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
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+ Revision of the geographical coverage area.
+ Increased emphasis on provision of comprehensive PMTCT services in the lower level facilities and
strategies to increase the uptake of HIV testing and counseling to male partner of women attending ANC
services.
+The district total expected pregnancies have been provided and NARESA is expected to support the
respective districts reach the stipulated percentage population coverage.
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS
This activity supports key attributions in human capacity development through the training of health care
service providers on PMTCT and other HIV prevention and care topics, in order to equip them with
knowledge and skills to provide quality PMTCT services. These service providers include doctors, nurses,
clinical officers, nutrition officers and health record clerks.
COP 2008
1. LIST OF RELATED ACTIVITIES
This activity relates to KEMRI ARV Services in Nyanza, APHIA II ARV services in Nyanza; CDC TBD and
Columbia University and APHIA II Central ARV services in Central Province.
2. ACTIVITY DESCRIPTION
The Network of AIDS Researchers in Eastern and Southern Africa (NARESA) was among the first
organizations to partner with the Ministry of Health and pilot PMTCT services in Kenya. With Emergency
plan funding, NARESA has been supporting implementation of PMTCT services in health facilities in over
12 districts of Bondo, Rachuonyo, Homa Bay, Kisii and Gucha in Nyanza Province, Nyeri, Muranga,
Maragua, Kiambu and Kirinyaga in Central Province and Kitui in Eastern Province. ANC HIV prevalence
ranges from 4% in Kirinyaga district to 28% in Bondo district. In 2008, NARESA supported the
implementation of PMTCT services in the Nyanza and Central region covering 250 health facilities with the
aim of providing comprehensive HIV care to all the HIV-positive pregnant women and their infants and
families. In 2009, NARESA will continue to support implementation of PMTCT services in the Central
Province (Kiambu, Muranga, Maragwa, Kiambu, Kirinyaga and Nyeri Districts) and Nyanza Province
(Bondo, Rachuonyo and Homa Bay Districts). Following the Government of Kenya's revision of
administrative boundaries, the names and number of districts in these two regions may change, however
the geographic area and target population will remain as described here. The expected total number of
pregnancies in the geographical area of coverage is 100,594 for Central province and 47,427 in Nyanza
region. During COP '09, NARESA will support HIV testing and counseling of a total of 110,765 (93%) (i.e.
75,146 in Central and 35,619 in Nyanza region) pregnant mothers in MCH and Maternity units and facilitate
CD4 count test as well as WHO clinical staging to all women with an HIV-positive test result. Based on
these parameters and Ministry of Health Guidelines, the program will provide ARV prophylaxis to 10,949
(93%) of 11,722 HIV-positive pregnant women identified. Of these 5,475 HIV-positive women will get AZT
and Single Dose Nevirapine, 2,190 HIV-positive women will get Triple ARV Therapy and 3,284 HIV-positive
women who present to the ANC in advanced pregnancy for their first visit will get sdNVP only. NARESA will
work with the MoH and other PEPFAR partners to establish and maintain a functional referral and
laboratory network to ensure HIV-positive women access comprehensive HIV care services in the
respective regions. All HIV-positive women will be initiated on Cotrimoxazole prophylaxis in addition to other
basic care package provided in ANC within the safe mother hood initiative. In line with expanding access to
HIV testing for men and strengthening prevention, the program will target to support the testing and
counseling of at least 20% of the partners of women accessing PMTCT services. This will be achieved
through innovative approaches of reaching the male partners for example through couple HIV testing and
counseling. A total of 22,154 men will be reached with this intervention (15,030 in Central region and 7,124
in Nyanza region). All men testing HIV-positive will be linked to ongoing HIV care and treatment services.
300 service providers will be trained on PMTCT service delivery. The program will provide ARV post
exposure prophylaxis to 10,949 HIV exposed infants in line with the revised national ARV guidelines. The
ongoing follow-up clinics for HIV positive women and their infants in all facilities will be strengthened
through the provision of a defined package of care for both mother and infant. For the mother, the care
components include counseling on appropriate infant feeding practices, TB screening, linkage to family
planning services, and linkage to HIV care and treatment services. The care package for the infant includes
administration of Cotrimoxazole to 10,949 HIV exposed infants starting six weeks and DBS for PCR-HIV for
Early infant diagnosis and will target 6,570 infants with this intervention. The program will strengthen
strategies to provide pediatric HIV treatment through collaboration with the HIV/AIDS treatment/ARV
services and/or provision of ART within the MCH where feasible. Additional strategies include provision of
HIV testing and counseling to sick children attending pediatric outpatient clinics and pediatric inpatient
wards. The program will wrap around other Child Survival activities for example immunization, growth
monitoring and Malaria prevention and treatment which all contribute to improved quality of life for the
infant. Other program activities include increasing access to HIV testing to family members of HIV infected
women through facility and home based Provider Initiated Counseling and Testing (PITC), strengthening
Prevention with Positives (PwP) in PMTCT settings and couple counseling to address primary HIV
prevention in PMTCT setting. The program will continue to consolidate other continuing strategies for
program uptake including using PLWA as peer counselors, mentor mothers and providing joint monthly
supervision with MOH staff, supporting continuing education for MOH staff and supporting the collection and
use of data at both facility and national levels. The program will also support the orientation of service
providers on the use of the national mother-child health record book, the PMTCT logistics tools and the
revised national PMTCT guidelines among other MoH tools.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
PMTCT activities in these districts will significantly contribute to PEPFAR goals for primary prevention and
care by contributing 8.5% of 2009 overall Emergency Plan CT PMTCT targets for Kenya and 12.8% of the
ARV PMTCT prophylaxis. This activity contributes to Kenya's Five-Year strategy of encouraging women,
their partners to know their HIV status and availing services to avert HIV infections among infants. It also
contributes to improved networks for pediatric ART.
Activity Narrative: 4. LINKS TO OTHER ACTIVITIES
This activity relates to KEMRI ARV Services in Nyanza, APHIA II ARV services in Nyanza, CDC TBD and
Columbia University ARV services in Central Province. This activity is most immediately linked to Palliative
Care and HIV/AIDS treatment/ARV services through the provision of ongoing care to the HIV-positive
woman in the ante-natal and post natal settings, care of the HIV exposed and infected infant in the post
natal period and appropriate referral to Pediatric HIV Care services.
5. POPULATIONS BEING TARGETED
This activity targets children (less than 5 years), adolescents aged 15-24 years, adults, people living with
HIV/AIDS, and pregnant women.
6. KEY LEGISLATIVE ISSUES ADDRESSED/ EMPHASIS AREAS
This activity will increase gender equity in HIV/AIDS programs through providing PMTCT of HIV services to
pregnant women and their partners; in-service training to build staff capacity, and wrap around program to
improve the health outcome of women accessing PMTCT services. The wrap around activities include
improved access to Family Planning services through staff training and support supervision, increased
access to malaria prevention and treatment services at the facility and community levels through the
provision of focused antenatal care and community mobilization, and safe mother hood through the
provision of focused antenatal care services.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14944
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14944 4146.08 HHS/Centers for Network of AIDS 6983 296.08 $2,000,000
Disease Control & Researchers in
Prevention East and Southern
Africa
7013 4146.07 HHS/Centers for Network of AIDS 4269 296.07 $1,780,000
4146 4146.06 HHS/Centers for Network of AIDS 3223 296.06 $600,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $81,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
