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
NEW/REPLACEMENT NARRATIVE
This is a continuing activity in FY2009 COP, the fifth and final year of Track 1 central funding for Blood
Safety activities. (The Blood Transfusion Service of Namibia) NAMBTS anticipates that PEPFAR funding
beyond FY2009COP will be significantly reduced. FY2009 COP activities therefore focus on investing in
implementation of the new National Blood Policy to reinforce newly strengthened national systems for long-
term sustainability. With FY2009 COP funding NAMBTS will:
a. Establish the National Blood Authority for Namibia
b. Draft legislation to regulate blood transfusion nationwide
c. Conduct ongoing surveillance of transfusion transmitted infections (TTI) prevalence in sub-populations of
donors to identify lowest risk sub-groups
d. Define criteria for the import and export of blood and blood products
e. Develop a quality management system for the entire blood program
f. Define the level of service to be provided at each of the hospitals in Namibia that use blood or blood
products
g. Procure appropriate reagents and equipment for blood transfusion activities at all hospital blood banks
h. Train hospital blood bank staff on crossmatch techniques, quality management and cold chain
management
i. Develop a nationwide haemovigilance program
j. Strengthen hospital therapeutic/transfusion committees
k. Conduct blood bank and hospital audits to ensure conformity with best practices use of blood and blood
products by the blood banks, and best bedside transfusion practices by the hospitals
l. Extend crossmatching services to northern Namibia. Investigate the feasibility of opening a NAMBTS
blood bank in the north-east town of Rundu in order to improve the provision of blood and allied services to
the area
NAMBTS became a recipient of USG support in FY04 through a direct funding Cooperative Agreement.
Prior to 2004, Namibia had no National Blood Policy, no Strategic Plan to Strengthen the National Blood
Program, nor National Guidelines on the Appropriate Clinical Use of Blood and Blood Products. Since then,
National Guidelines on the Appropriate Clinical Use of Blood and Blood Products have been developed
(released June 2006) and a National Blood Policy has been finalized (released September 2007). The 3-
Year Strategic Plan for the implementation of the National Blood Policy was released in June 2008 and a
legislative framework will follow. Prior to PEPFAR support, there was one blood bank, one fixed site blood
collection facility, and one testing facility in Windhoek; and one blood bank facility in the northern region
(Oshakati). Collection of blood in the Oshakati area was discontinued in 2003 due to the high prevalence of
malaria, HIV and hepatitis, but mobile teams collected blood in most other regions of the country. These
facilities, as operated at that time, were inadequate to meet the safe blood supply needs of a country as
vast as Namibia.
With USG support, NAMBTS opened a second fixed donor site in Windhoek and a blood bank and donor
clinic facility in Swakopmund; donor clinics in Oshakati were resumed in July 2006 with an improved pre-
donation education program to assist potential donors in understanding the risk factors that contribute to a
higher risk of TTIs. Mobile teams collect blood from other sites (e.g. schools and businesses) throughout
the country. During 2006, an equipment upgrade for the Windhoek blood component laboratory improved
the quality of the blood components produced and the proportion of collected units converted into
components has increased steadily and reached 100% early in 2008.
In 2005 eight blood transfusion staff persons were funded by the project. A part-time medical officer was
hired and has been actively involved in developing the Guidelines for the Appropriate Use of Blood and
Blood Products and developing and conducting training programs to be provided to the medical community
on appropriate use of blood. She has also provided much needed medical backup to the donor clinic in the
selection of donors, to the blood bank in the provision of blood and blood products and to the doctors who
use the products. An officer for quality management and training was hired by NAMBTS in 2005 and
continues to provide and arrange training at all levels. He has been involved in the development of the
National Blood Policy, the Clinical Guidelines for the Appropriate Use of Blood and Blood Products, and the
proposed Standards for the Practice of Blood Transfusion in Namibia. Other ongoing projects include the
Quality Management System, the development of documented policies and procedures, and the internal
audit program, among others.
Although the number of units of blood collected has increased only slightly over the past few years,
improved stock management, more appropriate use of blood, and reduction in discards has enabled
NAMBTS to meet the vast majority of requests for blood resulting in a considerable reduction of shortages.
During the past twelve months the only shortage experienced was during the summer holiday period in
December.
All donated blood is tested for HIV, syphilis, and hepatitis B and C. This testing is currently carried out by
the South African National Blood Service in Johannesburg, on behalf of NAMBTS, because it was
determined that this was the most cost-effective method of providing the safest blood possible (including ID-
NAT for HIV, HCV and HBV) and to overcome the issues of prohibitive cost for local NAT and the lack of
adequately trained local staff. This policy was reviewed during a workshop held in February 2008 and a
decision was made to retain the present test procedures for at least another two years. Namibia's current
testing for TTI screening exceeds international recommendations/standards. Prospective donors who are
found to be TTI-positive are referred by a trained counselor to appropriate services.
A survey of blood usage practices in 26 hospitals in Namibia was conducted in collaboration with WHO,
NAMBTS and the MOHSS, to establish present practices and to identify areas for improvement. A plan is
being developed to standardize the level of blood transfusion services that will be provided at each hospital,
based on the current and predicted usage of blood and blood products. Appropriate NAMBTS staff
received training in Quality Management, Supervisory/Management skills, pre- and post-donation
Activity Narrative: counseling, training in cold chain management, general technical training and general donor clinic training.
This training is ongoing.
The NAMBTS is funded through a system of cost recovery, with majority of the service fees being paid by
the MOHSS since 80% of blood and blood products are supplied to the MOHSS. NAMBTS will focus on
cost control methods to help improve financial sustainability.
New/Continuing Activity: Continuing Activity
Continuing Activity: 16115
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16115 5124.08 HHS/Centers for Blood Transfusion 7354 1455.08 Track 1 $1,200,000
Disease Control & Service of Namibia
Prevention
7321 5124.07 HHS/Centers for Blood Transfusion 4379 1455.07 Track 1 $1,200,000
5124 5124.06 HHS/Centers for Blood Transfusion 3625 1455.06 $1,000,000
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $200,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Program Budget Code: 05 - HMIN Biomedical Prevention: Injection Safety
Total Planned Funding for Program Budget Code: $600,000
Total Planned Funding for Program Budget Code: $0
Table 3.3.05:
