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: 2010 2011
Documenting and Addressing Obstacles in PMTCT: Poor ARV Prophylaxis Uptake, Limited Facility Deliveries, and Lack of Integration of PMTCT with MCH Platform - Analysis, Recommendations, Technical Assistance
The Prevention of Mother-to-Child Transmission (PMTCT) program in Tanzania aims to reach pregnant women with quality PMTCT services during antenatal clinic visits and labor and delivery. These services are best provided in the Maternal-Child Health (MCH) platform and in an integrated manner. The specific services include HIV counseling and testing services and, for those found to be HIV positive, ARV and other interventions to prevent mother-to-child HIV-transmission.
The PMTCT program in Tanzania has scaled up, and PEPFAR Tanzania has recorded impressive results in terms of site coverage and women counseled, tested, and received results. However, the coverage of ARV prophylaxis has not been satisfactory. At the same time, the proportion of facility deliveries are below 50%; considerably lower in some remote locations. The program is still struggling to understand and address factors influencing facility delivery and its impact on ARV prophylaxis uptake. Also, while several initiatives to integrate PMTCT with MCH, there is little documentation of successes related to the provision of PMTCT on to the Maternal Child Health platform and its impact on patient outcomes and the district. In the light of the Global Health Initiative, it is important to document and understand the interventions that work best for effective service delivery so that best practices can be understood and shared.
Objectives: The PMTCT program in Tanzania plans to:
1. conduct a study to understand why women fail to access ARV prophylaxis, and why they deliver outside the health facility (precluding prophylaxis for the infant), including identification of barriers to these interventions;
2. document approaches for the provision of PMTCT on the MCH platform and
3. use the information collected in objective 1 and 2 above to target technical assistance needs and interventions that will help increase facility-based deliveries and the uptake of prophylaxis, reduce mother-to-child transmission, increase the sustainability of the PMTCT program, and further the goals of the Global Health Initiative for more comprehensive and integrated programs.
4. Scale up the most effective interventions to achieve increased facility-based deliveries and uptake of prophylaxis for broader scale.
Technical advisors from USAID/Washington, working through an implementing partner (TBD), will provide technical assistance to the Tanzania interagency PMTCT team up to three times a year with the following objectives:
1. Identifying and sharing best practices in PMTCT interventions;
2. Relating the goals of the Global Health Initiative with the ongoing PMTCT programs, documenting opportunities and recommendations;
3. Assisting the country team to address some of the bottlenecks facing ARV uptake in PMTCT, identifying areas for operational research to further improve program quality.
Contributions to system strengthening
The study will build on the previous efforts to identify challenges related to the limited use of facilities for deliveries. Results of the study and documentation will be shared with the Ministry of Health and Social Welfare (MOHSW), as well as implementing partners to inform policy and strategies for effective scale-up of PMTCT services and increased uptake of ARV prophylaxis. The technical assistance will help to identify the most effective service delivery model, which will also have spill over effect of increasing facility-based deliveries and reduce maternal and infant mortality.
Geographic Coverage
The program will be conducted in TBD sites in selected regions on Tanzania mainland. The target population will be HIV+ women receiving PMTCT services at RCH and maternity wards.
Links to Partnership Framework
The study is linked to Goal 1 of the PF: maintenance and scale-up of quality services. Results of this program will help identify obstacles to service and inform strategic scale up of services.
Goal 2 of the PF focuses on prevention, including PMTCT efforts. This program is directly in line with this goal, as it will strengthen PEPFAR Tanzania's current understanding of the barriers and help to target more effective PMTCT interventions.
Goal 6 of the PF aims to ensure evidence-based decision making and strategic planning. The program will inform decision making around the obstacles to deliver PMTCT services especially ARV prophylaxis and delivery services so that more infants can be reach with prophylaxis.
Monitoring and evaluation
PEPFAR Tanzania is working to improve the quality of services and the uptake of prophylaxis by pregnant women. The program will contribute to a better understanding of the most effective deployment of ARV interventions in PMTCT programs, while the technical assistance will inform how to improve measurement of quality of service delivery in PMTCT in Tanzania.
