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
PEDIATRIC AIDS CASE RETENTION ON CARE AND TREATMENT - RMO MBEYA and RUKWA REGION
Goal
Improving Quality in Pediatric HIV Care and Treatment Program
Objectives
1. To strengthening continuum of care to HIV infected infants
2. To Train HBC providers, community health workers and volunteers on pediatric HIV services.
3. To Facilitate movement of community HBC providers, community health workers and volunteers n the community by providing means of transport (Bicycles)
4. To provide district teams with proper skills to orient and supervise community and facility HBC providers on pediatric follow up.
5. To Establish and keep service providers motivated
Target Population:
(1) HIV exposed and HIV-positive children and their families, (2) HBC providers, Community Health workers and volunteers.
Description
Over 90% of children acquire HIV from their mothers; currently only 5% of HIV infected pregnant women in the African countries receive ARV for prevention of MTCT. In the absence of ARVs for PMTCT 25-40% of infants born to HIV infected women acquire the virus vertical, and those who are infected are at risk of rapid disease progression and early death. It is documented that, without treatment, more than 50% of HIV infected infants will die before their second birthday and 75% will be dead by age five. ART is increasingly available and children respond well when treated. Mbeya has an estimated population prevalence of 9.2% while Rukwa has an estimated prevalence of 4.9%. In Mbeya HIV prevalence in ANC is approximately 14.7%, which translate into 7,144 HIV infected women delivering annually. Assuming a 40% transmission rate, an estimated 2,858 will become HIV infected each year in the absence of any intervention. More than 50% (1,429) of the HIV infected children are likely to die by the age of 24 months if not provided with proper care and treatment. Prompt diagnosis of HIV infected infants is important in saving the lives of infants. In both regions the diagnosis, which was formerly done using tests that look for HIV antibodies in the infant's blood, is currently done using DNA PCR machine which is located and accessible at Mbeya Referral Hospital.
Mbeya region currently has 43 functioning Care and Treatment Clinic (CTC) sites, while Rukwa has 19. 146 functioning Prevention of Mother-to-Child Transmission of HIV (PMTCT) sites and Rukwa has 103 functioning PMTCT sites. Of now, a total of 31 health facilities in Mbeya and 32 in Rukwa offer HIV Early Infant Diagnosis (HEID) services. All these sites have an integration of CTC, PMTCT and RCH services. Currently the proportion of children provided with ART services among adult is estimated at 9% against the National target of 20%. While scaling up HEID, the retention of HIV positive children into care and treatment needs to be addressed by improving linkage and referral system between facility and community. To improve retention we need to effectively use the community HBC providers, community health workers and volunteers to regularly conduct longitudinal follow up of children on ART and all HIV exposed children whose parents will agree to be followed up.
Implementation
Ensuring adherence to HIV care and treatment amongst the pediatric population has been a great challenge to health programs. Care of children mainly relies on the abilities of the caregivers who more often may not be the parents.
To improve adherence and follow-up, DOD will adopt a community approach to pediatric HIV care and treatment. All patients seeking treatment will be linked to a HBC provider, community health worker (CHW) or volunteer for follow-up and continuum of care.
CHWs and volunteers will be selected and nominated by their communities for training guided by pre-determined criteria. They will receive intensive training followed by 6 month field mentorship. Key activities will include awareness campaigns/meetings, tracking loss to follow-up, referral and follow-up of pediatric patients in their homes.
Linkage to PF
Efforts to improve pediatric ART quality of service are a key element for achieving the Partnership Framework between the GOT and the USG. One of the objectives in the PF document is to expand prioritized care, treatment, and support services, dependent on available resources and the USG is committed to fund/support introduction of innovations/new care, treatment, and support services, as well as agreed upon priority requests. Use of HBC workers, community health workers and volunteers to improve pediatric ART quality of services is one of the innovative methods to achieve PF objectives.
M&E
DOD through the RMOs will continue to promote outreach services/supervisory visits from the facilities to the communities. Each facility will have lists of pediatric ART service supporters involved in HIV/AIDS linkages and referral of children to care and treatment, indicating geographical coverage and types of services offered. These lists will be displayed in the MCH units so health staff can refer clients to them necessary.
M&E data activities for all the supporting CTC and care and support groups will be supported by TA from the DoD SI team based at the Mbeya Referral Hospital. A standardized data collection tool will be developed for use by the care and support groups and the supporting health facility. CTC1 and CTC2 forms will continue to be used at the CTC, based on NACP and facility data needs, entered into the electronic medical record system (EMRS) and transported to the DoD data center located at Mbeya Referral Hospital for synthesis, and produce USG reports as well as to provide feedback to reporting CTC and the care and support groups for use in improving quality of services
The additional funding will be used to strengthen linkages and refferal between facility and communities to improve retention of children in HIV care and treatment services.This will be achieved through advocacy and awareness campaigns, training of care providers, improving recording and tracking of loss to follow-up, home visits and provision of insentives to care providers. Activivties will be implemented in high prevalence regions
