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
COP 2010 Overview Narrative
FANTA-2 is a continuing implementing mechanism from FY09.
1. Goals and objectives: FANTA-2 works to improve nutrition and food security policies, strategies and programs through technical assistance (TA) to the USG and its partners including host countries, international organizations, and non-governmental (NGO) partners. The objectives of the program in Namibia are: 1) to provide TA to consolidate and scale up of integrated food and nutrition programs for eligible PLHIV and OVC; and 2) to improve nutrition and food security programs as well as livelihood support through TA to host country government entities and NGO partners.
Since COP07, FANTA-2 has designed PEPFAR-funded nutrition support for malnourished PLHIV and provided TA to strengthen the capacity of health care workers (HCW) in nutrition assessment, education, and counseling (NAEC) and support in HIV care and treatment sites. Activities link with USAID/Namibia's aims to strengthen the effectiveness of services and improve malnourished ART client outcomes through targeted, time-limited nutrition support; these activities also support UNICEF's work with the national integrated management of acute malnutrition program and the World Food Program's efforts to improve food security of PLHIV.
2. Link to Partnership Framework (PF) goals and benchmarks: FANTA-2 will continue to work with the Ministry of Health and Social Services (MOHSS) and PEPFAR implementing partners to improve client outcomes by strengthening NAEC, therapeutic and supplementary feeding of eligible adult and pediatric ART clients, PMTCT clients, and OVC. The food by prescription (FBP) approach initiated with FANTA-2 TA in COP09 and provision of TA to host government agencies and local NGOs to improve nutrition and food security policies and programs is in line with the National Strategic Framework (NSF), PF and Namibian National guidelines.
FANTA-2 TA aims to contribute to the following PF goals and objectives:
Pediatric and adult treatment care and support: FANTA-2 will improve ART adherence and treatment outcomes by supporting training and TA for the MOHSS to provide quality NAEC.
Prevention: FANTA-2 will strengthen NAEC in PMTCT sites and improve clinic-community linkages.
Impact mitigation: FANTA-2 will enhance nutrition for vulnerable households by working with the MOHSS and possibly Ministry of Agriculture, Water and Forestry to integrate food and nutrition into HIV programs and services.
3. Coverage and target populations: FANTA-2 activities will cover the national level (capacity building of the MOHSS to guide and monitor nutrition support and food security interventions for eligible clients) and regional clinic- and community-based care services supported by PEPFAR. Target populations include clinically malnourished adult PLWHA, HIV-positive pregnant and lactating women regardless of nutritional status, and OVC, including pediatric ART clients.
4. Contributions to health systems strengthening: Training of HCW in NAEC.
5. Cross-cutting programs: FANTA-2's activities in COP10 will support two cross-cutting PEPFAR programs under Food and Nutrition: Policy, Tools, and Service Delivery; and Human Resources for Health.
FANTA-2 will support consolidation of services in pilot FBP sites with a possible expansion to other sites if Global Fund resources become available. FANTA-2 will continue to work with the MOHSS to promote NAEC as a standard of care in HIV and OVC services; support training and reprinting of job aids and counseling cards; and visit sites to assure the quality of NAEC and follow-up. FANTA-2 will assist the MOHSS in strengthening systems for follow-up, mentoring, and supervision of trained service providers and document lessons from the FBP sites and/or specific components to inform further programming. FANTA-2 will work with relevant entities to address food security and livelihoods.
6. Cost-efficiency strategy: FANTA-2 will contribute to the sustainability of nutrition interventions in HIV services by continuing to build the capacity of HCW in NAEC and provision of specialized food products to treat malnutrition. Trained trainers and instructors will be available to train others on an ongoing basis. National nutrition and HIV guidelines and counseling materials will be available for reproduction or reprinting by other partners as needed. Supporting expansion of nutrition and HIV services will make these services more cost-efficient because of economies of scale. Integrating nutrition interventions into existing care and treatment services will be cost efficient because new services are not needed and existing services will improve outcomes. Support for local production of specialized food products may lead to greater cost efficiency.
7. M&E plans: FANTA-2 will work with HIVQUAL, a quality improvement program, and the USG to adapt the HIVQUAL facility self-assessment tools, which focus on food security, to assess NAEC quality in FBP sites. A full M&E plan will be developed along with plans to ensure data quality of program results. FANTA-2 will also support MOHSS staff to conduct regular site visits for supportive supervision, a crucial element in data quality assurance.
1. Conduct assessments of resource and logistical capacity of five new FBP sites.
New Activity
Estimated Budget = $30,675
2. Collaborate with TBD/training partner to train additional health care providers in NACS.
Continuing Activity
Estimated Budget = $40,000
3. Provide alongside the MOHSS regular mentoring and supervisory visits to FBP sites.
Estimated Budget = $35,000
4. Support design and dissemination of health service provider job aids and client education materials on nutrition and HIV.
5. Develop additional client education materials on nutrition and HIV.
Estimated Budget = $70,000
6. Conduct an assessment of progress, challenges, and lessons learned in the Namibia the FBP program.
Estimated Budget = $44,000
7. Provide TA to develop a livelihood strategy and strengthen existing livelihoods interventions for supported partners like CAFO, CAA etc.
Estimated Budget = $85,828
ADDITIONAL DETAIL:
Building on achievements and progress under COP 10, FANTA-2 will work with the MOHSS to scale up nutrition assessment, counseling, and support (NACS) to five additional district hospitals providing ART services. This scale-up will include assessments of the human resource and logistical capacity of each site to implement food by prescription (FBP), training of at least two health care providers from each site in NACS, and provision of job aids and client nutrition and HIV materials. FANTA-2 and the MOHSS will continue to visit FBP sites established under COP 10 for mentoring and supervision and follow up on nutrition and HIV data collection.
In the new FBP sites, FANTA-2 and the MOHSS will assess adequacy of space for nutrition assessment and counseling and storage of specialized food products; need for nutrition and HIV guidelines, job aids, and counseling and client materials; need for anthropometric equipment (scales, height boards and length boards, MUAC tapes); and need for NACS training. Based on the results of the assessments, FANTa-2 will provide technical assistance to the sites to improve their capacity to implement NACS services. FANTA-2, the MOHSS Food and Nutrition Sub-division, and the International Training and Education Center on HIV/AIDS (I-TECH) will conduct training in NACS for least 2 health care providers from each of the 5 new FBP sites and 24 from other ART sites not designated to provide specialized food products for malnourished PLHIV. FANTA-2 will also co-facilitate refresher training for health care providers in existing FBP sites who were trained earlier in NACS. FANTA-2 and the Food and Nutrition Sub-division of the MOHSS will make regular site visits to follow up health care providers trained in NACS to monitor the quality of nutrition assessment and counseling and provide technical support as needed. Nutrition and HIV job aids and client education materials produced under COP 10 will be reprinted for dissemination to the new FBP sites and to replenish stocks in existing sites. FANTA-2 will work with the MOHSS to develop new client education materials on nutrition and HIV based on needs identified through social and behavior change communication (SBCC) formative research carried out under COP 10. Results of the assessment of the FBP program will be disseminated to stakeholders in Namibia to inform planning of HIV care and treatment programs and services by the MOHSS, PEPFAR/Namibia, and the Global Fund.
FANTA through its sister project LIFT will provide the PEPFAR program with technical assistance (TA) in promoting livelihoods and food security interventions as sustainable options for graduates of FBP and other vulnerable households particularly child headed and OVC households. Such TA will include assisting the PEPFAR Team to develop a Livelihood strategy that is closely aligned with GRN's new nutrition and food security strategy, establishing and facilitating linkages to connect individuals in care and treatment programs to Economic Strengthening and livelihood opportunities. LIFT technical assistance would include support to strengthen existing referral and wrap-around mechanisms between clinic and community services. This activity is related to FANTA's activity in HKID and will work to strengthen existing livelihood interventions implemented by supported partners. It will also foster linkages with the Ministry of Agriculture and leverage resources from Food and Agricultural Organization projects in the north
1. Provide TA to develop a livelihood strategy and strengthen ongoing livelihood interventions of partner organizations proving care for vulnerable households.
Estimated Budget = $87,000
FANTA through its sister project LIFT will provide the PEPFAR program with technical assistance in developing a strategy for promoting livelihoods and food security interventions as sustainable options for graduates of FBP and other vulnerable households particularly child-headed and OVC households. LIFT will provide the PEPFAR program with technical assistance (TA) in promoting livelihoods and food security interventions as sustainable options for graduates of FBP and other vulnerable households particularly child headed and OVC households. Such TA will include assisting the PEPFAR Team to develop a Livelihood strategy that is closely aligned with the new GRN's nutrition and food security strategy, establishing and facilitating linkages to connect individuals in care and treatment programs to Economic Strengthening and livelihood opportunities. LIFT technical assistance would include support to strengthen existing referral and wrap-around mechanisms between clinic and community services. In addition linkages will be established with the Ministry of Agriculture as well as strengthening existing IGA activities within PEPFAR-supported CSOs through linkages to the market and increasing the value chain. This activity is related to FANTA's activity in HBHC and will specifically support development of a livelihood strategy and strengthen existing livelihood interventions implemented by supported partners.
1. Provide training in NACS to additional PMTCT providers.
Estimated Budget = $20,000
2. Support the development and dissemination of client education materials on IYCF in the context of HIV.
Estimated Budget = $30,000
3. Train HBC providers in nutrition management and support, including IYCF in the context of HIV.
Estiamated Budget = $30,000
FANTA-2 will continue to work with the MOHSS and TBD Training partner to train health care providers in ANC and MCH clinics in nutrition assessment, counseling, and support (NACS), including infant and young child feeding (IYCF) in the context of HIV. Trainees will be drawn from sites that provide PMTCT services and have referral links to district hospitals providing FBP services. FANTA-2 and the MOHSS will visit ANC and MCH sites with trained health care providers for mentoring and supervision and follow-up of nutrition and HIV data collection. FANTA-2 will work with the MOHSS to develop and print IYCF counseling materials for providers and clients in these sites. FANTA-2 will provide MUAC tapes and, pending discussions with UNICEF/Namibia, may support purchase of scales and length and height boards.
Following on NACS training under COP 10 for ANC and MCH clinic staff that provides PMTCT services, FANTA-2 and the MOHSS Food and Nutrition Sub-division will train staff from additional ANC and MCH clinics with referral links to district hospitals that provide FBP services. The training will focus on nutrition assessment and counseling of HIV-positive pregnant and post-partum women on maternal nutrition and IYCF in the context of HIV, as well as referral of clinically malnourished clients to FBP services. Based on needs identified through SBCC formative research under COP 10, FANTA-2 will work with the MOHSS Primary Health Care Directorate to develop needed take-home client education materials based on 2010 WHO guidance on IYCF in the context of HIV. Based on needs and discussion with UNICEF/Namibia, FANTA-2 will provide support to the MOHSS (PDCS) to ensure appropriate anthropometric equipments (scales, height boards and length boards, MUAC tapes) for nutrition assessment are provided in the additional ANC and MCH sites. FANTA-2 and the MOHSS Food and Nutrition Sub-division will visit the sites to monitor the quality of nutrition assessment and counseling and provide technical support as needed. FANTA-2 will build the capacity of HBC providers in nutrition management and support of HIV-affected families, especially infants and young children.
