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: 2008 2009
Background
The USG uses HIVQUAL's program to provide support to the MOH and the President's Emergency Plan for
AIDS Relief's (PEPFAR) partners to develop a standard system of QA/QI to improve the quality of HIV care
in the country. Activities will expand upon the HIVQUAL-Haiti work which began in Fiscal Year (FY) 2007 to
reach 20 sites. HIVQUAL will expand the program in FY 2008 to 60 new sites. The overarching goal of
HIVQUAL is to facilitate the development of a national HIV quality management program that is operated
and directed by the Ministry of Health. The program is designed to improve the quality of care and services
provided to people living with HIV.
Program staff is identified within MOH to manage HIVQUAL in partnership with the CDC team, with
mentoring and guidance from the US-based HIVQUAL team. The project is implemented through HIVQUAL
-International which is supported by the New York State AIDS Institute, and through its administrative and
fiscal managing agent, Health Research, Inc.
The goal of HIVQUAL is to allow health services and individual health care providers to engage in a
participatory process of quality improvement based on evidence and data collected locally by their own
teams. Using the HIVQUAL model, Health Units, districts, provinces and the MOH at the central level will be
able to gauge the quality of services provided to the HIV+ population using indicators based on national
guidelines and to propose feasible and sustainable strategies to improve quality through implementation of
these established standards of treatment and care. As directed by the MOH, HIVQUAL will be implemented
in health care facilities and in coordination with all implementing partners.
Activities and expected results
Activity 1: Established indicators measure key elements of HIV care, including continuity of care, access to
antiretroviral therapy and CD4 monitoring, TB screening, prevention education and adherence assessment.
The specific emphasis of this activity is at the clinic-level, adapting the methods of quality improvement to
each organization's particular systems and capacities. An assessment tool to measure the capacity of the
quality management program at each facility is used and will both measure the growth of quality
management activities as well as guide the coaching interventions. Aggregated facility-specific data can
provide population-level performance data that indicates priorities for national quality improvement activities
and campaigns.
Activity 2: The unique approach of HIVQUAL-Haiti is that it targets regional networks of providers who are
engaging in quality improvement activities that enables them to work together to address problems that are
unique to each area, including, for example, human resource shortages and coordination of care among
multiple agencies. Quality improvement training will be conducted for groups of providers. The project will
work in partnership with all treatment partners who will help disseminate quality improvement strategies and
activities throughout their networks.
Activity 3: The USG HIVQUAL team will build quality improvement coaching skills among MOH staff and
providers in Haiti and provide advanced level trainings for sites as well as basic trainings for new
participants. Mentoring of Haiti-based HIVQUAL staff will continue throughout the activity. Work will
continue in close partnership with the Ministry of Health, CDC-Haiti, and implementing partners. One of the
goals for 2008 will be to identify a lead staff person in the MOH to assume direction for the project.
HIVQUAL will provide travel funds for this individual and other selected MOH staff to the US for an intensive
mentoring program in New York (AIDS Institute) and California where the US-based QI lead is located.
Additional staff for the activity will be recruited as necessary although efforts will be directed to promote
sustainability through building capacity for management in direction within the MOH.
Activity 4: Funding supports the activities of the US-based HIVQUAL team to provide mentoring, travel to
Haiti for mentoring visits and site visits to introduce the tools and techniques of quality improvement and
quality management. Training in the methods of quality improvement and assessment of quality
management programs will be provided at central and regional levels.
Targets:
60 sites reinforced with HIVQUAL
