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
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS.
For the Wide Area Network, a new focus on sustainability and transfer will be initiated with FY2009 funds.
For sustainability of this program the funding should be shared with the regions as well as the MOHSW- IT
department; however there is need to help the regions better understand the costs and benefits of a WAN
system. The three WAN staff funded under NIMR and seconded to MOHSW- IT Unit will be maintaining
the current system and number of sites (12) and completing and disseminating the results of an assessment
that will lay they groundwork for future years where USG funding for the WAN will be phased out.
TITLE: Strengthening the National and Regional Use of the Wide Area Network (WAN)
NEED and COMPARATIVE ADVANTAGE: The fight against pandemic diseases such as HIV/AIDS can be
made more effective when complete, accurate and timely data and information is available. Information and
Communication Technologies (ICTs), particularly Wide Area Network (WAN), can be used as a tool to
enhance the collection, processing, dissemination and availability of such information. This could be through
e-mails, file sharing, access to the World Wide Web, publishing information on the web and speedy delivery
of data via web-enabled data collection tools from upcountry to the ministry headquarters. This project is
therefore a timely initiative to modernize how health workers and policy makers collect, process,
communicate, disseminate and share information.
ACCOMPLISHMENTS: Implemented Local Area Networks (LAN) in seven regional medical
offices/hospitals and 1 referral hospital namely: Mbeya, Iringa, Lindi, Mtwara, Dodoma, Arusha, Mwanza
and Mbeya Referral Hospital; provided Internet connectivity for the above regional medical offices; recruited
two system administrators to manage the WAN and provide end user support; provided LAN and WAN for
two NIMR sites (Mwanza and Tabora); provided training to end users on e-mail use and internet surfing;
maintained all LAN and WAN equipment in 6 Dar es salaam sites and seven regional sites in good working
condition.
ACTIVITIES: Maintain and strengthen the existing LANs and WAN including connectivity, hardware, and
software updates through continued technical support to the 16 sites in seven regions
1. Conduct quarterly supportive supervisory visits to the existing 16 sites in seven regions
2. Train Health workers in seven regions on computer applications and training them about email and
internet use at the sub-national levels to ensure proper use of the technologies and timely data transfer.
3. Perform maintenance of the WAN system to the existing 16 sites in seven regions to ensure systems are
operating and address any issues. The sites under maintenance will include: Headquarters of the Ministry of
Health and Social Welfare (MOHSW), National AIDS Control Program (NACP), Prevention of Mother to
Child Transmission (PMTCT), Mbeya Referral Hospital, Regional Medical Offices/Regional Hospitals of
Mtwara, Lindi, Mbeya, Iringa, Arusha, Mwanza, Dodoma, NIMR Headquarters, Tukuyu, Muhimbili, Mwanza
and Tabora.
4. Maintain Annual Internet subscription fee for shared bandwidth for all 16 sites
5. Awareness and dissemination through websites and electronic newsletters
LINKAGES: NIMR collaborates closely with MOHSW and particularly with HMIS unit and NACP in
implementation and management of LAN/WAN at Dar-es-salaam and upcountry sites. In FY 2005 the
assessment of ICT needs for regional connectivities was carried out from July to September 2005. The
assessment team was composed of three officials from the MOHSW's Policy and Planning Department, two
from CDC, one from NIMR and two from a private company, AFSAT. The MOHSW team was headed by the
Head of HMIS Unit. Planning meetings involved stakeholders from CDC, NIMR, MOHSW HQ and NACP
who formed a task force that implemented LAN/WAN to Dar-es-salaam and regional sites. The senior
ministry officials (Permanent Secretary and Director of Policy and Planning) launched the MOHSW
LAN/WAN and website that was developed.
Regionally, the project involved the Regional HMIS Focal persons in implementing and managing the
LAN/WAN. This collaboration has always been done when LAN was implemented and VSAT based-
Internet was provided for the following regional hospitals (Regional Medical Offices) of Mtwara, Lindi,
Mbeya, Iringa, Arusha, Mwanza, Dodoma and Mbeya Referral Hospital. Also, upcountry NIMR's IT officers
were also involved during connecting NIMR sites of Mwanza and Tabora which also received LAN and
VSAT connectivity.
CHECK BOXES: Conduct In-service training to health workers in seven regions on computer applications
and train them on email and internet use at the sub-national levels to ensure proper use of the technologies
and timely data transfer.
M&E: 1. Conduct quarterly supportive supervisory visits to all 16 sites to ensure that the systems are
operating and address any issues.
2. Review the usage of official e-mails on MOH.GO.TZ, NACPTZ.ORG and NIMR.OR.TZ domains. Review
will answer question about how many users are properly using the system, what are the gaps/limitations
and recommendation on improvements will be outlined.
SUSTAINABILITY: 1. The program staff will collaborate with the Ministry's HMIS staff to conduct basic
computer training, including basic troubleshooting of the systems to HMIS Focal person of the seven
regions where the regional and/or referral hospitals are connected.
2. Conduct end-users training and follow up for all sites. This will specifically involve conducting training to
end-users about email and internet use at the sub-national levels to ensure proper use of the technologies
New/Continuing Activity: Continuing Activity
Continuing Activity: 13547
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13547 4910.08 HHS/Centers for National Institute 6544 1153.08 $335,000
Disease Control & for Medical
Prevention Research
7761 4910.07 HHS/Centers for National Institute 4567 1153.07 $340,000
4910 4910.06 HHS/Centers for Ministry of Health 2892 1130.06 $250,000
Disease Control & and Social
Prevention Welfare, Tanzania
Emphasis Areas
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $100,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.17:
REPROGRAMMING APRIL 2009
Capacity development activity was not approved during the COP approval process, so funding for that part
of the activity has been moved to SI.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
NIMR will continue working in the area of capacity development for NIMR staff so they will be better able to
undertake public health evaluations in the future as needed; this work will be extended to include other
research institutions and government officers who also work in research. Training in operational research
for immediate action will also extend to involve eight more districts which were not covered with COP 2008
funds. COP 2009 will not feature funding for FELTP as this program will be funded under the MOHSW.
*END ACTIVITY MODIFICATION*
TITLE: National Institute of Medical Research (NIMR), Build Capacity and Implement Health Workforce
Research and Evaluation for Policy Change in Tanzania
A strong workforce in the health sector is a critical component in meeting the challenges of the HIV/AID
crisis. In Tanzania there is a need to urgently increase health manpower as well as the performance and
productivity of health workers. Improvements in human resources for health (HRH) require policies that are
informed by evidence based research about Tanzania's unique problems and issues. There is the need to
build the capacity for this research, perform the evaluations and use the results to inform and improve the
system and policies relating to human resources for health.
National Institute of Medical Research (NIMR) has played a critical role in supporting the Ministry of Health
and Social Welfare (MOHSW) to address human resource crisis through operational research and
evaluations related to HRH. NIMR has experience in research in the fields of epidemiology, biomedical,
and general public health and began work on the HRH issue in 2004. The presence of NIMR offices
throughout the country and the availability of a network of researchers are added advantages. NIMR, which
is part of the MOHSW under the Policy and Planning Department, is in a key position to advocate for major
policy decisions based on the results of their evaluations. In addition NIMR as a member of the HRH
Working Group of the MOHSW is strategically placed to give input, advocate and advise MOHSW on
changes in HRH policies and systems.
Since 2004 NIMR has made strides in performing evaluations and assessments in the area of HRH,
advocating for policy changes in HRH and building capacity through support of Tanzanians in the Field
Epidemiology and Laboratory Training Program (FELTP) in Kenya. More specifically, operational research
centered on workload and productivity was conducted. These studies were important in informing policy
makers and local/district leaders on productivity and the means to improving it. After analysis, triangulation
of data, and through discussions with health care workers root causes and possible solutions that could be
applied were identified. As a result, at the national level the MOHSW and NIMR are redefining staffing for
health facilities and are developing activity standards and workload indicators. A major finding from the
workload study was that retaining health workers in rural areas is a major challenge. Therefore a retention
study was undertaken. Analysis and dissemination is ongoing and is expected to inform policy decisions on
which cost-effective retention schemes to embark on at the national and district levels.
Another component of NIMR work involves capacity development. In FY 2006-07, through the Kenyan Field
Epidemiology and Laboratory Training Program (FELTEP) program, two graduates completed masters'
degrees. These two graduates will strengthen both communicable and non-communicable units of the
MOHSW. Additional residents have been recruited, one for strengthening the Zanzibar AIDS Control
Program of Zanzibar and the other for Laboratory Diagnostic Unit of the MOHSW on Mainland. The FELTP
graduates and students are beginning to play a major role in outbreak investigation (measles, rift valley
fever and malaria), in studying the epidemiology of HIV/AIDS and have prepared epidemiological bulletins
and materials for short course for laboratory workers. One current student is conducting a study on
antiretroviral (ARV) drug resistance in patients starting ARV treatment.
Major activities for NIMR for COP 2008 include: continued work on HRH related issues; strengthening the
capacity of Tanzanians to undertake public health evaluations (PHEs); building capacity for GIS; and
continued support for Tanzanians in the FELTP program.
1) Operational research will continue, with a greater emphasis on capacity building at NIMR zonal/district
levels to decentralize the research. As a follow up to previous work, a job description assessment will be
completed to measure the effect of providing clear job descriptions and job aides on improving performance
of health workers. In addition NIMR, with additional funds for one PHE, will conduct an evaluation of the
feasibility of task shifting of health workers in health facilities and its acceptability among consumers and
communities. Results from these two activities will be translated into policy changes for improving HRH in
Tanzania. In addition, NIMR will continue to disseminate information and build health worker capacity
through production of the quarterly NIMR HRH newsletter and through membership of the MOHSW HRH
working group. Lastly, in collaboration with the Capacity Project, a retention scheme intervention at district
level will be implemented and evaluated.
2) FY 2008 funding will also support strengthening Tanzanian capacity to undertake public health
evaluations. By strengthening this capacity NIMR will be a strong local partner to serve as co-investigator in
public health evaluations. They will be able to offer services such as protocol and tools development, field
data collectors, data entrants/analysts and report writers. Databases will be established of research
assistants who would assist in fieldwork and data entry. Funds will also be used to purchase equipment to
assist in easy data collection and transfer such as PDAs. In addition NIMR will provide assistance in data
analysis and validation of the SAVI (social assets and vulnerabilities indicators) database.
3) With FY 2008 funds, NIMR will support two students to complete their studies in the Kenyan Field
Epidemiology and Laboratory Training Program (FELTP) which will build capacity in Tanzania to address
the current shortages in these fields. As part of the MOHSW Epidemiology Unit activity plans are
Activity Narrative: underway to establish a Tanzania FELTP program and these two students who will graduate in 2008 will
play a key role in this future program.
4) NIMR will use FY 2008 funds to build its capacity to complete GIS mapping through close collaboration
with the MEASURE project. As part of this activity GIS experts will work closely with NIMR to build in-
country capacity and use. Although GIS mapping is widely applied in health data, efforts have not been
coordinated resulting in duplication. Given, the existence of GIS experts in NIMR and NIMR's position as a
national research institute, coordination also falls under its mandate. In addition, NIMR will coordinate the
GIS group, through; routine meetings and updates, sharing of information among the group, organizing and
offering coordinated support to PEPFAR activities and linking GIS data sets.
In order to achieve the FY 2008 objective NIMR will link with a number of other key partners. NIMR will work
with the Capacity Project and the Health Policy Initiative for research and advocacy on HRH. Kenyan
FELTP students and graduates program will be linked with PMI, AFENET, Muhumbili University and the
new Tanzania FELTP program. NIMR will collaborate with institutions that have research experience for
implementation of the PHE component. For the GIS activities linkages will be developed MEASURE
Evaluation, University College of Lands and Architectural Studies and the National Bureau of Statistics.
NIMR has a strong focus on M&E and will employ the following M&E strategies: feedback from readers;
quality assurance plans for data collection; and visits to districts and respective zones to review use and
implementation of operational research after training. NIMR will strictly adhere to the PEPFAR reporting
and planning requirements.
All NIMR activities will be initiated in a participatory manner from both national and local level. Key
stakeholders will be involved through a bottom up approach to get their input into specific activities. Such
stakeholders include: ministries; NGOs; district leaders; and community representatives. Where possible,
additional funds will be leveraged to create a wider ownership and to ensure sustainability. Most of the
NIMR activities will include a capacity building component to build the necessary skills to sustain activities in
the future.
Continuing Activity: 13548
13548 3407.08 HHS/Centers for National Institute 6544 1153.08 $1,155,000
7778 3407.07 HHS/Centers for National Institute 4567 1153.07 $400,000
3407 3407.06 HHS/Centers for National Institute 2842 1153.06 $563,207
Estimated amount of funding that is planned for Human Capacity Development $500,000
Table 3.3.18:
