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.
INTEGRATED ACTIVITY FLAG: The Academy for Educational Development (AED) will collaborate with other PEPFAR partners, including FHI (#7587) and JHPIEGO (#7888), in the PMTCT program area with links to Treatment, Basic Health Care and Support, and TB/HIV services.
SUMMARY: AED will use FY 2007 PEPFAR funding to support integration of maternal nutrition and Infant and Young Child Feeding (IYCF) in the context of HIV policy into healthcare and community services through three components: training of healthcare providers and community health workers from all nine provinces; assistance for implementation of integrated IYCF and PMTCT model in two districts of KwaZulu-Natal and one district each in North West, Mpumalanga and Eastern Cape; and support to enhance public awareness of the importance of maternal nutrition and IYCF in PMTCT.
BACKGROUND: This is an ongoing AED project, initiated in FY 2004 with PEPFAR funding. The first activity was development of guidelines on nutrition for pregnant and lactating women and IYCF in the context of HIV and AIDS. AED has been working in collaboration with the South African National Department of Health (NDOH) nutrition directorate and local NGOs to build health workers' capacity to integrate maternal nutrition and IYCF into existing healthcare and community services based on these guidelines. This will continue with FY 2007 funding. In addition, AED will continue to support efforts to enhance public awareness of the importance of improved nutrition for HIV-infected women in general and pregnant and lactating women in particular, as well as the importance of IYCF counseling as an aspect of PMTCT. Furthermore, AED will provide technical assistance to the National, Provincial and District Departments of Health and selected NGOs and FBOs to enhance male involvement to address gender issues in PMTCT. AED will also provide technical assistance to ensure sustainability through continuing support and monitoring of PMTCT data. AED will also provide technical assistance to provincial DOH staff to encourage expansion to other sub-districts in the provinces and promote greater sustainability.
ACTIVITIES AND EXPECTED RESULTS: ACTIVITY 1: Technical Assistance to NDOH, NGOs and FBOs Building on the development of Maternal Nutrition Guidelines in collaboration with the NDOH, further technical assistance will be provided to National, Provincial and District Departments of Health and selected NGOs and FBOs. This technical assistance will increase Human Capacity Development (HCD) by training health workers to integrate counseling on maternal nutrition and IYCF in the context of HIV into existing healthcare and community services. AED will provide technical assistance to the targeted provincial Departments of Health in the implementation of the guidelines.
In addition, following last year's successful training of lecturers from universities and schools of nursing in the integrated model, AED will provide technical assistance to develop capacity to include the integrated program into existing professional development curricula of nurses and dieticians' pre-service orientation. Additional trainers from these institutions in the nine provinces will be trained at the national level as well as provincial level in Gauteng, Limpopo, Northern Cape, Western Cape and Free State provinces. Healthcare providers from each of the five target provinces will be trained to provide direct integrated services to clients in their respective districts.
Policies and guidelines on pregnant and lactating mothers and IYCF in the context of HIV will continue to be disseminated and implemented. Technical assistance will be provided to Mpumalanga, Eastern Cape and North West provinces to conduct needs assessments at clinics and community services in three sub-districts, and will be followed by mentorship and supervision in view of implementing integrated PMTCT and nutrition for pregnant and lactating women and IYCF into service outlets. Facilities where AED is currently working will continue to receive support, mentorship and in-service training around issues not fully addressed during the initial implementation of the program, such as stigma and family planning. Program managers working with women and children (on integrated management of childhood illnesses, PMTCT, VCT, Maternal, Child and Women's Health, and Health Promotion) will be mobilized on the promotion of the Baby Friendly Community Initiative in the context of HIV.
ACTIVITY 2: Quality assurance Building on the activities of FY 2006 in the four sub-districts (Kagisano Molopo, North
West; Qaukeni, Eastern Cape; Umzumbe, KwaZulu-Natal; and Kabokweni, Mpumalanga), AED will support existing facilities to increase the provision of quality care by supporting the provision of refresher courses for performance and quality improvement in the integration of nutrition to the basic PMTCT package. AED will provide technical assistance for the integration of safe-feeding practices in PMTCT into antenatal, labor and delivery practices, as well as post-natal care. Quality assurance and supervision will be provided using the trained Baby Friendly Hospital Initiative assessors to conduct internal and external assessments.
ACTIVITY 3: Family Centered Community Care Technical assistance will be provided to three sub-districts to implement the "Family Centered Community Care" approach, with clear follow-up and referral system for mothers and infants. CBOs, NGOs and FBOs will contribute to community mobilization. Technical assistance will be provided to care workers and community volunteers to address stigma and discrimination, including gender issues. In addition, key community members, leaders, and religious leaders will be trained to organize behavior change communication activities on male involvement and people living with HIV in each of the three target facilities.
AED will support development of linkages and referrals to existing services such as family planning, TB treatment, and care and support for HIV-infected mothers and families. AED will strengthen linkages between facility interventions and community services for follow-up, couple counseling, family-based counseling and testing, specifically involving men in PMTCT activities, and will also encourage and facilitate public private partnerships.
ACTIVITY 4: Integrated IYCF/PMTCT expansion to Northern Cape AED is intending to expand to the Northern Cape with FY 2007 funding. In the Northern Cape, AED will work in partnership with FHI and JPHEIGO to harmonize the PMTCT provincial guidelines and monitoring systems. Future expansion of the integrated IYCF/PMTCT model will target the Western Cape, Gauteng, Limpopo and Free State provinces.
Activity 5: Plus-Up funds will support the roll-out of and training on the new NDOH PMTCT guidelines with the integration of maternal nutrition and Infant and Young Child Feeding practices. This will include capacity development of non-governmental organizations and community health care workers in existing provinces so they will be able to play a key role in achieving project targets, strengthening referrals and linkages; improving monitoring and evaluation to ensure program sustainability within the selected provinces. Funds also will be used to expand the program by providing onsite support to other service outlets within the existing districts.
These activities will directly contribute to the seven million infections averted component of the 2-7-10 objective of PEPFAR by training additional health workers on safe infant feeding practices, hence reducing the risk of transmission via mixed feeding. AED will contribute to the PEPFAR vision outlined in the five-year strategy for South Africa by expanding access to PMTCT services and by improving PMTCT related counseling of mothers.
