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
Research Triangle Institute (RTI International) is an international, independent not-for-profit organization
dedicated to improving the human condition through multidisciplinary technical assistance, training and
research services that meet the highest standards of professional performance. During FY 2007, RTI in
partnership with AIDS Healthcare Foundation (AHF) supported the Uganda Ministry of Health (MOH) to
provide Routine HIV Counseling and Testing (RCT) and basic care (BC) services to patients in district 16
hospitals and health center (HC) IV facilities in six districts of Kaberamaido, Kasese, Kabarole, Masindi,
Mubende and Mpigi. With supplemental funding, two additional districts of Pallisa and Bugiri will be added
to the program by the end of FY 2007.
During FY 2007 RTI initiated AB interventions aimed at stemming HIV infections among the target
population groups of patients, youth (in-school and out of school) and adults in the supported districts, with
AB needs assessments and preliminary implementation through community education outreaches and
drama activities.
In FY 2008, RTI will scale-up AB activities in 16 facilities in four new districts as part of program scale-up.
This activity proposes to reach 350,000 individuals with AB prevention messages. Activities will be
conducted in partnership with health workers at supported facilities, local community based organizations
(CBOs), and PHA networks who will receive small grants to implement project activities. Selection of the
CBOs and PHA networks will be conducted in a competitive and transparent manner after evaluation and
verification of the CBOs' competencies and experiences to accomplish the tasks in the target districts. We
also will assess the readiness of the supported health facilities to roll out AB programs given their staffing
levels. All selected health facilities, CBOs and PHA networks will be provided with a clear scope of work that
describes the activities to be done, timeline for completion of the activities and the results/targets to be
achieved under each activity. This will be done after training of health workers, CBO and PHA
representatives on how to conduct and disseminate AB prevention messages to patients, PLWAs and
community residents through health education and community outreaches. The training will also focus on
behavior change practices that emphasize mutual fidelity among partnerships. Health workers will also be
trained to disseminate AB prevention messages when counseling patients. RTI project staff will perform
routine monitoring and support supervision of activities including sitting in a sample of outreach sessions
conducted by the partners. Each health facility or sub-grantee will be expected to submit monthly financial
and activity reports detailing the work done and the corresponding accountability of the funds used in
conducting the work. Disbursement of funds will be by installments and subsequent releases will be tied to
performance and timely submission of quality reports that pertain to the previous period. All reports will be
done according to guidelines provided by RTI project staff. A partner with unsatisfactory performance and
accountability will be disqualified for further support.
RTI will create mechanisms through which the dissemination of HIV prevention messages in the
communities will be sustained after the project. Behavior change entails not just having knowledge about
the risk factors related to HIV infection, but also understanding and overcoming the circumstances that lead
to those risk factors at individual and societal levels. This requires recognizing the special vulnerability and
needs of the various population groups, e.g., women versus men, youths versus adults, single versus
married workers. As part of our efforts, we will seek to identify and address challenges arising from gender
norms and expectations, including lack of sexual and social negotiating/decision-making skills among young
adults, especially women, and how to handle social-cultural beliefs/views about having multiple partners
being a sign of sexual prowess among men.
to the program by the end of FY07.
During FY07, RTI initiated prevention with positives (PWP) interventions during post-test counseling and
initiation of palliative care. By June 2007, achievements included, conducting of a needs assessment to
identify gaps and identification of potential CBOs for partnership which can be incorporated into HIV-related
counseling of patients, palliative care and treatment.
In FY08, RTI will expand OP services to 16 facilities in four new districts as part of program scale-up. This
activity will reach 10,000 individuals with PWP messages in health facilities for HIV-positive individuals and
their communities. Working with health workers at supported facilities, PHA networks and where appropriate
local community groups, RTI will support several activities aimed at increasing risk perception for HIV
transmission. Supported activities will include counseling of patients on disclosure of sero-status to sexual
partners, partner testing, use of family planning methods that reduce vertical HIV transmission, and
promotion of behavior change that emphasizes correct and consistent condom use among sero-discordant
couples and populations that engage in high-risk behaviors. We will support the setting up of, or
strengthening of clinic-based support groups and post-test clubs, including discordant couple clubs, to
assist in providing post-test counseling and psychosocial support to HIV-positive individuals. Potential PHA
leaders will be identified for training in leadership skills to support post-test activities. We also will support
the sharing of information and education aimed at reducing negative perceptions and attitudes about
HIV/AIDS that promote stigma and discrimination. This will be done through several mechanisms that
include community meetings and education sessions at health facilities so as to foster a dialogue among
members of the target population.
research services that meet the highest standards of professional performance. RTI is partnering with AIDS
Healthcare Foundation (AHF) to support the Uganda Ministry of Health (MOH) in providing Routine HIV
Counseling and Testing (RCT) and basic care (BC) services to patients in district hospitals and health
center (HC) IV facilities. In this partnership, RTI contributes to the national response to address the
significant service gaps that still exist in the provision of HIV counseling and testing (HCT) and linkages to
care and support services in Uganda.
As of June 30, 2007, the project has identified 10,134 HIV-positive clients who have been linked to health
facilities so as to receive PC that includes septrin prophylaxis, basic care kits and specialized care. In
addition, RTI has supported the strengthening of the referral system for HIV-positive persons leading to
about half of the identified HIV+ persons enrolling in the HIV clinics within three months after diagnosis.
Although close to 80% of HIV+ patients attending HIV clinics in the project supported health facilities have
been identified through the RCT/BC program RTI Will conduct an assessment to better understand the
reasons for low enrollment in the chronic care clinics.
In FY 2008, RTI will expand palliative care services to 16 facilities in four new districts as part of program
scale-up. This activity proposes to initiate septrin prophylaxis, provide basic care kits and refer 10,000 HIV+
patients for specialized care in a total of 30 health units between 1st October 2008 and 30th September
2009. Emphasis will be laid on increasing access for child and adolescent patients through child-friendly
approaches. An equally important aspect to palliative care that the program will work one is to institute
measures that improve the quality of care provided to PHAs. Clinical staff will be trained to show
compassion when treating and/or caring for HIV-infected patients and their dependents. The program will
also ensure that patients receive other specialized PC services including psychosocial counseling and
support to prevent sexual and vertical HIV transmission, STI treatment and family planning.
To bridge the existing human resource gaps in the health facilities, volunteer health workers and/or PHAs
will be recruited and trained to support the provision of on-going counseling, psychosocial support and
helping patients to develop sexual behavior, care and treatment plans in order to prevent HIV transmission
and improve adherence. All health care workers in the new facilities and newly recruited staff in currently
supported health facilities will be trained to provide facility-based palliative care and /or referral for further
assessment and specialized care for HIV+ patients. Refresher training and technical support supervision will
be provided as needed to ensure quality delivery of PC services. The project will also distribute MOH
standard operating procedures, protocols and job aids on PC to all supported health facilities. In order to
minimize stock-outs, RTI will support health unit staff to enable them forecast and requisition for the right
amounts of septrin and other basic care supplies
During FY 2007, the project continues to make significant progress in the integration of TB and HIV
management through the linkage between CT service delivery points, chronic care clinic and the TB clinic in
all project-supported facilities. RTI contributed to the response to the challenges to effective TB/HIV care for
patients. These challenges include a limited capacity to identify TB cases using either sputum smears or
chest x-rays in some facilities; limited access to TB treatment centers by patients; shortage of qualified/well
trained health workers and; poor treatment adherence.
During FY 2008, RTI will expand TB/HIV services to 16 facilities in four new districts. This activity will reach
4,050 individuals with TB/HIV services between 1st October 2008 and 30th September 2009. RTI will
support this activity by strengthening capacity of health unit staff to better understand policies and
guidelines for integrating TB/HIV interventions. This will lead to better management of TB/HIV co-infected
patients, to maximize TB case detection, increase treatment completion rates and ART literacy. TB Infection
control measures in HIV care settings will be enhanced through literacy campaigns for patients and staff,
triage of symptomatic patients and enhanced TB case-finding. The program will continue to support efforts
that provide cross-referral and integrate diagnosis, treatment and support services for TB and HIV in the
target facilities. HIV-positive individuals will be actively screened and treated for TB at initial diagnosis and
during follow up at the chronic care clinics. HIV counseling and testing will be offered to all patients in the
TB clinics.
The program will also emphasize strengthening of laboratory capacity for TB and HIV. RTI will conduct an
assessment of laboratory capacities at all target facilities to identify areas that will need priority actions. The
assessment will examine factors such as the availability of laboratory staff and their level of
training/experience, the number and types of laboratory services currently available (with emphasis on
HIV/AIDS and TB) , current infrastructure (quality of testing tools, and other non-expendable equipment),
availability of supplies and expendable equipment (reagents, sputum mugs, and protective gear) and the
frequency of stock-outs, availability of operating procedures and protocols for laboratory management and
performance, and the level of resources allocated to laboratory performance by district planning
committees. Following the assessments, the program will then develop and implement a support plan for
strengthening existing capacity depending on the needs identified, using MOH guidelines and in
collaboration with various partners including the National TB and Leprosy Program. In collaboration with
the Zonal and District TB and Leprosy supervisors, RTI project staff will work to support the implementation
of the existing guidelines for EQA in TB microscopy. Depending on the need, this support will include
provision of EQA materials and re-examination of selected samples during technical support supervision.
Working with district IEC teams, the program will provide support for a communications campaign aimed at
increasing TB case detection, TB treatment adherence and ART literacy in the target health facilities and
surrounding communities. Health facility staff will be supported in data management and analysis to enable
them better monitor adherence to relevant treatment regimes and to track progress in the performance of
their activities. RTI will collaborate with MOH to ensure constant supply of TB drugs, septrin and ARVs to
TB/HIV co-infected patients. Support supervision and on-job training will be done to strengthen TB/HIV
integrated services in collaboration with district and facility TB and HIV focal persons.
research services that meet the highest standards of professional performance. During FY07, RTI in
by the end of FY07. This activity contributes to the national response & the PEPFAR strategy to increase
knowledge of people's HIV status.
Since program inception, a number of accomplishments have been made in the program area of CT: (a)
RTI contributed to the development of materials for use in training and implementing RCT activities by
health workers in collaboration with several other partners in the country. These materials which include
training manuals, provider cue cards, standard operating procedures and implementation protocols have
been useful in the harmonization of HCT training programs for health workers around the country. Since
project inception in March 2005, the project has trained more than 900 health workers in RCT/BC
implementation; (b) By the end of July 2007, an estimated 62,500 persons had been counseled, tested for
HIV and received their results in eight supported health facilities located in Kaberamaido, Masindi and Mpigi
districts. Eight new health facilities in Kasese, Mubende and Kabarole districts will commence providing
RCT services by September 2007 following the completion of training and setting up of testing points in
those facilities. It is hoped that by the end of FY 2007, more than 81,000 persons will have been provided
with CT services under this program using the current funding. RTI has also applied for supplementary (plus
-up) funding, will enable the project to train an additional 250 health workers and further increase the
coverage of the program to twenty health facilities, reaching more than 100,000 persons by March 2008. (c)
The project has also conducted several Information, education and communication (IEC) activities to
increase program awareness. These include IEC materials produced in English and local languages that
are distributed and posted in conspicuous places within supported health facilities and sensitization
meetings with health facility, district and community leaders, so as to further inform the target audience
about the program. (d) The project has adapted MOH health management information (HMIS) tools to
generate accurate RCT/BC data.
In FY08, RTI will expand CT services to 16 facilities in four new districts as part of program scale-up. This
activity proposes to reach 100,000 individuals with CT services between 1st October 2008 and 30th
September 2009. Final selection of districts for expansion will be done in consultation with MOH. The
districts currently being considered include Sembabule, Mityana, Kyenjojo, and Iganga. This scale up will
lead to a total of 30 health facilities where the program will be working in FY 2008, each with an average
attendance of 1,100 patients per month. In-service training will be provided in the new facilities while
technical support supervision will continue in the existing districts. Training and supervision will build the
capacity of health workers to implement CT and to maintain a high quality of service delivery. Quality
Assurance for the counseling and testing process will be emphasized and external quality control for HIV
testing will be conducted. The project will also train and provide technical support supervision to adhere to
guidelines related to proper management and disposal of medical waste. Standard operating procedures
and protocols for implementation of RCT and waste disposal will be distributed to the new sites. Where
necessary, RTI will provide materials for destroying medical waster. RTI will also support the setting up of,
or strengthening of clinic-based support groups and post-test clubs to assist in providing post-test
counseling and psychosocial support to persons who test for HIV. Family-member HIV testing will be
strengthened through use of index patients as a point of entry for spouses and children. Emphasis will be
placed on couple counseling, disclosure of HIV testing and support for discordant couples. In the case of
infant testing, the program will partner with other implementing agencies working in this area especially the
Pediatric Infectious Diseases Clinic (PIDC) to provide CT services to children. While our support will be
varied depending on level of presence of PIDC and/or similar partners in the facility, we anticipate
supporting activities that could include the specialized training of select health workers in infant and child
counseling and testing. Where necessary, the project will support the transporting of specimens from lower
level facilities to referral laboratories for conducting polymerase chain reaction (PCR) HIV testing on the dry
blood spot samples and for submitting results back to the facilities. To increase utilization of CT services,
sensitization meetings will be held with key community leaders in the areas surrounding the new project
facilities. RTI will work closely with the district health teams and health unit CT focal persons to enhance
ownership and sustainability of the service. RTI will produce IEC materials on routine CT which will be
disseminated in the health facilities, community leaders and clients. Frequent stock-out of essential HCT
commodities is anticipated and we will collaborate with other MOH, National Medical Stores (NMS) and
Supply Chain Management Systems (SCMS) to strengthen logistics management to minimize stock-outs.
Technical support will be provided to improve the collection, analysis, distribution and use of data on routine
HIV counseling and testing so as to inform and improve program activities.
