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: 2010 2011 2012 2013 2014 2015 2016 2017 2018
The overall goal of this activity is to improve the quality of care and support services provided to OVC and PLHIV. The Health Care Improvement Project (HCI) has been providing technical support to the MMAS, USG and its implementing partners to engage in a quality improvement process by helping to define minimum service standards for OVC. A Quality Improvement Task Force (QITF) has been established and is chaired by the MMAS. The QITF has taken the leadership to coordinate efforts across Ministries, donors, and civil society towards developing effective and efficient services for vulnerable children and families. Through a consensus building process, draft standards defining quality care were developed with substantive inputs from the OVC beneficiaries, implementing partners, the MOH, MMAS and other government and donor agencies. The draft standards are defined within the following service areas - health, education, protection, shelter and care, food and nutrition, economic strengthening, vocational
training/livelihoods - and will be tailored to better understand what measurable difference need to be made to meet the desired outcomes of children's wellbeing. These draft standards are to be piloted during FY 2009 in two provinces Gaza and Zambezia with several OVC implementing partners as selected by the QITF. For FY 2010, HCI proposes to continue to strengthen the MMAS and its implementing partners in organization and applying the science of quality improvement to achieve better outcomes.
In Mozambique, as in other countries, there is a limited definition of the desired outcomes that care and support services need to achieve, the range of essential actions that would comprise this service, and depending on the situation of the household the indicators that would measure the impact of home visits. In addition, there is limited harmonization among direct service providers (local CBO, NGOs, and international NGOs) concerning HBC services and the level of skills and knowledge required of the HBC care providers. As we move towards a family-centered approach, this exercise will align with the piloted definition of quality standards for OVC.
Identified HBC program priorities are focused on quality improvement: 1) Strengthen linkages and the continuum of care between the clinical care facility with a community based approach, centered on the whole family; 2) Clearly define the minimum actions that are needed to take place during the home visit, depending on the situation of the household; 3) Integrate and strengthen linkages between programs providing assistance to all family members who are ill, it is also an opportunity to assess, identify and refer all at risk family members; 4) Clearly define across all levels the skills, knowledge and attitudes needed to provide an effective service.
The HCI project will directly contribute to the Partnership Framework's Objectives 5.1 and 5.3, through technical assistance to improve the quality of care for OVC and affected households, development of M&E instruments, facilitation of best practice exchanges, training and development of standards, and clarifying roles between health facilities and community care providers.
HCI will monitor the effectiveness based on the results of activities being developed, from which indicators measuring quality will be identified. Such indicators will include both outcome measures (changes in children's and PLHIV well being) and also process measures (such as community participation, PLHIV and children's involvement) that relate to the essential actions as defined in the standards.
Building upon current efforts to define minimum service standards for OVC, The Health Care
Improvement project will extend activities to include defining care and support standards for PLHIV. The
process will engage the MOH, MMAS, USG implementers, PLHIV and other stakeholders, with
representation from the three regions in Mozambique (south, center, north). Once the quality standards
are defined, they can be harmonized across all implementing partners. The QI process engages
stakeholders (primarily service providers) in a process defining a set of standards and clearly desired
outcomes for each service intervention. The process also entails identifying a range of essential actions
that all organizations agree upon in the pursuit of effectiveness, efficiency, equity and sustainability. This
activity will draw on the work currently underway with services for OVC. Standards will be defined with
the context of integrated, family-centered care and support in Mozambique. This activity will help to
identify the essential interventions service providers need to focus on to ensure effective services for
PLHIV (i.e. treatment adherence, psychosocial support) which improve quality of life.
In FY09, HCI worked with the Ministry of Welfare and Social Action (MMAS), the Quality Improvement (QI) Task Force (established by MMAS) and implementing partners to begin the process of defining
minimum service standards for Orphans and Vulnerable Children (OVC). The definition of minimum service standards is the first key step in improving the quality of services provided for OVC. The draft service standards will be piloted in Gaza and Zambezia provinces in January 2010.
With FY10 funds, HCI will identify and document best practices and lessons learned from the first phase of implementation of the minimum service standards in Gaza and Zambezia provinces. The QI Task Force will identify at least three additional provinces (likely Maputo, Tete, Manica) to rapidly scale up the process of quality improvement for OVC. HCI will provide technical support to these additional three provinces to ensure that services standards are disseminated, understood by implementers, OVC, policy makers and other stakeholders. As service providers implement the new minimum service standards, HCI will help to document this process as well as make adjustments to implementation based on challenges encountered in the field at the point of service delivery.
Representatives of local government, local NGOs and their partners (CBOs and volunteers) are organized into QI teams to analyze what the standards describe as quality services and reflect on their current practices with respect to the essential actions as described in the standards.
In an effort to ensure local ownership and leadership of the quality improvement process, HCI will identify individuals from provincial level MMAS who will be trained as QI Coaches. These Coaches, will be key to ensuring a cadre of experts who can lead the process of implementation of service standards and ensure consistent application. HCI will facilitate the organization of Provincial QI Task Forces to coordinate and lead the sharing across Implementing Partners engaged in the process of quality improvement.
HCI will document the QI process across implementers, facilitate the sharing of promising practices and develop supportive networks of QI champions within Mozambique.
