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
Technical Support for Scaling up pediatric HIV Care and Support Services at Primary Health Care Level
ACTIVITY REMAINS UNCHANGED IN FY09
The African Network for Care of Children Affected by HIV/AIDS (ANECCA) is a network of pediatric HIV
experts with extensive experience in pediatric HIV care and treatment throughout Africa.
The numbers of children under care and support in Ethiopia are extremely low compared to the estimates of
exposed/infected and as a percentage of all HIV-infected people under care and support. An important
activity that will increase these numbers is identification and referral of HIV-infected children at health
centers.
ANECCA will provide site-level technical support to primary health care units - health posts and health
centers - in selected health networks.
ANECCA will build human resource capacity through the following activities:
(a) Formal training of various categories of health care providers within the health centers. The aim is to
equip the providers with knowledge and skills in the identification of HIV-exposed/infected children through
provider initiated testing and counseling (PITC) and voluntary counseling and testing (VCT); provision of
care and support services for HIV-infected/exposed children, and utilization of referral networks to close up
gaps in the continuum of care for exposed/infected children and their families;
(b) On-the-job training of health care providers by a clinical mentorship team, comprised of a pediatrician,
nurse, nurse-counselor and a laboratory technician, to cover all aspects of pediatric diagnosis, care and
support;
(c) Supervised preceptorship at specialized higher levels of care (e.g. hospital pediatric ART sites).
ANECCA will promote the identification and care of HIV-exposed/ infected infants/children through the
following ways:
(a) Establish and strengthen linkages between prevention of mother-to-child transmission of HIV (PMTCT),
maternal-child health (MCH) and other routine child health services at health centers. This will promote
identification and follow-up of HIV-exposed infants;
(b) Establish and strengthen routine HIV testing services at health center level, using HIV antibody testing to
identify exposed infants less than 18 months of age, HIV antibody testing to identify HIV infected children at
age 18 months and above, and DNA PCR testing using dried blood spot (DBS) to identify HIV-infected
infants less than age 18 months. This will be done by providing HIV testing logistics support, establishing
laboratory referral networks and specifically training health workers at the sites in conducting antibody tests
and collecting, referring and transporting DBS specimens to DNA PCR laboratory sites;
(c) Promote use of Ethiopia national pediatric HIV testing guidelines within the health centers and assist
Management Sciences for Health (MSH) in providing a comprehensive basic pediatric care package to HIV-
infected children.
ANECCA will provide professional development activities for health providers which are necessary to
provide a basic service package to HIV-infected children. The basic package includes the following:
(a) Early identification of HIV-exposed children within the facility-based services as well as the community.
The latter will involve the strengthening of health center - community links;
(b) Follow-up for exposed infants: Cotrimoxazole preventive therapy (CPT), support for safe feeding
practices, growth and development monitoring and HIV testing services (DNA PCR and HIV-antibody tests)
at the appropriate time;
(c) Provision of routine child survival best practices for HIV-exposed/infected infants/children: routine
immunizations, use of insecticide-treated mosquito nets, safe water use, screening for tuberculosis (TB) and
provision of Isoniazid (INH) prophylaxis for those exposed to active pulmonary TB;
(d) Routine HIV testing (antibody test and/or DNA PCR DBS - as appropriate) for infants and children
accessing care for poor health within facilities or those identified in the MCH clinics who exhibit signs of HIV
infection such as growth faltering;
(e) Nutrition education, support for food supplementation, counseling and support for safe infant feeding
practices for HIV-exposed infants as well as supplementation with vitamins and micronutrients;
(f) Appropriate and timely referral for pediatric ART services: health workers will be equipped with skills to
evaluate, clinically and with laboratory tests where available, HIV positive children and refer them for ART at
the appropriate time;
(g) Establishing and strengthening referral mechanisms between the community and health centers as well
as between health centers and higher levels of care, follow-up and referral guidelines will be instituted;
(h) Establishing community outreach services specifically targeted at mothers/care givers and expectant
mothers support groups. Issues to be addressed by these will include pediatric HIV care and support
awareness, support and monitoring, stigma reduction, reproductive health and family planning services as
well as assisted delivery;
(i) Treatment of opportunistic infections as well as other childhood illnesses in children who present to the
health center with these conditions;
(j) Provision of psychosocial support services to infected children and their families; and
(k) Provision of HIV-infection prevention services to care givers and parents as well as HIV-infected
children, specifically addressing adolescent issues.
ANECCA will also strengthen referral mechanisms at health center level through:
(a) Referral of family members for HIV testing at counseling and testing service points. For some of the
health centers, counseling and testing for children and their family members will be carried out within the
health centers. Referral from their communities to the health centers will be enhanced by strengthening
referral links between the two;
(b) Referral of HIV-infected children to other facilities for the health centers that do not provide ART
services;
(c) Strengthening cooperation between communities and health centers to develop stronger community
level activities with traditional birth attendants and health extension workers.
This will further strengthen referral activities from communities to health centers and vice-versa.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.10:
Strengthening Pediatric Case Finding Utilizing Community and Facility Approaches
ACTIVITY AREMAINS UNCHANGED IN FY09
COP08 NARRATIVE
The number of children on ART in Ethiopia is extremely low compared to the estimates of children infected
and as a percentage of all people on antiretroviral treatment (ART). An important activity that will increase
these numbers is identification and referral of HIV-positive children at health centers.
ANECCA will provide site-level technical assistance to primary healthcare units (i.e. health posts and health
centers) in selected health networks. ANECCA will build human resource capacity through the following
activities, including training of health providers:
(a) Formal training of various categories of healthcare providers within the health centers. The aim is to
equip the providers with knowledge and skills in the identification of HIV-exposed infants, identification of
HIV-positive children (through routine counseling and testing, etc.), provision of care and treatment services
for HIV-positive children, and utilization of referral networks to close gaps in the continuum of care for
exposed and infected children and their families
(b) On-the-job training of healthcare providers by a clinical mentorship team, comprised of a pediatrician,
treatment
(c) Supervised preceptorship at specialized higher levels of care (e.g., hospital pediatric ART sites) - once a
year for each team
ANECCA will promote the identification of HIV-exposed and infected infants/children:
(a) To establish and strengthen linkages between PMTCT, maternal-child health (MCH), and other routine
child health services at health centers. This will promote identification and follow-up of HIV-exposed infants.
(b) Establish and strengthen routine HIV-testing services at health-center level, using HIV antibody testing
to identify exposed infants less than 18 months of age, HIV antibody testing to identify HIV-positive children
at age 18 months, and DNA PCR testing using dried-blood spot (DBS) to identify HIV-positive infants less
than age 18 months. This will be done by providing HIV-testing logistics support, establishing laboratory
referral networks and specifically training health workers at the sites in conducting antibody tests and
collecting, referring, and transporting DBS specimens to hospital DNA PCR sites.
(c) Promote use of Ethiopia National Pediatric and Adult HIV Testing guidelines within the health centers.
Assist IntraHealth in providing a comprehensive basic pediatric care package to HIV-positive children.
provide a basic service package to HIV-positive children. The basic package includes the following:
(a) Early identification of HIV-exposed children within the facility-based services, as well as the community.
The latter will involve the strengthening of health center-community links.
(b) Follow-up for exposed infants: cotrimoxazole preventive therapy (CPT), support for safe feeding
practices, growth and development monitoring, and HIV testing services (DNA PCR and HIV antibody tests)
at the appropriate time
(c) Provision of routine child-survival best practices for HIV-exposed/positive infants/children: routine
immunizations; use of insecticide-treated mosquito nets; safe water use, screening for tuberculosis (TB) and
provision of isoniazed prophylaxis for those exposed to active pulmonary TB;
infection, such as growth faltering
(e) Nutrition education, support for food supplementation, counseling and support for safe infant-feeding
practices for HIV-exposed infants as well as supplementation with vitamins and micronutrients
evaluate clinically, and with laboratory tests where available, HIV-positive children and refer them for ART at
the appropriate time
as between health centers and higher levels of care. Follow-up and referral guidelines will be instituted.
(h) Establishing community outreach services specifically targeted at mothers/caregivers and expectant
mothers' support groups. Issues to be addressed by these will include pediatric HIV treatment awareness,
pediatric ART adherence promotion, support and monitoring, stigma reduction, reproductive health and
family planning services, as well as assisted delivery
health center with these conditions
(j) Provision of psychosocial support services to infected children and their families
(k) Provision of HIV infection-prevention services to caregivers and parents as well as HIV-positive children,
specifically addressing adolescent issues.
ANECCA will also strengthen referral mechanisms at health-center level:
referral links between the two
(b) Referral of HIV-positive children from health centers to higher levels of care where they will access
pediatric ART services;
(c) Strengthening cooperation between communities and health centers to develop stronger community-
level activities with traditional birth attendants and health extension workers
New/Continuing Activity: Continuing Activity
Continuing Activity: 18062
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18062 18062.08 U.S. Agency for African network for 7600 7600.08 $400,000
International Care of Children
Development Affected by
HIV/AIDS
Emphasis Areas
Health-related Wraparound Programs
* Child Survival Activities
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $360,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.11:
