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
ACTIVITY IS MODIFIED IN THE FOLLOWING WAY
Activity Narrative
This Palliative Care activity links to HTXS (#9182) and HVCT (#9181), to CRS HKID (# 8852), to RAPIDS
HBHC (#8946), and AIHA HBHC (#8809). This activity links to HVCT (#9181) and HTXS (#9182) and to
other palliative care (HBHC), counseling and testing (CT), and prevention of mother to child transmission
(PMTCT) activities. The CRS SUCCESS II Project was a follow-on to the first SUCCESS Project. The
Close-Out/Phase-Over period is from October - December 2009.
By October 2008, SUCCESS II expected to receive a Cost Extension to cover the period October 2008 -
December 2009 that includes the last 3 months known as Phase-Over/Close-Out. "Phase-Out" refers to all
activities during the period of transition whereby CRS SUCCESS partners will transition their activities to
other potential USG partners. "Close-Out" refers to a specific set of required activities whereby the
SUCCESS award will end.
During Phase-Over, this activity will continue with the Palliative Care Prevention Package that includes
Positive Prevention; cotrimoxizole prophylaxis; provision of bednets to prevent malaria (supported by the
President's Malaria Initiative through RAPIDS); Clorin to ensure safe drinking water; increased support for
pediatric ART (P-ART) through the use of Dried Blood Spot testing of infants and referrals of HIV+ infants
for P-ART; nutritional counseling for People Living With HIV/AIDS (PLWHA), and risk reduction prevention
messages. SUCCESS II will continue to provide a quality package of adult and child palliative care, which
will include pain management in hospices. During Phase-Over , SUCCESS II will continue emphasizing
prevention for positives such as avoiding risky sexual behavior, promoting abstinence and faithfulness, and
reducing alcohol intake. SUCCESS will collaborate with USG Zambia to develop and implement a food
and nutrition strategy, including shifting to a "Food by Prescription" approach.
During Phase-Over, CRS will continue to provide quality, community-based palliative care (HBHC) services
through six Catholic Diocese home-based care programs and twelve faith and community-based hospices
in 45 districts providing geographic coverage to roughly 62% of all districts in Zambia at an average cost of
about $81 per client. Nationally, SUCCESS II will have 104 service locations. The SUCCESS M&E system
enables managers and staff to account for individual clients, analyze data effectively, and use data for
program management and planning.
SUCCESS II links to other PEPFAR-funded projects, such as AIDS-Relief, CIDRZ, and ZPCT, and to GRZ
services, for treatment of opportunistic infections (OIs), sexually transmitted infections (STIs), and for ART
and to Prevention of Mother to Child Transmission services (PMTCT), such as ZPCT. For example,
SUCCESS will provide PMTCT sites with coordinates of its home-based care programs, to which PMTCT
providers will refer PMTCT clients for follow-up in the community from birth through at least six months to
support breast-feeding and timely weaning using appropriate weaning and complementary foods.
SUCCESS will also refer female PLWHA who are (or may be) pregnant to PMTCT. All of the
aforementioned activities will continue during Phase-Over.
SUCCESS II is a leader in hospice care in Zambia. It leverages the nationwide health care infrastructure of
the Catholic Church to reach underserved, rural areas. SUCCESS II collaborates with RAPIDS, a HBC
project serving urban PLWHA, and refers clients to government health facilities for clinical care and ARV
treatment. SUCCESS II provides a standardized package of quality, holistic HBHC and services in-line with
international and national HBC guidelines. Quality assurance mechanisms will include caregiver checklists,
patient chart review, and monthly care improvement meetings between caregivers and nurse supervisors.,
all of which will be prepared and ready for handover to future grant holders.
The HBC service package includes home visits, basic nursing care, pastoral and psychosocial support,
malaria prevention, nutrition counseling, Clorin for household safe water to reduce diarrheal disease, DOTS
for HIV co-infected TB PLWHA, plus clinical referral for OIs, TB and ART. SUCCESS will identify more HIV-
positive infants and children in need of HBHC, nutritional support, and/or referrals.
SUCCESS II has established three care categories to provide a better match between client needs and
caregiver support: 1) HIV+ asymptomatic; 2) HIV+ symptomatic or 3) HIV+ in advanced stages of disease.
The SUCCESS II family-based CT model will identify newly infected clients earlier for appropriate treatment
and care. SUCCESS II will support and extend the outreach of ART, sharing the load of patient follow-on
monitoring and care. SUCCESS will support Prevention for Positives. For example, SUCCESS will
counsel PLWHA on behavior change (reducing alcohol intake to decrease risky sexual behavior, increasing
abstinence and faithfulness), nutrition, and provide appropriate, factual information prevention strategies.
SUCCESS II will continue to support hospices to improve the quality of in-patient care for PLWHA, and to
provide CT and family support including day-care for HIV+ children. FY 2007 was the launch of oral
morphine for hospices. SUCCESS II will continue to support the provision of oral morphine for quality pain
management and will continue to work with MOH to ensure that the initiative is extended further to HBHC
providers throughout Zambia SUCCESS II works with the Palliative Care Association of Zambia (PCAZ) to
ensure palliative care is included in the national HIV/AIDS strategy, Specifically during Phase-Over,
SUCCESS will ensure that all client data, program information and records and key documents will be
available for transfer to future grant holders. In particular, information on working with hospices, PCAZ and
GRZ on oral morphine will be available, discussed and transferred; this will include names and contact
details for key personnel in MOH, PRA and other relevant authorities necessary for the sustainable
provision of oral morphine to the hospices. SUCCESS will facilitate meetings between all parties to ensure a
smooth transition.
All SUCCESS II activities will continue during the Phase-Over; it will focus on symptom and pain control,
patient and family education, linkages with OVC, PMTCT, ART, TB program sites, and a standard quality
training package for HBHC volunteers and staff. It will increase referrals to pediatric services; ART and PC,
Activity Narrative: ensuring clinical care for children. SUCCESS II partners will procure basic medications especially oral
morphine and supplies for HBHC as needed, using private matching funds. SUCCESS II leverages non-
PEPFAR sources to ensure availability of basic medications for home-based care.
SUCCESS II care coordinators will refer clients to needed services, and link clients to clinical care in district
and provincial facilities, to ART services, and follow up with community-based adherence support. Partners
also link to local branches of PLWHA and OVC support groups and to local GRZ structures. All of this
information and records concerning the same will be available for transfer to follow-on award holders.
Similarly, names of trained volunteer caregivers and nurses who supervise them, will also be given. In
particular, SUCCESS has actively recruited male and youth caregivers, a specific training was developed in
collaboration with APCA for male caregivers. The names and location of the aforementioned groups will be
transferred to any future parties. If necessary, information or training in the use of the male caregivers
curriculum will be given to ensure its continuation into future grants and to ease gender-based burdens in
care giving. SUCCESS II will continue to offer its volunteers monthly support meetings, tools for work, and
CT services details of which will be transferred.
SUCCESS will, during the Phase-Over period, continue to support gender equity efforts in palliative care
(led by SHARe), for example, to reduce violence against women related to HIV diagnosis or discordant HIV
results. SUCCESS will also support efforts by SHARe to promote leadership initiatives, especially those
focusing on promoting increased leadership roles for PLWHA in all HIV/AIDS activities. SUCCESS will
support efforts by AIHA-PCAZ to advocate for, promote, and disseminate policies and guidelines for
comprehensive palliative care.
SUCCESS II will use the APCA Palliative Care Outcome Scale as a measurement tool of improved quality
of life for PLWHA, findings of which will be analyzed and available for follow-on awardees.
Annual meetings have been a feature to bring SUCCESS II partners together for cross-fertilization of
programming ideas, issues, and lessons learnt; during the Phase-Over period there will be at least one such
meeting. This meeting will serve as a time for all SUCCESS partners to meet and to share lessons learnt
from the program.
Because most care and support clients are carried over year to year, CRS SUCCESS expects to reach
almost the same number in COP 09, 38, 320, as in COP 08, although it will provide the services for one
month.
All SUCCESS II targets will be reached by the end of the Phase-Over period, December 31, 2009.
New/Continuing Activity: Continuing Activity
Continuing Activity: 14374
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
14374 3568.08 U.S. Agency for Catholic Relief 6807 527.08 SUCCESS II $3,100,000
International Services
Development
9180 3568.07 U.S. Agency for Catholic Relief 5058 527.07 SUCCESS II $3,100,000
3568 3568.06 U.S. Agency for Catholic Relief 2930 527.06 SUCCESS $2,145,000
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
Health-related Wraparound Programs
* Malaria (PMI)
* TB
Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.08:
This activity is linked to HBHC (#9180), HVCT (#9181) and to other ART adherence and PEPFAR-funded
palliative care projects. SUCCESS does not provide ART directly, rather, it supports adherence by clients
of other direct ART providers. The CRS SUCCESS II Project was a follow-on to the first SUCCESS
Project. The Close-Out/Phase-Over period is from October - December 2009.
During Phase-Over, partner activities will include the provision of comprehensive palliative care that
includes C&T, ART adherence, ART referrals, pediatric palliative care, transfer of all SUCCESS related data
on clients, volunteers, program staff and activities. All efforts will be made to ensure the smooth transition
of service delivery at SUCCESS RTL sites during the Phase-Over period. SUCCESS staff will facilitate this
transition by providing technical support to implementing partners for the transfer of data, client and financial
records.
SUCCESS targets of 2,500 PLWHA for ART adherence support will continue to be met during the Phase-
Over period. SUCCESS referral linkages will be solidified prior to Phase-Over, SUCCESS RTL will ensure
that all signed MoUs between Diocesan and Hospice partners with AIDS-Relief, CIDRZ, DHMTS and ZPCT
ART sites will be transferred to future USG partners. This transfer will be important for the continuation of
the two-way referral system - from Home-Based Care/Hospice to ART clinical facilities and back for
adherence support.
During the Phase-Over period, SUCCESS II will continue to promote and support the rapid scale up of ART
for Zambian PLWHA through its partners. Pediatric ART (through referrals) and adherence referral and
support will also continue. SUCCESS II will continue the referral of as many of its Home-Based Care
clients and post-test HIV positive people to USG-supported ART sites during the Phase-Over period so that
the target of providing adherence support for 18,945 PLWHA will be achieved by the end of project. The
use of SUCCESS RTL adherence vehicles will continue to ensure that ART clients who live far from ART
sites to the clinic for care or for ARV re-supply will be supported as a means to boost adherence, and to
minimize the difficulty of reaching ART sites for PLWHA who live in remote areas.
During the Phase-Over period, SUCCESS will continue to promote Positive Prevention as well as a gender
balanced approach to care and inclusion of clients. GIPA principles will also continue to play a role in the
program and these guiding principles will also be transferred to any takeover parties.
A further dimension of sustainability will be achieved when Home-Based Care or Hospice /ART clients
return to active family and community life, knowing how to manage their now-chronic illness. Many
positive-living PLWHA become role models in their communities helping to reduce stigma and effectively
breaking one of the barriers of accessing treatment for HIV. Collaboration across SUCCESS II partners is
achieved in numerous ways. Annual meetings have been a feature to bring SUCCESS II partners together
for cross-fertilization of programming ideas, issues, and lessons learnt; during the Phase-Over period there
will be at least one such meeting. This meeting will serve as a time for all SUCCESS partners to meet and
to share lessons learnt from the program.
All SUCCESS RTL targets will be reached by the end of the Phase-Over period, December 31, 2009.
Continuing Activity: 14376
14376 3734.08 U.S. Agency for Catholic Relief 6807 527.08 SUCCESS II $1,370,000
9182 3734.07 U.S. Agency for Catholic Relief 5058 527.07 SUCCESS II $760,000
3734 3734.06 U.S. Agency for Catholic Relief 2930 527.06 SUCCESS $425,000
Table 3.3.09:
This activity links to HBHC (#9180) and HTXS (#9182) and to other palliative care (HBHC), counseling and
testing (CT), and prevention of mother to child transmission (PMTCT) activities. The CRS SUCCESS II
Project was a follow-on to the first SUCCESS Project. The Close-Out/Phase-Over period is from October -
December 2009.
During Phase-Over, partner activities under HVCT will include Counseling and Testing (CT) that includes
the use of finger-prick methodology in the community; greater focus on the palliative care prevention
package in all service settings including CT; as well as increased support for Pediatric ART (PART) through
screening of infants using Dried Blood Spot (DBS) samples for diagnosis using Polymerase Chain Reaction
technology, where available, with consequent referral of HIV positive infants for PART and PMTCT.
SUCCESS II will continue to support partners plans for sustainability by providing ongoing technical support
to the end of the project. This will include assisting the partners during the Phase-Over to other USG
partners by ensuring that all SUCCESS C&T data and information relating to clients such as client records
are available for any future parties. All efforts will be made to ensure that the transition period is a smooth
one for program staff, volunteers and clients.
SUCCESS II has established a large platform for HIV service delivery in six of nine dioceses (7 provinces)
in Zambia. SUCCESS II views CT as an integral component of high quality, community-based palliative
care (HBHC). SUCCESS II has achieved its CT targets in 45 of Zambia's 72 districts (geographic coverage
of more than 62% of all districts) and trained 850 persons, including health workers, caregivers, teachers,
and local leaders in counseling or testing, as well as pediatric CT. SUCCESS II works largely in rural areas,
the cost per client therefore is higher than for CT delivered in densely populated urban and peri-urban
areas. The target and cost estimate rely heavily on provision of test kits by the GRZ's District Health
Management Team, which the USG is supporting through the JSI/Supply Chain Management Services
project. All of this relevant information will be documented and transferred to future grant holders.
SUCCESS II will continue until the end of the project to support its partners in the provision of on-site CT
services that meet national and international standards. CT, the entry point for HIV/AIDS care and
treatment, enables SUCCESS II to identify and refer PLWHA early for palliative care and ART. Early
identification of HIV infection allows PLWHA to initiate behavior change and participate in Positive
Prevention programming. This reinforces USG Zambia Prevention targets. It also helps in preventing or
delaying orphanhood for Zambian children born to couples, in which one or both partner is HIV-positive,
provided that they take appropriate precautions.
SUCCESS II has set an indirect target of referring at least 4,550 individuals found to be HIV positive for
ART, including infants and children.
Catholic Diocese partners will mobilize communities and use community participation to increase
acceptance and the uptake of CT, taking CT activities directly into the communities and households.
SUCCESS-II introduced finger-prick testing technology at a community level following NAC/GRZ and
International CT guidelines. This builds on the established care relationships in the communities and allows
for privacy and convenience of CT in the home. Since rapid testing is not effective in infants under 18
months, they will either: a) drawn a drop of blood for PCR analysis using Dry Blood Spot (DBS) technology
(available in Lusaka, Livingstone, and Ndola); or b) where DBS and PCR are not available, home-based
care volunteers will visually screen infants for signs of "growth faltering" and other symptoms associated
with HIV/AIDS, and refer for presumptive clinical care until confirming diagnosis. This community CT model
also provides some relief for the health care human resource crisis in Zambia, by providing additional health
care providers to work in SUCCESS II rural service delivery sites and allowing scarce GRZ facility CT staff
to remain at their service sites to meet the increasing demand for CT services. The 850 individuals trained
in counseling and testing will continue to provide services for clients during the Phase-Over period.
SUCCESS II partners use a network model and create linkages to existing ART services. SUCCESS II
works hand in hand with the GRZ local health structures to coordinate CT services and link to other NGOs
and CT providers who operate Mobile Testing services.
SUCCESS II partners collaborate in numerous ways. Annual meetings have been a feature to bring
SUCCESS II partners together for cross-fertilization of programming ideas, issues, and lessons learnt;
during the Phase-Over period there will be at least one such meeting. This meeting will serve as a time for
all SUCCESS partners to meet and to share lessons learnt from the program.
All targets will be reached by December 31, 2009.
Continuing Activity: 14375
14375 3569.08 U.S. Agency for Catholic Relief 6807 527.08 SUCCESS II $1,000,000
9181 3569.07 U.S. Agency for Catholic Relief 5058 527.07 SUCCESS II $1,000,000
3569 3569.06 U.S. Agency for Catholic Relief 2930 527.06 SUCCESS $800,000
Table 3.3.14:
