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.
The NBTS TA TBD will contribute to prevention of medical transmission of HIV through technical assistance to National Blood Transfusion Service for provision of safe and adequate blood and components to all transfusing facilities in Kenya. TBD will collaborate with Kenya MOH, U.S. Government in-country Emergency Plan team, and HHS/CDC Kenya office to improve the breadth, scale and quality of the Blood Safety program through mobilization of low-risk, voluntary non-remunerated blood donors, blood collection, transport through the cold chain, testing for transfusion transmissible infections (HIV, HBV, HCV, syphilis) at quality assured laboratories, establishment of national quality system, monitoring and evaluation, coordination and monitoring for appropriate clinical use of blood and outcomes of transfusion - haemovigilance. A comprehensive quality system covering the entire transfusion process, from donor recruitment to the follow-up of recipients of transfusion will be established. TBD will implement evidence based strategies to improve on program management and evaluation. TBD will build the capacity of local organizations responsible for blood safety and transfusion services.
Collection of blood only from voluntary, non-remunerated, low-risk blood donors, universal blood screening for HIV, hepatitis B and C viruses and syphilis and the appropriate clinical use of blood. All potential blood donors will receive HIV prevention messages. HIV positive donors will be referred for care, treatment and Prevention for Positive programs.
An adequate supply of safe blood in partner countries, prescribed by clinicians trained in the appropriate use of blood, is an important component of the U.S. President's Emergency Plan for AIDS Relief's (PEPFAR) global HIV prevention strategy.
TBD will build the capacity of NBTS and health care workers in technical, managerial and administrative capacity. Provision of safe blood will improve patient care and strengthen the laboratory capacity with equipment and information management systems. TBD will support hospital transfusion committees to improve collaboration of blood users and the blood banks.
This activity will establish linkages with HIV prevention and counseling programs for appropriate messages to blood donors. HIV positive donors will be referred to and HIV care & treatment services. Linkages will be strengthened with high blood using programs such as malaria and reproductive health as well as pre-service training institutions.
Collaboration with Injection Safety program will enhance medical waste management.
TBD will establish government commitment, support and recognition for the NBTS as a separate unit with an adequate budget, necessary legislation/regulation, management team, and the formation of an organization with responsibility and authority for the BTS. Additional funding sources including Global Fund will be identified. TBD will foster development and implementation of a budgeting and finance system for sustainability through cost recovery and/or annual budget allocation, will strengthen public-private-partnerships. TBD will give technical assistance on cost effectiveness for efficient systems in collection, testing and processing of blood. This will be done through improved financial management system, efficient automated blood testing systems and centralized testing of blood.
The technical assistance partner will give expert guidance to the National Blood Transfusion Service of Kenya (NBTS) in PEPFAR II. The NBTS consists of six regional blood transfusion centers (RBTC) which collect, process, test, and distribute blood, and nine satellite centers, which distribute blood to health facilities. The NBTS collaborates with three non-governmental organizations for mobilization of volunteer blood donors among high school, college and university students, community and faith-based organizations, and adults in the work place. Other partners strengthen hospital transfusion practices and raise awareness on blood transfusion through media. The TBD will give support to these blood safety stakeholders.
Previous technical support has included development of policies, standards and guidelines; guidance on procurement of reagents and equipment; infrastructural planning support; collection , screening, processing and appropriate use of blood; training of health workers and strengthening of a monitoring and evaluation system. The support has led to increased blood collections to over 140,000 units in the last two years up from about 40,000 in 2003. HIV prevalence among donors declined from 6% in 2000 to 1.4% in 2008.
Despite great progress some challenges still remain. Current blood collections stand at about 3-4 units per 1000 population which is below the WHO recommendation of 10-20 per 1000 population. Although NBTS recruits low risk donors, the Kenya AIDS Indicator Survey (KAIS), 2007 showed that about a third of blood is collected in hospitals from family replacement donors reflecting inadequate safe supplies nationally.
Goals and Strategies for the Coming Year
The technical assistant partner will work with NBTS and its partners to strengthen all activities related to blood safety as outlined below. Activities will build on and complement on achievements of PEPFAR-1. They will be in line with the Kenya National Strategic plan-3 (KNASP) and the partnership framework whose objective is to eliminate medical transmission in healthcare settings with emphasis on blood safety. Blood Safety Policies will be reviewed as necessary, disseminated and implementation supported. This will include transitioning of the NBTS to semi-autonomous status and implementing a cost recovery system to promote sustainability. NBTS will be supported to seek other funding sources from bilateral donors like the Global Fund and to engage public-private-partnerships to increase its funding base. Innovative methods of reaching a broader blood donor base will be implemented such as increasing knowledge on need to donate blood through mass media campaigns, use of cellular phone short text messaging (sms) technology and support for donor clubs such as Club-25. Information on blood donation will be disseminated through the prevention, counseling and testing programs along other prevention packages. This will mainly be done in outreaches for the general population and not for programs targeting the most at risk populations (MARPS) who may compromise blood safety. All blood donors will be notified of their blood screening test results and HIV positive donors linked to counseling care and treatment services. External quality assurance services will be outsourced to enhance testing. Quality management systems will be put in place and a roadmap to achieve WHO Step-wise accreditation of all NBTS blood banks be implemented. The move to improve quality through centralization of testing will be advanced by equipment installation in a second region of the country. Service contracts will be made for preventive maintenance of all the NBTS testing and processing equipment and incinerators. TBD will collaborate with the injection safety program for waste management. To improve monitoring and evaluation an internet based laboratory information system for the blood banks will be reinforced and linked to key health facilities. Linkage with programs that use a lot of blood such as malaria and reproductive health programs will be strengthened. In FY-10 the hospital end of the transfusion service will be strengthened through improvement of cold chain cold chain maintenance. Ten more hospital transfusion committees will be established and existing eight will supported to enhance good transfusion practices. A national haemovigilance system will be established. Plans to improve equity in distribution and access to safe blood will be developed. To improve human capacity development specialized training in blood transfusion medicine will be supported for physicians at Emory University or equivalent while technical laboratory staff will be sponsored to attend higher diploma training in Transfusion Science at the Kenya Medical Training College (KMTC) or equivalent.
