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: 2008 2009
This is continuing activity from FY 2008. No narrative required
New/Continuing Activity: Continuing Activity
Continuing Activity: 16976
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
16976 16976.08 U.S. Agency for Catholic Relief 6287 6146.08 Ibyringiro $1,700,000
International Services
Development
Emphasis Areas
Gender
* Increasing women's access to income and productive resources
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $700,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $1,000,000
and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
The USG, through Title II and WFP, support a number of partners to provide food assistance and address
food insecurity, especially for PLHIV, in Rwanda. In order to better link this food assistance with ongoing
HIV and AIDS care, treatment and prevention services, the EP will (beginning with FY 2007 funding) issue
an RFA to support and incorporate care for PLHIV and OVC into ongoing food distribution. In FY 2008, this
will be expanded to include prevention services. The EP anticipates making awards to one to three partners
that are able to leverage significant amounts of non-EP funded food assistance to support prevention and
care activities.
These awards will include HIV prevention activities to youth and PLHIV associations as part of food
distribution. HIV prevention activities will focus on increasing community support for young people to choose
abstinence until marriage; for people in unions to remain faithful to their partner; for addressing gender
related issues in the community; and, to increase community support for healthy sexual behavior, including
correct and consistent condom use. Funding will also increase the demand and uptake for TC services
through links to other USG clinical partners. The EP expects to reach approximately 35,450 people with
AB.
These partners will primarily be working in food insecure areas and will coordinate closely with other
community and clinical based partners in those areas to ensure there is no overlap in services being
provided.
Continuing Activity: 16856
16856 16856.08 U.S. Agency for Catholic Relief 6287 6146.08 Ibyringiro $153,000
Table 3.3.02:
through links to other USG clinical partners. The EP expects to reach approximately 38,838 people with
prevention messages beyond AB.
Continuing Activity: 16857
16857 16857.08 U.S. Agency for Catholic Relief 6287 6146.08 Ibyringiro $180,000
Table 3.3.03:
ACTIVITY UNCHANGED FROM FY 2008:
The Food and Nutrition Interventions project has been referred to in Kinyarwanda as "IBYIRINGIRO or
"That in which we have faith for a better to-morrow". A cooperative agreement was signed between
PEPFAR and CRS, the lead organization of a consortium that implements Ibyiringiro project on August 1,
2008. PEPFAR Ibyiringiro Project is a 5 year project that aims at ensuring that high quality, sustainable and
comprehensive services are provided to People Living with HIV and AIDS (PLWHA) and Orphans and
Vulnerable Children (OVCs) in Rwanda. PEPFAR will provide $16 million to CRS and its sub-grantees in
order to implement this project over 5 years. The project aims at improving the quality of life for PLHWA and
vulnerable populations in 22 PEPFAR Districts and will be implemented by food aid partners that have been
distributing food aid to PLWAs and other vulnerable people, for the last 8 years in Rwanda (CRS, WV,
ACDI/VOCA/Africare). Other partners such as EGPAF, WFP and the GoR at different levels will also be
involved.
Under Basic Care and Support (BCS) current food partners will work with clinical sites, community-based
organizations and associations and District Health Teams to integrate care and support in the services of
over 15,000 beneficiaries and their families in food insecure areas. The Ibyiringiro project will adopt the
family/household centered approach to expand the support to include nutritional counseling, home
gardening techniques, small animal husbandry, income generating and microfinance activities, training for
home-based care, prevention messages, promotion of PMTCT, and adherence counseling. In 2010 the
project expects to reach 15,802 PLHIV with a comprehensive menu of services and train 850 caregivers.
Community health workers (CHW) and clinics will formalize the continuum of care of PLWHA between the
clinic care and community /home based care.
Community health workers (CHW) will be equipped to deliver quality home based care (HBC) to PLWHA.
In collaboration with CHAMP, the project will develop the system to regularly re-supply the HBC kit of
existing CHW in the catchment area and provide complete kit to newly trained CHWs- Existing CHWs use a
kit to teach and provide care to sick PLWHA at the household level. Some items in the HBC kits need to be
replenished regularly. Ibyiringiro in collaboration with CHAMP/MoH will develop a replenishment system to
avoid breakages in stock. The project will also utilize CHAMP/MoH integrated HBC Behavior Change
Communication tools to ensure the quality of nutrition education and HBC are made by CHW. The BCC tool
-kit will be distributed to each CHW to assist them in their home based care activities and to ensure
harmonized communication about nutrition, positive living and drug adherence across all CHWs. MoH and
FANTA's nutrition booklet of images and posters will be used by CHW to educate PLWHA on healthy
nutrition practices. Mid-Upper Arm Circumference (MUAC) measuring tapes will be purchased and
distributed to all CHW and a simple format developed on how to record and read the result in the household
health service card. Training in MUAC is critical and will be complemented by training from HC staff. All
moderately and severe cases of malnutrition will be immediately reported to the health center and the
severe cases followed by the District Hospital.
An important focus of the project will be to improve capacity of CHW and equip them to provide appropriate
nutritional counseling based on MUAC and BMI monitoring. In support of this the project will enhance
nutritional training/monitoring offered by CHAMP and FDO to CHW (training of trainers) to include
community based monitoring of health and nutrition status including refresher training for existing CHW and
training for new CHW on how to regularly assess the health and nutrition status of PLWHA. CHW will use
their MUAC measuring tapes and simplified checklist to assess the health and nutrition status of PLWHA.
AIDSRelief, a PEPFAR clinical partner, is currently using a simplified checklist, the project will therefore use
available standardized checklists developed by the MoH. MUAC is a screening tool that can be conducted
quickly during the home based visits by well-trained CHW.
To ensure that PLWHA practice improved health, nutrition and sanitation behaviors, vulnerable PLWHA will
receive health and hygiene kit. These kits will be distributed by CHW to PLWHA whose health status is
satisfactory. The kit will facilitate adoption of recommended hygiene and disease prevention behaviors
such as proper hand washing, mouth and teeth cleaning, dishwashing, fruit and vegetable washing,
sleeping under an insecticide-treated net, etc. The kit will include materials such as soap, blanket, cooking
pot, and jerry can. A major component of positive behavioral practices will be geared towards supporting
PLWHA to have increased access to diverse foods through small gardening systems. In this regard PLWHA
will be trained on bio intensive techniques for making small kitchen/backyard gardens- A "kitchen garden" is
a viable production option for households who have little land.
All nutrition education programs will be integrated with hygiene and sanitation sessions. In this regard,
CHWs will be trained using existing materials from MoH and FANTA on adult education and participatory
approaches for behavior change. Existing visual aids and tools will be used to pass messages about
nutrition, sanitation and hygiene and the particular risks for PLWHA. In a bid to intensify the adoption of
health seeking practices, vulnerable PLWHA will be supported to pay their health insurance on household
basis.
In addition to providing the above care services, the project will collaborate closely with clinical sites to
identify PLHIV in need of food support (moderately and severely malnourished) and to ensure adequate
follow-up. Food rations provided by FDO (Food Distribution Organizations) to PLWHA will come to an end
with the close out of the FFP Title II program on September 30, 2009. In order to make the transition from
food aid to autonomy without jeopardizing the food security of the most vulnerable PLWHA, the project will
work with clinical partners to define appropriate criteria for identifying PLWHA in need of continued
nutritional support. The food by prescription program will target PLHIV who are identified to be moderately
or severely malnourished. It is expected that 4000 moderately and severely malnourished PLHIV including
pregnant women and OVC would be reached with food rations.
The project will therefore emphasize that food distribution will shift from household rations to individual
rations based on BMI and other criteria before the end of FY 2009. PLWHA who meet the criteria mentioned
above will be given a prescription for an individual supplemental ration harmonized in quantity and duration
with WFP's "Food for ART" program. This supplemental ration will be closely linked to the nutritional and
Activity Narrative: food security status of the client which will be monitored by CHW through the nutritional surveillance system
set up at the community level as well as the health center staff. Linking the supplemental ration to clinical
services will increase contacts with the health system, especially during ART initiation, thereby increasing
opportunities for follow up. The food by prescription will be regionally procured through CRS' procurement
procedures, which conform to USAID regulations. This will include either a competitive process, or in the
case of a single provider, through a sole source contract. Like the PMTCT weaning food, product and bid
standards will be established prior to acquisition and provided to weaning food manufacturers in the region.
In order to address issues of stigma and discrimination, PLWHA associations will be facilitated to receive
support from HIV negative people. Many HIV negative people are already members in PLWHA associations
and will be encouraged to remain in the association when forming cooperatives. Savings and Internal
Lending Communities (SILC) are targeted at PLWHA associations. Membership of HIV negative in PLWHA
associations inherently reduces stigma for PLWHA by giving legitimacy to their efforts to improve the lives
of their members. SILC are self-selected groups and neighbors or potential members not already in the
association, form SILC groups. SILC needs a level of solidarity and trust among its members and sero-
positive status is not considered.
Target Communities will be sensitized about the importance of establishing Savings and Internal Lending
Groups including mobilization of communities to organize themselves into savings groups.
It is envisaged that access to credit to PLWHA will be increased through SILC methodology. SILC groups
who reach maturity will give out loans and dividends to members. After 8 months of continued monitoring
and technical support from SILC agents, the SILC group should be strong enough and have enough capital
to give small loans to members. The project will also increase the capacity to the SILC groups to reach the
next stage managing self-identified IGAs.
The strategy will also identify PLWHA households interested in small animal husbandry. Of the PLWHA
households interested in animal husbandry; beneficiaries will be selected based on the recommendations of
local leaders and PLWHA cooperatives keeping in mind the need for beneficiaries to own a minimum
amount of land for grazing and upkeep
The project will support efforts by the GOR to develop the capacities of PLWHA cooperatives for
sustainable management. The project aims to develop capacities of 50 cooperatives comprising 4500
members during the FY 2010. The GoR is requiring PLWHA associations that have or will have income-
generating activities (IGAs) to register as cooperatives. As a large number of the project activities will use
PLWHA associations as the main point of contact with beneficiaries, the project recognizes the need to
facilitate the difficult transition into legal cooperatives which require managerial and financial capacity to
manage IGAs in a sustainable way. World Vision (in their 6 Title II districts), and ACDI/VOCA (In CRS and
Africare's Title II districts) will be responsible for the implementation of this component. A comprehensive
package of activities will be implemented to achieve the above goals. In collaboration with RRP+ and
CHAMP focal programs in the area of FDO operations PLWHA cooperatives will be provided with the
capacity to establish sustainable managerial, financial and organizational systems.
Selected PLHIV associations will be assisted with the transformation process into cooperatives. Project
partners ACDI/VOCA and world Vision in collaboration with CHAMP and RRP+ will train partners and
associations in the registration process. The project believes in providing training and technical assistance
in order that associations will be able to register themselves, while developing their capacity at the same
time, versus doing the registration on behalf of the associations. Training will be provided on the
development of by-laws, internal rules and regulations, and election of officials as well as the requirements
of the government of Rwanda to register per the new cooperative law. As previously mentioned, training
and assistance for registration will be prioritized to associations based on the assessments and the current
ability of the association to quickly become registered and begin an IGA. Cooperative development support
covers a wide rage of areas including capacity to develop cooperative roles as advocates to ensure
member voices are heard; assistance in understanding the cost/benefit of various approaches such as
working through umbrella organizations, joining forces with other cooperatives, or acting independently as
necessary depending on the issue.
Another area of emphasis will be capacity PLWHA cooperatives in leadership and governance. The project
will provide training to elected board members on their roles and responsibilities, parliamentary procedures,
transparency and accountability. An emphasis will be placed on negotiating skills and conflict resolution.
This training will also include the rights and responsibilities of members as shareholders of the
cooperatives, proper procedures and ways to hold leaders accountable. Members will be empowered to
demand accountability of their elected leaders, and will be provided with the skills and confidence to
question financial statements and to review budgets. Members must perceive that the cooperative is theirs
and not just part of a project or program. Requirements of new members will be clearly outlined. Leaders
and members will also be trained in understanding the cooperative's role beyond the specific income-
generating activity in which it is engaged. This includes understanding the role of the cooperative as an
advocate, its role with other partners or umbrella organizations such as the RRP+, and its role with the
community PLWHA associations.
Cooperatives should be able to write their own plans business plans after training and with technical support
based on an analysis of costs, a market assessment, cooperative position, and potential for integration into
the value chain. To achieve this, training will be provided in development of business plans. Cooperatives
will be provided the tools necessary to identify appropriate income generating activities, and to conduct
analyses and identification of constraints to competitive markets. Furthermore, the project will provide
technical assistance to the cooperatives to enable them to factor in risks and develop mitigation and
monitoring strategies into their business plans. Emphasis will be laid on ensuring business plans are
appropriate for the cooperatives and that the cooperatives have the ability to modify them without external
assistance.
The project will help cooperatives understand quality controls and standards, and meeting the needs of the
clients, even as different social and economic priorities may be affecting the members. Implementing
partners for this component will use local consultancies in doing gap analysis and trainings of the
cooperatives in addition World Vision will use the services of a cooperative officer (Farmers' Association
Facilitator) who will work alongside cooperatives in helping them put in practice the trainings provided.
Activity Narrative:
Continuing Activity: 12768
12768 12244.08 U.S. Agency for Catholic Relief 6287 6146.08 Ibyringiro $966,940
12244 12244.07 U.S. Agency for Catholic Relief 6146 6146.07 TBD--TBD Food $1,175,000
* Increasing gender equity in HIV/AIDS programs
Table 3.3.08:
ACTVITY UNCHANGED FROM FY 2008:
"That in which we have faith for a better tomorrow". A cooperative agreement was signed between USAID
and CRS, the lead organization of a consortium that implements Ibyiringiro project. USAID Ibyiringiro
Project is a five-year project that aims at ensuring that high quality, sustainable and comprehensive services
are provided to People Living with HIV and AIDS (PLWHA) and Orphans and Vulnerable Children (OVCs) in
Rwanda. The project aims at improving the quality of life for PLHWA and vulnerable populations in 22
health districts that are supported by PEPFAR. The project will be implemented by food aid partners that
have been distributing food aid to PLWAs and other vulnerable people, for the last 8 years in Rwanda
(CRS, WV, ACDI/VOCA/Africare). Other partners such as EGPAF, WFP and the GoR at different levels will
also be involved.
The USG, through Title II and WFP, supports a number of partners to provide food assistance and address
food insecurity, especially for PLHIV including children in Rwanda. In order to enhance linkages between
food assistance and ongoing HIV and AIDS care, treatment, and prevention services, this PEPFAR funded
Partner will incorporate care and prevention services for OVCs into ongoing food distribution.
Under OVC support, current food partners have access to over 2,000 children through the PLHIV
associations they are working with to provide food assistance. The current IBYIRINGIRO project will
support the provision of services to OVC, based on their needs. Partners will work through associations to
monitor the children within the communities where they work to identify needs and address those needs or
refer to other services in the community as necessary.
In addition to providing care and prevention services for communities, partners will be expected to link
closely with clinical sites to identify children enrolled into care in need of food support and to ensure
adequate follow-up.
Finally, IBYIRINGIRO project will primarily be working in food insecure areas and will need to coordinate
closely with other community and clinical based partners in those areas to ensure there is no overlap in
services being provided.
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $75,000
Estimated amount of funding that is planned for Food and Nutrition: Commodities $75,000
Table 3.3.10:
ACTIVITY UNCHANGED FROM FY 2008.
The Food and Nutrition Interventions project - Ibyringiro (that in which we have faith for a better tomorrow) -
aims at ensuring that high quality, sustainable and comprehensive services are provided to PLWHA and
OVC who are receiving food aid through the USG Title II food program in Rwanda. A consortium of Title II
food aid partners, led by CRS, will implement this project in 22 PEPFAR districts in coordination with other
partners - EGPAF, WFP and the GOR.
This project will leverage the experience and expertise of CRS to procure and distribute food for PMTCT
programs. CRS will work with PEPFAR clinical partners to determine the needs of PMTCT programs at
each distribution site. To maximize efficiency, CRS will combine the delivery of Title II and weaning food to
PMTCT sites in the nine FDO (Food Distribution Organizations) districts. Where this is not possible, CRS
will identify a delivery mechanism to insure on-time delivery of the weaning food to the remaining PMTCT
sites.
In addition to procurement and distribution of weaning foods, the project will complement existing food aid
program with support for home-based care, nutrition, income-generating and food security activities and
OVC services. The program will work closely with existing USG partners to ensure a standard package of
services to OVC. The project will also use existing tools such as the MoH and FANTA's nutrition booklet of
images and posters to educate OVC on health and nutrition practices.
Additional beneficiaries will be identified in coordination with existing USG-supported clinical and community
partners.
The project will reach 6,000 OVC with a comprehensive menu of services and train 400 caregivers during
the period. Furthermore, OVC in school will be targeted during holidays at holiday camps with nutrition and
hygiene education activities.
Continuing Activity: 16945
16945 16945.08 U.S. Agency for Catholic Relief 6287 6146.08 Ibyringiro $750,000
Estimated amount of funding that is planned for Food and Nutrition: Policy, Tools $150,000
Estimated amount of funding that is planned for Economic Strengthening $250,000
Estimated amount of funding that is planned for Education $100,000
Table 3.3.13:
