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: 2010 2011 2012
UNICEF Zambia in March 2008 was awarded a grant from CDC to support the acceleration of the scale-up of PMTCT services as well as reduce the geographical inequity in the distribution of sites implementing PMTCT and pediatric HIV care services being provided in one of the northern region provinces of Zambia-Luapula Province. UNICEF worked with the MOH, Luapula Provincial Health Office (PHO), and District Health Management Teams (DHMTs) in the districts of Milengi, Samfya and Kawambwa. Through these efforts, PMTCT and Pediatric HIV service delivery at public sector facilities has been strengthened. The basic package of services that are being provided at the health facilities include counseling and testing (including child counseling); PMTCT; early infant diagnosis including referral of dried blood spot (DBS) samples for PCR examination, and identification and referral of children for pediatric ART. The identified sites will continue receiving HIV-related commodities (drugs, test kits, reagents, etc.) through the established supply chain management system. UNICEF has excellent relations with the PEPFAR supported programs such as Zambia Prevention Care and Treatment (ZPCT) and Centre for Infectious Disease Research in Zambia (CIDRZ) and will continue to work nationally, providing financial and technical assistance to selected districts of Luapula and Western provinces to expand implementation of PMTCT and Pediatric HIV care and support.
In FY 2010 the programs main goal will be to reduce the proportion of new HIV infections transmitted from mother to child transmission through the implementation of delivery of more efficacious dual and triple regimens for PMTCT and ensuring that HIV positive pregnant women who need ARVs for their own health are able to access them. In addition the program will aim at improving the quality and duration of life of HIV-infected women and their children and families through delivery of a comprehensive package of care in line with the 2007-2010 PMTCT/Pediatric HIV care national scale-up plan. UNICEF will continue to support the Ministry of Health (MOH) to improve PMTCT and Pediatric HIV care program management in Luapula and Western province and work with the PMTCT Technical Working Group to update guidelines according to WHO recommendations.
Goal
To reduce the proportion of new infections transmitted through mother to child transmission and improve the quality and duration of life of HIV-infected women, their children, and families, through the delivery of a comprehensive package of care to at least 80% HIV positive pregnant mothers and 80% infected children in line with the 2007-2010 national PMTCT/Pediatric HIV Care Scale-up Plan.
Objective
1. To optimize the provision of routine confidential Opt-Out HIV testing for prevention of mother-to-child transmission of HIV to 80% of pregnant mothers and pediatric HIV care, support and treatment services (including early infant HIV diagnosis) to 80% HIV infected children.
2. To strengthen infant feeding and nutrition advice, counseling and support for women, their children and families in the context of PMTCT and HIV care and treatment for children.
3. To integrate PMTCT and Pediatric HIV services as part of maternal neonatal and child health (MNCH) service delivery system.
Geographic areas
Using the routine screening model, all expectant mothers in Milenge, Samfya and Kawambwa district of Luapula province and Lukulu, Kalabo, Senanga and Shangombo districts of Western provinces.
Key Contributions to Health systems strengthening
Through this PMTCT grant UNICEF will assist the Government of the Republic of Zambia (GRZ) in offering a minimum package of care in antenatal clinics. The package includes taking a detailed medical and reproductive history, family planning counseling, emergency obstetric care, safe mother hood and relevant laboratory investigations. The set of routine investigations includes checking hemoglobin (Hb) which estimates the level of anemia if present, a screening test for syphilis (RPR) and a rapid (same day) HIV test. In addition, they are provided with folic acid and ferrous sulphate to build up blood stores, Fansidar for malaria treatment and Insecticide Treated Mosquito Nets (ITNs).
Cross cutting programs and Key issues
UNICEF will support the PMTCT/Pead ART TWG so that MOH can galvanize all partners and support evidence-based interventions and effectively oversee utilization of available resources.
UNICEF works closely with MOH and plays a key role in systems strengthening and advocacy at a national level. We will continue to facilitate counselling and testing (CT), using the "opt out" approach, for women and their partners integrated into antenatal care (ANC), labor and, in postnatal settings. CD4 count for all HIV-positive pregnant women using the sample referral system will be employed and determination of hemoglobin (Hb) levels in HIV positive mothers for the initiation of dual ARV prophylaxis will be assured. UNICEF will also continue to promote institutional deliveries, facilitate HIV testing of all HIV-exposed infants at the appropriate age (at six weeks if PCR is available, or at 9 and 18 months if no PCR is available and /or after cessation of breast feeding) and conduct routine counseling and testing for all in-patient children
Comprehensive care and support to mothers, children and their families (PMTCT-Plus) will be provided through post-natal prevention counseling; family planning and infant feeding counseling as well as community support and follow up.
Zambia has a strong immunization program integrated with growth monitoring and promotion. This link will be strengthened with routine testing of both the well child and any child admitted to health centre. The Maternal and Child Health program offers the opportunity for follow-up of exposed and infected children during postnatal visits at 6 days and 6 weeks, and facilitates co-trimoxazole prophylaxis for all HIV-exposed babies.
Integration of HIV services in Child Health Week and national immunization activities have been piloted in 2009 and the success of this will be replicated in coming years. The 'Road to Health' card has been updated to include the HIV status of the mother antenatally and where infant testing is available the child's status is indicated too.
Integrated reproductive health services offer a package that includes not only PMTCT, Malaria prevention but family planning too. FP starts in antenatal period at the same time that HIV CT are being offered and continues through postnatal period.
Capacity building of health care workers in PMTCT, pediatric HIV care management, Integrated Management of Childhood Illness (IMCI) and counseling services are a priority. UNICEF will continue to work with PEPFAR projects (ZPCT and CIDRZ) in the implementation of PMTCT services and Pediatric HIV care, infant young child feeding in the context of HIV and safe motherhood in FY 2010.
UNICEF will support the MOH to conduct the bi-annual technical supervision offered by the provincial and district health offices technicians to build capacity of health staff at health facilities. Additional support will be provided to conduct the quarterly PMTCT/Ped ART data audit meetings at every provincial site.
PMTCT one time plus-up funds are being added to support UNICEF in the provision of training in infant feeding to nurses to improve the quality of nutrition within the national PMTCT program.
