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: 2010 2011 2012 2013 2014 2015
The blood safety project PEPFAR COP11, to support the Government of Lesotho to strengthen and expand safe Blood Transfusion Services will be the second year of cooperative agreement with HSS/CDC from 2010 to 2014, with a total potential value of $5,000,000. This support will improve collection, screening, storage and distribution of blood and blood products, access to safe blood throughout the country. The support includes, but not limited to, renovation and furnishing of regional blood banks, improving supply management, human resource, and national data management and information system.
The Ministry of Health and Social Welfare (MOHSW) is the responsible body for the Blood Transfusion Service in the country with regulatory, coordination and oversight roles in addition to its services. The Lesotho Blood Transfusion Service (LBTS), an integral part of the Central Laboratory of the MOHSW, supplies all of the nation's hospitals with safe blood through the recruitment, collection, screening, storage and distribution of blood. The MOHSW has improved the human resource for Lesotho Blood Transfusion Service (LBTS) with the support from PEPFAR for COP10. The two regional blood banks will be renovated and expected to be operational by December 2010.
There will be one national blood bank in Maseru and two regional blood banks, one in Mohale's Hoek and the other one in Motebang hospital Leribe. There is going to be one more mobile blood collection team adding to the one that has been the only one for the National blood bank. The second team will be for the regional centres. LBTS collects blood from voluntary non-remunerated blood donors who contribute 93 percent of the donations and 7 percent from family/replacement donors. Most of the clinics are from mobile clinics at secondary schools and colleges which accounts 60 percent of the collection. Other institutions contribute 10 percent while walk-in donors contribute about 30 percent. All donated bloods are screened for ABO and RhD grouping, HIV, HBV, HCV and Syphilis. LBTS is involved in WHO external quality assurance (EQA) scheme with National Institute for Communicable Diseases (NICD) for HIV, South African National Blood Service (SANBS) for blood grouping and National Health Laboratory Services (NHLS) South Africa for syphilis.
Currently, LBTS collects 1.4 units per 1000 population, which is far less than the WHO-recommended 10-20 per 1000 population. It has been has estimated that Lesotho requires approximately 10,000 units of blood annually. LBTS has limited infrastructure and organizational capacity to meet this clinical demand. The high prevalence of HIV in the country has also contributed ash also an impact in recruiting donors.
MOHSW in collaboration with partners has developed a national policy and a five year strategic plan for the national blood transfusion services. The goal of national blood transfusion services is to provide blood and blood products that are safe and adequate to meet the needs of all the patients in the countries. This goal is achieved through the education of population, recruitment of voluntary non-remunerated blood donors, screening and processing blood, establishing a quality management, and training health care providers and donors.
MOHSW through LBTS will lead and coordinate implementations in partnership PEPFAR, Millennium Challenge Account-Lesotho (MCA-L), WHO, and Safe blood for Africa (SBFA) for scale up blood collection and transfusion service through infrastructure capacity development, human resource development, and expanding quality management systems in BTS nationwide.
As part of strengthening the infrastructure of the blood transfusion services in the country, three blood banks (national and regional centers in Leribe and Mohale's Hoek districts) will be constructed and furnished. The MCA-L, in collaboration with the MOHSW will support the construction and furnishing of the central blood bank in Maseru. Through PEPFAR support, the blood transfusion services will be strengthened including staffing of central and regional blood transfusion service centers. Generic national and site-specific protocols for screening and processing of blood, logistics and supply chain management, equipment maintenance, waste disposal, record keeping; quality management will be developed . A system will be developed to maintain a network of blood donor recruiters and blood donor counselors, identify a network of low risk and repeat blood donors, and promote voluntary, non-remunerated regular blood donation.
The human resource will be strengthened by recruiting additional staff, training, developing retention schemes. Training programs and continuing education programs related to blood donor recruitment and blood collection will be provided to health care professionals involved with blood transfusion services throughout the country. Physicians, nurses and laboratory technicians will be trained in basic principles and practice of blood banking and transfusion medicine, including the rational utilization of blood.
M & E system that includes clear and actionable indicators such as the number of outreach and recruitment, the number of donors; repeat donors and the frequency of their donations; and the number of units of blood donated and screened will be developed and implemented. Tools will also monitor and evaluate the overall blood transfusion for planning and decision making process. The national data collection and information management system will also be established to ensure the traceability of donors, donated blood and transfusion recipients.
When fully functional, the regional centers are expected to augment the blood collection efforts in Maseru by providing 50 percent of the nation's blood needs. Regional centers will support collection of 4,500 units of blood between them and the mobile units assigned to each center. A fully operational and expanded blood transfusion service can meet the indeed targets and provided 10, 000 units of safe blood per annum to the health service. It will also play an important role in prevention of infections associated blood transfusion serves as well as providing counseling and testing services to all potential blood doors. PEPFAR through Partnership Framework represents an opportunity to support the LBTS and establish an integrated approach to blood safety in Lesotho with potential cross cutting benefits to many programs and make it sustainable.
In FY11, the national blood transfusion services will be strengthen through infrastructure capacity development, human resource development, and quality management systems. The following are major activities planned to be implemented.
1) The renovations will require the specialized physical conditions required by a blood banking facility, including a stand-by generator to ensure a constant supply of electricity.
2) Strengthening human resource
Staff will be trained in phlebotomy, counselling, donor recruitment, preparation of blood components, cold chain management, effective clinical use of blood and blood products, information management, quality assurance and leadership and management.
3) Improvement of the quality of services
Based on accepted international standards, generic national and site-specific protocols will be developed for blood screening; managing blood processing facilities; implementing quality assurance plan, documentation and reporting system, and disposal of medical waste. Perform quality control checks on operations to improve the services and safety standards. Policy and strategic plans will be reviewed.
4) Monitoring and evaluation (M&E) and information system
M&E tools will be developed and to used track donated units of blood, measure clinical outcomes and evaluate the overall blood transfusion for planning and decision making process. National data collection and information management system will be established to ensure the traceability of donors, donated blood and transfusion recipients. The national blood bank data base system will also be established.
