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: 2007 2008 2009
This activity relates to EGPAF/CIDRZ (#9000).
The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)-Center for Infectious Disease Reseacrh in Zambia (CIDRZ)-supported government sites have enrolled 59,159 adults and children and started 36,675 on ART as of the end of July 2006. Presently, 44 ART sites in Lusaka, Eastern, Western and Southern Provinces are being supported. EGPAF-CIDRZ has trained 1,171 health care workers in adult & pediatric ART delivery. EGPAF-CIDRZ has presented 14 abstracts, published one paper with three additional papers currently in preparation.
EGPAF/CIDRZ plan to maintain the existing programs at the joint Government of the Republic of Zambia (GRZ) sites. There are four proposed components to this track 1.0-funded activity, including: (1) continued support for existing services at 41 sites in 16 districts, (2) a focus on women's health care, to include expansion of our cervical cancer screening program; (3) a pilot clinic-wide model for complete integration of HIV care and treatment services; and (4) focus on improved delivery of palliative care.
The successes of this program have been elaborated in activity #9000.
EGPAF through its partner CIDRZ will continue to provide support for 46,800 adults and 5,200 children under antiretroviral therapy (ART) care at 41 existing sites in four provinces. CIDRZ is on track to reach 52,000 cumulative on ART in 2007 and will continue to support these individuals through 2008. The goal is for 15 percent of the patients on ART will be children. CIDRZ will more fully integrate pediatric services within the clinics and strengthen pediatric services at all CIDRZ supported sites. To continue to provide quality services in ART clinics, CIDRZ will expand the training of nurses to equip them with the knowledge and skills needed to function in an expanded role, to thoroughly assess, examine, diagnose and treat simple conditions commonly encountered in HIV care and treatment. Long-term mentoring and follow-up will be provided to ensure that nurses continue to develop and enhance their physical assessment and patient management skills.
The CIDRZ team is particularly strong in women's health expertise with five full-time obstetrician-gynecologists in country. Major emphasis will be placed on, strengthening women's health services in the 60 sites that we support, building linkages between those services and HIV/AIDS care and treatment, and the expansion of their successful cervical cancer screening and prevention program in HIV positive women. Services that need strengthening include providing; better information and counseling around reproductive health issues, improved screening and treatment of sexually transmitted infections, HIV-specific family planning services, and referral for long-term HIV care and treatment.
The cervical cancer prevention project currently offers cervical screening and treatment services to HIV positive and AIDS women in four Lusaka Urban District Health Management Team Clinics: Chelstone, Mtendere, Matero Reference, and Kanyama. So far this program has screened 312 women starting ART, over half of whom have qualified for cryotherapy, and eight of whom have been referred to UTH for suspected cancer. In 2007, CIDRZ will expand cervical cancer screening services to five new Lusaka District clinics and three rural clinics for a total of 12 sites. We will also offer screening to all women seeking HIV care at existing sites, including those not qualifying for ART. At University Teaching Hospital and Monze Mission Hospital, CIDRZ will continue training in radical pelvic surgery and will provide ongoing professional education of Zambian healthcare providers around the subject of cervical cancer. New clinics will be provided with the equipment needed for cervical cancer screening services, including cryosurgery machines, digital cameras and attachments, examination tables with stirrups, and compressed carbon dioxide gas. In addition, the Community Services Unit at CIDRZ will provide patient and community education in 12 clinic communities. This will require a formalized community-based education program employing peer educators.
Currently, all EGPAF-CIDRZ supported sites provide ART services in dedicated clinics that care specifically for HIV-infected patients. This is a common model throughout Zambia despite discussion of service "integration." While this model works well at start-up, it can present human resource problems as the program expands. This activity supports a pilot offering HIV care and treatment services in all departments at one or more select clinics in
order to promote sustainability. Services will be organized so that the central component of care will be the ART pharmacy. All dispensations, irrespective of referring service, will occur at the ART pharmacy, as will adherence monitoring. Other departments, such as tuberculosis, maternal child health, and outpatient departments will be responsible for managing the patients, prescribing the medication, and monitoring for opportunistic infections and drug toxicities. This will mean that the majority of HIV-related medical care will be provided in the outpatient departments, rather than at a dedicated ART clinic thereby ensuring sustainability. Patients with complex medical problems will continue to be seen by more experienced clinicians with HIV-specific training, and part of this activity will involve extending basic ART and OI training to a much wider group of clinicians at the pilot facilities.
CIDRZ also aims to improve pain and symptom control at all CIDRZ-supported sites. Despite huge progress made in providing antiretrovirals (ARVs), palliative care remains an area of weakness. This includes both improved pain management and management of other symptoms. CIDRZ will integrate palliation into general ARV training, develop and implement palliative care algorithms and guidelines for all sites, procure adequate analgesics, identify and procure other drugs used for control of symptoms, and CIDRZ will work with Palliative Care Association of Zambia to ensure the more rational restriction of opiate drugs used for pain control.
Targets for this activity are presented in the EGPAF/CIDRZ (#9000) entry in this section.
