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
ACTIVITY UNCHANGED FROM COP 2008
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.
1. LIST OF RELATED ACTIVITIES
This activity relates to activities in Counseling and Testing, Palliative Care: TB/HIV, and HIV/AIDS
Treatment: ARV Services.
2. ACTIVITY DESCRIPTION
The IMC umbrella will support and fund the Uniformed Services Project (USP) to implement PMTCT
services in the non-military Uniformed Services. These comprise of the Prison Services (KPS), National
Youth Service (NYS), Kenya Police Department (KPD), Kenya Wildlife Services (KWS), and Administration
Police (AP). With Emergency Plan funding, KEMRI U/S project has been supporting implementation of
PMTCT activities in the non-military Uniformed Services as part of the HIV/AIDS program. This was done
through training of service providers, minor infrastructure renovations, logistics supply, and management
and technical assistance. These services have many similarities; the young men and women working there
often serve away from their homes and are thus vulnerable to risky sexual behaviors. The various camps
and stations have significant numbers of young families. Health services in these camps are also accessed
by the surrounding civilian communities who benefit from the PMTCT services. In 2009 COP, the IMC
umbrella will continue supporting KPS and NYS, and AP and the non-military Uniformed Services, with the
following objectives: (i) increase access to quality PMTCT services to both members of staff, families and
neighboring communities, (ii) integrate quality PMTCT service into routine maternal and child health
services, (iii) increase awareness, benefits and availability of PMTCT services within the selected sites. CT
services will be offered to 1,500 pregnant women and will target to provide a complete course of ARV
prophylaxis to 90 HIV-positive pregnant women and all 90 exposed infants. All HIV-positive pregnant
women will have WHO clinical staging and CD4 cell count test to determine the appropriate ARV
prophylaxis as outlined in the National PMTCT guidelines. Postnatal care and follow up of all HIV-positive
women and their infants will be strengthened. The care package for the mothers will include regular follow
up, linkage to family planning services, OI prophylaxis and counseling on correct infant feeding practices;
while infant additional care activities will include OI prophylaxis using Cotrimoxazole starting at six weeks of
age, and DBS for HIV- PCR (Early Infant HIV Diagnosis-EID). The program will target 90 for DBS and will
link all infants with an HIV +ve PCR test result to the ART program (for initiation of ART within the Pediatric
ART program). The program will also encourage male partner HIV testing as well as male involvement and
support and will target to reach 20 men. The program will also support the training of 30 service providers
on PMTCT.
3. CONTRIBUTIONS TO OVERALL PROGRAM AREA
The planned activities will improve equity in access to HIV prevention and care services to the uniformed
services under "Special Population" category. These activities will contribute to the result of increased
access by pregnant women and their families to HIV counseling and testing services, and those identified
as HIV infected will be referred for care and treatment.
4. LINKS TO OTHER ACTIVITIES
This activity relates to IMC Umbrella U/S ARV services program, PATH U/S counseling and testing and IMC
Umbrella U/S TB/HIV services. Linkages between PMTCT service and care outlets will be strengthened to
improve utilization of care opportunities created through PEPFAR funding.
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. EMPHASIS AREAS/KEY LEGISLATIVE ISSUES ADDRESSED
This activity will increase gender equity in programming through PMTCT services targeted to pregnant
women and their male sexual partners. Identifying the women through PMTCT will give them an opportunity
to access care, improve pregnancy outcomes, and access services for their partners and family members.
Other emphasis areas include in service training, and wrap around health programs to include Family
Planning, Malaria (PMI) and safe motherhood through the provision of comprehensive PMTCT care
package at the maternal and child health facilities. The activity also targets "Military Personnel" as the
program aims to provide services to the Uniformed Services, their families and surrounding community
members.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Health-related Wraparound Programs
* Family Planning
* Safe Motherhood
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $10,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
1. ACTIVITY DESCRIPTION & EMPHASIS AREA
In FY 2008, the Prisons program was supported thru the KEMRI cooperative agreement (CoAG) and
managed to introduce the Men As Partners Program in the Prison Training college for new recruits. Each
year, the Kenya Prisons services recruits nearly 2000 young men and women aged 18-24. Most of these
young people are out-of- school youth. Due to the nature of their jobs and age, the prisons personnel are in
high risk of acquiring STIs and HIV. The spouses and children of Prison staff are equally at risk of acquiring
HIV. The activity aims at identifying adolescent children of staff and the recruits at the entry point of their
uniformed careers and targeting specific behaviors that are consistent with ensuring prevention of HIV.
Efforts to build skills of young people and communication for their parents through the "Families Mater
Initiative" will be strengthened in view of protecting young people from HIV acquisition. The program will
also address pervasive gender stereotypes and male behaviors that are relevant to prison services
personnel. Due to the wide distribution of Kenya Prison services installations, the program will train peer
educators to promote abstinence and faithful programs. During the FY05/06 period the Kenya Prisons
Services Chaplains were trained on Behavior Change Communication and Pastoral counseling including
HIV counseling and Testing. This initiative will be supported to enable the chaplains reach many Prisons
personnel, their spouses and children with behavior change communication and HIV education, counseling
and information during their routine interaction with the Prisons Population including the prisoners. The
major emphasis of the AB component of the program will contribute to the outcome of changed social
norms to promote HIV prevention behaviors among the youth who constitute a part of the population highly
vulnerable to HIV infection. This will ensure larger numbers are reached with HIV prevention efforts and
adults become actively involved as supportive mentors for youth. A total of 43,000 individuals will be
reached with messages that promote HIV prevention through Abstinence and/or Being Faithful while 299
will be trained.
2. CONTRIBUTIONS TO OVERALL PROGRAM AREA
AB activities within the Prisons Services Program will contribute to FY09 prevention targets for Kenya,
especially among young recruits who are entering the Kenya Prison Services. The activities will also focus
on the youthful dependants within the Prisons and young people living within their neighborhood of the
Prisons in order to address the prevention needs of the whole Kenya Prison services.
3. LINKS TO OTHER ACTIVITIES
This activity is linked to the Counseling and testing activity by promoting VCT services as a way of
promoting secondary abstinence. The activity also links to the Condoms and Other Prevention activities by
offering comprehensive prevention messages for the non-military community.
4. POPULATIONS BEING TARGETED
This activity targets young adults and adolescents, both men and women in reproductive age. It will have a
special focus on the Prisons personnel who, due to the nature of their duties are vulnerable to HIV
transmission. Particular emphasis will be placed on young prison recruits and young dependants of prison
staff residing inside the prison camps as well as young people living in the neighborhood of the prison
camps.
Workplace Programs
Table 3.3.02:
1. ACTIVITY DESCRIPTION AND EMPHASIS AREAS
This activity involves promotion of correct and consistent use of condoms among the Kenya Prison Service
Personnel who are most at risk of HIV infection and who engage in high risk behaviors. Proper condom
supply channels will be put in place to ensure availability in all the Kenya Prison Services camps;
strategically placed for easy access by staff and members of neighborhood communities country-wide.
Regular monitoring of condom utilization will be done through a requirement for all units to file reports on
both male and female condom use on monthly basis. Since the law doesn't permit provision of condoms to
high-risk incarcerated persons, appropriate HIV information and education of acquisition/transmission, and
role of condom in prevention of HIV will be provided to prisoners. Education on most efficacious
habits/methods of HIV transmission, including IDU and unsafe sexual practices will be done. Another aspect
will target the young prison recruits, who number nearly 2000 annually. Most of these young people are out-
of- school youth. They will be targeted in the focused program referred as "Men As Partners" in their training
colleges/institutions to strengthen behavior change and address gender norms and stereotypes that put
them at risk of HIV acquisition. Uniformed instructors/staff will be trained as Trainers of Trainers (TOT) to
educate all recruits on all aspects educate all recruits on all aspects of comprehensive HIV prevention
including risks of cross generational sex, multiple concurrent partnerships, male involvement on gender
based violence, benefits and risks of Male circumcision and encouragement to knowing ones HIV status as
well as the partners status. Links will be established to promote Prevention with Positives (PWP) activities.
These activities will result in reaching 87,234 individuals with HIV prevention information, training of 259
staff as well as establishing 235 condom outlets.
2. CONTRIBUTION TO OVERALL PROGRAM AREA
OP activities within the Kenya Prison Services will contribute to the overall Emergency plan for COP 2009
prevention targets for Kenya. This activity contributes to Kenya's Strategic emphasis of reducing the risk of
HIV transmission among young people. The Kenya Prisons Service will integrate their OP program with
other sexually transmitted infection (STI) clinics and reproductive health clinics at the various health facilities
within the prisons.
This activity is linked to CT activity targeting to serve Kenya Prisons services personnel and prisoners since
all OP activities will at all times encourage routine counseling and testing among the Kenya Prisons Service
community. This OP activity is also linked to Kenya Prisons Service AB activity by partnering with other
activities that promote prevention among the youth of the Prisons community. Persons requiring HIV care
and treatment will be served under the HBHC and HTXS activity.
4. POPULATION BEING TARGETED
The OP activities will reach the most at risk population by targeting the Kenya Prison Services personnel,
discordant couples and prisoners. It will also reach the civilian population living and working in the Kenya
Prison Services work places and also the host population living in the Kenya Prison Services neighborhood.
Medical personnel working in these Prisons Health services will also be targeted for appropriate training.
HIV/AIDS affected families and inmates PLWHA will be a target for positive prevention services.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14890
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14890 5064.08 HHS/Centers for Kenya Medical 6966 5093.08 Prisons Project $102,500
Disease Control & Research Institute
Prevention
9228 5064.07 HHS/Centers for Kenya Medical 5093 5093.07 Prisons Project $205,000
5064 5064.06 HHS/Centers for Kenya Medical 3263 1246.06 Uniformed $70,000
Disease Control & Research Institute Services Project
Table 3.3.03:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS FROM COP 2008:
+ New activity emphasis on prevention with positives among patients coming for care and treatment
services.
COP 2008
This activity relates to activities in Adult ARV Services, Counseling and Testing, TB/HIV, and PMTCT.
2. ACTIVITY DESCRIPTION.
The adult care and treatment activities within the Kenya prisons were formerly implemented by Kenya
Medical Research Institute (KEMRI) in collaboration with the Kenya Uniformed Services Program (USP). In
2008 International Medical Corps (IMC) in consortium with Catholic Relief Services (CRS) and Legal
Resources Foundation (LRF), will initiate these activities and by September 2010 provide basic health care
and support to over 600 HIV-positive service personnel, their dependents, prisoners and surrounding
communities at 20 clinic sites all over Kenya. Additionally, 30 individuals will receive training in the provision
of HIV care services. Activities will focus upon improving the quality of life of Kenya Prisons Service
personnel, their families, prisoners and surrounding communities infected with HIV and needing care. In
addition, IMC will provide basic health care, in line with the national guidelines which includes;
cotrimoxazole prophylaxis for prevention of opportunistic infections, treatment of opportunistic infections and
psychosocial support. Prevention of spread of HIV from those infected will also be emphasized. These
centers are already providing HIV/TB clinical care for staff, prisoners and the local populations. Referral
systems and networking will be developed to ensure care. IMC will manage data on people served and will
report both nationally and through Emergency plan. Over 22,000 people are targeted to receive HIV
counseling and testing services within these populations in 2009, with an anticipated 600 (3%) HIV infected
individuals to be offered care services. An appropriate referral system will be developed to refer non-
prisoners to the Ministry of Health or other approved health facilities for HIV/AIDS care and treatment. A
follow-up network system will also be developed to cover transferred staff as well as inmates on drug
therapy who get discharged from prison.
3. CONTRIBUTION TO OVERALL PROGRAM AREA.
These activities will contribute to the expansion of care services for HIV infected individuals among special
populations, strengthen human resource capacity to deliver care services, and strengthen referral networks
for the provision of HIV services.
4. LINKS TO OTHER ACTIVITIES These activities will link closely with counseling and testing services,
PMTCT, ARV services and TB/HIV.
The target populations for this activity are HIV-infected prisoners, prison staff, their families, and residents in
the neighborhoods where prisons are located. The activity also targets public health workers.
6. KEY LEGISLATIVE ISSUES ADDRESSED
This activity addresses legislative issues related to stigma and discrimination through community
sensitization activities.
7. EMPHASIS AREAS This activity include minor emphasis in workplace programs, training, commodity
procurement, logistics, development of networks, infrastructure, quality assurance and supportive
supervision, and strategic information.
Continuing Activity: 21406
21406 21406.08 U.S. Agency for Pathfinder 9253 9253.08 APHIA II - $385,000
International International Nairobi
Development
Table 3.3.08:
IMC has been awarded this cooperative agreement that was previously supported through KEMRI.
This activity relates to activities in Adult/Pediatric Care and support, Counseling and Testing, TB/HIV, and
PMTCT.
The HIV treatment activities within the Kenya prisons were formerly implemented by Kenya Medical
Research Institute (KEMRI) in collaboration with the Kenya Uniformed Services Program (USP). In 2008,
International Medical Corps (IMC) in consortium with Catholic Relief Services (CRS) and Legal Resources
Foundation (LRF), will, support the provision of antiretroviral treatment (ART) to 300 HIV-infected service
personnel, their dependents, prisoners and surrounding communities including 100 new patients. This will
bring the total of patients ever provided with services to 400 at 4 clinic sites. Additionally, 30 health care
workers will receive ART training according to the national guidelines. This program will build upon
established services including HIV/TB diagnostic counseling and testing and provision of non-ART care
(e.g., treatment of opportunistic infections, psychological and spiritual support, etc.). The Prison Services
health facilities offer services to their staff, the local communities as well as prison inmates. These groups
will all be targeted by this program. Antiretroviral (ARVs) drugs will be provided at the sites through the
Kenya Medical Supplies Agency (KEMSA) and Mission for Essential Drugs and Supplies (MEDS). Funds
will also be used to provide training for 30 health care workers; and support the procurement of necessary
equipment and supplies, such as test kits, laboratory reagents, and drugs for prevention and treatment of
opportunistic infections. The Prisons Service Program will manage data on the people served and will report
both nationally and through Emergency Plan. The Kenya Prison Services have had a longstanding
collaboration with U.S. government agencies in Kenya. This collaboration has resulted in effective VCT and
PMTCT services and establishment of both non-ARV and ARV treatment services with a special emphasis
on provision of integrated TB/HIV services. The transfer and release of prison inmates is frequent and there
is a need to introduce mechanisms for follow-up care, and support for such prisoners, to ensure adherence
to ARV and TB treatment.
These activities will contribute to the expansion of ARV treatment for clinically qualified HIV-positive
patients, strengthened human resource capacity to deliver ARV treatment and an improved referral network
for provision of ARV treatment.
This activity relates to activities in Palliative Care, Counseling and Testing, TB/HIV, and PMTCT.
The target population for this activity is HIV-infected prisoners, prison staff and their families, and residents
in the neighborhoods where prisons are located.
7. EMPHASIS AREAS
This activity includes minor emphases on commodity procurement, development of referrals, logistics,
human resources and training and quality assurance, supportive supervision as well as strategic information
and workplace programs.
Table 3.3.09:
This activity relates to activities in CT, Palliative Care: Basic Health Care and Support and ARV Treatment
and PMTCT.
2008, International Medical Corps (IMC) in consortium with Catholic Relief Services (CRS) and Legal
Resources Foundation (LRF) will support TB/HIV services in prisons. Activities include TB screening for
5000 HIV patients and HIV screening for 1200 TB suspects/patients will be offered as a standard of care in
all the facilities; approximately 600 patients will be identified as being infected with both TB and HIV. TB and
AIDS are the leading causes of deaths in overcrowded Kenyan prisons, where the majority of prisoners
remain underserved. Failure to contain TB and HIV in the prisons is also a failure to contain TB and HIV in
the civilian population from which the prisoners come from and to which they are released. Controlling
TB/HIV in the prisons is one of the priorities of the Government of Kenya and constitutes a multi-faceted
reform agenda that is being implemented to decongest and improve prison living conditions. In partnership
with the Division of Leprosy, TB and Lung Disease (DLTLD) and Kenya Prisons Services (KPS), IMC will
coordinate a phased support for collaborative TB/HIV services in the prisons. This activity will leverage
additional support through partnerships with other programs and with other donor agencies, such as WHO
and the Futures Group.
In FY 2007, USG supported KPS and the DLTLD to develop a new medical tool for screening new inmates
for TB, HIV and other medical conditions. This tool will be used to monitor the scope and trend of diseases
new inmates come-in with and/or acquire during their incarceration. FY 2009 activities will focus on
additional investment in prisons' TB/HIV infrastructure and human resource capacity. These efforts, which
also support antiretroviral treatment (ART) services in selected prisons, will be strengthened and expanded
through partnerships with other programs. Positive prevention activities will also be initiated and expanded
at selected prison sites. The key TB/HIV activities that target the inmates, prison staff and host
communities alike include: expanded HIV testing of TB patients/ suspects for HIV, screening HIV-infected
persons for TB, ensuring that symptomatic patients access TB diagnostic services, and those with
confirmed disease receive TB treatment and are reported to the NLTP, providing HIV-infected TB patients
with additional care (cotrimoxazole, ART), risk reduction counseling and psycho-social support, training of
prison health workers to build capacity to deliver TB/HIV services, and supporting infrastructure and supply
of HIV test kits and medicines.
These activities will result in strengthened capacity to deliver integrated HIV and TB services in the Kenya
prisons, including strengthened referral systems, improved diagnostics and treatment of TB among HIV-
positive patients and of HIV in TB patients, strengthened capacity of health workers to provide integrated
HIV and TB services and strengthened systems capacity for program monitoring and evaluation and
management of commodities.
These TB/HIV activities will be linked to ongoing VCT, PMTCT, STI and ARV treatment services in some
prisons and will be mainstreamed into the national network of services coordinated by the NLTP and
NASCOP and supported by KEMRI , Kenya Prisons Services, PLWHA organizations and other partners.
TB suspects and PLWHA among all prisoners, prison staff and host communities.
Diagnostic HIV testing for all TB patients will be on an "opt out" principle. Guidelines on HIV testing based
on consent, confidentiality and counseling will be observed as part of standard practice. Increased
availability of counseling and testing in the prisons and increased access to HIV care for TB patients will
help reduce stigma and discrimination. This program serves the needs and rights of prisoners as a special
risk population
Emphasis areas include commodity procurement, development of network/linkages/referral systems, IEC,
infrastructure, local organization capacity development, quality assurance, supportive supervision, and
training.
Table 3.3.12:
1. ACTIVITY DESCRIPTION & EMPHASIS AREAS
Kenya Prison Services received support from the Emergency Plan to implement a comprehensive HIV/AIDS
program since FY 2005. These activities have previously been supported thru the KEMRI CoAg. In FY09
this program will be supported by International Medical Corps (IMC). One of the key components of this
program is HIV testing and counseling (HTC), which is required, both for prevention and for ensuring access
to care. Prison Population, including the prisoners, can be classified as high-risk, given that they often travel
far away from their families and live in congregate settings respectively. A comprehensive HIV/AIDS
program, including HTC is therefore essential in the Prison Population. In FY 09 Kenya Prisons will expand
its HTC activities in both the static sites and through community and mobile (outreach) activities. Old
operational sites will be maintained while 4 new VCT sites will be created. Core activities will include
training and continued support to the existing VCT sites and counselors, introducing them to new
counseling protocol especially PITC approach. By so doing Prisons will have adequate capacity to provide
CT to an additional estimated 20,000 people, including Prison Staff and their dependants, Prisoners, civilian
employees, and the general population living in the neighborhood. All those who test HIV positive will be
referred to the nearest Prison clinics for care. In terms of training, 200 people (mostly health care workers
and lay counselors) will be trained and retrained in Provider-Initiated Testing and Counseling (PITC), lay
counselors including PLWHA will be trained in VCT .In FY 2009, the Prison program will intensify mobile
VCT services targeting the distant prisons with no fixed site in all regions in Kenya (Nairobi, Central, Rift
Valley and Coast). In addition, greater involvement of people living with HIV/AIDS (GIPA) will be sought and
encouraged as one of the ways of reducing the stigma associated with CT and by formation of Post test
clubs in major prisons. Quality assurance (QA) for both counseling and testing will be expanded to cope
with increased service uptake during the planned scale up in FY 2009. The QA program will be done in
keeping with national and international standards. QA for counseling will involve monthly support
supervision to practicing counselors.
Kenya Prisons CT program will contribute to the overall national CT target by providing CT services to the
Prison Officers and their dependants and also the inmates which are a special high risk population, as well
as civilians living in the neighborhood of prisons. The mobile VCT services will improve access to HIV
prevention and care services in remote areas that do not have fixed VCT sites, thus ensuring better access
to CT services and contributing to universal access. This activity will also contribute substantively to
Kenya's 5-year strategy that emphasizes universal knowledge of HIV status amongst Kenyans. Links
between CT services and medical sites where AIDS care and treatment are available.
This activity is part of a comprehensive HIV care and treatment program within the Prisons program and it is
linked to other services such as AB, OP, TB/HIV and ART. Linkages between CT services and care outlets
will be harmonized and strengthened to improve utilization of care opportunities in the Kenya Prison Service
health infrastructure through PEPFAR funding.
This activity will mainly target the Kenya Prisons personnel, their dependants, the inmates and members of
the general public in the immediate neighborhoods. The Prisons Health facilities and VCT sites are open to
the general public and are popular health service delivery points for the surrounding communities. New sites
will include facilities with large populations and will be placed strategically to optimize service delivery, either
to the prisoners or the Staff/civilians in the neighborhoods.
5. SECONDARY CROSS-CUTTING BUDGET ATTRIBUTIONS
There are no secondary cross-cutting budget attributions for this activity.
Table 3.3.14:
