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: 2011 2012 2013 2014 2015 2016
1) Overall goals and objectives:
Protecting Families Against HIV/AIDS (PREFA) is currently the largest Ugandan indigenous Non-
Government Organization (NGO) supporting the Ministry of Health (MOH) in the provision of Prevention
of Mother to Child Transmission (PMTCT) of HIV services since 2004. PREFA proposes to Scale up
Integrated, Effective, and Sustainable Services for the prevention of Mother to Child HIV Transmission
(PMTCT) in the 31 districts of Uganda with a goal of contributing to the reduction of MTCT through
support to PMTCT programmes in 31 Districts of Uganda under the following objectives:
a) Increase service coverage of comprehensive, high quality, integrated, PMTCT services up to all HC III
and functional HC II in the 31 districts. Under this objective, PREFA in collaboration with MOH intend to
equip health facilities in all the 31 Districts to provide quality, comprehensive and effective PMTCT
services on site. PREFA will also support the Districts to bridge PMTCT service gaps caused by stock out
of essential PMTCT supplies through procurement and distribution of PMTCT test kits, ARVs and
Cotrimaxazole tablets. The programmed will also ensure that there is timely transportation of CD4 and
DBS samples from and to the 628 Health facilities. PREFA will also assist the Districts to hire and train
additional human resource for PMTCT service provision in IMAI / IMPAC, IYCF, EID/rapid test training
and CCA refresher training.
b) Increase uptake of comprehensive PMTCT services from 65% to 80% of all pregnant women. Activities
under this the programme will increase demand for high quality, comprehensive PMTCT services through
increasing awareness of availability of comprehensive, integrated PMTCT services by conducting radio
talk shows, community education sessions, facilitation of PHA and male peer groups activities. PREFA
and its partners will also increase the proportion of HIV infected pregnant women and their babies who
receive comprehensive PMTCT services by ensuring that pregnant women are tested for HIV in all the
628 sites, ensuring that HIV positive women and their babies receive PMTCT and other basic PMTCT
interventions, and increase referrals of PMTCT clients for care and support
c) Provide early infant HIV testing to 80% of HIV exposed babies. Through this more HIV exposed babies
will receive appropriate care and treatment. This will increase the proportion of HIV infected babies that
are identified among all HIV exposed babies. HIV exposed babies will also be guided to the point of care
through referrals to treatment sites for chronic care and support.
d) Promote integration of PMTCT with Reproductive Health (RH), nutrition, and HIV care and treatment
services. This will increase access to quality PMTCT, ART, RH and nutrition services at PMTCT sites
which will result into integrated planning and management of PMTCT/RH/PHC programmes at District
level. PREFA and its partners will also make available integrated PMTCT/ART/RH/nutrition services at
facility and community level by establishing demonstration kitchens among others at Health sub district
and community level.
e) Strengthen Administration, management and information systems at all levels of the project. Under this
object, the programme will hire, build capacity and equip key project staff where there are gaps. This
team will also provide Performance based grants (PBGs) to the 31 Districts for service delivery. PREFA
will also support Districts to establish PMTCT Workplans and budgets. Linkages will also be done
between MOH, SURE and NMS and Districts to procure all laboratory supplies, ARVs and Cotrimaxazole
from NMS, districts and lower level health facilities. We will also facilitate coordination meetings with
existing PEPFAR and non PEPFAR implementing partners at district level in order to avoid duplication of
programme implementation. PREFA will also build capacity for monitoring and evaluation in addition to
routine data collection and management through upgrading of the data systems at PREFA.
2) Target populations and geographical coverage:
PREFA shall support up to 628 health facilities (59 hospitals, 65 HCs IV, 424 HCs III and 80 HCs II) in the
31 districts of Kampala, Kalangala, Mityana, Mubende, Kayunga, Wakiso, Nakaseke, Nakasongola,
Luwero, Mukono, Mpigi, Masaka, Sembabule, Rakai and Lyantonde in Central Uganda; Soroti, Kumi,
Katakwi, Jinja, Bukedea, Amuria, Tororo and Manafwa in Eastern Uganda; and Arua, Moyo, Yumbe,
Nebbi, Maracha-Terego, Adjumani and Koboko in West Nile, to provide quality comprehensive PMTCT
services. The target population includes 620,642 pregnant women and their male partners. 607,387
pregnant women and their male partners shall be tested and given their HIV test results and the expected
40,335 HIV positive pregnant women identified shall be assessed for eligibility for ART using CD4 testing
and/or WHO staging. All the identified HIV positive pregnant women shall be offered ARVs/HAART for
prophylaxis according to the new Ministry of Health guidelines while those eligible will be offered lifelong
HAART through linkage to ART centers. 32,268 HIV positive pregnant women are expected to deliver
under skilled supervision at the supported facilities. All the 32,268 HIV exposed infants shall be given
ARV prophylaxis and linked to chronic HIV/AIDS care services through the early infant HIV diagnosis and
care points (EID care points) in the respective PREFA supported health facilities. HIV exposed infants
shall be tracked and identified in post-natal, immunization and out-patient clinics for PCR testing. 27,405
HIV exposed infants (including the 19,693 who will be referred from the community by CCAs) shall be
identified and DBS samples shall be taken off them for PVCR testing
3) Enhancing cost effectiveness and sustainability:
The PREFA-led project will place emphasis on ownership and cost effectiveness as local ownership is
one key to sustainability. Our project strategy is focused on sustaining region-wide delivery of PMTCT
services at all levels through:
• Involvement of leadership at district, and HSD, as well as HUMC at the facility levels in planning,
management, M&E, and supervision of health services.
• Training and mentoring of managers at district, HSD and facility levels in program management
concepts such as planning, organizing work plans around results, implementation, and M&E.
• Performance based grants (PBGs) that allow service providers and managers to achieve results quickly,
thus showing them what is achievable in the long run and motivating them to continue services.
• Collaboration with the MOH and districts ensures implementation by the providers within the local
government establishment who will be available even when the project ends.
• Linkages with other PEPFAR partners, universities, and hospitals that will integrate the different levels of
the referral system and permit sharing of resources and training;
• Community participation and mobilization of the extensive network of volunteers (VHTs and CCAs)
ensures continuity even with dwindling resources, and is key to bridging resource gaps.
4) Health systems strengthening:
In the first one year, PREFA will support the Districts to hire 31 staff (Midwives, laboratory assistants and
peer counsellors). Also 330 Health workers will be trained comprehensive HIV/AIDS care using
IMAI/IMPAC approach. Additionally 150 will be trained in infant and young child feeding, 90 in training of
trainers in comprehensive PMTCT counselling, IYCF and RH/FP, 930 CCAs will be oriented in PMTCT
service delivery including provision of modern FP services, 90 District PMTCT trainers will be refreshed
on PMTCT counselling, IYCF,EID and RH/FP, 210 family support group members will also be trained as
peer mentors and a post training follow up will done on the 180 health workers who have been trained in
3 months.
5) Cross cutting budget attributions:
a) Human resources for health: PREFA will assist the Districts to recruit 31 health workers (Midwives,
laboratory assistants and peer counsellors) with a view that they will be integrated into the district payroll
within 2 years. About 95,082 USD will be spent on this activity.
b) Construction / renovation:
REDACTED
c) Food and nutrition commodities: PREFA as part of the integrated implementation in districts will
procure buffer stocks of RUTFs worth 31,238 USD.
d) Gender: reducing violence and coercion:
This will be taken care of in a separate application.
6) Key issues:
a) Health related wraparounds:
• Child survival activities: PREFA will collaborate with other implementing partners working in the 31
districts in this area to implement this activity.
• Family planning: PREFA will emphasize provision of FP services at MCH settings as well as to families
at community level and will also procure a buffer stock of selected FP commodities for the districts.
• Safe motherhood: PREFA will collaborate with other implementing partners in this area.
• TB: PREFA will train Health workers in techniques of screening mothers for TB and then link them to
care.
b) Gender: PREFA will collaborate with other implementing partners in this area.
c) End of programme evaluation: PREFA will conduct internal and external evaluation of the programme
at the end of 2 year (process) and 5 year (terminal).
d) Mobile population: PREFA will collaborate with other implementing partners in this area.
e) Military population: PREFA will collaborate with other implementing partners in this area.
f) Workplace programmes: PREFA will collaborate with other implementing partners in this area.
PREFA will work with districts to strengthen health systems in all areas related to PREFA's work --
human resources for health, commodities, information systems, leadership and financial systems). In
addition, in two districts, PREFA will actively support integration of health services beyond HIV. This will
include examining the different causes of morbidity and mortality, supporting corresponding surveillance
or health information systems, working with District local governments and other partners to
systematically coordinate priority interventions and measuring population impact.
1) Target populations and programme targets.
PREFA shall support up to 628 health facilities (59 hospitals, 65 HCs IV, 424 HCs III and 80 HCs II) in
the 31 districts of Kampala, Kalangala, Mityana, Mubende, Kayunga, Wakiso, Nakaseke, Nakasongola,
services.
The target population includes 620,642 pregnant women and their male partners. 607,387 pregnant
women and their male partners shall be tested and given their HIV test results and the expected 40,335
HIV positive pregnant women identified shall be assessed for eligibility for ART using CD4 testing and/or
WHO staging. All the identified HIV positive pregnant women shall be offered ARVs/HAART for
2) Description of service delivery or other activity to be carried out.
PREFA together with her partners will test all pregnant women and their partners for HIV and given their
results. Those found to be HIV positive will be assessed for ART eligibility using WHO clinical and or CD4
testing with those with CD4 count = 350 will be referred for ART. They will also be offered ARVs for
prophylaxis according to WHO / MOH guidelines. For those who deliver, ARV prophylaxis will be
appropriately given to their infants and linked to care through HIV exposed infants care points where DBS
will be done. Tracking of lost to follow infants will also be carried out under this programme. The DHT will
also be facilitated to do quarterly support supervision. Each district will dedicate specific staff to transport
and deliver CD4 and DBS from to the health facilities. PREFA will also procure selected commodities in
order to mitigate stock outs hence avoid interruption of services. Appropriate skills and training will be
provided to the health workers in line with approved MOH trainings. PREFA will also strengthen
administration, management and information systems at all levels of the project.
3) Integration with other health activities.
A variety of approaches to enhance integration of PMTCT, RH, PHC and other HIV activities in the health
care setting will be done. Provision of Family planning will be emphasized as well as routine cervical
cancer screening. Also nutrition counselling and screening will also be integrated into PMTCT/MCH
programmes.
4) Relation to the national programme.
PREFA will collaborate with MOH, SURE, and NMS with districts to procure all necessary medical
supplies. We will also continue with regular participation in national PMTCT coordination committees that
oversee the PMTCT and paediatric programmes. PREFA will also continue to support the STD/ACP in
the development of a health sector HIV M&E framework and plan including PMTCT and paediatric care
and also orient the various DHT on its content.
5) Health systems strengthening and human resources for health.
PREFA will support the Districts to hire 31 staff (Midwives, laboratory assistants and peer counsellors).
Also 330 Health workers will be trained comprehensive HIV/AIDS care using IMAI/IMPAC approach.
Additionally 150 will be trained in infant and young child feeding, 90 in training of trainers in
comprehensive PMTCT counselling, IYCF and RH/FP, 930 CCAs will be oriented in PMTCT service
delivery including provision of modern FP services, 90 District PMTCT trainers will be refreshed on
PMTCT counselling, IYCF,EID and RH/FP, 210 family support group members will also be trained as
