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.
This is a new implementing mechanism, and supports the roadmap to accelerate the reduction of maternal and neonatal mortality and morbidity.
The overall goal of this activity is to provide technical assistance to the Ministry of Health and Social Services (MoHSS), Directorate of Primary Health Care (PHC) in addressing the challenges posed by the Maternal and neonatal Health (MNH). The expected results are increased quality of MNH, and reduced maternal and neonatal morbidity and mortality by the end of the five-year award.
This implementing mechanism links up with the Partnership Framework's prevention program area, and more specifically Objective 1.6: Enhance Prevention of Mother-To-Child Transmission. It is also in line with the GON Roadmap to Accelerate the Reduction of Maternal and Neonatal Morbidity and Mortality. It is a key priority of the government and will also enhance the MoHSS' capacity to meet its Millennium Development Goals (MDG).
Namibia's maternal death rates have almost doubled in the past decade. It has steadily increased since 1992 from 225 to 449 in 2006 (NDHS 2006-7) per 100,000 live births. Consequently, the country is unlikely to achieve its MDG five (improve maternal health) by 2015. Serious shortcoming in treating causes of death has been identified, including insufficient coverage of basic emergency obstetric care services. Nationally, only 4 (11.8%) out of 34 district hospitals provide comprehensive emergency obstetric care services and all are located in the central regions (two in Windhoek, one in Otjiwarongo and one in Oshakati). This finding and other related factors place Namibia with unmet need for emergency obstetrical care of over 80%.
The high prevalence of both obstetric-related maternal mortality and HIV among pregnant women further demonstrates the need for programs that simultaneously address both problems. HIV/AIDS is the third leading cause of infant mortality (8%) and second leading cause of child mortality.
In COP 2010, USAID will transition support from an implementing partner (Intrahealth) to the MOHSS PHC's roll-out of the "Road Map for the Acceleration of the Reduction of Maternity and Neo-Natal Morbidity and Mortality". Under the leadership of PHC, USAID, in collaboration with the WHO, will strengthen PHC's capacity to oversee the integration of PMTCT into overall maternal health services with a focus in the mostly affected northern regions. USAID will contribute to the funding activities identified by PHC's in the roadmap funding gap analysis. This support will contribute to the health system strengthening since it was identified in the MoHSS health systems review as one the major weaknesses that has contributed to drive poor MNH.
This implementing mechanism will leverage the Government of Namibia (GRN) and WHO funds, and has great potential to build the capacity of existing MoHSS staff at minimal cost and without incurring additional costs of doing business through a prime partner. Additionally, the mechanism transitions the GRN from donor dependency for direct service delivery to more of a partnership based on technical assistance needs. While the focus would be on northern regions, USAID will participate in resource mobilization that will ensure that activities under the roadmap can be scaled up in other regions as per the NSF recommendations.
Monitoring and evaluation is fundamental to the success of this program. Routine data from District
Health Information System (DHIS) will be tracked with regards to MNH indicators and data quality assurance will be conducted through joint support supervision with PHC staff. The demographic health survey of 2011 will provide a good opportunity to evaluate concerted efforts of reversing the current trend of maternal mortality.
This is a new activity for FY10.
In line with the National Strategic Plan (NSF) and the Partnership Framework, the roadmap for the acceleration of the reduction of maternal and neonatal morbidity and mortality is a key priority. This new activity will be undertaken under the leadership of Directorate of Primary Health Care (PHC) in the Ministry of Health and Social Services (MOHSS) in collaboration with WHO. It has three main components: 1) improved governance, 2) financing and resource mobilization, and 3) Human Resources for Health (HRH) capacity development.
1. Improved governance. This will be achieved by working with regional structures and local
constituencies to improve inefficiencies among service providers, including changing policies to increase maternal and neonatal service delivery coverage. 2. Finance and resource mobilization. a. Translate the National Health Account Sub Account on Maternal and Child Health into evidence-based actions. b. Assist the PHC to conduct its own assessments and discussions with stakeholders to rapidly respond to the barriers women face in accessing safe delivery services. c. Assist the PHC in defining, costing and rolling-out a high-impact minimum package of interventions for mothers, children, and their partners at all levels of the health care delivery system, based on a self- sustaining model. 3. HRH capacity development. In line with the Partnership Framework Agreement (PFA), transitioning to Government of Namibia (GRN) ownership will require innovative capacity building. USAID-supported capacity building in the areas of governance, finance, and resource mobilization directly to the GRN will support an improved enabling enviornment for maternal, neonatal and child health, and PMTCT by addressing health care workers and improveing linkages and referral networks for HIV positive women.
The partnership between USAID and the MOHSS has been consolidated through participation in technical working groups and joint support supervisions. Supporting the GRN directly will allow for integration and PMTCT transitional plans from USG implementing partners to occur more rapidly in line with the PF.
To ensure quality maternal and child health, the WHO tools will be used to track progress towards meeting the standard in the various components of a comprehensive emergency obstetrical care.
This activity is focused on filling the current gaps identified in the Roadmap for Accelerating the Reduction of Maternal and Newborn Morbidity and Mortality. The result is an integration of PMTCT into PHC care services, reduced maternal and neonatal morbidity and mortality, enhanced capacity of service providers, and improved governance. This direct technical assistance to PHC management over the next four years will build capacity and transition technical skills to sustain improved governance, HRH capacity, and resource mobilization.
