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
While scale-up of HIV care and Anti-retroviral treatment (ART) has been rapid, with nearly 250,000 Zambians currently on ART, HIV prevention has not shown the same success and more adults become infected each year than are placed on ART. HIV prevalence in pregnant women was highest in 1994 at 20%, but declined only to 19% in 2004 and 17% in 2007/8. Two population-based DHS+ surveys have been completed, with HIV prevalence in the general adult population of 16.3% in 2001/2 and 14.3% in 2007. Women have higher prevalence than men (16.1% vs. 12.3%), and rates in urban areas are double that of rural (19.7% vs. 10.3%). While declines in HIV prevalence are substantial in the 20-29 year age groups in women and the 25-34 year age groups in men, young people make up the majority of new cases of HIV. Despite reaping the immediate benefits of rapid scale-up of HIV prevention and treatment initiatives, Zambias HIV prevalence has stabilized at high levels (14.3%). The epidemic among Zambias 12.9 million residents is driven by heterosexual transmission. It is estimated that 71% of new infections in the future will occur in people with non-regular sexual partners and 21% in people with one reported sexual partner. The major drivers of the Zambian HIV epidemic include: Multiple and Concurrent Sexual Partners (MCP); low and inconsistent condom use; low levels of Male Circumcision (MC); mobility and labor migration; vulnerability among most-at-risk populations (such as sex workers and in male-to-male sexual relationships); and vertical transmission from mother to child (MTCT). Furthermore, underlying social factors and behaviors such as alcohol abuse, gender inequality, beliefs about male dominance and sexuality, gender-based violence (GBV) and sexual coercion, taboos and barriers regarding couple communication about sex, trans-generational and transactional sex further fuel the epidemic.
To date, prevention efforts have been concentrated in urban areas and have achieved moderate success. Zambian prevention programs must also focus more on targeting their efforts to the most geographically-needy areas in the country. Though urban HIV prevalence is declining, rural prevalence is rising. The epidemiological challenges in Zambia necessitate an intervention that addresses the underlying issues that prevent the utilization of community level interventions in high-prevalence areas. HIV prevention programs have tended to reach out to urban populations, without seeking the buy-in of local communities in designing and shaping their HIV prevention efforts. A program that motivates communities to own their HIV prevention efforts, reaches out to the most vulnerable and provides community incentives to drive the achievement of HIV prevention would be a useful addition to ongoing Zambian prevention efforts. Catholic Medical Mission Board (CMMB), working with its partner the Society for Family Health (SFH), will implement a comprehensive, community-based HIV prevention project among the most underserved districts in Western Province. However during fiscal year 2011, FSH will not be a sub-partner, but as resources become available in susquent years SFH will be part of the consotium to provide Voluntary Medical Male Circumcision services.The project approach is informed by CMMB and SFHs extensive experience in successfully mobilizing and engaging communities in HIV prevention programs that better health-seeking behaviors. The project will increase the uptake of targeted community-level HIV prevention interventions through Community Compacts - agreements that incentivize comprehensive community-based prevention efforts that reduce the spread of HIV. Targeted communities will establish Compact agreements with the project to work toward achieving prevention goals that increase uptake of HIV prevention activities. The project will strengthen the HIV prevention initiatives at community level with linkages to health facilities and will implement its strategy in close collaboration with the Provincial Health Offices (PHOs) and District Health Management Teams (DHMTs). The initial targeted districts include Kaoma, Mongu and Lukulu with combined total population of 503,003.
The Project defines Compact Communities as residents of a catchment area of health facilities in targeted districts, due to Zambians close identification with their local health facility. The Project will promote Men Taking Action (MTA) initiative, CT services targeting couples, and PwP. The strategy will involve establishment of Community Compact Committees for each health facility catchment area. The Committees will comprise: health facilities staff; community leaders including chiefs, village headmen, herbalists; Traditional Birth Attendants (TBAs); the clergy; civic leaders; Community Health Workers (CHW); and members of Neighborhood Health Committees (NHCs). The Project will also seek support from the Community AIDS Task Forces (CATFs), the District AIDS Task Forces (DATFs) and the Provincial AIDS Task Forces (PATFs). This approach will ensure a strong foundation for buy- in by communities.
CMMB will develop an M&E system that captures relevant data from the Project, providing the appropriate tools and training for community workers (CHW, TBAs, FSWs, traditional community leaders and supervisors).
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