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.
Years of mechanism: 2008 2009
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The African Medical Research Foundation (AMREF) will continue with the above activities. However, in line
with the external Comprehensive HIV/AIDS Quality Assurance (CHAQA) review, and FY 2009
recommendations by the Centers for Disease Control and Prevention (CDC), AMREF will not implement
Activity 2 (Community Mobilization and Sensitization). Thus, the key strategies to be employed will include
1) health system strengthening through human capacity development (training and mentoring), 2)
strengthening referral systems for HIV and tuberculosis (TB), and (3) assessment of HIV-TB integration.
ACTIVITY 1: Health Systems Strengthening (training and mentoring)
AMREF will largely restrict its activities to supporting 180 public health care facilities to deliver quality
voluntary counseling and testing (VCT) TB services and will support health providers to apply policy
guidelines around provider initiated counseling and testing (CT).
The project will tap into previously developed and tested training curricula (from AMREF, the Department of
Health and CDC/World Health Organization) on CT. Activities will focus on building the capacity of VCT
services to improve quality, confidentially, equity, access and demand for services and strengthen
coordination between VCT and TB services.
AMREF will train mentors on mentoring and coaching of VCT staff and will develop a mentoring system and
to support TB and HIV service management for clinic staff. AMREF will strengthen the district health
information systems (DHIS) and improve health providers' ability to collect and analyze data, document
results, and use data effectively in health service planning and management. AMREF will train government
HIV/AIDS STI and TB (HAST) committee members in monitoring and evaluation (M&E) for comprehensive
care.
AMREF strengthen and support HAST committees to encourage networking and collaborative service
provision between TB and HIV/AIDS services in the supported local service areas (LSAs). AMREF will also
document the model of VCT-TB integration in the supported LSAs.
AMREF will also use FY 2009 funds to care for health providers through counselors support systems aimed
at reducing burn-out of counselors and help improve the quality of counseling services offered to clients;
ACTIVITY 2: Health Systems Strengthening (Referral Systems for HIV and TB)
With FY 2007 and FY 2008 funds, AMREF refined the Eastern Cape Department of Health's referral
protocol for VCT and TB. FY 2009 funds will be used to scale-up and institutionalize the use of this referral
system (and tools) for cross referrals from VCT and TB services in Eastern Cape, Limpopo and KZN
provinces. AMREF will work in collaboration with service providers to monitor implementation of the referral
system. In line with the mentoring strategy, monitoring of the referral system will involve checking the usage
of the referral tools and tracking access to services for referred clients. This will enable accurate data and
monitoring of the number of HIV infected clients that are undergoing screening for TB. AMREF will also
expand referral systems from to include expansion sites.
The program will also strengthen the capacity of health service staff at VCT and TB clinics to monitor and
evaluate and keep accurate records of patients and services.
ACTIVITY 3: HIV-TB Assessment
AMREF will largely restrict its activities to supporting health care facilities to deliver quality VCT-TB services
and will support health providers to apply policy guidelines around provider initiated CT.
However, in line with external programme evaluation and recommendations (CHAQA), and as
recommended by CDC under the FY 2009 COP review process, AMREF will redirect FY 2008 funding for
sub-granting community-based organizations (CBOs) to increase 1) human resources support for mentoring
of facilities, 2) M&E for an expanded programme (from one to three provinces, or 71 to 180 facilities), and 3)
documentation of best practices which can be used in collaborating and working with CBOs in increasing
access to HIV-TB.
Taking lessons from AMREF's FY2007 challenges in identifying and recruiting suitably established CBOs to
conduct community mobilization and testing for VCT, AMREF plans to assess and document best practices
for partnering with CBOs within a VCT-TB integration model. Thus, the above assessment will include
documentation of constrains, opportunities and gaps in partnering with community-based organizations.
AMREF will map CBOs and non-governmental organizations (NGOs) in supported sites to determine the
service in terms of confidentiality practices, compliance with quality assurance methods for rapid testing,
accessibility, quality, utilization of VCT services, data management; and client awareness/perceptions of
local communities of VCT services and facilities. With the aim of expanding access to VCT services,
AMREF will review the relationship between NGOs offering (or seeking to offer) VCT and the Department of
Health, specifically to understand what role CBOs/NGOs can play in expansion of VCT services.
AMREF will assess clients' referral sources, perceptions, opening hours of and waiting times at the VCT
service; application of existing policies and guidelines on VCT related services; and audit the structural
conditions of VCT facilities. AMREF will assess the extent to which TB staff from health facilities are testing
TB patients for HIV and monitoring the CD4 count of TB patients.
-------------------------------
SUMMARY:
Activity Narrative: African Medical Research Foundation (AMREF) will employ three key strategies: 1) Implement social
marketing and stigma reduction strategies; 2) Health system strengthening (training and mentoring including
sub-granting and support); and 3) Community partnerships. The project will tap into previously developed
and tested AMREF training curricula, partnerships with government and community counseling and testing
(CT) providers. The project will expand CT coverage by both improving and ensuring quality, accessibility,
appropriateness and convenience of services and developing targeted social marketing campaigns to
improve CT uptake.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: NGO VCT Assessment
AMREF will map NGO VCT sites surrounding selected facilities; assess the service in terms of
confidentiality practices, compliance with quality assurance methods for rapid testing, accessibility, quality,
utilization of VCT services, data management; and client awareness/perceptions of local communities of
VCT services and facilities. AMREF will assess clients' referral sources, perceptions, opening hours of and
waiting times at the VCT service; application of existing policies and guidelines on VCT related services;
and audit the structural conditions of VCT facilities. AMREF will assess the extent to which TB staff from
health facilities are testing TB patients for HIV and monitoring the CD4 count of TB patients. With the aim of
expanding access to VCT services, AMREF will review the relationship between NGOs offering (or seeking
to offer) VCT and the Department of Health, specifically to understand the role that NGOs can play in
expansion of VCT services.
ACTIVITY 2: Social Marketing and Stigma Reduction
Key activities include: 1) Desktop review of VCT social marketing activities (Government, CBOs, etc);
consultation at all levels (national to district); assessment of knowledge, attitudes and perceptions (KAP)
about HIV/AIDS and VCT within local targeted communities; 2) Design and develop information, education,
and communication materials; (3) Build capacity of local stakeholders in order to fight stigma; 4) Social
marketing campaign and facilitation of access to wider sources of care and support for people living with
HIV; and 5) Conduct monitoring and evaluation (M&E) and documentation of best practices.
ACTIVITY 3. Health Systems Strengthening
Activities will focus on building the capacity of VCT services through training and mentoring to improve
quality, confidentially, equity, access and demand for services and strengthen coordination between VCT
and TB services. The program will also strengthen the capacity of health service staff at VCT and TB clinics
to monitor and evaluate and keep accurate records of patients and services.
AMREF will train and mentor 30 VCT staff at selected VCT centers in HIV counseling and testing according
to national and/or international standards; support TB and HIV linkages, TB symptoms and referral to TB
testing; improve VCT service management and mentoring for clinic staff. To strengthen quality assurance
AMREF will train 60 mentors in mentoring and coaching VCT staff and will develop a mentoring system to
ensure that VCT testing staff are mobilising and referring. AMREF will strengthen the district health
information systems (DHIS) and improve providers' ability to collect and analyze data, document results,
and use data effectively in health service planning and management. AMREF will train 60 government
HIV/AIDS STI and TB (HAST) committee members in M&E for comprehensive care.
AMREF will train 30 CBO carers, managers and nurses in ARV literacy; strengthen and support HAST
committees to encourage networking and collaborative service provision between TB and HIV/AIDS
services; mobilise and motivate TB patients for HIV testing and vice versa. AMREF will develop a referral
system, tools and guidelines for health professionals, local NGOs/CBOS, primary health care and
community service providers, in collaboration with VCT and TB nurses; and will monitor the implementation
of the referral system.
New/Continuing Activity: Continuing Activity
Continuing Activity: 15872
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15872 15872.08 HHS/Centers for African Medical 7279 7279.08 $455,000
Disease Control & and Research
Prevention Foundation
Emphasis Areas
Gender
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* TB
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $879,300
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.14:
