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
The Walter Reed Army Institute of Research US Military HIV Research Program (USMHRP) maintains a fully serviced agency in Abuja Nigeria. This office is known as the Department of Defense HIV Program in Nigeria (DODHPN). The office is dedicated to PEPFAR country-level management activities (partners with the CDC and the USAID). These include participation in USG technical working group activities; strategic vision development and Country Operational Plan development. In addition to the USG country-level management activities, the office also directly implements PEPFAR activities in partnership with the Emergency Plan Implementation Committee (EPIC) of the Nigerian Ministry of Defence (NMOD). The partnership is dedicated to the provision of comprehensive HIV Prevention, Care and Treatment services to the Nigerian Military personnel, their dependents and catchment populations.
The Military to Military health diplomacy & partnership that serves as the foundation of the program is providing a working model for the current efforts at development of a partnership framework for Nigeria. Key examples from this program will be factored into the design of the framework.
The DOD HIV program and services are offered through 20 military sites that are located across 15 States of the Federation (Edo, Benue, Cross River, Rivers, Delta, Enugu, FCT, Kaduna, Lagos, Oyo, Plateau, Sokoto, Kano, Imo, and Anambra) and the Federal Capital territory. Primary target population includes military personnel, their dependents and the catchment population around the facilities. An estimated 2,200,000 people fall within this catchment population.
Human capacity development through regular training both locally and international for Military health personnel is a key HSS activity of the program that speaks to Human resources for Health issues within the military. Also a cohort of temporary National Youth Service Corps (NYSC) Personnel who had been hired to bridge human resource gaps at sites have been facilitated to be absorbed by the Nigerian Military . Also a cadre of transition (contractor) staff (site administrators and data entry clerks) is currently in service at the sites and it is anticipated that these personnel will be absorbed also by the NMOD-EPIC program in the long term. The salaries of this cadre mirror the Government of Nigeria pay scale and can be sustained by the government in the future.
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Cost efficiencies have been progressively achieved through a pooled procurement mechanism currently in use in the Nigerian PEPFAR program. ARV drugs and test kits are centrally procured while the SCMS mechanism is used to do further procurements of other commodities in a pooled fashion.
Plans are in progress to commence the Government Owned-Contractor Operated (GOCO) warehousing mechanism that has cost saving attributes and sustainability potential for procurement, storage and delivery of HIV and other health related materials.
For monitoring and evaluation purposes, the program has a functional SI unit that provides technical support to the NMOD-EPIC team. Collectively they have developed harmonized tools for use in the program.
Routine Data quality audits (RDQA) and data dictionaries are built into the tools to allow for similar interpretation of both the National and PEPAR indicators.
Data quality assurance exercises are also conducted on a biannual basis at the sites during which the data collection sources, processes are reviewed and data integrity and reliability efforts are evaluated. Hands on training for data personnel are provided during such encounters.
Dedicated data entry specialists were recruited and deployed to the sites to further improve on the data gathering and use processes with training and re-training a major feature in the units' workplan.
An electronic medical records system (The Registry) is currently being developed and will soon be piloted in 10 selected sites. On complete deployment across the program, it will further simplify the data collation and use process. These activities are aimed at ensuring ownership and sustainability of the Nigerian Military response to the HIV epidemic and they are cross-cutting across several technical areas.
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ACTIVITY ONGOING FROM FY2009 REDACTED.
ACTIVITY DESCRIPTION The Nigerian Military provides prevention, care and treatment to its service members and the surrounding civilian community (constituting approximately 75% of the Military's patient load). The Department of Defense (DOD) Nigerian Ministry of Defence (NMOD) HIV Program will provide free comprehensive PMTCT services, which will follow the revised national guidelines (2008), to 20 existing sites in COP10. 15,000 pregnant women will receive HIV counseling and testing for PMTCT and receive their test result. 600 women will receive a complete course of antiretroviral prophylaxis in a PMTCT setting. 120 individuals will be trained to provide these services.
A family-centered network approach will continue to be used and group health information with routine "opt out" counseling and testing will be provided to pregnant women presenting for antenatal services. Testing will be done following the National testing algorithm with same day results. Post-test counseling will include prevention counseling and education for both HIV+ and HIV- women. Partner testing will be promoted. DOD will promote couples counseling and testing to promote disclosure, address discordance and to increase support for infant feeding choices. Staff will counsel clients on their disclosure of HIV status and partner/family notification with an emphasis on client safety. Partner referrals for HCT (individual and/or couple) will be provided. Also, referrals to community-based and barracks-based support groups will be provided to HIV+ clients. Linkages will also be enhanced by counselors who are members of PLWHA support groups. HIV testing will be offered to all women of unknown HIV status presenting for labor and delivery and in the postpartum period. In accordance with National guidelines, a full course of ARV prophylaxis will be provided to approximately 600 women. ARV prophylaxis will include ZDV at 28 weeks or 3TC/ZDV at 34/36 wks and single dose Nevirapine (sdNVP) and AZT/3TC in labor with a 7 day 3TC/ZDV tail. All HIV positive clients will be commenced on cotrimoxazole prophylaxis commencing after the first trimester and stopping at 36 weeks gestation. All infants born to HIV+ women will be provided with sdNVP at birth and ZDV for 6 weeks. HIV-exposed infants will be provided with cotrimoxazole (CTX) prophylaxis from 6 weeks and will be discontinued once confirmed HIV- and no longer breastfeeding. Post partum women who are clinically eligible for ART will be referred for ARV services at the sites. Family planning and other reproductive health best practices will be promoted while linkages to OVC activities will be enhanced.
Infant feeding education and counseling will begin in the antenatal period in accordance with National guidelines, accompanied by appropriate prevention messages and education to all pregnant women and family members. After delivery, mothers and infants will be followed up to monitor the mother's health and to support the mother's compliance of her infant feeding option as well as to provide nutritional support for both. DOD will actively participate in Early Infant Diagnosis (EID) as a component of its pediatric care and treatment program, using revised national guidelines (2007).
In support of DOD's commitment to build capacity and long-term sustainability in the NMOD, formal training for an additional 120 staff from the existing 20 sites, covering physicians, nurses, midwives and others involved in PMTCT services will be conducted. Trainings will be done in line with the revised National PMTCT training curriculum (2007). By training uniformed members and civilian employees that are in a career track in the Government of Nigeria, this program fosters a generation of skilled workers who are more likely to remain in the military. This contributes to fulfilling PEPFAR goals for independent and sustainable programs.
In addition, commodities and equipment that are required in PMTCT services will be procured via SCMS ($150,000). Depending on site inventories and needs, commodities may include gloves, soap or other disinfectant and other medical consumables. Commodities will be provided to all 20 military sites.
By the end of COP10, the DOD will support 20 NMOD sites in Edo, Benue, Borno, Cross River, Rivers, Delta, Enugu, FCT, Kaduna, Lagos, Oyo, Plateau, Sokoto, Kano, Imo, Anambra and the FCT (15 states and FCT).
CONTRIBUTION TO OVERALL PROGRAM AREA The DOD PMTCT program will providing HIV counseling and, testing to 15000 pregnant women and provide ARV prophylaxis to 600 women. This contributes to the goal of preventing new HIV infections in Nigeria. The PMTCT services identify HIV+ women who may need HAART for their own health, thus contributing to PEPFAR Nigeria's care and treatment goals.
LINKS TO OTHER ACTIVITIES This activity relates to activities in adult and pediatric care and treatment, laboratory infrastructure, safe blood, TB/HIV, FP, Malaria, Cervical cancer screening and strategic information. Pregnant women who present for counseling and testing services will be provided with information about the PMTCT program and referred accordingly. ART treatment services for infants and mothers will be provided through ART services. Basic pediatric care support, including TB care, is provided for infants and children through pediatric care and treatment activities. Linkages to OVC services will be made for orphans and vulnerable children.
POPULATIONS BEING TARGETED This activity targets pregnant women and their family members. Activities also target military personnel, civilian employees, dependents and the general population in the communities surrounding the 20 sites.
EMPHASIS AREAS This activity will address gender equity in HIV/AIDS programs by specifically targeting pregnant women and girls for counseling, testing and treatment.
In COP10, under 'PEPFAR Nigeria's accelerated PMTCT plan', DoD, 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.
