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 2013
Clinical and Laboratory Standards Institute (CLSI) works strategically to provide capacity building assistance aligned with Ministry of Health (MOH) and CDC/PEPFAR goals. CLSI also supports broader country goals, developing mechanisms to strengthen individual laboratories, while supporting the enhancement of the national laboratory systems as a whole. Using a standards-driven approach, our goal is to raise the operational quality of the laboratories up to and including laboratory accreditation by implementing CLSI and other internationally accepted best practices. Our work is scalable to the level of the laboratory, and acceptable to various accreditation agency models.
CLSI's program builds on six phases of activities, ultimately providing assessments, training and direct technical assistance to strengthen the laboratory over time. CLSI's full cycle of program activities are typically conducted on a quarterly basis, including on-going advisement, mentor/twinning program, self-assessment, and continuous quality improvement (CQI) activities. Our results show that this approach reduces accreditation preparedness time by as much as 50%. In Tanzania and in Mali, accreditation/gap analysis scores improved from an average of 30% to 80% in approximately one year.
The six phases of our Laboratory Strengthening Program activities include:
1. Phase One (Assessment/Gap Analysis I): CLSI volunteers and staff conduct an on-site interactive Gap Analysis tour. Our program is scalable to suit the laboratory's design, and level of complexity. The Gap Analysis may be based upon CLSI's Key 2 Quality document, and an international accreditation model, such as ISO 15189 or WHO-AFRO.
2. Phase Two (Training and Education): In partnership with in-country lab staff and leadership, CLSI prepares training modules, directly addressing the needs of the lab and areas that require improvement. CLSI has over 30 training modules.
3. Phase Three (Mentor Program): Following our training programs, CLSI works closely to assist in the implementation of selected improvement plans and "best practices." CLSI's Mentorship and Twinning Program is a one to three month program, whereby our expert volunteers stay in country to work side by side with laboratory staff and managers to facilitate improvement strategies and continue to prepare the laboratories for accreditation. The goal of this program is to not only facilitate improvement but to empower and build long-term working relationships with laboratory staff, and expand their network of laboratory professionals and vendor services.
4. Phase Four (Self assessment): CLSI in partnership will facilitate the development of self assessment tools, with subsequent action items as defined for ongoing improvement to lead to accreditation and or sustain quality. The laboratory leadership conducts the self-assessment and report findings to the CLSI/Lab team. This is the first step of our approach to facilitating a peer review system in-country.
5. Phase Five (CQI): Upon review of the self-assessment, CLSI facilitates the development and implementation of CQI strategies. CLSI continues to provide ongoing advisement to sustain quality.
6. Phase Six (Gap Analysis II): CLSI together with in-country laboratory members will prepare and perform the second phase of the Gap analysis, beginning the cycle again.
Deliverables:
CLSI will provide necessary CLSI standards, guidelines and best practice documents for
dissemination in Zambia.
Two 12month CLSI memberships for Zambian MOH designees; including Infobase
CLSI's electronic access to over 200 CLSI approved and proposed consensus
documents.
CLSI will sponsor two individuals to attend the Leadership Conference in April 2011, and subsequent visits to clinical laboratories to observe best practices.
Beginning in September 2010 (or as funds become available), CLSI will plan the
initial Gap analysis (phase 1) visit of four labs during Quarter 1.
Quarter 2, CLSI will provide Quality Management/Capacity Building workshops
(phase 2).
The CLSI mentor program (phase 3) with be initiated by Quarter 4.
Quarter 4, CLSI will continue providing consistent support and advisement remotely
(phases 4 and 5) to facilitate a self-assessment and CQI to prepare for accreditation.
Measurable Outcomes:
After completion of our full scope of work and full program with on-going advisement:
i. Four laboratories will have achieved set milestones and/or be close to achieving
accreditation status.
ii. Key individuals will have the opportunity to participate in standards document
development.
iii. CLSI will have provided measurable anchors, in support of the Laboratory Strategic Plan and PEPFAR partner activities.
CLSI will have trained new mentors and trainers who will be invited as a CLSI volunteer to provide technical assistance and training to other countries and other labs in Zambia.
Number of laboratories supported to obtain accreditation up to 4.
Percentage of laboratory tests that have written standardized SOPs 100%.
Number of core standardized SOPs developed 30.
Number of laboratories enrolled in proficiency testing and EQA programs, and performing internal and external audits up to 4.
Number of laboratorians trained minimum of 60.
Overall increase in Gap analysis scores 50%.
CLSI will work closely with CDC Zambia to provide technical experts to the MOH to conduct activities that are described above for lab strengthening. The suggested budget for the full scope of work is estimated for four participating laboratories which will be chosen by the MOH. This funding level assumes CLSI administrative costs, indirect cost, and travel-related costs for CLSI staff and volunteer consultants. In-country meeting expenses are not included. CLSI staff works to coordinate program travel within Africa, ensuring judicious use of program funds.