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.
The Food and Nutrition Interventions for Uganda (NuLife) Follow-on is a new USAID/Uganda project that will provide technical support to the MOH and USG care and treatment partners to implement integrated nutrition interventions to people living with HIV/AIDS with the goal of improving their health outcomes and efficacy of antiretrovirals (ARVs). The program builds on the achievements of the NuLife program at
national and district level i.e. at 54 health units across 51 districts through the Ministry of Health and USG partners. The program will be aligned to the national food and nutrition polity and the National Nutrition and HIV and TB Strategy (2009-2014) that advocate for the scale up nutrition assessments, counseling and support as an integral component of HIV/AIDS and TB care and support services.
The primary beneficiaries for the program are: PLHIV including adults and children (aged below 18 years) in ART and care programs; HIV-positive pregnant & lactating women/mothers with children less than six months; and Orphans and Vulnerable Children (OVC)
The program will strengthen the capacity of Redo Industries to produce the locally produced the locally produced ready-to-use therapeutic food (RuTF) and build on the achievements of the NuLife program in strengthening the economic livelihoods of individuals exiting the NACS program through farmer groups who are growing the ground nuts for the factory.
The NuLife follow-on program focus on building the capacity of health care workers to provide sustain the management of acute malnutrition for people living with and affected by HIV by providing nutrition assessments and counseling to clients attending HIV/AIDS care and treatment services, pregnant and lactating women attending maternal and child health clinics and to OVC programs that are supported by USG partners. Targeted nutrition support will be provided in form of supplementary, supplemental and therapeutic feeding (using RuTF) to that target beneficiaries. Community and facility linkages will be strengthened for active case finding; referral and follow-up care for adherence support; reduction of loss to follow up; and, improve the cure rates for individuals receiving treatment for acute malnutrition.
The NuLife follow-on project will continue to use the quality improvement (QI) approach to expand the provision of comprehensive nutrition care for PLHIV to additional high volume health facilities and their catchment areas in the current 51 districts. Anthropometric equipment, job aides, MUAC tapes and nutrition IEC materials will be provided. National and regional technical teams will be availed to prove on-going support and supervision to the health units and the districts.
HIV positive adults who will exit the nutrition assessment, counseling and support (NACS) programs will be linked to food security and livelihoods programs within their catchment areas.
In FY2011, the program will support targeted food and nutritional support services to HIV negative clinically malnourished OVC aged 0-17 years identified at both the facility and community level. In most cases, these OVCs will be identified at other clinics other than the HIV clinic which the outpatient department, Young Child Clinic, the MCH clinics and acute care clinics. The nutrition related services to be provided to the OVCs will include nutritional assessment, counseling, Infant and Young Child Feeding, and treatment for acute malnutrition. The malnourished children and their care takers will be counseled on eating well, relationship between HIV and nutrition, increasing their energy and nutrient intake, dealing with symptoms and signs of opportunistic infections, food and drug interactions, infant and young child feeding practices, dealing with loss of appetite, preventing infections, encouraging positive leaving and
seeking early treatment. In addition to counseling, the malnourished will be treated using RUTF so as to improve on their nutritional status.
This new activity will provide technical support to USG OVC to integrate nutrition into their OVC programs. Technical support will range from training service providers in partner facilities, training of partner staff as trainers, provision of a minimum technical package required to integrate nutrition, regular one on one meetings, and organized workshops to update partners on the minimum package and new developments in the area of nutrition, support to integrate nutrition indicators into data collection tools and reporting system, provision of training manuals and job aides developed.
Regional coaching teams will make monthly visits to the facilities to mentor facility quality improvement (QI) teams to systematically integrate nutrition into OVC services at the facility level using the seven steps developed from the training manual to simplify activity implementation at the facility. The first step is nutrition assessment for all OVCs; the second is categorization into normal moderate and severe acute malnutrition based on the colors of the MUAC tape; the third is nutrition counseling of malnourished OVC; the fourth is RUTF prescription using the recommended dosing charts; client follow up for those receiving RUTF; the sixth is general nutrition education for all OVC and their caretakers at the clinics; and the seventh being community mobilization at the community level for identification and follow up of malnourished OVC. To augment the coaching team, the NuLife technical team will provide quarterly technical support visits to support and follow up on technical issues raised through the coaching and mentoring visits.
As a strategy for strengthening the facility-community linkages for increased accessibility for nutrition care and support services for OVC, the program will train and equip new community volunteers using the community training cascade model and the revised set of training manuals. Training topics include adult learning and effective facilitation skills, effective communication skills, basic nutrition care and support for OVCs, the role of the community in integrated management of acute malnutrition, counseling materials for nutrition care and support, management of HIV related symptoms, and management of malnutrition at community level. The community volunteers are drawn from USG partner organizations and their primary role will be to identify, refer and follow up malnourished OVC to health facilities providing nutrition care and support.
Based on lessons from FY2010, it will be critical that the program strengthens and develops new linkages with partners implementing livelihood and food security programs in the targeted districts to take on graduates from the outpatient therapeutic care. The goal is to reduce the number of malnutrition relapses and allow for continuity of nutrition care and support when OVCs graduate from the OTC program. The program will develop a comprehensive "graduation and continuum of care strategy" that involves the
provision of (or graduation to) supplemental foods for PLHIV suffering from moderate acute malnutrition and livelihood support for PLHIV and their families. The program will establish collaboration and linkages with food security and economic growth program e.g. the USG Title II MYAP program; Feed the Future (FTF) Program; and World Food Program.
Nutrition services to HIV exposed and infected children will be provided as a component of reducing vertical transmission through breast feeding and improving the health and wellbeing of the children. The NuLife follow-on award will utilize the national infant and young child feeding (IYCF) and the upcoming national guidelines of the Integrated Management of Acute Malnutrition (IMAM) to provide comprehensive NACS services at facility and community level.
The program will promote good infant feeding practices through exclusive breastfeeding for infants below
6 months and utilize the new WHO infant feeding guidance for the HIV exposed child that advocate that HIV positive mothers should breastfeed for a minimum of 12 months and beyond until safe and adequate replacement feeding is available, coupled with HAART or ARV prophylaxis for the mother (option A or option B) and/or the infant. Postnatal infant feeding counseling and food demonstrations on preparation of appropriate weaning local foods will be provided in collaboration with the PMTCT USG partners.
Malnourished children will receive appropriate supplementary and therapeutic food using Ready-to-use therapeutic foods (RuTF).
The program will promote good infant feeding practices through exclusive breastfeeding for infants below 6 months and utilize the new WHO infant feeding guidance for the HIV exposed child that advocate that HIV positive mothers should breastfeed for a minimum of 12 months and beyond until safe and adequate replacement feeding is available, coupled with HAART or ARV prophylaxis for the mother (option A or option B) and/or the infant. Postnatal infant feeding counseling and food demonstrations on preparation of appropriate weaning local foods will be provided in collaboration with the PMTCT USG partners.
