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
This continuing activity from COP 2010 focuses mainly in developing capacity of health care providers and HIV/AIDS program managers at different levels to provide improved services of comprehensive HIV prevention, care and treatment using Integrated Management of Adolescent & Adult Illness and integrated Management of Childhood Illness (IMAI/IMCI) methodology.
Over the last five years, Ethiopia's response to the HIV/AIDS epidemic has shown considerable progress and achieved encouraging results. This progress was noted across all sectors but, most notably, in the health sector response of HIV/AIDS. Currently the government of Ethiopia is scaling up the HIV prevention, treatment, care and support services towards universal access by 2010. In line with this, the country is decentralizing the HIV treatment (ART) and care services and to date a total of 632 ART sites (146 hospitals, 383 health centers and 3 NGO clinics) have started providing the service. As a result, more than 443,964 PLWHA have been enrolled in HIV care and treatment services while more than 246,367 eligible PLWHA have been started with ART in the country.
In support of the scale up, WHO is contributing to the national efforts by providing technical and financial assistance to MOH/HAPCO at different levels through expanding access to HIV testing and counseling, scaling-up ART, care and support, maximizing HIV prevention in the health sector, generating and using strategic information as well as strengthening and expanding health systems. Accordingly, WHO has contributed in development of national normative guidelines, strategic documents, training materials, tools and capacity building of health workers and HIV program managers based on IMAI/IMCI. Additionally, WHO has contributed in conducting national HIV programs' assessments, supportive supervisions and review meetings at different levels.
The geographic coverage for WHO will be national and target groups include general population including PLWHA. In continuing the activities, WHO in collaboration with PEPFAR Ethiopia key partners will provide on-going technical assistance to MoH/HAPCO at different levels in further scaling up of comprehensive HIV prevention, treatment and care services in the country. This will be based on the principles of comprehensive public health approach which include simplification and standardization; decentralization in integrated delivery of care; equity; task shifting including participation of people receiving antiretroviral therapy and the community.
Activities will include: adaptation, standardization and dissemination of IMAI/IMCI new updates to be addressed in national comprehensive HIV care/ART training curriculum, tuberculosis care with TB/HIV co-management, Prevention of Mother to Child Transmission of HIV (PMTCT), reproductive health (RH) and family planning (FP). The integrated management approaches to health system using IMAI/IMCI will improve the case management of adult & pediatric ART services, TB/HIV co-management, STI management, improved maternal health services through the expansion of an integrated approach to PMTCT, and RH/FP. This will ensure that Ethiopia continues to benefit from innovative technical approaches supporting the integrated health services across the care continuum for patients.
WHO found the findings and recommendations of the PEPFAR Ethiopia/USAID mid-term evaluation of IMAI program in Ethiopia, September 2008, very crucial and timely in the process of improving the quality of the comprehensive HIV prevention, treatment and care services particularly at the health center level. In view of this, WHO will continue working with other PEPFAR Ethiopia/USAID, notably with MSH Care and Support follow-on project to address the gaps/challenges identified as well as the recommendations came out from the evaluation.
As to the quality of data on HMIS particularly the patient monitoring, WHO will continue supporting the MOH at different levels in strengthening the monitoring and evaluation system including electronification of patient monitoring data, conducting regular supportive supervisions and review meeting in order to have an improved quality of services. Strengthening of the non-ART data and establishing a coordinated linkage of HIV related activities within health facilities is very crucial. This will be done through regular site visits, during which review of recording and reporting formats will take place.
As one of the major components of health system strengthening is human resource, WHO will continue strengthening the health system through providing technical assistance to MOH on the implementation of the "Treat, Train & Retain" initiatives, seconding expert staff at the federal and regional levels as well as capacity building of the health workforces at different levels. Moreover, WHO will continue supporting the Global Fund Country Coordinating Mechanism (CCM) to facilitate, support and monitor the implementation of the Global Fund.
For the COP 2010 WHO Ethiopia will continue being active member of different national technical working groups on the areas of HIV care and treatment. With this WHO will focus on updating new developments, adaptation, standardization, printing and dissemination of national normative guidelines, strategic documents, training materials, tools including job aids.
Based on IMAI/IMCI methodology WHO will provide trainings for different cadres of health care providers and these include the national comprehensive HIV care/ART training for the health centers' clinical team (physician/health officer, nurse, pharmacy personnel & lay adherence counselor), who treat the adult HIV positive clients in the health centers. In line with this, WHO will provide trainings for the Expert Patent Trainers, who will be utilized as facilitators in the comprehensive HIV care/ART trainings for health workers by simulating (role playing) different cases related to HIV care and treatment. WHO will also provide trainings for heath workers on STI syndromic case management, PMTCT (in context of strengthening and integration of PMTCT in the RH/MCH services), TB/HIV and clinical mentoring.
In building the capacity of health care providers through continued learning process and based on the findings on the national clinical mentoring assessment, WHO will provide support to the RHBs in development of regional clinical mentoring implementation plan and build the regional capacity to coordinate the clinical mentoring program. All these activities will be done in coordination with other PEPFAR Ethiopia partners particularly MSH Care & Support Contract in order to avoid any duplication of efforts.
In the area of strengthening the regional, zonal and woreda health structures on the comprehensive HIV prevention, treatment and care services, WHO will continue providing support to the regional, zonal and woreda HIV/AIDS program managers through District Coordinators Course (DCC) training based on IMAI. And this would capacitate the HIV program managers at different levels to have appropriate planning, regular supportive supervision and coordinate the comprehensive HIV prevention, care and treatment services.
WHO will closely working with the RHBs, local universities and regional health colleges to create a pool of trainers in all regions. Thus, intensified training of trainers (TOT) will be conducted for the potential trainers selected from regional health facilities, public and private local universities and colleges. This would help the RHBs to cascade the required training of health care providers accordingly. On the other hand, as sustainability of the decentralized ART program is very crucial, WHO in partnership with PEPFAR Ethiopia, RHBs and local universities/colleges will focus on the further development and finalization of the pre-service training curriculum as well as on the pre-service training.
WHO will continue providing technical and necessary logistic support for MOH/RHBs to have regular supportive supervisions and review meetings to improve the quality of services. In the context of data management/monitoring and evaluation, WHO will provide support in capacity building of data clerks and data managers to improve the quality of data handling and reporting. In collaboration with relevant PEPFAR Ethiopia partners, WHO will continue working on the development of electronic (software) of patient monitoring data management system.
In the areas of "Train, Treat and Retain" initiative, WHO continue supporting the capacity building of health workers on Infection Prevention (IP) and PEP and will provide technical assistance MOH at different level in further development of health workers' retaining mechanisms.
World Health Organization (WHO) Ethiopia will continue to be an active member of different national pediatric technical working groups with focus on updating new developments, adaptation, standardization, printing and dissemination of national normative guidelines, strategic documents, training materials, and tools, including job aids.
Based on the integrated management of childhood illnesses (IMCI) methodology, WHO will continue to provide training for health care providers particularly at the health center level. Further, WHO will provide trainings for the expert patent trainers, who will be utilized as facilitators in the comprehensive HIV care/antiretroviral therapy (ART) trainings for health workers. To ensure sustainable technical capacity, WHO will work with the relevant partners to review and develop pre-service training curriculum.
As a way of building the capacity of health care providers through continued learning process, WHO will provide support to the Regional Health Bureaus (RHB) in development of regional clinical mentoring implementation plan and build the regional capacity to coordinate the clinical mentoring program. All these activities will be done in coordination with other PEPFAR Ethiopia partners particularly the MSH Care & Support program in order to avoid any duplication of efforts.
To strengthen local capacity for managing pediatric HIV programs, WHO will continue to provide support to the regional, zonal, and woreda HIV/AIDS program managers through District Coordinators Course (DCC). Further, WHO will continue providing technical and necessary logistic support for Federal Ministry of Health/RHBs to have regular supportive supervisions and review meetings. In addition, WHO will provide support in capacity building of data clerks and data managers to improve the quality of data handling and reporting. In collaboration with relevant PEPFAR Ethiopia partners, WHO will also continue working on the development of an electronic (software) patient monitoring data management system.
The Government of Ethiopia has Country Coordinating Mechanism (CCM) which was established in early 2002. The 17 CCM members include: Ministry of Health (MOH, 4 members including Chair); HIV/AIDS Prevention and Control Office (HAPCO) (1); Ethiopian Health and Nutrition Research Institute (EHNRI) (1); WHO (2: the WR as CCM Member Representing Bilateral Institutions and the HIV/AIDS Team Leader as CCM Secretary as of August 2008); Joint United Nation Program on HIV/AIDS (UNAIDS) (1); Health, Population and Nutrition (HPN) Donors' Group (2); PEPFAR Ethiopia (1); Department for International Development (DfID) (1); Christian Relief and Development Association (CRDA) (1); Vice Chair Dawn of Hope (Association of PLWHAPLWHAA) (1); Ethiopian Chamber of Commerce (ECC) (1); Ethiopian Public Health Association (EPHA) (1); and the Ethiopia Inter-Faith Forum for Development Dialog for Action (1).
PEPFAR Ethiopia has made major contributions towards implementation of the Global Fund. Some examples of the depth and scope of PEPFAR's involvement include: active membership on the CCM since its inception, technical assistance for proposal development, support of the Secretariat since November 2003, and chairing the sub-committee tasked to prepare the mechanism's Terms of Reference (TOR). During FY05, FY 2006, FY 2007, FY 2008 & FY 2009 PEPFAR provided modest funds to support the CCM Secretariat. This USG contribution leveraged funds from UNAIDS and the Royal Netherlands Embassy, and has been managed through the WHO Ethiopia Country Office. PEPFAR Ethiopia proposes to continue this modest funding in COP 2010 to assure the successful management of Ethiopia's grants in HIV/AIDS, Malaria, and TB.
