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
SUMMARY: Mothers2mothers (m2m) will implement activities to improve the effectiveness of prevention of mother-to-child transmission of HIV (PMTCT). Services are carried out through facility-based, peer-to-peer education and psychosocial support programs for pregnant women, new mothers and caregivers, all living with HIV and AIDS. There are four components of the program: curriculum-based training and education programs; psychosocial support and empowerment services; programs to increase uptake for counseling and testing; and bridging services linking PMTCT treatment and care to antiretroviral treatment (ARV) and other health services.
The primary emphasis area is Human Resources, with a minor emphasis on Training, and Local Organization Capacity Development. Specific target populations include women of reproductive age, pregnant women, people living with HIV and AIDS, HIV-infected pregnant women, and HIV-exposed and infected Infants.
BACKGROUND: With PEPFAR's support, m2m will increase the effectiveness of PMTCT services through a comprehensive program of facility-based, peer-to-peer education and psychosocial support for pregnant women, new mothers and caregivers living with HIV and AIDS. m2m addresses issues of stigma (key legislative issue) through group counseling, support groups, and linkages to income generation. All activities have been and will continue to be coordinated with local PMTCT service providers and their partners, and will also be carried out in conjunction with provincial, district and municipal health authorities. The programs have the active support of the Departments of Health for KwaZulu-Natal, Mpumalanga and Western Cape provinces and will be integrated into their healthcare structures.
Current m2m programs are located in over 60 healthcare facilities in four provinces in South Africa as well as in Ethiopia and Botswana. With PEPFAR funding received as a sub-partner to the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) in FY 2006, m2m established and maintains programs like those described below at 16 PMTCT facilities in KwaZulu-Natal and Mpumalanga. With direct PEPFAR funding in FY 2007, m2m will enhance these programs, add significant numbers of facilities in these two provinces, and add programs throughout the Western Cape.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Human Capacity Development and Training PEPFAR funding will be used to support the delivery of a cascade of curriculum-based training and education programs designed to improve PMTCT outcomes through education and training of pregnant women and new mothers with HIV and AIDS. The training curriculum provides guidance about PMTCT and ARV treatment tied to maternal and infant health, with the objective of encouraging women living with HIV (PLHIV) and AIDS to take responsibility for their own health, their child's health, and the health of their partners. Additional critical subjects covered in the training include family planning, couples counseling, and prevention guidance for these PLHIV and their partners ("Prevention with Positives").
Training begins with m2m site coordinators (SC) and Mentor Mothers (MM), all of whom are PLHIV. They, in turn, provide curriculum-guided education and support (individual and group) to mothers in PMTCT programs during antenatal care, post-delivery recovery, and their return to clinics after delivery. In addition, working in collaboration with local and provincial government health authorities, indigenous staff (including nurses, lay counselors and other related health providers) also receive this training on PMTCT interventions and wellness care.
With FY 2007 PEPFAR funding, the program will add a complement of trained PMTCT care providers (SCs and MMs) to supplement the resources of frequently overburdened local healthcare providers. Simultaneously, the program will also hone the skills and knowledge of existing healthcare staff In PMTCT related care and support. The lasting impact of these activities will make a significant contribution to the sustainable development of the capacity of local organizations.
ACTIVITY 2: Service and Mentoring
PEPFAR funding will be used to provide individual and group psychosocial support and empowerment programs for pregnant women and new mothers with HIV and AIDS to help them with issues including stigma and discrimination (key legislative area), disclosure, reducing risky behavior ("Prevention with Positives") and pediatric support. Nutritional support and guidance is also part of the programs. A related activity focuses on providing specific support programs for the MMs and SCs ("Care for Caregivers"), contributing to their own physical and emotional well-being as well as that of their clients.
One objective of both group and individual support is specific knowledge transfer around the many issues women living with HIV and AIDS faces in navigating the PMTCT process. Another outcome is empowering the women to focus on and take responsibility for the health of their babies, and their own health. By encouraging behaviors that can help mothers sustain their well-being, the programs aim to reduce the potential that their children could become Orphans and/or Vulnerable Children (OVC).
Similarly, the programs address the reality of the high rates of violence against women (key legislative area) in the communities served, as well as the specific ties between HIV and domestic violence. They provide tactical as well as emotional support aimed at helping women confront this issue and reduce their likelihood of becoming targets and victims.
ACTIVITY 3: Counseling and Testing Supported by PEPFAR funds and working in close partnership with local health and government programs, MMs and SCs become part of the antenatal intake process at both the community and facility levels. In this role, they focus on increasing counseling and testing uptake by serving as committed advocates, working with women like themselves and drawing on their training and their own personal experience. Through this program, the MMs and SCs also provide significant support for Pediatric Counseling and Testing during home visits by advocating for pregnant women to return to clinics post-delivery to test their infants, supporting the women in the post-delivery period, and providing referrals of babies to testing and treatment programs.
ACTIVITY 4: Linkages and Referrals This activity provides linkages and referrals, specifically by acting as a bridge between PMTCT services and other health services. In active collaboration with local and provincial health officials, PEPFAR funding will be used to link women and infants with AIDS-defining conditions to ARV therapy programs, and to refer all ante/post natal women to clinics providing wellness care for themselves and their infants.
The above results contribute to the PEPFAR 2-7-10 goals by increasing the number of women cared for by PMTCT programs; by improving prevention (PMTCT) outcomes, thus reducing the number of infected children; and by increasing the number of pregnant women, new mothers, and infants receiving treatment by providing a referral system from PMTCT to ARV services.
The Mothers to Mothers Program will use plus up funds to augment the shortfall of funding from the Mpumalanga provincial conditional grants program for 2007. The province intended to fund the Mothers to Mothers support services for PMTCT in the province, however are currently unable to. Plus up funds will also expand services in Western Cape, KZN, and Limpopo. All four provinces have asked for additional assistance from the Mothers Program. Additional women will be trained as "mother mentors" and additional sites will receive services.
