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
This is a continuing activity from FY08 and the narrative replaces the FY08 narrative; it relates to Columbia
University's activities that are funded through country funds to supplement Track 1.0, as well as the system
strenghthing, PMTCT, pediatrics care and support, laboratory and infrastructure, and strategic information
activities funded in FY09.
Columbia University's (CU) scale-up of treatment services is supported by USG and guided by
Mozambique's national HIV strategic plan. In collaboration with the Ministry of Health (MOH), CU will
continue support to 41 HIV care and treatment facilities at various stages of development and expansion in
Maputo City, Gaza Province, Inhambane Province, Nampula Province, and Zambezia Province. SAPR data
reported from 13 sites for FY08 showed that 78% of patients were alive and on treatment at 12 months of
treatment initiation.
In FY09, CU plans to initiate support at 12 additional facilities to a total of 53 sites in 33 districts and 4 the
provinces reaching 60,000 adult patients on ART by the end of the fiscal year. Expansion plans are in
accordance with MoH policy and plans. Special emphasis will be maintained on the decentralization and
integration of services with a emphasis on urban settings. Major urban treatment facilities will be enabled to
down-refer stable patients on ARV treatment and similarly, urban Health Centers will be capacitated to
absorb these patients as well as to initiate new patients on antiretroviral therapy. Complicated cases and
treatment failures will be managed at bigger health facilities. This is a part of a national process of
decentralization and integration of HIV services that, according to the current MoH timeline should be
completed by December 2009.
The following activities will be implemented in FY09:
-Finance, train and mentor MOH staff per facility supported
-Provide equipment and supplies to maintain facility operations,
-Improve patient management, drug management and strategic information systems,
-Reinforce follow-up and referral systems,
-Strengthen linkages with organizations providing services for PLWHA, Voluntary Counseling and Testing
outlets, TB clinics and pMTCT centers
-Strengthen linkages with services to increase HIV case-finding (including TB, pMTCT, Youth Centers)
Human Resources: Continue financing the salaries of MOH health-care providers to supplement existing
staff at health facilities. These providers include, doctors, medical technicians (técnicos de medicina),
nurses, counselors, pharmacists, data technicians and administrative staff. This activity will be carried out
through sub agreements with Provincial Health Authorities (DPS) in provinces supported by CU. This is part
of a sustainability strategy with the final objective being of DPS to incorporate these staff in the MoH
system. Supported staff receives salaries in accordance with the national salary grids.
Training and Mentoring: CU will maintain clinical-support teams to work in the field and provide clinical
mentoring, technical assistance and logistical support to staff at the HIV care and treatment facilities and
districts supported by CU. Mentorship activities and formal training are carried out at site level (with
enhanced one on one skills-transfer for clinical, M&E, pharmacy and administration) as well as formal
training at site, district and provincial level. The clinical staff travels regularly to CU-supported facilities in
the province. Mentoring activities at facility level aim at building the local capacity in order help maintain the
activities and services currently offered once a phase out of support is implemented. CU will also work with
the USG Mozambique team to establish and standardize criteria and best strategies for site graduation.
Adherence and psychosocial support: Activities aimed at improving adherence to therapy will continue and
be reinforced during COP09. Activities will include provincial trainings on adherence and psychosocial
support, training of peer educators, initiatives with PLWHA including positive prevention using materials
already developed through CDC support, and support for "positive teas".
Sub-agreement will be established with organizations working in the community to strengthen defaulter
tracing, community linkages, and identification of new patients. The proposed sub agreements will work
through three complementary technical intervention areas: community mobilization for prevention and care
and treatment, improvement of quality of services through strengthening PLWHA support groups and
defaulter-tracing systems at HIV care and treatment and PMTCT services, and conducting Home Visits for
adherence support and defaulters tracking and return to care and treatment.
Linkages between services: CU will work on a "one partner per district approach" as per USG and MoH
guidance. This will include a process of transition of services between partners and will, once the transition
is completed, enable better integration between different services at the same site. The transition will result
in CU supporting all care and treatment, pMTCT and counseling and testing services within CU supported
facilities.
CU will continue to provide technical support at the central level to the Department of Medical Assistance
(DNAM). This support is aimed to assist the Government of Mozambique in developing policies and
guidelines for managing the national ART expansion effort. Specifically, CU technical staff will provide the
following support: guidance to HIV Management and ARV Committees, development and revision of clinical
guidelines and HIV service decentralization plan, development and revision of training curricula and
materials, development of adherence and psychosocial support materials and guidance to the National
Adherence Support Work Group, and refinement and roll-out of the electronic patient-tracking system and
paper-based system.
Health System Strengthening:
In line with the USG partner rationalization, CU will be the lead partner in Maputo City, Inhambane Province
and Nampula Provinces. In these provinces CU will work particularly closely with the DPS to strengthen the
provincial system primarily by hiring three Clinical Advisors to provide technical support to the Provincial
Health Directorates in Nampula, Inhambane and Maputo City. The advisors will assist the DPS office in
planning, implementation, coordination and monitoring of clinical care and mentoring activities related to
HIV/AIDS and Tuberculosis within the province they are assigned to work. As lead partner, CU will also
support the DPS to coordinate HIV/AIDS activities at provincial level including organizing and convening
Activity Narrative: monthly/quarterly provincial partners' meetings, taking the lead in supporting expansion of treatment
services where there is no partner coverage provided resources permit such expansion.
In addition, CU will shift towards a district focus of support for ARV services and work more closely with the
District Health Management Teams for planning, budgeting, coordinating, supervising and monitoring HIV
programs within CU supported districts.
Sustainability plan:
CU has been working on a model to transfer knowledge and health management skills to the Mozambican
counterparts. In order to reach this objective, CU has been establishing sub agreements with Provincial
Health Directorates to create conditions for future absorption of these cadres into the national health
system. Beside this strategy, CU has been working and will increase efforts on development of
programmatic capacities of Mozambican staff across various intervention areas through participation in
quality of care initiatives, in implementation of larger and broader package of care, capacity building and
mentoring. Support to pre-service training will help creating additional local capacity. CU is supporting
infrastructure development through rehabilitation projects.
By 2012, ICAP will transition to indigenous organizations (governmental or non-governmental) key
functions in an organized, incremental and deliberate manner. In addition, ICAP will collaborate with USG
funding agencies to identify the domains in which technical support by international or local organizations
with expertise in these specific domains may be required to continue to support these indigenous
organizations after a successful transition.
Specific activities for this coming year include: 1- Conduct a mapping exercise with the goal of identification
of indigenous governmental and non-governmental organizations engaged in HIV-related programming in
Mozambique, with a focus on those with activities in the locations where ICAP works.
2- Define the domains of activities provided by ICAP with the goal of developing a listing of activities in
various domains that would be candidates for transitioning e.g. support activities, technical inputs.
3- Develop or adapt an assessment tool to identify an organization's capability to manage USG funds and to
implement the proposed activities.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13948
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13948 5181.08 HHS/Centers for Columbia 6665 3580.08 Track 1 ARV $4,125,000
Disease Control & University
Prevention
8837 5181.07 HHS/Centers for Columbia 4765 3580.07 Track 1 ARV $4,500,000
5181 5181.06 HHS/Centers for Columbia 3580 3580.06 Track 1 ARV $4,500,000
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $880,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.09:
