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.
SUMMARY:
This project conducted by John Snow Research and Training, Inc. (JSI) aims to bring about an environment where patients, healthcare workers and the community are better protected from transmission of HIV and other blood-borne pathogens through medical practices. The project's primary target population is healthcare workers. Emphasis areas include training and human resources, development of policy and guidelines and commodity procurement.
BACKGROUND:
As part of the Making Medical Injections Safer (MMIS) project in South Africa, John Snow Research and Training Inc. is implementing interventions aimed at reducing the risk of medical transmission of HIV and other infections. This project started as a pilot initiative in 2004, and is now active in all nine provinces of South Africa. MMIS is supported by the National Department of Health (NDOH) and the policies of the activity are consistent with the NDOH's Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment. Provincial and local government agencies also support this initiative. The project's three main programmatic areas are logistics, waste management and behavior change communication (BCC). Training is a core activity and is provided to professional and non-professional staff. A national injection safety survey conducted in 2006 indicated that 100% of the surveyed facilities used sterile needles and syringes to administer injections. Although no re-use was observed, quality improvement is still needed in the three programmatic areas mentioned above. The results of the survey also showed that shortages are only related to certain types of syringes and that in cases where this occurs, nurses simply use a bigger syringe and try to adjust the gauge so as to keep the exact same dosage. South Africa unlike many other African countries does not have supply problems when it comes to standard needles and syringes as these are made available in sufficient quantities by the South African Government. The project's activities in 2007 will include addressing recommendations emanating from this survey.
The NDOH is not providing auto-disable syringes, some facilities do use them but not all types and not in the quantities required to adhere to good standards of infection control and undertake waste management activities with minimal exposure. Currently, the NDOH is expected to award a tender for public facilities to be able to buy auto-disable syringes.
ACTIVITES AND EXPECTED RESULTS:
ACTIVITY 1: Healthcare worker training
More healthcare workers will be trained in FY 2007. Senior managers, middle managers and clinical staff as well as waste handlers will be trained to increase the public health sector's capacity in injection safety and infection control. This will be done in partnership with local organizations such as MINDSET Health, Excellence Trends, the Basel Convention office in South Africa and the Democratic Nurses' Organization of South Africa. In addition, the project will work with the NDOH's Quality Assurance and Environmental Health Directorates to have an amended version of its "Do No Harm" manual institutionalized to ensure the sustainability of training efforts. Part of the training will take place through tele-education through a partnership that was initiated last year with MINDSET. Training of trainers will also take place. Over 360 healthcare workers were trained in 2006.
ACTIVITY 2: Injection safety materials
MMIS finalized a national BCC strategy in 2006. FY 2007 funds will be used to publish materials on injection safety and these will be disseminated to healthcare workers and the communities they serve. The community outreach program will form part of the South African government's Khomanani campaign whereby community outreach workers visit 100,000 persons each month to disseminate health information. In FY 2007, the outreach workers will incorporate information on injection safety as part of this campaign. The visits will not only serve to educate and inform community members, but safety boxes for storing medical injections at home will also be distributed where necessary.
ACTIVITY 3: Protective equipment
As part of follow-up on monitoring and evaluation activities conducted in 2006, the project will also devote PEPFAR resources to improve logistics and procurement, and waste management procedures in public health facilities. JSI will continue to use PEPFAR funds to purchase protective equipment for healthcare workers in FY 2007 to ensure an uninterrupted supply of safe injection material and safety boxes.
ACTIVITY 4: Norms and standards
MMIS will work with the NDOH and the Council for Health Service Accreditation of South Africa to implement norms and standards, and a supervision check list to allow the structuring of mentoring and supervision of activities related to injection safety and infection control in healthcare facilities.
The Making Medical Injections Safer activity contributes to meeting the vision outlined in the USG Five-Year Strategy for South Africa by strengthening the health sector's capacity to provide safe medical injections and thereby represents an important prevention activity. It is a sustainable program such that it is building human capacity and working closely with the SAG to implement long-lasting policies for injection safety. It also supports PEPFAR's goals of preventing 7 million new infections.
