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: 2012
This new IM Capacity Plus, led by IntraHealth International Inc., is a global flagship project uniquely focused on the health workforce needed to achieve the Millennium Development Goals. In Namibia, the project will work with the Government of the Republic of Namibia (GRN) to: 1) Enhance human resources for health (HRH) policy and planning, including human resource management and information; 2) Generate and disseminate knowledge and analyses to promote use of evidence-based HRH approaches; 3) Support the donor HRH transition process; and 4) Support the GRN to improve health worker recruitment and retention. This support is critical to achieving the GHI intermediate results and principles of transition, sustainability, country ownership and strengthened HRH. By supporting the GRN to strengthen its capacity to better plan, budget and make informed decisions about its staffing complement needs and projections, this activity will help the GRN sustain and improve upon the gains made to deliver needed HIV/AIDS services to Namibians. The project targets the national and regional levels.
The monitoring and evaluation plan will entail joint-developed indicators and targets with the Ministry of Health and Social Services; regular joint assessments will be conducted to measure progress towards benchmarks and targets.
No vehicle purchases envisaged.
This is a new budget code which supports transition. Within the OHSS budget code, IntraHealth International, Inc. (IH) will utilize COP13 funding to support the Office of the Prime Minister in developing a workforce plan for the health sector. In the first phase, IH has supported the MOHSS to: (1) Conduct the Workload Indicators of Staffing Need (WISN) assessment for all regions; (2) Migrate all Health Resource Information Management Systems (HRIMS) from the civil service HRIMS to the Oracle-based Human Capital Management System (HCMS); and (3) Initiate the gradual delegation of mentoring and supervision responsibilities to partner organizations. These activities support USG efforts to strengthen the GRN and transition staffing and health information systems (HIS).
The MOHSS WISN workload assessments for all 13 regions will build on the COP12 WISN pilot in the Kavango region. In COP13, IH will continue its support to the MOHSS to finalize the national workload assessment by focusing on establishing workload estimates for supervising the clinical rotations of student doctors and nurses. Support will include modeling different staffing mix approaches, using the workload estimates, staffing projections, and costs for clinical and non-clinical staff. The outcome of the assessments will then be used to inform and justify the request by MOHSS to the Public Service Commission for new staffing ratios. The assessment supported by IH, will streamline MOHSS human resources for health (HRH) recruitment and hiring processes that are often delayed.
As recommended by the Human Resources for Health (HRH) Technical Working Group (TWG), IH will support the MOHSS to conduct a review of its HRH recruitment and hiring processes to identify bottlenecks in the recruitment and hiring processes; as well as areas that could be strengthened/streamlined. IH will support the design of costed health worker retention strategies geared to retain staff trained in the HIV/AIDS program after transition to the GRN payroll.
Currently, the Health Professional Council of Namibia (HPCN) is entirely reliant on an external consultant to extract data from their system in cases where standard reports are not available. IH will support HPCN and the MOHSS in the migration, integration, and linkages of parallel systems. In particular, IH will support migration of all HRIMS to the Oracle-based HCMS also ensuring linkage of key information to the national HRIS.
IH will provide technical assistance to the National Health Training Network for in-service training to customize IH open source iHRIS; an electronic database of health professional students, which can then be linked to the National HRIS to provide health workforce pipeline data. As part of transition, IH will initiate the gradual delegation of mentoring and supervision responsibilities to partner organizations. To transfer skills IH staff will support partner organization staff to participate in these visits to observe, coach, and provide feedback to the mentors in order to ensure the complete transfer of the skills and processes for supportive supervision and QA.
This narrative is linked to activities, HVCT, HBHC, PDTX, HVSI. No funds are allocated for construction, renovation and vehicles in 2013 under this budget code.
This is a new budget code which supports transition. Within the HVCT budget code, Intrahealth (IH) will utilize COP13 funding to support the provision of HIV counseling and testing (HCT), as it remains a key program area in ensuring access to HIV prevention, care and treatment services in Namibia where there is a national prevalence of 13.2%.
IH will work in collaboration with the MOHSS, faith-based integrated HIV testing facilities, and mobile HIV testing units. IH activities focus on strengthening HCT services and developing a mixed model approach to HCT in Namibia in five (5) regions: Hardap, Oshikuku, Oshana, Kavango, and Ohangwena.
IH will support the following interventions: (1) Expansion of Provider Initiated Testing and Counseling (PITC); (2) Roll out of HIV rapid testing; (3) Strengthen referrals from HCT to essential HIV related services, e.g. care and treatment, PMTCT, MC ; (4) Support MOHSS with the smooth closure of the standalone VCT sites; and (5) Support GRN in expanding HCT using mix models and ensure quality assurance. With the MOHSS, IH will improve access to HCT services by continuing to provide technical assistance (TA) towards the institutionalization of a mix model approach; including: VCT, PITC/ point of care (POC), and mobile and outreach. IH support will focus on faith-based institutions and coverage of hard-to-reach and high risk populations including couples. Couples HCT (CHCT) is low (14%) in Namibia. To increase uptake of CHCT, IH will provide TA to facilitate partner disclosure, and provide counseling for HIV negative and discordant couples. IH will provide TA the MOHSS to strengthen bi-directional referrals and; prioritize linkage of HCT to MC. Focus will be on supporting an increase in HCT update through PMTCT services during antenatal clinic (ANC) visits and male involvement.
IH will support MOHSS efforts to ensure a staggered phase out of stand-alone VCT, in favor of integrated and mobile and faith-based HCT. Throughout the transition, IH will provide quality assurance (QA) to the integrated and standalone VCT sites. IH will strategically make efforts to transition HCT QA to respective hospital management teams and regional MOHSS chief/ senior health program administrators.
This narrative is linked to activities, PDCS, OHSS, and HVSI. No funds are allocated for construction, renovation and vehicles in 2013 under this budget code.
This is a new budget code which supports transition. Under the MTCT budget code, IntraHealth International, Inc. (IH) will utilize COP13 funding to support the provision of quality Maternal and Child Health Care (MCH) in faith-based health care facilities and communities.
IH will provide technical assistance (TA) to faith-based facilities and the surrounding communities in five regions of Namibia. Within this activity IH will focus on: capacity building, quality assurance (QA), performance improvement, supportive supervision, and the established reliable M&E systems to use data for program within MCH and the virtual elimination of mother to child transmission (eMTCT).
IH will support the eMTCT plan, comprised of two prongs: (1) Strengthening prevention of HIV among women of reproductive age, and (2) Prevention of unintended pregnancies in women living with HIV. In collaboration with the MOHSS, IH will strengthen synergies with existing programs for HIV, maternal, newborn and child health (MNCH) and family planning (FP). Using the Performance Improvement Approach (PIA), IH will support its partners to identify existing gaps in eMTCT, and develop interventions to close these gaps. IH will contribute to the revision and finalization of PMTCT guidelines aimed at implementation Option B+; as well as strengthening referral and patient follow-up through supporting the dual protection tool pilot conducted in eight sites.
In collaboration with the MOSS Directorate Primary Health Care, IH will strengthen community systems by supporting mother-to-mother (M2M), and aiming at ensuring HIV positive mothers are informed about issues such as infant feeding and the importance of adhering to treatment/prophylaxis to eliminate MTCT. IH will also support access to quality MCH care by procuring a prefabricated structure, which will serve as maternity waiting home for women with limited access to MCH facilities.
With the Regional Management Team (RMT), IH will support strengthening of maternal death review committees at partner health facilities, at the regional/ zonal, and national level as a QA approach, and then implement recommendations, using PIA. To accelerate the reduction of maternal and neonatal morbidity and mortality, IH will support the MOHSS to conduct a study on the contributing factors to maternal and neonatal mortality in five regions. IH will support eMTCT program evaluation utilizing innovative tools and the bi-directional referral system.
In collaboration with the MOHSS and the University of Namibia, IH will support in-service training short courses and trainings for medical doctors and nurses in neonatology, emergency obstetric care (EMOC) and neonatal resuscitation. IH will provide TA to incorporate EMOC into pre-service training and other sustainable training methodologies. Within the Global Health Innitiative (GHI) framework, IH will develop Family Planning (FP) messaging, which is integrated with HIV and eMTCT, which is sensitive to the teachings of the Catholic Church. Once FP messaging is developed, messaging will be implemented in selected IH supported sites.
This narrative is linked to activities in the following budget codes: PDCS, HVCT, OHSS, and HVSI. Cross-cutting activities include HRH/In-service training, and performance quality improvement with an estimated funding of $100,000. No funds are allocated for construction, renovation and vehicles.
Through the new Capacity Plus implementing mechanism, IntraHealth International, Inc. will draw upon its international expertise and experience as one of the leading HRH TA providers to focus on strengthening the underlying human resources for health (HRH) building block of systems strengthening for the Government of Namibia (GRN) so it is better able to budget, plan, and deploy needed health care workers to meet the needs of the epidemic. This work is particularly important as the USG transitions to a stronger TA model, whereas in the past, one of the major efforts of the USG to support treatment scale-up was to finance the salaries of health care workers to deliver needed treatment.
As defined in the Ministry of Health and Social Services (MOHSS) systems review, there are major systems barriers associated with HRH, notably, the Ministry experiences high vacancy rates, high levels of attrition, and outdated staffing norms that do not accommodate the current and emerging health system needs. Also, in the HIV/AIDS program (including those in the public and faith-based facilities), health care worker salaries are heavily dependent on financing from donors, namely the USG and the GF. Given the impending declines in external resources, donor supported health workers, who are deemed critical beyond donor-related projects, will need to be transitioned to the GRN payroll (including those in the faith-based facilities which are otherwise largely financed by the public sector). This process began in COP 10 and COP 11 with the establishment of a joint GRN/donor HRH transition technical working group and taskforce. In line with the GHI strategys transition objective and to support the GRN to make informed decisions about who should be transitioned and how they will fit into a new MOHSS structure that is being defined, a number of data estimates, analyses, and staffing projection numbers are needed.
Capacity Plus will support the following targeted leveraging activities some of which are complemented by HRH activities supported by WHO: 1) Determining the regional staffing complement: Support regions to conduct workload estimates and develop staffing projections to inform and justify their proposed staffing complement request as part of the MOHSS restructuring process; 2) HRH implications of strategic integration: Support the MOHSS with scenario modeling to describe the workload burden on cadres if different elements of the HIV/AIDS program were integrated within other health system services, such as primary health care. This modeling can inform the development of staffing norms to meet the needs of the newly revised minimum district service package. This activity will work closely in collaboration with the Health System Strengthening IM to develop cost estimates for various scenarios of integration; and 3) Developing better retention approaches: Through an analysis of the market and other tools such as discrete choice experiments, this mechanism will support the MOHSS to implement better recruitment and retention practices to reduce HRH turnover in the public sector.
This is a new budget code which supports transition. Within the PDTX budget code, IntraHealth International, Inc (IH), under the implementing mechanism Capacity Plus, will utilize COP13 funding to support technical assistance (TA) for the Government of Namibia (GRN) to provide integrated and comprehensive HIV/AIDS care and treatment program for children (0-15 years of age) who are current, newly and/or ever enrolled on treatment in six (6) mission facilities, comprised of five (5) district hospitals and one (1) health center. This activity extends to IH satellite facilities through outreach services and Integrated Management of Adulthood Illnesses (IMAI) and will support improving access, quality, and retention to treatment among children. This activity is designed to ensure mission facilities maintain high quality services as the GRN increases subsidies to their operations and as the USG reduces its financial support.
This activity is strategically aimed at building the capacity of health care providers and facilities to treat children (0-15 years of age). In particular, IH will build capacity at national and regional levels, with the District Coordinating Committee (DCC) and Regional Management Teams (RMT), by developing and implementing pediatric Standard Operating Procedures (SOP) and national guidelines.
IH will continue to strengthen and develop new, cost-effective strategies in order to reduce lost-to-follow-up (LFTU). Along with its partners, IH will ensure facilities collaborate with existing community based organizations, and volunteers, to follow up and trace patients who miss appointments and/ or are LFTU. Retention strategies already being used include: radios, telephoning, and liaising with Primary Health Care (PHC) outreach teams. IH will work with its partners to assess the effectiveness of these strategies.
Within PDTX, IH will mentor and support partners to increase outreach points and IMAI sites in their catchment areas using performance improvement assessment (PIA) to increase opportunities for all HIV positive children (0-15 years old) to receive care close to home. IH will monitor the existing outreach and IMAI sites during Supportive Supervision Visits (SSV) to ensure efficiency and effectiveness and ensure that partners skills are developed to conduct independent SSV.
This narrative is linked to activities, OHSS, HVSI, and MTCT. No funds are allocated for construction, renovation and vehicles in COP13.