products at affordable
prices in local markets.
Please note that PEPFAR Ethiopia will not fund social marketing activities through this activity except to
cover the cost of WuhaAgar utilized by PLWHA at health facilities or at commercial outlets through the
voucher system.
This market-assisted approach will support sustainability, increase availability of the product through
commercial outlets and reduce possible stigmatization of purchasers. Moreover, the implementing partners
will collaborate with other USG partners, including the Millennium Water Alliance, to work on safe water and
health promotion to maximize impact of this particular intervention. The point of use safe water product,
WuhaAgar, is approved by Ethiopian authorities.
With plus up funding received in late FY07, and continuing into FY08, the project will produce and distribute
a Preventive Care Package essential preventive care elements to pre-ART and ART clients through facility
and community-based care programs. Distribution will be supplemented by the training and deployment of
approximately 800 women living with HIV to counsel on using the prevention products and to sell items such
as affordable home water treatment in the community to their peers living with HIV as well as the general
community. This will create income generating activities for women living with HIV. Implementation will be
as per national guidelines, will attempt to leverage existing MOH malaria and TB programs and will test
Activity Narrative: various implementation models of delivery for cost and efficiency metrics.
The Preventive Care Package includes a range of services and items to reduce morbidity such as TB,
diarrhea and malaria referral; home water treatment and locally available safe water storage vessels; oral
rehydration salts; basic hygiene products including soap, bleach and antiseptic; multivitamins;
antihelminthics; long-lasting insecticide treated nets (as required); and condoms for use by sexually active
beneficiaries.
The package will include behavioral change and IEC elements meeting low-literacy levels regarding
products described above in simple, pictorial form, as well as information and referral advice on
cotrimoxazole prophylaxis, family planning methods to prevent unwanted pregnancy among women living
with HIV, leaflets about STI treatment, referral for counseling and testing among family members over 18
months to know their HIV status, and referral of HIV-positive clients for TB screening.
Packages will be delivered through selected health networks, including community based care, hospitals
and health clinics across Ethiopia. Staff at community organizations or clinic sites will receive training to
provide counseling on the use of the package products. Community services and clinics will be provided
with BCC materials to facilitate displays that promote water purification, nutrition, adherence and hygiene.
The package's effectiveness will be evaluated through three complementary methods: PEPFAR Ethiopia
will work closely with USG partners in the US and a local public health institution to conduct a
comprehensive evaluation of the Basic Care Package. The implementing partner will conduct regular
mapping surveys to track availability of retail elements of the package, and map these to measure proximity
to ART clinics, and to networks of community agents that have been trained. Finally, the implementing
partner will conduct annual tracking surveys at the general population level to monitor the community's
opportunities, ability and motivation to use water purification products and insecticide treated nets.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18697
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18697 18697.08 U.S. Agency for Population 12031 12031.08 $1,860,000
International Services
Development International
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
* Increasing women's access to income and productive resources
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Estimated amount of funding that is planned for Water $450,000
Table 3.3.08:
