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
The goal of the Malaria Laboratory Diagnosis Monitoring (MLDM) project, which is being implemented by International Center for AIDS Care and Treatment Programs (ICAP), is to provide technical, strategic, managerial and operational support to implement and strengthen malaria laboratory diagnosis activities in Oromia, thereby contributing to the goal of the President's Malaria Initiative (PMI) goal of achieving a 50% reduction in malaria-associated mortality by 2010. The objective of the program is to ensure availability of quality malaria laboratory diagnosis at health facilities in five administrative zones of Oromia by improving smear microscopy and utilization of RDTs.
The MLDM Project is being implemented in selected health facilities in Oromia Regional State, which is the focus state for PMI in Ethiopia. The health facilities in Year 1 of the MLDM Project have been purposefully selected and will gradually increase to 167 facilities by Year 4. Facilities include a mixture of hospitals, health centers and health posts. The target population of the MLDM Project is suspected malaria patients attending selected health facilities, i.e., populations at risk of malaria living in the facilities' catchment areas.
The MLDM Project strengthens health systems by improving malaria laboratory diagnosis at health facility level through a combination of capacity building, provision of laboratory materials, comprehensive supervision, provision of quality assurance and control, adherence to national laboratory and case management guidelines. As a result, the overall laboratory diagnostic capabilities of supported health facilities should be strengthened.
The project addresses two cross-cutting areas: (1) Human resources for health -- health care workers at supported facilities are trained to provide comprehensive laboratory diagnosis services; and (2) Construction/renovation-- to strengthen laboratory best practice, laboratory safety at a selected number of facilities will be assessed, including the rehabilitation of a limited number of medical waste incinerators.
From the outset the premise of the MLDM Project was to leverage existing USG investment. Thus, PMI support for malaria laboratory strengthening activities is being implemented by ICAP, an organization that has been for many years an USG implementing partner for HIV laboratory strengthening, diagnosis and treatment under PEPFAR. With PEPFAR and ICAP support, the MOH and its regional references laboratories have strengthened hospital laboratory HIV/AIDS diagnosis, patient management and follow-up; laboratory curriculum and standard operating procedure development; training of clinical and laboratory health personnel; quality assurance/quality control and supervision of laboratory strengthening activities. The MLDM Project leverages a lot of these efforts and systems, thereby maximizing USG investment.
The MLDM Project has a comprehensive performance monitoring plan, measuring project outputs as well as impact. Many of the indicators outlined in the plan are standardized PMI indicators that are collected at facility as well as aggregate level. A baseline assessment of 60 health facilities will serve as reference to which the implementation of the MLDM Project's activities will be compared. Monitoring and evaluation will be accomplished through a range of activities, including regular field visits as part of the establishment and implementation of the laboratory quality assurance and control systems as well as a follow-up health facility assessment.
In September 2009, ICAP was awarded, under PMI, a Cooperative Agreement (Malaria Laboratory Diagnosis Monitoring Project, MLDM). The objective of this project is to strengthen the capacity of laboratories at health facilities in the Oromia Regional State to diagnose malaria. The MLDM Project is implemented in close collaboration with MOH, EHNRI, RHB and other PMI implementing partners. MLDM activities will include developing national malaria laboratory guidelines; training laboratory and clinical health facility personnel; assessing health facility laboratory capacity; developing, piloting and establishing a malaria diagnosis QA/QC system; and monitoring anti-malarial drug efficacy in selected sites. The current PMI support is not sufficient to address the biological interactions between HIV and malaria or to maximize the integration of malaria laboratory diagnosis activities into existing laboratory activities for HIV and TB.
PMI funds will be leveraged to strengthen integrated laboratory diagnostic activities, particularly at the health center level. The project will work to link resources from both Presidential initiatives (e.g. laboratory curriculum and SOPs; QA/QC systems and supervision), maximizing USG investments. The following activities are to be carried out under the MLDM Project: health facilities with up-to-date national guidelines on HIV and malaria case management; training of clinical and laboratory health facility personnel in HIV and malaria laboratory diagnosis, treatment and data reporting; integrated supervision of HIV/malaria laboratory diagnostic services; reporting of health facility level HIV/malaria case data; and implementation of facility safety program, ensuring laboratory best practice at supported health facilities.
The quality assurance and control system to be developed will be implemented through regular monthly visits to health facilities, on-the-spot trainings and supervision, and regular dissemination of facility reports on HIV/malaria data.
This activity will track the: number of government health center facilities capable of laboratory diagnosis of malaria diagnosis in HIV patients; and the number of HIV patients referred to laboratory for malaria diagnosis.
