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.
NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES The International Laboratory
Branch (ILB) consortium partners' main goal is to strengthen laboratory systems through technical
assistance to the Namibia Institute of Pathology (NIP). NIP, in turn, provides quality laboratory services to
MOHSS HIV, TB and OIs programs.
To achieve this goal each of the four ILB consortium members provides technical assistance in specific
areas. For the American Society for Microbiology (ASM), those objectives include:
1) Training on TB microscopy, culture and drug susceptibility testing
2) Technical assistance to establish a TB diagnostics quality assurance system
3) Assist in the decentralization of TB culture services to Oshakati and Walvis Bay Laboratories.
Links to the Partnership Framework goals and benchmarks over the life of its agreement/award.
Through support for quality TB diagnostic and monitoring services, this implementing mechanism is key to
the USG commitments related to the PF goal of "reducing TB/HIV co-infection." The technical assistance
delivered through this IM will specifically aid the GRN and the USG to meet the following PF objectives:
1) Enhance the quality of ART care through quality assured bio-clinical monitoring.
2) Expand coverage of screening for TB/HIV co-infection.
Geographic coverage and target population:
This mechanism is designed to provide national coverage through the NIP network of laboratories. ASM
will work with NIP and other partners to cover all TB diagnostic laboratories in Namibia. Trainings and
microscopy quality assurance will target all laboratories performing TB diagnosis. This assistance will also
strengthening TB culture and drug susceptibility testing at the Windhoek central reference laboratory, as
well as at the Oshakati and Walvis Bay laboratories.
Key contributions to Health System Strengthening:
The ASM technical approach is built on the results of continuous situation assessments. These are
followed by training on quality management and the development of implementation plans. Emphasis is
placed on Train-the-Trainer (TOT) courses, which produce local trainers. These individuals represent a
growing core of local expertise to provide on-going supervision, mentoring and additional training.
Through this system, ASM helps build capacity at the systems level and at each facility. This local
capacity will sustain the national laboratory system over the long-term and gradually reduce NIP's
dependence on external TA.
Cross-cutting programs and key issues:
As noted above, technical assistance from ASM contributes to a strengthening of local expertise. NIP
laboratory staff trained to conduct trainings and supportive supervision represent a strong foundation on
which future human resources for health may be built.
Strategy to become more cost efficient over time:
All ILB consortium partners provide short-term technical trainings. NIP manages the logistics of the
trainings to be conducted, and, increasingly, provides trainers from its own staff to conduct follow-up
mentoring and monitoring. NIP is also responsible for procuring equipment and reagents for the trainings.
These procurements, including stock management and delivery, are done through NIP's local ordering
system. As indicated above, the training of trainers as instructors and mentors will, over time, reduce
ASM's role in Namibia. On that note, ASM's role is already 100% technical assistance. NIP is solely
responsible for laboratory service delivery. A USG objective for the next five years is to develop NIP's
administrative capacity to allow NIP to contract and fund its own technical relationships, as needed, with
IDP consortium members.
Monitoring and evaluation plans for included activities:
All CDC cooperative agreement grantees must submit a detailed work plan with their annual continuation
application. This work plan must be based on PEPFAR indicators and aligned with targets set for each
country. All IDP consortium members must also submit bi-annual status reports to the IDP program
manager in Atlanta. These reports are shared with CDC program managers in Namibia and used to
inform any year-on-year changes to the work plan. All trainees are required to develop an individual work
plan. These are followed up by NIP and ASM mentors during supportive visits. Other key indicators
include the monitoring of TB diagnostic results for quality and progress made toward accreditation by
SANAS.
NEW/REPLACEMENT NARRATIVE WITH SUBSTANTIAL CHANGES
This is a continuing activity from COP09. It includes one component: 1) technical assistance from the American Society of Microbiologists (ASM) to enhance TB laboratory services at the Namibia Institute of Pathology (NIP). ASM support is provided through a cooperative agreement managed by the CDC Global AIDS Program International Laboratory Branch.
1) Technical assistance from ASM. ASM has provided short- and long-term technical advisors to work with the CDC laboratory technical advisor, alongside NIP staff at the main laboratory in Windhoek, to improve their proficiency with TB diagnostic testing. This assistance has included on-the-job training on TB-related laboratory equipment and infection control practices. In COP 10, ASM will focus support on peripheral NIP laboratories. Areas of technical focus for this training and TA will include establishing a blinded quality assurance process for rechecking slides; strengthening the management of existing external quality assurance systems, and; training for NIP laboratory technicians on fluorescence microscopy.
Supportive Supervision: ASM experts will provide direct technical assistance and supportive supervision to NIP staff. Additional supervision and mentoring will be provided by laboratory advisors from CDC
Namibia. NIP managers and supervisors will provide day-to-day management oversight and supervision.
Sustainability: NIP is a public limited company established by Act of Parliament in 1999. NIP started operations in December 2000 and has assumed responsibility for 37 MOHSS laboratories since then. NIP's budget is structured to recover a substantial portion of its costs through reimbursements from public and private insurance plans. PEPFAR will work with NIP to ensure that appropriate administrative systems exist to allow NIP to sustain an independent relationship with partners like ASM. Support for improve TB diagnostic services will contribute to case identification and promote efficiencies in linking new cases to treatment.
