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
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Partners for Development (PFD) and their faith-based organization (FBO) sub-partner the Daughters of Charity (DC) implement the PMTCT component of their CDC funded project entitled ""Counseling, Care and Antiretroviral Mentoring Program" or CAMP, the name of PFD's CDC-funded project. In COP 09 PFD and DC worked in two sites located in Delta and Akwa Ibom states providing PMTCT services through a combination of satellite PHC facilities. Satellite PHC facilities in Benue and Bauchi states were also added in COP 09.
In COP 10, PFD will continue to provide PMTCT services to the same target population and plans to reach 2000 pregnant women. Utilizing a network model with primary health care outposts linked to secondary "hub sites" that provide more complex PMTCT care and lab testing, pregnant women receive PMTCT counseling & testing and receive their results. A total of 2 PMTCT hub sites will be supported linked to at least 10 satellite sites. In Akwa Ibom and Delta states, PMTCT stand alone points of service in the network are linked to adult and pediatric ARV care through utilization of a PMTCT network. Using the referral SOP, HIV+ pregnant women who require HAART are linked to an ARV point of service. Particular emphasis is placed on the involvement of community health workers who are the primary source of care for women in the pre and post-partum period and are integral to a program that seeks to engage women where they seek care. This program will work closely with the care and support team to maximally engage community based PMTCT and ARV linkages. In addition to receiving PMTCT services, each HIV+ pregnant woman will be referred to OVC services in order to facilitate care for all of her affected children. In Benue and Bauchi states, satellite PHC facilities are mentored by PFD staff and assisted by local NGOs.
Opt-out HCT with same day test results will be provided to all women presenting for ANC and untested women presenting for labor and delivery. All women are provided pre-test counseling services on prevention of HIV infection including the risks of MTCT. Partner testing is offered as part of counseling through referral to on-site HCT centers. A step down training of couple counseling and a prevention for positives package will be utilized in all sites. This will provide an opportunity to interrupt heterosexual transmission, especially in discordant couples. Master trainers for HCT will train labor and delivery staff in the use of HIV rapid tests for women who present at delivery without antenatal care.
As a result of these PMTCT HCT activities, an anticipated 2000 HIV+ pregnant women will be tested and an anticipated 200 identified as HIV+ and provided with a complete course of ARV prophylaxis . HIV+ women will have access to supported lab services including CD4 counts without charge. This will be available on-site or within the network through specimen transport. Women requiring HAART for their own health care are linked to a network ARV service provision point. For the anticipated 2/3 of women not requiring HAART, the current national PMTCT guidelines recommended short course ARV option will be provided which includes ZDV from 28 weeks, ZDV/3TC from 34/36weeks and intra-partum NVP, and a 7 day ZDV/3TC post-partum tail. All HIV+ women will be linked post-partum to an HIV/ARV point of service, which will utilize a family centered care delivery model whenever feasible, co-locating adult and pediatric care and providing a linkage to family planning services.
HIV+ women will be counseled pre- and post-natally regarding exclusive breast feeding with early cessation or exclusive BMS if AFASS using the National infant feeding curriculum. Couples counseling or family member disclosure will be utilized to facilitate support for infant feeding choices. As part of OVC programming, we would provide safe nutritional supplements as well as water guard, bed nets and other home based care items. HIV+ women will be linked to support groups in their communities which will provide both education and ongoing support around infant feeding choices and prevention for positives. This will ensure that HIV+ women remain in care throughout pregnancy, receive ARV prophylaxis, are supported in their infant feeding choice, access EID, and are linked to HIV care post-partum, thereby reducing loss to follow-up throughout the PMTCT cascade.
Infant prophylaxis will consist of single dose NVP with ZDV for 6 weeks in accordance with Nigerian National PMTCT Guidelines. Cotrimoxazole suspension is provided to all exposed infants pending a negative virologic diagnosis. Testing of infants will be carried out using dried blood spot (DBS) specimen collection. We will actively participate in the national early infant diagnosis initiative by providing infant for DBS testing from 6weeks of age. A systematic coordinated approach to program linkage will be operationalized at the site level and program level including linkages to adult and pediatric ART services, OVC services and basic care and support. Quality monitoring will be undertaken through site visits using an existing assessment tool and routine monitoring and evaluation indicators.
PFD will train 5 HCWs from 2 sites including community-based health workers in the provision of PMTCT services and infant feeding counseling. The national PMTCT training curriculum, national infant feeding curriculum and new national training tools will be utilized.
CONTRIBUTIONS TO OVERALL PROGRAM AREA
This activity will provide counseling & testing services to 2000 pregnant women, and provide ARV prophylaxis to 200 mother and infants pairs. This will contribute to the PEPFAR country specific goals of preventing 1,145,545 new HIV infections in Nigeria by 2009.
LINKS TO OTHER ACTIVITIES
This activity is linked to care and support, OVC services, ARV services, laboratory infrastructure, sexual prevention, and SI. Prevention for positives counseling will be integrated within PMTCT care for HIV+ women. The basic package of care provided to all HIV+ patients will be available to HIV+ pregnant women. Women requiring HAART for their own health care will be linked to ARV services. Our lab staff will ensure that HIV testing provided within the PMTCT context is of high quality by incorporating PMTCT sites into the laboratory QA program.
POPULATIONS BEING TARGETED
This activity targets pregnant women who will be offered HCT, HIV+ pregnant women for ARV prophylaxis and infant feeding counseling, and exposed infants for prophylaxis and EID.
KEY LEGISLATIVE ISSUES ADDRESSED
This activity is related to issues of gender equity since treatment will be provided to women and will promote male involvement in PMTCT programming.
EMPHASIS AREAS
The major emphasis area is training as most supported personnel are technical experts. A secondary emphasis area is commodity procurement as ARVs for prophylaxis and laboratory reagents for infant diagnosis will be procured. Another secondary emphasis area is network/ referral systems as networks of care will be supported which are critical to ensuring quality of care at the PHC level, identifying women in need of HAART, and ensuring access to HAART within the network. In addition, partners and PABAs will be identified for linkage to care and support services.
MONITORING AND EVALUATION
CAMP clinics will track the number and proportion of women attending antenatal care each year who receive PMTCT services and the number of HIV+ women receiving antiretroviral prophylaxis. Quality of PMTCT sites will be monitored through indicators such as reduction in waiting time experienced by participants, the percentage of participants who complete their treatment, and the number of HIV+ women who undertake peer education activities in their communities about the benefits of VCT.
In COP10, under 'PEPFAR Nigeria's accelerated PMTCT plan', PFD, will strengthen its support to PMTCT service delivery by implementing activities that further improve the coverage and quality of PMTCT services. These activities will be directed towards increasing utilization of PMTCT services at existing service outlets through demand creation in collaboration with community resources and ensuring the upgrade of existing supported PHCs offering stand alone HIV counseling and testing to render at least minimal package of PMTCT services. In order to leverage resources, priority will be given to PHCs located in the selected focal states with presence of other donor agencies and in local government areas already earmarked for HSS support through GFATM. Where new sites are envisioned, those that are used for national ANC sero-sentinel surveys but yet to commence PMTCT services as well as PHCs located in communities with high HIV prevalence rates above the National average will be given priority.
