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.
WHO supports rapid scale-up of activities in Ethiopia for the establishment of a sustainable, nationally coordinated Blood Transfusion Service. The technical assistance is aimed at the establishment of efficient, sustainable, national blood transfusion services that can assure universal access to quality, safe and adequate blood and blood products to meet the needs of all patients requiring transfusion in Ethiopia. This project began in FY04 with an assessment of existing blood transfusion services to determine the baseline status and gaps that would need rapid strengthening into the Blood Transfusion Service infrastructure and program. WHO, assisted by the Federal Ministry of Health (MOH), developed a five-year strategic plan in collaboration with all key stakeholders for strengthening and restructuring the blood supply system through the regionalization of key services, including testing and processing. WHO has provided support in training and development of instruments and tools to improve blood donor recruitment, blood testing, and appropriate clinical use of blood, as well as establishment of quality systems in the national blood transfusion service. This marked the initiation phase of the program.
From FY06 through FY09, WHO provided technical support for implementation of the five-year strategic plan. WHO, in collaboration with the MOH, conducted assessments of strategies in blood donor recruitment as well as quality systems. Roadmaps to address the identified gaps in blood donor recruitment and quality were developed, and the implementation of these roadmaps was initiated and is on course. National Guidelines for Appropriate Clinical Use of Blood were developed and distributed training of staff on the use of the guidelines is ongoing.
WHO supported the initiation of hospital-level transfusion committees (HTCs) and a few hospitals have established HTCs and roll out of this to all hospitals will be one of the main focus areas in 2010.Through one at Black Lion Teaching hospital in Addis Ababa, review of clinical transfusion practice, documentation, data management, inventory management as well as safe hospital practices are being rolled out to regional and other hospitals.
To date, WHO has trained 1,138 individuals involved in blood transfusion services including community blood donor mobilisers, donor recruiters, blood collection staff, laboratory technicians of various cadres, doctors and nurses. Additionally, four technical staff members have been out-posted in other countries to gain experience and further professional development. Considering the anticipated scale up of the service due to the number of blood banks that are going to be operational and the increasing number of hospitals that will access the service in FY09, there will be need to enhance training activities both in terms of the number of trainees, training sessions as well as initiate distance learning using WHO materials in COP 2010.
In collaboration with Regional Health Bureaus (RHB) and ERCS, WHO worked to build capacity and develop partner engagement mechanisms through forums focusing on equity and quality issues in service provision. WHO has supported the establishment of 7 regional and 4 zonal BTS coordinating units which have helped secure ownership and partnerships for blood safety at the regional and zonal levels. WHO also collaborated on development of draft legislation for the blood transfusion service legal framework and a human resource development plan. WHO will continue to consolidate these mechanisms and advocate for enactment of the legislative framework.
As part of the quality system roadmap, WHO supported development of standards for blood transfusion in Ethiopia, standard operating procedures and other quality elements as well as capacity building in the area of total quality management. WHO will continue to support establishment of additional quality elements as well as roll out of the quality system to the current as well as the new regional blood banks as they become operational.
Activities to improve functions at the clinical interface including establishment of hospital transfusion committees (HTCs) and capacity building are ongoing. WHO will continue supporting these endeavors in order to achieve ultimate safety of the patient. These activities will cover all the regions and all health facilities performing blood transfusion.
Through these efforts, the blood collection although modest has increased from just over 24,000 units in 2004 to 33,541 units in 2008, which was due to a number of factors including delays in finalizing construction and procurement; the proportion of voluntary blood donors have increased to 50% in some regions although overall national average is at 37%; testing of donor blood has increased to 100% for all transfusion transmissible infections, discard rates for TTIs have reduced from 13.5% in 2004 to 7.1% in 2008.
In FY2010, WHO will continue to provide technical assistance to expand and consolidate the blood safety program. This will be achieved through:
1. Strengthening national coordination through creating a national advisory committee, supporting the functions of regional coordinating units and creating conducive linkages with the national level. This will include regionalization of blood bank functions to enhance cost-effective service provision while preserving quality service.
2. Enhancing blood collection from voluntary non remunerated donors through recruitment of community mobilizers, and training of journalists and staff. Productivity of mobile donor drives will be enhanced through onsite support, training and mentorship. WHO will support development of an in-house donor counseling and notification system which will contribute to national initiatives aiming at prevention of spread of HIV and other TTIs, offering opportunities for accessing treatment and support.
3. Achieving cost-effective quality testing and processing by establishing blood bank laboratory functions, particularly in the regions with the aim of 100% testing of blood for all TTIs in quality assured laboratories. This will include scale-up of component production, establishing facility level blood storage, inventory management systems, blood transportation, as well as systems for cold chain maintenance.
4. Continuing to support improvement of hospital blood transfusion practices through training, development and implementation of requisite systems such as hospital transfusion committees. Assessment of current practices will be undertaken with the view of using the generated data for improving access to and reduction of unnecessary transfusions, and promoting safe and appropriate transfusion practices.
5. Supporting strengthening and roll out of quality systems to the regions through onsite support and training. Through these trainings, WHO foresees establishment of quality elements in blood transfusion services.
6. Continuing to strengthen systems for regular monitoring, evaluation, review, and planning. WHO will support improved mechanisms for data collection and management, including the use of appropriate indicators.
