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: 2007 2008 2009
SUMMARY:
In COP09, IYCN will continue to improve the quality of counseling on infant and young child feeding and
nutrition practices (IYCF/NP) through technical assistance to the Ministry of Public Health and Population
(MSPP), the Institut de Sante Communautaire (INHSAC), and non-governmental organizations (NGOs).
This activity emphasizes preventing mother-to-child transmission (PMTCT) and malnutrition and promoting
HIV-free survival of OVC by supporting improved nutrition for HIV-positive mothers and safe and optimal
IYCF/NP through both clinical and community level services and activities.
BACKGROUND:
This work is an extension of activities started in 2007 and continued in 2008 to improve the enabling
environment for infant and young child feeding and nutrition practices (IYCF/NP) and programs. In 2008,
IYCN supported a stakeholders' meeting to achieve consensus on infant feeding in the context of HIV/AIDS
and the development of an evidence-based curriculum on IYCF for the Institut Haitien de Sante
Communautaire (INHSAC) for health and community workers. In addition, IYCN assisted MSPP in the
development of norms and guidelines for infant feeding in the context of HIV. All of these activities will
improve the quality of training for health and community workers on IYCF/NP and contribute to HIV-free
survival in infants and children (0-24 months) of HIV-positive (HIV+) women by decreasing the risks of
MTCT, malnutrition and child mortality. A goal continues to be to increase HIV-survival of infants and young
children by increasing the use of optimal IYCF/NP at the household level throughout the country.
IYCN also strives to improve gender equity in the context of HIV through the development of curricula and
counseling materials that empower HIV+ women to make informed choices about infant feeding options and
their own nutritional needs. The project will also support community-based groups and workers to
encourage women to develop skills and confidence to reject stigma in respect to her feeding choices.
ACTIVITIES AND EXPECTED RESULTS:
Building upon the IYCN Project support received in COP 07 and COP 08, the project plans will complete the
activities described below:
ACTIVITY 1: This activity will use the "24/9" (24 months for children/9 months for pregnant women)
approach to nutrition in the face of HIV/AIDS to develop a maternal nutrition strategy, which focuses on the
importance of promoting maternal nutrition as means of improving health outcomes and survival for infants
and young children. The period of pregnancy and the first 24 months of life represents a window of
opportunity to fill the gaps in infant and young child feeding and nutrition (IYCF/N). Low CD4 counts are
associated with underweight in women which, in turn, increases the risk of low birth weight (LBW) in infants.
LBW increases neonatal mortality in all infants and increases the risk of HIV-transmission in HIV-exposed
infants. Underweight also has consequences for mother by increasing their risk of dying. Because
underweight in women has life-threatening consequences for both mothers and their infants, it is important
to ensure that maternal nutrition practices (MNP) and weight gain are adequate in pregnancy.
ACTIVITY 2: This activity will assist the MSPP to diffuse the norms and technical guidelines for IYCF/N in all
ten departments of Haiti through a series of twelve workshops for approximately 360 staff. In April 2008, the
MSPP Directorate of Nutrition supported by IYCN, UNICEF, WHO, and Fondation Sogebank sponsored a
two-day national stakeholders' meeting with participants from 110 organizations. The results of this meeting
were policy guidelines based on WHO 2006 recommendations, which formed the basis of the Haitian norms
and technical guidelines. IYCN provided technical guidance to the MSPP to develop the norms and
technical guidelines. Nutrition partners validated these documents during a nutrition partners workshop held
in August 2008. They will need to be diffused throughout the country for implementation.
ACTIVITY 3: IYCN will support human capacity development through participation in ongoing training of
trainers (TOT) courses in collaboration with the World Health Organization/Pan American Health
Organization (WHO/PAHO). This will support the Government of Haiti's strategy in IYCF/N with counseling
skills using the health worker curriculum developed jointly by MSPP, INHSAC, and IYCN.
ACTIVITY 4: This activity will improve and strengthen the current supervision system to monitor improve
health provider performance in nutrition and increase retention of staff. IYCN will assist in monitoring the
supervision system to identify good supportive supervision and monitoring practices, which will improve
nutrition services and strength the overall quality of care provided. This activity will also increase the
coverage of other essential services for HIV-affected infants and young children by encouraging health
workers to offer HIV+ mothers the complete child survival packages, including immunizations, essential
drugs, micronutrients, etc. This improved support to health workers will improve job satisfaction, which
promotes staff retention.
ACTIVITY 5: In this activity, IYCN will provide technical assistance (TA) to the MSPP and INHSAC to
review, update, and develop new Creole-language IYCF counseling and support materials. The materials
will enable health workers at the facility and community level to better engage HIV+ mothers in behavior
change negotiation to improve maternal nutrition and IYCF.
ACTIVITY 6: IYCN will continue to provide TA and support to assess the knowledge, attitudes, and
practices of health workers (at facility and community level). The assessment will assist the MSPP in
identifying facilitating factors and barriers to optimal IYCF/N practices at the community level. This activity
will support a follow-up study (originally titled endline study) of progress in health provider performance and
community attitudes and practices toward IYCF/N. The information will be used to identify areas for
improvement during training, supervision, and in the devleopment and use of behavior change
communications materials and activities.
ACTIVITY 7: This activity will support the development of an integrated community-based nutrition model to
be tested in two departments: one rural with CARE and the second one urban with a USAID health partner
in high risk areas for HIV/AIDS. This model will develop methods and tools to strengthen technical capacity
for clinical services and community activities for active prevention of malnutrition. The model will also
Activity Narrative: identify acutely malnourished children for treatment, recuperation and reintegration. This activity will
increase the coverage of families' knowledge about optimal IYCF/N and MNP in the context of HIV to
ensure that all influential family members support optimal MNP and IYCF/N practices.
ACTIVITY 8: IYCN will provide TA as needed to local organizations, USAID-non-governmental
organizations, community-based organizations, mother support groups, schools, community agents, and
events such as World Breastfeeding Week to strengthen the dissemination of information through identified
channels about optimal IYCF/N and MNP in the context of HIV. This will include general support to PMTCT
programs to strengthen services at the community level through targeted TA to HIV+ women's support
groups and community health agents.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17219
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17219 9670.08 U.S. Agency for Program for 7694 5766.08 Infant and $150,000
International Appropriate Young Child
Development Technology in Feeding
Health
9670 9670.07 U.S. Agency for Program for 5766 5766.07 Infant and $150,000
Emphasis Areas
Health-related Wraparound Programs
* Child Survival Activities
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $150,000
and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
ACTIVITY #7: This activity will support the development of an integrated community-based nutrition model
to be tested in two departments: one rural with CARE and the second one urban with a USAID health
partner in high risk areas for HIV/AIDS. This model will develop methods and tools to strengthen technical
capacity for clinical services and community activities for active prevention of malnutrition. The model will
Activity Narrative: also identify acutely malnourished children for treatment, recuperation and reintegration. This activity will
ACTIVITY #8: IYCN will provide TA as needed to local organizations, USAID-non-governmental
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.13:
