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:
In FY09 APHL will develop a version of its Laboratory Management Workshop for medical laboratory
technicians and technologists to complement the current senior professional curriculum. APHL will develop
appropriate curricula, and has identified the Muhimbili University of Health and Allied Sciences (MUHAS)
continuing education department as an appropriate partner for the development of the Laboratory
Management Workshops for technologists. APHL will assist in installation of a computer network and the
appropriate internet connectivity at the National Quality Assurance and Training Center to support the
training and National Health Laboratory Information System. APHL will collaborate with the Supply Chain
Management System and Custom Software to customize the inventory management module and train for
its application in the National Health Laboratory Quality Assurance and Training Center and the other four
laboratories where the Electronic System has been installed. APHL will collaborate with MOHSW and CDC
Tanzania representatives to customize its equipment maintenance training to Tanzania's needs. APHL will
then deliver hands on technical trainings on equipment preventive maintenance in Tanzania. APHL will
support 3 members of Tanzania's laboratory equipment maintenance team to receive extensive training
ranging from 3 weeks in country training to 4 months outside the country. The shorter term training will
cover general equipment maintenance while the longer term will include specific equipment maintenance.
*END ACTIVITY MODIFICATION*
TITLE: Improving Quality and Information Systems at Ministry of Health Laboratories
NEED and COMPARATIVE ADVANTAGE: There is a need for robust Laboratory Information Systems (LIS)
at Ministry of Health and Social Welfare (MOHSW)-Tanzania administered laboratories throughout
Tanzania. Demand for timely and reliable laboratory testing services has increased as Voluntary
Counseling and Testing (VCT) for HIV and Anti-retroviral (ARV) Treatment Programs expand across the
country. In addition, laboratories face an increased demand for aggregate statistical data reporting from
MOHSW and partners. Currently laboratory managers collect and tally data manually from multiple
handwritten laboratory ledger books. USG has assisted MOHSW with the renovation of a National HIV
Quality Assurance Laboratory and Training Center (NHQALTC) and as quality systems development will
continue to be a requirement for ensuring reliable laboratory testing. As a leader on quality laboratory
systems and an LIS expert in the international public health arena, and as the lead partner for LIS
implementation in Vietnam, Mozambique, and Tanzania, APHL is well suited to provide technical assistance
in these areas.
ACCOMPLISHMENTS: Paper based strengthening training materials and laboratory tools were developed
and printed. Paper based strengthening trainings were delivered at field sites. Computer hardware for the
LIS pilot was purchased and installed. LIS pilot launched in 4 sites - the Shinyanga Regional Hospital
Laboratory, the Songea Regional Hospital Laboratory, Mbeya Referral Hospital Laboratory, and the
Bugando Medical Center Laboratory
ACTIVITIES:
In FY 2008, APHL will use its experience in developing a five-year strategy and implementation plan for the
NHQALTC. This will complement activities by the Clinical and laboratory standards institute (CLSI) who will
focus on the development of standards and document development and the American Society for Clinical
Pathologist (ASCP) whose focus is on the development of quality assurance for Chemistry, Hematology and
CD4 count tests. The American Society for Microbiology (ASM) will focus on quality assurance for
opportunistic infections and TB. APHL will begin plans to working with care and treatment partners to link
the information from the laboratory to care and treatment clinics. APHL will expand paper based
information tools for implementation to the rest of the regions beyond the four pilot sites. The specimen
identification system that was drafted in FY 2007 will be finalized thereby enabling the procurement of labels
for the four pilot sites. Quarterly reporting forms registers will be printed while pending laboratory registers
for histopathology, general laboratory management and general laboratory LIS management tools will be
reviewed and printed. APHL will provide technical assistance on the training of 150 participants
on the use of the reviewed tools. A package of finalized tools will then be sent to sites where training on the
use of the tools has been conducted for implementation. APHL will monitor and evaluate the
implementation process.
To ensure standardized quality training is delivered, APHL will use lessons learned from the pilot sites to
refine existing training materials (power points, users' manual, facilitators' guide, etc.) and develop job aids.
The remaining implementation of the paper passed tools at the remaining seven sites is completed by end
of FY 2007. APHL has trained trainers in Tanzania who will train the additional regions and district hospital
laboratories. APHL will provide the necessary technical assistance in FY 2008.
APHL will launch the expanded electronic LIS in FY 2008. LIS Working & Management Group meetings will
be held to review phase one electronic LIS pilot with MOHSW, USG and other stakeholders, continue basic
computer training for 100 pilot site users, with the assistance of the University of Dar es Salaam, which has
assisted MOHSW and APHL with LIS implementation. With MOHSW, APHL will identify 11 regional
laboratory sites for expanded electronic LIS implementation and determine a schedule for installation and
implementation. The Mkapa Foundation in Tanzania has undertaken solar power installation for all regional
laboratories. APHL will liase with the Mkapa Foundation in order to complement the solar power installation
for the electronic LIS where necessary.
APHL will assist the MOHSW with the development of a five-year strategic implementation plan for the
NHQALTC. The five-year plan will be in collaboration with in country and USG laboratory partners. The five
-year plan will detail initial program capacity building and highlight program needs to ensure sustainability
through 2012. Components of the plan will include: organizational structure, human resources, capital
equipment requirements, training, pilot programs, scale up, expansion of services, and proficiency testing
implementation with timelines for implementation of each component. Each of the USG laboratory partners
Activity Narrative: will use their expertise and focus on specific areas such as implementation of standards and document
development (CLSI); Quality assurance in chemistry, hematology and CD4 testing (ASCP), Quality
assurance for opportunistic infections and TB (ASM) and LIS implementation for the center by APHL. APHL
will avail its expertise and resources to support the preparation of CD4, HIV serology, chemistry and
hematology panels including training and training materials. APHL will assist MOHSW in the development
of standardized assessment tools and feedback forms for monitoring the implementation of the five-year
strategy.
LINKAGES: APHL is committed to supporting strong linkages with: the Ministry of Health and Social
Welfare to continue providing technical resources and guidance for the implementation of the projects
throughout the country; MOHSW laboratories, especially the Muhimbili Laboratories, to continue to serve as
resources for LIS and Laboratory management, planning and reporting; The University of Dar-Es-Salaam to
continue to provide basic computer training for LIS users; APHL to collaborate with ASCP, ASM and CLSI
to assist the MOHSW with the development of a National HIV Quality Assurance Laboratory and Training
Center; APHL to work with MOHSW, and ART care and treatment partners to facilitate flow of information
from the laboratories to their clinics.
CHECK BOXES: This activity focuses on in-service training and capacity building of laboratory staff and
infrastructure support, and Strategic Information with the electronic LIS and data monitoring activities.
M&E: Both paper based tools, as revised with APHL assistance, and electronic tools will be used to capture
patient data. Pre and post tests as well as training evaluation forms will be shared with all participants from
the Laboratory Management Workshops. The results from these surveys will serve as the tools to capture
the effectiveness of the training.
The effectiveness of the LIS implementation will be monitored through feedback from laboratory personnel
on the ease of data entry, the ability to generate management and aggregate reports, and the receipt of
data by the MOHSW and care and treatment sites. Quarterly reviews of the NHQALTC strategic
implementation plans will be conducted. Seven percent of the APHL budget is dedicated to monitoring and
evaluating the effectiveness of this program and its activities.
SUSTAINAIBLITY: APHL will work with the Ministry of Health and Social Welfare and with the pilot sites to
ensure capacity is built within the Ministry to sustain the ongoing initiatives. This will be through the training
of trainers for both the paper based systems and the electronic LIS system. The roll-out of training beyond
the regional levels will be supported by the MOHSW and regional level trainers. APHL will continue to offer
technical assistance to the trainers.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13439
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13439 4962.08 HHS/Centers for Association of 6498 3572.08 $700,000
Disease Control & Public Health
Prevention Laboratories
7682 4962.07 HHS/Centers for Association of 4520 3572.07 $363,521
4962 4962.06 HHS/Centers for Association of 3572 3572.06 $200,000
Table 3.3.16: