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.
Linked to Activities: 10666, 9264, 10124, 10123, 10129, 10111.
SUMMARY: This program will support palliative basic care andn support in three regional departments of Haiti: Grande Anse, Artibonite and North West. Major emphasis areas will be psychological, social, nutrition and preventive care support to people living with HIV/AIDS (PLWHAs) and their families in these departments. When appropriate, end of life care to help the PLWHAs die with dignity will be provided. The entry door for the program will be the counseling and testing (CT) and ARV treatment sites in these departments where PLWHAs are being detected and enrolled. CARE will develop networks and linkages with these sites as well as with other local community-based organizations (CBOs) providing services to ensure a continuum of care to PLWHAs from the clinics to the communities. The program will wrap around the Title II Food Program and the OVC and the palliative care programs in these departments which are supported by CARE with Track 1 and Global Funds resources. The target population is people living with HIV/AIDS and their families.
BACKGROUND: CARE is a primary partner implementing the Title II Food Program in Haiti. For many years, they have supported HIV services such as community mobilization, OVC, and community palliative care support in the North West, Artibonite and the Grande Anse departments. In the Grande Anse, CARE has been particularly active in supporting PLWHA community groups which provide social support services and play an important role in the adherence of PLWHAs enrolled in ARV in this department. CARE has also played a key role in making food available to PLWHAs in coordination with clinical-based and community services. With existing PEPFAR and Global Fund resources, a network of CT, palliative clinical care, PMTCT and ARV treatment sites have been implemented in each of these three departments where PLWHAs have been receiving a continuum of counseling, clinical care and anti-retroviral treatment (ART) services. With FY 2006 resources, these services are being expanded and reinforced, but are not being integrated with a comprehensive and well structured package of community care. As of now, about 5,000 PLWHAs have been identified in these three departments.
With FY 2007 resources, the USG will continue the CARE programs in these three departments and will expand and reinforce the package of community palliative care to 12,000 PLWHAs and their families to include nutritional, psychosocial, spiritual and preventive care support. CARE, as the primary CBO for this program, will develop linkages with the clinic-based sites and other local CBOs to deliver these community support services. CARE will reinforce its capacity and the capacity of other local CBOs to implement this program, which will be integrated with the CARE OVC activities in the same departments to promote a family-centered approach. CARE will continue to use Title II Food resources to distribute food rations to PLWHAs. As necessary, some PEPFAR 07 resources will be used to buy local foods to for a limited time period to address critical PLWHA needs.
ACTIVITIES AND EXPECTED RESULTS:
CARE will provide a package of psychological, nutritional, social and spiritual support services to 12,000 PLWHAs in three departments: the Grande Anse, North West and Artibonite through linkages with CT, PMTCT, palliative clinical care and ARV centers as well as with other local CBOs in these departments.
Activity 1: Capacity Building: CARE will reinforce logistical and human capacity in each of these three departments by hiring social workers, adding community workers and expanding office space. CARE will also identify and expand the capacity of local CBOs (at least 5 in each department), particularly faith-based organizations, to provide community services. CARE will coordinate with Family Health International (FHI) and Haitian Institute for Community Health (INHSAC) to train the community workers and establish a supervisory structure using national guidelines and curricula. CARE will contribute to the implementation of a community-based information system to track PLWHAs and to monitor services.
Activity 2: Linkages. In each department, CARE will develop linkages to and a referral system with the different VCT, PMTCT, clinical care and treatment sites which will continue to detect and enroll PLWHAs in care at clinics and in the community. Linkages will also be
created with local CBOs providing expanded community sevices. CARE will work with the Ministry of Health (MOH) departmental staff and other local stakeholders to develop tools for this referral system. CARE will encourage and support regular departmental meetings to implement and monitor the system.
Activity 3: PLWHA Support Groups: CARE will coordinate with other local organizations to expand and reinforce PLWHA support groups. CARE will provide resources to structure these groups according to national guidelines and enhance their roles in PLWHA education on HIV, stigma reduction, best health practices and adherence to treatment. CARE will provide space and operational costs for these groups. CARE will train religious leaders and other community groups to engage their in support for PLWHAs and their families.
Activity 4: Distribution of commodities: CARE will distribute commodities for safe drinking water, e.g., water vessels, chlorine and hygiene kits. CARE will also work with Global Fund and MOH partners to distribute treated bed nets to PLWHAs for malaria prevention according to the national guidelines and will assist in supporting the logistics system for distribution of these commodities. The USG will procure the commodities thru the Partnership For Supply Chain Management (PFSCM).
Activity 5: Social Support Services: CARE will provide funding in each department for a PLWHA transit house located near an ARV center. CARE will also support micro-credit activities in coordination with private or other NGOs involved in this activity. This support will complement other social support that is being provided through the OVC program and through the clinics such as transportation and school fees.
Activity 6: Nutrition services. Nutritional support will also be provided by linking recipients to the USAID Title II food assistance programs and to the World Food Program (WFP). Some of the resources will be used to buy local food for a limited time frame to address critical shortages. For this activity, the CARE team will work closely with the sites assessing and monitoring the nutritional status of PLWHAs to identify those are in greatest need of food.
Added February 2008: The funding mechanism that USAID Haiti planned to use for both CRS and CARE community activities (Palliative Care:HBHC and OVC for both and TB/HIV for CARE) were the Title II agreements. When the proposals came in for the Title II program this year, CRS and CARE formed a consortium on one proposal, with CRS as the prime partner and CARE as the sub-partner. Thsu, the CARE activities are being reprogrammed to CRS and CARE will be a sub-partner to CRS.
Linked to Activities 10110, 10666, 9286, 9676, 9675.
SUMMARY: CARE International receives support from the USAID bilateral health program to support the National TB Control program and, with PEPFAR FY 05 and 06 funds, has integrated HIV/TB interventions into this network in the Grand'Anse, NorthWest, Artibonite and Nippes Regional Departments. FY 07 funds are planned for the expansion and scale-up of services and will address these overall objectives: 1) Increase integration in 16 Directly Observed Therapy (DOTS) clinics in 4 departments with HIV Counseling and Testing (CT) and referral of all positive patients to anti-retroviral treatment (ART) sites for further care and treatments 2) Increase to 52 the number of DOTS clinics in 4 departments and link them to the TB/HIV network 3) Improve health professionals skills in HIV/TB to provide clinical prophylaxis and or treatment for TB/HIV infected individuals according to the national and international standards.4) Assure jointly supervision and Quality Assurance / Quality Control (QA/QC) through mobile coordinating teams. Specific target populations include: 600 HIV-infected clients attending HIV care or treatment.
BACKGROUND: CARE has the institutional capacity to adequately support communities within its working area through an integrated approach which strengthen existing as well as newly created community networks. In addition CARE has been one of the leading private voluntary organizations (PVOs) providing supports to strengthen and expand the DOTS strategy in 4 departments: Grand'Anse, Nippes, Artibonite and North West, using both United States Agency for International Development (USAID) central funds and PEPFAR resources. Remarkable gains were made in the Grand'Anse and Nippes departments, where all targeted TB health centers have adopted the DOTS strategy, but services still need to be expanded in the Artibonite, the second most crowded department, and also in the North West which is among the poorest. With USAID funds resources, CARE will continue to strengthen and expand the DOTS strategy in these four targeted departments and will offer integrated HIV/Tuberculosis testing and palliative care.
CARE will carry out activities in this program area:
Activity 1: Linking of TB DOTS clinics with CT services: This involves provision of prophylaxis for TB to HIV infected individuals in a palliative care setting. 52 CT health facilities in the GrandÁnse (19), North West (17), Upper Artibonite (8) and Nippes (8) Regional Departments will be linked to the TB DOTS network of clinics so that proper referral will take place to offer preventive and curative treatment TB services to 600 HIV infected clients according to national and international standards. Improved identification of TB cases: Continue surveillance systems at all Diagnosis and Treatment Centers (CDT). Monitor changes in detection rates with health service providers at quarterly meetings; ensure adoption of necessary corrective measures. Ensure proper transport of mucus specimens/smears to CDTs and test results back to Treatment Centers (CTs). Identify and refer suspect cases.
Activity 2: Community Mobilization Participation: Funds will be also used to implement information, education and communication / community coalition care (IEC/CCC) IEC sessions for non-health care professionals (e.g. journalists, policeman etc.). Monthly radio programs in 28 stations.(Grand'Anse 7- North West 8, Artibonite 9 Nippes 4) 200 awareness sessions in schools or youth clubs. Quarterly meeting per department with 400 voluntary treatment peer supporters to update information and ensure follow-up. 24 Information/awareness raising sessions in addition of the International TB day.
Activity 3: Quality Assurance and Supportive Supervision: Special attention will be given to supervisory visits to ensure they are used as opportunities for training and quality control. 416 supervisory visits at DOTS institutions
Activity 4: Training:
This activity is designed to strengthen capacity of institutions and communities (at their respective levels) to provide counseling, detection and diagnosis, treatment and monitoring of TB cases. Specific trainings include: 20 additional health providers will be trained in TB/HIV integration prophylaxis IEC training (3 days) for 100 providers in Nippes and North West Departments; training of 10 additional lab technicians to perform screening HIV/TB tests; continued training sessions for 800 members of community volunteer's network; and TB/HIV management training for 21 field staff in Artibonite and North West Departments.
Added February 2008:The funding mechanism that USAID Haiti planned to use for both CRS and CARE community activities (Palliative Care:HBHC and OVC for both and TB/HIV for CARE) were the Title II agreements. When the proposals came in for the Title II program this year, CRS and CARE formed a consortium on one proposal, with CRS as the prime partner and CARE as the sub-partner. Thsu, the CARE activities are being reprogrammed to CRS and CARE will be a sub-partner to CRS.
Linked to Activities 10110, 9264.
SUMMARY: These OVC activities will expand and scale-up services through four main activities: 1) Improve services to OVCs, including addressing psychosocial needs, human rights protection, and legal and economic support after the death of a parent; 2) Improve OVC's access to health services; 3) Improve community capacity to address the needs of OVCs and foster families; 4) Link institutions to communities. The OVC program will wrap around the PEPFAR supported sites and complement the palliative care component to be developed by CARE as well to offer a comprehensive family-oriented package of services to PLWA and their families identified at the sites. Major emphasis areas are community mobilization/partnership; information, education, and communication; and training. Specific target populations include orphans and vulnerable children and caregivers (especially families affected by HIV/AIDS). CARE International, in partnership with other networks propose to support OVC interventions in selected areas of the Nippes, the Grand Anse, the Artibonite, and Northwest to complement and expand existing OVC programs.
BACKGROUND: CARE supports OVCs through its network of community-based programs in 4 departments. CARE, with the Ministry of Health (MOH) and the Minister of Social Affairs, were active organizers of this year's first national forum on OVC with the objective of defining a national framework for the support to OVCs affected by HIV/AIDS. During the country operating plan (COP) 07 funding period, CARE will expand community support for OVCs and ensure that its program wrap around the PEPFAR supported sites and that children and dependants of PLWA identified at those sites have access to comprehensive HIV/AIDS services and adequate follow-up from the institution to the community and vice-versa. Wrap around resources will give OVCs access to the Title II food program, and PEPFAR HIV programs at the MOH sites. (Key legislative issue). This program will be executed through the CARE community network
ACTIVITY 1: Identification of OVC and provision of Basic Package of services : CARE will establish in collaboration with the PEFAR supported sites mechanisms to systematically identify and service OVC from the sites. The sites are the following. In the Artibonite: Hopital des Gonaives et de Marchand, Centre de Raboteau et de K-soleil, et d'Ennery, In the Northwest: Hopital de Port de Paix, de Jean Rabel, de Beracca et de Bombardopolis ; In the Nippes: Hopital de Miragoane and Aquin; in Grande Anse: Hopital St Antoine, Centre Santé St Helene, AEADMA, Centre Pestel. CARE will ensure that its outlets for delivery of OVC services are accessible to the population served by those sites, and staffed with trained personnel, including social workers to organize the services and manage the information system. The core set of services that will be available at each outlet include: psychosocial support for the OVC and their families or caregivers, educational activities for both groups, school fees, nutritional supplement; transportation cost for access to health care, schools or other basic services; support for birth registration. Others services may be provided based on assessment of specific needs within selective community and capacity of the local partners and may include: day care center or canteen for OVC, placement services for children without family care, and cooperative activities, access of mothers and other caregivers to income generation opportunities through micro-credit and other micro-finance assistance.
Activity 3:Linkage to other services: CARE will ensure that OVCs' access to education and health services is improved by increasing the capacity of community members, especially caregivers, to care for HIV infected and/or affected children and by enrolling OVCs in primary health care and Integrated Management of Childhood Illnesses (IMCI) services in MCHN clinics in the area, and in schools. CARE will also increase linkages to HIV facilities through its community network to help identify HIV/AIDS vulnerable children and refer them to these facilities. The program will identify the barriers to access those services and put in place locally appropriate strategies and mechanism to override them. Fees and hidden costs being the major obstacles to access other services, the support to be provided will be assessed on a case by case basis and may include: purchasing of drugs, supply of uniforms.
Activity 2: Empowerment Of OVC and caregivers: CARE will improve psychosocial services
for OVCs. At least 3.200 OVCs of ages 8 to18 will participate in discussion fora with experienced staff, receive counseling to help them manage and restore/build self-esteem, and develop social and coping skills in areas such as household management, caring for younger siblings, budgeting, interpersonal skills, and succession planning. They will receive comprehensive and accurate sexually transmitted disease (STD) and HIV/AIDS education. Prevention messages will address specific situations that these children face that make them more vulnerable than other children to becoming infected. The program will also support and finance group-led-activities that those children may want to undertake such as : peer education activities, edutainment activities. Attention will also be given to caregivers to ensure that they receive proper training and support to care for the children. They will be supported in adoption of strategies aimed at raising and supporting their income.
Activity 4: Support to Community response: Community Health Workers (CHWs) will be trained to sensitize and educate the general population about HIV/AIDS to reduce discrimination and stigmatization and to promote the respect for the rights of people living with HIV/AIDS (PLWHAs) and children. CHWs will also develop the skills and knowledge to provide psychosocial support and home-base palliative care to HIV/AIDS infected children. Community leaders, teachers, service providers, and support group members (eg, PLWHAs) will also be trained in order to reduce stigma experienced by PLWHAs, especially children (key legislative issue). Community and foster care will be encouraged. Specific education materials about infant and childcare will be developed for the families caring for OVCs. The program will also foster and support initiatives organize by the community in support to those children such as: community gardens, community day-care centers, local adoption and foster care or other cooperative activities,. Funding from the program may be used for: information session, startup capital for community activities.
These results will contribute to reach the 2-7-10 PEPFAR objectives by preventing new infections in youth and providing care to infected, affected children and their families. TARGETS: 3,200 OVCs will receive care, support, and services through expanded HIV/AIDS program 602 individuals will be trained on OVC issues (226 caregivers/ health service providers, 226 directors and schoolteachers, 150 community health workers)
