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: 2008 2009
NOTICE - Per the recommendation from OGAC that Malawi as an FY2008 Compact Country, submit a mini
-COP (i.e. program area level narratives only), this activity level narrative has not been updated prior to the
submission of the FY09 Full COP. The Malawi country team anticipates updating narratives upon
completion and final approval of the negotiated 5-year Compact between the United States Government
and the Government of Malawi.
Summary
Baobab will develop a point of care electronic data system (EDS) for TB and PMTCT, establish a national
data warehouse for the Ministry of Health (MoH) and develop robust electronic transfer mechanisms for
patients receiving ART as they move between care sites.
Background
Baobab, a local NGO, is dedicated to improving the delivery and management of HIV/AIDS care in Malawi
through continued development, enhancement and support of information systems used in real-time by
clinicians at the point of care. Baobab has been working with the MoH to incubate, design and deploy IT
applications in healthcare. In Malawi, paper-based registers have traditionally been used to record
patient/client data. This data is commonly transcribed and subsequently manually aggregated by staff with
little or no training in medicine or clinical terminology. When attempts are made to retrospectively enter
patient-level clinical data into computers, data entry errors are numerous, resulting in data that is generally
incomplete and inaccurate. Baobab's strategy to improve data quality is to replace traditional paper-based
data collection with point-of-care systems. Such systems, when appropriately conceived, augment
clinicians' abilities to solve problems and make decisions related to clinical care, while transparently
collecting complete and accurate clinical data as a by-product of system use.
Among the main challenges in Malawi in strategic information are: 1) addressing the issue of poor
completeness and accuracy of routinely collected data; 2) facilitating the sharing of patient/client level data
between sites (e.g. ART patient transfer between sites, TB and ART programs, ancillary services such as
lab, pharmacy, x-ray and the clinical providers; and 3) generating and maintaining routine and ad-hoc
reports. With USG Emergency Plan (EP) funding, Baobab will: 1) develop point-of-care EDS solutions for
TB and PMTCT, 2) establish a national data warehouse for ART data, and 3) develop robust electronic
transfer mechanisms for patients receiving ART as they move between care sites.
Activity 1: Develop Point-of-Care EDS Solutions for TB and PMTCT
With USG EP funding, two new modules will be created in FY 2008 as part of the broader suite of software
applications created by Baobab to address HIV/AIDS care and treatment in Malawi. Both modules will be
developed to share pertinent information with existing Baobab modules (e.g. HTC, ART, lab, x-ray), and
existing modules modified to accommodate this integration. These new modules will be piloted at the
Lighthouse Clinic/Martin Preuss Center, Kamuzu Central Hospital and Bwaila Hospital. However, it will
leverage software tools previously developed for Baobab EDS systems, currently being utilized for HTC.
Expected results with FY 2008 funds include the introduction and integration of a point-of-care TB module,
which is expected to improve the management of co-infected patients receiving TB treatment as well as
increase uptake of patients starting ART, and facilitate a more holistic management for both HIV and TB.
Introduction and integration of a point-of-care PMTCT module is expected to increase the uptake of mothers
and children starting ART. An improved mechanism for transferring patients between ART sites is expected
to improve continuity of care and minimize silent transfers (patients who unofficially switch care sites,
sometimes starting treatment from scratch at a new site). And finally, the creation of a data warehouse for
patient-level HIV data will facilitate meta-analysis of data across multiple sites.
Activity 2: Establish a National Data Warehouse within the MoH
To date, MoH keeps only aggregate data from sites in electronic form. With the introduction of EDS
systems at sites it is now feasible to keep patient-level data and, over time, build a large repository of
longitudinal patient-specific information. The data warehouse will be populated with data from sites using
EDS for ART. The number of sites will be dependent on the level to which the Baobab ART system (BART)
has been rolled out across Malawi. This is a new activity. However, it will leverage previous work done in
developing HL7 messaging for transferring patient-level data in Malawi.
Activity 3: Develop Robust Electronic Transfer Mechanisms for Patients Receiving ART Moving Between
Care Sites
The system will be piloted at MoH sites using BART. The number of sites will be dependent on the level to
which BART has been rolled out at that time. This is an ongoing activity that will leverage previous work
done in developing the HL7 messaging system for electronically transferring patient-level data in Malawi.
Indigenous Baobab employees will conduct all activities in collaboration with an international counterpart.
This approach is intended to build capacity within Baobab to both develop and support EDS systems in
Malawi in an effort to ensure maximum sustainability.
Baobab has focused on improving the integration of electronic systems currently used in HIV care and
treatment. To date (end of FY 2007) these systems have included HIV counseling and testing, managing
patients on antiretroviral therapy, laboratory specimen management and the management of radiology data.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14597
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14597 10745.08 HHS/Centers for BAOBAB Health 6882 5576.08 Baobab $200,000
Disease Control & Partnership
Prevention
10745 10745.07 HHS/Centers for BAOBAB Health 7562 7562.07 Baobab GHAI $135,004
Table 3.3.17:
