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: 2011 2012 2013 2014 2015
COP 2010 Overview Narrative
This is a new implementing mechanism.
PEPFAR Namibia will competitively award a single partner or consortium to promote normative change and adoption of safer sexual behaviors, with the aim of reducing new HIV infections among general population adults and youth. The new program will incorporate distinct activities in two sectors that will be closely coordinated by local partners during implementation: 1) media, and 2) comprehensive, community-based prevention. Activities under this award will provide coordinated social and behavior change communication and interventions to support sexual prevention, male circumcision (MC), HIV counseling and testing (CT), and prevention with HIV-infected persons.
This follow-on program responds to a headquarters review in March 2009 which found that many PEPFAR prevention interventions lack adequate structure and "dosage," and are limited in coverage to scattered sites across the country. Several existing prevention agreements that support media and community outreach are ending, including the NawaLife Trust agreement. This provides an opportunity to restructure the prevention portfolio to substantially enhance quality, geographic focus, and potential for impact.
The program will align with Government of Namibia (GRN) priorities and directly support the Prevention Thematic Area of the Partnership Framework, especially Objective 1 "Increase Social and Behavior Change focusing on the Key Drivers of the Epidemic." The recipient will participate in the Prevention TAC and implement activities falling within the national HIV prevention strategy.
The media component will be national in scope. This component will build capacity of the GRN to plan and manage an effective media program, while also providing implementation support for specific media campaigns and activities. The comprehensive community-based prevention component will focus on the northern zone of Namibia, which has the highest HIV prevalence and where two-thirds of the population resides. This component will build the capacity of regional and local-level GRN structures for program coordination and monitoring, while providing implementation support for a comprehensive, robust program of social and behavior change. Since USG resources are insufficient to provide national coverage of more intensive (and high cost) outreach and interpersonal approaches, implementation will focus selectively on priority regions and districts where the aim will be to provide "saturation" community-level coverage in conjunction with other PEPFAR and non-PEPFAR partners.
At the core of the strategy is support for effective implementation of an appropriate combination package that includes behavioral/social, bio-medical, and structural interventions with populations at high risk of infection in high incidence areas. These interventions will focus on: breaking the sexual networks that drive transmission; increasing consistent and correct condom use, especially in high risk sexual encounters and by HIV-positive persons; increasing the number of males who are circumcised; and increasing the age of sexual debut. The package of interventions will be based on evidence and use proven technologies and approaches. It will be grounded in local culture to address epidemic drivers through clear, specific, consistent messages and behavior and social norm change approaches.
A gender lens will be integrated into all activities, recognizing that cultural and gender norms reinforce key drivers of the epidemic such as multiple and concurrent partners and cross-generational and transactional sex. A high priority will be prevention for young adult women, who in Southern Africa have among the highest rates of HIV infection, together with efforts to influence norms, attitudes and behaviors of the adult men who put them at risk.
The program will build capacity and leadership of the Namibian government and civil society institutions to plan and implement effective prevention interventions. The program will promote sustainability by engaging individuals, communities, and leadership in ways that enable them to feel ownership of activities and results. Key principles will include using resources effectively and strategically; achieving quality, scale and scope; strengthening systems; and using existing structures to ensure sustainability beyond PEPFAR. It will create synergies through effective linkages with other partners, programs, and activities.
Evaluation will focus on changes in individual behavior and social norms relating to rates of multiple concurrent partnerships, age mixing in sexual partnerships, transactional sex, condom use in different types of relationships, alcohol use related to high risk sex, sexual violence, as well as onset of sexual activity and secondary abstinence among youth. Evaluation efforts will seek to measure trends in estimated HIV incidence in program districts. The program will also assess the capacity of GRN leadership at various levels to use data and evidence for improved programming and to coordinate partners and institutions in a sustained effective prevention effort. USG Namibia will seek HQ support to design, fund and conduct a rigorous evaluation of this ambitious program.
Implementation and support for coordination of community outreach prevention efforts.
New Activity
Estimated Budget = Redacted
ADDITIONAL DETAIL:
Proposed geographic scope Media: National, Community activities: Erongo, Hardap, Karas, Kunene, Omaheke, possibly Caprivi and Khomas
TBD partner will implement activities that integrate Positive Health, Dignity and Prevention (PHDP), formerly the PWP initiative, into broader HIV prevention efforts through community outreach services. Partner will collaborate with the existing PHDP lead training partners to implement these activities
Monitoring and evaluation efforts will be conducted and represent approximately five percent of costs associated to activities.
Implementation of media efforts, including related media campaigns to promote routine counseling and testing services
Implementation of complementary community outreach activities to support community mobilization, and promotion and uptake of routine counseling and testing services.
In media and community outreach activities, the activity will initiate a comprehensive program to promote normative change and adoption of safer sexual behaviors, with the aim of reducing new HIV infections among general population adults and youth. Media efforts will fully leverage USG/CDC and domestic funding to MOHSS for mass media design and implementation supporting national HCT campaign days. Efforts will focus on refining existing interpersonal materials, supporting events and promotions and additional language adaptations, and focusing on intensifying depth, breadth and dosage of HIV prevention activities and strengthening linkages to biomedical interventions.
In COP10 activities supported by Nawa Life Trust developed and implemented an umbrella communications and community outreach campaign to increase the overall uptake of HIV testing services in voluntary counseling and testing, the acceptance of provider-initiated counseling and testing, promoting acceptance of couples counseling and other models of HCT including outreach and mobile services. The key behavioral objectives were to mobilize persons that don't know their HIV status. Based on current findings from the implementation, this required increasing a sense of risk perception and decreasing fear of positive results among the target population as well as helping create convenient opportunities for testing. Activities were also structured to reinforce HIV prevention behaviors for those who complete HCT and are HIV negative. Materials will be utilized at IPC/community in outreach activities. Radio components of the campaign are expected to continue in the new award.
Represents HVSI funding allocation to a comprehensive HIV prevention program. This activity shall provide limited technical assistance and M&E support to local organizations and GRN community health initiatives including emphasis on community and regional planning, operationalize standard M&E systems (with emphasis on HIV prevention) and increase the use of data analysis for HIV prevention program performance improvement and decision making in regions of operation and by the program. M&E activities will build upon existing GRN and international standards and systems. Costs represent an M&E Advisor and associated operational costs to provide routine support to project M&E and limited technical assistance to GRN/partners.
This is a new award that will build on results of the Nawalife Trust activities in COP10, and local partners will conduct distinct media and community outreach activities that will support and reinforce normative changes associated with known epidemic drivers including: multiple concurrent partnerships; inconsistent condom use; excessive alcohol use; intergenerational and transactional sex; and a lack of HIV testing and public awareness of HIV serostatus.
Media and community outreach activities:
Media activities will be on a national scale and will build capacity of the GRN to plan and manage an effective media program, while also providing implementation support for specific media campaigns and activities. Community outreach will be implemented within regional and local-level GRN structures for program coordination and monitoring, while providing implementation support for a comprehensive, robust program of social and behavior change. Local partners conducting community outreach activities will adapt outreach materials and training guidelines previously developed under PEPFAR, strengthen community groups' implementation of structured prevention activities and implement a strengthened M&E system to support program management.
The behavioral change objectives include building skills for safe behaviors such as abstinence and delay of sexual debut, increasing perceptions of risk regarding multiple concurrent partnerships, increasing correct and consistent condom use, increasing risk perceptions of alcohol consumption, cross generational and transactional sex, and increasing positive attitudes for gender empowerment and male engagement. An integration of Positive Health, Dignity and Prevention (PHDP), formerly the PWP initiative, will offer comprehensive HIV prevention programming to sero-positive individuals.
Support to local organizations and GRN community health initiatives:
Regular supportive supervision, distribution of standardized materials and monitoring visits will be undertaken by prime recipients to ensure that media and community outreach activities are being conducted to standards established by the GRN and USG, that linkages are strengthened to biomedical interventions available and that data reporting is accurately reflecting progress against PEPFAR indicators. Activities shall support GRN community health initiatives.
Sustainability components will include capacity building of local civil society and regional administrations to better coordinate and implement evidence-based HIV prevention strategies.
Promote normative change and adoption of safer sexual behaviors through media and community outreach activities associated with known epidemic drivers.
Build upon an existing MC communication strategy, including demand creation activities and others that reinforce and support the MC communication strategy.
Activities that promote normative change:
This activity will promote normative change and adoption of safer sexual behaviors through media and community outreach activities associated with known epidemic drivers. Building on results of the Nawalife Trust activities in COP09, local partners will conduct distinct media and community outreach activities that will support and reinforce normative changes associated with known epidemic drivers, including: multiple concurrent partnerships; inconsistent condom use; excessive alcohol use; intergenerational and transactional sex; and a lack of HIV testing and public awareness of HIV serostatus.
Demand creation for MC and implementation of MC Communication Strategy:
This activity will build upon an existing MC communication strategy, which includes demand creation strategies, informational campaigns for males and females to better understand the procedure, as well as positioning MC within the larger context of HIV prevention strategies to discourage inhibition. Expanding on basic materials developed or adapted to Namibia, the recipient will partners with other stakeholder to implement campaigns utilizing mass media. Local partners conducting media and community outreach activities supported under CIRC will participate in the National Male Circumcision Task Force. The task force ensures a coordinated effort to develop and adapt non-clinical training, message development, and outreach models related to the promotion and demand creation of adult male circumcision.
Design, implementation and support for coordination of National media HIV prevention efforts to increase adoption of safer sexual behaviors through improved and expanded prevention services and changes in social norms that facilitate HIV transmission.
Design, implementation and support for coordination of community outreach prevention efforts including integration of primary prevention and PHDP activities to increase adoption of safer sexual behaviors through improved and expanded prevention services and changes in social norms that facilitate HIV transmission.
Provision of technical assistance and support to local organizations and GRN community health initiatives including emphasis on community and regional planning, operationalize standard M&E systems and increase the use of data analysis for program performance improvement and decision making.
Gender: In an effort to be responsive to concern over the incorporation of gender the recipient shall consider interventions to address male norms and health seeking behavior, intimate partner violence, alcohol abuse.
PEPFAR Namibia will initiate a comprehensive program to promote normative change and adoption of safer sexual behaviors, with the aim of reducing new HIV infections among general population adults and youth. The award will provide coordinated social and behavior change communication and interventions to support sexual prevention, male circumcision (MC), HIV counseling and testing (CT), and prevention with HIV-infected persons. The new activity will incorporate distinct activities in two sectors that will be closely coordinated during implementation: 1) media; and 2) comprehensive, community-based prevention.
Media and community outreach activities will be closely coordinated.
Media activities:
These activities will be on a national scale and will build capacity of the GRN to plan and manage an effective media program, while also providing implementation support for specific media campaigns and activities. Local partners conducting media activities will assess and adapt past campaign materials to address national audiences in selected areas of Namibia. Activities will continue to support the Ministry of Information, Communication and Technology's (MICT) Take Control program.
Community outreach:
Community outreach and related activities will build the capacity of regional and local-level GRN structures for program coordination and monitoring, while providing implementation support for a comprehensive, robust program of social and behavior change. Local partners conducting community outreach activities will adapt outreach materials and training guidelines previously developed under PEPFAR, strengthen community groups' implementation of structured prevention activities and implement a strengthened M&E system to support program management.
The behavioral change objectives include building skills for safe behaviors such as abstinence and delay of sexual debut, increasing perceptions of risk regarding multiple concurrent partnerships, increasing correct and consistent condom use, increasing risk perceptions of alcohol consumption, cross generational and transactional sex, and increasing positive attitudes for gender empowerment and male engagement. An integration of components of Positive Health, Dignity and Prevention (PHDP), formerly the PWP initiative, will offer comprehensive HIV prevention programming to sero-positive individuals.
