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
ACTIVITY UNCHANGED FROM FY 2008.
TITLE: Scaling-up Palliative Care Services in Tanzania through the Tanzanian Palliative Care Association
(TPCA)
NEED and COMPARATIVE ADVANTAGE: Palliative care in Tanzania has need for updating of guidelines,
enhancement of services, and strengthening of providers, the Tanzanian Palliative Care Association
(TPCA) is a national organization for all palliative care providers and will be strategically placed to
spearhead palliative care development in Tanzania. However, TPCA is a relatively new organization; thus,
it is important that they collaborate with the African Palliative Care Association (APCA) to support their
organizational development and to leverage APCA's expertise. APCA is a multi-national and well-
established organization that has a wealth of experience from which they can provide technical assistance
to TPCA and the National AIDS Control Programme (NACP) to build their capacity and expand the
provision of high-quality palliative care in Tanzania.
ACCOMPLISHMENTS: APCA has completed the establishment of the TPCA secretariat; a review of
existing palliative care and home-based care (HBC) standards with recommendations on how these can be
strengthened; development of a national framework for palliative care standards across the care continuum;
and the development of care standards and guidelines that address the needs of children for discussion
with NACP.
ACTIVITIES: The major activities for FY 2009 will include updating and implementation of the national
Palliative Care Guidelines. This will involve stakeholders' meetings with the NACP at the Ministry of Health
and Social Welfare (MOHSW), the National AIDS Council, and other key stakeholders in Tanzania. APCA
will also work to develop pediatric palliative care programs. APCA will work with NACP to implement the
TPCA national palliative care strategic plan. The strategic plan, developed in FY 2006/07, is based on the
World Health Organization palliative care core foundation measures: education development, drug
availability, public policy and pubic awareness, and implementation. The strategic plan will also review and
refine existing basic care packages (including prevention care packages, access to clean water,
cotrimoxazole prophylaxis, basic hygiene and insecticide treated nets). APCA will work closely with TPCA
to develop a program of work under the key areas of education and training and public policy. APCA will
train a core group of trainers (approximately 35 people) to build on the achievements of FY 2008. This will
involve clinical placements both across and outside Tanzania to ensure that the trainers have clinical
experience. APCA will support TPCA to continue to develop the action plans developed at Entebbe,
Uganda by the country drug availability team. Specifically, APCA will provide technical assistance to TPCA
to develop opioid guidelines and advocacy skills to influence government-level policy changes that favor
drug availability. There will also be series of national workshops and a national palliative care conference to
increase public awareness of palliative care.
APCA will help NACP develop palliative care standards based on the APCA African Palliative Outcome
Scale. They will also draft national guidelines for monitoring and evaluation, including a public health
evaluation of palliative care in Tanzania. Materials will be translated into local languages for dissemination.
APCA will work with the NACP to integrate palliative care into existing HBC networks though a pilot project.
APCA will draw lessons from its current work in Namibia to develop a protocol for integrating palliative care
into HBC across the country and to develop tool kits to facilitate this process. APCA will work with training
institutions to integrate palliative care into the curriculum of nurses and doctors across Tanzania to increase
the skills base for palliative care. They will develop a national task force for palliative care to ensure local
support for TPCA and long-term sustainability after APCA has departed.
LINKAGES: Key linkages will include TPCA, MOHSW, and NACP, to support integration of palliative into
the national HBC guidelines. With Family Health International and Pathfinder International, the project will
link to and integrate palliative care with HBC networks. APCA will also link with the Foundation for
Hospices in Sub-Saharan Africa's New Partner Initiative program working with the Evangelical Lutheran
Church of Tanzania in Arusha, Tanzania so that lessons learned can be shared widely and the project can
utilize the trainers trained under this program to increase the delivery of training of trainers services.
CHECK BOXES: APCA will work at the national level in collaboration with TPCA, a national body
representing palliative care providers in Tanzania. APCA will target mainly people living with HIV/AIDS
across both gender and age categories. However, given that children are routinely neglected in palliative
care, APCA will work with NACP to develop appropriate programs for children based on pediatric palliative
care guidelines.
M&E: APCA will work with TPCA to develop national M&E frameworks and protocols for palliative care
service development. APCA/TPCA will participate with other palliative care providers and NACP in the
development of a national monitoring system for palliative care. These protocols and the national
monitoring system will be linked to existing national guidelines and PEPFAR indicator protocols, and will
build on the work achieved in FY 2008. The program will also develop minimum data sets for data
collection from partners. APCA will support TPCA in developing data analysis procedures, storage and
retrieval systems, and reporting templates for disseminating M&E information. Further development of the
M&E frameworks will also include information acquired from the public health evaluation, anticipated to take
place in FY 2009. The M&E work will also incorporate feedback mechanisms for stakeholders so that
collected data can be used as a quality improvement tool for services.
SUSTAINAIBLITY: APCA will build the human and organizational capacity of TPCA through an
organizational development program. This will help strengthen TPCA into an effective organization which is
able to attract donor funding and has the capacity to deliver palliative care expertise within Tanzania. To
achieve this, APCA will support TPCA in developing organizational policies, providing a board development
program, and hosting a fundraising/donor relations skills development program. More importantly, APCA
will link TPCA with international partners, so as to ensure continuous support for their work.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13428
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13428 8704.08 U.S. Agency for African Palliative 6491 5413.08 $400,000
International Care Association
Development
8704 8704.07 U.S. Agency for African Palliative 5413 5413.07 APCA $400,000
Table 3.3.08:
