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
In FY2012 COP, the following activities will be implemented
1) Infection Control Measures: Procure N95 Masks,paper masks,sputum jars, refurbishment of St James Hospital, Mantaonyane to accommodate TB Patient separately from general patients to enhance infection control.
2) TB Monitoring and Evaluation: TB/HIV will be supported through procurement of lap top. Strengthening Advocacy, Communication and Social Mobilization (ACSM) nationally will be done through commemoration of World TB day. Activities will include development and dissemination of IEC material according to the current Stop TB Partnership tool kit and support branding of TB messages.
3) Site assessment and supportive supervision: In order to help set a baseline for determining the true magnitude of the TB problem in the country, the 2010 external programme review recommended to conduct at least one TB disease prevalence survey in the country before 2015.According to the WHO 2010 report the prevalence of TB is 635/100,000. Information gathered through prevalence survey will assist the programme to design targeted activities with clear knowledge on where to put more efforts. There is also a concern of low notification in other districts like Thaba-Tseka and without the survey it becomes difficult to appreciate that indeed the TB prevalence is declining in such districts.
4) Human resource-training: The program will support admin and technical staff to implement the TB-HIV coordination at national and district levels. As part of human resource strengthening, the National TB Program (NTP) plans to send at least two officers to attend IUATLD trainings and conference.
4) Human resource-training: The program will support admin and technical staff to implement the TB-HIV coordination at national and district levels. As part of human resource strengthening, the National TB Program (NTP) plans to send at least two officers to attend IUATLD trainings and conference
In FY2012, the following activities will be implemented
1) Expansion and strengthening the National Quality Assurance Program. To ensure high quality services are being offered by all health facilities providing diagnostics and monitoring services quality assured and tiered laboratory services will be supported. MOHSW will implement the WHO-AFRO Stepwise laboratory accreditation approach in all facilities. The support will include refresher trainings, site assessment and supportive supervision and EQA schemes. The QA Unit will support the preparation and distribution of the HIV Rapid proficiency panels and quality control samples to all 266 facilities twice a year. TB smear microscopy panels will be prepared, distributed and on site assessments will be conducted. Annual Quality Review meetings will be conducted, where all participants will be sharing their achievements, experiences and challenges.
2) Strengthen referral test services and scale up EID: Referral of samples has been maintained through courier services and sample transporters. Facilities have benefitted from the installed Toll free line for the speedy access of DNA-PCR results, timely management of exposed infants has been achieved and the activities will be continuing and referral system will be strengthened through courier services. In FY2012, 65% of infants born to HIV-positive women will receive virologic HIV testing (DNA PCR) in the first 2 months of life.
3) Equipment maintenance: In order to provide uninterrupted laboratory services, MOHSW will Rapid support equipment maintenance and validation through vendor contract for major laboratory equipment. Procurement of minor equipment will also be provided.
4) Procurement of minor equipment and laboratory supplies and inventory management: Laboratory Supply Chain Management will be strengthened to ensure that there is constant supply of reagents/testing kits for PMTCT clients
5) Expansion and Strengthen CD4 monitoring: CD4 monitoring services will be available at hard to reach facilities with high workload, six POC analyzers, reagents and consumables will be procured, as CD4 testing is being done by non-laboratory personnel intensive supportive supervision will be conducted. 6) Minor renovation and furnishing with basic equipment will be supported for 5 hospital/health center laboratories. This will improve the workflow laboratory diagnosis and monitoring, biosafety, storage and cold chain system. The health center renovation will ensure the PMTCT lab packages are provided at primary health care level, laboratory services will be established at health centers. This included renovation of facilities and furnishing with minor equipments. .
In FY2012 the following activities will be implemented.
1) Two specific surveys will be conducted i.e. the HIV Sentinel Surveillance and Drug Resistance survey. They will assist the ministry to monitor the extent and trends of the national HIV and AIDS Epidemic besides the DHS and also contribute to the overall national strategy of the HIV and AIDS and STI. These surveys have been partially supported through the Global Fund Round 8, Phase 2 year 3. The COP2012 budge will be used to fill the finical gaps required to complete the surveys.
2) Support DHMT: will continue mentoring 10 districts to collect, clean, analyze, use and demand data. The formal feedback and data utilization mechanisms through Performance Reviews will be strengthened. All the districts, the central programs and the Health sector will continue to be supported to execute their performance reviews. Four performance review meetings will be held at the district, central and one annual review meeting in which all stakeholders participate. The M&E Unit will continue to sensitize staff working at all levels, including health leaders, on data demand and use concepts emphasizing the potential programmatic benefits of using data for decision making.
3) Strengthening institutionalized Routine Data Quality Assurance (RDQA) at district level: Poor data quality limits health leaders at the level ability to use data for evidence-based decision making and has a negative impact on facilities strategic planning activities and their efforts to advocate for resources. To address data quality concerns the M&E Unit is institutionalizing Routine Data Quality at district level. The Unit will conduct one M&E system assessment and continue to mentor RDQA champions at district level and support the 10 districts to carry out data verifications per quarter. The system will be assessed to establish its capacity to manage data and also monitor capacity improvements and performance of the data management and reporting system at the level
4. Strengthening Strategic Information (SI) HR capacity
The unit in collaboration with Institute for Health Measurement (IHM) and will facilitate access to regional and in-country M&E training events.
The M&E Unit will continue to sensitize staff working at all levels, including health leaders, on data demand and use concepts emphasizing the potential programmatic benefits of using data for decision making.
SI seeks to secure four positions to support and ensure functionability as well as sustainability of the integrated HMIS.
Two (2) HMIS officers trained in Regional M&E curricula
60 data clerks trained in M&E concepts locally; data collection tolls and reporting mechanisms
Total In service training completed is 125
Human resource
The Ministry of Health will continue support personnel for efficient implementation of cooperative Project programmatic activities towards improved health services. The following positions will be supported with salaries and administrative and technical staff already employed. These include project Manager, Logistics Coordinator, Administrator, administration assistances (2), LIS Focal person, Laboratory Technologists and Data Clecks (10) and 60 M & E data clerks.
In FY 20212, there will be a need to strengthen human resource at health centre level-employment of ten (10) lab data clerks will be required to supplement existing staff and task shift activities from the laboratory technologists.
The newly developed data ware house requires technical support by these people. There is need to put in place two (2) Information officers and retain some of the key HMIS personnel (3) is very crucial. An addition of one (1) M&E Officer and Two (2) HMIS officers also stems as very essential. These key HIMS personnel ensure proper data management while also strengthening data flow and reporting mechanisms. The MOHSW will support and supervise the 60 data clerks. They will be provided refresher training in basic M&E especially honing down to MOHSW data collection and reporting tools
Lesothos HIV prevalence is 3rd highest in the world at 23% and a generalized HIV epidemic. An estimated 290,000 people are living with HIV. Currently, only about 62% are on antiretroviral therapy. Approximately 21000 new adult infections occur every year.
Key gaps and challenges in the HTC program include low levels of HTC. Limited access of HTC services by most at risk populations (sex workers and MSM), quality assurance for HTC services (pre-test and post-test counseling) is inadequate. Other challenges include inadequate linkages and retention into care and treatment to ensure continuum of response.
Key Lesotho priority actions include expanding scale up of quality HTC services to ensure timely and universal access to prevention, treatment and care. An effective HTC program will result in a larger number of people with HIV receiving an early diagnosis of, and care and treatment for, HIV. Approximately 572,000 HIV tests are required every year with incremental increases as the program grows. Currently resources for HTC commodities and supplies and HTC personnel are cost shared between the Global fund, Government of Lesotho and PEPFAR. In addition PEPFAR has a targeted HTC programs for mobile populations and home based HTC through the TARGET program. Community mobilization, promotion of HTC activities and creation of demand is currently also funded by PEPFAR through the LETLAMA project.
The HTC funding in this grant will mainly focus on improving the coordination of the Provider initiated counseling in health facilities both in public and private settings;
(1) Strengthening of provision of HTC services to support scale up of the treatment program with focus on PMTCT, VMMC, TB, HIV care and Treatment clinics, STI, outpatients and inpatient wards.
(2) Support and strengthen linkages to ensure continuum of response from testing into care and treatment. Linking HTC and care/treatment remains a challenge as most patients tested are lost to follow up into care and/or documentation of such a system is very weak. This includes strengthening referral systems in TB, VMMC, PMTCT including national tools, referral guidelines, and use of mobile technologies to track leakages from the cascade.
(3) Strengthening of monitoring and evaluation of HTC services nationally both Provider and Client initiated settings.
(4) Quality assurance, quality improvement for HTC services and mentorship of HTC personnel implemented according to the WHO and Lesotho HTC guidelines and standards.
(5) Coordination of HTC services. There is also a weak central level coordination in the provision of HTC services from all sites (GOL, private and NGO) and the necessary referral to ART services, and as a result district level coordination of HTC services also and needs to be strengthened. A steady and uninterrupted supply of HTC commodities is another essential element in the strengthening of services provision as the recurrent stack outs negative impact on the services. Therefore central level coordination between provision of HTC services nationwide and a steady provision of the required medical supplies and commodities need to be strengthened. To effectively coordinate the program, one national HTC coordinator; one HTC Supply Chain Manager and 10 District Senior Counselors/coordinators will be supported in this budget period
