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
1. ACTIVITY DESCRIPTION AND EMPHASIS AREAS
This activity is a follow on to activities carried out by the POLICY project in FY 2006 which contributed
indirect results to the Palliative care area through activities with the Networks such as the Network of
People Living with HIV/AIDS in Kenya (NEPHAK) and the National Muslim Council of Kenya (NMCK).
Various problems impinge on service delivery in this area and include the following: a) Ineffective referral
linkages particularly between home and communities to institutional services compounded by weak
capacities amongst community groups and People Living with HIV/AIDS networks; and b) Gender
imbalances that lead to barriers to accessing care and treatment for women and girls because of i) their
vulnerability to HIV/AIDS due to poverty and low social status compounded by harmful traditional customs
and ii) the burden of care predominantly falling on women that sees them expend enormous costs in time,
energy and resources caring for sick parents, orphans and vulnerable children (OVC), running households
etc. This activity will seek to expand access to community based non-clinical palliative care and strengthen
the referral network for opportunistic infections (OIs) and tuberculosis (TB) treatment services. The activity
will train 680 individuals and establish 150 service outlets which will provide HIV-related palliative care and
reach 6,000 individuals with HIV related palliative care. This will be achieved through: strengthening the
capacity of People Living with HIV/AIDS (PLWHA), faith-based organizations (FBOs), teachers and people
with disabilities networks to provide palliative care in their communities through training and mentoring;
providing community-based care and support and linking adults and children to antiretroviral therapy
(ARVs), opportunistic infections (OIs) and tuberculosis (TB) treatment; providing technical assistance to
strengthen the traditional community structures to target the vulnerable and hard to reach women in HIV
prevention care and treatment; and, providing technical assistance to build the capacity of community
institutions in gender equity in home and community based care focusing on social transformation for
increased male involvement.
The main emphasis area for this program is development of network/linkages/referral systems and a minor
emphasis on local organization capacity development.
2. CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will contribute 2.4% to the overall target area of number of individuals provided with community-
based HIV-related palliative care by working with PLWHA and FBO networks.
3. LINKS TO OTHER ACTIVITIES
This activity relates to activities in System Strengthening and Policy Analysis and Orphans and Vulnerable
Children. This activity links to HPI's activities in: the program areas of Systems Strengthening and Policy
Analysis, that seek to enhance the capacity of local institutions and PLWHA networks; of OVC, working to
create a supportive social and policy environment for OVC and care givers to access basic services.
4. POPULATIONS BEING TARGETED
These activities target OVC, PLWHA and caregivers of OVC and PLWHA.
5. KEY LEGISLATIVE ISSUES ADDRESSED
The key legislative issue addressed is gender.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.08:
ACTIVITY UNCHANGED FROM COP 2008
The only changes to the program since approval in the 2007 COP are:
+ Prime partner is a TBD because Health Policy Initiative (HPI) Task Order 1 with Constella Futures has
reached its ceiling and therefore since the Health Policy Initiative mechanism is an IQC a new country task
order process will be issued for competitive selection of a partner to implement the activities.
1. ACTIVITY DESCRIPTION
TB remains a major cause of morbidity and mortality among the productive age groups and particularly
amongst HIV positive populations. Plus up funds were provided in FY07 for advocacy work particularly
amongst nascent networks of People Living with HIV and AIDS to be better advocates on TB/HIV issues at
the national level resulting in increased awareness of TB/HIV.
In Kenya it is appreciated that chronic coughers tend to be late in seeking diagnosis and treatment of their
coughs thus helping in the spread of TB. There is need therefore to address this knowledge gap with an
Advocacy, communication and social mobilization strategy. This will be done by working with the National
AIDS and STI Control Program (NASCOP), the National Leprosy and Tuberculosis Program (NLTP) and
other NGOs and FBOs to develop an appropriate comprehensive Advocacy, Communication and Social
Mobilization strategy and framework for action on TB. This strategy will also address an appropriate
communication strategy to disseminate TB/HIV interventions to the communities.
In addition to the above activities HPI will assist to implement the new TB/HIV guidelines facilitating the
process of dissemination of these guidelines.
This activity will contribute to TB/HIV advocacy in expanding access to prevention, care and treatment
services for the two diseases, especially during this time when more resistant TB variants are emerging in
many countries. This funding will enable the Health Policy Initiative to support nascent networks of people
living with HIV/ AIDS to be better advocates on TB/HIV issues at national level. The main outcome of these
activities will be increased awareness of TB/HIV at the national level.
This activity links to USAID-OHPS-HPI-TBD an activity that will continue building the capacity of PLWA
networks in various areas including advocacy for continued access to treatment, prevention and care and
support services; USAID-HBHC-HPI-TBD an activity that seeks to develop and disseminate a national non-
clinical palliative care policy and guideline; and USAID-HKID-HPI-TBD an activity working on building the
capacity of indigenous organizations to care for OVCs and also training experts on psychosocial support for
OVCs.
This activity will target: People living with HIV/AIDS via working with Networks of people living with HIV and
AIDS; the general population via working on the Advocacy, Communication and Social Mobilization
strategy.
5. EMPHASIS AREAS / KEY LEGISLATIVE ISSUES ADDRESSED
The emphasis area for this activity is local organization capacity building working to build the capacity of not
only networks of PLWAs on TB/HIV issues but also assisting the national TB program in developing a
comprehensive advocacy, communication and social mobilization strategy on TB.
New/Continuing Activity: Continuing Activity
Continuing Activity: 15010
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15010 12454.08 U.S. Agency for To Be Determined 7007 342.08 Health Policy
International Initiative
Development
12454 12454.07 U.S. Agency for The Futures 4286 342.07 Health Policy $50,000
International Group Initiative
Development International
Health-related Wraparound Programs
* TB
Table 3.3.12:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+ Prime partner will be competitively selected to implement the activity
+Activity will support expansion of services to address gender-based violence (GBV).
SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS
This activity will contribute $ 640,000 of its total budget towards human capacity development by building
the capacity of the department of children services in developing policies that safe guard the rights of the
OVC.
COP 2008
1. LIST OF RELATED ACTIVITIES
This activity relates to activities in Systems Strengthening and Policy Analysis (#7040), Palliative Care:
Basic Health Care and Support (#8863, #8867, #8928, #8929, #8931, #8934, #8936), TB/HIV (#9059,
#9062, #9065, #9066, #9068, #9069, #9072), CT (#8760, #8776, #8777, #8778, #8781, #8782, #8976) and
OP (#8874, #8927, #8930, #8932, #8937, #8942, #9040).
2. ACTIVITY DESCRIPTION
Various issues beleaguer OVC support in Kenya today and include the following: the government has a
National OVC response plan but it is yet to be operationalized; the Ministry of Home Affairs has taken on
increased responsibilities in mainstreaming OVC issues into its cores functions but lacks the requisite
technical and management capacity to deliver effectively; the need to build the capacity of communities and
PLWHA groups to promote women and OVC's access to services and property ownership; the need to link
OVC to available support like bursaries, psychosocial support and counseling services. This activity will
serve to ameliorate the above problems and result in creating a supportive social and policy environment for
OVC and caregivers to access basic services. This will be achieved through: providing technical assistance
to strengthen government systems and structures to enact OVC legislation and responsive laws and
support policy dialogue and advocacy on the protection of children's rights with the HIV/AIDS and OVC
networks; strengthening the technical and management capacity of the Ministry of Home Affairs (Children's
Department) to co-ordinate OVC policy implementation including monitoring and supervision; providing
technical assistance to strengthen legal and traditional community structures to promote OVC and women
access to essential services and property ownership under the Women Property Ownership and Inheritance
Rights (WPOIR) initiative; providing technical assistance and training to Kenya Network of Positive
Teachers (KENEPOTE), Parents-Teachers Associations (PTA) and caregivers to improve OVC access to
education and strengthen related psychosocial support; and, train and build the capacity of indigenous
CBOs/NGOs to scale-up and/or initiate new and sustainable programs on OVC psychological support
through small grants programs. In FY 09 activities will expand to include working with the Sexual Offences
Bill Task Force to address protection issues of OVC (both legal and physical). This will be done through
training of local community organizations, health providers, local religious leaders, prosecutors, magistrates
and local law enforcement officers. The Task Force will be strengthened to be able to disseminate the Bill
up to the grassroots.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
It is anticipated that in FY 2009 this activity will contribute to the indirect target of over 50,000
affected/infected OVC. This will be done through the dissemination and roll out of Sexual Offences Bill,
OVC Policy, dialogue and advocacy to community based, non-government and faith based organizations,
policy makers, community leaders, religious groups and various HIV/AIDS and OVC networks.
4. LINKS TO OTHER ACTIVITIES
This activity links to HPI's activities in: Systems Strengthening and Policy Analysis (#7040), that seek to
enhance the capacity of local institutions and PLWHA networks; Palliative care (#8863, #8867, #8928,
#8929, #8931, #8934, #8936) that expand access to community based non-clinical palliative care and
strengthen referral networks to OIs and TB medical treatment services; Counseling and Testing (#8760,
#8776, #8777, #8778, #8781, #8782, #8976) that enhances CT amongst people with disabilities (differently-
abled persons) and other prevention (#8874, #8927, #8930, #8932, #8937, #8942, #9040) that promotes
HIV/AIDS prevention amongst positives through other behavior change messages beyond abstinence and
being faithful by providing technical assistance to PLWHA networks to develop their own behavior change
messages.
5. POPULATIONS BEING TARGETED
This activity targets policy makers, community and religious leaders and Country coordinating mechanism.
It also targets people affected by HIV/AIDS and specifically orphans and vulnerable children and also
caregivers of OVC, widows and widowers.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity addresses issues related to gender increasing women's legal rights and access to services.
7. EMPHASIS AREAS
The main emphasis area for this activity is capacity of local organizations specifically the Children's
department in the Ministry of Gender, Children and Social Development and minor emphasis is community
mobilization/participation serving to increase the participation of PLWHA groups in caring for OVC.
Continuing Activity: 15011
15011 5104.08 U.S. Agency for To Be Determined 7007 342.08 Health Policy
7041 5104.07 U.S. Agency for The Futures 4286 342.07 Health Policy $1,300,000
5104 5104.06 U.S. Agency for The Futures 3232 342.06 POLICY Project $394,000
International Group
* Increasing women's access to income and productive resources
* Increasing women's legal rights
* Reducing violence and coercion
* Child Survival Activities
Estimated amount of funding that is planned for Human Capacity Development
Table 3.3.13:
+ Support for the formulation and implementation of the health sector financing strategy
+ Support to the Ministries of Health to help in the decentralization of health services
+ Support the Ministries of Health efforts to enhance their program and fiscal management efforts
• Prime partner is a TBD because Health Policy Initiative Task Order 1 with Constella Futures has reached
its ceiling and therefore since the mechanism is an IQC a new country task order process will be issued for
competitive selection of a partner to implement the activities.
• HPI will work to review, update and disseminate existing and the following new key policy and guidelines:
- the Gender Based Violence (GBV) advocacy strategy aimed at increasing awareness on GBV and reduce
women's vulnerability to HIV and AIDS; ART to incorporate emerging concerns relating to among others
2nd and 3rd line treatment, food and drug interaction, pediatric treatment and continuing education for
medical staff; and, RH/HIV integration policy that seeks to increase service uptake and promote
comprehensive service delivery.
• HPI will also work to implement the sexual offences act via enhancing the capacity of staff in the health
and justice sectors to correctly interpret and implement the act in the interest of the client.
• HPI will establish and strengthen four new PLHIV networks. These networks will be active in policy
advocacy seeking to enhance access to treatment, prevention, care and support services. These networks
will include the following: - tertiary and higher education staff infected and affected by HIV and AIDS;
Positive Health Care Workers Networks; Informal sector networks; and African Women of Faith Network.
• HPI will develop and strengthen an integrated policy process management system. This system will aim at
enhancing the facilitation, management, coordination and implementation roles of the government in the
policy process. This task will involve the establishment of a policy data base in the Ministry of Planning and
National Development and also a policy process management system and database at the Ministry of
Health.
• HPI will also develop and implement a strategic planning guide and costing framework for hospitals with
comprehensive care centers that aims at promoting evidence- based planning and management, better
articulation of priority interventions and better resource mobilization techniques for sustainability.
• HPI will also work with the informal sector assisting in the development of workplace HIV/AIDS policy.
1. LINKS TO RELATED ACTIVITIES
This activity relates to activities in Strategic Information (#9012), Palliative Care: Basic Health Care and
Support (#8823), Orphans and Vulnerable Children (#7041) and other System Strengthening activities
including (#8693).
In this program area, the Health Policy Initiative (HPI) will work in several distinct but related components,
as described below. 1) While Kenya continues to expand its HIV/AIDS care and support services, the
capacity of existing institutions and particularly the networks of people living with HIV/AIDS (PLWHA) are
fragmented, with poorly coordinated multi-sectoral responses, limited capacity to develop and implement
policies and programs for advocacy of stigma reduction; weak institutional structures for PLWHA networks
with high staff turnover; insufficient attention to gender, poverty and human rights issues; ineffective
leadership for community action; and limited engagement by PLWHA in the policy process. HPI will work in
this area to strengthen local institutions and networks such as the Kenya Network of Positive Teachers and
Educators (KENEPOTE), NEPHAK, a Muslim organization, UDPK, KENERELA, and KETAM for policy and
program implementation. HPI will also work closely with a TBD partner in this program area to develop
support groups for medical professionals living with HIV/AIDS. 2) In the policy arena, several issues have
been identified for support, including the need to disseminate user-friendly national policies to PLWHA and
other target groups; the lack of policies that pay attention to orphans and vulnerable children, food security
and safety nets; operational policy barriers that impede access to HIV treatment care and support; lack of
an appropriate index on stigma and discrimination activities; and an inadequate exchequer allocation to
HIV/AIDS due to lack of advocacy within the Medium Term Expenditure Framework (MTEF) process that
would provide increased allocations for HIV/AIDS. HPI will work on policy development, advocacy and
implementation, and also work to build the Government of Kenya's capacity to mobilize resources for
HIV/AIDS. Specifically, HPI will provide technical assistance to the National AIDS Control Council (NACC)
and the National AIDS, STI Control Program (NASCOP) to review, update and disseminate existing policies
to PLWHA networks and target groups. HPI will further provide technical assistance to NACC and Ministry
of Planning and National Development to mainstream HIV/AIDS into the MTEF budgeting and planning
process, as well as other areas of assistance that will be identified in close consultation with NACC. 3)
There is an identified need to increase the participation in the Sector Wide Approach to health programming
to include networks of faith based organizations (Inter-religious Consortium) and the private sector (Kenya
Private Sector Advisory Network); to strengthen the GFATM's country coordinating mechanism (CCM) and
AIDS-Interagency Coordinating Committee (AIDS-ICC) in accordance with the governance manual; and the
need to increase contributions by civil society organizations and other grass root level stakeholders in the
Joint AIDS Program Review (JAPR), all of which affect the MTEF planning and budgeting. In FY 2007, HPI
will continue to offer technical assistance to strengthen Global Fund activities by strengthening Civil Society
member organizations of the CCM. HPI will convene and facilitate FBOs, NGOs and private providers
involved in the planning and budgeting process, and provide technical assistance to NACC to promote the
participation by CSOs and other stakeholders at the grass-root level in the JAPR process. 4) In the stigma
and discrimination arena, HPI will field test the "USAID Interagency Working Group on Stigma &
Discrimination Indicators" questionnaire on measuring HIV/AIDS related stigma and discrimination. 5) In FY
2007, as part of PEPFAR's support to public private partnerships, HPI will also work closely with the Nairobi
Women's Hospital (NWH) Board of Directors to strengthen its capacity as a decision-making body, and to
help expand a vital resource, NWH's Gender Violence and Recovery Center (GVRC), to other parts of
Kenya. The GVRC offers counseling, treatment and support for women battling rape and gender violence.
Currently, GVRCs are located in Nairobi and Nyanza only. These activities will result in 4,000 individuals
trained in community mobilization, 150 individuals trained in institutional capacity building and also policy
development; and 1,800 individuals trained in stigma and discrimination reduction. In addition 15
Activity Narrative: organizations will benefit from institutional capacity building and 20 organizations' receive help in HIV-
related policy development.
System Strengthening activities under HPI contribute directly to building the management and leadership
abilities of indigenous organizations, fortifying the GFATM management structure, and to creating an active
and engaged policy environment surrounding issues of HIV/AIDS.
This activity links to HPI's activities in palliative care that expands access to community based non-clinical
palliative care and strengthens referral networks to OIs and TB medical treatment services; orphans and
vulnerable children working to create a supportive social and policy environment for OVC and care givers to
access basic services; counseling and testing that enhances CT among differently-abled persons; and other
prevention that promotes HIV/AIDS prevention amongst positives through other behavior change messages
beyond abstinence and being faithful by providing technical assistance to PLWHA networks to develop their
own behavior change messages.
This activity will target People Living with HIV/AIDS, HIV/AIDS affected families, caregivers of OVC and
PLWHA, host country government workers including policy makers, teachers, NACC staff and other MoH
staff including NASCOP. In addition the activities will target CBOs, FBOs, NGOs, and the CCM for the
GFATM.
HPI's activities will address issues related to gender, as well as stigma and discrimination.
Emphasis areas include local organization capacity building, policy and guidelines, and community
mobilization and participation. The Health Policy Initiative (HPI) Kenya office has been a key partner in
PEPFAR/Kenya's groundbreaking work in supporting networks of People Living with HIV/AIDS (PLWHA). In
addition to support for a single inclusive national network, HPI has provided critical organizational and
capacity building support to networks of HIV-positive educators, religious leaders, persons with disabilities,
and Muslim women. These networks are increasingly proving their effectiveness in elevating the level of
policy dialogue between providers and recipients of services as well as holding providers, donors and the
host government accountable for results and transparency. ($50,000) On a separate project, HPI will also
work closely with National AIDS Control Council (NACC) to continue strengthening its ability to coordinate
AIDS programming in Kenya. Funds will also assist with costs of relocation and establishment of more user-
friendly offices for NACC ($200,000).
Continuing Activity: 15012
15012 7040.08 U.S. Agency for To Be Determined 7007 342.08 Health Policy
Table 3.3.18:
