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:
This activity relates to the BroadReach Health Care (BRHC) activities in CT (#7513), TB/HIV (#7939), ARV Drugs (#7512), and ARV Services (#7510). This partner may benefit from the Partnership for Supply Chain Management ARV Drugs activity (#7935), which will explore current pain and symptom management practices, drug availability and cost, and provide recommendations.
SUMMARY:
BRHC activities include doctor consultations, lab testing, adherence support, patient counseling, remote decision support, quality assurance monitoring, training for both patients and health professionals, support groups and data management. Basic Care and Support activities are in support of individuals participating in an anti-retroviral therapy (ART) program, largely representing the population of those HIV-infected, but not yet eligible for ART. The major emphasis is on Human Resources with minor emphasis on Quality Assurance and Supportive Supervision and Training. These emphasis areas are realized through clinical and non-clinical services, human capacity development, quality assurance, referrals and linkages and South African Government (SAG) support including meeting equipment, infrastructure and human resource needs. Primary target populations include people living with HIV and AIDS (PLHIV) and their families/households, program managers, public and private doctors, nurses, laboratory workers, pharmacists, other health care workers, the business community/private sector, CBOs, FBOs, and NGOs.
BACKGROUND:
PEPFAR funds support BRHC initiatives which provide HIV and AIDS clinical management, care and support services to HIV-infected, uninsured individuals in public sector government facilities and areas where the SAG ART roll-out has not yet reached or where there is high demand. The BRHC PEPFAR program began in May 2005 and now operates in 15 communities across five provinces. Today, BRHC is supporting approximately 3,500 individuals directly with care and treatment and 15,000 indirectly. The BRHC mission is to tap into private sector health professionals to provide comprehensive care and treatment, fostering capacity building initiatives and service delivery within the public health system, and partnering with and supporting community-based programs with sustainable impact on long-term patient care. BRHC leverages the community-based PLHIV support programs to identify and assist with treatment literacy, adherence support and ongoing community mobilization, prevention education activities, and positive living initiatives. In addition, BRHC works to build capacity in public health facilities, focusing on human capacity development including clinical training, clinical mentorships, patient training and operational assistance training. BRHC is expanding its provision of additional staff and infrastructure support to SAG facilities. Finally, BRHC is expanding its involvement in the design of scaleable down referral models in partnership with FBOs, CBOs, and as a partner in innovative public private partnerships (PPPs).
ACTIVITIES AND EXPECTED RESULTS:
The primary goal of this program area is to ensure that new patients are started on ART when clinically qualified and enrolled patients continue to receive outstanding care and support.
ACTIVITY 1: Clinical Services
BRHC patients will be treated in accordance with SAG ARV National Guidelines and provided regular doctor visits, laboratory tests, HIV and AIDS education, counseling and cotrimoxazole prophylaxis. Using a family-centered approach, BRHC will recruit eligible family members of HIV-infected patients - including greater numbers of men and children - in order to improve the health of families/households and facilitate family doctor visits and drug pick ups. Care includes the preventive package, symptom and pain management, a wellness program (during the time from when a patient finds out his or her HIV-infected status until eligible for ART), are care during and after the initiation and possibly failure of ART. Patient nutrition and wellness needs will be met by the provision of multivitamin supplements, and doctor, patient and facilitator training in nutrition.
ACTIVITY 2: Human Capacity Development
1) BRHC will continue to provide training to its network of providers including doctors, nurses, pharmacists and other healthcare professionals through a variety of initiatives including remote decision support, telemedicine, web-based training, didactic training, and clinical mentoring from experienced HIV and AIDS clinicians. Comprehensive HIV and AIDS training for health professionals includes ART Management, TB, adherence, management of complications and side-effects, prevention and pediatric HIV management.
2) BRHC will continue to focus on community training on topics including HIV and AIDS, ART, adherence, living positively, universal precautions and accessing psychosocial support in communities. BRHC will continue to train support group facilitators on topics including HIV and AIDS, ART, adherence, disclosure, and linking patients with psychosocial services in the community.
3) The BRHC adherence program supports patients by providing features such as treatment buddies, support groups, text message reminders, a patient call center and adherence counseling.
ACTIVITY 3: Support to SAG
BRHC will support capacity development for care and support services at partner SAG facilities. According to SAG articulated needs, these services will include commodity procurement, healthcare financing, human resource recruitment and salary support (for doctors, nurses, pharmacy staff etc.), BRHC doctors providing temporary services at SAG facilities, training of SAG staff in HIV care and treatment and/or ART program management, and physical infrastructure building/refurbishment and equipment procurement. BRHC will work with SAG staff to improve operational efficiency in SAG facilities through needs assessments including identification of key bottlenecks and then generate and implement solutions. Additionally, BRHC will support SAG National Department of Health (NDOH) efforts, by assisting with development of down-referral models. Finally, BRHC will build on its existing public private (PPP) model (SAG - BRHC - Daimler Chrysler) in East London and develop new PPPs to further involve small to medium enterprises in supporting employees and dependents in the communities where they operate, alleviating some of the burden on government services.
ACTIVITY 4: Referrals and Linkages
Development of Network/Linkages/Referral Systems will be provided through strengthened referral networks between the public and private sectors (including referring stable patients back to the SAG ARV program), assistance to local clinics to facilitate SAG down referral process. Finally, BRHC will continue to expand its community-based linkages with CBOs in order to refer patients in need of non-USG funded food parcels and other wrap around services intended to support patients.
ACTIVITY 5: Quality Assurance/Quality Improvement (QA/QI)
Recognizing the critical role of monitoring and evaluation in ensuring a successful program, BRHC QA/QI activities include regular internal data and systems audits, collection of patient level surveillance data, exception reports, doctor-specific feedback report, and doctor decision-making support. The BRHC adherence program monitors and evaluates patient adherence through monitoring of drug pick up information, clinical reports, self-reported adherence, and pill counts.
BRHC Basic Healthcare and Support activities directly contribute to the 2-7-10 objectives of supporting 10 million people with basic healthcare and support by expanding these services in South Africa.
The TB/HIV activity described here is one component of a comprehensive set of services detailed in Basic Health Care and Support (#7873), CT (#7513), ARV Drugs (#7512), and ARV Services (#7510).
BroadReach Healthcare's (BRHC) integrated TB/HIV care and treatment activities will take place within the context of a larger anti-retroviral therapy (ART) Treatment Program that includes doctor consultations, lab testing, patient counseling, remote decision support, training for health professionals, monitoring, and data management. The major emphasis area for TB/HIV is Training. BRHC support the South African Government (SAG) in terms of meeting equipment, infrastructure and human resource needs. Primary target populations include PLHIV and their families, public and private doctors, laboratory workers, nurses, pharmacists, and other health care workers, the business community/private sector, CBOs, FBOs, and NGOs.
PEPFAR funds support BRHC initiatives which provide HIV and AIDS clinical management, care and support services to HIV-infected, uninsured individuals in areas where the SAG roll-out has not yet reached and supports service delivery in public sector facilities. The BRHC PEPFAR program began in May 2005 and now operates in 15 communities across five provinces. Today, BRHC is supporting approximately 3500 individuals directly with care and treatment and 15,000 indirectly. BRHC's mission is to tap into private sector health professionals to provide comprehensive care and treatment, fostering capacity building initiatives within the public health system, and partnering with and supporting community-based programs with sustainable impact on long-term patient care. BRHC leverages the community-based PLHIV support programs to identify and assist with treatment literacy, adherence support and ongoing community mobilization, prevention education activities, and positive living initiatives. In addition, BRHC works to build capacity in public health facilities, focusing its efforts on human capacity development (HCD) activities including clinical didactic training, clinical mentorships, patient training and operational assistance training. BRHC is expanding its provision of additional staff and infrastructure support to SAG facilities. Finally, BRHC is expanding its involvement in the design of scaleable down referral models in partnership with FBOs, CBOs, and as a partner in innovative public private partnerships (PPPs).
ACTIVITY 1: Human Capacity Development (HCD)
This program aims to provide TB care and treatment for HIV infected patients by strengthening the TB skills of health professionals through didactic training and clinical mentorships focusing on TB, TB/HIV co-infection and systems integration. Health professionals will also receive decision support and training from the BRHC clinical expert panel and disease management system for difficult cases. This TB-focused HCD effort will take place within the broader context of comprehensive HIV and AIDS training for health professionals and support from the disease management system. At the local level, HCD efforts will target the communities in which the program operates by providing training and information, education, communication (IEC) to patients and support group facilitators on TB, as well as HIV and AIDS, ART, adherence, living positively, and accessing clinical psychosocial support and linkages to other sectors and initiatives in their communities.
ACTIVITY 2: Support to SAG
This program will support the SAG TB program to increase the capacity of facilities in the testing and identification of TB patients. This will be accomplished through general healthcare financing which could include commodity procurement such as screening equipment to salary support of TB-focused clinical staff. Salary support would be given in line with government facility rates along with transition plans for the government facility to
absorb the staff into their budget within a finite period. Alternatively staff would be financed on a contract basis while plans were implemented in government facilities to accommodate staffing needs, Further assistance could be given in assisting with health professional recruitment and developing retention strategies, as well as supporting BRHC network doctors who assist with TB/HIV care and treatment within government health facilities in their communities in order to increase treatment capacity. Training of these doctors assists with sustainability as it provides ongoing stable support to government facilities and allows government infrastructure to cope with fluctuating need through the provision of sessionals. Finally, BRHC will support SAG TB/HIV efforts through infrastructure upgrade by building and/or refurbishing hospital/clinic/lab space and purchasing equipment as needed, in order to support government clinic activities such as screening, diagnosis and closely supervised treatment. The approach would be to address the individual needs of each facility within areas where BroadReach provides assistance in the form of ARV treatment or CT services across the provinces. The scope in terms of providing this assistance is broad but would be limited to services BroadReach is able to provide. The focus therefore being on operational processes, training, staffing etc. The extent to which assistance may be rendered would be limited to financial constraints.
ACTIVITY 3: Referral Networks
Additional support to SAG will be provided in the form of systems strengthening around TB/HIV activities. This will include improvement of referral linkages between the private sector general practitioners (GPs) and public sector facilities that treat BRHC patients for TB infection in the BRHC Comprehensive Care model. In addition, BRHC may work with government sites to facilitate linkages between TB and HIV clinics, as well as creating capacity and linkages within communities to support BRHC patients with TB/HIV co-infection within the context of a BRHC supported private public partnership with Daimler Chrysler (PPP). These linkages will be established by implementing referral processes between care givers by holding workshops, creating referral material (referral forms that inform the receiving provider where the patient originated and the findings of the original provider), and informing various groups of activities in the area. Processes will specify whether HIV patients with TB are referred to HIV clinics or TB clinics or vice versa. The expected outcome is that patients are treated holistically and not in isolation by various providers. Since these diseases are closely linked it is important that the treating physician treats the patient for TB and HIV so that he is able to manage treatment regimes. Patients with TB should have access to HIV testing and should they require ARV therapy, they would need to be treated or referred to an ARV facility.
ACTIVITY 4: Quality Assurance/Quality Improvement
TB/HIV activities will benefit from the same level of oversight and quality control as all other aspects of the BRHC treatment program including regular internal data and systems audits, collection of patient level surveillance data, exception reports, doctor-specific feedback report, and doctor decision making support, and community-based modified (directly observed treatment) DOTS programs. TB/HIV quality assurance is further enhanced by the tracking of co-infected patients through screening, diagnosis and treatment through the use of improved clinical forms and referral forms. A clinical oversight committee provides any guidance to GPs regarding complicated cases presenting with TB/HIV co-infection.
BRHC TB/HIV activities will directly contribute to the 2-7-10 objectives by ensuring that co-infected patients remain in care and treatment thereby optimizing health outcomes.
BroadReach Healthcare's (BRHC) activities in counseling and testing (CT) are one component of a comprehensive set of services further described in the Basic Health Care and Support (#7511), TB/HIV (#7939), ARV Drugs (#7512), and ARV Services (#7510) program areas.
BRHC counseling and testing (CT) support activities include test-kit procurement, meeting infrastructure and human resource demands, increasing testing uptake, prevention, patient counseling, referral systems, and training. The program's major emphasis area is human resources, with additional emphasis on training and development of network/linkages/referral systems, which include South African Government (SAG) program support. Primary target populations include children and youth (non-OVC), adults, pregnant women, HIV and AIDS affected families, public nurses, and other healthcare workers.
PEPFAR funds support BRHC initiatives which provide HIV and AIDS clinical management, care and support services to HIV-infected, uninsured individuals in areas not yet reached by the SAG roll-out and assistance for the ART roll-out in the public sector. The BRHC PEPFAR program began in May 2005 and now operates in 15 communities across five provinces. Today, BRHC is supporting approximately 3,500 individuals directly on care and treatment and 15,000 indirectly. BRHCs mission is to tap into private sector health professionals to provide comprehensive care and treatment, fostering capacity building initiatives within the public health system, and partnering with and supporting community-based programs with sustainable impact on long-term patient care. BRHC leverages the community-based people living with HIV and AIDS (PLHIV) support programs to identify and assist with treatment literacy, adherence support and ongoing community mobilization, prevention education activities, and positive living initiatives. In addition, BRHC works to build capacity in public health facilities, focusing its efforts on human capacity development (HCD) activities including clinical didactic training, clinical mentorships, patient training and operational assistance training. BRHC is expanding its provision of additional staff and infrastructure support to SAG facilities. Finally, BRHC is expanding its involvement in the design of scaleable down referral models in partnership with faith-based organizations (FBOs), community-based organizations (CBOs), and as a partner in innovative public private partnerships (PPPs).
The primary goal of the program is to ensure that those testing positive for HIV are started on ART when clinically qualified and enrolled patients continue to receive outstanding care and support. CT is the entry point for this goal.
ACTIVITY 1: Voluntary Counseling and Testing
BRHC will provide access to rapid voluntary counseling and testing (VCT) at enrollment sessions when required and, where available, CD4 testing services for patients who test positive to determine eligibility for treatment. In accordance with SAG guidelines, BRHC patients will be properly counseled (pre- and post-test), tested and referred as appropriate (to a BRHC network doctor or to an accredited SAG facility).
BRHC will expand access and availability of CT by: (1) procuring testing materials (rapid test kits when unavailable through the government system); (2) improving operational efficiency through needs assessment, identification of operational bottlenecks, implementing solutions to address bottlenecks; (3) assisting with refurbishing physical space at government clinics/hospitals; and (4) advising SAG partner clinics on increasing VCT uptake and improving the percentage of results received. BRHC will further support SAG efforts in meeting the increased demand created by testing. This will range from
providing salary support for counselors to improved processes and systems for enrolling and following up greater numbers of new patients.
ACTIVITY 3: Outreach
Using a family centered approach to care and treatment, BRHC will encourage the testing of families and households, utilizing patients already enrolled in the BRHC program as a point of entry. BRHC will also promote community-based programs such as support groups, CBOs, and churches as entry points for VCT services.
All HIV-infected patients identified through BRHC-supported VCT efforts, will be linked (via BRHC network doctors, home-based care (HBC) and support groups) to other services such as TB care, nutrition and wellness, and psychosocial support.
ACTIVITY 5: Human Capacity Development
BRHC may enhance the quality of VCT services at selected sites (assigned by the relevant district authorities) through training and mentoring for counselors, health professional staff, outreach workers and support group facilitators. In addition to training, BRHC will assist VCT programs at sites by providing salary support to counselors as sites expand access to VCT services.
BRHC VCT activities directly contribute to the 2-7-10 objectives by identifying infected individuals who are unaware of their HIV status and who may be eligible for treatment. Greater numbers of people tested means meeting the treatment and care and support objectives. Moreover, prevention messages given to both infected and uninfected individuals during post-test counseling will contribute to the goal of averting 7 million infections.
BroadReach Healthcare's ARV Drugs activity is one component of a comprehensive set of services further described in the Counseling and Testing (#7513), Basic Health Care and Support (#7511), TB/HIV (#7939), and ARV Services (#7510) program areas.
BRHC antiretroviral (ARV) drug activities include drug procurement and distribution, training for health professionals on drugs, supporting pharmacy staff salaries, training patients, quality assurance (QA), and data management. The major emphasis area is commodity procurement, with additional emphasis in quality assurance and supportive supervision, logistics, and training through community capacity development and support to the South African Government (SAG). Primary target populations include people living with HIV (PLHIV) and families/households, the private sector, and public and private doctors, nurses, pharmacists, and other healthcare workers. BRHC is exploring the use of the Partnership for Supply Chain Management project for drug procurement.
PEPFAR funds support BroadReach Healthcare (BRHC) initiatives which provide HIV and AIDS clinical management, care and support services to HIV-infected, uninsured individuals in areas where the SAG rollout has not yet reached communities, and support services delivered through the public sector. The BRHC PEPFAR program began in May 2005 and now operates in 15 communities across five provinces. BRHC is supporting approximately 3500 individuals directly with care and treatment and 15,000 indirectly. BRHC implements its mission by tapping private sector health professionals to provide comprehensive care and treatment, fostering capacity building initiatives within the public health system, and partnering with and supporting community-based programs. BRHC leverages community-based PLHIV support programs to identify and assist with treatment literacy, adherence support and ongoing community mobilization, prevention education activities, and positive living initiatives. In addition, BRHC works to build capacity in public health facilities, focusing its efforts on human capacity development activities, including clinical didactic training, clinical mentorships, patient training and operational assistance training. BRHC is expanding its provision of additional staff and infrastructure support to SAG facilities. Finally, BRHC is expanding its involvement in the design of scaleable down referral models in partnership with faith-based organizations (FBOs), community-based organizations (CBOs), and as a partner in innovative public-private partnerships (PPPs).
The primary goal of this program area is to ensure that new patients are started on ART when clinically qualified and enrolled patients continue to receive high-quality care and support.
ACTIVITY 1: Drug Procurement and Distribution
BRHC will continue commodity procurement of ARVs through its supply chain vendors including, its courier-based pharmacy partners. BRHC will oversee the delivery of drugs to the accredited community-based providers. In some instances, the community-based providers will be paid a capitated rate per patient and those providers will be procuring drugs according to PEPFAR standards and national guidelines. BRHC will negotiate best available pricing for USG and SAG approved ARV drugs. Community-based providers are trained in drug forecasting, procurement and supply chain management.
BRHC partners with a private mail order pharmacy provider, Pharmacy Direct (PD), in its procurement and distribution efforts for the BRHC general practitioners (GP) network. Pharmacy Direct liaises directly with the BRHC GP network to manage patient prescriptions, dosing, medicine delivery and pick-up of returned medicines. In partnership with Pharmacy Direct, BRHC manages patient adherence through monitoring of medicine collection and regular data reports.
ACTIVITY 2: Human Capacity Development (HCD)
BRHC will continue to provide comprehensive HIV and AIDS training to its network of providers including doctors, nurses, pharmacists and other healthcare professionals through a variety of initiatives including remote decision support, telemedicine, web-based training, didactic training, and clinical mentoring from experienced HIV and AIDS clinicians. Topics will include drug supply chain logistics, operational improvements for drug management, disposal of unutilized drugs, comprehensive ART management, adherence, management of complications and side-effects, prevention and pediatric HIV management. BRHC-supported human capacity development (HCD) activities, such as training and clinical mentoring, will also take place within SAG facilities.
BRHC will support capacity development for drug procurement and pharmaceutical management at partner SAG facilities. BRHC will conduct a needs assessment that will examine the operational processes for drug procurement, forecasting, stock management, and dispensing. Based on this assessment, solutions will be identified and implemented to improve operational capacity.
BRHC maintains a close relationship with its drug procurement and distribution client. The client provides regular feedback and reports to BRHC regarding delivery problems, missed medicine pick-ups, and collects all unused medicines. Drug distribution, pick-up, and returns data is collected and maintained in the BRHC program database. This data feeds into numerous reports including doctor-specific feedback reports and patient exception reports.
This activity facilitates the ARV service delivery component of the project, which contributes directly to the PEPFAR 2-7-10 goal of two million people receiving treatment. BRHC will contribute to PEPFAR's vision outlined in the Five-Year Strategy for South Africa by expanding access to ART services for adults and children, building capacity for ART service delivery, and increasing the demand for and acceptance of ARV treatment.
BroadReach Healthcare's (BRHC) ARV Services activity is one component of a comprehensive set of services described in the Counseling and Testing (#7513), Basic Health Care and Support (#7511), TB/HIV (#7939), and ARV Drugs (#7512) program areas.
BRHC supports integrated ARV services that include doctor consultations, lab testing, adherence support, patient counseling, remote decision support, quality assurance (QA), and data management. BRHC's emphasis areas are human resources, local organizational capacity development, quality assurance, and training, through clinical services, pediatrics care, and support for the South African Government (SAG). Primary target populations include people living with HIV (PLHIV), their families, the private sector, public and private doctors, lab workers, nurses, pharmacists, and other healthcare workers, CBOs, FBOs, and NGOs.
PEPFAR funds support BRHC initiatives that provide HIV and AIDS clinical management, care and support services to HIV-infected individuals in areas where the SAG rollout has not yet been implemented and assists ART rollout in the public sector. The BRHC PEPFAR program began in May 2005 and now operates in 15 communities across 5 provinces. BRHC is supporting approximately 3,500 individuals directly with care and treatment and 15,000 indirectly. BRHC taps private sector health professionals to provide comprehensive care and treatment, fostering capacity-building initiatives within the public health system, and supporting community-based programs. BRHC leverages PLHIV support programs to identify and assist with treatment literacy, adherence support and ongoing community mobilization, prevention education activities, and positive living initiatives. BRHC also works to build capacity in public health facilities, focusing efforts on human capacity development (HCD) activities, including clinical didactic training, clinical mentorships, patient training and operational assistance training. BRHC is expanding its provision of staff and infrastructure support to SAG facilities. Finally, BRHC is expanding its involvement in the design of scaleable down referral models in partnership with faith-based organizations (FBOs), community-based organizations (CBOs), and public-private partnerships (PPPs).
To ensure that new patients are started on ART when clinically qualified and enrolled patients continue to receive quality care and support, BRHC will carry out the following activities:
BRHC patients will be treated in accordance with national guidelines by ensuring that all elements for effective treatment are provided in a coordinated manner. This includes addressing issues of human resources, provision of technical expertise, training, IEC, community mobilization, laboratory and testing, drug logistics, equipment and supplies, physical space, M&E, and other cross-cutting support functions such as budgeting, finance, policy and planning support. Patients see doctors regularly, and will receive laboratory tests, HIV and AIDS education, adherence support, counseling, cotrimoxazole prophylaxis and linkage to other support and wellness (including prevention) services. Patient nutrition and wellness needs will be assisted by local FBOs and NGOs (e.g. food parcels). BRHC supports patients through the private sector until those patients can access treatment through public services and through strengthening services in the public sector.
BRHC will provide comprehensive HIV and AIDS training to its network of providers including doctors, nurses, pharmacists and other healthcare professionals through a variety of initiatives including remote decision support, telemedicine, web-based training,
didactic training, and clinical mentoring from experienced clinicians. Comprehensive HIV and AIDS training for health professionals includes ART management, tuberculosis (TB), adherence, management of complications and side-effects, prevention and pediatric HIV management. BRHC human capacity development activities, such as training and clinical mentoring, will also take place within SAG facilities. BRHC will continue to train patients and support group facilitators on topics including HIV and AIDS, ART, adherence, living positively, and accessing psychosocial support in communities. The BRHC adherence program supports patients by providing features such as treatment buddies, support groups, cell phone message reminders, a patient call center and adherence counseling.
BRHC will conduct an initial needs assessment at each SAG partner facility. The assessments will identify problems that impact overall capacity and efficiency. Solutions for each institution include recruitment and salary support for doctors, nurses, and pharmacy staff. BRHC general practitioners provide part-time services at SAG facilities, and train SAG staff in HIV care and treatment and related management. Other support may include infrastructure, such as refurbishment, equipment and supplies procurement. Finally, BRHC will build on its existing public-private partnership (PPP) model with SAG and Daimler Chrysler in East London and develop new PPPs to further involve private companies in supporting small business employees and dependents in communities where they operate.
Support systems for treatment will be provided by strengthening referral networks between the public and private sectors, including referring stable patients back to the SAG ARV program, and support to local clinics to facilitate SAG up and down referral. Finally, BRHC will continue to expand its linkages with CBOs in order to refer patients in need of food and other community services.
Recognizing the critical role of M&E in a successful treatment program, BRHC QA/QI activities include regular internal data and systems audits, collection of patient-level surveillance data, exception reports, doctor-specific feedback report, and doctor decision-making support. The BRHC adherence program monitors patient adherence through monitoring of drug pick-up information, clinical reports, self-reported adherence, and pill counts. BRHC will also work with SAG facilities to improve data management and medical records systems.
ACTIVITY 6: Pediatric care and treatment
BRHC will expand pediatric enrollment using a family-centered approach. BRHC will encourage testing of families/households, using patients already enrolled in the BRHC program as the index case and point of entry into the household. By recruiting eligible family members, BRHC will enroll greater numbers, including children, into the program. Finally, the family-centered approach will allow BRHC to link an entire household to a single doctor in order to facilitate doctor visits and drug pick ups.
These activities directly contribute to the PEPFAR 2-7-10 goals by increasing the number of people receiving ARVs, improving access to HIV services, and increasing the capacity of local organizations.
