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 2012
The goal of the Baylor-Tanzania program is to contribute to the reduction of HIV-related morbidity and mortality among infants, children and adolescents using a family-centered approach. Specific objectives supporting this goal include provision of comprehensive pediatric HIV care and treatment services; expanded pediatric HIV case finding; health systems and human resources capacity building; and community mobilization for pediatric HIV care and treatment services.
These objectives are aligned with goals one and five in the Tanzania Partnership Framework, which focus on service maintenance and addressing human resource challenges. The geographic coverage of the cooperative agreement is the Lake and Southern Highlands Zones.
Cost efficiency strategies will include using the training model of training regional and zonal level trainers and mentors to become master trainers in pediatric HIV care and treatment for cascaded capacity building. Coordination and collaboration with government health system leaders and implementing partners will be prioritized to achieve efficiencies in service delivery and capacity building.
Transitional strategies include close partnership with tertiary level host institutions to create pediatric HIV zonal leadership and ownership, which will incorporate program activities into zonal, regional, and council level health plans, e.g. Comprehensive Council Health Plans (CCHP). The M&E Plan incorporates the Balanced Score Card approach for holistic organizational health and efficient program implementation. Evidence-based programming will be implemented to ensure programs are improved and build upon factual information.
Linkages to pediatric HIV care and treatment services with orphan and vulnerable child (OVC) services will be a main activity, specifically with OVC service providers/implementing partners in operating regions that will establish meaningful OVC service and facility referrals, such as services to support family/household food security, child protection, education, and income generating activities.
Increased linkages with the social services system at the national, regional, district and ward/village levels will be enhanced in FY 2012 through engagement and sensitization of regional, district and community level stakeholders. Meetings and sensitization events focused on pediatric HIV testing, care, and treatment issues will be held periodically. Creation and adaptation of existing community and most vulnerable child community (MVCC) training curriculum to include pediatric HIV case identification and care and treatment issues will be supported.
Participating and supporting a multi-sectoral response will help to raise awareness of child care and protection issues, including post-exposure prophylaxis (PEP) care and treatment for victims of abuse. At the national level, integration of pediatric HIV care and treatment issues into the Early Childhood Development (ECD) social welfare guideline and annual action plan will also be supported through collaboration with the Department of Social Welfare. Community level events, media messages, and other culturally appropriate communication mediums supporting pediatric HIV case identification, testing, and stigma reduction will increase sensitization and help facilitate dialogue within the communities.
Efforts to measure the outputs and outcomes activities and build evidence-based programming in this area will include monitoring responses to radio programs, documentaries, and messages; participation in community sensitization events using a crowd estimation tool; and closely monitoring pediatric HIV testing and enrollment in care in the areas in which intervention activities are undertaken.
In FY 2012, scale up of cotrimoxazole (CTX) prophylaxis for HIV-exposed and infected children will be a focus. As identified by PEPFAR, there is a lack of nutrition assessment tools and nutrition information in communities. To address this shortage, provision of nutrition assessment tools and counseling and support services, including infant feeding and supportive breastfeeding in the context of HIV, will be offered. Assessment tools that identify household food insecurity will also be developed. Additionally, limited and targeted support for therapeutic food (Ready-to-Use Therapeutic Food), facility-based, and outpatient based food support will be provided. Pediatric-specific palliative care and psychosocial support, including adolescent and caregiver peer support groups, will be offered to promote healthier concepts in dealing with the various and complex health and livelihood issues.
Teen Clubs highlighting relevant issues, such as adolescent prevention with positives (PwP) concepts, self-esteem issues, life skills, sex and sexuality, treatment adherence and transitioning into adult care, will offer adolescent psychosocial support in a safe and caring environment.
Caregiver peer support groups will be organized to improve skills in supporting HIV positive children/adolescents. Plans for income generating activities will also be developed within the caregivers support group. Activities will be initiated through the Children's Clinical Centers of Excellence (COEs) at Bugando and Mbeya referral hospitals. Replication of services from COEs to lower level facilities are intended to be provided to allow for scale-up of activities and support groups. Additionally, improved linkages to community-based care, including under-five child survival interventions and community HIV support services, such as home-based care (HBC) for support of home visits, and lost-to-follow up patient tracking will ensure a more comprehensive approach to the health services. These activities will be achieved through training, on-site mentorship and COE clinical attachments, establishment of coordinating committees with local government and community-based organization, and advocacy combined with community mobilization.
Baylor-Tanzania will scale its COE clinical attachment activities will support capacity building for comprehensive pediatric HIV care and treatment. Expanded activities will include specific clinical attachments addressing pediatric HIV care and treatment counseling and nutrition/malnutrition management. National and local-government level, pediatric-focused technical support and input will also be provided on various technical groups addressing TB, nutrition, and maternal and child health issues, as appropriate.
The phased approach of both treatment partner and health professional capacity building for pediatric HIV care will take place in the Lake and Southern Highlands Zones.
In FY 2012, funds will be used for the following activities:
(1) Implement updated pediatric-focused URT national HIV care and treatment guidelines, which incorporate a phased approach to the updated WHO treatment guidelines, including treatment of all HIV-infected children <24 months;(2) Provide increased support to national level working groups and technical committees, including the Pediatric Technical Working Group, National HIV Care and Treatment Working Group, treatment partners, and quality improvement groups, to provide pediatric-focused advocacy and technical input to various national guidelines, curricula, and programs;(3) Enhance the identification and diagnosis of HIV in infants and children through EID and exposed infant care, pediatric-focused provider-initiated testing and counseling (PITC) at all entry points, such as inpatient and outpatient settings, immunization, and TB/HIV clinics;(4) Identify, diagnose, and link to care children and adolescents through "Know Your Child's Status" HIV testing events aimed at children of CTC clients and other high risk groups;(5) Improve follow-up services for HIV exposed infants and children, including tracking and retention of children in care and on treatment;(6) Monitor patient response and adherence to treatment; and(7) Provide adolescent-friendly services, including reproductive health services.
These activities will be implemented through training, side-by-side mentorship, and expanded clinical attachments to the Children's Clinical Centers of Excellence (COEs) at Bugando and Mbeya referral hospitals. Clinical attachments will support all cadres of health professionals, including facilities throughout the Lake and Southern Highland Zones. Through the two COEs that were established in early 2011, direct provision of pediatric HIV care and treatment services and support for health professional capacity building will be provided.
The COEs will continue efforts to improve the quality of care and health professional capacity. In efforts to do so, the COEs will eventually serve as models of the highest level of pediatric HIV care and treatment services available in Tanzania, with attention paid to management of complicated referral cases. Additionally, specific efforts will be taken to support health facilities in pediatric focused data collection, monitoring and data use, supporting pediatric HIV diagnosis, and implementing care and treatment initiatives. Basic health evaluations will be conducted to review issues such as EID/exposed infant care cascade models, barriers to pediatric-specific PITC, and HIV disclosure issues in children are planned. National level participation and collaboration with UCC for pediatric updates to the care and treatment clinic (CTC) database and M&E/data collection initiatives will also continue.
