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.
N/A
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.12:
Program Budget Code: 17 - HVSI Strategic Information
Total Planned Funding for Program Budget Code: $625,000
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
OVERVIEW
Lesotho's National HIV/AIDS Strategic Plan (2006-2011) places priority on improving capacity to plan, gather, manage, report and
effectively use quality strategic information within and across programs. The National HIV/AIDS M&E Plan (2006-2011) is
currently under revision. While GOL agreed with the "Three Ones" principle, there are three HIV and AIDS M&E systems currently
coexisting in Lesotho: one managed by the Ministry of Health and Social Welfare (MOHSW) collecting health sector data, one by
the National AIDS Commission (NAC) collecting community-based data and one in by the Global Fund Coordinating Unit (GFCU)
within the the Principal Recipient, the Ministry of Finance. All hold quarterly reviews of their respective response to HIV and AIDS
epidemic. GFCU is planning to align its M&E system to the GOL's in the near future. With the decentralization of health services to
districts, a fourth body, the Ministry of Local Government and Chieftainship (MOLG), is playing an increasing role in monitoring
the community/ district level. In its revised HMIS Strategic Plan (2008-2012), MOHSW took the approach of integrating HIV data
within the general health sector management information system managed by the MOHSW Health Planning and Statistics Unit.
With the support of World Bank, a Lesotho Output Monitoring System for HIV and AIDS (LOMSHA) operations manual is currently
in development. This will define clearly how routine HIV response data should be managed by all stakeholders and service
providers.
CURRENT USG PROGRAM
PEFPAR/Lesotho provides support to national level SI activities through its SI Liaison. Prior to 2008, PEPFAR focused on building
M&E capacity for NAC, supporting the formation of the national M&E working group, and assisting in developing the design and
implementation of the National HIV program monitoring system. PEPFAR provided financial and technical support to the national
strategic information assessment and selected national M&E information products, including the 2005 National ANC HIV sentinel
surveillance survey and the 2004 Lesotho DHS. PEPFAR has also been instrumental in developing national HIV/AIDS indicators.
In Spring 2008, PEPFAR/Lesotho provided input to the revision of the National HIV/AIDS Strategic Plan through participation in a
national M&E assessment. PEPFAR also contributed to quarterly partnership forums sponsored by NAC to review the national
response to HIV/AIDS.
National level support activities have been hampered by the lack of a PEPFAR-funded SI partner. JSI's Enhancing Strategic
Information (ESI) project was recently brought on-board, and will be working closely with the SI Liaison to continue strengthening
national-level SI activities. PEPFAR/Lesotho also builds the capacity of its implementing partners to provide quality program data
and encourages data use at all levels in the development of strategic priorities.
Through the Southern Africa Human Capacity Coalition (SA-HCD), PEPFAR is supporting Human Resources Information System
(HRIS) activities and training managers and policymakers from MOHSW, CHAL, Ministry of Public Service, and training
institutions on data-driven decision making. SA-HCD is also providing TA to develop a Training Information Management System
(TIMS) and train staff at health training institutions, regulatory councils, and the MOHSW training department to use TIMS data to
rationalize intake of students into health training institutions and immediately recruit and deploy graduates. At the local and
community level, Pact continues to build its sub-grantees capacity in M&E and reporting and conducts data quality assessments.
USG FY 2009 SUPPORT
PEPFAR/Lesotho has three main priorities for FY 2009:
1. Strengthening the capacity of district health management teams (DHMT) and District AIDS Councils to carry out monitoring and
evaluation, manage data, and coordinate local implementing partners.
2. Improving the capacity for data capture, data quality and timely data use within PEPFAR-funded partners, and at the district
and national levels.
3. Supporting a more integrated approach to HMIS across all sectors (HIV/AIDS, TB, HR, etc.) in collaboration with the Millennium
Challenge Corporation (MCC) compact with the GOL.
In FY2009, the SI Liaison will provide leadership and management of SI activities with the assistance of new partner JSI/ESI. JSI
will 1) mentor DHMTs and district M&E officers (in collaboration with GF, WB/GAMET, UNAIDS, and MCC/MCA); 2) provide SI-
related trainings, workshops and on-going support; and 3) participate with PEPFAR SI liaison, MOHSW, NAC, and GF in joint
data quality assessments of HIV/AIDS programs across the health sector.
The SI Liaison, as a member of the National M&E TWG, will work with NAC, MOHSW, MCC/MCA, GFCU, World Bank/GAMET
and UNAIDS to develop a comprehensive review of the national response using Service Coverage Reports (to be produced
quarterly and annually), as well as monitoring of the national M&E plan implementation. Service Coverage Reports include results
against defined core output indicators, and will be used for monitoring the HIV response at district and national level. The
information for these reports will be collected from implementers at district level and collated by MOHSW District AIDS
Coordinators and NAC District Data Officers on a quarterly basis. So far, PEPFAR's contributions were collated by the PEPFAR
SI Liaison and reported centrally to NAC. In FY 2009, the SI Liaison will strengthen the ability of PEPFAR implementing partners
to feed data into the national reporting system directly and, together with JSI, assist NAC District Officers to manage all this data.
At the local and community level, a new umbrella organization (Pact follow-on) will continue to build the capacity of current and
new sub-grantees/indigenous organizations to monitor, evaluate, and report their programs. Additionally, this partner will work with
all sub-grantees in developing knowledge management processes and conduct data quality assessments.
In the revised HMIS Strategic Plan, one of the major management challenges acknowledged by MOHSW is the lack of timely
health data to support informed decision-making, which is due in large part to the weak Information, Communication & Technology
(ICT) infrastructure in the districts. Following the Rwanda assessment of Phones for Health, MOHSW requested MCC support in
assessing ICT infrastructure needs. As a result, MCC is currently the lead in supporting HMIS development with the MOHSW.
While MCC support will be more directed at infrastructure, PEPFAR, through JSI, will actively participate in future HMIS
development, by implementing activities that will ensure data standards and data confidentiality, building capacity of MOHSW staff
at all levels. DOD will provide technical assistance to the Lesotho Defense Force (LDF) in developing their Electronic Medical
Records system. PEPFAR Lesotho, through SA-HCD, will provide technical assistance to MOHSW to decentralize HRIS to the
district health and hospital management teams including the training information systems management team. HRIS will include
the community-based health service providers and social welfare department. JSI, in collaboration with GTZ, will also support
NAC and MOLG in developing community-based monitoring systems (e.g., Community Level Program Reporting - CLPR) to
monitor community delivery of the essential HIV and AIDS services package (ESP).
USG will provide support for several surveillance and survey activities. PEPFAR will work in concert with other donors to provide
TA for the 2009 DHS+. PEPFAR will also provide TA for writing protocols and conducting the 2009 ANC sentinel surveillance to
MOHSW through a planned cooperative agreement with CDC. DOD will work with the LDF to develop HIV prevalence and
Behavioral Survey protocols and assist with data entry and data analysis. Survey results will be used by LDF to update prevention
activities and to forecast care and treatment needs.
A priority for the PEPFAR team is data use for portfolio management, accountability to GOL, and feedback to partners for their
own evaluation and planning. FY 2009 funds will support a new database that will be used to track partner progress, budget
information, project timelines and document management, and to provide analysis capacity. Currently, performance and results
data are returned to implementing partners via partner meetings, annual performance reviews, and through ad hoc data requests.
The planned database will allow easier and timelier dissemination of data back to partners as well as the PEPFAR team, GOL and
other stakeholders via regular reports, and will allow more sophisticated evaluation and analysis capacity as data use and data
demand increases among the partners. The database will be created by JSI, and ongoing updates and maintenance will be the
responsibility of JSI.
LEVERAGING AND WRAPAROUNDS
USG Lesotho remains committed to a strong partnership, along with GF, UNAIDS, MCC/MCA, and WB/GAMET to support NAC
and MOHSW in the building of national and district-level HIV/AIDS-related SI capacity.
PROPOSED COMPACT EXPANSION
As PEPFAR/Lesotho moves forward to negotiate a Partnership Compact with GOL, we anticipate further strengthening SI
activities, particularly around linking together the many, non-integrated HMIS systems that have been developed or proposed. As
Compact negotiations are only at the early stages, we understand that we may need to revise expectations, and will be in touch
with our core team and DP "friend" as we move forward.
OTHER QUALITATIVE ACCOMPLISHMENTS
-All District data managers and NAC staff trained in M&E and data utilization by September 30, 2010
-Institute regular production of Quarterly Service Coverage Reports by September 30, 2009;
-ANC surveillance completion by December 2009;
-DHS survey data collection completed by September 2010
-Documentation of Lesotho health operations (governance and management structures, business practices and work flows) by
September 30, 2009.
-Data driven decision making curricula development to improve recruitment, deployment and retention of health workers; and
TIMS development to reduce vacancies and speed absorption of graduates, to address out-migration issues and improve
management of tutors and students by September 30, 2009.
Table 3.3.17:
