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: 2007 2008
Track 1 and 2 funds are combined for this activity.
This activity is linked to IS activities implemented by the following implementing partners: ICAP - Columbia (#6819), CRS/AIDSRelief (#6820), ACTION - UMD (#6821), SBFAF (#6822) and GHAIN (#9776).
Making Medical Injection Safer (MMIS) implemented IS (IS) program in five states (Anambra, Edo, Cross River, Lagos, Kano) and the Federal Capital Territory since 2004. We use the four technical areas approach as recommended by the World Health Organization (WHO) and Safe Injection Global Network (SIGN) to address challenges which may be encountered in programming for the prevention and management of the medical transmission of HIV, specifically through unsafe injections. These are capacity building, behavioral change of healthcare personnel and communities, ensure availability of needed equipment and supplies and appropriate healthcare waste management.
A significant change in MMIS activity from COP06 to COP07 is the expansion strategy within selected local government areas (LGAs); this will entail coverage of IS in sites supported by other PEPFAR Implementing Partners (IPs) in addition to sites supported by JSI/MMIS only, such as Government of Nigeria (GON), Faith based and other private health facilities.
In COP07 MMIS will partnership with Catholic Relief Services (CRS)/AIDSRelief, Columbia University (CU)/ICAP, Family Health International (FHI)/GHAIN, the University of Maryland, Institute of Human Virology (IHV)/ACTION and Safe Blood for Africa Foundation (SBFAF). MMIS' support to IPs will range from training of trainers to procurement and supply of commodities for safe injection and waste management as well as provision of Information Education Communication (IEC) material on universal precaution and behavior change. The scope of partnership will actually vary among IPs depending on their needs and while some IPs (such as FHI and SBFAF) will have MMIS support them in all areas mentioned above others (such as IHV and CU) will get support in only one area. MMIS can also support the setting up of supervision system at sites level, as they will do for CRS in addition to other areas of support.
MMIS will continue to build capacity towards the four technical areas mentioned above in the 462 previously supported health facilities. In addition MMIS will extend its activities to an approximated 100 PEPFAR IPs supported public and private health facilities through ad hoc partnership with corresponding IPs.
As of April 2006 MMIS provided training to 5,207 individuals, exceeding their COP06 targets (3,000) by 2,207. In COP07 MMIS will provide IS training to a total of 8,000 individuals using WHO AFRO/JSI training curriculum. The FMOH is in the process of adapting this particular training curriculum for use in Nigeria. MMIS will institutionalize supportive supervision system by strengthening infection prevention committees at facility level. Additional Training coordinators and consultants will be hired to accommodate these scopes of work.
Advocacy and behavior change communication (BCC) efforts include periodic advocacy meetings at all levels of healthcare management and dissemination of BCC materials, tools, job aids, posters and pamphlets to health care providers. MMIS will also promote safe injection practices, and oral medication to reduce unnecessary demand for injections at community level through Community Based Organizations (CBOs) interventions and mass media. Collaborative BCC work will continue with national and local institutions/organizations such as NAFDAC, and local/community and religious organizations. MMIS subcontracted BBC activities to AED (Academic for Educational Development).
MMIS will continue to work towards commodity security. MMIS is procuring IS commodities such as injection devices and safety boxes through its sub-contractor; PATH (Program for Appropriate Technology). Commodities are stored at the Government Central Medical Store in Oshodi (Lagos) and distributed by UPS to the focal States' stores. Sites pick up their supply on a quarterly basis from the States stores. MMIS has established a tracking system to collect data on consumption and stock levels along the supply chain.
MMIS will support health care waste management through provision of seed waste segregation commodities and through building needle pits and encouraging the building of incinerators for proper disposal in accordance with WHO standards such as encapsulation in rural areas. A midterm National IS assessment is planned for 2007 to measure impact of MMIS intervention and to look at adherence to safe injection practices and proper waste disposal among other things. MMIS also plan to do a desk review of the injection practices in the informal sector, which includes the patent medicine vendors, traditional healers, traditional circumcision practitioners and uvulectomist.
MMIS is working towards sustainability through both enabling environment and capacity building of human resources. MMIS is working with the Federal Ministry of Health (FMOH) and other stakeholders (such as the Nursing Council of Nigeria and Medical and dental Council of Nigeria) on national IS and healthcare waste management policy. Besides, JSI/MMIS is working with training health institutions (such as Medical, Dental, Pharmacy, Nursing and Midwifery schools and Schools of health technology) to review, include and updated safe injections issues in their various curricula. In addition continuous on the job training is taking place at the sites mentioned above.
CONTRIBUTION TO OVERALL PROGRAM AREA As MMIS plans to extend coverage to some sites supported by other PEPFAR IPs, this integrated HIV/AIDS programming will improve collaboration amongst partners, will maximize the impact and will contribute to the prevention of 1,145,545 new HIV infections by 2010 and contribute towards the PEPFAR global achievement of the 2,7,10. This will also improve the equity in access to HIV prevention services to the communities most in need; both rural and urban by reducing the risk of transmission to the community as well as to health care workers. These activities would contribute substantively to NACA's 5-Year Strategy Frame work implementation; develop strong links between MMIS services and other service providers such as PEPFAR IPs, National Programme on Immunisation (NPI), UNICEF, the World Bank and WHO, working on HIV/AIDS issues, IS and healthcare waste management.
LINKS TO OTHER ACTIVITIES MMIS is implementing IS activities in all health facilities services and is linked to MTCT (3.3.1), HMBL (3.3.3), HVTB (3.3.7), HVCT (3.3.9) HTXS (3.3.11) HLAB (3.3.12) to ensure that health workers under all these areas adhere to and implement IS principles and universal precautions.
POPULATIONS BEING TARGETED Targeted population includes healthcare workers at focal health facilities; which include doctors, nurses, pharmacists, laboratory scientists, store keepers and waste handlers. Religious and community leaders, community-based organizations are also targeted within the community as part of MMIS BCC strategy to create awareness on safe injections. In addition, government policy makers, line ministries and National AIDS control program staff are also targeted for advocacy to leverage policy decisions, national guidelines and sustainability issues.
KEY LEGISLATIVE ISSUES ADDRESSED Through wide implementation of universal precautions and improved knowledge, skills, and availability of safe injection devices, MMIS will improved health workers and clients safety and therefore help reduce stigma and discrimination at heath care settings.
EMPHASIS AREAS The major emphasis is training of human resources and minor emphasis includes policy and guidelines, IEC, commodities procurement and quality assurance, quality improvement and support supervision.
