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:
TITLE: Making Medical Injections Safer (MMIS).
NEED and COMPARATIVE ADVANTAGE: Currently the working environment in health facilities still poses
risks for health workers and the general community of acquiring blood borne infections such as HIV and
Hepatitis B and C. In order to combat these risks, improved injection safety practices must be implemented
through training of health care workers regarding infection control, management of safe injection equipment,
and supplies at service delivery points. There is a need to support the hospital-based training of trainers
(TOT) to continue training the wealth of workers in hospitals and dispensaries who have yet to receive
training. Institutional initiative on spot supervision is lacking, therefore, hospital management teams must
receive training to effectively monitor and supervise their facilities. For sustainability purposes, MMIS must
include infection control/injection safety in health college curricula, in addition to TOT in pre-service
colleges. An integrated monitoring and evaluation (M&E) tool will be required for all facilities to ensure
correct implementation of best practices, ensure adherence to local and national guidelines, and to possess
documentation of arising issues and improved performance.
ACCOMPLISHMENTS: In Tanzania, MMIS has successfully trained 35% of health workers in injection
safety practices utilizing 51 and 870 zonal and hospital-based TOT respectively. In addition, MMIS has
procured and distributed roughly 12 million auto disable syringes and over 237,000 safety boxes to
hospitals. MMIS has also designed, developed, printed, and distributed advocacy and behavioral mass
media communication to individuals, communities, and facilities. In collaboration with the Ministry of Health
and Social Welfare (MOHSW), MMIS developed and printed 1020 training IPC-IS slide manuals. In addition
to the Do No Harm facilitators' guide and health workers manual, MMIS printed 1500 copies each of
national standards and procedures for healthcare waste management (HCWM), HCWM national policy
guidelines, and HCWM monitoring plans. In collaboration with the MOHSW, integrated supportive
supervision checklists were developed, and in March 2007, a mid-term review on the IPC-IS program was
conducted. Finally, MMIS supported the MOHSW in printing 2000 t-shirts and caps for the World
Environment Day cerebrations and the launch of HIV/AIDS prevention awareness in the workplace.
ACTIVITIES:
FY 2009 activities are scaled back considerably because of a significant reduction in funding. The focus for
the coming year will be on targeted training in collaboration with MOHSW and technical assistance to
support training efforts. MMIS will also develop a sustainability plan and exit strategy to support a transition
to the ministry as lead for these program activities. During FY 2009 funds will be allocated to improve
injection safety practices through the following core activities.
1.Training and capacity building of health care workers, which will include: supporting the MOHSW with
finalization, printing, and dissemination of training materials; training of health workers in all public and
private health care facilities focusing on lower level facilities; collaborating with the MOHSW, regional health
management team (RHMT), district health management team (DHMT) and the National AIDS Control
Programme (NACP) to support the inclusion of the PEP policy and monitor implementation of strategies at
facility level; training hospital management teams (HMT) effective on-site supportive supervision.
2.Contributing funds to develop and strengthen sustainable and safe healthcare waste management
systems by advocating and leveraging resources to ensure maintenance of incinerators. Additionally, MMIS
work with MOHSW in positioning health officers at health facilities to assist in HCWM will allow more
effective monitoring and ensure better adherence of standards. In addition, MMIS will print and disseminate
policy guidelines, plans, and standards related to HCWM to all health facilities.
3.Developing and strengthening sustainable safe health care waste management systems and reduce
unnecessary injections through targeted IEC/advocacy and behavior change strategies; expanding the
scope of communication and advocacy efforts to the general public through audience segmentation and
strategically sequenced activities; improving health care worker safety through advocacy for effective
needle stick prevention and management guidelines and policies. In addition, activities will continue to
advocate for the provision of post-exposure prophylaxis and vaccination against hepatitis-B for health care
workers and guidelines to be put into place regarding the provision of personal protective equipment (PPE).
Continual support to all facilities will be funded in FY 2008, supporting needlestick prevention
implementation, post exposure prophylaxis (PEP), documentation of needle stick injuries including the
requirement of PPE. MMIS will collaborate with the MOHSW to conduct an evaluation of the IPC-IS training
program for health workers at all levels and disseminate findings to stakeholders.
4.Collaborating with Supply Chain Management System in the procurement of safe injection equipment and
supplies.
END ACTIVITY MODIFICATION
Activity Narrative: media communication to individuals, communities, and facilities. In collaboration with the Ministry of Health
ACTIVITIES: During FY 2008, funds will be allocated to improve injection safety practices through training
and capacity building of health care workers. This will include: supporting the MOHSW with finalization,
printing, and dissemination of training materials; training of health workers in all public and private health
care facilities focusing on lower level facilities; collaborating with the MOHSW, regional health management
team (RHMT), district health management team (DHMT) and the National AIDS Control Programme
(NACP) to support the inclusion of the PEP policy and monitor implementation of strategies at facility level;
training hospital management teams (HMT) effective on-site supportive supervision.
Safe injection equipment and supplies must always be readily available; therefore, effective commodity
procurement and in-country logistics plans must be in place, including the development of strategies to
achieve injection device security. Additionally, MMIS will support Medical Stores Department (MSD) in
custom clearance of safe injection commodities through pooled procurement of non re-usable injection
devices, safety boxes, and personal protective equipment. Collaboration with national regulatory authorities
is essential to efficiently and accurately provide updates on specifications, technologies, good
manufacturing practices, and highlight the importance of controlling the quality and appropriateness of
products being imported.
MMIS will contribute funds to develop and strengthen sustainable and safe healthcare waste management
will develop a hired position whose sole responsibility it is to support staff in collecting and handling health
care waste in a health care environment. Collaboration between MMIS and MOHSW in positioning health
officers at health facilities to assist in HCWM will allow more effective monitoring and ensure better
adherence of standards. In addition, MMIS will print and disseminate policy guidelines, plans, and
standards related to HCWM to all health facilities.
Other activities include: developing and strengthening sustainable safe health care waste management
systems and reduce unnecessary injections through targeted IEC/advocacy and behavior change
strategies; expanding the scope of communication and advocacy efforts to the general public through
audience segmentation and strategically sequenced activities; improving health care worker safety through
advocacy for effective needle stick prevention and management guidelines and policies. In addition,
activities will continue to advocate for the provision of post-exposure prophylaxis and vaccination against
hepatitis-B for health care workers and guidelines to be put into place regarding the provision of personal
protective equipment (PPE). Continual support to all facilities will be funded in FY 2008, supporting needle
stick prevention implementation, post exposure prophylaxis (PEP), documentation of needle stick injuries
including the requirement of PPE. MMIS will collaborate with the MOHSW to conduct an evaluation of the
IPC-IS training program for health workers at all levels and disseminate findings to stakeholders
LINKAGES: MMIS works closely with the MOHSW programs and units that include health services
inspectorate works using a mutually accepted work plan. Education updating health workers on a continual
basis link with adult learning techniques as thematic groups that include JHPIEGO. Injection safety
applicably links with environment health and hygiene surrounding health care waste management.
Additionally, the NACP collaborates with existing partners to design and develop information educational
communication materials. Similarly, reproductive and child health (RCH) is invested in the safety of
injections administered to children. The World Health Organization (WHO) gives technical support on
incineration of medical waste. Furthermore, the Department of Human Resources Development links with
MMIS to TOT using the Zonal Training Centers.
M&E: In collaboration with the MOHSW, a draft checklist has been developed with the aim of integrating the
tools into one master tool. The tool will be used by the program, the health management, and the DHMTs.
Evaluation will be completed at the middle and at the end of the program. Key measures to be assessed in
the M&E should include the achievement and challenges of the program activities, sustainability, safety
adherence, and the impact of the program to Tanzania as a nation.
SUSTAINABLITY: The program, in collaboration with the MOHSW, the Tanzania Food and Drug Authority
(TFDA), and TBS has encouraged private importers to import the non-reusable injection devices and other
injection safety commodities. A factory known as Emunio-Tanzania Ltd will begin production of non-
reusable syringe/needles and assemble safety boxes for use in health care facilities in Tanzania. In
collaboration with the MOHSW, MSD, and the Prime Ministers Office Regional and Local Government
(PMORALG), injection safety programs will advocate the inclusion of non-reusable injection devices in their
comprehensive council health budgets.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13503
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13503 3441.08 HHS/Centers for John Snow, Inc. 6529 1192.08 Track 1.0 $2,213,249
Disease Control &
Prevention
7732 3441.07 HHS/Centers for John Snow, Inc. 4547 1192.07 JSI Track 1.0 $0
3441 3441.06 HHS/Centers for John Snow, Inc. 2856 1192.06 $2,115,000
Table 3.3.05:
