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.
This is a new activity under COP09.
Activity Narrative: RFP for Infrastructure - Contracts Direct (Training Center, Warehouses)
The PEPFAR program has already made a considerable contribution to infrastructure development in
Mozambique. By July 2008, it had supported the renovation or construction, and equipment, of fifteen
laboratories, forty-eight health centers and maternity units, twenty-five hospital consulting rooms, three staff
houses, and twenty-three administrative offices. In addition, thirty-four transportable pre-fabricated
laboratories and diagnostic facilities had been deployed and equipped. A further fifteen houses, seven
maternity units, five health centers and one rural hospital are scheduled for completion by the Fall of 2009.
This work was implemented through PEPFAR's Clinical Treatment and Laboratory Partners.
.
The Public Works sector in Mozambique is quite strictly regulated. Technical standards ensure that
buildings are properly designed and fit for purpose, and materials meet minimum standards. Engineers and
supervisors must be appropriately qualified and registered. The procedures for Contract award through
public tender, aimed at ensuring transparency, are rigorous. PEPFAR funded building projects are also
subject to USG legislation, such as the Foreign Assistance Act, and environmental scrutiny. Consequently,
the several PEPFAR Partners currently involved in infrastructure development have had to hire full time
technical staff to manage their small infrastructures programs, or retain expensive consultants on a project-
by-project basis.
COP09 will, for the first time, treat infrastructure development as a discrete rather than embedded program
area, with appropriate budgetary provision, and a program structure designed to improve the speed, quality
and cost-effectiveness of implementation. These arrangements will relieve PEPFAR's Clinical Treatment
and Laboratory Partners of much of the burden of managing activities somewhat removed from their
primary fields of excellence. Two new mechanisms will be employed: Centrally Managed (see "RFP for
Infrastructure construction - contract health centers, housing, labs, etc."), and Direct Contracting, the
activities described here.
Warehouses
Currently, the country is facing significant warehousing and distribution challenges, for which the USG
through SCMS is providing technical assistance and financial support. A September 2008 Warehousing and
Distribution Needs Assessment conducted by SCMS has identified a series of steps leading up to the
preparation of a 3-5 year Pharmaceutical Logistics Master Plan, that will cover the policy, infrastructure,
supply-chain, and financial needs of CMAM to achieve lasting improvements in HIV/AIDS commodity
security.
The Assessment identifies the poor physical state of Beira Warehouse, and its limited capacity, as major
constraints to the efficient distribution of pharmaceuticals within the central Provinces. It recommended that
the existing warehouse should be repaired, and a new extension built and fitted out.
The Northern Provinces are currently served by warehouses in Nampula. The MoH facilities are too small,
and in poor condition, so additional warehouse space is rented from a private company. The Ministry
intends to rationalize this situation by transferring operations to a new, purpose designed facility in Nampula
or Nacala.
The Global Fund has also committed to supporting warehouse upgrading and rationalization. PEPFAR will
work with the GF to leverage funds to best effect to implement both projects, Central and Northern.
A firm of Architect-Project Managers will be selected, by competitive tender, to draft plans, specifications
and tender documents for the projects, in line with USG and Mozambican legislation, and subsequently to
supervise construction.
USAID will let the Contracts through a Request for Proposals (RFP) process, adjudicated by a committee
including representatives of the Ministries of Health and Public Works.
Marracuene Training Center
Human resource constraints have proven the single greatest threat to meeting PEPFAR prevention, care
and treatment targets in Mozambique. The Minister of Health has affirmed that the lack of human resources
is one of the greatest problems encountered by the public health system.
One of the Minister's priorities is to rehabilitate and convert a former mental hospital at Marracuene, Maputo
Province, to serve as an Institution for training mainly middle level health workers cadres. This center was
used in the past as an annex of the Health Sciences Institute (HIS) to train Maternal and Child Health Care
nurses.
The HIS is the largest health training institution in the country and trains nurses, clinical officers, lab,
pharmacy, preventive medicine, dentist, ophthalmologist, physiotherapy, health statistics and psychiatric
technicians. Also they provide specialization courses in different areas for health workers. In 2008, they are
running 27 courses of 30 students in each one. While these courses run at different times, the HIS campus
has only 7 classrooms, so other classrooms are rented at the secondary school near to the Central Hospital
of Maputo (CHM) and classrooms from CHM are being utilized as well. The HIS is sharing the campus with
ISCISA, a higher level training institution created in 2004, who also needs classrooms for their students.
Construction on the Marracuene site will make it possible for the MOH to move all students and faculty to a
new location, one that will be owned by the Government of Mozambique thereby eliminating payment of
rent as is being done now. The renovations to Marracuene will also include student accommodations which
are not available in the present location.
Activity Narrative: Plans for this project are in the final stages of development and should be released in November 2008. A
firm of Architect-Project Managers will be selected, by competitive tender, to review the plans and
specifications and prepare tender documents for the project in line with USG and Mozambican legislation,
and subsequently to supervise construction.
USAID will let the Contract through an RFP process, adjudicated by a committee including representatives
of the Ministries of Health and Public Works.
Provisional Budgets
Beira Warehouse Upgrade: $1,000,000
Northern Provinces Warehouse: $4,000,000
Marracuene Training Center: $5,000,000
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.18:
