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 NEW ACTIVITY IN FY09.
STAFF
USAID will fund 100% of the PMTCT Advisor; 50% of the Health Development Advisot and 50% of the Sr.
Health & Nutrition Advisor:
All are existing positions.
1. Health Development Advisor (USPSC)
This activity supports the costs of a Health Development Advisor to provide strategic guidance on behalf of
USAID and USAID partners in implementation of PMTCT activities. He/she will provide overall planning and
management related to all PMTCT activities, coordinate with the Ministry of Health and other partners
involved in PMTCT and MCH-related activities, and collaborate closely with other USG activites supported
by SO8/Health, including malaria, family planning, and child survival activities. He/she will actively engage
the Ministry and provide overall technical leadership in collaboration with the FSN PMTCT Advisor on
integration of family planning and strengthening infant feeding activities for PMTCT. He/she will supervise
the Senior FSN PMTCT Advisor.
2. PMTCT Advisor (FSN)
This activity supports the salary and activities of a local Foreign Service National Staff to provide PMTCT
guidance and management of USAID clinical partners providing PMTCT services. He/she will work closely
with the Health Development Specialist in managing PMTCT activities, conducting site visits, coordinating
with Ministry of Health and the Reproductive Health Unit at the MOH, and collaborating with the CDC
PMTCT counterpart on PMTCT-related activities and technical working groups.
3. Senior Health and Nutrition Advisor (USPSC)
This activity supports the costs of a Senior Health and Nutrition Advisor for strengthening linkages between
PMTCT and HIV and other health and nutrition activities. He/she will provide overall technical guidance
and leadership in collaboration with the Senior FSN PMTCT Advisor and Senior Health Development
Specialist for strengthening linkages and integration of PMTCT into health and nutrition activities, and for
strengthening best practices for infant feeding among all infants. He/she will manage and monitor the food
and logistics commodity RFP and provide strategic guidance on implementing food and nutrition activities in
the context of PMTCT and MCH programs.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.01:
THIS IS A NEW ACTIVITY
These funds will cover the costs of the following four positions:
SUPERVISORY DEVELOPMENT ASSISTANCE SPECILALIST. Part of this position is under HVOP - will
lead the Prevention Unit in carrying out the full range of responsibilities for planning, implementing,
monitoring, and overseeing HIV/AIDS activities related to behavior change and risk reduction in the
PEPFAR. The Advisor will provide regular contact and collaboration, at technical and policy levels, in a
complex and rapidly evolving country context, with counterparts in the Government of Mozambique (GRM)
Ministry of Health, Ministry of Women and Social Action, and National AIDS Council, and other government
ministries and agencies; with civil society organizations and private companies; with other donor and
international organizations; and, with other USG entities working in HIV/AIDS prevention, care, treatment,
and mitigation in Mozambique.
The Advisor will exercise judgment in planning and carrying out tasks, in resolving problems and conflicts,
and in taking steps necessary to meet deadlines. The Advisor will manage a portfolio that is expected to
expand significantly during each year of the PEPFAR. And the Advisor will provide technical expertise and
experience in HIV/AIDS prevention and care, the role of civil society and the private sector in service
provision, and the cultural and economic context of the epidemic in Southern Africa and in Mozambique.
and in taking steps necessary to meet deadlines. The Advisor will manage (either as the designated
Cognizant Technical Officer [CTO] or through supervision of the CTO or project manager) a portfolio that is
expected to expand significantly during each year of the PEPFAR. And the Advisor will provide technical
expertise and experience in HIV/AIDS prevention and care, the role of civil society and the private sector in
service provision, and the cultural and economic context of the epidemic in Southern Africa and in
Mozambique.
The Advisor will provide supervision to all Prevention Unit staff, with each Unit member responsible for
selected HIV prevention activities. And, develop and update systems for tracking workload among
Prevention Unit members and for assuring program coverage.
COMMUNITY RISK REDUCTION SPECIALIST - This is an existing position
The local ABc FSN position is entitled, 'Community Risk Reduction Specialist'. PEPFAR Mozambique is
administered by an interagency team which includes the US Embassy, Public Affairs Office, Department of
Defense, centers fro Disease Control and Prevention, Peace Corps and USAID. The HIV/AIDS team has
four units: Behavior Change and National Response, Clinical HIV Services, Community Risk Reduction
(CRR) Specialist is to manage and administer USAID/Mozambique is to manage and administer
USAID/Mozambique PEPFAR programs supporting HIV prevention as a member of the Behavior Change
and National Response (BC & NR) unit. The CRR Specialist will serve as Activity Manager and provide
technical expertise to and administrative oversight of behavior change communication (BCC) and
community risk reduction activities related to promoting reducing of multiple concurrent partnerships, delay
of sexual debut and abstinence for youth, partner reduction, mutual faithfulness and correct and consistent
condom use as well as activities fostering enabiling enviroments and communities supportive of these
behaviors. The CRR Specialist will initiate and foster linkages between PEPFAR prevention programs to
HIV care, treatment and other Strategic Objective (SO) programs, such as family planning and food
security, managed by USG and other stakeholders.
DEVELOPMENT ASSISTANCE SPECIALIST (GENDER ACTIVITIES ADVISOR) - This is an continuing
position.
The Development Assistance Specialist (Gender Activities Advisor) (the Advisor) will be responsible for
carrying out a range of cross-cutting responsibilities for designing, planning, monitoring, and overseeing
HIV/AIDS activities related to PEPFAR and other Presidential Initiatives and USG activities, and ensuring
that Peolple living with HIV-AIDS - PLWHA and the Most at Risk Populations - MARPS, (which includes
commercial sex workers and their clients, male and female prisoners, migrant workers and de-miners,
refugees fleeing the on-going crisis in Zimbabwe, and the highly mobile truckers who move through and
work in high prevalence corridors), considerations are fully covered throughout the spectrum of PEPFAR,
and related health activities in Mozambique. These responsibilities will include regular contact and
collaboration, at technical and policy levels, in a complex and rapidly evolving country context, with
counterparts in the Government of Mozambique (GRM) Ministry of Health, the National AIDS Council, and
other GRM ministries and agencies; with civil society organizations and private companies; with other donor
and international organizations; and, with other USG entities working in HIV/AIDS prevention, care,
treatment, and mitigation in Mozambique. The Advisor will play an important interagency role in ensuring
that best practices and lessons learned regarding Prevention with positives and the Most at Risk
Populations are considered and implemented, fostering public-private partnerships, and increasing
coordination between PEFPAR, PMI, and other USG initiatives, including the Millennium Challenge
Corporation (MCC).
BEHAVIOR CHANGE COMMUNICATION ADVISOR - This a continuing but this activity replaces the BBC
Advisor activity previously listed under Public Health Institute/ Global Fellow. Half of the position is under
HVCT.
The Behavior Change Communication Advisor position and staff person are continuing but this activity
replaces the BCC Advisor activity previously listed under Public Health Institute/Global Health Fellows
Program (GHFP).
The position was converted from the GHFP mechanism to a US PSC as the former mechanism did not
allow the incumbent full CTO authorization. In addition to continuing management and TA to the sexual
prevention (AB and C&OP) portfolio, the conversion also increased the scope of work of the position to
include oversight and management of USAID's counseling and testing (CT) activities, both facility and
community-based. Half of the position is under AB; the other half of the position is listed under CT.
The BCC Advisor US PSC will 1) serve as CTO and provide technical expertise to oversight of BCC for
Sexual Transmission Prevention (STP) and CT activities to the HIV/AIDS Team, PEPFAR Mozambique
Activity Narrative: Interagency Team, the Mission and GRM; 2) Manage assigned STP and CT programs preparing
documentation for contracts and agreements and conducting site monitoring visits; 3) Provide technical
assistance to partners to ensure STP and CT portfolios that are responsive to the epidemics, effective,
linked to other services and in line with the GRM's HIV strategy.
New/Continuing Activity: Continuing Activity
Continuing Activity: 18278
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
18278 5303.08 U.S. Agency for US Agency for 7282 3685.08 USAID-USAID- $170,000
International International GHAI-Local
Development Development
9145 5303.07 U.S. Agency for US Agency for 5050 3685.07 USAID-USAID- $382,795
5303 5303.06 U.S. Agency for US Agency for 3685 3685.06 $218,452
International International
Table 3.3.02:
These funds will cover part of salary and ICASS costs of the Supervisory Development Assistance
Specialist (the remaining is under the HAVB). This is an existing position
The Supervisory Development Assistance Specialist (Sr Health Development Advisor) will be responsible
for the cooperative agreements that link multiple HIV interventions to strengthen the continuum of HIV care
and prevention or provide specialized technical support for HIV/AIDS programs. S/he will be the lead
USAID/Mozambique HIV/AIDS Team member carrying out responsibilities for planning,
implementing,monitoring, coordinating and overseeing HIV/AIDS activities related to selected HIV program
areas, namely counseling and testing (CT) for HIV, other clinical activities services and health systems
related to HIV/AIDS, prevention of mother-to-child-transmission (PMTCT), HIV policy, and monitoring and
evaluation. Given that most agreements encompass multiple program areas, this will sometimes entail
serving as alternate for another Cognizant Technical Officer (CTO) and overssing components of an
agreement in the Specialist's assigned program areas, or vice-versa. HIV/AIDS is a cross-cutting issue and
the Emergency Plan is an interagency effort, requiring that the Specialist be able to work collaboratively and
effectively with other HIV team members, USAID Strategic Objective Teams, other US agencies as well as
with implementing partner organizations and other donors. These responsibilities include regular contact
and collaboration at technical and policy levels, ina complex and rapidly evolving country context, with
counterparts in Mozambique's Ministry of Health, Ministry of Women and Social Action, National AIDS
Council, and other government ministries and agencies; with civil society organizations and private
companies; with other donor and international organizations; and with other USG entities working in
HIV/AIDS prevention, care, treatment and mitigation in Mozambique, such as the Centers for Disease
Control. S/he will be a member of the US Mission in Mozambique interagency working group for the
Emergency Plan, and may head a relevant sub-group as Chair or Co-Chair.
The Specialist is required to exercise extensive judgement in planning and carrying out tasks, in resolving
problems and conflicts, and in taking steps necessary to meet deadlines. The incumbent manages (either
as the designated CTO or through supervision of the CTO or activity manager) a portfolio that is valued at
more tha $12 million in FY2007 and that is expeted to expand significantly during each year of the
Emergency Plan. The incumbent must provide technial expertise and experience in HIV/AIDS prevention
and care, health services and systems in a resource-constrained African context, and monitoring and
evaluation. The Specialist will be responsible for selected HIV prevention and inter-related activities and
liaise with teh Health Strategic Obejctive Team of USAID on integrated HIV activities and systems, such as
integration of HIV/AIDS into related health services. The Specialist may be called upon to support the
Team in managing selected implementation tracking or planning systems.
Table 3.3.03:
This is a new activity under COP09.
This activity will fund 100% of the HBC Activity Manager Salary and 50% of the Community Based Support
Specialist salary.
The Project Management Specialist PMS (activity manager) is responsible for implementing selected
portions of the SO-9 HIV/AIDS Team portfolio in USAID/Mozambique, with shared responsibility with the
OVC/HBC Advisor for full CTO oversight and professional management, implementation, and direction to up
to ten (10) activities that are conducted by a variety of Implementing Partners (IPs). The assignment
includes responsibility for monitoring and evaluation of existing program activities, and for implementing
new activities, as required. The PMS participates with professionals of all Mission Sectors in the planning,
design, development, management, and monitoring of USAID programs. In the course of the assignment,
the Specialist will represent USAID, its activities, and its programs to senior host-government counterparts
(at Ministerial levels, local government leaders, counterparts, etc.), to other donor agencies, and to NGO
counterparts and the private sector.
The Community Based Support Specialist (CBSS) provides technical leadership to assist in responsiblities
for planning, implementing monitoring and overseeing activities related to community care, in particular,
care for OVC and home based care adn support for PLWHA. CBSS also serves as CTO for and activity
manager for several community based projects.
Table 3.3.08:
These funds will cover the salary and ICASS costs of the following two positions on the USAID PEPFAR
Team:
Senior Medical Advisor for USAID (USPSC). This is an existing position: The Advisor will serve as a
resource to the USAID team, as well as the lead focal point for all USAID-funded treatment activities.
He/She will provide technical guidance and leadership to USG-funded partners involved in care and
treatment activities, and monitor and evaluate USAID-funded care and treatment activities. He/She will
coordinate with and provide technical assistance to the Mozambican Ministry of Health, including DNAM,
DPS/DDS, and other national institutions involved in scaling up Mozambique's care and treatment program.
The Advisor will participate in interagency and national technical working groups on care and treatment, and
provide updates to the USAID team and USAID-funded partners. He/She will work in an interagency fashion
with other USG agencies, including coordinating technical working group meetings, joint planning and
strategic development for USG treatment activities and support to the Ministry of Health.
Project Management Specialist (Clinical Outreach). This is an existing position: The Specialist is
responsible for Clinic-to-Clinic and Clinic-to-Community support, providing technical support that
strengthens programmatic links between health facility services and communities, strengthening the
HIV/AIDS referral system, promoting biosecurity at health facilities, and ensuring a strong continuum of care
and treatment. The Specialist provides clinical knowledge and expertise in order to seek higher levels of
treatment adherence, and improvements in the quality of life of people living with HIV/AIDS. The Project
Management Specialist (Clinical Outreach) serves as CTO, and is responsible for management,
implementation, evaluation, and monitoring of portions of the SO-9 HIV/AIDS Team program/project
portfolio related to strengthening hospital and clinical treatment of persons with HIV/AIDS, tracking and
mapping health delivery sites for antiretroviral treatment, counseling, and testing. Activities include
prevention of mother-to-child transmission and community support. Personally and through implementing
partners (IPs), works to strengthen programmatic links between clinic sites and the community, linkages
between clinic sites and services to orphans and vulnerable children, and linkages between clinic sites and
home-based care providers. She is responsible for fostering the establishment and strengthening of
linkages between Health and Nutrition programs, and coordinate the leveraging of support for PEPFAR
activities through wrap-around services. Plans, designs, and advocates effective strategies for
improvement in HIV/AIDS treatment and care, by building human capacity, optimizing local human
resources, etc.
Table 3.3.09:
This is a contuing activity under COP09.
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
This activity will fund 100% of the Project Management Specialist salary, 50% of the Community Based
Support Specialist salary, and 50% of the Sr. Health and Nutrition Advisor's salary. All are existing positions.
The Project Management Specialist (OVC Program Manager) - This is a new activity in that it is organized
in a different way, but it is also a continuation of the Activity ID# 11415 in COP08. This position is
responsible for managing the OVC portfolio of the SO-9 HIV/AIDS Team in USAID/Mozambique, with
shared responsibility with the OVC/HBC Advisor for full CTO oversight and professional management,
implementation, and direction to up to ten (10) activities that are conducted by a variety of Implementing
Partners (IPs). The assignment includes responsibility for monitoring and evaluation of existing program
activities and for implementing new activities, as required. The PMS participates with professionals of all
Mission Sectors in the planning, design, development, management, and monitoring of USAID programs.
In the course of the assignment, the Specialist will represent USAID, its activities, and its programs to senior
host-government counterparts (at Ministerial levels, local government leaders, counterparts, etc.), to other
donor agencies, and to NGO counterparts and the private sector.
The Community Based Support Specialist (CBSS) provides technical leadership to assist in responsibilities
for planning, implementing, monitoring and overseeing activities related to community care, in particular
care for OVC and home based care & support for PLWHA. The CBSS also serves as CTO for and activity
manager for several community-based projects, and has responsibility for ensuring coordination for
community based care programs funded by USAID through a variety of governmental and non-
governmental partners at provincial, district and community levels.
The Sr. Health and Nutrition Advisor is responsible for technical leadership and assistance to implement
care approaches within USAID/Mozambique's portfolio, as well as technical and management support for
nutritional care for people living with HIV and AIDS and orphans and vulnerable children. In addition, the
consultant will focus on food for treatment adherence and mother-to-child transmission (MTCT). The
consultant will also coordinate closely with the Mission's PL 480 and agriculture programs, leveraging their
resources and expertise to strengthen the HIV/AIDS Office's work in nutrition, and will provide consistent,
high quality technical assistance to the USAID program, the broader USG program and the Government of
Mozambique. The consultant will substantially increase the quality of USG programs as well as transfer
skills and best practices to the Government of Mozambique programs and institutions.
This is a continuing activity under COP08. The FY2007 narrative below has not been updated.
This activity funds a full time FSN position responsible for OVC activities, created in response to the OGAC
recommendation. This position is part of the Community Based Care unit of the HIV and AIDS team, and
reports to the Senior Community HIV Specialist. Responsibilities include: 1) work with USG/OVC partners
to improve quality in programs; 2)work with the Ministry of Women and Social Affairs on policy, monitoring
and evaluation of OVC programs; 3)serve as the contact for the OGAC technical working group on OVC;
4)activity manager, and when qualified, CTO for OVC programs.
Continuing Activity: 13358
13358 11415.08 U.S. Agency for To Be Determined 6449 3673.08 USAID-TBD
International Local (USAID)-
Development GHAI-Local
11415 11415.07 U.S. Agency for To Be Determined 5048 3673.07 USAID-TBD
Table 3.3.13:
This activity provides partial support to two (2) US PSC positions.
Interagency Team, the Mission and GRM; 2) Manage assigned STP and CT programs preparing
Health Develpment Advisor - This is an existing position - the Health Development Advisor will provide
strategic guidance on behalf of USAID and USAID partners in implementation of PMTCT ativities. He/she
will provide overall planning and management related to all PMTCT activities, coordinate with the Ministry of
Health and other partners involved in PMTCT and MCH-related activities, and collaborate closely with other
USG activites supported by SO8/Health, including malaria, family planning, and child survival activities.
He/she will actively engage the Ministry and provide overall technical leadership in collaboration with the
FSN PMTCT Advisor on integration of family planning and strengthening infant feeding activities for
PMTCT. He/she will supervise the Senior FSN PMTCT Advisor. Other half time of this position is under
PMTCT.
Table 3.3.14:
FY 09 funds will support salaries for an offshore USPSC Senior Pharmaceutical Logistics Advisor and a
local FSN Logistics Manager. these are existing positions. These staff are funded to provide almost 100% of
their time to managing pharmaceutical logistics activities. Activities include the management of SCMS and
monitoring of SCMS activities in collaboration with other USG agencies, providing strategic planning and
guidance to SCMS and USG in line with USG and GOM priorities, coordinating and planning with relevant
CDC counterparts and other USG agency counterparts, providing technical assistance to CMAM and other
stakeholders, coordinating with SWAP donors, coordinating meetings between SCMS and relevant
partners, and informing USG agencies and their partners of all pharmaceutical related developments.
Program Budget Code: 16 - HLAB Laboratory Infrastructure
Total Planned Funding for Program Budget Code: $11,230,166
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The tiered public health laboratory network in Mozambique is organized into 4 levels: Quaternary (Central Hospitals), Tertiary
(Provincial Hospitals), Secondary (District, General, and Rural Hospitals), and Primary (Health Clinics). The National Directorate
of Medical Assistance oversees the Clinical Laboratory section, which coordinates the activities of the clinical labs in general. The
laboratory network currently consists of 254 laboratories (3 Central, 7 Provincial, 35 District/Rural/General Hospitals (Hsp), and
209 Health Clinic Labs). Additionally, there are three Military Hsp Laboratories, under the oversight of the Ministry of Defense,
and three National Reference Laboratories: Immunology and Virology, Malaria, and Tuberculosis. National Reference
Laboratories for Immunology and Virology and Malaria fall under the National Institute of Health Directorate and the National
Tuberculosis Reference Laboratory falls under the National TB Program. To date, the USG provides support to 30 clinical labs (3
Central Hsp Labs, 7 Provincial Hsp Labs, 15 District/Rural/General Hsp Labs, 3 Health Center Labs, 2 Military Hsp Labs) and 2
National Reference Labs (Immunology and Virology and TB).
Challenges: The public health laboratory system in Mozambique continues to face multiple challenges, the most critical of which is
the shortage of qualified personnel to staff and manage the laboratory network. Furthermore, the ability to recruit and retain
young and promising individuals to the public health sector is threatened by low salaries and lack of career development
opportunities. A second critical challenge to ongoing access to quality laboratory testing services is a weak, understaffed, and
underfunded system for forecasting, procuring, and distributing laboratory reagents and commodities. Other challenges include:
deficient physical infrastructure; sub-optimal coordination between laboratory and clinical services; absence of National
Laboratory Quality Assurance Program; absence of expertise in laboratory equipment maintenance and repair; and absence of
policies and processes for decentralization of laboratory services to support the ongoing decentralization and integration of clinical
services into primary health care. A third critical challenge to the National Public Health System is the fragmented nature of
management and oversight of public health functions as well as the lack of co-location and unsafe working conditions for the
nation's Public Health Reference Laboratories. The majority of the country's reference laboratories are located within the MoH
administrative building, which is inadequate for housing laboratories and lacks appropriate barriers and biosafety features to
protect the laboratorians as well as others working in the building. Recent discussions between USG and International
Association for National Public Health Institutes (IANPHI) focused on how best to work together with the MOH to develop a
National Public Health Strategic Plan that includes construction of a National Public Health Institute that would co-locate all
functions of public health including all National Reference Laboratories. Following a recent assessment by IANPHI, the MOH
developed a National Public Health Strategic Plan and asked for USG assistance in planning and constructing this new facility.
Policy: An August 2007 MOH-approved National Strategic Plan for Laboratory focuses on the clinical laboratory network.
Subsequently, an effort led by WHO was undertaken to draft a new national strategic plan for laboratory, which integrated clinical
and public health laboratory functions. MOH, however, has not decided whether this new plan will supersede the existing plan.
Primary objectives of the currently approved Strategic Plan include:
1)To improve capacity and access to testing services by strengthening the organizational structure of lab services; implementing a
hierarchical system for testing; reinforcing and standardizing equipment; putting in place staff development programs; and
promoting research.
2)To increase the quality of lab services by establishing a quality management system; strengthening information management;
and establishing a biosafety program with necessary policies, resources, and training.
3)To increase the cost-effectiveness of lab services through strengthening the system for forecasting, procurement, warehousing,
and distribution of lab commodities and building local capacity to maintain and repair laboratory equipment.
The USG team seeks to support the MOH to improve and expand the clinical laboratory capacity for the provision of quality
diagnostic services to support HIV prevention, care and treatment through implementation of the National Strategic Plan for
Laboratory. As defined in the Plan, USG-supported partners are improving laboratory and warehouse physical infrastructure;
procuring lab equipment and commodities; strengthening logistic systems at Central Level; building human capacity through
technical assistance, mentoring and training; and assuring quality lab services through implementation and support of a National
Quality Assurance Program. In FY09, clinical partners will add Laboratory Technical Advisors to their programs. As these
advisors will be distributed across all 11 Provinces in Mozambique, they represent a network of technical experts to create a link
between site level and central level lab capacity building. It is expected that monitoring and evaluation of USG-supported
investments in the area of lab will be improved and gaps in human, material, and technical capacity will be rapidly identified and
addressed. Technical Lab Advisors will work closely with their Provincial Government counterparts to foster increased ownership
and oversight of laboratory supervision and management.
Donor Coordination: PEPFAR support to MOH in the area of laboratory is coordinated with support from other donors including:
the World Bank and AXIOS/Abbott for HIV test kit procurement; Global Fund for equipment and general lab commodity
procurement; Clinton Foundation and UNITAID for technical assistance, equipment, and reagent procurement for Early Infant
Diagnosis and pediatric CD4 testing; Sant' Egidio Community, the Irish Cooperation and the Italian Cooperation for equipment,
reagents, and technical assistance; President's Malaria Initiative (PMI) for logistics strengthening of rapid diagnostic tests; and
USAID, through the TB-Country Assistance Program (TB-CAP) for TB laboratory diagnostic strengthening.
Additionally, USG worked with the IANPHI and the Mozambique National Institute of Health (INS) to outline the structure and
functions of the new public health institute and develop a five-year strategic plan, timeline, and summary of the roles and
responsibilities needed to accomplish the project.
Accomplishments and FY09 Priorities: USG-funded achievements to date and FY09 plans include:
1)Physical Infrastructure Improvements. To date, renovations of 3 referral laboratories situated at Mavalane General Hsp (in
Maputo City), Quelimane Provincial Hsp, Xai-Xai Provincial Hsp and 12 district and health center laboratories have been
completed. Renovations at 2 Central Hsp Laboratories in the north and central regions of the country are currently underway.
Infrastructure improvements and equipment placement are currently underway in training laboratories at 2 Provincial Health
Science Institutes (Nampula and Zambezia Provinces). Physical infrastructure improvements will continue in FY09 through a new
mechanism, whereby, funding for physical infrastructure will be consolidated and awarded through a competitive Funding
Opportunity Announcement process to one or more partners with construction expertise. In FY09, funds from the consolidated
Infrastructure Budget will be used to support the planning and design of a National Public Health Institute. The MOH has
identified property for the facility and roles and responsibilities of the various units that will occupy the facility are being developed.
Collaboration with other donors to leverage the necessary funds to complete the construction of this new facility will continue.
2)Equipment and reagents. By end of FY08, USG supported CD4 testing in 26 labs; biochemistry in 20 labs; and hematology in
18 labs, resulting in 250,000 CD4 tests and 800,000 biochemistry and hematology tests performed. By end of FY09, as physical
infrastructure projects are completed and additional equipment is placed, these numbers are expected to increase to 350,000 for
CD4 and 1,100,000 for biochemistry and hematology. Further expansion of testing capacity will be reduced in FY09 as the
emphasis shifts to improving quality of testing at existing sites and maximizing existing capacity by strengthening specimen
referral systems. Transition of equipment and reagent support to Supply Chain Management System was completed in FY08 and
implementation of a laboratory inventory management system (LIMS; paper-based) was initiated. In FY09, TA to MOH to
strengthen procurement and logistics systems at Central Level will be expanded to include laboratory commodities. Support with
be coordinated with the President's Malaria Initiative to strengthen logistics system for rapid tests.
3)DNA PCR for Early Infant Diagnosis (EID). In FY08, 15,000 DNA PCR tests for EID were performed to support the pediatric
treatment program in all 11 Provinces. A second DNA PCR lab for EID was opened in October 2008 in the northern region of the
country (Nampula; supported by Clinton Foundation with plans to transition to USG support). FY09 funds will support a third
laboratory in the central region of the country, bringing national EID capacity to 4,000 tests/month by end of FY09. TA to support
and strengthen specimen transport will continue in FY09.
4)External Quality Assurance (EQA). Through USG support, EQA programs have been established for CD4, HIV serology, and
DNA PCR. All 26 USG-supported CD4 testing labs participate in EQA. The number of sites participating in EQA for HIV serology
increased from 80 to 129 in FY08. These sites include clinical labs, blood banks, VCT and PMTCT sites. INS participates in EQA
program for EID through International Lab Branch, CDC-Atlanta and facilitates the participation of the Nampula DNA PCR lab in
this program. FY09 funding will support EQA for all new CD4 and EID testing sites within the MOH laboratory network; further
expansion of HIV serology EQA through decentralization of the program to Provincial Level; and establishment of an EQA
program for Biochemistry and Hematology.
5)Laboratory Information System. At end of FY08, electronic laboratory information systems (eLIS) have been implemented in 4
sites, including Mavalane General Hsp, Quelimane and Xai-Xai Provincial Hsps, and the INS. In FY09, USG funds will support
installation of eLIS systems in 2 additional sites, as well as expansion and customization of existing eLIS systems to
accommodate addition tests, laboratory inventory management, and specimen tracking needs. FY08 funds supported revision of
the paper-based laboratory information system to promote standardization across laboratories and reporting of data necessary to
monitor laboratory performance at both site level and Central level; FY2009 funds will support implementation and evaluation of
the paper-based LIS.
6)Human capacity building. To address the critical shortage in qualified laboratory personnel, several approaches to human
capacity building have been implemented. USG funding via South-to-South collaboration has included upgrading of technical
skills for existing lab technicians through on-site laboratory mentoring and technical training in Brazil. These programs will
continue through South-to-South partnership in FY09 and will include assessment of impact of investments to meet the human
resource needs of the lab network. A second strategy is to capacitate Biologists working in the MoH system to staff clinical
laboratories and serve as focal points for quality assurance and biosafety. This activity will extend into FY09 and follow up
assessment of performance of Biologists will be conducted. Various in-service trainings (refresher and first time courses) will
continue as in previous years to expand and strengthen technical as well as management capacity of technicians within the MoH
system. Microbiology capacity building through on-site lab mentorship will continue in Central Hsps and include development of
mechanisms and strategies to expand microbiology testing capacity to lower level labs through Central Level staff who have
worked closely with mentors and have gained the skills to facilitate trainings for Provincial and District level staff.
7)Strengthening of Central Level Laboratory Section, MoH. At the request of the MOH and in accordance with the National
Strategic Plan, FY09 USG funds will support the development of the Central Level Lab Section Head and staff to organize,
implement, and monitor Quality Assurance of the Laboratory Network. To date, there is no National Quality Assurance Program
for Laboratory and no one within MOH with the skills and knowledge to implement and manage such a program. This program will
bring together the current test-specific EQA programs; organize and oversee integrated site supervision; coordinate initial and
follow-up training; and manage the process of lab accreditation across the network.
Sustainability: USG supported activities for FY09 are intended to build upon previous years' accomplishments with an intentional
focus on human capacity building, both technical and managerial, and sustainability through infrastructure and systems
strengthening. All activities implemented by PEPFAR funded lab partners will be planned in collaboration with MOH counterparts
and strive to transition ownership, responsibility, and oversight of programs and activities to Mozambicans. USG-funded partners
will continue to use the MOH approved National Strategic Plan for Laboratory to guide activities and investments and will continue
to encourage and support the MoH to implement their Plan and monitor their progress towards accomplishing the goals and
objectives therein.
Table 3.3.16:
These funds will cover salary and travel costs for the following SI-related positions in the USAID HIV/AIDS
Community M&E Advisor (USPSC) - this is an existing position - The Community Monitoring and Evaluation
(M&E) Specialist provides M&E expertise for the HIV/AIDS Team and implementing partners. S/he also
manages implementing partners whose primary activities focus on monitoring and evaluation, and may also
support the HIV/AIDS Team in managing selected implementation planning and/or tracking systems. Given
that most agreements encompass multiple program areas, s/he will serve as needed as Cognizant
Technical Officer (CTO) or Alternate CTO for other CTOs for additional multi-activity agreements as
needed.
Site Monitoring Specialist (FSN) - this is an existing position - the Site Monitoring Specialist provides on-site
guidance to PEPFAR partners on M&E requirements and tools including data quality assessment; data
collection that meets PEPFAR needs; and wrap-around quantification, among others. The incumbent will
also feed technical staff with key information to replicate successful models, promote cross-fertilization
between programs, and collect and document success stories that demonstrate the breadth of PEPFAR's
impact.
M&E Assistant (FSN) - this is an existing position - The M&E Assistant assists the SI Advisor and the
Community M&E Advisor in providing the Team with support in the monitoring, evaluation, and impact
analysis of Team-administered PEPFAR programs in Mozambique. S/he ensures that the Mission complies
with all PEPFAR and Agency requirements for performance monitoring and evaluation, such as the
Performance Monitoring Plan and Data Quality Assessments.and serves as the lead Team Specialist in all
questions pertaining to evaluation, monitoring, program review, and other strategic exercises relating to
Team programs/projects.
Other support costs, e.g. residential rent and maintenance, office maintenance, and training, among others,
are being funded under the management and staffing program area.
Table 3.3.17:
These funds will cover the salary and ICASS costs of the following positions on the USAID PEPFAR Team:
Organizational Capacity Development Advisor (USPSC) - this is an existing position: the incumbent will
manage USAID-supported institutional strengthening activities, including the $7 million agreement with the
Academy for Educational Development to build the capacity of local organizations to respond to donor
requirements and the UGM that will be launched in FY 09 to further mozambicanize the response to
HIV/AIDS. The incumbent will also focus on system strengthening at the Government of Mozambique level
to ensure sustainability of PEPFAR and post-PEPFAR activities.
Community Health Advisor (USPSC) - this is a planned position: the Community Health Advisor will be fully
seconded to the Ministry of Health with the purpose to manage the revitalization of the Community Health
Workers' Program. S/he will work in close coordination with teh USAID Community Health Specialist to
maximize coordination between PEPFAR and the MOH and ensure that expected results are achieved.
Special Projects Advisor - this is an existing position: PEPFAR implementation involves coordination with a
number of other Presidential Initiatives and USG activities that contribute to wrap-around achievements and
further PEPFAR objectives. The Special Projects Advisor will manage public-private partnerships, the New
Partners Initiative, and increase coordination between PEFPAR, MCC and PMI.
Other supporting costs, e.g. residential rent and equipment and office equipment, among others, have been
budgeted under the Management and Staffing area.
Table 3.3.18:
This funding will support contracting a team with strategic design experience to write, review existing
indicators, budgetary systems and help develop feasible targets for the PF as well as support the
government of Mozambique's effort to develop a national HIV/AIDS strategy.
This sum is dedicated to the logistical arrangements necessary to successfully negotiate the signing and
development of a Partner Framework and Implementation Plan. It will include conferencing, workshop and
meetings set up for host government and other relevant counterparts.
Program Budget Code: 19 - HVMS Management and Staffing
Total Planned Funding for Program Budget Code: $16,380,918
FY09 support costs for management and staffing (M&S) for the USG team managing PEPFAR in Mozambique is $16.3 million,
and includes implementing agency staffing costs, all related training costs, travel, housing, benefits, & entitlements. USG
agencies report to the Chargé d'Affaires via an interagency management structure with 3 management/operational levels: a
Principals group (Chargé, USAID, CDC, & Peace Corps directors, USAID Health Team Leader, & PEPFAR Coordinator); a Task
Force group (Technical Working Group (TWG) chairs, PEPFAR Coordinator & Assistant Coordinator), and the various TWGs.
This year-old structure has provided an alternative way of presenting and discussing ideas, processes, implementation, and
reviews and will be reassessed soon for its further effectiveness as a way to manage PEPFAR. Management challenges have
arisen, in part, because Mozambique has never had a full-time PEPFAR coordinator. The USG PEPFAR team supported Staffing
for Results by implementing two key retreats which made a serious effort to improve interagency communication and
collaboration. The January 08 retreat facilitated clarity of roles and established the present interagency management structure,
while the June 08 retreat allowed all team members to actively engage in discussions on all program aspects in a creative format
called Open Space Technology.
Currently there are 62 positions (CDC) and 47 positions (USAID) approved under various mechanisms, with current vacancies of
23 and 11 positions, respectively. Of the 23 CDC vacant positions, selections have been made for 5 positions and are awaiting
final clearances. Of these 5 positions, 2 are interagency in nature. Additionally, 3 of the 23 positions are in the final stage of the
selection process, with placement expected shortly. The remaining 15 positions are at various stages of the recruitment process,
from finalizing position descriptions to advertising positions to interviewing of candidates. On the USAID side, incumbents have
been selected for 5 of the 11 vacant positions, pending security and medical clearance. The remaining 6 positions are at various
stages of the recruitment process, from re-advertisement to interview of applicants.
Despite not incorporating all approved COP 08 positions, PEPFAR Mozambique has staffed up in the past year and, more
recently, selected a person for the PEPFAR coordinator position whose contract is being processed. There is a new commitment
to restructuring our interagency organization, revitalizing our Technical Working Groups, and re-assessing our staffing needs.
Consequently, until this management and staffing review is fully conducted, PEPFAR Mozambique is only requesting 2 local
positions for DOD, and State with COP 09 funding at this time. The PEPFAR team, however, will re-assess unfilled, approved
positions and restructured program needs and request staff accordingly. PEPFAR Mozambique's new strategic direction and
emphasis in PEPFAR II necessitates candid, flexible assessments of staffing complement for this program. In early-2009, we
hope to approach the Office of the Global AIDS Coordinator with a proposal to reassign certain approved positions, with the
possibility of requesting a few additional technical personnel.
Recruiting and hiring in Mozambique has proven to be difficult on many fronts because of a lack of available hiring mechanisms
(Comforce is no longer available for new overseas hires and existing positions are being transitioned), Work permit/visa
restrictions by local government for third country nationals, and severe shortage of local human resources. M&S working group is
interested in providing more training opportunities related to project management and monitoring and evaluation skills. This
training focus will enhance uniform reporting, improve field data collection accuracy, as well as improve the quality of the joint
program reviews.
Presently, the Department of State has three PEPFAR-funded positions at the Embassy: a Grants Coordinator, a Political Affairs
PEPFAR Assistant, and a Public Affairs PEPFAR Assistant. The Embassy in Mozambique is proposing 1 additional technical
position that will manage the significant increase in activities for 2009 and beyond.
A. PEPFAR Deputy Coordinator: The PEPFAR program will administer more than $200 million US dollars in FY09 in
Mozambique, a priority country. The PEPFAR Deputy Coordinator will assist the PEPFAR Coordinator in Mozambique's Strategic
Planning process for PEPFAR FY09 funding in Mozambique, in conjunction with other USG agencies in Mozambique (Peace
Corps, DoD, CDC, USAID, and US Embassy). The incumbent will prepare and edit Country Operational Plan narratives and
supporting documents; will coordinate PEPFAR reporting and response requirements among other agencies; will develop reports,
memoranda, press releases, and other material regarding PEPFAR for internal and external audiences; will assist in evaluating
overall performance of current PEPFAR partners and agencies; will maintain liaison with host country government officials and
non-governmental partners involved in PEPFAR; will coordinate technical assistance from Washington with USG officials in
Maputo, Washington, and Atlanta, as well as with local governmental and non-governmental partners, and will work in an
interagency capacity to identify and document valuable lessons learned, best practices, and PEPFAR success stories.
The Department of Defense at the Embassy in Mozambique has one existing position that has already been approved. This year,
however, the DAO has requested the approval of one additional technical position that will manage the increase in activities for
2009 and additional years as needed.
B. DoD PEPFAR Assistant Coordinator: Works directly for and with the DoD PEPFAR Manager to assist in the implementation
and execution of DoD funded PEPFAR activities. Due to the increased funding of DoD PEPFAR in the $3 Million dollar plus
range, the need for an assistant to better help the current program manager meet the increasing goals and projects of the
program is necessary as the original position and responsibilities have evolved from a one person office as planned for three
years ago. This assistant would start out working directly for and with the DoD PEPFAR Manager; however, a transition is
envisioned for this position as the professional becomes more familiar with their duties and is ready to receive more responsibility
by managing projects independently with their supervisor's concurrence. Having an assistant will also allow for more site visits by
DoD PEPFAR manager to various projects located across Mozambique at the different military bases where we work, while
ensuring that the office in Maputo is always covered.
PEPFAR in Mozambique continues to face challenges when attempting to fill technical positions; fluency in English and the level
of technical skills required for these positions are still insufficiently represented in Mozambique. Moreover, our efforts to
strengthen the country's professional skills, as well as the agreement established between our government and the Ministry of
Health preclude us from hiring staff from within the Government of Mozambique. Additionally, the USG FSN pay scale is not as
competitive as the private sector and we often lose selected professionals in the negotiation process. Attracting American staff
with Portuguese language skills is also a challenge. We are continuing to look at innovative approaches to attract and retain
highly skilled citizens of Mozambique.
Table 3.3.19:
This is a continuing activity under COP09.
This entry covers costs for USAID/Mozambique staff and related support required to plan, manage,
oversee, and report on Emergency Plan activities. Estimated costs for FY 09 are higher than those for FY
08 (but are not over the recommended 7% earmark, at slightly under 7 %) due to the rapid increase in
program size and complexity, budgeting for positions previously supported by OE funds, and increases in
shared Mission costs borne by the HIV/AIDS Team.
In FY09, USAID will have no new positions, bringing total planned staff to 47 management, technical, and
administrative positions. Of the total, 19 positions are technical non-management positions that are funded
within the PMTCT, HVAB, HVOP, HBHC, HKID, HTXD, HVSI and OHSS program areas.
In FY 2008, USAID undertook a concentrated effort to staff up quickly with excellent results, i.e. from a team
of 15 staff members to 30 in less than one year. Of the approved vacant positions, 4 will be filled before the
end of CY 08, and 1 in early 2009. Recruitment is ongoing for another 6 administrative and professional
staff. The team is expected to be fully staffed by mid-CY 2009.
The requested funds include the following: (1) $XXX in Emergency Plan staff costs (including salary,
benefits, administrative support, and entitlement travel); (2) $XXX in office costs and $XXX for non-office
costs, including residential furniture and maintenance; (3) $XXX in ICASS charges; (4) $XXX in IRM tax
charges for HIV/AIDS program and support staff; (5) $XXX in other program costs, including the Emergency
Plan share of the Mission air charter contract for site visits and support, translation services, in-country and
international travel including conferences, and a variety of other program support costs.
As in FY08 COP, ICASS and IRM costs have been entered as separate activities.
This is the activity narrative from FY08.
oversee, and report on Emergency Plan activities. Estimated costs for FY 08 are higher than those for FY
07 (but still less than the recommended 7% level) due to the rapid increase in program size and complexity,
budgeting for positions previously supported by OE funds, and increases in shared Mission costs borne by
the HIV/AIDS Team.
USAID requests 21 new positions, bringing total planned staff to 47 management, technical and
administrative positions. Of the total, three positions are technical non-management positions that are
funded within the AB, C&OP, and OVC program areas.
USAID has budgeted for nine new technical management/program manager positions in FY 2008. This
includes staff to manage cross-cutting activities such as gender-related activities, public-private
partnerships, capacity development for local NGOs, and nutritional support. New positions are also
requested in areas such as child development, pharmaceutical logistics management, and health and
nutrition linkages where USAID has growing programs and provides technical leadership. Positions
essential for sound management and accountability are also requested, including two Deputy Team
Leaders, a Legal Advisor, and a Site Monitoring Specialist. USAID also proposes to fund positions in the
USAID Office of Administrative Management, Procurement Management Unit, and Program Office that are
key to PEPFAR implementation. Hence, of the new positions, six are existing OE-funded staff supporting
PEPFAR whose contracts will be funded by PEPFAR for the first time in FY 2008. PEPFAR will still receive
substantial support (30% of time) from 18 OE-funded positions. All new positions have been developed
through interagency analysis and collaboration, in keeping with the Staffing for Results Guidance.
The requested funds include the following: (1) $3,750,300 in Emergency Plan staff costs (including salary,
benefits, administrative support, and entitlement travel); (2) $439,570 in office costs and $964,400 for non-
office costs, including residential furniture and maintenance; (3) $302,000 in ICASS charges; (4) $252,000
in IRM tax charges for HIV/AIDS program and support staff; (5) $998,650 in other program costs, including
the Emergency Plan share of the Mission air charter contract for site visits and support, translation services,
in-country and international travel including conferences, and a variety of other program support costs.
USAID has faced challenges in hiring professional staff for Mozambique. International recruitment is
challenging due to the need for Portuguese language capability and the high demand for HIV-related
professional skills, both in Mozambique and worldwide. The market for qualified Mozambican staff is
fiercely competitive due to human resource constraints, and the USG local compensation plan is not
attractive to many potential Foreign Service National employees. Nonetheless, adequate staffing is critical
to results, sustainability, and accountability, and solutions have been identified to reduce recruiting time and
fill vacancies. For example, USAID has won USAID/Washington approval to offer pre-service language
training at post (only one other USAID post, Indonesia, is authorized to do this). This will greatly expand the
range of eligible candidates and improve staff effectiveness. In addition, efforts to recruit Third Country
National PSCs have been expanded. USAID will also bring in short-term experts in recruitment and
contracting to expedite hiring and will explore greater use of the new Public Health Institute Fellows
Program.
ICASS and IRM costs have been entered as separate activities.
Continuing Activity: 15875
15875 5322.08 U.S. Agency for US Agency for 7282 3685.08 USAID-USAID- $6,152,920
9122 5322.07 U.S. Agency for US Agency for 5050 3685.07 USAID-USAID- $4,557,850
5322 5322.06 U.S. Agency for US Agency for 3685 3685.06 $3,076,698
