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.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
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
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
The African Palliative Care Association (APCA) is dedicated to applying lessons learned from other African
countries to scale-up cost-effective, culturally-appropriate palliative care for Namibian persons living with
HIV/AIDS (PLWHA) and their families. This continuation from COP07 relates to other Basic Care services:
USAID, MOHSS, I-TECH and PACT grantee links.
Palliative care technical expertise in Namibia is increasing and has expanded beyond the cancer centre to
doctors, nurses and community volunteers through palliative care training provided in FY 2006 and FY
2007. The development and expansion of palliative has been limited by the lack of expertise to support not
only provision of palliative care but efforts to advance programs. In FY 2006/2007, the USG and its
partners, including the Ministry of Health and Human Services (MoHSS) received technical assistance from
APCA and its members. This included support for the Catholic AIDS Action (CAA) community and home-
based care (CHBC) program to pilot a program to integrate key palliative care strategies and training into
their efforts within Anamulenge & Rehebooth. Sensitization of the MoHSS, other key stakeholders and USG
care and treatment partners about the palliative approach to HIV/AIDS care and effective bi-directional
referrals has also been carried out. Initial work has begun in conjunction with I-TECH to review the
Namibian adaptation of the IMAI palliative care module, along with I-TECHS HIV/AIDS modules for the
University of Namibia School of Nursing. Mobilization for Namibian leadership in palliative care training,
service delivery and policy development has been key through the initial development of a National Task
Force for Palliative Care and the later establishment of a Namibian Palliative Care Association.
While significant program accomplishments are underway, continued technical support is needed to build
on program successes, address existing gaps and develop dedicated in-country expertise. In COP 2008,
APCA will support the MoHSS, USG partners and other stakeholders with to roll out HIV-related palliative
care services, including continued support for the national Integrated Management of Adult Illnesses (IMAI)
palliative care program and the development and piloting of a national palliative care training program for in-
service training, training of trainers (ToT) and supportive supervision. In 2008, the IMAI palliative care
module will be completed and implementation will begin in selected health centers and clinics. APCA will
support the MoHSS and ITECH with implementation through ongoing review of training materials and
essential drug lists, and technical assistance with on the current policy environment for ensuring availability
and accessibility of essential palliative care drugs. While initial work during FY 2006 resulted in palliative
care being included in the national policy on HIV/AIDS, APCA will advocate and support the MoHSS in the
development of further palliative care policies and guidelines; the development and implementation of
standards of care; monitoring and evaluation of palliative care and movement towards the development of a
national palliative care policy that allows nurses to prescribe narcotics and other symptom-relieving
medications. Technical assistance will follow for nurse training and the possible integration of this topic into
the University of Namibia's Advanced Nursing Diploma. Building on successes to date of APCAs Regional
Drug Availability Workshops in Entebbe (2006) and Accra (2007), APCA will work with the National
Palliative Care Task Force to ensure Namibian follow-through on the work plan to be developed by
Namibian stakeholders at the drug availability meeting set for Windhoek in February 2008.
During COP 2007 APCA supported the National Palliative Care Task Force and the MoHSS to develop a
detailed plan for palliative care leadership and integration at policy, service delivery and education/training
levels. This was informed through a study tour for key MoHSS and NGO personnel to share lessons learned
and best practices across Africa. In FY COP 2008 APCA will support the development of a functional
national palliative care association out of the task force, with clear terms of reference, strategic plan and
The CAA/APCA pilot program to integrate palliative care into select sites in the CAA home-based care
program was completed in COP 2007 and lessons learned along with implementation challenges are being
disseminated. In COP 2008, this program will be expanded to additional sites that selected in partnership
with the MoHSS and CAA. APCA will train a further 20 health care professionals to receive ToT in palliative
care and also directly train up to 200 community volunteers. APCA will also provide refresher training and
on-going support and mentorship for persons previously trained. APCA will ensure gender-sensitive
approaches, including equitable training and support of male and female health care workers with the goal
of equitable access to HIV/AIDS services for PLWHA and their families throughout USG-supported
programs. APCA will also build upon its programs in other countries looking at men as care givers for
PLWHA and will integrate the lessons learned into its program in Namibia.
The USG supports a tremendous range of palliative care activities in Namibia. Some palliative care is
provided by partners and subpartners under the "palliative care" program areas; other palliative care is
provided by partners in other program areas, such as prevention, counseling and testing, and HIV
treatment. Care-related activities extend from clinical interventions focused on the patient (e.g. infection
prophylaxis and pain management) to psychological, spiritual and social care interventions for the patient
and the patient's family. More information is needed on the range, levels and quality of activities being
supported. In FY 2006/2007 APCA conducted a palliative care public health evaluation (PHE) in Kenya and
Uganda. During COP 2007, lessons learned from this PHE will be disseminated and applied to the
Namibian context. APCA will then conduct a similar PHE which was supported in COP 07 in Namibia. The
results will be finalized in COP 2008 and will help develop: 1) an inventory of PEPFAR-supported palliative
care activities in Namibia; 2) a practical framework for categorizing these activities including the levels of
palliative care provided; 3) a set of process indicators that can be used to evaluate the quantity, quality and
levels of palliative care provided; 4) a model that estimates the demand for and supply of palliative care by
select PEPFAR-supported palliative care partners in a specified geographic area including an appraisal on
implementation of elements of the preventive care package, and strategies that support treatment
adherence and management of symptoms and pain; and 5) a situational analysis as requested by the
MoHSS on the status of palliative care in Namibia. The results will be used to inform program planning by
the USG/NAMIBIA team and Namibian Government, expand palliative care service delivery in under-served
areas, and identify priorities for monitoring and evaluation. The results will also help APCA support the
MoHSS to develop a framework for palliative care monitoring and evaluation for Namibia and APCA will
provide technical assistance in the developing tools for ongoing monitoring and evaluation of palliative care.
This activity will be undertaken in consultation with USG-supported palliative care partners, including the
Throughout COP 2008 the work of APCA in Namibia will be co-ordinated by an in-country project co-
ordinator supported by the Southern Africa Regional Co-ordinator who will make quarterly supervision visits
Activity Narrative: and provide, alongside other APCA staff, technical assistance as required.
This activity was erroneously entered into the South Africa Regional Associate Award of Pact, Inc.
All targets and narrative, as well as funding should have gone to Pact TBD Leader with Associate