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.
PEPFAR's blood safety technical assistance project is a cooperative agreement awarded by HHS/CDC from 2007 to 2011, with a total potential value of Redacted. Through the partner, support has been provided to strengthen Lesotho blood transfusion services (LBTS), which include strategic planning, policy development and implementation, quality improvement in blood screening and processing, blood donor management, clinical use of blood, training and M &E.
Blood transfusion can be life saving, and expedites recovery in many illnesses. Blood transfusion is an essential part of modern health care delivery, and directly supports several Millennium Development Goals. However transfusion may be associated with complications and carries the risk of transmission transmissible infections (TTI's). These TTI's include diseases of immense public health importance such as HIV and hepatitis. Blood services require financial and human resources which are scarce in developing countries. PEPFAR supports Blood Safety through Biomedical HIV prevention, and enables improvement through key activity objectives. The PEPFAR program in Lesotho aims to address human resource capacity, policy and infrastructure challenges experienced by the LBTS by providing training and technical assistance for a strengthened and sustainable service which contributes directly to the health system. Lesotho's health services are compromised by a chronic shortage of safe blood. LBTS collects just over 3000 units of blood annually, falling far short of the most conservative estimated need for blood in Lesotho of 10 000 units. The most important single reason for an inability to meet this clinical demand is inadequate capacity in the service. Together with the high prevalence of HIV, it is extremely challenging to access a safe and adequate supply. Despite external funding for health issues in the country, LBTS has received little support for its essential service to date. A fully capacitated LBTS which provides the target of 10 000 units of safe blood per annum to the health service represents at least 10,000 counseling and testing interactions (specifically for potential blood donors) per year. Although less than the WHO recommended figure for a country of Lesotho's population size, this target is appropriate for the current status of health services in Lesotho.
Through PEFPAR, the partner will support development of LBTS. Specialist training staff will provide advocacy, donor management training, quality systems training and mentorship in LBTS and in hospital blood banks. It will also facilitate access to the skills resources of the above mentioned services.
PEPFAR 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. Links to Lesotho PEPFAR framework exist in the areas of HIV reduction through increased blood safety and in patient care through provision of an adequate and safe blood supply, and is a critical treatment adjunct to manage HIV related anemia since up to 70% of all patients with HIV develop anemia. LBTS is well positioned to support the adult and pediatric ARV treatment programs, maternal health, counseling and testing, and health care infrastructure, as well as HIV prevention through biomedical prevention. The need to develop human capacity and train highly specialized staff requires skills which extend beyond the scope of routine laboratory services, and therefore requires specialist training and dedicated technical assistance. The overall goal of PEPFAR support is to ensure availability of a safe and adequate blood supply and to promote the development of LBTS, aligned with international norms and standards of best practice. This entails: 1. Health System Strengthening: the implementation of a (revised) national blood policy and supporting legislation 2. Blood Donor Management: the collection of blood from regular, low risk, voluntary non-remunerated donors 3. Laboratory: effective and universal screening for HIV, hepatitis B and C and syphilis, with appropriate storage, processing and distribution of blood and blood products 4. Appropriate Clinical Use of Blood: development of transfusion guidelines, monitoring demand and optimizing prescribing practices and transfusion outcomes through continuing medical education and hemovigilance program. 5. Training: in-service training and mentorship of blood service and hospital personnel 6. Strengthening "Club 25: PEFPAR will support a youth blood donor club for voluntary non-remunerated blood donators (VNRBD) for promoting HIV prevention through peer support, safe lifestyles and regular counseling and testing for blood donors. 7. Monitoring & Evaluation: to measure performance using PEPFAR blood safety indicators, and progress toward meeting objectives and implementing best practice systems, including exploration of Information Management Systems 8. Sustainability: to ensure continuity after PEPFAR through adequate capacity and ensuring Lesotho MOHSW commitment and support. Among other strategies, this will need to be achieved by accurate costing of blood and blood products, and demonstrating cost efficiency.
The technical assistance to be provided will be cost effective because the national blood program will improve blood utilization in clinical environments and utilization of resources through improved quality management. Moreover, it will reduce patient mortality and cost of care through shorter hospital stays, and fewer cross border referrals for access to blood and blood products.
The primary objective to achieve a safe and adequate supply of blood for Lesotho's clinical needs. The activties nclude:
1. Pursuing a national blood policy, and enactment of supporting legislation;
2. Providing training of BTS and hospital personnel in donor management, best operational practices, appropriate clinical blood use, and monitoring and evaluation;
3. Assisting development of long term sustainability and planning for LBTS; and
4. Ensuring an effective cost efficient operation
In FY11, the technical support will focus on the following.
A. Infrastructure and policies: The partner will support the LBTS stakeholders committee to monitor and assist LBTS development. Technical assistance will provided for design and development on blood centre infrastructure development at national and regional levels.
B. Training support: The in-service trainings include the following areas:
Training of hospital blood banks staff on quality management systems to improve the management of blood transfusion services;
Training of Voluntary Non-remunerated Blood Donor (NRBD) recruitment staff on blood donor recruitment and management systems;
Training on phlebotomy, blood collection, and pre and post-donation counseling;
Training of laboratory staff on Quality Assurance /External Quality assessment (QA/EQA) on blood screening of transfusion transmitted infections (TTI) and blood grouping and blood component processing; and
Training of staff on blood distribution, cold chain storage and logistics management;
Provide regular training, updates and reviews on clinical blood usage,
Develop and train staff on hospital blood usage and hemovigilance .
In addition to training, follow up and supportive supervision will be provided to LBTS and hospital blood transfusion services to ensure quality system is implemented.
C. Data management support: Technical assistance will be provided on the identification of a data management system including, data collection, monitoring and evaluation of activities.
D. Development of sustainable systems: PEPFAR will assist with the establishment and identification of suitable operational policy development, identifying gaps to improve the blood collection and distribution processes. Moreover, PEPFAR will provide regular updates and reviews on clinical blood usage and quality management.
E. Support for "Club 25": Technical support will be provided in recruiting more youth members in schools, workplaces and establishing 'Club 25" at district levels.
