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: 2008 2009
Under its cooperative agreement the CDC will continue to support the strengthening of the PMTCT
program to effectively screen patients and prevent the transmission of HIV, and provide adequate care and
support. HIV screening is integrated into the ante-natal care system which also includes screening for other
STIs. Currently there are 45 PMTCT sites (public and private) and in FY09 it is expected to increase to 110
PMTCT sites, the program will support the entire program, not just the 45 sites established through the
GHARP program during the first five years of PEPFAR implementation.
Pregnant women who qualify by national guidelines receive HAART during their pregnancies and
prophylaxis is offered to HIV+ pregnant women. The program will encourage partner testing for all STIs
including HIV, discordant couple counseling and consistent family planning for HIV positive mothers. New
initiatives are planned to reach such partners for testing outside the PMTCT program through targeted
counseling and testing activities given low turnout of partners in the PMTCT setting.
In 2009, transition of GHARP case navigators and outreach officers to the MOH will occur in a process
similar to the previous successfully implemented transition of nurses from GHARP to the MOH in FY07/08.
These social workers will continue to reach out to identify women who are not accessing ANC services and
link them to the PMTCT program, as well as screen women for possible cases of gender-based violence.
Strengthening the quality of services (counseling, and testing)
Appropriate infant feeding methods will continue to be promoted at PMTCT sites including the provision of
breast milk substitutes where appropriate.
Through the Cooperative agreement CDC will continue to provide rapid test kits, laboratory supplies,
counseling and referrals for family planning services, contract staff support, technical guidance, quality
assurance and strong links to care and treatment. Supported areas will include MOH data collection and
utilization, supervision of field implementation, educational materials and programs, and contract nurses for
providing and supervising services, including counseling at health facilities. Funds will also support related
staff training and travel and the development of IEC material. Psychological support will be provided for
PMTCT counselors.
CDC/GAP will also continue to support the MCH Unit and the MOH Strategic Information Unit for data
collection and utilization (including data entry staff and computers), supervision of activities at the field level,
and quality assurance. To improve the environment of HIV services in small health centers, CDC will
continue to support upgrades to ensure areas for confidential counseling and testing and adequate facilities
for family counseling and education
New/Continuing Activity: Continuing Activity
Continuing Activity: 15958
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
15958 15958.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $246,000
Disease Control & Guyana Health, Guyana
Prevention
Emphasis Areas
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Safe Motherhood
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $270,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Estimated amount of funding that is planned for Food and Nutrition: Commodities $75,000
Economic Strengthening
Education
Water
Table 3.3.01:
The Ministry of Health through its Adolescent Health Program have been targeting young people in and out
of school on the coastland and in the more remote areas using the secondary school system and health
clubs to educate young people about HIV prevention and the value of VCT. It is clear that there will be
great benefit to extend this program to the primary school level so as to encourage delay in sexual initiation.
This program embarked on during FY07 continued during FY08 and will continue into FY09. It is aimed at
increasing the knowledge of primary school children about HIV prevention by supporting the HIV component
of the Health Promoting Schools Strategy (HPS) and designing child-friendly and age sensitive HIV/AIDS
materials for that program. Primary school teachers will be taught how to use the materials and there will
be periodic evaluation to ensure the effectiveness of the program. Community support will be garnered for
the school based activities to ensure that behaviors taught at school are reinforced in the home. The MoH
Co-Ag will also include funds to carry on work to expand youth-friendly health services and health club
programs that emphasize AB education, counseling, and inter-personal communication sessions. This
activity was previously funded through the Global Health Fellows Program/CSDS transitioned to MoH in
July 2008. These activities complement those being undertaken through the MARCH initiative. USAID has
been supporting the unit technically and financially for several years through grants and the placement of a
prevention fellow in the Ministry of Health. In FY08 the program graduated to financial support alone,
allocated through the CDC cooperative agreement to the MOH.
The MOH Co Ag will include funds to carry on work to expand youth-friendly health services and health
programs that emphasize OP education for high risk youths, counseling, and interpersonal communication
sessions and the distribution of condoms will continue through NAPS and the MCH services.
Through the Cooperative agreement CDC will continue to provide contract support, at both the central level
and youth-friendly sites (YFS), technical guidance, development and production of educational and training
materials to empower youth through the development of leadership skills, and staff training and travel.
Targets include youth reached through the youth friendly health services initiative.
Continuing Activity: 15834
15834 15834.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $100,000
Gender
* Addressing male norms and behaviors
Estimated amount of funding that is planned for Human Capacity Development $60,000
Estimated amount of funding that is planned for Education $30,000
Table 3.3.02:
July 2008. These activities complement those being undertaken thorough the MARCH initiative. USAID has
Continuing Activity: 16899
16899 16899.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $25,000
* Increasing gender equity in HIV/AIDS programs
Estimated amount of funding that is planned for Human Capacity Development $15,000
Estimated amount of funding that is planned for Education $10,000
Table 3.3.03:
Through its Cooperative Agreement with the Ministry of Health (MOH), CDC supports the National AIDS
Program Secretariat (NAPS) for treatment services in Guyana. NAPS provides services at the Genito-
Urinary Medicine clinic (renamed National Care and Treatment Centre), the primary out-patient treatment
facility and other coastal facilities. In addition a mobile unit accesses remote regions of Guyana for
treatment, counseling and testing services (See separate activity under VCT). Since FY08 the mobile unit
has been staffed by a physician supported through the Cooperative Agreement. The mobile unit provides
ART services, phlebotomy services for treatment monitoring, and utilizes the national patient monitoring
system so all patients are accounted for and treatment progress is well-documented. NAPS will coordinate
all activities related to treatment services to ensure non-duplication of services between program areas and
regional health authorities. The CDC Cooperative Agreement also supports NAPS in its role as the national
authority for treatment guidelines and coordination of treatment linkages with other services.
1.One mobile unit is not adequate to meet the need of the remote regions. These services would be
expanded and will require the contracting an additional physician(s) and developing strategies for long term
human capacity needs.
2.Establishing a National Quality Management Program to monitor the extent to which care and treatment
provided complies with the national treatment guidelines for HIV/AIDS care.
Continuing Activity: 12738
12738 12738.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $75,000
Table 3.3.09:
CDC supports counseling and testing (C&T) services in Guyana through its cooperative agreement with the
Ministry of Health (MOH). This support includes counselor-testers at the MOH who serve the PMTCT
program and also training for counselor-testers ; in FY09 this program will continue to emphasize couples
counseling in order to increase the number of men seeking C&T. Other activities supported through the
National AIDS Program Secretariat (NAPS) will include provider-initiated counseling and testing in the
Family Health program and at clinical facilities. Contract staff including drivers, phlebotemists, clerks and
counselor-testers will be supported. CDC-supported staff will target youth through the Adolescent Health
Program; both in-school and out-of-school youth will be encouraged to know their status and to reduce risk
behavior through improved access to youth friendly counseling and testing sites. NAPS will continue to
provide C&T services to the hinterland areas through its mobile unit. CDC also supplies rapid test kits and
quality assurance for testing as detailed under laboratory infrastructure activities.
All training for counseling for HIV testing is implemented in collaboration with the MoH according to
established national curricula and guidelines and includes critical components on PMTCT, family planning,
disclosure, domestic violence, prevention counseling on abstinence, condoms, and partner reduction.
1.A USG/GOG common goal is for the complete integration of all counselor/tester training and curricula.
Such cross-training would develop personnel with the capability to implement comprehensive counseling
and testing (including provider-initiated) with no differentiation between a VCT, PMTCT, or youth-friendly
setting as well as include approaches for couples counseling, home-based testing, etc. This will call for a
revision in curriculum as well as refresher training for all current employees.
2.CDC will also support minor repairs and rehabilitation to existing facilities to provide youth-friendly and
family-centered integrated care to facilitate the provision of services.
Continuing Activity: 12721
12721 8673.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $136,000
8673 8673.07 HHS/Centers for Ministry of Health, 4720 2246.07 Ministry of $139,960
Workplace Programs
Estimated amount of funding that is planned for Human Capacity Development $80,000
Table 3.3.14:
Over the last four years, MOH has implemented HIV rapid testing at PMTCT and VCT sites, provided
infrastructural support for CD4 testing, provided technical, policy, human resources, and equipment support
for National Public Health Reference Laboratory (NPHRL), and in collaboration with the EU laboratory
strengthening project has strengthened the Quality Assurance (QA) program at central, regional and district
laboratories. In FY09, MOH laboratory activities will be aligned to the objectives of the National Strategic
Plan for Medical Laboratories 2008-2011. The main focus of MOH laboratory activities in FY09 will be to
support laboratory services required for the delivery of HIV care and treatment programs.
The bulk of these activities will be concentrated at the NPHRL and will include CD4 enumeration, chemistry
and hematology for drug toxicity monitoring and HIV rapid testing (for some VCT/PMTCT sites) and
confirmatory testing for all public sector care and treatment sites (including the regional sites as required). In
early FY08 CD4 enumeration for all public sector care and treatment sites was done at Central Medical
Laboratory (CML), Georgetown Public Hospital Corporation. This function has now transitioned to NPHRL.
HIV rapid/confirmatory testing and drug toxicity monitoring will also transition to NPHRL in late FY08
pending provision of appropriate laboratory equipment by MOH through Global Fund monies. In FY09 MOH
will ensure that the NPHRL and the care and treatment sites have the appropriate equipment required for
the delivery of high quality laboratory services. In FY 09 CDC will provided CD4 (NPHRL only), and
chemistry and hematology reagents required for HIV care and treatment programs to NPHRL and 4 regional
care and treatment sites through SCMS. MOH will ensure that these facilities are adequately equipped and
have appropriate infrastructure in place for automated testing and ensure that appropriate equipment
service contracts are in place.
In FY09 MOH will continue, with technical assistance from CDC, to develop laboratory services at NPHRL
to include HIV early infant diagnosis, viral load monitoring, and TB drug sensitivity testing. In FY 08 MOH in
collaboration with the Clinton Foundation and CDC implemented a protocol for pediatric testing that
included a system for shipping of specimens to an external reference lab until DNA PCR technology
became available in Guyana. The procurement of DNA PCR equipment (Global Fund) will occur by the end
of FY08. In FY09, the MOH will work closely with CDC (installation, training and TA) and Clinton Foundation
(reagents) to establish early infant diagnosis at NPHRL. In FY09 MOH with assistance from CDC will
continue to maintain and improve the laboratory TB program developed by Canadian Society for
International Health. This will involve training and procurement of reagents. MOH will expand the range of
OI to PCP, HSV and Cryptococcus in FY09. Establishment of TB drug sensitivity testing in Guyana will be a
major area of focus in FY09.
In FY 09 the MOH will continue to invest in the maintenance of the NPHRL by funding a facility manager
position and by ensuring that the appropriate facility service contracts (e.g. cleaning, security, maintenance)
are in place. In FY 09 MOH with support from CDC and other in-country partners will ensure that there are
clear plans for staffing of the NPHRL in the near and far term. As the NPHRL will require staff not currently
listed on the public service establishment this may require the MOH to hire contract staff to fill key positions
until they can be put on the establishment. In FY09 MOH will continue to fund NPHRL staff positions funded
in FY08.
In collaboration with CDC and ASCP MOH will continue to roll out training in hematology and chemistry to
the regional laboratories. Additionally, MOH will be working closely with ASCP to establish local certifying
board exams which will pave the way for local technologist to acquire the International ASCP certification.
This will involve review of the Medical Technology curriculum at the University of Guyana which will be a
continuous collaboration among ASCP, MOH and the University of Guyana.
MOH will work closely with CDC, FXB, APHL, and ASCP to identify training required for NPHRL and
regional/district hospital laboratory staff and facilitate local training and international training for key
technical and managerial personnel.
In FY 08 MOH supported enrolment of CML, regional laboratories and VCT sites in an External Quality
Assurance program. These activities will continue in FY09 with enrollment in EQA programs extended to a
greater number of sites, including NPHRL. In FY09 MOH will support QA managers at NPHRL to travel to
regional/district laboratories and VCT sites to provide oversight, training and assessment of compliance with
QA programs. In FY09 MOH will work with CDC to attain local certification of NPHRL (Guyana National
Bureau of Standards) and two regional laboratories.
In FY09 MOH will develop a sample transportation network including but not limited to HIV-related
specimens (laboratory networking) with the assistance of CDC and APHL. This will ensure appropriate
sample flow through the referral system and optimal utilization of limited laboratory resources, particularly in
the area of high-complexity testing.
Continuing Activity: 16055
16055 16055.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $85,000
Estimated amount of funding that is planned for Human Capacity Development $128,000
Table 3.3.16:
Through Atlanta and country-based technical assistance and financial assistance through a cooperative
agreement, CDC will work to improve the MOH capacity for internal SI and M&E. Through the cooperative
agreement funds will be obligated to provide contract staff, equipment, travel, supplies and contractual
services related to SI activities.
1.Currently, data collection at NAPS is not centralized in the M&E unit and responsibility lies with each
individual coordinator. A priority of the MOH is to make NAPS the central location for HIV/AIDS-related data.
The systematic and coordinated flow of data to NAPS will ensure proper data collection and usage. MOH
will ensure to make NAPS M&E unit the central repository of HIV/AIDS data.
2.CDC will support the Institutional Review Board in Guyana to facilitate public health evaluations,
surveillance, surveys and special studies.
Continuing Activity: 12750
12750 12750.08 HHS/Centers for Ministry of Health, 6269 2246.08 Ministry of $125,000
Estimated amount of funding that is planned for Human Capacity Development $99,000
Table 3.3.17:
