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
COP 2011 Overview Narrative
SUBSTAINTIALLY CHANGED FROM LAST YEAR
The CDC Global AIDS Program (GAP) provides technical assistance and direct funding to partners working in the national HIV/AIDS response in Namibia. CDC's main partner is the Ministry of Health and Social Services (MOHSS), which hosts CDC's offices through a co-location agreement. CDC technical advisors and administrators provide direct support to MOHSS to strengthen public health infrastructure and build human resource capacity.
CDC support for MOHSS includes technical input through evaluations, assessments and surveys, supportive supervision and mentoring, human resource capacity building, and collaboration on joint initiatives such as the Partnership Framework (PF).
In COP10, continuing technical emphasis will be placed on:
Training for providers on revised ART, PMTCT and STI guidelines.
Expanding and evaluating prevention efforts
Supporting the decentralization of ART services.
Integrating TB and HIV services.
Surveillance systems
Evaluating the impact of task-shifting.
Expanding access to palliative care and pediatric treatment.
Assisting with the response to drug-resistance (TB and HIV)
Supporting rapid HIV testing by community counselors and through mobile services.
Building the evidence base to support expanded HCT and care and treatment services in Namibian prisons.
Coordinating resources with the Global Fund, the government of Namibia (GRN) and other donors.
CDC also provides technical and financial assistance to local partners, including, Development Aid People to People (DAPP), the Namibia Institute of Pathology (NIP), and the Blood Transfusion Service of Namibia (NAMBTS). In COP09, 86% of CDC-managed funds were allocated to partners, of whom 79% were local Namibian entities. The balance of CDC's budget supported CDC technical advisors and office operations.
Links to the Partnership Framework
In Namibia, unlike many other PEPFAR-supported countries in sub-Saharan Africa, a majority of the PEPFAR budget provides direct support to the GRN and other local entities. Given these considerable local investments, CDC is already deeply engaged in strengthening GRN capacity and ownership, especially in the areas of human resources, and the financing and operation of national healthcare systems. In COP10, PEPFAR will emphasize the GRN's capacity to plan, oversee, manage and, eventually, finance a growing share of the commitments made in the four priority areas identified by the PF: Prevention; Treatment, Care and Support; Impact Mitigation; and Coordination and Management.
Coverage and Target population
CDC supports activities with a national scope. In COP10 and beyond, CDC will increasingly promote multi-sectoral coordination and integration to mainstream the impact of PEPFAR's HIV/AIDS investments.
Health Systems Strengthening
In 2008, an MOHSS review identified two areas of structural weakness within the GRN healthcare system: Unequal access to health facilities and human resources.
In COP10, CDC technical assistance will emphasize training and other capacity building for all cadres of health workers. CDC will also support expanded access to services. Special emphasis will be placed on supporting administrative systems to manage Human Resources for Health.
Cross-Cutting Programs and Key Issues
This activity's main cross cutting area is Human Resources for Health. This program will contribute to PEPFAR's broader effort to build human resource capacity by improving the capacity of MOHSS to recruit, manage and retain staff. CDC's support for pre- and in-service service training will also build a sustainable pool of Namibian healthcare workers in nursing, medicine, pharmacy, counseling, and laboratory sciences.
Cost Efficiencies Over Time
CDC's technical assistance to the MOHSS and other partners supports the development of sustainable engagement and, where relevant, transition plans. These plans are evidence-based. Special emphasis will be given to cost-efficient strategies, including task-shifting and the recruitment and deployment of locally-trained community lay healthcare workers. In COP10, CDC will continue support for on-going GRN costing activities, and conduct programmatic assessments to determine the costs and impact of community-based strategies. These assessments will be linked to the bi-annual PEPFAR reporting calendar, and respond to reporting requirements embedded in the cooperative agreement mechanisms used to manage PEPFAR funds. CDC will also continue support for long-term strategic planning, including the National Strategic Framework and associated costing exercises. Key areas for CDC support in this area include: 1) Actual and projected costs; 2) non-financial resources needed to meet program goals (e.g., human resources, equipment); 3) resource mobilization strategies, and; 4) options to institutionalize the activity within a particular sector (e.g., GRN, NGO community, for-profit).
Over time, CDC is committed to working with MOHSS to identify activities that may be absorbed completely by the GRN, that require continuing technical assistance from the USG, and that could be terminated.
Monitoring and Evaluation Plans
The CDC works with MOHSS and other development partners to strengthen, integrate, and align M&E plans, indicators and systems. All of CDC's program indicators have been aligned with NSF and PEPFAR targets. Bi-annual reports identify progress and describe any necessary changes based on available evidence.
A portion of the costs of HIVQUAL program administration. Funding for this activity is reflected 85% in Adult Treatment (HTXS) and 15% in Pediatric treatment (PDTX)
Continuing Activity
Estimated Budget = $143,250
ADDITIONAL DETAIL:
HIVQUAL program administration: Funds will be used to support general in-country administration and operational costs of the HIVQUAL program. These costs are related to in-country travel for quality improvement (QI) coaching and training costs related to rolling out the HIVQUAL program in treatment and care settings. The sharing of best practices is necessary to learn from the experiences of others and promote quality improvement. Regional quality improvement workshops will continue to be used as effective platforms where facilities meet to review and discuss their performance data and learn from each other how to improve the quality of clinical care. The national coordinators of HIVQUAL will participate in QI conferences to present the progress of the various QI initiative sin the country as well as to learn from others and share experiences.
Support for Strategic Information (SI)-related programs. This activity will include government- to- government technical assistance, training, mentorship and logistical support for HMIS, M&E, and surveillance activities as prioritized by the MoHSS and USG.
Estimated Budget = $350,000
Support for building capacity for rapid assessments, population-based size estimations and behavioral surveillance of most at risk populations (MARPS) through technical assistance, stakeholder meetings, and analytical and dissemination workshops.
Estimated Budget = $160,700
Support for an assessment and planning activities for a long-term certificate epidemiological training program (Field Epidemiology and Laboratory Training Program) for public health personnel in conjunction with a local institution of higher learning.
New Activity
Estimated Budget = $200,000
1) Support for Strategic Information (SI)-related activities. CDC will support technical assistance for the MoHSS Response, Monitoring and Evaluation unit and also possibly the HIS Directorate or others areas as appropriate. Areas that require in depth support include M&E systems guidance at the partner, regional and national level, M&E and surveillance reports, surveys, and maintain, update and integrate program level and national aggregate systems. This support will include M&E, survey, HMIS, epidemiological and statistical training, database management, data quality assessments, analytical and dissemination workshops and revising protocols (e.g., due to changes in ART guidelines). Additional support will promote software and indicator standardization across MOHSS M&E units, and ensure software licenses are up to date.
2) Rapid assessment, population size estimation, and bio- behavioral survey of MARPS. To enhance understanding of HIV epidemiology among most at risk populations in Namibia (e.g., sex workers and men who have sex with men), CDC will support technical and logistical aspects of planning, implementing, analyzing and disseminating workshops through mentorship, stakeholder meetings, and workshops.
3) Support for an assessment and planning activities for long-term epidemiological training for public health personnel. USG aims to build local capacity to implement strategic information activities. In order to do so, specialized training in epidemiology with mentorship is required over a period of time. The participants would ideally apply concepts learned in the classroom to field-based projects. The US CDC-based Field Epidemiology and Laboratory Training Program (FELTP) will be the model for this activity.
Expansion of support and technical assistance for PMTCT services within the regions. In addition efforts will be made to enhance integration with primary health care to strengthen maternal-child health care. Support will include technical assistance, equipment, and supplies.
Continuing Activitiy
Estimated Budget = $156,455
Continued technical support for the Electronic TB Register (ETR)
Estimated Budget = $50,000
Electronic TB Register: Namibia is one of several southern Africa countries that adopted the ETR developed by the BOTUSA Project (Botswana-CDC collaboration) in Botswana. The ETR records information on HIV status and use of ART in TB/HIV patients and is used to measure key indicators and monitor expansion of HIV care and treatment among TB patients. The ETR is expected to further contribute to enhancements in TB surveillance, and inform improvements in TB prevention, early detection, and treatment. CDC will continue to support the Ministry of Health and Human Services' (MOHSS) ongoing implementation of the ETR through a local contract with WAMTech of South Africa. WAMTech is the sole provider of ETR software and support. The MOHSS is interested in adding an X/MDR component to the ETR to enhance monitoring and surveillance of X/MDR TB cases.
