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 2011 2012 2013
Ethiopia has a low number of HIV-infected children on ART, comprising only 5.6 percent of all the patients on ART. At the health center level, only 2.0 percent of the patients on ART are children at the HIV/AIDS care and support program (HCSP) sites.
Building on COP 2009 activities, the African Network for Care of Children Affected by HIV/AIDS (ANECCA) will continue to support Ethiopia in decentralizing and scaling up pediatric services in the country, particularly at health center level in Southern Nations Nationalities and Peoples Region, Oromia, Tigray, Amhara, and Addis Ababa regions.
ANECCA's goal will be to build capacity at primary health care level for providing quality comprehensive pediatric HIV treatment, care and support HIV services.
The objectives of this support will be to: (1) Strengthen technical capacity for improved delivery of pediatric HIV services at health centre level through training of service providers; (2) Promote and support application of skills for delivery of quality and comprehensive pediatric HIV services through support supervision and clinical mentoring; (3) Facilitate decentralized pediatric HIV service delivery with appropriate resource materials; and (4) Strengthen linkages between facility-based pediatric HIV and OVC services.
Technical support will be provided under the following capacity building framework: (1) Needs-targeted in-service training courses for facility-based health care provider teams; (2) Provision of technical support to health training institutions in Ethiopia in revising curricula with regard to pediatric HIV; (3) On-the-job competence building for quality comprehensive pediatric HIV management among health care providers through supportive supervision and clinical mentoring; (4) Updating, strengthening, production, dissemination and promotion of use of appropriate pediatric HIV resource materials including job aids such as: pediatric ART eligibility charts, ARV dosage cards, ART monitoring tools; and (5) Development and replication pediatric HIV quality assurance systems especially at health center level.
To enhance child survival, ANECCA will promote the provision of pediatric HIV services as a comprehensive package comprising of: early HIV diagnosis and enrollment into care/treatment; child growth and developmental monitoring; routine immunization; provision of cotrimoxazole and isoniazid prophylaxis; assessment and prompt treatment of common and opportunistic infections including TB; nutritional counseling and support; safe water, hygiene and sanitation; psycho-social support; provision of insecticide treated nets; and routine deworming. This will be done in liaison with other child survival programs such as the President's Malaria Initiative, TB program; Expanded Program for Immunization (EPI); Water, Sanitation and Hygiene (WASH) program; and food and nutrition program.
To strengthen the general health system, ANECCA will promote the adoption of its pediatric HIV systems and resource materials in the management of other diseases. Further, it is hoped that the knowledge and skills acquired for pediatric HIV management will boost the confidence and competence of health workers at Primary health care level to effectively manage other pediatric illnesses.
The initial costs for capacity building, especially at the primary health care level, are relative high with intensive didactic and practical training; supportive supervision; mentorship; development, production and dissemination of resource materials; and development and replication of health management systems. However, as the project progresses, more health centers will be expected to develop enough capacity for managing pediatric HIV services on their own with little external technical support. In addition, ANECCA will promote a strategy of graduating some health centers into model pediatric HIV service facilities that would then function as preceptorship centers at a lower cost. Further, with revised curricula for health training institutions, it is expected that graduates from pre-service training will be able to manage pediatric HIV effectively in a sustainable manner.
ANECCA's performance will be monitored and evaluated using selected output, outcome and impact indicators with the aide of a performance monitoring and evaluation plan. The output indicators will include: the number of health workers trained; the number of health clinics provided with supportive supervision and mentorship; the number of job aids and other resource materials developed or updated; number of copies of job aids and produced and disseminated, to mention a few examples. All the capacity building activities will be expected to improve health worker performance resulting in expanded and quality pediatric HIV services. The impact should be a decrease in morbidity and mortality for HIV-exposed/infected children. All these outcomes/impact will be monitored and documented to assess the effectiveness of the ANECCA project.
ANECCA will work closely with the HIV/AIDS Care and Support Project (HCSP) and the Government of Ethiopia (GOE) to strengthen local technical capacity for accelerated expansion of pediatric HIV care and support services particularly at the health center level in the main five regions of Oromia; Amhara; Tigray; Southern Nations, Nationalities and Peoples Region (SNNPR); and Addis Ababa. Priority will be given to high HIV prevalence sites especially those that have a relative high adult HIV patient load. Identification of the sites will be done in conjunction with MSH/HCSP. ANECCA's contribution will be based on its rich experience in providing technical support for expansion of comprehensive and quality pediatric HIV care and support services in several countries in sub-Saharan Africa.
ANECCA will conduct a series of pediatric care and support refresher courses for the already trained health workers in the selected sites. Health workers will be equipped with knowledge and skills in identification of exposed infants; follow-up for exposed children including cotrimoxazole preventive therapy (CPT); support for safe feeding practices, monitoring growth and development, and DNA-PCR testing; and provision of routine child survival services for HIV-exposed/infected children, including immunization, use of insecticide-treated nets (ITN), safe water, isoniazid preventive therapy (IPT); and nutritional support..
Through expert mentors, ANECCA will equip HCSP mentors with the necessary competence for supporting pediatric care and support health center teams. In addition, ANECCA will provide intensive on-the-job training of health workers in the selected sites.
Further, ANECCA will complement HCSP and GOE efforts in the review, development, production and dissemination of pediatric care and support resource materials including job aids with due emphasis on health officers and nurses.
To ensure sustainable technical capacity, ANECCA will promote appropriate in-service training with regard to pediatric HIV pediatric care and support. This will be done through curriculum review and development with focus on health training institutions for health officers and nurses.
ANECCA will work closely with the HIV/AIDS Care and Support Project (HCSP) and the Government of Ethiopia (GOE) to strengthen local technical capacity for accelerated expansion of pediatric HIV treatment services particularly at health center level in the main five regions of Oromia; Amhara; Tigray; Southern Nations, Nationalities and People Region and Addis Ababa. Priority will be given to high-yield health centers based on the numbers of adult ART patients and HIV-infected children under care. Identification of the sites will be done in conjunction with MSH/HCSP. ANECCA's contribution will be based on its rich experience in providing technical support for scaling up pediatric treatment services in several resource-constrained African countries.
ANECCA will conduct a series of refresher courses for the already trained health center antiretroviral therapy (ART) teams in the selected sites. Health workers will be equipped with knowledge and skills in evaluating HIV-infected children for ART; initiating of treatment; monitoring children on ART including side effects and treatment failure; and making appropriate referrals as per the Ethiopia national guidelines. The target is to conduct at least two training sessions per quarter each with 25 participants, making a total of 200 in one year.
Through expert mentors, ANECCA will equip HCSP ART mentors with knowledge and skills for supporting pediatric ART health center teams. In addition, ANECCA will provide intensive on-the-job training of health workers in the selected sites to boost their competence and confidence in pediatric ART management.
Further, ANECCA will complement the efforts HCSP and GOE in the review, development, production and dissemination of pediatric ART resource materials including job aids. The materials will be particularly tailored to the health officers and nurses that provide pediatric ART services at health center level.
To ensure sustainable capacity building, ANECCA will promote appropriate in-service training with regard to pediatric HIV diagnosis and treatment. This will be done through curriculum review and development with focus on health training institutions for health officers and nurses.
