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
COP 2010 Overview Narrative
This mechanism is intended to develop and build the institutional capacity of the Ministry of Defense/Namibian Defense Force (MOD/NDF),through pre- and in-service training and mentoring, to strengthen ownership, leadership, management and planning capacities and ultimately to sustain the HIV/AIDS response in the Namibian military.
The overall goal of this mechanism is to support the strategic goals and objectives of the 5 year National Strategic Framework (NSF) and the Partnership Framework Agreement (PFA) by providing comprehensive HIV care and treatment services in MOD/NDF.
1. I-TECH has five comprehensive goals under this mechanism. I-TECH assists the MOD/NDF to build capacity to:
a) Expand and strengthen military counseling and testing services and promote use of these services;
b) Pilot and establish male circumcision (MC) services;
c) Strengthen and expand HIV treatment, care and support (including tuberculosis (TB) services and laboratory support), prevention with positives, and promote use of these services;
d) Build capacity and fortify infrastructure for strategic information; and
e) Strengthen health systems and enhancing human resources for health, through both in-service and pre-service capacity building and mentorship programs for military health personnel, improving the pharmacy and medicine logistics, ensuring quality laboratory services, addressing stigma and discrimination, fostering leadership and management, and supporting MOD policy initiatives.
2. I-TECH will contribute to the goals and benchmarks of the PFA and Partnership Framework Implementation Plan (PFIP) through a focus on building the MOD/NDF's capacity to create an enabling environment to effectively manage and deliver quality, accessible HIV care and treatment services. COP10 activities supported the USG supported objectives and commitments in the following focus areas: care support and treatment; prevention, and coordination and management. COP11 activities will continue to strengthen the implementation of the program at the military facilities. Specifically, I-TECH contributes by:
a) Assisting the military to tailor MOHSS service delivery systems and tools to fit the specific needs of the military, with emphasis on the establishment of quality assurance (QA) systems. Maintaining focus on building MOD/NDF capacity, including trainings structured to ensure services remain uninterrupted during the military staff rotation process, the continuation of mentoring activities, and introduction of pre-service bursaries in the most critical health areas to address the shortage of human resources for health in the military. Reflecting Namibia's long term goal to integrate antiretroviral treatment (ART) services into primary health care (PHC) settings, activities include supporting the MOD to scale up a standardized, comprehensive package of HIV services that can be expanded as tasks are shifted to the nursing level.
b) Providing technical assistance and equipment/supplies to support the military to pilot and scale-up MC services.
c) Enhancing management and leadership skills at both the facility level and the national level so that the military can ultimately take over overall planning, budgeting, management and monitoring and evaluation of the entire health system.
3. The target population is approximately 15,000 MOD/NDF staff and civilian workers at the military bases and camps spread throughout the country.
4. Key contributions to health systems strengthening include support to: roll out the MOD/NDF's first sectoral HIV policy, address HIV-related stigma and discrimination, and enhance management and leadership. In addition, I-TECH works to tailor MoHSS systems to military settings in order to ensure synergies between the national program and the military program and to ensure coordination between MOD/NDF and MOHSS; strengthen QA systems; enhance physical infrastructure; and procure equipment and provider imitated testing and counseling (PITC), and MC services. To date, assistance has enabled the MOD/NDF to launch its first treatment site and to establish the first military laboratory capable of processing HIV-related tests. Technical assistance will be provided to the military in order to strengthen linkages between community based and clinic based HIV care services.
5. Cross-cutting programs and key issues.
X-cutting: Human resources for health
Key issues: Military population (also a mobile population and workforce program)
Health Wrap around: TB and Prevention with Positives
Gender: Addressing male norms and behaviors, through Positive Health Dignity and Prevention (PHDP), VCT and MC counseling
6. Highlights of activities to become more cost efficient over time include: Integrating military HIV services into services regularly provided at each clinic and sick bay, will lower the cost of providing services. Making provisions for MOD/NDF staff to participate in the MOHSS's existing training programs eliminate the need to update curricula and creates an economy of scale for the MOD.
7. The monitoring and evaluation plan includes PEPFAR indicators and is fully integrated into the overall USDOD M&E plan for assistance to the MOD/NDF. In COP 11, I-TECH will continue to provide TA to MOD/NDF in the area of M&E.
The Namibian Ministry of Defense/Namibian Defense Force (MOD/NDF) continues to implement a comprehensive care and support program for its military members on Home Based Care (HBC), where military health care workers conduct regular visits to their members on HBC and provide them the required support services, including HBC kits and other prevention messages. This activity is implemented by MOD/NDF health care officials at the various military installations. The MOD/NDF has close working relationships with the Ministry of Health and Social Services (MoHSS) in implementing health related program in the military. HBC guidelines and other care and support materials used in the military are adapted for military settings but developed with the input of the MoHSS. This activity will continue to assist to strengthen clinical and community HBC for military personnel and civilian employees working on military bases and those military personnel on HBC.
1. Support the MOD/NDF with provision of Clinic-based and home based palliative care through:
Expanding the implementation of a comprehensive package of HIV services at 2 additional military health facilities,
building military capacity through training military health care workers to expand prevention and treatment of opportunistic infections and HIV-related symptoms and pain through identifying palliative care courses and support military health care workers to the courses,
strengthening military Health Care Workers' (HCW) capacity to record home based care patient data, generate reports and use report data for planning purposes
Continuing Activity
Estimated Budget = $ 24,600
2. Strengthening support groups activities and benefits to at least 2 Military sites through promotion of psychosocial through,
building military health workers capacity to conduct nutrition assessments and provide counseling and monitoring of nutritional status for their members receiving care and support,
Train military HCWs to educate support groups on basic nutrition activities and how to eat healthy considering also their cultural diets.
Assist the military to maximize nutritional status of HIV positive military personnel,
Procuring and supporting distribution of nutritional supplements (vitamins) for military members who are in need, according to the MoHSS guidelines.
Estimated Budget = $36,900
3. Continue to procure and distribute cervical cancer screening equipment and supplies for MOD/NDF health facilities where these services are conducted (moved from treatment as per technical recommendations)
Estimated Budget = $ 7,400
4. Support the MOD/NDF to improve home-based care for needy military personnel through:
training and provision of technical assistance including routine clinical mentoring on home-based palliative care to military home-based caregivers,
training HBC-givers in Positive Health Dignity and Prevention (PHDP) activities,
Training Support Group members in Positive Health Dignity and Prevention (PHDP)
Assisting the military to establish a system for monitoring quality of home-based care; and
Supplying HBC kits refills as needed (MOD/NDF will take over the supply of kits over time).
Estimated Budget = $ 18,500
5. In collaboration with the DoD Prevention Partner, develop, adapt and distribute military specific IEC materials on nutrition, positive living etc., as per the MoHSS guidelines and materials.
6. Personnel and Administrative Costs
Estimated Budget = $ 54,600
The Ministry of Defense/Namibian Defense Force (MOD/NDF) manages its own hospital, laboratory, pharmacy, and clinics and sick bays at its various military installations managed by trained military health care workers. Although these facilities are managed by trained military personnel, the MOD/NDF has built a strong working relationship with the Ministry of Health and Social Services (MoHSS) and implements its programs in line with the MoHSS guidelines and policies. Where necessary, MOD/NDF also receives technical and material support from MoHSS. This activity will continue to provide TA in order to strengthen the capacity of MOD/NDF to make available high quality HIV treatment services for staff members and civilian employees working on military bases.
1. Support a comprehensive package of HIV services at 2 military sick bays which includes treatment services offered by doctors and registered nurses RNs (screening and pre-ART treatment, medicine adherence counseling, follow-up and monitoring as well as cervical cancer screening). Equipment for cervical cancer screening are procured under the care and support program area.
2. Provide technical assistance (TA), continuous on site mentoring and train military health workers in provision of ARVs, adherence monitoring and counseling, pharmaceutical services, and Positive Health Dignity and Prevention and cervical cancer screening
Estimated Budget = $ 58,800
3. Supporting the military in delivering quality HIV care through building capacity in:
recording (patient records and registers),
generating monthly, quarterly , and annual reports and analyzing them for planning purposes, patient tracking and providing the necessary support services.
Submitting reports to the MOD Headquarters, and
Monitoring quality of HIV care.
(This activity is linked to strategic information)
Estimated Budget = $ 14,700
4. Support MOD/NDF to expand access to ARV treatment and other HIV services through outreach visits and appropriate referrals from military HCT sites. This activity will be implemented according to the MoHSS outreach guidelines.
Continuing Acitivity
Estimated Budget = $ 73,400
5. Assist the military to provide efficient and quality treatment services through undertaking monthly clinical HIV mentoring to the health facilities, and establishment of an internal HIV mentoring system. This activity is implemented by the same mentoring team providing clinical support services to the MoHSS.
Estimated Budget = $ 22,100
6. Collaborate with the DOD Prevention partner to assist MOD/NDF to create demand for HIV services through military facilitated viewings of RE3 (total: 500 people) and strengthening referrals from military HCT sites.
7. Collaborate with the DOD Prevention partner to develop, adapt and distribute military specific IEC materials on treatment based on the MoHSS treatment guidelines and any other treatment information.
Estimated Budget = $ 8,600
8. Personnel and Administrative Costs
Estimated Budget = $ 135,500
This activity will continue to support the Ministry of Defense and the Namibia Defense Force (MOD/NDF) to strengthen and expand HIV counseling and testing services by making services more accessible to military personnel. MOD/NDF works very closely with the Ministry of Health and Social services (MoHSS) and the Namibia Institute of Pathology (NIP) in the implementation of counseling and testing services. The MOD/NDF uses the MoHSS national guidelines and receives support from both NIP and the MoHSS in terms of quality assurance and control. The MOD/NDF counseling and testing centers are certified by the MoHSS before the commencement of these services in the military. ITECH continues to build the capacity of the MOD/NDF to provide HCT services through:
1. Training military staff to provide counseling (VCT) provider initiated testing and counseling (PITC) and rapid testing (RT).
Training military site managers to monitor services and assure quality.
Train 6 military health care officers to become trainers in HCT (TOT)
Estimated Budget = $ 70,000
2. Expand accessibility to quality HCT services through:
training of additional service providers for existing static sites,
supporting Outreach and Mobile HCT services and referrals,
Supporting the opening of new static site(s) as per the request of MOD/NDF.
Estimated Budget = $ 45,600
3. Provide ongoing technical assistant to the data personnel at the VCT sites in the use of the HCT data base, monitor its use and facilitate its review when needed and ensure linkages with the ARV facilities
Estimated Budget = $ 22,000
4. Continue to assist the military to establish internal and external quality assurance systems for counseling, rapid testing, and data functions and facilitate linkages between MOD/NDF the Ministry of Health and Social Services and the Namibia Institute for Pathology in conducting quality assurance as per national Guidelines.
Estimated Budget = $ 9,400
5. Provide technical and logistical support for routine and special promotions for HCT services (National Testing Days and World AIDS Day Commemorations, World TB Day) through:
refresher training in HCT and RT,
procurement of testing kits and supplies,
procurement of promotional materials, as needed,
Provision of onsite support and supervision.
Estimated Budget = $ 60,600
6. Collaborate with the DOD Prevention partner to develop, produce and distribute military specific IEC Materials for HCT services, possibly including a training video on counseling.
Estimated Budget = $ 10,000
7. Provide continual IT training to all HCT staff to boost computer literacy, improve data management, its communication and its security and work with MOD/NDF to determine the usefulness of electronic information captured by mobile outreach services.
Estimated Budget = $ 10,200
Estimated Budget = $ 133,927
PEPFAR funding has been used to support the Ministry of Defense/Namibian Defense Force (MOD/NDF) to establish an integrated health management information system (HMIS) for its military health care facilities and to train military health care workers and data clerks on the use of the HMIS. A paper based patients' record, adapted from that of the Ministry of Health and Social Services (MoHSS), was developed and is being used at the military ARV Clinic. MOD/NDF has been sharing their health care data with the MoHSS and will continue to do that as per ministry to ministry arrangements. However, ITECH will provide continued technical assistance to the MoD/ NDF to further develop their HIV-MIS system (installation, use and maintenance of the Electronic Medical Records (EMR) system, including any structural modifications to the existing infrastructure).
1. Assess need for and feasibility of creating a link between care and treatment database to pharmacy and laboratory databases
Estimated Budget = $ 5,400
2. Procure computer equipment as needed and expand internet connectivity to all HCT and treatment sites
Estimated Budget = $ 6,600
3. Build MOD IT Capacity through sponsoring Military IT specialists/ personnel to attend accredited identified IT short courses on systems management and hardware maintenance as well as Computer short courses for program staff offered by different institutions.
4. Support the MoD/NDF in the maintenance and review of the HCT, the treatment and care and laboratory data bases.
Estimated Budget = $ 3,100
5. Provide partial funding for MOD/NDF's HIV sero-prevalence and behavioral survey through
Local TA to support the process.
Training of MOD/NDF staff to implement the survey and analyze data.
Training MOD/NDF staff to use data for planning and policy development purposes and on how to share the data with their members for behavior change purposes.
Estimated Budget = $ 12,300
6. Assist in development of a system to enable MOD/NDF to collect information from different sites and integrate and analyze it using the Electronic Medical Records system.
Estimated Budget = $ 15,000
7. Support MoD IT Staff training on OpenMRS and other related technologies needed to implement the proposed HIV-MIS (EMR) system.
Estimated Budget = $ 9,200
Estimated Budget = $ 38,400
This ongoing activity continue to focus on support to strengthen the institutional capacity of the Ministry of Defense/Namibian Defense Force (MOD/NDF) by promoting an enabling policy and legal environment for the effective implementation of the HIV prevention, care, and treatment services. The activity also contributes to long term ownership and sustainability of the program by providing support in human capacity development via pre and in-service training, mentoring and enabling MOD/NDF members to effectively implement the program of MOD/NDF. Men make up over 70% of the military population; however, training under COP09 and COP10 has been focusing on addressing various issues also related to gender and HIV/AIDS mainstreaming, as well as promoting the participation of female military personnel in leadership and management, policy development and monitoring and evaluation courses.
ITECH will continue to :
Facilitate training for senior personnel on leadership and management, and on HIV policy implementation and monitoring
Collaborate with the DOD Prevention partner to build the capacity of the MOD/NDF HIV Steering Committee to better monitor and advocate for HIV/AIDS issues, including resource mobilization for the military program.
Facilitate management training for MOD/NDF mid level management staff at the national and facility levels.
Continue the roll-out of HIV-related stigma and discrimination reduction, male norms and gender trainings among military personnel and promote the effective participation of the gender focal persons at all the military installations in HIV/AIDS programs.
Estimated Budget = $ 22,500
Collaborate with the DOD Prevention partner to assist MOD/NDF to with additional training for peer educators on the HIV/AIDS policy and ensure that young women soldiers are also part of the peer groups.
Estimated Budget = $ 2,200
Assist the MoD conduct a training impact assessment of military personnel that have gone through different training programs nationally and regionally to assess whether the trained personnel are utilizing their skills effectively, assess the impact of these training on the military health care workers and to provide recommendations for future interventions.
Assist MOD/NDF to increase the number of trained pharmacy personnel through funding bursaries for two military students on the pharmacist's assistant program at national training institutions.
Help the MoD/NDF identify opportunities for learning from other militaries on the use of EMR systems.
Estimated Budget = $ 6,200
Support MoD/NDF personnel participate in national and international training programs, conferences and workshops on HIV/AIDS with the view to share best practices and learn from other experiences, including the participation in PEPFAR related meetings and conferences and sharing of southsouth experiences with neighboring countries.
Personnel and Administrative Costs
The goal of this continuing activity from COP10 is to decrease new HIV infections in the Ministry of Defense/Namibian Defense Force (MOD/NDF) through the establishment and expansion of male circumcision (MC) services at various military installations as well as providing training to military health care workers to conduct the activity within their own settings. Building the capacity of and providing technical assistance to the MOD/NDF to offer MC services is critical considering the majority of these military officers are young male and mobile. ITECH will continue to support MOD/NDF to scale up male circumcision in military facilities and possibly through outreach services depending on the Ministry of Health and Social Services (MoHSS) Guidelines for scaling up MC in the country:
Pilot outreach MC services to at least 2 other military sites,
procure equipment for outreach services,
Procure ongoing supplies for all service sites conducting MC.
Estimated Budget = $ 20,300
1. Work with the military to coordinate and participate in regular onsite supportive supervision and quality assurance for both military sites and for MC outreach services,
Estimated Budget = $ 6,100
2. Provide training for:
additional clinicians and counselors in MC provision,
other military health care workers to deal with pre and post MC clients,
Military personnel in MC awareness for demand creation; and
Military commanders in MC advocacy while promoting the reduction of multiple and concurrent sexual partnerships and consistent condom use.
Estimated Budget = $ 21,327
3. Assist in raising awareness on the benefits of MC through :
production and/or adaptation of IEC materials specific to the military (including videos, pamphlets, brochures etc) in collaboration with the DoD Prevention Partner
incorporating MC education into HCT and Peer education and other counseling services
4. Providing TA to military health care workers (HCWs) in order to deliver confidential MC services to their members as part of a comprehensive HIV prevention program which also includes HIV testing and counseling with referrals, treatment for other STIs, counseling on risk-reduction and safer-sex practices, including multiple sexual relationships, and condom distribution.
EStimated Budget = $ 6,100
5. Provide TA to the MOD/NDF to develop a military strategy and operational plan for further scaling up of MC services, including a multi-year plan for meeting the back-log of MC demand and also for quality assurance measures
Estimated Budget = $ 3,000
6. Assist MOD/NDF to evaluate MC services and demand creation activities, including the establishment of an electronic data capturing system for essential reporting which should ultimately be linked to other health information systems within the military health facilities.
Estimated Budget = $ 24,300
7. Personnel and Administrative Costs
The Ministry of Defense/Namibian Defense Force (MOD/NDF) has a well established laboratory at its military hospital. This laboratory is managed by a qualified military laboratory technologist and an assistant laboratory technician. In addition to the services provided at the military laboratory, MOD/NDF has established close working relationships with the Namibia Institute for Pathology (NIP) and the Ministry of Health and Social Services in this field in order to harmonize activities and to provide ongoing technical support to the MOD/NDF. ITECH will continue to provide technical assistance to the military to implement effective and quality laboratory testing services.
1. Assist the MOD/NDF to ensure high quality laboratory services, specifically to:
Provide and monitor laboratory equipment maintenance.
Train on bio-clinical monitoring assays.
Provide TA to the laboratory technologist to ensure that the laboratory continues to meet external quality assurance requirements as per the guidelines of MOHSS and NIP
Provide mentoring to laboratory staff including quality management systems and preparation for accreditation to the South African National Accreditation System (SANAS) which is the only regional body internationally accredited.
Support MOD/NDF to continuously review and update and review Laboratory Standard Operating Procedures (SOPs)
Estimated Budget = $ 12,200
2. Procure additional laboratory equipment and supplies as needed, and train lab technologists in the use of the new equipment.
Estimated Budget = $ 24,400
3. Assist the MOD/NDF to transition from a paper-based system to an electronic Laboratory Information System.
Estimated Budget = $ 20,000
4. Provide assistance to MOD/NDF in strategic planning and strengthening laboratory logistics and internal quality assurance.
Conduct further laboratory and training needs assessments as necessary.
5. Facilitate in-service training for three military laboratory personnel through Namibia Institute of Pathology (NIP) and to other relevant specialized courses in order to strengthen the provision of and ensure the sustainability of quality services
Estimated Budget = $ 7,300
6. Assist MOD/NDF to increase the number of trained laboratory technologists through the funding of two 2nd year and 2 first year military students for the Biomedical Sciences program at Polytechnic of Namibia.
Estimated Budget = $18,200
7. Train 25 military nurses in specimen collection, storage, transport, client preparation, and specimen referral systems.
Estimated Budget = $6,100
The Ministry of Defense/Namibian Defense Force (MOD/NDF) has a well established TB program at its health facilities where military personnel are screened for TB. With DOD PEPFAR funds, ITECH has been supporting the MOD/NDF to integrate TB/HIV into its health facilities since COP10. The goal of this continuing budget code narrative is to decrease HIV/TB co-infections in the military. This activity is a priority because military personnel living at the bases are at high risk for TB because they reside in congregate living settings that could easily facilitate TB transmission. Both the Military hospital and the ARV clinic at Grootfontein have TB programs. ITECH will continue to support MOD/NDF to provide integrated HIV/TB treatment and care services to its military population by assisting the military hospital at Grootfontein to ensure an integration of TB and HIV and continue to work with Military sick bays and facilities to scale up TB/HIV services for HIV-infected clients through:
1. Training of military TB focal persons (nurses - 20), doctors and counselors/peer educators to provide TB treatment, promote adherence and trace defaulters, to screen for TB and to provide isoniazid preventive therapy (IPT) to HIV-infected clients without active TB.
Conduct on-going supportive TB mentoring visits to health facilities and mentor trained personnel
Estimated Budget = $21,600
2. Continue to assist the military to build a strong referral network for patients with suspected drug resistant TB, or sputum negative TB suspects at facilities not staffed by a physician and without access to x-ray services.
Estimated Budget = $3,300
3. Assist MOD/NDF to establish a recording and reporting system for Isoniazid Preventive Treatment (IPT) at all facilities and to reinforce linkages with the National TB Control Program for the reporting and management of TB cases. MOD/NDF usually shares its data with the MoHSS.
Estimated Budget = $9,800
4. Continue providing technical assistance to the MOD/NDF to implement and monitor the provision of TB prophylaxis, TB/HIV treatment in the military and TB infection control at all health facilities in line with Namibian MoHSS TB policies.
5. Provide technical assistance to health care workers (HCW) to be able to advocate for TB and HIV program linkages through referrals between and among the sick bays/ hospital, ART Clinic(s) HCT site (s) and the Laboratory.
Estimated Budget = $ 3,300
6. Continue providing training and mentoring to laboratory technologists in TB diagnostic testing.
Estimated Budget = $ 7,900
7. Develop, adapt and distribute military specific IEC materials on TB/HIV in collaboration with the DoD Prevention Partner. These materials will be developed according to the national TB and TB/HIV guidelines and adapted to military settings.
Continuing Activitiy
Estimated Budget = $ 27,500
