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.
The main objective of this programme is to provide improved and expanded equitable access to quality basic health services for all through the deployment of medical personnel as volunteers. This will also strengthen capacity to sustain universal access to HIV prevention, treatment, care and support with a specific focus on Maternal and Child Health and PMTCT. International volunteer specialists will be placed in different health facilities in Lesotho to provide improved medical services to the local population and to build capacity to ensure the continued delivery of quality medical care after the volunteer placement has ended.
The human resource crisis forms a major concern for the Government of Lesotho (GoL) and especially for health service provision in the Kingdom. A large number of trained clinical staff is being lost to South Africa and overseas countries while the demand for health services is ever increasing partly due to the HIV&AIDS pandemic.
Within the context of the short-term Emergency Human Resource Plan, this joint programme has been developed in close collaboration with WHO, UNDP and UNV with the objective of supporting the GoL by deploying Medical Doctors for the provision of health care services at different levels of the health care system. The proposed programme will be complementary to several other programmes (see below). Given that these programmes will not deliver immediate results, it is imperative that a stop-gap measure is designed to make qualified medical staff available to ensure adequate delivery of health services in the short- to medium- term.
Qualified doctors are sourced globally through the UNV roster and will serve in country for a minimum of two years. The partnership with the Ministry of Health and Social Welfare (MoHSW) has led to an efficient management structure for placement of UNV medical doctors. The recruitment process has been significantly shortened by 1) by-passing of the required procedures for face-to-face interview by the Public Service Commission and 2) agreement with MoHSW to conduct telephone interview for the doctors with verification of identity and qualifications done at the country of origin through the local UN office. This has significantly reduced the deployment lead time which is one of the main challenges for the health system in Lesotho. Training, accommodation and logistical arrangements for the doctors have also been agreed with the MoHSW.
Efforts and benefits brought about by this project will be sustained through the following strategies:
The continuing fellowship programme implemented under the WHO for training various health professionals - medical doctors and other health professionals. This will build up the number of trained professionals to complement the national health workforce. Results of this programme will only be visible after completion of the training, as each batch of medical staff will require a minimum of 5 years training before qualification.
GoL has initiated a programme of training doctors abroad with an annual intake of 20 students per year. The first batch of qualified doctors is expected to join the national workforce in the last year of the implementation of this project. This should facilitate a smooth transition from the UNV Medical doctors to the nationals.
GoL is also establishing a Medical School which will be able to take over the training of doctors from the above-mentioned programme in a more sustainable matter. It is envisioned that in 2 to 3 years the overseas programme will be limited to pre-clinical training.
Boston University has initiated the Family Residence Programme, which is being implemented in two districts. While this programme is in its first year of implementation, it is hoped that it will attract more Basotho who will undergo a training programme in Medicine while they are in the service. When qualified, they will be assimilated into the stream of doctors to be assigned to different parts of the country.
The Emergency Human Resource Plan intends to double the production of trained health professionals from the local training institutions. A larger pool of trained health personnel of different cadres will impact positively during the departure of the UNV Medical doctors.
Baylor and Clinton Foundation also have ongoing mentoring programmes to improve health service delivery. The improved capacity of those involved in the mentoring programme will support continuity of the results from this project.
It is, therefore, imperative that the UNV programme is seen as a bridging arrangement designed to cover the first years during which no or limited qualified staff will become available through the above mentioned programmes. As such, in a complementary fashion with the other programmes, the UNV programme will, in a sustainable manner, ensure that qualified medical staff is made available to Lesotho throughout the coming years.
The second objective of the UNV programme is to build the capacity of in-situ medical staff through quality supervision, peer- and on-the-job training. It is expected that these activities will take place during the entire placement of the UNV Medical doctors. The length of the programme (i.e. 4 years) will allow for sufficient and continued training opportunities which, in turn, will ensure sustainable results.
The current budget for the UNV programme is directly linked to the main objectives outlined in the mechanism narrative.
Output 1 - High quality medical care provided in the beneficiary health facilities over the project duration
Of the present funded budget, 82% is linked to the allowance structure of the doctors (pro-forma costs for a doctor is USD 65,174 per year). Other budget items under this first output are the upgrading of the accommodation for those doctors serving in Maseru (all other accommodation will be provided through MoHSW) and monies related to orientation training and continued sharing of experience of the doctors in the different districts.
Output 2 - Junior doctors and nursing personnel in the beneficiary health facilities given on the job training and supervision
Budget lines under this output are linked to the development and dissemination of training material.
In addition to the budget lines associated with these major outputs, several cross-cutting budget lines are introduced for Communication material on the programme and its achievements, Evaluation & Audits as part of a comprehensive monitoring and evaluation framework and Support costs for the UN agencies involved to compensate for the time commitment of various professional and support staff in the selection, deployment and management of the volunteer doctors.
