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: 2011 2012 2013 2014 2015
The National Blood Transfusion service, Kenya (NBTS) will contribute to prevention of medical transmission of HIV through provision of safe and adequate blood and blood components in all transfusing facilities in Kenya. It will work in collaboration with the Kenyan MOH, the U.S. Government in-country Emergency Plan team, and the HHS/CDC Kenya office to improve the breadth, scale, and quality of the Blood Safety program. This will be accomplished through mobilization of low-risk, voluntary non-remunerated blood donors; blood collection; transport through the cold chain; testing for transfusion transmissible infections (HIV, HBV, HCV, syphilis) at quality assured laboratories; processing of blood to components; establishment of national quality system, including guidelines, standard operating procedures, accurate records; monitoring and evaluation; distribution of blood and blood products to the health facilities; coordination and monitoring for appropriate clinical use of blood and outcomes of transfusion (hemovigilance) and the establishment of a comprehensive quality system covering the entire transfusion process, from donor recruitment to the follow-up of recipients of transfusion. NBTS will implement evidence based strategies to improve on program management and evaluation. In addition it will build the capacity of other indigenous organizations responsible for blood safety and transfusion services.
The NBTS will work to provide safe and adequate supply for blood in the country. This blood will be tested in a quality assured manner for HIV and other transfusion transmissible infections contributing to the prevention of medical transmission of HIV through blood. This will support the PEPFAR- Kenya partnership framework goals for HIV prevention. The partnership framework implementation plan is based on the Kenya National AIDS Strategic Plan-3 (KNASP-3). This plans targets to eliminate HIV medical transmission in health care settings in the next 3 years. Provision of safe blood free of HIV will be a major step towards achieving this goal.
The blood safety program will have a national coverage. The target population for blood donation is persons aged 16 and 65 years and at low risk for HIV and other transfusion transmissible infections Transfusions are given to the general population with one third going to children and another third to pregnant women for child birth related complications.
NBTS will build the capacity of the health care workers both in technical, managerial and administrative capacity. Provision of safe and adequate blood will lead to shortened hospital stays for patients resulting in cost-savings to the health system. This activity will also strengthen the laboratory capacity with equipment, quality systems and information management systems.
The NBTS mobilizes safe voluntary non remunerated donors from the general population. During mobilization campaigns AB HIV prevention as well as healthy lifestyle messages will be disseminated to the youth who are the majority of blood donors. Counseling and testing programs will educate and refer low risk HIV negative clients for possible blood donation. Donors who test HIV positive during routine donation process will be referred for care and treatment. Additionally they will be encouraged to take their partners for counseling and testing and enroll in prevention with positives programs (PWP).
NBTS will seek to establish government commitment, support and recognition as a separate unit with an adequate budget, necessary legislation, management team, and the formation of an organization with responsibility and authority for the BTS. It will foster development and implementation of a budgeting and finance system to ensure a sustainable blood program through cost recovery and/or annual budget allocation. ?It will also seek to work with public-private-partnerships to improve blood recruitment efforts. It will explore the best ways to be cost effective including using efficient systems in collection, testing and processing of blood. This will be done through improved financial management system, efficient automated blood testing systems and centralized testing of blood. An expanded safe blood donor pool will ensure collection of blood safe from HIV and other transfusion transmissible infections thus minimizing the cost of mobilizing new blood donors and of discarding blood from reactive donors.
Health Related Wrap-around issues
Improved access to safe and adequate blood especially in pediatric packs is important in improving child survival especially because some infant mortality is related to anemia due to malaria or other causes. Blood or red blood cells concentrate are important therapies in anemia caused by malaria which is a common complication. Adequate safe blood is critical in averting deaths related to childbirth-maternal hemorrhage is a major contributor to maternal mortality thus compromising safe motherhood
The NBTS consists of six regional blood transfusion centers (RBTC), which collect, process, test, and distribute blood, and nine satellite centers, which distribute blood to health facilities. The NBTS collaborates with three partners for mobilization of volunteer blood donors among high school, college and university students, community- and faith-based organizations, and adults in the work place. Other partners strengthen hospital transfusion practices; raise awareness on blood transfusion through media and offer technical assistance to NBTS.
Since 2004, PEPFAR complements Kenya Government efforts in achieving blood safety for the country. Support has led to development of policies, procurement of reagents and equipment; infrastructural support; collection, screening, processing and appropriate use of blood; training of health workers and strengthening of a monitoring and evaluation system. The PEPFAR Blood Safety program has collaborated with stakeholders such as JICA, WHO and Global Fund. However the JICA blood safety project ends in 2009 creating a potential gap in activities and funding.
NBTS collected 124,190 units in 2007 from voluntary non remunerated donors, 25% of whom were regular repeat donors. HIV prevalence among donors declined from 6% in 2000 to 1.4% in 2008.
Despite great progress in blood safety and sufficiency some challenges remain. Current blood collections are 3-4 units per 1000 population. (WHO recommends 10-20 per 1000 population). The Kenya AIDS Indicator Survey (KAIS), 2007 showed that about a third of blood is collected in hospitals from family replacement donors. This is an improvement from 2003 when 80% of the donors were family replacement. Sustainable funding for blood safety is lacking.
NBTS partners have created linkages with communities, student and local celebrities to raise awareness on blood donations. One of the partners has engaged public-private partnerships resulting in up to $100,000 raised annually from local corporations in support of donor recruitment. NBTS has developed a referral mechanism for HIV-positive donors for care and treatment and is also developing a plan where prevention, counseling and testing programs will educate their clients about blood donation. NBTS will work with partners to develop standard HIV prevention packages for blood donors to ensure positive lifestyles so that they remain negative and continue donating blood. NBTS will collaborate with the PEPFAR Injection Safety program for waste management. Procurement of testing supplies will be synergized with Global Fund procurement.
Activities will build on achievements of PEPFAR-1 and align to Kenya National Strategic Plan-3 and the partnership framework whose objectives are to eliminate medical transmission in healthcare settings with emphasis on blood safety. Blood Safety Policies will be reviewed and implemented. This will include transitioning of NBTS to semiautonomous status and implementation of a cost recovery plan for sustainability through funding from bilateral donors like Global Fund and public-private-partnerships. Innovative methods to reach a broader blood donor base will be implemented such as market segmentation, mass media, use of cellular phone short text messaging technology and support for Club-25 donor clubs. Blood donation messages will be disseminated through Prevention, Counseling & Testing programs for the general population but not in programs targeting the most at risk populations who may compromise blood safety. Quality of blood services will be improved, through enrollment in external quality assurance, establishment of quality management systems and a roadmap to achieve WHO accreditation of all NBTS blood banks. Service contracts will be made for the preventive maintenance of testing and processing equipment and incinerators. Additional Infectious Disease Testing equipment will be installed in a second region of the country. Internet based blood bank laboratory information system will be reinforced and linked to key health facilities to improve monitoring and evaluation. Linkages with care and treatment for referral of HIV positive clients and programs that use a lot of blood such as malaria and obstetric will be strengthened. Blood utilization will be strengthened through improved cold chain maintenance and support for 20 hospital transfusion committees. To improve equity and access to safe blood more satellite blood centers will be built and transport systems strengthened by procurement of durable vehicles able to withstand all terrains. To improve human capacity development specialized training in blood transfusion medicine will be supported for physicians at Emory University or equivalent while technologists will be sponsored to attend higher diploma training in Transfusion Science at the Kenya Medical Training College.
