NOTE: The following is taken from summaries released by PEPFAR on the PEPFAR Data Dashboard. They are incomplete summary paragraphs only and do not contain the full mechanism details. When the full narratives are released, we will update the mechanism pages accordingly.

The objective of this mechanism is to improve the quality, coverage and access of HIV (and related) services for 2.6 million people in 7 districts (Likoma, Nkhata Bay, Blantyre, Mwanza, Neno, Chiradzulu and Thyolo) in Malawi.

On the basis of programmatic data (collected through quarterly supervision by the Department of HIV and AIDS in the Ministry of Health), other reports and data collected by zonal and district health authorities and specific assessments, a continuous assessment and analysis of performance of health services in all health facilities is done. We plan targeted interventions and implement in close coordination with zonal and district health authorities and other implementing partners.

We will specifically support HIV-related supervision and mentoring activities and provide direct support to the implementation through in-service training, provision of medical equipment and furniture, and rehabilitation of decrepit health facilities. We will support measures to increase the identification and linkage of PLHIV into care, improve the quality of services rendered, and increase retention in care. In addition, we will strengthen health systems by bringing staff levels in hard-to-reach health facilities to minimum levels, support drug supply chain management systems, and support diagnostics and laboratories.

We will increase the cost efficiency over time as capacity of the districts will increase and a larger proportion of the available resources will directly support HIV activities in the district. This transition is effected through increasing the volume of sub-grants to the districts and sub-contracts to local CBOs.

Since COP2014, PEPFAR no longer produces narratives for every mechanism it funds. However, PEPFAR has now included performance targets or indicator information for each mechanism based on the Monitoring, Evaluation, and Reporting (MER) system. The MER guidance is available on PEPFAR's website https://www.pepfar.gov/reports/guidance/. Note that COP years 2014-2015 were under a previous version of the MER system and the indicators and definitions may have changed as of the new 2.0 guidance.