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
Population Services International (PSI) is a private non-profit organization with a mission to improve the
health of low income people worldwide through social marketing. PSI Uganda is an affiliate of PSI with
operations in Uganda since 1998. It aims at measurably improving the health of vulnerable Ugandans using
evidence based social marketing and other proven techniques that promote sustained positive behavior
change with added emphasis on rural populations. It is committed to effective collaboration in support of
the Ministry of Health's (MOH) priority areas including, but not limited to, HIV/AIDS, malaria, child health
and reproductive health.
Young women in Uganda, as is the case in all sub-Saharan countries are at much higher rates of HIV
prevalence than their male peers. Seminal research studies have linked this disparity in prevalence to
sexual relationships with older men a practice known as cross generational sex (CGS)—defined as a sexual
relationship between a young girl and an older man 10 or more years her senior in exchange for material
gains. Of girls aged 15 - 19, 10% report having had sex with men 10 or more years their senior in the past
12 months (National Survey of Adolescents - Uganda 2006) Another study reveals that among university-
going sexually active girls 19 - 24 years, 20% had been in a cross generational relationship, and 36%
believe it is normal to engage in such relationships (PSI Uganda Tracking Survey 2005). The Uganda
HIV/AIDS Sero-Behavioural Survey 2004/05 showed that the HIV prevalence peaks and is highest among
the 30 - 44 year olds among the men and yet cross generation sex is on the increase (PSI Tracking Survey
2005/06). As many men in this age bracket continue to have sexual relationships with young girls aged 15-
24 years; who are easily swayed with material things as little as a mobile phone (PSI Tracking Survey
2005/06), it is critical to address this CGS problem.
In FY2007 PSI/Uganda is implementing a dynamic, multifaceted intervention to address Cross Generational
Sex. The program focuses on the reduction of cross generational sex, along side delay of sexual activity,
secondary abstinence among girls 15 -24 and fidelity among men 30 -49 years. The intervention is in 10
universities and 50 secondary schools in the districts of Kampala, Mukono, Wakiso, Luwero, Mbarara, Gulu,
Masaka, and Mpigi. The program targets 3 main audiences; young women; older men engaged in the
practice and the general population. Among the program's components is the establishment of peer and
social support groups for young women dubbed the "Go-Getters." In FY 2008 in partnership with Straight
Talk Foundation, PSI will extend the "Go-Getters" to secondary schools. Through these clubs, young
women receive peer education and counseling about the risks involved in cross generational sex
relationships, guidance on planning for their dreams and mapping out a path to success in their future
careers. Go-Getters club members are also empowered with the life skills that will enable them to make
good, sound decisions and judgments when faced with choices that will ultimately either save or end their
lives. The aim of the campaign is to empower the girls 15 -24 to reject cross generational sex and abstain
from sexual activity, while encouraging fidelity among the men involved in the CGS practice. Besides the
"go-getters" interpersonal communications, the program has a multi-channel mass media campaign and
mobile HIV counseling and testing at universities. Those who test positive are linked up with care and
support centers nearest to their universities especially AIC sites; one of PSI's partners in the CGS program.
Free HIV Counseling and Testing has been included as an additional component in the universities
program, in response to data that showed that only 15% of women aged 20-24 have ever tested for HIV
(Uganda HIV/AIDS Sero Behavioural Survey 2004/05).
Current gaps: The current campaign has a strong emphasis on mass media and has generated a lot of
discussion in the media, but this needs to be integrated with an equally strong emphasis on interpersonal
communications. With the current program we are not able to obtain immediate feedback from the target
audience which would be valuable in crafting messages to address their concerns and underlying beliefs
and causes of CGS, early sexual activity and infidelity. The behaviors being addressed are individual in
nature and require a strong personal counseling and reflection. While the mass media campaign will lead to
increased awareness and education about the healthy behaviours promoted, these are insufficient bases for
personal action. The gap between knowing what to do and carrying it out is notorious. With funding from
CDC, PSI will develop a strong interpersonal communications campaign that allows for careful listening to
the target groups concerns and address them. Through this feedback mechanism PSI will be able to
develop a cost-benefit analysis of the promoted behaviors from the target groups' perspective. The activities
(explained below) will include community outreach events to the 50 secondary schools and 10 universities
and a short messaging service (SMS) media promotion targeting university students and married couples.
The SMS media campaign will target the 20 -24 year olds in university as SMS media is fashionable to this
category but will not target the 15 -19 year olds as they are unlikely to access mobile phones. Feedback
from the 15- 19 year olds will be obtained from school teachers and at the community outreach events.
In FY 2008 PSI will conduct the following activities to bridge the above gap.
1.Expand the interpersonal communications (IPC) to the 50 secondary schools and surrounding
communities, targeting the 15-19 year olds (male and female) with abstinence messages and messages
encouraging the rejection of cross generation sex. The IPC activities will include the screening of a new
cross generation video drama "the honorable" that is followed by discussions on the problem of CGS and
what young people can do to reject CGS. PSI will continue to partner with FBOs such as CHAIN
Foundation and Power Fm to lead the discussions after the film dramas. Through the IPC, PSI plans to
reach 50,000 male and female 15 -19 year olds in the schools and their surrounding communities with key
messages on abstinence, and cross generational sex.
2.The discussions held with a vicarious-interaction style, will be recorded, edited and aired weekly on Power
Fm for greater reach, especially to young people out of school. 200,000 male and female 15 -24 are
expected to be reached through the mass media campaign.
3.Another activity for the FY2008 will be the addition of a short messaging services (SMS) media promotion
to support the already existing mass media campaign. Through this promotion dubbed "One million reasons
to reject cross generational sex" PSI will engage the young girls 20 -24 years to send SMS messages with
their top reasons for rejecting CGS—an excise that will get them to deeply think about the benefits of
abstinence and rejecting CGS. A similar campaign targeting the men dubbed "One million reasons to
remain faithful" will engage the men in fidelity messages. This interactive element to the ongoing "No to
Sugar Daddies, No to HIV" media campaign will provide PSI with feedback directly from the target
audience, promote interaction with the target audience, enable real time access to the public through SMS,
and provide PSI with an accurate database of phone numbers of the target audience through incoming
SMS. The promotion will feature incentives such as One million shillings worth of tuition fees per semester
as a grand prize for the girls 20 -24 years and a one million worth of holiday/vacation grand draw prize for
Activity Narrative: the fidelity campaign. Other incentives will include T-shirts, caps, airtime among others. 100,000 people are
expected to be reached through the SMS media campaign.
evidence based social marketing and other proven techniques that promote sustained behavior change with
added emphasis on rural populations. It is committed to effective collaboration in support of the Ministry of
Health's (MOH) priority areas including, but not limited to, HIV/AIDS, malaria, child health and reproductive
health.
Over 900,000 people die of HIV related illnesses each year in Uganda despite sufficient evidence to show
that with simple yet comprehensive interventions, these illnesses can be avoided. Standardized, evidence-
based and innovative recommendations on HIV prevention have been put together as the HIV basic
preventive care package (BCP) to allow for provision of effective care to millions of people living with HIV
(PHA) who currently have limited access to HIV related services and health products. The BCP is a 5 year
program (September 2004 - March 2010) targeting 200,000 PHA in Uganda. The program goal is to help
reduce morbidity and mortality caused by opportunistic infections (OIs) in PHA and to reduce HIV
transmission. Currently, the BCP components include; identification of PHA through family based
counseling and testing; prolonging and improving the quality of their lives by preventing OIs; and prevention
with positives interventions (PWP). The PWP aim to avert HIV transmission to sexual partners and unborn
children through: screening and management of sexually transmitted infections, family planning, partner
testing and supported disclosure, partner discordance counseling, prevention of mother to child
transmission of HIV (PMTCT), and safer sex practices including abstinence, and fidelity with correct and
consistent use of condoms. The PWP are in harmony with the overall PEPFAR other prevention strategy. In
addition, BCP combines key informational messages, training and provision of affordable health
commodities. The health commodities include free distribution of a starter kit with two long lasting
insecticide treated bed nets, household water treatment chlorine solution, a filter cloth, and water vessel,
condoms and important health information to prevent HIV transmission.
The BCP program is implemented through HIV/AIDS prevention, care and support organizations across the
country and serves to increase the production, access and utilization of BCP health products and services
among PHA. Program implementation is supported by a multi-channeled communications campaign that
educates PHAs on how to prevent OIs, live longer and healthier lives through cotrimoxazole prophylaxis,
prevention of diarrheal diseases using household water treatment and safe storage, use of ITN for malaria
prevention, family planning and the prevention of HIV transmission to sexual partners and unborn children.
The campaign includes development and production of information, education and communication (IEC)
materials for PHA, health care providers and counselors. These materials include posters, brochures,
positive living client guides and stickers in eight local languages. In partnership with MOH and Straight Talk
Foundation (STF), PSI is producing spots and ‘parent talk' programs on radio. Service providers, peer
educators and drama groups are trained and are implementing activities that reinforce these messages. PSI
manages the procurement, packaging and distribution of all health commodities to ensure consistent supply
of the kits and re-supply.
The output of the condom and other prevention activity is to ensure regular and constant availability of
condoms to eligible PHA in Uganda. This will be achieved through the distribution of the complete starter kit
and annual replenishment of 60 condom pieces per adult client. Free condoms for the program are sourced
from the MOH stock. A buffer stock of 6,300,000 condom pieces has been procured using US $250,000
allocated to PSI by PEPFAR in FY 2007. Supply from MOH has remained irregular as was the case in FY
2006 were supplies were erratic and fell short of the national requirements and resulted in disruption of the
assembly and supply of starter kits. In FY 2008, US $250,000 has been allocated to the procurement,
shipping, handling, post shipment testing and packaging of a condom buffer stock to ensure continued
access by PHA.
In FY 2007, PSI has partnered with 60 HIV/AIDS care and support organizations in 33 districts. Fifty- three
of these distribute condoms to their adult clients. Between April and June 2007, PSI has distributed 2,730
starter kits, containing 163,800 pieces of condoms and 653,500 condoms re-supplied for adult PHA. 234
health service providers and 29 peer educators have been trained to promote HIV/AIDS prevention beyond
abstinence and/or being faithful including correct and consistent use of condoms. PHA have been actively
involved in interpersonal communication activities (IPC) at partner sites including health talks and
community sensitization on HIV/AIDS prevention. They have conducted 3,182 peer education sessions
reaching an estimated 164,456 people. 399,000 IEC materials including posters, client guides, brochures
and stickers have been distributed. To support the IEC campaign, STF has developed and aired 2,574 radio
messages in eight local languages on 18 radio stations countrywide and 60 parent talk programs in four
local languages on eight radio stations in the east, west, central and northern regions of Uganda. The radio
program is aimed at providing information to the general population and PHA in particular, on the benefits of
the basic care components and PWP. 1,287 messages that focus on PWP have been aired. Since program
inception, 97,308 adult PHAs have received starter kits containing 5,838,480 condom pieces. 2,666 health
service providers and 1,043 peer educators have been trained on BCP with focus on HIV/AIDS prevention
beyond abstinence and/or being faithful. Over 670,000 people have been reached with IPC activities.
Expansion of the BCP activities across USG partners has been initiated with the Plus-Up funding. This will
include the addition of 20 new HIV/AIDS care and support organizations. PSI has partnered with EGPAF
and NUMAT so as to scale up BCP implementation through the district health system. PSI is currently
carrying out a mapping exercise to clearly understand the coverage of all the partner sites and therefore
unmet need for BCP. Through this exercise efforts will be made to suggest strategies to avoid client overlap
by the sites.
In FY 2008, PHA in rural and hard - to - reach areas for example islands and conflict areas served by USG
partners across PEPFAR (EGPAF, IRCU, Hospice, Peace Corps, State IMC, State IRC, MUWRP,
DOD/UPDF, Alliance, JCRC) who newly initiated BCP activities or do not have the full range of preventive
care activities will be prioritized. 97,308 adult clients who have received starter kits containing condoms will
each have a replenishment of 60 condom pieces. Other planned activities in FY 2008 include; 1) Continue
to implement the BCP program at current sites. 40,000 new clients will receive BCP starter kits in FY 2008.
2) Continue to make available on the market all the elements of the BCP package to enhance their
availability to all PHA. This will also help minimize stigma for the BCP commodities and services. 3) On
going distribution of IEC materials to PHA and health service providers. 4) On going peer education to
Activity Narrative: support uptake and utilization of BCP components including condoms. 5) PSI will continue to coordinate
implementation of palliative care activities as part of the BCP at HIV/AIDS support sites, and not as a
parallel activity. 6) Refresher training and training for new health service providers and peer educators in
preventive care and prevention with positives initiatives. 7) On going monitoring activities to track program
implementation.
Additional activities that the program will cover in FY 2008 will include; 1) Support and strengthen PWP
activities at partner sites through: regular support supervision of partner sites, partnership with SCOT to
train and mentor health service providers and assist in establishment of linkages to PWP services among
BCP partners and other service providers; 2) Improve demand for refill commodities and replenishment of
insecticide treated bed nets; 3) Work with MOH, CDC, and stakeholders to expand components of BCP to
address emerging needs of PHA e.g. TB, nutrition, HSV2; 4) Establish implementing partner regional
network system and facilitate study trips across partner sites targeting unit heads and staff involved in BCP
activities so as to learn from each others best practices as well as improve integration of BCP activities; 5)
Meaningful involvement of PHA. PSI in partnership with Alliance, NUMAT and EGPAF in selected districts
shall pilot building capacity of PHA networks in preventive care. These will be supported to follow up and
support fellow PHA on BCP adherence; 6) Increase program staff to cope with program expansion. One
person is required to oversee the implementation of PWP component of BCP and 4 assistants to support
regional activities; 7) Procure vehicles to maintain standards of supervision and commodity supply at
current and new sites; 8) Support sites to step up community component of their programs to improve on
client follow up.
Plans for program sustainability include; PSI to continue working with local manufactures to produce BCP
health commodities, partnership with MOH, and scaling up of BCP activities through district health
structures.
health
program (September 2004 - March 2010) targeting 200,000 PHA including children in Uganda. The
program goal is to help reduce morbidity and mortality caused by opportunistic infections (OIs) in PHA
including children and to reduce HIV transmission to unborn children and sexual partners. Currently, the
BCP components include; identification of PHA through family based counseling and testing; prolonging and
improving the quality of their lives by preventing OIs; and prevention with positives interventions (PWP). The
PWP aim to avert HIV transmission to sexual partners and unborn children through: screening and
management of sexually transmitted infections, family planning, partner testing and supported disclosure,
partner discordance counseling, prevention of mother to child transmission of HIV (PMTCT), and safer sex
practices including abstinence, and fidelity with correct and consistent use of condoms. In addition, BCP
combines key informational messages, training and provision of affordable health commodities. The health
commodities include free distribution of a starter kit with two long lasting insecticide treated bed nets,
household water treatment chlorine solution, a filter cloth, and water vessel, condoms and important health
information on how to prevent HIV transmission.
The BCP program is implemented through HIV/AIDS care and support organizations including those
offering pediatric care and PMTCT services across the country. Program implementation is supported by a
multi-channeled communications campaign that educates PHA on how to prevent OIs, live longer and
healthier lives through cotrimoxazole prophylaxis, prevention of diarrheal diseases using household water
treatment and safe storage, use of ITN for malaria prevention, and PWP interventions. The campaign
includes development and production of information, education and communication (IEC) materials for PHA,
health care providers and counselors. These materials include posters, brochures, positive living client
guides and stickers in eight local languages. In partnership with MOH and Straight Talk Foundation (STF),
PSI is producing spots and ‘parent talk' programs on radio. Service providers, peer educators and drama
groups are trained and are implementing activities that reinforce these messages. PSI manages the
procurement, packaging and distribution of all health commodities to ensure consistent supply of the kits
and re-supply.
In FY 2007, PSI has partnered with 60 HIV/AIDS care and support organizations in 33 districts. Between
April and June 2007, PSI has distributed 3,400 starter kits and, 20,902 bottles of chlorine solution for water
treatment and 653,500 condom pieces as refills for adult PHA. 234 health service providers and 29 peer
educators have been trained to promote use of BCP components. PHA have been actively involved in
interpersonal communication (IPC) activities at partner sites including health talks and community
sensitization on HIV/AIDS prevention. They have conducted 3,182 peer education sessions reaching an
estimated 164,456 people. 399,000 IEC materials including posters, client guides, brochures and stickers
have been distributed. To support the IEC campaign, STF has developed and aired of 2,574 radio
local languages on eight radio stations in the eastern, western, central and northern regions of Uganda. The
radio program is aimed at providing information to the general population and PHA in particular, on the
benefits of the basic care components. In partnership with Hospice Africa, a symptom and pain
management curriculum is under development for the BCP training manual, and will be included in the BCP
staff and peer educator trainings. Since program inception, 116,591 PHA have received starter kits. 2,722
health service providers and 1,151 peer educators have been trained on BCP. Over 670,000 people have
been reached with the IPC activities.
carrying out a mapping exercise to clearly understand the coverage of all the partner sites and therefore the
There is overwhelming evidence attesting to the effectiveness of HIV/AIDS preventive care, including
chemoprophylaxis, use of bed nets and safe water in delaying HIV disease progression and consequently
improving the quality of life for PHA. However, access to these commodities remains low in Uganda. This
activity is aimed at expanding access to cotrimoxazole prophylaxis, long lasting treated bed nets, condoms
as well as safe water systems. In FY 2008, PHA particularly in rural and hard - to - reach areas for example
islands and conflict areas served by USG partners across PEPFAR (EGPAF, IRCU, Hospice, Peace Corps,
State IMC, State IRC, MUWRP, DOD/UPDF, Alliance, JCRC) who have newly initiated BCP activities or do
not have the full range of preventive care activities will be prioritized. 36,000 PHA who received the BCP
starter kits in FY 2005 will have their bed nets replaced following wear and tear due to consistent use. Other
planned activities in FY 2008 include; 1) Continue to implement the BCP program at current implementing
partner sites. Expansion of BCP distribution through the PEPFAR care and treatment implementation
partners will make the BCP components available to over 200,000 PHA through out Uganda by the end of
FY 2008. 40,000 new clients will receive BCP starter kits in FY 2008. 2) Continue to make available on the
market all the elements of the BCP package to enhance their availability to all PHA. This will also help
minimize stigma for the BCP commodities and services especially the safe water vessel. 3) On going
distribution of IEC materials to PHA and health service providers. 4) On going peer education to support
uptake and utilization of BCP components. 5) Continued support for palliative care activities, together with
Hospice Africa by production of palliative care IEC and advocacy materials, and BCC focusing on pain and
symptom management, psychological, and social support. PSI will continue to coordinate implementation of
palliative care activities as part of the BCP at HIV/AIDS support sites, and not as parallel activity. 6)
Activity Narrative: Refresher training and training for new health service providers and peer educators in preventive care and
prevention with positives initiatives. 7) On going monitoring activities to track program implementation.
health commodities and scaling up of BCP activities through district health structures.
Through the OVC activity, there is increased knowledge, access and utilization of BCP products and
services among children affected and infected with HIV/AIDS, their families and children vulnerable to
HIV/AIDS. Training sessions with focus on the unique needs of the OVC have expanded awareness among
health service providers on the benefits of the BCP. In FY 2007, PSI has partnered with 60 HIV/AIDS care
and support organizations in 33 districts. Sixteen of these offer PMTCT services to pregnant women while
two offer specialized pediatric care to children living with HIV/AIDS. Between April and June 2007, PSI has
distributed 307 starter kits to children living with HIV/AIDS and their families. PHA including parents and
care takers of the OVC have been actively involved in interpersonal communication (IPC) activities at
partner sites including health talks and community sensitization on HIV/AIDS prevention and care. They
have conducted 416 peer education sessions reaching an estimated 22,000 children. 89,000 IEC materials
including posters, client guides, brochures and stickers have been distributed to PMTCT and pediatric
centers. To support the IEC campaign, STF has developed and aired 2,574 radio messages in eight local
languages on 18 radio stations countrywide and 60 parent talk programs in four local languages on eight
radio stations in the eastern, western, central and northern regions of Uganda. The radio program is aimed
at providing information to the general population and PHA and their care takers in particular, on the
staff and peer educator trainings. Since program inception, 8,814 starter kits have been distributed to OVC.
109 health service providers and 76 peer educators have been trained on BCP with focus on the unique
needs of the OVC. Over 147,000 children have been reached with IPC activities on BCP.
In FY 2008, OVC particularly in rural and hard - to - reach areas for example islands and conflict areas
served by USG partners across PEPFAR (EGPAF, IRCU, Hospice, Peace Corps, State IMC, State IRC,
MUWRP, DOD/UPDF, Alliance, JCRC) who have newly initiated BCP activities or do not have the full range
of preventive care activities will be prioritized. 4,465 children who received starter kits in FY 2005 will have
their bed nets replaced. Other planned activities include; 1) Continue to implement the BCP program at
current sites. Expansion of BCP distribution through the PEPFAR care and treatment implementation
partners will make the BCP components available to over 200,000 PHA including 18,800 OVC throughout
Uganda by the end of FY 2008. 40,000 new PHA including 3,760 OVC will receive BCP starter kits in FY
2008. 2) Continue to make available on the market all the elements of the BCP package to enhance their
availability to all PHA. This will also help minimize stigma for the BCP commodities and services especially
the safe water vessel. 3) Development of OVC specific IEC and on going distribution of current IEC
materials to OVC and health service providers. 4) On going peer education to support uptake and utilization
of BCP components. 5) Continued support for palliative care activities, together with Hospice Africa by
production of palliative care IEC and advocacy materials, and BCC focusing on pain and symptom
management, psychological, and social support. PSI will continue to coordinate implementation of palliative
care activities as part of the BCP at HIV/AIDS support sites, and not as parallel activity. 6) Refresher
Activity Narrative: training and training for new health service providers and peer educators in preventive care and prevention
with positives initiatives. 7) On going monitoring activities to track program implementation.
health commodities and scaling up of BCP activities through district health structures including PMTCT
sites.
