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: 2010 2011 2012
PATH, in partnership with the Eastern Cape Department of Health, Health Information Systems Programme (HISP) and South Africa Partners (SAP) was awarded a five year cooperative agreement, 1U2G/PS000731-01 with the CDC on July 1, 2007. In an effort to create a program identity that was
inclusive of all partners, and not just the PATH project, the team adopted the name The Khusela Project. In Xhosa, the local language where the project is working, Khusela means to prevent, to protect, to handle with care, like you would with an egg.
The goal of this program is to increase the utilization of high-quality, comprehensive PMTCT services in Eastern Cape. This project will strengthen the ability of current PMTCT facilities to provide a minimum package of services, enable the Eastern Cape Department of Health (ECDOH) to expand PMTCT services by training and supporting providers such that they can provide comprehensive services, and raise awareness of and support for PMTCT service use within communities. The objectives of the project are to: • Improve availability and quality of counseling and testing services during ANC. • Increase access to and provision of antiretroviral prophylaxis for PMTCT. • Improve counseling and support for safe infant feeding practices. • Improve quality of family planning counseling, particularly during the postpartum period. • Increase awareness of and demand for services in communities.
The project uses three strategies to achieve its goals and objectives, each working at a different level of health service delivery system.
Strategy 1: Support DOH systems that strengthen the delivery of high-quality, comprehensive PMTCT services. This strategy addresses critical higher-level NDOH systems that influence access to and provision of high-quality, comprehensive PMTCT services. Interventions will strengthen human resource capacity by ensuring there is additional capacity to train more providers who will in turn train the remaining untrained facility staff (Strategy 2), such as nurses, midwives, and lay counselors to provide PMTCT services, reinforcing the skills of currently trained PMTCT staff, and orienting other staff (e.g., child/wellness clinic nurses, community health workers) who help ensure a continuum of care. The Khusela project will assist in ensuring that monitoring and supervision systems are fully operational at all levels (district, local service area, facility), providing on-site technical support as needed. The Khusela project will strengthen ECDoH data and logistic systems, improving the quality of data recorded, collected, reported, and used at all levels and address specific policy and guideline issues that directly affect PMTCT services. Finally, the Khusela project will work to improve referral systems, especially referral of pregnant or postpartum women and their children to antiretroviral (ARV) care and treatment sites and pediatric centers.
Strategy 2: Build the capacity of health facilities and staff to provide high-quality comprehensive PMTCT services. Interventions that support this strategy focus on the facility level to strengthen the provision of high-quality, comprehensive PMTCT services, from community-based clinics to community health centers
to district hospitals and large tertiary institutions. Initially the project will focus on forty facilities including priority hospitals and select feeder-community health centers and clinics to ensure that women have access to the full continuum of PMTCT services, from the first antenatal care visit through follow-up of the mother and baby after birth. In year three the Khusela project will scale up an additional ten sites per quarter. The package of interventions is tailored to each facility's needs and includes training in essential PMTCT skills, monitoring and supervision to maintain high-quality services and/or upgrade staff skills, data management for ongoing corrections and decision-making, integration of services to give women and babies necessary care and treatment, and linkages to the community so that PMTCT services are fully utilized.
The ECDoH chose three target sub-districts in two of the most populous districts of Eastern Cape for project implementation: Mbashe and Mnquma in Amatole District and King Sabata Dalindyebo (KSD) in OR Tambo District. The project initially worked in 40 clinics and has now expanded to 80 clinics.
Strategy 3: Increase community engagement and leadership in promoting, supporting and utilizing PMTCT services. The ECDoH has prioritized the need to broaden the role of the community in promoting, supporting, and utilizing PMTCT services. This includes providing health education, reducing stigma, generating demand for services, working with the partners and families of HIV-infected women to increase support for PMTCT, developing community networks for client follow-up, and strengthening tangible links between the community and the facility. Underlying these interventions is the need to build the capacity of community networks and organizations to implement and monitor programs. Interventions include strengthening HIV prevention programs providing PMTCT information, and reducing stigma in the community; strengthening peer support for HIV-infected pregnant women to increase demand for and adherence to PMTCT and ARV regimens; and improving community-facility collaboration to increase local ownership and utilization of services.
Additionally, through supplemental funding, the project has added two components
Component two: Initiated the Midwives AIDS Alliance (MAA) The goal of the MAA is to provide a platform for midwives to advocate for the integration of HIV prevention, treatment and care into maternal and child health. The MAA focuses on mobilization and empowerment of midwives work and advocacy work.
Mobilization and empowerment The MAA will recruit midwives into the association through existing networks, associations and organizations. Points of access include: SOMSA, DENOSA, HOSPERSA, NEHAWU, SADNU, PSA, NUPSAW, SAMWU, NASA and the private sector.
Advocacy MAA will advocate for: • HIV training: Comprehensive training of all midwives in HIV prevention, treatment and care. • Clinical Practice: Enhanced role for midwives in HIV prevention, treatment, and care of mothers and their children from the stages of preconception to postpartum care. • Patient Status\; Access to clear and accurate information on the HIV status and history of care of mothers and their newborns in patient records. • Occupation Safety: Access to and utilization of health and safety measures to protect midwives from HIV transmission.
Strategy 5: TB Infection Control in Swaziland (See Swaziland COP 2010) PATH will continue its collaboration with Stellenbosch University to provide technical assistance, training, and supportive supervision to improve infection prevention and control (IPC) practices to reduce transmission of TB and HIV among health care workers and clients in Swaziland. This project will focus one central TB referral hospital and 15 peripheral health facilities and laboratories that diagnose and treat people with tuberculosis, many of whom are co-infected with HIV.
This project provides technical assistance requested by CDC and the Government of Swaziland to review and finalize infection control guidelines, assess current IPC practices and training needs at the identified facilities, train health care workers in basic IPC, and develop a cadre of trainers in Swaziland who can provide ongoing training and technical support to their peers in infection control. PATH and IPC experts from Stellenbosch University/Tygerburg Hospital in Cape Town, South Africa work closely with the Ministry of Health of Swaziland, CDC, and other implementing partners to ensure good coordination and synergy with other planned activities.
The overall goals and objectives of this component are to: • Assess TB infection control practices and make recommendations for improvement in selected facilities and laboratories. • Review current infection control guidelines in the context of TB/HIV to ensure they are responsive to the current evidence base and assist in the development of updated guidelines. • Provide broad infection control training for different cadres of health care workers as well as a more advanced course for key personnel; • Provide technical assistance in the selection of equipment and services for limited infrastructure changes.
None
