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
Over the last six years PEPFAR Implementing Partners have refurbished and equipped more than 375 laboratories throughout Nigeria for the diagnosis and treatment of HIV/AIDs patients. The volume of laboratory testing and diversity of laboratory settings results in a need for a mechanism for the management and evaluation of the consistency of the results produced by these laboratories. Additionally, a process for identifying and developing remediation plans for under-performing facilities is required to facilitate the effective strengthening of the laboratory facilities. Such sustainable laboratory systems strengthening is imperative to maintain and improve the laboratory expertise that has been built over the years in the country through implementation of quality control and quality assurance support functions.
Accordingly, the Axios Foundation, in cooperation with the CDC, PEPFAR Implementing Partners and the Government of Nigeria is developing an External Quality Assessment (EQA) process for PEPFAR laboratories to address these needs. The objectives of the EQA process are to: • Assess quality of laboratory performance among all PEPFAR laboratories • Provide assurance to consumers (physicians as well as patients) that results are reliable • Identify possible deficiencies in laboratory practices and guiding participants in corrective action towards improvement • Build and strengthen the capability of the national Medical Laboratory Science Council (MLSC) to provide quality assurance and over sight for laboratory services in the country in a sustainable manner • Encourage good laboratory practice • Collect information on the reliability characteristics of particular methods, materials and equipment and taking corrective actions as appropriate • Encourage implementation of quality assurance and control measures within laboratories • Collect information on performance of measurement principles in order to guide professionals and/or Government bodies towards achieving harmonization
• Identify laboratories of excellent performance for their involvement in training and education • Stimulate information exchange and networking among PEPFAR laboratories • Provide updated information on new developments in HIV diagnostics.
The focus of the project is creation of a national laboratory quality assurance process that is sustainable and scalable so that the EQA objectives can be applied to all PEPFAR laboratories. Over the last six years PEPFAR Implementing Partners have refurbished and equipped more than 375 laboratories throughout Nigeria for the diagnosis and treatment of HIV/AIDs patients. The volume of laboratory testing and diversity of laboratory settings results in a need for a mechanism for the management and evaluation of the consistency of the results produced by these laboratories. Additionally, a process for identifying and developing remediation plans for under-performing facilities is required to facilitate the effective strengthening of the laboratory facilities. Such sustainable laboratory systems strengthening is imperative to maintain and improve the laboratory expertise that has been built over the years in the country through implementation of quality control and quality assurance support functions.
Accordingly, the Axios Foundation, in cooperation with the CDC, PEPFAR Implementing Partners and the Government of Nigeria is developing an External Quality Assessment (EQA) process for PEPFAR laboratories to address these needs. The objectives of the EQA process are to: • Assess quality of laboratory performance among all PEPFAR laboratories • Provide assurance to consumers (physicians as well as patients) that results are reliable • Identify possible deficiencies in laboratory practices and guiding participants in corrective action towards improvement • Build and strengthen the capability of the national Medical Laboratory Science Council (MLSC) to provide quality assurance and over sight for laboratory services in the country in a sustainable manner • Encourage good laboratory practice • Collect information on the reliability characteristics of particular methods, materials and equipment and taking corrective actions as appropriate • Encourage implementation of quality assurance and control measures within laboratories • Collect information on performance of measurement principles in order to guide professionals and/or Government bodies towards achieving harmonization • Identify laboratories of excellent performance for their involvement in training and education • Stimulate information exchange and networking among PEPFAR laboratories
• Provide updated information on new developments in HIV diagnostics.
The focus of the project is creation of a national laboratory quality assurance process that is sustainable and scalable so that the EQA objectives can be applied to all PEPFAR laboratories.
This narrative describes Axios Foundation's continuing activities in Health Systems Strengthening through the development of an External Quality Assessment (EQA) scheme for PEPFAR laboratories in Nigeria for COP10.
REDACTED, Axios Foundation will continue the necessary system strengthening and human capacity development activities to have the site begin operations in COP10 in order to harmonize the PEPFAR supported laboratories within Nigeria and take the first steps toward the ultimate goal of WHO AFRO accreditation for the center.
Axios will build on and strengthen partnerships with WHO, Medical Laboratory Science Council (MLSC) and NBTS with an emphasis of inexpensive partnerships to guarantee the sustainability of EQA activities in country. As part of the focus on system strengthening in COP10, Axios will establish a partnership for
mentoring and coaching to be provided by key technical staff within the EQA supply partners of NHLS/NICD in South Africa to Zaria staff and its in-country partners.
This relationship will include a tailored training session by a team of experts from NHLS and will include not only the staff at Zaria, but selected key individuals from the Medical Laboratory Science Council of Nigeria (MLSCN) and the Center for Disease Control as well. This training session will either take place in Zaria or South Africa
In COP10, the educational component of the EQA scheme will be refined; high and low performing laboratories will be identified and mentoring relationships with appropriate training sessions and field visits from Zaria staff to supporting laboratories will take place.
Building on the initial partnerships established in COP09, Axios will arrange with panel supply partners for the shipments of HIV serology and CD4 panels for a selected group of USG/PEPFAR laboratories who will form the initial pilot group of the scheme with a planned phased approach to include all USG/PEPFAR labs by the end of COP10.
Following the initial rounds of panel testing and results submission in COP10, Axios will conduct a brief assessment in to track improvements in the quality of testing among participating laboratories. Significant challenges will be identified and the means to address these challenges will be explored in collaboration with the PEPFAR partners. As part of an internal quality assurance (QA) process, Axios will also assess the feedback loop between the IPs and Zaria EQA center as well as a feedback loop between the participating laboratories and the IPs. This analysis will be used to identify strengths, weaknesses, opportunities and threats to the operation of the EQA scheme. Lessons learned and challenges overcome will be documented and shared through regular written communication such as newsletters with all USG/PEPFAR IPs as well as all members of the USG partners.
As part of the focus on Health Systems Strengthening in COP10, Axios will identify new partnerships and links to source hematology & chemistry EQA panels for Zaria EQA center, followed by an evaluation of the potential to introduce real time polymerase chain reaction (PCR) techniques such as Viral Load Testing and HIV pediatrics (DBS) EQA schemes. To enable such services, a suitable structure within the compound of the National Tuberculosis and Leprosy Centre in Zaria, Kaduna State will need to be identified. REDACTED. of the Zaria staff in PCR technology.
When the Zaria EQA center is operating, it will systematically gather all relevant operational data to provide an evidence base for replicating and expanding the Zaria model into another region in Nigeria.
