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
HIV can cause or aggravate malnutrition through reduced food intake, increased energy needs, or poor nutrient absorption. Malnutrition can hasten the progression of HIV and worsen its impact by weakening the immune system, increasing susceptibility to opportunistic infections and reducing the effectiveness of treatment. There is evidence that malnutrition increases the risk of mortality among clients on ART as well as clients who are not on ART. Food and nutrition interventions help to break this vicious cycle by improving immune response, management of symptoms, response to treatment, nutritional status, and quality of life and productivity.
FANTA-2 works with PEPFAR implementing partners and the MOH/FHAPCO to integrate food and nutrition components of care and treatment services. The goal of FANTA-2's work is to improve the quality, reach, and impacts of HIV services by addressing the food and nutrition needs of PLWHAPLWHAA and OVC in conjunction with ART and care services. In particular, this activity supports scale up and quality improvement of nutrition assessment, education and counseling, and provision of therapeutic and supplementary food products for clinically malnourished PLWHAPLWHAA and OVC.
FANTA-2 technical assistance to FHAPCO/MOH and updating of guidelines and training materials will be at the national level. Training and other technical assistance to implementation of integrated clinical nutrition care at health centers supported by PEPFAR will be in the five regions with higher prevalences of HIV: Oromiya, Amhara, SNNPR, Tigray and Addis Ababa. This activity links to ART and clinical care activities and to the Food by Prescription program.
The activity builds on and scales up work carried out in COP 2008 and COP 2009 to establish and roll out clinical nutrition services for PLWHAPLWHAA at hospitals and health centers and develop resources for pre-service training of health care professionals and resources for introducing nutrition into community and home-based care services. Under COP 2010 FANTA-2 will continue strengthening FHAPCO/MOH capacity and coordination of nutrition and HIV services; update national training materials, provider and client support materials and as needed guidelines on nutrition and HIV; train 500 health care providers in integrated clinical nutrition care for PLWHAPLWHAA; support supervision, mentorship, and M&E for nutrition and HIV; build on efforts initiated under COP 2008 and 2009 to expand and strengthen quality assurance and quality improvement systems for nutrition and HIV activities; using materials adapted under COP 2009, FANTA-2 will work with the MOH and PEPFAR IPs to integrate nutrition into community-based HIV care and support services; using the pre-service materials developed under COP 2009, FANTA-2 will support training of health professionals in colleges and universities in nutrition and HIV; work with PEPFAR partners to strengthen the design of activities aimed at improving access to food among HIV-affected households and links between clinical and food security services.
Integration of nutrition into client flow, health management information systems, and clinical protocols strengthens the broader health system by helping to routinely and more comprehensively address malnutrition, which is a significant problem among PLWHAPLWHAA and OVC in Ethiopia and which significantly increases mortality risk.
The entire activity supports the cross-cutting area of Food and Nutrition: Policy, Tools, and Service Delivery. While many parts of the activity support provision of nutrition commodities, the activity does not directly support procurement and distribution of commodities. Several aspects of the activity support Human Resources for Health. Training, mentoring, and quality assurance and quality improvement efforts in nutrition and HIV at facility and community levels all serve to strengthen human resources by improving the capacity of health care providers in nutrition care of PLWHAPLWHAA and OVC.
The activity involves working with FHAPCO/MOH to incorporate nutrition-related indicators into the national M&E system for HIV services. Data will also be collected on the results of this specific activity, e.g. people trained, materials developed, etc.
The activity will contribute to the sustainability of nutrition interventions by building the capacity of FHAPCO/MOH and regional health bureaus, by training trainers to be available to train others on an ongoing basis. Integrating nutrition interventions into existing care and treatment services is a cost efficient approach because new service delivery structures are not needed and existing services will yield better results. Supporting scale up of nutrition and HIV services will make these services more cost efficient due to economies of scale for training, coordination, and distribution of materials.
FANTA-2 will support the HIV/AIDS Prevention and Control Office (FHAPCO), Federal Ministry of Health (MOH) and PEPFAR implementing partners (IPs) in scaling up and improving the quality of clinical nutrition care for PLWHAA in the five regions with higher prevalence of HIV: Oromiya, Amhara, SNNP, Tigray, and Addis Ababa. The activity will not directly support provision of nutrition services or food commodities to clients.
FANTA-2 will strengthen FHAPCO/MOH capacity and coordination through continued placement of a nutrition and HIV specialist within the MOH and technical assistance to the nutrition and HIV subcommittee under the national palliative technical working group.
FANTA-2 will also train 500 health care providers from health centers and possibly hospitals in integrated clinical nutrition care for people living with HIV/AIDS (PLWHAA), in collaboration with PEPFAR IPs. The project will also use materials adapted under COP 2009, and in collaboration with MOH and PEPFAR IPs, to integrate nutrition into community-based HIV care and support services.
Building on efforts initiated under COP 2008 and COP 2009, FANTA-2 will expand and strengthen quality assurance and quality improvement systems (QA/QI) for nutrition and HIV activities, including expansion of QA/QI to community settings and incorporation of nutrition into existing QA/QI systems.
FANTA-2 will update national guidelines, training materials, and provider and client support materials to address recent developments and integrate emerging evidence on nutrition care for PLWHAA. The program will also develop and print a pocket guide to clinical nutrition care for PLWHAA for use in clinical and community settings.
Using the pre-service materials developed under COP 2009, FANTA-2 will support training of health professionals in colleges and universities in nutrition and HIV. It will also support the MOH in developing registers and reporting formats to assist in integrating nutrition indicators and data collection into routine M&E systems. The project will support continued incorporation of nutrition into support supervision and mentoring training and other activities, including through training of mentors and direct support visits by FANTA-2.
