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
TITLE: PATH Tanzania TB/HIV Project
NEED and COMPARATIVE ADVANTAGE: HIV/AIDS greatly contributes to the TB burden in Tanzania. TB
causes about 30% of deaths in PLHA. TB/HIV co-infection occurs in more than 46% and 50% of TB patients
and PLHA respectively. Collaborative TB/HIV services have yet to cover all the districts in Tanzania, and
scale up in the private sector is very limited. The goal of NTLP is to reach the whole country by June 2008.
Since 2006, Program for Appropriate Technology in Health, (PATH) in collaboration with National TB and
Leprosy Programme (NTLP), National AIDS Control Programme (NACP) and Association of Private Health
Facilities in Tanzania (APHFTA) has spearheaded TB/HIV services scale-up in Tanzania. Backed with local
government support, and equipped with a strong, decentralized, fully integrated team that coordinates
TB/HIV services, PATH has the experience and capacity to scale-up TB/HIV services to 16 new districts as
requested by Ministry of Health and Social Welfare (MoHSW).
ACCOMPLISHMENTS: By June 2007, PATH scaled up TB HIV services in 18 districts, trained 44
coordinators and 181 health care providers on TB/HIV, and established collaborative TB/HIV services in
121 outlets. Support was provided to develop training materials, TB/HIV tools, and a National TB/HIV
manual. A Knowledge, Attitudes and Practices (KAP) study to develop a National TB/HIV Advocacy,
Communication and Social Mobilization (ACSM) Strategy was completed and regional-based training teams
were established; more than 5,888 TB patients were counseled and tested for HIV and received their
results.
ACTIVITIES: To improve quality of services, PATH will strengthen technical supervision, on-the-job training,
and provide training to health care providers. PATH will support infection-control practices and undertake
setting-up services ‘under one roof.'. PTH will utilize supervision findings and program indicators to improve
the quality of services. With CSH/TB funding, districts will be supported to develop and implement TB
infection control plans.
1. Scale-up integrated TB/HIV services in eight new districts and enhance services in the existing 18. This
will take services closer to communities through 112 new service delivery outlets. 1a. Rapid facility
assessment and selection of seven sites per district for introducing TB/HIV services in seven regions:
Arusha (Karatu and Ngorongoro districts), Pwani (Rufiji district), Zanzibar North (North A & B districts)
Zanzibar South (Central, South districts), Zanzibar Town/West (Town, West districts), Pemba North
(Micheweni , Wete districts), and Pemba South (Chakechake, Mkoani districts).
1b. Coordinate and strengthen services in 18 current project districts through regular technical support,
quality control, and increasing service delivery outlets. 1c. Carryout minor renovations to establish services
"under one roof" in 10 facilities. 1d. Support establishment of District and Regional TB/HIV Collaborating
Committees in eight districts and six regions respectively.
2. Strengthen human capacity by recruiting coordinators and training health care providers on TB/HIV. 2a.
Recruit and deploy one Project Technical Officer to provide technical and managerial support, two Zonal
TB/HIV Coordinators (ZTHCs) to coordinate TB/HIV services in Arusha region and the Islands of Zanzibar,
and eight District TB/HIV Coordinators (DTHCs) to coordinate services in the eight new districts. Services in
Zanzibar's 10 districts will be coordinated by five DTHCs, each covering two districts (a region) according to
Zanzibar TB/Leprosy Programme (ZTLP) structure. This is indispensable for ensuring achievement of
project targets. 2b.Train 30 TB/HIV Coordinators, 13 District TB/Leprosy Coordinators (DTLCs), and 678
health care providers on TB/HIV using regional facilitators. 2c. Refresher training on TB/HIV and new HIV
testing algorithm for 200 health care providers.
3. Strengthen community awareness on TB and TB/HIV, and mobilize them to reduce stigma and promote
HIV testing. 3a. Support introduction of TB and TB/HIV in primary school health education curriculum in
collaboration with the MoHSW National School Health Programme (NSHP) under Reproductive and Child
Health Section (RCHS) unit in seven districts (six in Pwani and two in Dar es Salaam regions). 3b. Finalize,
publish, and distribute 100 copies of National TB/HIV ACSM Strategy in collaboration with MoHSW and
other stakeholders. 3c. Train Village Health Workers on TB/HIV and facilitate establishment of 16
community-based IEC committees. 3d. Develop, print, and disseminate three different community and
patient TB/HIV education materials according to National TB/HIV ACSM Strategy. 3e. Introduce TB
‘Photovoice' (uses visual images and accompanied stories) in three pilot districts (Kisarawe, Misungwi,
Arumeru) as a strategy to enhance community involvement, promote client-centered care, combat stigma,
encourage TB and TB/HIV testing, and advocate for resources for TB and TB/HIV.
4. Strengthen Public-Public and Public-Private Mix (PPM) according to Private Sector TB/HIV Strategy in
collaboration with NTLP, APHFTA and other stakeholders. Dar es Salaam, Mwanza, and Arusha regions
will be the focus as these regions contribute about 36% of the national TB burden. $ 67,000
4a. Finalize, print and distribute 100 copies of Private Health Sector TB/HIV Strategy. 4b. Establish 20 new
private collaborative TB/HIV services delivery outlets in Arusha, Dar es Salaam, and Mwanza regions.
LINKAGES: PATH works closely with regional and district authorities and management teams, and is
represented in National TB/HIV Steering Committee, Information Education and Communication (IEC),
TB/HIV Tools working groups and TB planning. Linkages will be established with the NSHP, and Regional
and District School Health Coordinators who will facilitate training of school teachers on TB/HIV and monitor
implementation. TB/HIV scale-up will be linked to implementation of TB activities funded with USAID Child
Survival funds.
CHECK BOXES: Areas of emphasis selected reflect planned activities that include capacity building, minor
facility renovations, and wraparound agreements with NTLP and APHFTA. Council Health Management
Teams (CHMTs) will be supported in planning and incorporating TB/HIV activities in Comprehensive
Council Health Plans (CCHPs). Activities are engendered and target both adults and school children, and
focus on areas where TB burden is high.
M&E: NTLP data collection, recording, and reporting tools will be used. Data quality and timely quarterly
reporting will be supervised by ZTHCs in collaboration with Regional TB and Leprosy Coordinators
(RTLCs). DTHCs will be trained to use the Electronic TB Register (ETR). DTHCs and ZTHCs will conduct
regular monthly and quarterly supportive supervision to delivery sites respectively. National level supportive
supervision will be done in collaboration with NTLP and RTLCs. Quarterly reports will be compiled and
Activity Narrative: shared with stakeholders. About 7% of budget will support M&E.
SUSTAINAIBLITY: PATH will support districts to integrate TB/HIV activities in CCHPs and budgets. To
improve administrative capacity, PATH will support CHMTs to build their technical and managerial capacity
to manage the program. The facilities will provide staff and health infrastructure. TB/HIV scale-up is
implemented in the public and private sectors as a standard national package. DTHCs and ZTHCs will be
eventually absorbed in district staff establishment according to National TB/HIV Policy. Development of
national tools, strengthening of CHMT capacity, involvement of local government, and sensitization of local
leaders and communities will create ownership and strengthen the health system.
