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 NARRATIVE
This mechanism will provide direct USG support for a broad portfolio of country-driven approaches to build health care systems and strengthen country capacity to deliver quality health care.
Objectives: This mechanism will support a general expansion of the MOHSS's ability to implement cross- cutting programs that leverage investments in HIV/AIDS and other areas across the entire healthcare system. Specific areas of emphasis will include, but not be limited to:
• Development of a national quality management program • Strengthen laboratory systems planning and management • Interventions that reduce maternal and infant mortality rates (e.g., the MOHSS Roadmap for the Acceleration of the Reduction of. Maternal and Newborn Mortality.) • Integration of health management information systems
Support for these objectives will focus on strengthening existing healthcare systems, leveraging investments for expanded or new systems, and improving coordination between the public and private healthcare sectors. Support for human capacity development will focus on training and retention of Namibian staff. Special emphasis will be placed on expanding the ability of the GRN civil service to absorb new categories of healthcare workers, and manage short-term contracts to Namibian outsourcing firms. Building transparent and flexible systems will be a priority for this mechanism.
Partnership Framework: In COP10, PEPFAR will emphasize the GRN's capacity to plan, oversee, manage and, eventually, finance a growing share of the commitments made in the four priority areas identified by the PF: Prevention; Treatment, Care and Support; Impact Mitigation; and Coordination and Management.
This mechanism will encompass a broad range of activities and commitments described in the PF. Specifically, key objectives supported under the Coordination and Management thematic area will include leadership and governance, human resources/human capacity development, and monitoring and evaluation. This mechanism builds on more than five years of government-to-government engagement through a CDC cooperative agreement with the MOHSS for specific support to the national HIV/AIDS response. In line with PEPFAR's strategic emphasis on mainstreaming HIV/AIDS investments and supporting multi-sectoral interventions, this cooperative agreement will expand CDC's ability to deliver USG-funded technical assistance for health systems strengthening, primary health care, maternal and child health, and other services offered by the MOHSS.
The direct support model have already proven successful in Namibia, where matching MOHSS contributions to primary care services have grown with the PEPFAR-supported scale-up of ART and other HIV/AIDS services.
Coverage: The activities under this mechanism are national in scope.
Health systems strengthening: This mechanism will leverage on-going MOHSS investments in strategic planning, costing, decentralization and multi-sectoral coordination. Expanding PEPFAR's ability to support cross-cutting programs in primary healthcare, maternal and child health, sanitation and nutrition will open opportunities to leverage PEPFAR's HIV/AIDS investments and integrate them into the broader healthcare system. This new mechanism will also improve PEPFAR's visibility in other areas of the healthcare sector, and allow for new collaborations with other development partners.
The mechanism's specific focus on Human Resources for Health will build on recent MOHSS HR policy changes driven by revisions to the Namibian Labour Law in 2009. While the USG will continue to support the GRN civil service as the primary public sector employment mechanism, technical assistance will encourage the development of flexible and diverse HR mechanisms within the civil service, including outsourcing.
Cross-cutting/Key issues: As noted above, this mechanism will promote the development of strong, transparent and flexible human resource systems within the MOHSS. These systems will allow the GRN to recruit and retain a broader spectrum of healthcare workers, including community-based outreach workers. Through the GRN task-shifting initiative, these workers increasingly contribute to non-HIV health promotion activities, including immunization campaigns, clean water and nutrition awareness, and referrals to testing for TB. The efficient management of these community based human resources will reduce Namibia's dependence on external implementing partners and allow for a realignment of resources to improve access to basic healthcare for all Namibians.
Cost efficiency: This mechanism will specifically strengthen MOHSS ability to plan, implement, monitor and evaluate cross-cutting strategies within and beyond the national HIV/AIDS response. In line with the PF requirement that the USG assess the appropriate role for external partners, this mechanism will expand the MOHSS's capacity to identify, choose and finance its own technical assistance. Support for training and HSS will also promote the availability and use of national experts rather than external partners.
M&E: 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. Grantees must also submit bi-annual status reports to program managers in Namibia. Data in these reports may be used inform any year-on-year changes to the work plan.
This is a new activity in COP10. It includes one component: 1) Cross-cutting technical and other assistance to the Ministry of Health and Social Services to expand the impact of HIV/AIDS investments across the national healthcare system.
The MOHSS will develop a work plan based on existing program needs and evidence. Focus activities should include, but not be limited to:
Policy and guideline development. Support for human capacity development in the field of healthcare policy and program management. This support will focus on policies and guidelines related to quality improvement, the national laboratory strategic plan, integration data systems across the healthcare sector, and maternal and child health.
Strengthen management capacity at all levels. Training will strengthen the managerial capacity of health managers at all levels. This will promote the MOHSS strategic objective of devolving decision making to sub-national and facility levels, and strengthening the quality improvement feedback loop.
Training. Training for Namibian healthcare workers in Namibia will promote the availability and use of national experts rather than external partners, and address personnel gaps in MOHSS facilities. Training will cut across multiple technical areas and seek to integrate non-HIV/AIDS elements where possible (e.g., IMAI).
Health Management Information Systems. The MOHSS collects and manages data across several non- integrated systems. In COP10 the USG will support the MOHSS' efforts to integrate these health information systems and promote the timely use of data at the facility level. Additionally, USG will provide TA to support operational research, disease surveillance and provide short term training of staff in epidemiology and research methods.
Maternal and Newborn Health. In support of the Roadmap for Accelerating the Reduction of Maternal and Newborn Morbidity and Mortality, MOHSS will expand cross cutting training for health care workers, e.g., in delivering Basic and Emergency Obstetric (and Neonatal) Care. Activities will link with those under HMBL in the provision of safe blood products for women who may need blood transfusion.
Quality Management. Quality assurance is a health system element that has grown in importance as costs of health care have escalated and consumer awareness and demand for quality services have increased. Ensuring the safety of patients and personnel and improving quality have therefore become important objectives for National health systems. The MOHSS will strengthen the national quality management program through training and task-shifting to enhance patient and personnel safety, and improve overall healthcare quality.
Laboratory Services. In conjunction with activities in the HLAB areas, the MOHSS will promote cross- cutting training and capacity building within the national laboratory system. Specific activities may include:
1- Strengthening the Laboratory Liaison Committee 2- Developing a comprehensive national laboratory strategic plan 3- Coordinating and integrating fragmented testing services 4- Coordinating and integrating surveillance and response capacities and capabilities 5- Training to ensure adequate numbers of laboratory professionals are available.
Supportive Supervision: CDC technical advisors and nurse coordinators will provide supportive supervision to MOHSS counterparts. Other short term TA support will be leveraged from other technical areas e.g. HVSI support for HMIS, or HLAB support for laboratory training.
Sustainability: This activity will specifically strengthen MOHSS ability to plan, implement, monitor and evaluate cross-cutting strategies within and beyond the national HIV/AIDS response. In line with the PF requirement that the USG assess the appropriate role for external partners, this mechanism will expand the MOHSS' capacity to identify, choose and finance its own technical assistance. Support for training and HSS will also promote the availability and use of national experts rather than external partners.
