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:
At the request of the National Department of Health and CDC, Leonie Selvan Communications will use PEPFAR funding to broaden the current integrated prevention of mother-to-child transmission (PMTCT) strategy to ensure improved implementation and integration of PMTCT on national, provincial and facility levels. Leonie Selvan Communications are building on the integrated PMTCT strategies developed by Kagiso Communications using FY 2005 funding, while broadening the scope of the strategies to cut across the three levels of implementation. The primary emphasis area for the activity is local organization capacity development; with secondary emphasis on community mobilization/participation, training, development of network/linkages/referral systems, information, education and communication (IEC), quality assurance and supportive supervision. Target populations include South African Government workers, public healthcare workers, traditional leaders, traditional healers, traditional birth attendants, family planning clients, pregnant women, people living with HIV and AIDS (PLHIV), families of PLHIV, community-based organizations (CBOs) and non-government organizations (NGOs).
BACKGROUND:
Using FY 2005 and FY 2006 funding, Leonie Selvan Communications has facilitated the development of training curricula for professional healthcare workers and community healthcare workers, and the development of strategies to improve working relationships between these two cadres of workers at the clinic level. As a result, Leonie Selvan Communications is strategically placed to facilitate the development, implementation and expansion of national, provincial and community-based PMTCT strategies aimed at integration at the national and provincial level, improving quality of care and service delivery at the clinic/facility level and improving awareness and understanding of PMTCT and improving uptake at the community level. The integrated PMTCT strategy will cut across all levels of implementation by ensuring clear, consistent and uniform messaging around PMTCT, identification of gaps, bottlenecks and challenges and developing activities to address these. In addition, Leonie Selvan Communications will continue to work with PMTCT course directors and trainers ensuring that they incorporate the strategy into the existing PMTCT training curricula and facilitating the development of a mentoring system to support healthcare workers at the facility level. At the national and provincial level, the strategy will also focus on strengthening of linkages and networks between PMTCT and treatment programs, ensuring that pregnant women who test positive are staged and referred for monitoring.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Development of Clear and Consistent PMTCT Messages
Using PEPFAR funding, Leonie Selvan Communications will work with national and provincial health departments and NGOs to standardize PMTCT messaging targeting pregnant women. A workshop will be conducted with all stakeholders to review current PMTCT messaging and IEC materials, identify gaps in IEC materials, and develop standardized PMTCT messages that can be used by province, facilities, NGOs and communities to create awareness for PMTCT services and highlight the importance of testing during pregnancy. In addition, messages targeting the community will also focus on infant feeding. Leonie Selvan Communications will work with family planning clinics to ensure integration of PMTCT messaging into family planning services. In addition, information on nevirapine and the importance of PMTCT will be distributed to clinics, community centers, and universities. Community radio stations will be provided with material on PMTCT and encouraged to incorporate issues into their programming, and workshops will be held with community leaders around media issues relating to PMTCT. Expected results of this activity include the development and implementation of uniform messaging for PMTCT.
ACTIVITY 2: Identification of Gaps and Bottlenecks to PMTCT Implementation
Although the PMTCT program is five years old, challenges to implementation are still inherent in the program. PMTCT uptake remains at 50% and nevirapine only reaches
about 30% of women who need it. To understand why these challenges are still present in the program, it is necessary to hold a consultative technical meeting, bringing together stakeholders from government, universities, implementing partners, NGOs, CBOs, traditional healers and traditional leaders to understand the reasons behind the low uptake and develop specific activities to address these. In addition, the stakeholders' consultation will focus on implementation and integration challenges at the national and provincial level. Expected results of this activity include the development and implementation of program-specific activities to address challenges to PMTCT uptake. Since this will be a consultative process, details of the challenges and the activities will only be available after the consultative process has taken place.
ACTIVITY 3: Development of Mentorship Program
Using PEPFAR funding, Leonie Selvan Communications will continue to work with PMTCT course directors and trainers. FY 2007 funding will be used to set up a mentoring system for healthcare workers and community healthcare workers. A core group of course directors and trainers from each province will be identified and trained as mentors to assist healthcare workers with implementation at the facility level after they have attended training. The role of the mentor will be to ensure that training translates into improved service delivery. In addition, funding will be used to facilitate a mentor network allowing the mentors to support and assist each other. The mentorship program will also ensure that individuals working at the National AIDS hotline are trained in PMTCT issues and that counselors answering the phones are able to answer questions appropriately. Expected results of this activity will be capacity building of healthcare workers and community healthcare workers.
ACTIVITY 4: Development of Tools to Strengthen Linkages between PMTCT and Treatment Programs
One of the downfalls of the PMTCT program is that service delivery takes place away from the treatment program. Women are identified during antenatal care. The national policy states that all pregnant women testing positive should be staged and referred to antiretroviral services. However, the reality is that most HIV-infected pregnant women are not given a CD4 test and are not referred to treatment programs for monitoring. As a result, after delivery, most of these women are lost to follow up and only show up at health facilities with advanced stages of AIDS. To address this challenge, PEPFAR funding will be used to work with the national and provincial departments of health to develop strategies for healthcare workers to ensure better linkages between PMTCT and treatment programs.
These activities contribute to the 2-7-10 PEPFAR goals by ensuring improved PMTCT implementation, identifying women eligible for antiretroviral treatment (ART) early and ensuring appropriate monitoring of HIV-infected pregnant women. This will result in a significant number of infections averted via vertical transmission and a great number of women enrolled in ART programs.
ACTIVITY 5: Updating of PMTCT training curriculum
Using PEPFAR funding, Leonie Selvan Communiction will work with the National Department of Health, and the National PMTCT Steering Committee to update the existing PMTCT training curriculum. The curriculum will be updated to include a dual theraphy PMTCT regimine. In addition, Leonie Selvan Communication will work with the NDOH to develop a training plan to ensure successful rollout of the updated training curriculum.
