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: 2007 2008 2009
INTEGRATED ACTIVITY FLAG:
This Track 1-funded activity is part of a comprehensive program that receives both Track 1 and in-country funding. Columbia's country-funded submission is comprised of activities described in the Basic Health Care and Support (#7304), TB/HIV (#7305), Counseling and Testing (#7306), ARV Drugs (#7303) and ARV Services (#7302) program areas. Please note that the targets below reflect the totals from both Track 1 and country funding.
SUMMARY:
Activities are carried out in FY 2007 to support implementation and expansion of comprehensive HIV treatment and care primarily through human resources and infrastructure development, technical assistance and training and community education and support, primarily in public sector facilities in the Eastern Cape and KwaZulu-Natal. Columbia University will support these activities by using funds for: development of network/linkages/referral systems, human resources, local organization capacity, quality assurance activities and supervision, improving strategic information and training. The degree of activity effort will vary in each site but these emphasis areas will occur in all sites. The target population will include infants, children and youth, men and women (including pregnant women) and people living with HIV (PLHIV). Columbia will continue to support the recruitment of doctors, nurses, pharmacists and pharmacist assistants.
BACKGROUND:
Columbia University (Columbia), with PEPFAR funds, began supporting comprehensive HIV care and treatment activities in FY 2004. Health facilities were initially identified in the Eastern Cape and in FY 2006, due to new boundary demarcations and additional PEPFAR funds, Columbia started providing similar assistance in KwaZulu-Natal. In FY 2006, in response to provincial HIV care and treatment priorities, Columbia began strengthening the down referral of services from hospitals to primary health clinics. This resulted in a total of 36 health facilities receiving technical and financial support from Columbia, including public hospitals, community health centers, primary health clinics and a non-governmental wellness center. In FY 2007 an additional two health facilities in KwaZulu-Natal (East Griqualand Usher Memorial Hospital and the Kokstad Community Clinic) will receive technical and financial assistance for HIV care and treatment services.
ACTIVITIES AND EXPECTED RESULTS:
All activities are in line with South African government (SAG) policies and protocols, and activities will be undertaken to create sustainable comprehensive HIV care and treatment programs, and primarily include four programmatic areas:
ACTIVITY 1: Support Recruitment and Placement of Health Staff
Since FY 2005 Columbia has been involved in the recruitment of staff to support the HIV comprehensive program at health facilities. High staff attrition rates of Department of Health (DOH) recruited personnel have been a challenge in guaranteeing a steady enrolment of eligible PLHIV into care and treatment. Columbia will continue to support the recruitment of doctors, nurses, pharmacists and pharmacist assistants through existing partnerships with University of Fort Hare, Nelson Mandela Bay Metropolitan Municipality, Ikhwezi Lokusa Wellness Center, University of KwaZulu-Natal Cato Manor, and the Foundation for Professional Development. In FY 2006, Columbia supported the recruitment and placement of approximately 15 doctors, 30 nurses (registered and enrolled nurses), 2 pharmacists and 7 pharmacist assistants. These health personnel provide direct patient care in the hospitals and clinics including: clinical assessment, screening for tuberculosis (TB) and antiretroviral treatment (ART) eligibility, opportunistic infections (OI) diagnosis and management, and offering OI prophylaxis and treatment, and ART. The health providers also develop patient treatment plans as part of the multidisciplinary team in the health facility; and assist patients to access relevant SAG social grants.
ACTIVITY 2: Training and Clinical Mentoring
Columbia has established a partnership with the Foundation for Professional Development to provide ARV didactic training in all supported health facilities. A second partnership with Stellenbosch University assists the rural health facility staff (St. Patrick's, Holy Cross and Rietlvei hospitals and their referral clinics), with the management of patients on ART by conducting case discussions on a monthly basis. Columbia has clinical advisors as part of its South African team consisting of nurse mentors, and medical officers who provide day-to-day clinical guidance on the management of patients on ART.
ACTIVITY 3: Strengthen ART Down and Up Referral Linkages Between Hospitals and Primary Healthcare Clinics
In the early phases of the ART program, all patients are evaluated and initiated on therapy at hospital-level. Within three to six months of providing support to the hospital-based ART program, designated referral clinics are integrated into the services. In the rural health facilities, a small team of health providers, usually comprising of a medical officer, professional nurse and peer educator, travel to the primary healthcare clinics (PHC) to screen patients for OIs and to determine suitability for ART. This approach has enabled expansion of ART services at PHC level and has resulted in improving and increasing access to treatment. The team of health providers has also developed capacity of the onsite health providers and the goal is to have the onsite DOH health staff eventually provide the full package of HIV care and treatment services. In FY 2007, Columbia will continue to support linkages with the public clinics and the development of a more sustainable system of service provision.
ACTIVITY 4: HIV Care and Treatment Information System
Columbia will continue to support the implementation of a provincial information system that captures information regarding HIV palliative care and ART. Activities in FY 2007 will include: a. Continued implementation of facility paper-based ART registers that capture both adult and pediatric ART indicators. b. In collaboration with the Eastern Cape Department of Health (ECDOH) and other partners in the Eastern Cape, support the development and implementation of standardized individualized patient records for use at health facilities that incorporates information on client ART use. c. Develop an ART software system. Columbia is working in partnership with Africare (a PEPFAR partner) and Health Information System Program (HISP) to customize and develop ART software that captures and collates HIV and AIDS program data. This ART database will be adapted for data entry, and then installed and tested for use. Using FY 2006 funds, the system will be piloted at three health facilities in East London: Frere, Cecilia Makiwane and Duncan Day Village hospitals. In FY 2007, after assessing results from the pilot sites, Columbia will engage the ECDOH in discussion on how the module could be added into the existing District Health Information System to efficiently generate reports on the HIV program, and thereafter implemented at more ART services outlets.
By providing support for ARV services in the public sector and two NGO sites, Columbia's activities will contribute to the realization of the PEPFAR goal of providing care to 2 million people. These activities will also support efforts to meet HIV and AIDS care and support objectives outlined in the USG Five-Year Strategy for South Africa.
