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
JSI R&T/JSI project has been implementing injection safety and proper health care waste management interventions for five years in Rwanda (2004 - 2009). During this period JSI R&T worked with the MOH/Environmental Health Desk (EHD) to reach goals that were assigned to the project, and provided technical support to the MOH to put in place transition structures to conducted most of activities.
Ending the first phase of the project, JSI R&T/JSI obtained an award to continue implementing the program over the next five years.
During this second phase, JSI R&T will concentrate its efforts on reinforcing mechanisms to ensure capacity building within the MOH through a team of implementers within the Environmental Health Desk of the MOH and other partners (including SCMS), so that they can be able to continue implementing injection safety and health care waste management without JSI R&T.
The establishment of the COP 09 activities is based on priorities set by the MOH: capacity building, procurement and commodities supply, health care waste management, infection prevention and control, behavior change and communication and monitoring and evaluation.
In the area of capacity building, JSI R&T will provide technical assistance to the Environmental Health Desk by training its technical staff.
Also JSI R&T will assist the EHD to organize and conduct training of 1,600 new health providers, 462 environmental health officers, 300 waste handlers and 90 incinerators' operators.
JSI R&T will also focus on pre service training by extending the integration of IS & HCWM aspects into training curricula of laboratory technicians. Training in nursing schools will be reinforced by supporting the directorate of nursing and training schools to install a sustainable supervisory system of trainees in nursing practicing hospitals.
In the area of logistics and procurement, JSI R&T will mainly work with SCMS and MOH in supplying IS commodities (autodisable syringes, safety boxes) and personnel protective equipments. JSI R&T will continue to provide information and data that will help in forecasting, procurement and distribution of commodities.
In the area of infection prevention and control, JSI R&T will assist the MOH/Quality of Care to promote and reinforce the use of standard precautions, particularly systematic hand washing practices within health facilities, by supplying alcohol and alcohol serving bottles to 9 pilot hospitals.
Also, JSI R&T and MOH will continue sensitization of district health directors and district pharmacy managers on the importance of inserting injection safety and health care waste management supplies into the cost recovery and budgeting mechanism to ensure sustainability.
Regarding BCC, JSI R&T plans to work with the MOH, URUNANA and the Rwandan Association of Diabetics (RAD) to produce and disseminate BCC messages towards the community and diabetics, through printed materials, radio and community outreach shows to assuring that community members are aware of ways to prevent risks related to unsafe injections.
In regards with diabetics (insulin dependent patients), JSI R&T plans to conduct joint supervisions with the MOH/EHD and RAD to reinforce best practices of injections and safe management of used syringes at home.
In clinical settings, JSI R&T plans to work with the EHD, the National Reference Laboratory and the National Center for Blood Transfusion, through joint supervisions, to promote best practices of blood withdraw and transfusion, in the context of phlebotomy.
In the area of health-care waste management, the major activities include the support to the MOH in building appropriate incinerators and secured waste pits in district hospitals and health centres.
Also, JSI R&T will continue working with the MOH/EHD and districts to define ways to securely collect and transport filled safety boxes from health centers to district hospitals for incineration.
In Monitoring and Evaluation domain, JSI R&T will hire a M&E specialist to strengthen the program and to facilitate joint supervision (JSI R&T, MOH & Districts) at the facility level.
Concerning the safety of health personnel, JSI R&T, MOH and districts will continue to monthly collect and analyze data on PEP in order to jointly define appropriate solutions to problems identified. In addition, JSI R&T and MOH will conduct advocacy to partners on the immunization of health personnel against hepatitis B.
JSI R&T and the Ministry of Health have agreed to work closely in the implementation of the present workplan.
Finally, periodic meetings between JSI R&T and its task force and the EHD will be held for tracking the implementation of planned activities and the level of transferring roles and responsibilities to MOH.
FY 2010 Funding:
FY 2010 funding for JSI R&T will allow the project to continue building capacity of the Ministry of Health (MOH) and district teams to expand interventions to newly created and uncovered health facilities. In this way, the establishment of FY 2010 activities will focus on the reinforcement of injection safety (IS) and health care waste management (HCWM) best practices through capacity building, health care waste management, behavior change and communication (BCC) and monitoring and evaluation (M&E).
In the area of capacity building, JSI R&T will, through training and joint supervisions, continue to ensure that the MOH Environmental Health Desk (EHD) team is complete and equipped with capacity to support district and health facility teams in implementation of best practices. Also JSI R&T will assist the EHD to plan and conduct the training of 1,060 new health providers and 276 waste handlers. At the same time, JSI R&T will organize a refresher course for district/hospital trainers. The project will also continue the distribution of comprehensive brochures that highlight the best practices of IS and HCWM.
Pre-service training will also continue by extending the integration of IS and HCWM aspects into training curricula of environmental health technicians, nurses and laboratory technicians at institutions where they are taught. JSI R&T and the MOH will continue to monitor and reinforce the supervision system of
nurses in training during their practical training at practicing centers.
In the area of logistics and procurement, JSI R&T will continue to work mainly with SCMS and MOH in supplying IS commodities (auto-disable (AD) syringes, safety boxes), personnel protective equipments (PPE) to project sites. As the transition of procurement for IS and HCWM supplies from JSI R&T to SCMS continues in FY 2010, JSI R&T will continue to provide advice on the specifications of these supplies, as needed. In addition, supply of alcohol and alcohol serving bottles to promote systematic hand washing practices within all health facilities will be scaled up from the pilot facilities to the entire country.
JSI R&T will continue to provide device specifications and quantification of needs to SCMS and the MOH, and support efforts aimed at inserting these commodities into cost recovery systems and budgets of districts and facilities in order to assure sustainable availability of appropriate and sufficient quantities of injection safety products.
Regarding BCC, JSI R&T envisages continuing to work with the MOH, URUNANA and the Rwandan Association of Diabetics (RAD) to sensitize the community and diabetics, through printed materials, radio and community outreach shows on risks related to unsafe injections. With diabetics specifically (insulin dependent patients), JSI R&T will conduct joint supervisions with the EHD and RAD to reinforce best practices of injections and safe management of used syringes at home.
In clinical settings, JSI R&T will continue joint supervisions, in collaboration with the EHD, the National Laboratory of Reference (NRL) and the National Blood Transfusion Center (CNTS), to promote best practices of blood draw and transfusion, in the context of phlebotomy and support development and dissemination of guidelines. JSI R&T will participate in a public-private partnership with Becton Dickinson to improve phlebotomy practices in Rwanda.
In the area of HCWM, the project will continue to provide support to the MOH in its efforts to extend the installation of appropriate incinerators and secured waste pits within health facilities and provide for their proper maintenance. In the same light, JSI R&T will continue working with the EHD and districts to strengthen mechanisms of securely collecting and transporting filled safety boxes from health centers to district hospitals for incineration.
In the context of reinforcing public and private sectors involvement in HCWM, JSI R&T and MOH will focus on the collaboration with Kigali Institute of Science, Management and Technology (KIST) and Compagnie Pour le Developpement et Environnement (COPED) to produce locally safety boxes and expand the existing system of plastic waste recycling.
In the monitoring and evaluation domain, JSI R&T will continue joint supervisions (JSI R&T, MOH & districts) and monitoring of interventions to identify various issues regarding IS and HCWM practices, systematic wearing PPE, use and maintenance of incinerators, etc. in order to continuously fine-tune strategies.
JSI R&T will continue to encourage the MOH to ensure periodic meetings of the Environmental Health Task Force to continuously track the implementation of planned activities and monitor the transition process from JSI R&T leadership of IS and HCWM to the MOH.
Concerning health workers' safety, JSI R&T, MOH and districts will continue to monitor accidental exposures, PPE and the status of hepatitis B vaccination among health workers and support the formulation of policies and guidelines to address concerns and gaps.
In order to assess the impact of BCC interventions, JSI R&T plans to carry out a knowledge, attitude & practices (KAP) survey, the results of which will be used to produce new trainings and BCC materials to continue to support MOH's efforts to sustain IS and HCWM interventions
