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:
Activities will focus on a family-centered approach to care and support. This will include enhancing facility-
based management of palliative care (including pain and symptom management and cotimoxazole
prophylaxis). Strengthening pre-antiretroviral therapy (ART) and ART support care based in the clinics and
at community level will help to support down referral from hospitals and health centers. This will include
particular emphasis on implementation of the Basic Care Package.
ACTIVITY 1: Family-centered approach to care and support
The awardee will strengthen existing support groups and form new support groups that is linked to a health
clinic in the community(each clinic should have at least 1 support group. Expert patients (PLHIV) and other
support group facilitators will be trained on implementing a basic package of care and support services that
will include (acceptance of status;Disclosure; HIV and AIDS and TB/HIV; Alcohol and Substance abuse and
HIV and AIDS; Prevention with Positives; Treatment Literacy; Nutrition assessment and counseling and
Treatment adherence and support). PLHIV will be encouraged to join the support groups from the time they
are tested HIV-positive where they will receive information on HIV and AIDS, ongoing counseling and
support, referral for additional care when needed, thus forming a link for continuity of care to community
level. PLHIV will be encouraged to bring along family members and other community members so they can
receive information and support. Family counseling sessions will be conducted where counseling and
testing for other family members will be encouraged and other prevention messages (e.g. prevention with
positives) will be disseminated. Children within families will be referred to the health facility for HIV testing
and support.
ACTIVITY 2: Nutritional support through gardens
To promote quality, economical nutrition, the team will work with the Department of Health (DOH) to
develop a local low-literacy cookbook (in Xhosa) and home economics guide. Clinic nurses will be trained
on the use of the guide. Community health workers and support group leaders will be trained on the national
curriculum for HIV and AIDS and nutrition using the national training manual and reference guide. Cooking
demonstrations will be established at clinics and selected churches on using nutritious foods, especially the
foods and herbs from the permaculture gardens. Funding will support referral for nutritional support and
monitoring as well as training clinic teams and as budget allows, outfitting modest kitchens, such as adding
a table, stove or sink to existing clinic kitchens.
ACTIVITY 3: Gender-related activities
The awardee will integrate gender norms, roles and behaviors into the support group activities. Activities
will focus on exploring behaviors that may lead to gender violence, exploitation and abuse and together find
ways and alternatives to deal with/avoid such behaviors. Negotiation skills will be developed through role
plays and discussion around gender issues.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Reducing violence and coercion
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Estimated amount of funding that is planned for Water
Table 3.3.08:
The project will provide support to antiretroviral (ARV) services in the district in which they will be operating.
The aim of this program area is to extend access to antiretroviral therapy (ART) through increased uptake
and the accreditation of more health care facilities within the district.
ACTIVITY 1: Increased access to ARV services
The project will work with district HIV and AIDS managers to identify health facilities for strengthening to
provide ART services. The project will work with health care providers within these facilities to identify
strategies that will increase access to ART. This would include introduction of treatment readiness
programs from the time one is tested HIV-positive through the support groups, thus shortening the time to
initiate ART. Also, the project will facilitate down referral of stable patients on ART to primary health care
sites and recruit and train private general practitioners in the area to support primary health care clinics to
provide ART services.
Table 3.3.09:
Africare's Injongo Yethu Project encourages identification of HIV infection among TB clients, and TB
disease detection and management among HIV clients. Major emphasis is on local organization
development of clinics in the Hewu Hospital catchment area in the Eastern Cape and the feeder clinics for
Frontier Hospital and Glen Grey Hospital. Emphasis of project interventions is also on training, monitoring
and evaluation support through information technology development (the ARV and HIV electronic register)
and developing supportive supervision. FY 2008 will include Nkonkobe LSA and a selection of the clinics
feeding those hospitals.
BACKGROUND:
This is an follow-on activity that has received some support for training of nurses in TB and HIV care and an
orientation of Service Corps Volunteers on the frequency of HIV infection among TB clients. Activities will
focus on providing tools and mechanisms to improve the quality of home- and facility-based management of
TB screening and management in HIV-infected clients, and HIV screening and management for clients on
TB treatment. Tools for monitoring, supportive supervision and referral will also be provided.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Improve HIV Testing Rates of TB Clients
This activity will support development of a standard HIV education flip -chart for TB clients similar to the
CDC-supported antenatal care (ANC) counseling guide that achieved much success in Botswana. Nurses
from 10 clinics will be recruited to field-test the flip chart and the counseling routine and note any effect on
HIV testing among TB clients. Nurses will be encouraged to offer counseling at the initiation of TB therapy
and after the two-month intensive treatment phase to clients who had declined testing at initiation. South
African government DOT supporters from selected clinics will be provided with additional basic HIV and
AIDS training, particularly for those not recently trained or provided with an update and refresher course.
The flip chart piloted by clinics will be made available to DOT supporters from the same clinics in order to
further encourage HIV testing among the TB clients.
ACTIVITY 2: Improve TB Screening Among HIV Clients
Active TB screening will be implemented in home-based care along with an orientation of HIV chronic care
nurses on TB screening. In addition, key support group members will be trained to help screen for
pulmonary TB and key signs of non-pulmonary TB and refer to the clinic. Increased screening will be
captured in the home-based caregiver records and the clinic chronic care record.
ACTIVITY 3: Training and Capacity Building
To ensure effective integration of TB and HIV care, doctors and nurses from Hewu Hospital, Sada
Community Health Clinic, Frontier Hospital and Glen Grey Hospital will be prioritized for updated training on
TB and HIV co-management, using recent WHO and NDOH materials. Training for doctors will be open to
20 local general practitioners. Routine technical information packets consisting of e-newsletters, tools and
guides from PEPFAR partners, publications from USG cooperating agencies, such as WHO and the AIDS
Vaccine Bulletin will be collated and distributed to the doctors, HIV service managers and nurses in
antiretroviral treatment clinics. The project will subscribe to newsletters and training materials from various
membership organizations on behalf of the health-care providers at the three hospitals.
ACTIVITY 4: Strengthen Organizational and Supervisory Support for TB and HIV Integration
The project will support the Chris Hani District HIV, AIDS, STI, TB (HAST) committee to create objectives
and a standing agenda item for monitoring progress toward integration of TB and HIV services.
Development of tools to monitor and evaluate the effectiveness of integration will be advocated.
ACTIVITY 5: Ensure and Monitor Cotrimoxazole Therapy Implementation
Cotrimoxazole therapy is widely given to HIV clients, but the effects are not routinely monitored. To ensure
that all appropriate clients benefit from cotrimoxazole, relevant data elements will be included in the HIV
patient electronic register and therapy will be included in the algorithms as will the proposed HIV client care
plans.
ACTIVITY 6: Effective Monitoring of TB and HIV-infected Patients
The flow of information and documentation of information between services to HIV-infected and TB patients
will be assessed for bottlenecks and potential for losing follow-up of clients using client flow analysis and
current client records to find where clients drop out of the system and delays are experienced. Africare will
collaborate with another PEPFAR partner, QAP to capitalize on, and to reinforce, principles and processes
of quality assurance that will allow facility teams to uncover their local constraints and to plan solutions.
ACTIVITY 7: Support to TB Clients as Potential or Diagnosed HIV Clients
TB clients will be informed of, and welcomed to the new HIV support groups at the clinics. It is understood
that some TB clients are not ready to be tested for HIV and might find support to do so in the group. FY
2009 activities will also include dissemination of the new TB guidelines, accompanied by refresher training
for hospital and private doctors.
Table 3.3.12:
SUMMARY AND BACKGROUND:
The project's activities will emphasize the development of sound public sector and community responses to
OVC needs. Public sector departments involved are the Department of Social Development (DOSD),
Department of Health (DOH) and Department of Education (DOE). FY 2008 will include efforts to engage
the Department of Labor (DOL) and the Department of Agriculture (DOA).
ACTIVITY 1: Strengthen Communities to Meet the Needs of OVC Affected by HIV and AIDS
Service Corps Volunteers (SCVs) will be recruited to support OVC community-based activities. To support
the identification and tracking of support to OVC, the project will support the Eastern Cape DOSD in
designing and developing an OVC services tracking system and other tools for identifying vulnerable
households, their needs, and tracking services delivered. SCVs, health sector community care-givers and
the Child Protection Committees (CPCs) members will be trained to identify OVC and vulnerable
households, and ongoing household needs assessments will be initiated and made routine. CPCs will
continue to be developed for 15 wards (or clusters of wards) to provide a mechanism for coordinating
resources to meet the children's needs. CPCs will also function as the accountability body for local OVC
identification, monitoring and services coordination. Small grants will be provided to the CPCs to enable
them to meet and coordinate activities for OVC. A memorandum of understanding will be signed with each
CPC, each will be assessed for its development and resource needs; each forum will meet at least
quarterly. Teh project support will be provided through a Service Corps Volunteer to establish patterns of
OVC needs identification, work planning, and the development of an OVC community service plan. Kids'
Clubs will be established with Africare support, designed in conjunction with the DOSD and their district
committee for HIV and OVC ("DACCA"). Workshops will continue to be held to jointly establish roles,
functions, and the service complement of CPCs and Kids' Clubs. CPCs, Kids Clubs, and community
caregivers will link OVC and child heads of households to social services for necessary support in addition
to providing direct support where they are capable.
ACTIVITY 2: Community-based Responses in Support of OVC and Their Households
The project will provide grants and technical assistance to selected community-based organization (CBO)
members of CPCs. Two CBOs have been engaged and provided with initial grants. Orientation on financial
management and monitoring and evaluation will be provided to CBOs and as well as those engaged in OVC
activities. Grants will focus on enabling CBOs to provide care and support to OVC in their communities.
Training of CBO caregivers will enable them to monitor, directly provide, and refer to specific services. Both
service CBOs and public sector health volunteers will be provided with tools and training to monitor health
status and to promote child utilization of well-child health services and to be cared for when sick. OVC
households will be linked to ongoing and expanding food garden projects, soup kitchens and locally
available food parcels distributed by the DOSD, churches and CBOs. A local legal aid service will be
engaged to train child forums and volunteers in basic legal aid support for OVC and families, such as wills,
succession planning, identity documents, deferment of school fees, etc. The project will facilitate the
development of a referral system between the community, DOSD and legal aid for common legal needs.
The South African Depression and Anxiety Group (SADAG) will continue to provide specific support in
developing community-oriented psychosocial support training. They will initiate caregiver support groups,
and train the support group leaders. The SADAG 'talking book' for OVC will be used by community and
household caregivers for facilitating discussion and engaging children and youth. They will also establish a
toll-free call line for support.
ACTIVITY 3: Direct Assistance to OVC
The project will facilitate establishing effective referral patterns and access to social services and various
benefits. SCVs will be trained to assist CPCs and train child-headed households on home management,
services and entitlements. To foster school compliance with the provincial no-fee policy in disadvantaged
areas, minor repairs and rehabilitation or other school-wide benefits will be undertaken in exchange for
waiving fees for OVC. Enrollment by OVC in school and routine attendance will be monitored. The project
will capacitate the community volunteers and child care forums to ensure that OVC in need of shelter get
referred. Monthly monitoring of access and utilization of a standardized package of services will continue in
FY 2008. Children and youth attending Kids' Clubs will be trained in Life Skills. Kids' Clubs leaders will be
trained in HIV prevention, AIDS care and support of OVC. The project will provide small grants to Kids'
Clubs to organize recreational activities. The project will seek leveraged matching funds. Peer Educators
(40) and Peer Counselors (40) will be trained to support children and youth attending Kids' Clubs and in the
community. Children heading households and older OVC will be targeted for training in vocational and
livelihood skills through vocational training centers and training organizations. Local organizations will be
trained to support the development of income generating activities (IGA), and OVC and caregivers will be
assisted in securing funding for IGA activities.
ACTIVITY 4: Access to Health Care
Home-based caregivers based at clinics will ensure that OVC under two years old encountered in the
homes of their HIV clients are weighed, immunized, and those that are HIV-exposed are screened for
infections, receive their follow-up HIV test, and access care and treatment, when required. OVC caregivers
(OVCGs) deployed by the CBOs under each CPC will monitor clinic utilization for growth monitoring and
immunizations and will support the clinics in direct weight monitoring for high-risk children. Older children
encountered in the home will also be linked to clinic care and treatment services as needed. Schools and
Kid's Clubs will be alert to children and youth, who need referrals for healthcare and HIV treatment, linking
them through the structures above to ensure that clinic or hospital level care is provided.
CPC members will continue to be trained in FY 2008 to provide community-based support and advocacy,
Activity Narrative: e.g. prevention of exploitation and abuse, prevention of "land-grabbing", and identification of children and
households in distress. CPC development will continue to be nurtured to provide a sustainable response to
the need for OVC identification and service coordination.
Table 3.3.13:
The project will expand access to counseling and testing (CT) at community level and strengthen
counseling and testing services at health facility level.
Africare will carry out two separate activities in this program area.
ACTIVITY 1: Strengthening CT services at health facility level
The project will mentor staff at facility on implementing CT services including provider initiated CT for
sexually transmitted infections (STIs), tuberculosis (TB) and antenatal care (ANC) clients. The project will
train and place lay counselor at health facilities to counsel and refer clients for CT. All clients testing for HIV
irrespective of their results will be referred to the support groups where they will receive more information
and support on HIV/AIDS.
ACTIVITY 2: Implementing mobile CT services within the community
The project will implement mobile CT services that will services communities. These mobile services will
operate during and after clinic hours. The project will provide mobile CT services whenever there is an
event in the community e.g. candle light memorials, World AIDS Day, Stop TB Day, STI week and other
sporting events in the community. This service will be coupled with mass media activities (radio talks about
the mobile CT services, flyers) and community mobilization efforts to encourage community members to
seek counseling and testing for HIV.
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Table 3.3.14:
