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.
1. ACTIVITY DESCRIPTION AND EMPHASIS AREAS
This activity relates to the prevention of HIV transmission among health care workers, medical waste
handlers and the community. Training of 2,000 health workers in 55 Health Facilities in Nairobi City Council
and MOH on safe injection practices and infection prevention/ control so as to significantly reduce or
eliminate the transmission of HIV/AIDS and other blood-borne diseases resulting from unsafe injection
practices.
Funding is sought in FY 09 to ensure full coverage of Nairobi, a highly populated region with high HIV
prevalence. From FY06 - FY 08 training in Injection safety implemented through JSI-MMIS has in has
covered Nyanza, western, Coast, Eastern, Central Provinces as well as parts of Nairobi (Kenyatta National
Hospital) province. With a HIV prevalence of 9.3% Nairobi is second to Nyanza (15.4%) in HIV prevalence.
John Snow, Inc. - Making Medical injections Safer, (JSI-MMIS) partners with Academy for Educational
Development (AED) and Program for Appropriate Technology in Health (PATH) to implement the three-step
strategy recommended by the World Health Organization (WHO) and the Safe Injection Global Network
(SIGN) to implement the PEPFAR Injection Safety program in the following countries: Kenya, Botswana,
Cote d'Ivoire, Haiti, Rwanda, South Africa, and Tanzania from FY 06. JSI- MMIS funding comes to an end
on 30th September 2008. Whereas they have performed an exemplary job, it is necessary to continue the
program by training health care workers in Nairobi Province. These funds will enable the TBD- (CHF follow-
on) to scale up injection safety interventions through activities that build on internationally accepted
strategies to health care facilities in Nairobi province. The world Health Organization (WHO) estimates of
global burden of disease suggest that unsafe injections around the world account for 5% of HIV infections.
A 2004 survey by JSI-MMIS in Kenya revealed that over 70% of respondents received an average of 1.5
injections per year. Needle stick injuries within the previous six months were reported by 58% of health care
workers. These findings supported those of an earlier study by the University of Nairobi among 214 nurses
in Nairobi, which reported 61 % needle stick injuries in health care workers over a three-month period.
Needle recapping accounted for 46% of the injuries while 12% occurred during disposal of sharps. A
majority of health facilities surveyed reported having experienced a shortage of disposable injection
supplies in the 12 months prior to the survey, particularly in the curative sector. This reflects a less than
optimal logistics system for forecasting, procurement, distribution and stock monitoring that may contribute
to re-use of injections. Analysis of the status of injection logistics in the country revealed that there was no
data to support rational forecasting of injection requirements. Procurement was based on previous
consumptions. Appropriate product selection was poor due to lack of national standards for injection
devices, registered suppliers of injection equipment and an appropriate board to handle non-pharmaceutical
equipment. Injection safety activities in Kenya commenced in 2004 under PEPFAR. The aim is to: • Improve
training of health workers and managers on safe injection practices, infection control and disposal
procedures. • Institute an advocacy strategy to decrease demand for injections by the population. •
Establish reliable estimates of re-use prevention injection device equipment requirements, minimum stock
levels and effective supply and distribution systems for re-use prevention injection device equipment. •
Institute monitoring and supervision procedures to ensure adequate supplies at all levels and correct
practices by health workers. • Ensure safe disposal of used injection equipment through the progressive
introduction of appropriate incinerators. • Secure the required budget for injection safety and infection
control including safe disposal of used equipment. Significant changes in FY09 include scale up of activities
to 55 facilities in Nairobi province and nine districts in eastern Province. Funding is sought in FY 09 to
ensure full coverage of Nairobi, a highly populated and high HIV prevalence region. The Ministry of Health
has committed to increase procurement of auto- disable injection devices and health care waste disposal
containers as well as increased guidance and supervision for injection safety and infection prevention and
control at health care facilities. Significant reduction in prescription of injections and regular use of sharps
disposal containers has occurred in all health facilities that have benefited from this intervention regions.
This activity has major emphasis on training to impart improved skills, knowledge and attitudes regarding
safe injection practices to healthcare workers, waste handlers and the community. This activity will also
guide the development of policies to ensure adequate supplies of appropriate injection supplies at health
care facilities and their use thereof.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will avert at least 5% of HIV transmission in Kenya. To date over 18,000 health care workers
(clinicians, logistical officers and medical waste handlers) have been trained in safe injection practices and
medical sharps waste management. Interventions have been implemented in six provinces (Central,
Nyanza, Western, Eastern (part), Coast and the Kenyatta National Hospital. In FY09 an additional 8,000
health care workers will be trained in Nairobi (City Council clinics and hospitals) and Eastern provinces.
4. POPULATIONS BEING TARGETED
• Health care workers • Community • Medical Waste handlers • Policy makers
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.05:
