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.
Clinical Laboratory Standards Institute (CLSI) will provide technical assistance to standardize laboratory layouts and designs for efficiency and proper management. CLSI will assist the development and harmonization of standard operating procedures. It will support dissemination of CLSI standards, guidelines and best practice documents in Ethiopia. In addition, CLSI will develop competency assessment tools for the trainings at different levels. The implementation of clinical laboratory standards will increase efficiency of laboratory services, improve quality of services and leads towards accreditation of laboratory facility. In preparation for the laboratory accreditation, CLSI will work closely with CDC Ethiopia and Ethiopian Health and Nutrition Research Institute (EHNRI) to implement quality management system (QMS) practices through an active gap analysis program. Sites will be selected to pilot a quality management system gap analysis program. The gap analysis will identify current baseline QMS activities, assess progress in implementing quality management and work practice recommendations and help establish priorities for ongoing implementation. CLSI has the expertise and experience in implementation of the laboratory standards in different PEPFAR supported countries. The support is gap filling an critical in Ethiopia and CLSI will start preliminary activity with the reprogrammed budget and the activities will continue widely in COP08.
Table 3.3.13: Program Planning Overview Program Area: Strategic Information Budget Code: HVSI Program Area Code: 13 Total Planned Funding for Program Area: $ 10,515,000.00
Program Area Context:
PEPFAR Ethiopia has been providing significant support during FY05 and 06 in the development of various information systems where HIV/AIDS/STITB-HIV prevention, treatment and care intervention related data generation, capture, reporting, processing, storage and utilization through the various strategic information program areas. These have been geared towards integrating into as well strengthen the overall comprehensive Health Management Information System (HMIS) master plan currently being designed and implemented in Ethiopia by the Federal Ministry of Health.
While the term strategic information (SI) is not widely used in Ethiopia, PEPFAR Ethiopia in collaboration with several other major donors (e.g. Global Fund and World Bank) has undertaken several activities which address important elements in a comprehensive SI approach. Several technical working groups (TWG) have been established under the leadership of the Ministry of Health (MOH). The surveillance TWG is well established and has been very successful in fostering collaboration and consensus on data collection methods. The HMIS and M&E Advisory Committee, are recent and is still defining their scope. The TWG are made up of various organizations including government agencies and multilateral and bilateral organizations (including USG). While these TWG are valuable in developing consensus and leveraging resources effectively, there is still a need for more strategic information leadership from the MOH.
In COP06, progress has been made in implementing a coherent national M&E system supporting the "Three Ones" principle. There is a national coordinating organization, HAPCO, as well as functioning regional coordinating offices and district (Woreda) organizations. PEPFAR Ethiopia had been supporting the rollout of an HIV/AIDS prevention and care monitoring system including M&E systems for ART, PMTCT, VCT, TB/HIV, OVC and prevention activities. With PEPFAR's support the country has been able to implement a one national centralized monitoring and evaluation system. Moreover, physical and financial reporting system in M&E, HIV-QUAL/E and HIVQUAL/E software integration with the electronic patient tracking system and aggregated electronic systems at a national level have been supported. This monitoring system will roll out at the national level by focusing on building the capacities of regional, zonal, and district (Woreda) offices to supervise health facilities, collect aggregate data, and use it to improve quality of care at facilities under their supervision. The monitoring and evaluation mentorship program undertaken in the past year in collaboration with MOH and HAPCO regions and national universities to regional ART hospitals in the country need to be extended to include all facilities providing comprehensive HIV care and treatment. Moreover, sharing of data from program implementation needs to be strengthened so that policy makers and program people at different levels make informed decisions.
PEPFAR Ethiopia has assisted the MOH and regional health bureaus (RHB) to bring about significant improvements in the quality and rural representativeness of the HIV sentinel surveillance system. Moreover, it has supported the conduct of the 2005 EDHS+ survey and the systematic collection, analysis and dissemination of surveillance data from TB/HIV, STI and counseling and testing services. The information generated from these activities was used for HIV/AIDS care, treatment, prevention, and control program planning and M&E. However, the findings from these surveillance activities recommend the need to look at the level of HIV infections and risk behaviors in general populations of some rural hot spots and among specific population groups that practice high risk behaviors. In addition, more needs to be done to improve rural representation and quality of data generated through in the ANC-based sentinel site HIV surveillance despite all the improvements seen in the system over the past years.
During COP07, the support for the national monitoring and evaluation framework will continue. Medical records (paper-based as well as electronic) management will also be supported to capture and use the vast amount of clinical data generated from facilities. With the advent of treatment for HIV/AIDS, the country has started to monitor patients suffering from a complex chronic disease. This activity needs to be strengthened and expanded to all ART sites. While there have been efforts to develop standardized monthly reporting forms, the level of data needed for day-to-day patient monitoring must be strengthened
through effective medical records management, which must be supported by an electronic systems. The SI TWG will closely work with others TWG in effective implementation of the health network model between hospitals, health centers and the communities.
The certificate level formal course of study in monitoring and program evaluation supported by PEPFAR Ethiopia has helped to solve some of the problems associated with the lack of trained SI personnel. This program has to be expanded to include post-graduate level program that would involve the five regional medical schools and international partners as required. The one-year leadership in strategic information training program has also to expand in to a two-year field-based, service-oriented Master's degree level training program if the weak SI system of the country is to be strengthened to ensure sustainability.
To enhance the data generation and use at facilities, support will be provided to the hospitals and health centers providing HIV prevention, treatment and care services in data management for program improvement. These activities will be linked with the national M&E support activity.
The government has recently begun installation of a high-speed communications network (funded by World Bank) which is anticipated to reach every district (Woreda) and which is designed to allow shared use by local government, education, health, and agricultural sectors.
Program Area Target: Number of local organizations provided with technical assistance for strategic 930 information activities Number of individuals trained in strategic information (includes M&E, 4,036 surveillance, and/or HMIS)
Table 3.3.13:
