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 activity relates to Xstrata Coal South Africa (Xstrata) activities in CT (#8258) and ARV Services (#8260). This partner may benefit from the Partnership for Supply Chain Management ARV Drugs activity (#7935), which will explore current pain and symptom management practices, drug availability and cost, and provide recommendations.
SUMMARY:
Xstrata is a new PEPFAR partner, receiving funding in FY 2007 for a public-private partnership with the Mpumalanga Department of Health (MPDOH). The implementing partner for this is Re-Action! Consulting (RAC). RAC will facilitate a co-investment partnership with Xstrata to provide support for strengthening targeted government clinics, developing access to basic preventive, clinical care and psychosocial support services in two districts of Mpumalanga. The project will build on a public-private model for strengthening HIV and TB service delivery that Xstrata and RAC has already begun to implement with Xstrata in the province with funding from Xstrata. Xstrata and RAC will work through established partnerships with local government, the MPDOH, community groups and private providers. Project deliverables have been defined in response to specific requests for assistance from the MPDOH. Major emphasis will be given to development of human resources, with minor focus on community mobilization/participation, linkages with other sectors, local organization capacity development and strategic information. Target populations for the project are the two underserved communities of men, women and children in geographic locations where most company employees and contractors who live in and near Breyten and in KwaQuqa (Witbank) in Mpumalanga.
BACKGROUND:
Xstrata is a subsidiary of a multi-national mining group committed to practical ways of achieving sustainable development and contributing to the health and social welfare of employees and their communities. The company employs 4,000 people at 11 mines (collieries) located within the socio-economically deprived Coal Powerbelt region of Mpumalanga. This funding partnership will enable scale up of the community extension component of Xstrata's comprehensive workplace HIV and AIDS program (uBuhle Bempilo), managed by RAC. The project is based on implementing a public-private service-strengthening model that will capacitate available government providers to deliver HIV-related preventive, other clinical and psychosocial care services within two target districts. The scope of assistance is being finalized within a Memorandum of Understanding between Xstrata and the Mpumalanga Department of Health, and responds to specific requests for support by the provincial department's HIV and AIDS Unit, and fits within a broader range of interlinked community development investments by Xstrata.
The project will provide technical assistance, training and service monitoring to delivery quality HIV-related preventive and clinical care services. Emphasis will be placed on implementation of the evidence-based preventive care package interventions, other clinical care support, linkages with TB, CT and ART services and psychosocial care. This will contribute to strengthening district-level primary health care service networks and district service management, with a strong focus on improving human resource capacity. Partnerships with other PEPFAR contractors in the province will be established to achieve synergies in implementing project activities.
ACTIVITIES AND EXPECTED RESULTS:
Three activities are implemented to strengthen the delivery of preventive, other clinical and psychosocial care services in two areas of Mpumalanga. However, as the discussions with the MPDOH have not yet concluded, the activities described here are not final.
ACTIVITY 1: Strengthening primary health care and district hospital delivery of HIV-related preventive and other clinical care services
Xstrata will undertake a baseline assessment of services using the WHO Service Availability Mapping tool that defines the specific service strengthening priorities and mix of available
service providers. Approximately 100 medical and nursing personnel will be trained on the WHO's IMAI and IMCI modules that is aligned with the Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa' and has already been adapted for South African implementation. Emphasis will be placed on human resource support to deliver the preventive care package and other clinical care services. Service improvement plans for approximately eight primary healthcare sites within the two targeted communities will be developed. Access to TB diagnosis and treatment will be improved at supported sites by implementing TB/HIV collaborative activities. The program will ensure that HIV-infected adults and children in all facility settings are either provided or referred (with follow-up) for evidence-based preventive care interventions which include the following: OI screening and prophylaxis (including cotrimoxazole, TB screening/management), counseling and testing for clients and family members, safe water and personal hygiene strategies to reduce diarrheal disease, HIV prevention counseling, provision of condoms, referral for family planning services for HIV-infected women, appropriate child survival interventions for HIV-infected children and nutrition counseling. The package of services also includes basic pain and symptom management and facility-based support for adherence to OI medications (including cotrimoxazole prophylaxis and TB treatment) and antiretroviral therapy (ART).
ACTIVITY 2: Community mobilization, care messaging, treatment preparedness and referrals
Community health promoters will be trained to provide basic household health risk assessments. These health promoters work at community level to mobilize and refer for essential prevention and care services, and are already employed by the MPDOH. Xstrata resources will be utilized to strengthen their capacity to provide services through training. The existing "know the way to live" campaign will be utilized to enhance social marketing of HIV care and treatment in the community. The community health promoters and existing community-based treatment supporters will be trained in ART and OI prophylaxis and treatment adherence support, TB DOTS, HIV prevention messaging, delivery of condoms and referral for family planning services, mobilizing for counseling and testing for clients and family members, safe water and personal hygiene strategies to reduce diarrheal disease, appropriate child survival interventions for HIV-infected children, referrals and nutrition counseling.
ACTIVITY 3: Community Support and Psychosocial Care
Linkages with community-based service organizations (including faith-based organizations and non-governmental organizations) will be established. Peer support group activities in all facilities supported will be established and psychosocial support and preventive care messages provided. A network of 50 traditional healers, with referral mechanisms in place for ongoing chronic care support, will be mobilized and trained. Attention will be given to increasing the gender equity in the HIV and AIDS programs, increasing male involvement in the program, addressing stigma and discrimination, and partnerships with local NGOs, FBOs and CBOs.
The area of legislative interest that will be addressed is stigma and discrimination through community mobilization initiatives. Sustainability of this program is assured through the public-private partnership between Xstrata and the MPDOH.
By providing support for palliative care in underserved communities, Xstrata is contributing to the 2-7-10 PEPFAR goals.
This Xstrata Coal South Africa (Xstrata) activity also relates to Basic Health Care and Support (#8257) and ARV Services (#8260).
Xstrata is a new PEPFAR partner, receiving funding in FY 2007 for a public-private partnership with the Mpumalanga Department of Health. The implementing partner for this is Re-Action! Consulting (RAC). RAC will facilitate a co-investment partnership with Xstrata to provide support for strengthening targeted government clinics, expanding access to HIV and tuberculosis (TB) prevention, diagnosis and treatment in two districts of Mpumalanga. The project will build on a public-private model for strengthening HIV and TB service delivery that Xstrata and RAC has already begun to implement in the province with funding from Xstrata. Xstrata and RAC will work through established partnerships with local government, the provincial Department of Health, community groups, and private providers. Project deliverables have been defined in response to specific requests for assistance from the Mpumalanga Department of Health. Target populations for the project are men, women and children in in the the two underserved communities of Breyten and in KwaQuqa (Witbank) in Mpumalanga.
Xstrata is a subsidiary of a multi-national mining group committed to practical ways of achieving sustainable development and contributing to the social welfare of employees and their communities. The company employs 4,000 people at 11 mines (collieries) located within the socio-economically deprived Coal Powerbelt region of Mpumalanga. This funding partnership will enable further scaling up of the Community Extension component of Xstrata's well-established comprehensive workplace HIV and AIDS program (uBuhle Bempilo, or The Beauty of Life), managed by RAC.
The project is based on implementing a public-private service-strengthening model that will capacitate available government providers to deliver HIV-related prevention, diagnosis, treatment and care within target districts. The scope of assistance is being finalized within a Memorandum of Understanding between Xstrata and the Mpumalanga Department of Health, and responds to specific requests for support by the provincial HIV and AIDS Unit, and fits within a broader range of interlinked community development investments by Xstrata.
The project will draw on technical collaborations with the World Health Organization's (WHO) HIV and AIDS Department and Stop TB Partnership to provide assistance in implementing training and service monitoring, based on the Integrated Management of Adult and Adolescent Illness (IMAI) approach that is aligned with the 'Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa' and has already been adapted for South African implementation. This will contribute to strengthening district-level primary healthcare service networks and district service management, with a strong focus on improving human resource capacity. Partnerships with other PEPFAR contractors in the province will be established to achieve synergies in implementing project activities.
Three activities are implemented to strengthen the provider-initiated counseling and testing services provided in two areas of Mpumalanga, in collaboration with the Mpumalanga Department of Health.
ACTIVITY 1: Community-based HIV counseling and testing
Eight accredited voluntary counseling and testing (VCT) providers will be trained to provide VCT services at community level. HIV testing and counseling services (based on rapid test protocols) will actively be offered to community members. Test kits will be provided by the Mpumalanga Department of Health.
ACTIVITY 2: Assistance to small and medium-sized businesses (suppliers and other local businesses) to manage the impacts of HIV and AIDS on their employees
Ten small, medium and micro-enterprises will be offered HIV testing and active recruitment into the Xstrata facilities for employees. Test kits will likely be provided by the Mpumalanga Department of Health, and Xstrata.
ACTIVITY 3: Community mobilization
Health promoters will be trained to provide basic household health risk assessments to 1,500 households in the community. The "I Know! the way to live" campaign will be utilized to enhance social marketing of HIV care and treatment in the community.
The area of legislative interest that will be addressed through community mobilization will be stigma and discrimination. Household risk assessments and community health promoters will engage in social marketing of the "I Know! the way to live" campaign to dispel stigma and discrimination and encourage community members to participate in CT.
By providing support for counseling and testing in underserved communities, Xstrata is contributing to the 2-7-10 PEPFAR goals.
This activity also relates to Xstrata's activities in Basic Health Care and Support (#8257) and Counseling and Testing (#8258).
Xstrata Coal South Africa (Xstrata) is a new PEPFAR partner, receiving funding in FY 2007 for a public-private partnership (PPP) with the Mpumalanga Department of Health. The implementing partner for this is Re-Action! Consulting (RAC). RAC will facilitate a co-investment partnership with Xstrata to provide support for strengthening targeted government clinics, expanding access to HIV and TB prevention, diagnosis and treatment in two districts of Mpumalanga. The project will build on a public-private model for strengthening HIV and TB service delivery that Xstrata and RAC has already begun to implement with Xstrata in the province with significant funding from Xstrata. Xstrata and RAC will work through established partnerships with local government, the Mpumalanga Department of Health, community groups, and private providers. Project deliverables have been defined in response to specific requests for assistance from the Mpumalanga Department of Health.
BACKGROUND: Xstrata is a subsidiary of a multi-national mining group committed to practical ways of achieving sustainable development and contributing to the social welfare of employees and their communities. The company employs 4,000 people at 11 mines (collieries) located within the socio-economically deprived coal powerbelt region of Mpumalanga province. This funding partnership will enable further scaling up of the community extension component of the Xstrata comprehensive workplace HIV and AIDS program (uBuhle Bempilo), managed by RAC.
The project will draw on technical collaborations with the World Health Organization (WHO) HIV and AIDS Department and Stop TB Partnership to provide assistance in implementing training and service monitoring, based on the Integrated Management of Adult and Adolescent Illness (IMAI) approach that is aligned with the Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa, and has already been adapted for South African implementation. This will contribute to strengthening district-level primary healthcare service networks and district service management, with a strong focus on improving human resource capacity. Relationships with other PEPFAR partners in the province will be established to achieve synergies in implementing project activities.
Four activities are implemented to strengthen and scale up antiretroviral treatment provided in two areas of Mpumalanga, in collaboration with the Department of Health.
ACTIVITY 1: Strengthening primary health care and district hospital services
A baseline assessment of services using the WHO service availability mapping tool that defines the specific service strengthening priorities and mix of available service providers will be conducted. Clinic accreditation plans for eight government primary health care clinics will be developed in collaboration with district health service managers. Clinic facility rehabilitation for eight government clinics (including minor structural improvements, renovations and procurement of essential equipment) will be implemented. Referral linkages between public and private providers will be strengthened to establish an improved service delivery network. The distribution systems of antiretroviral drugs will be
strengthened to ensure regular down referral of treatment to primary care sites. Health management information systems will be strengthened by training up to 12 district management personnel on the IMAI District Managers course and providing supplementary training on human resource management to improve health worker recruitment and retention plans. Through Xstrata's own funding (non-PEPFAR), this may include infrastructure (a new clinic), training, commodity procurement and local capacity development.
ACTIVITY 2: Direct HIV care and antiretroviral treatment provision
A multi-disciplinary care team consisting of a medical officer, nurses and counselors will be trained and equipped to deliver chronic HIV care and treatment based on the Integrated Management of Adult Illness approach at the existing Xstrata clinic in Breyten. Community members have access to this clinic and are able to receive HIV treatment and care at the site.
HIV care and antiretroviral treatment programs to eligible community members at supported sites will receive antiretroviral drugs provided by the Provincial Department of Health through a down referral mechanism.
ACTIVITY 3: Community mobilization and treatment preparedness
Health promoters will be trained to provide basic household health risk assessments to 1,500 households in the community. The "I know the way to live" campaign will be utilized to enhance social marketing of HIV care and treatment in the community. Thirty treatment supporters who will provide adherence support and reinforce secondary HIV prevention will be trained.
ACTIVITY 4: Community Support
Linkages with community-based service organizations (including faith-based organizations and non-governmental organizations) will be established. Peer support group activities in all 8 facilities supported will be established. A network of 50 traditional healers, with referral mechanisms in place for ongoing chronic care support, will be mobilized and trained.
Nutrition and income generation (with particular focus on women) will be a focus. A gardening project that addresses sustainable food development for patients and community members that access the Breyten clinic will be operational in late 2006, and will continue to be funded by Xstrata (non-PEPFAR funding). This enables the clinic to link treatment and care with food security in the impoverished community.
The number and type of human resources to be recruited by Xstrata is still under negotiation with the Mpumalanga Department of Health.
Sustainability of this activity area for ongoing support to deliver antiretroviral treatment is assured through the public-private partnership (PPP) between Xstrata and the Mpumalanga Department of Health.
By providing support for HIV treatment in underserved communities, Xstrata is contributing to the 2-7-10 PEPFAR goals.
ACTIVITY 5: Human Capacity Development With reprogramming funds, two additional sites in Mpumalanga will be added for support. A key focus of all sites (including the two additional sites) will be capacity building of health workers, with a specific focus on retaining health workers within the system. The skills building will include clinical skills, but also increasingly on building management, leadership and decision-making capacity. (Because X-Strata funds were received later than expected and targets are set on the fiscal year, the targets are only moderately increasing with the additional reprogrammed funds.)
