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
Reprogramming is related to the transition of the Track 1 CRS care and treatment program to 3 local
implementing partners, including IYDSA.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.01:
Program Budget Code: 09 - HTXS Treatment: Adult Treatment
Total Planned Funding for Program Budget Code: $147,229,223
Total Planned Funding for Program Budget Code: $0
Table 3.3.09:
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
The Institute for Youth Development in South Africa (IYDSA) competed in the South Africa local Annual
Program Statement in 2008, and was approved for funding August 6, 2008. IYDSA as a prime partner is
also currently a sub-partner under the Track 1 Catholic Relief Services (CRS) program. However, in FY
2009 the Track 1 CRS program will transition, and IYDSA will become one of three local implementing
partners that will have CRS funds and responsibilities transferred to, and thus current funding levels will
increase in FY 2009. These will be adjusted through reprogramming in FY 2009.
The IYDSA treatment program Zisa Uncedo is implemented in the Eastern Cape, where the majority of the
population live in a rural setting. This is a resource and capacity poor province. The province requires a
further 10,700 professional healthcare workers in order to implement a primary health care service.
Buildings are old and space is limited. The disincentive for health workers is strong. The reason for starting
the work in these areas is in order to improve the services lacking in the South African Government (SAG)
sector, which is affected by the lack of qualified staff, high staff turnover, lack of public sector infrastructure
and other challenges related to the historical reality, where former 'black' areas were marginalized from
sufficient institutional and financial support by the previous regime.
IYDSA often works alongside and within existing government facilities, as well as supporting community
programs implemented the local church structures in these rural areas. Using this strategy IYDSA fosters
and gains active community participation. In doing so, the staffing and infrastructure challenges are
overcome through task shifting by the training of community healthcare workers. The lack of infrastructure
challenges are overcome by working through the existing local church structures and, in special
circumstances, provision of limited additional work space through purchase of refurbished shipping
containers. The hub and spoke model contributes to mitigating the existing space limitations by down
referring patients to satellite clinics within their own communities.
In order to support the down referral of patients, IYDSA plans to transport patients from distant communities
during their treatment preparation phase. Once on treatment they will be monitored at a satellite site within
their community. This program will be initiated at Kwelera, a site earmarked for Government accreditation.
Through this process a cohort of patients will be recruited and initiated in preparation for the implementation
of an accredited treatment site.
The average rural person faces very real challenges if they are to maintain their treatment, this includes
correct nutrition, stigma, and crucially transport. Often patients will travel extensive distances in order to
access care. The Great Kei Treatment Center (an existing treatment facility) is required to be an up referral
point for Kwlera, yet patients travel to East London as there are established transport routes. With the
initiation of an IYDSA satellite, it is anticipated that over 70 patients will be referred to Kwelera from East
London.
The necessity of this development is marked by the unacceptably high default and treatment failure rate in
this area. There are no Adherence Monitors and patients have to find the finances on a monthly basis to
travel to East London in order to maintain their treatment. This strategy will contribute greatly not only to
adherence and consistent treatment, but also to the increase of male and pediatric patients.
---------------------------------------
Summary:
The Institute for Youth Development South Africa (IYDSA) is a new PEPFAR partner selected for funding in
August 2008 (but not yet funded - the CDC is currently processing the paperwork to award a cooperative
agreement). However, IYDSA is a current sub-partner under the Track 1 Catholic Relief Services (CRS)
program. In FY 2009 the Track 1 CRS program will transition, and IYDSA will become one of three local
implementing partners that will have CRS funds and responsibilities transferred to it.
Background:
IYDSA is an indigenous South African organization providing care, treatment and support to people living
with HIV in the Eastern Cape Province (EC). Within IYDSA, the care and treatment program is called Zisa
Uncedo, which means ‘bring help'. Reducing HIV infection and AIDS morbidity and mortality is the purpose
of this program.
The IYDSA hub-and-spoke model includes main ART sites, extensions and satellite sites to ensure
equitable access for the poor with minimum cost to themselves. This is achieved through a strategy that
mobilizes clinical staff from major treatment sites to remote sites through an extensive outreach program.
There are three main treatment sites where all HIV care and ART are provided with a full staff complement
(Doctor, Social Worker, Nurses, Pharmacist, and Dietician). IYDSA has established three extensions that
are linked to an ART site. Remote satellites are located where there is a large concentration of enrolled
patients. Here VCT is provided, with referral back to treatment and extension sites for ART initiation. The
remote satellites are key to enabling ‘access for all'
Initiation and preparation for effective treatment is a crucial first step, the better the preparation, the better
the outcome. IYDSA strives to ensure that the treatment centers where people are initiated on ARV
treatment has all the necessary skills to ensure patients are properly prepared before being initiated on
HAART.
Once the patient is consistently taking their treatment and they have been stabilized, the best long-term
solution is for them to collect their treatment close to where they live, at the same time receiving localized
monitoring and support. It is with this as a philosophy that IYDSA works towards creating ‘access for all' in
the Eastern Cape.
Activity Narrative: Activities:
1) Provide access for all: Through the use of a this model IYDSA seeks to provide services at as many sites
as possible to ensure access to treatment with minimum cost. The maximized use of resources, spreading
scarce skills through a mobile staff strategy is cost and time efficient, supplemented by a high level of
training for the primary health care (PHC) staff, who remain in the community.
2) Provide comprehensive HIV medical care to 18,384 HIV positive adults and children, and initiate and
maintain 6,128 people on antiretroviral treatment: Zisa Uncedo will build on current treatment activities of
IYDSA in South Africa, using the extensive capacity and current network of sites to rapidly scale up
treatment numbers. Zisa Uncedo will include assessing site needs and readiness, capacity building of
medical professionals and developing continuum of care mechanisms. This will establish community-based
linkages and systems to support the continuity of care from the health facilities to the households.
3) Build Local capacity, enhancing sustainability: The resultant training of professionals located in rural
areas increases the professional skills within these areas which may be accessed by people from these
communities.
4) Enable people living with HIV and AIDS to lead healthy and productive lives: Ultimately care without an
enabling environment increases dependence. Healthy productive lives are the result of empowering the
individual. This is practiced throughout the program.
There are a number of organizations that IYDSA partners with, these include Government departments at
various levels, local NGOs and faith-based organizations, as well as contracted service providers. The
primary partners are ‘The Pill Box', providing a complete Pharmaceutical Solution, and ‘PEZ' who is
responsible for all administration, development and maintenance of the Adherence Monitors component of
the program.
New/Continuing Activity: Continuing Activity
Continuing Activity: 22322
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
22322 22322.08 HHS/Centers for Institute for Youth 9633 9633.08 $100,000
Disease Control & Development
Prevention
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $18,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.10:
Table 3.3.11:
Table 3.3.12:
Table 3.3.14:
Table 3.3.15:
