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 2012 2013 2014 2015 2016 2017 2018
In FY2012, DOD/PEPFAR activities supporting Lesotho Defense Force (LDF) will continue the successful collaboration which has been ongoing since 2002. The Lesotho Defense Force has seen tremendous scale up of their HIV/AIDS activities which include interventions to reduce stigma among military members living with HIV as well as military family members who are HIV positive. Military health care workers have been trained to provide home based palliative care for chronically and terminally ill clients. DOD supported the LDF to renovate and upgrade their current laboratory and procured a state of the art equipment, training of LDF nurses for ART, pharmacy training, provision of a mobile clinic for outreach to remote bases and surrounding communities, building of a wellness center which supports integrated care, conducted seropreavalence and risk factors study in the LDF and conducted a stake holders meeting for the dissemination of the results of the study, and implementation of an innovative electronic health record with portability for mobile services. PEPFAR funding has also supported education and sensitization of all ranks and family members on HIV prevention. DOD has also supported peer education, counseling and testing services. In 2012 DOD/PEPPFAR will support continued PMTCT training and provide alternative feeding supplements and training for mothers who choose not to breastfeed, LDF will hold workshops to disseminate the results of the seropreavalence and behavioral study to LDF senior officers and other ranks, support feeding for chronically and terminally ill patients and basic care activities including training to target reduction of stigma and discrimination, palliative care training, procurement of supplies for mobile clinic, training for peer educato
In FY13 DOD will support the care component of the Lesotho Defense Force HIV prevention program. The activity is focused on providing basic elements of clinical care and home based care, psychosocial care, and stigma reduction to military members living with HIV, as well as for any military family members. Services include prevention and treatment of opportunistic infections including provision of cotrimoxazole prophylaxis, provision of izoniazid preventive theraphy ( INH) for eligible clients, screening and care for sexually transmitted infections (STI's) screening and alleviation of of HIV related symptoms and pain. DOD will support training of LDF health care workers in proper prophylaxis and management of OI's including screening and tuberculosis treatment (TB) DOD will also support short term therapeutic feeding for clinically malnourished patients according to MOH entry and exit criteria and health care professionals will be trained on nutrition assessment.
Care for OVC is a growing concern in the Lesotho Defense Force, funding will support activities that strenghten comminities and families to meet the needs of children and families affected by HIV/AIDS. Activities will include supplementary feeding for malnourished children,hosting technical assistance to enable development of OVC programs in LDF. Based on needs assessment, specific interventions may include training caregivers and providing increased OVC access to education, food, and other supportive services. A number of 11 districts will be targeted for OVC's services and they will receive paediatric support from the Naval medical center. Assessementt and interventions will include participatory approches and program evaluations. This initial focus will determine the numbers and needs of the OVC dependants for service delivery in the Lesotho Defense Force and intergrated service delivery program, with related activities described in the prevention and palliative care sections.
Lesotho Defense Force will use the funding to continue TB activities that have been ongoing. HIV infected clients will be provided with Antiretrovals {ART] , TB clinical care will continue to be part of a package of comprehensive HIV/AIDS care strategy by improving the infrastructure at the military hospital and also by procurement of equipment for the TB clinic, training military health providers to diagnose, treat and monitor, and report TB progression trends. Preventive cotrimoxazole prophylaxis will continue to be integrated into HV care package for adults and children to encourage prevention and reduce clinical disease. Efforts will be made to ensure that hundred percent of HIV positive adults and children enrolled into care in military sites receive TB screening and treatment and if TB is confirmed patients will be tested for HIV. All TB/ HI/V co-infected adults and children eligible for ART will be automatically enrolled and followed up. TB preventive cotrimoxazole prophylaxis will also be provided to HIV infected adults and children enrolled on care to ensure successful TB prevention. TB exposed children of TB/HIV co-infected adults will be identified, evaluated and provided with appropriate prophylaxis or treatment as indicated by the national guidance for TB management in children. HIV positive children identified will be enrolled on in ART services as part of a familyapproach to TB/HIV services provision and part of efforts to improve the quality of services offered military personnel and their families. These activities support the national plan for TB/HIV and PEPFAR goals to prevent, diagnose and treat patients with both TB and HIV.
Lesotho Defense Force in collaboration with DOD and Ministry of health and social welfare have supported the building of a military LAB at the military hospital. DOD will support recruitment of senior LAB technologist in order to ensure that there is a qualified personnel in the LAB to ensure appropriate use of new equipment and provision of quality services and sustainability of services at the military services. As the ART services expand, CD4 testing becomes an important tool for determining clinical eligibility for HAART coupled with other basic laboratory tests for monitoring HIV disease. The LDF has indicated that it is essential to perform CD4 testing as well as other basic monitoring tests within the military laboratory in order to ensure effective and sustainable ART provision within the military Health Delivery System. Therefore DOD will procure on-site CD4 machine (PIMER). Efforts will be made to upgrade the LDF laboratory to provide laboratory diagnosis of HIV, immune function and opportunistic infections, and hematological status, on-site training of LDF laboratory personnel will increase the number of technicians in the military.
DOD has supported an electronic medical record (EMR) system for Lesotho Defense Force HIV program, FY13 funds will continue to support the LDF EMR, an additional benefit is that those involved in counseling and testing, support activiies andt in patients treatment wil now have access to on-line support materials and a wider network of expertise, funds will support training of personnel in data collection and data enrty, monitoring and evaluation techniques and reporting. This is currently one of the weakest aspects of the LDF effort. This activity will specifically target miliyary personnel and their family members, especially those living with HIV/AIDS. DOD will support procurement of netbooks computers for nurses and HIV counselor testers.
Funding will support Lesotho Defense Force HIV program by providing counseling and testing services to the military members, to train military nurses and HIV counselors in counseling and testing and to support the monitoring and evaluation and quality assurance though PSI. This activity will continue to support LDF HIV program by providing military community and their families with counseling and testing services at the counseling and testing sites. DOD will support mobile CT services to the rural bases, provider iniated CT(PICT) will be strenghtened testing on major campaigns will also be supported during the army day celebration and sports days where a large number of soldires will be counseled and tested with routine testing and PSI will train LDF counseors thereby building the capacity for health professionals to manage the epidemic. military personnel who test HIV positive will be reffered to ART services and will be monitored to ensure adherence DOD will support.identification of discordant couples and enhance HIV care particularly positive prevention programs.
"The Lesotho Defense Force will increase access to PMTCT services to military personnel and their families. Services also target other uniformed services. DOD will provide technical assistance to the LDF for delivery of quality, integrated PMTCT services within the platform of MNCH services provided at the hospital. The LDF will offer a standard package of PMTCT services as defined by WHO guidelines, contributing to the achievement of goals defined in the Lesotho PMTCT Acceleration plan and the National Plan for the Elimination of MTCT and Pediatric HIV. Services include CT with informed consent, ARV prophylaxis using combination regimens and HAART for eligible women, counseling, support, referral for family planning, MNCH services, follow-up of HIV-exposed infants for referral to appropriate services, and early infant diagnosis.
While the LDF currently does not have an accurate unit cost per patient, LDF will be included in a comprehensive costing exercise to be conducted with Acceleration funds.
In order to increase male involvement LDF will support couples and family-centered counseling and testing. PEPFAR Lesotho is currently developing a gender strategy which will help to strengthen interventions in this area. Although LDF has limited funding for care and support and OVC activities, LDF will ensure access to a comprehensive network of services for PMTCT clients and their families by linking with PEPFAR partners which have more substantial funds in these technical areas.
Mothers to Mothers will provide health education for clients to increase patient involvement and community participation in PMTCT services. In FY2011 LDF health care workers received training in prevention for PLHIV, which will also be integrated in the standard package of services provided to clients. In FY 2011 LDF personnel participated in MEASURE Evaluation training in order to improve the capacity of the LDF to routinely collect data. M&E continues to be a challenge for the LDF. With support from the lead SI PEPFAR partner, LDF facilities will receive technical support and training to improve the quality of data and monitor quality of services.
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Department of Defense works to improve the capacity of the Lesotho Defense force to provide quality HIV treatment and care for military personnel and their families. In FY13 DOD will support provision of a continuum of care and treatment services which includes clinical staging and CD4 counts for all patients, STI/OI's screening and treatment, provision of cotrimoxazole prophylaxis, ART, ART adherence support, psychosocial support, family planning, nutition counseling and support, prevention for positives. DOD will also continue to support and emphasize HIV prevention with positives through training of health professionals and lay counselors providers will be trained on how to assess patients with regard to risk behaviours, medical adherence, condom use. DOD will continue to provide technical and material support to the military treatment site to ensure provision of quality ART services to PLWHA.
