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: 2008
This is a new activity that is closely aligned with continuing activities by the implementing partner (IP) from
COP07. The IP will continue to collaborate with and provide Technical Assistance (TA) to the National
Agency for the Control of AIDS (NACA), National AIDS and STI Control Program (NASCP), selected states
and other stakeholders to improve HIV/AIDS Monitoring and Evaluation (M&E) systems. In the proposed
TB/HIV activity, the IP will collaborate with ENHANSE and Nigerian Prisons Medical Services in a cross-
sectional survey of the Nigerian prison population. The survey will gather sero-prevalence data on HIV
along with TB incidence data and demographic (e.g., age, site, period of incarceration, gender and
education), health, knowledge, attitude and behavioral data in order to assess influencing factors on the HIV
and TB burden among this population. The hypothesis is that HIV/AIDS and TB prevalence among
incarcerated populations is higher than in the general population. This survey will attempt to determine if
that is correct, and which factors play a role in increased prevalence. TB and HIV co-infection rates will also
The Nigerian Prison Service (NPS) consists of about 144 main and 83 satellite prisons with about 45,000
inmates and staff of about 27,000. Prisoners are mostly between the ages of 20 and 40 years—the age
bracket most affected by HIV/AIDS in Nigeria. The state of health services and nutrition among prisoners is
poor, and the likelihood of risk behaviors high. Of programmatic importance is the fact that this population is
a likely bridging population for perpetuating transmission beyond the prison system and civilian prisons
communities into the larger population, as they reintegrate back into society. A sero-prevalence survey
carried out in 2001 among 442 prison inmates showed a prevalence rate of 8.8%, and in Lagos prison a
rate of 6.7% from a sample of 300 in 2006.
This study will follow the National Testing Algorithm for HIV screening and use non-cold chain dependent
rapid test kits. Inmates who test positive will be given an opportunity to receive anti-retroviral therapy (ART),
depending on the results of their pre-assessment. All inmates that would be selected in the sample to
undergo HIV testing will receive pre- and post- counseling and give their consent before the test is
performed on their blood samples. Inmates will receive group counseling for pre-counseling and individual,
confidential post-counseling. The study will respect the "3 Cs" of informed consent, confidentiality, and
Nigeria has the World's fourth highest number of TB cases. HIV pandemic has led to a resurgence of TB in
Nigeria and particularly among Prison inmates because of the risk factors they are exposed to. Over 35% of
HIV positive individuals in Nigeria die as a result of TB infection. In this survey, sputum smear microscopy
will be used. Inmates with suspected TB will be asked to provide three sputum specimens following the spot
-morning-spot method. If any of the two specimens examined are positive for Acid Fast Bacilli (AFB), the
inmate is considered a TB case. Since sputum microscopy does not effectively detect active TB in persons
infected with HIV, a confirmatory Chest X-ray will be done for smear negatives that show clinical symptoms
The sampling design is a stratified random sample. States will be stratified according to HIV prevalence
bands (1.0-2.0; 2.1-4.0; 4.1-6.0; 6.1-8.0; and 8.1-10.0) and from each HIV prevalence band, a state will
be selected at random. Within each selected state, at least 2 prisons will be selected (one urban and one
rural), from which 300 prison inmates (150 each) will be randomly selected for potential inclusion in the
study sample. The sample size is based on the estimated HIV prevalence in the country, an acceptable
error margin of 2.5%, and a 95% level of confidence. The basic level of calculations will be the states (sites)
and results will be aggregated for the country. Site prevalence rates will be determined by expressing the
number of positive samples as a percentage of the total samples tested. Probability limits will be determined
for all rates.
USG Co-Investigators will participate, as appropriate. The implementing partner will obtain appropriate IRB
approval from local participating institutions and USG PEPFAR Nigeria agencies prior to data collection and
analysis. Nearly all UMD supported "hub" sites have an Ethics Committee with a current Federal Wide
Assurance filed with the US Office for Human Research Protections. This activity is anticipated to take one
year from the development of protocol through data collection and analysis. The projected budget is
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
Survey data will inform program development and intervention strategies, and may well have additional,
positive spin-offs in developing advocates and peer educators among groups that are often hard to reach
with TB and HIV prevention and care services. The findings of this survey will provide information about the
magnitude, severity and distribution of the problems in these populations and thus allow for the
development of appropriate strategies and interventions to combat them. It will also allow for evaluation of
the current policy for HIV/AIDS addressing the prisons population and whether there is a need for review of
this policy and other interventions that are currently being carried out in the sector. This information will also
form the basis for advocating to the prisons hierarchy in Nigeria for an increased commitment of resources
to address HIV/AIDS and TB in prisons and provide justification to seek out additional resources from the
MDG office (Debt Relief Gain) and the WB MAP program through NACA.
LINKS TO OTHER ACTIVITIES:
Information gathering among an at-risk population has direct links to prevention and care and treatment
program areas, as well as linkages with strategic information and policy strengthening.
POPULATIONS BEING TARGETED:
Nigerian prison population, policy makers, and TB and HIV program managers.
The major emphasis area of this activity is SI.
The Implementing Partner (IP) will provide Technical Assistance (TA) to the Federal Ministry of Women
Affairs and Social Development (FMoWASD) to improve information on OVC outcomes and to strengthen
the Ministry's capacity to collect, analyze, and use strategic information relevant to OVC programs. There
will be three activities in COP08. The first activity will provide technical assistance and training to
FMoWASD and other stakeholders at the national and state level in the adaptation and implementation of
the Child Status Index (CSI) tool. The CSI will be adapted for monitoring the status of OVCs at two levels;
monitoring coverage and children served, and surveillance of anticipated results. The CSI will provide care
givers with a system to monitor children served by programs and to better direct services to children in need
as a result of changes in various psychosocial indicators. The CSI will also be used as a surveillance tool to
monitor how OVCs in general are faring at the program level. This will mean designing and implementing a
program level system that will provide information on a group of children and will be pilot-tested in one or
two programs only. The TA and training to FMoWASD, the National Agency for the Control of AIDS (NACA),
and OVC IPs will cover use the CSI tool and information generated through it for decision-making at the
level of individual children and/or programs. This information will be helpful for guiding OVC program
management decisions on for delivering quality care and support to children. This activity will be supported
technically by central level OVC TA as well as through a local advisor.
The second activity will focus on capacity-building aimed at strengthening the organizational and
institutional capacity to produce information for use in improving program management and policy
formulation. The strategy for strengthening FMoWASD's M&E capacity will include targeted training in
routine M&E, improving data quality, and data use. When possible, FMoWASD staff will be included in M&E
trainings offered through SI activities. Also, if available, regional training opportunities in M&E will also be
sought out for FMoWASD staff. This M&E capacity building is expected to improve FMoWASD's staff M&E
technical skills, planning, use of information, training of lower level staff, and engagement of key
stakeholders in development and implementation of M&E activities. The primary thrust of the capacity
building will center on a training of trainers mechanism. IPs and other development partners will work at the
state and LGA levels to support the step-down training at the lower level, which will also include care-givers.
The third activity will include TA to the FMoWASD to further analyze data from the forthcoming national
OVC situational analysis and 2008 Nigeria Demographic and Health Survey (NDHS), especially the OVC
module. This will enable the FMoWASD and other stakeholders to develop a more focused OVC
intervention program that responds to the needs and vulnerabilities of the target population at state and
lower levels. Overall, the proposed activity will reach 125 trainees. Follow-up TA will be provided to review
the adaptation of the CSI and a workshop will be convened to identify and share the best practices.
Combined with other assistance, the expected results will improve the overall well-being of children affected
and infected by HIV/AIDS through improved implementation of OVC programs in Nigeria.
CONTRIBUTIONS TO OVERALL PROGRAM AREA:
The technical assistance and training being proposed by the IP will build on existing work by other IPs and
stakeholders. The proposed activity will contribute to effective and efficient execution of OVC program
interventions by the GoN (FMoWASD and NACA), USG IPs, and other development partners, such as
UNICEF, the World Bank and British Department for International Development (DfID). Availability of
accurate and timely data on the OVC situation will inform key strategies for program managers and policy
makers in designing activities for addressing OVC needs. In addition, information from further analysis will
provide input to the design and formulation of policy guidelines and other standard operating procedures for
quality service delivery. An anticipated 125 people will be trained as part of this activity.
LINKS TO OTHER ACTIVITIES:
TA to FMoWASD and PEPFAR partners is directly linked to system strengthening and policy development.
Targets for TA provided to agencies (5) and M&E training for individuals (125) will be reported in the SI
narrative. Linkages between TA in data collection, analysis and utilization of information will strengthen the
capacity of organizations and personnel to generate reliable, timely and accurate information that will
improve the ability of health managers, care-givers and providers at all levels to plan activities, set priorities,
and allocate human and financial resources in response to needs. The IP will collaborate with stakeholders
at all levels to improve data collection, reporting and use, and form linkages as appropriate, especially with
other SI capacity building activities.
Children affected by HIV/AIDS are the ultimate beneficiaries of improved evidence-based programmatic
decision-making and planning. Others include policy makers, program managers, community health
workers, volunteers, guardians and caregivers, and M&E staff, particularly from FMoWASD and NACA, who
will participate in the design of OVC assessment tools and the CSI training to enhance their skills in
systematically monitoring the outcomes of OVC interventions programs. Current PEPFAR IPs will also
benefit from the assessment results and training to enhance program management decisions. Training and
TA will extend to state, LGA and other OVC service providers at lower levels through step-down training
activities and supervision, to enable them to apply the CSI tools for monitoring OVC program performance.
The major emphasis area for the IPs activities is supporting FMoWASD with TA and capacity-building in
OVC program M&E. This will provide program managers, policy makers, beneficiaries and implementing
agencies with information to support strategy development and activities to address the needs of OVC and
subsequently improve their overall well-being. As part of this effort, the IP will enhance the capacity of
FMoWASD and other stakeholders in the application of the Child Status Index tools for monitoring OVC
This activity continues from COP07. The Implementing Partner (IP) will continue to collaborate with and
provide Technical Assistance (TA) to the National Agency for the Control of AIDS (NACA), National AIDS
and STI Control Program (NASCP), selected states and other stakeholders to improve HIV/AIDS Monitoring
and Evaluation (M&E) systems. The activity will improve HIV/AIDS information systems through training and
follow-up with Local Government Agencies (LGAs), facilities, and other IPs to improve reporting rates, data
quality and use of information for effective decision making. The IP will support these activities with two
Resident Advisors (both with capacity to provide technical support to all activities listed below), and TA from
headquarters (1-2 international TA visits to support each of the planned workshops, plus an appropriate
amount of remote support on all activities). Specific activities include:
SUPPORT TO NACA/NNRIMS: The IP will continue supporting the Nigeria National Response Information
Management System (NNRIMS), which has been rolled-out in all states with harmonized forms using
COP05, 06 and 07 funds. With COP08 funds, the IP will collaborate with Supply Chain Management
System (SCMS) to scale up the implementation of the SCMS/Voxiva web portal electronic platform to
improve reporting from facilities using the core indicators from NNRIMS. COP08 activities will focus on
building capacity at national and sub-national level (in 2-3 selected states) and developing a monitoring and
supervision framework that will be used by the stakeholders to ensure timely reporting, data quality, and
information use. This will be done in collaboration with the U.S. Government strategic information (USG SI)
team, SCMS/Voxiva to support IPs, and NACA to improve supervision. Three to four refresher workshops
on NNRIMS and training in use of the web portal will be provided. In FY08 the Community Level Program
Information Reporting (CLPIR) Toolkit will be applied to improve the quality and use of community based
indicator data. The IP will work with NACA and community and faith-based organizations to implement the
Engagement Tool of the CLPIR Toolkit, which guides front-line service providers to identify their own
information needs, produce adapted data collection forms and indicators, and facilitate information use.
SUPPORT TO NASCP: The IP will provide TA to NASCP and NACA (SACA at state level) on data
management, analysis and use of information for facility and program staff at all levels. In addition, the IP
will provide supportive supervision to selected states and facilities in collaboration with Government of
Nigeria (GoN) officials (National and state) to ensure improved data quality and use of information.
M&E CAPACITY BUILDING AND INSTITUTIONALIZATION OF M&E TRAINING COURSES: The IP, in
collaboration with a local training institution, will facilitate 2 general M&E workshops for GoN staff, IPs, USG,
and other non-governmental organizations (NGOs) to build M&E capacity for HIV/AIDS programs. This
activity will include institutionalizing the training by providing TA to a local university to incorporate M&E
courses or modules into their training or teaching curricula. The institutionalization of the training within a
local institution in Nigeria will enhance the sustainability of the M&E capacity building process.
DATA QUALITY/DDIU WORKSHOPS: The IP will support 4 specialized workshops—two on Data Demand
and Information Use (DDIU), and two on Data Quality Assurance (DQA). The DDIU training will focus at the
lower level such as states, and include staff from facilities and USG IPs to improving their skills in
information utilization. Participants will develop data use action plans using available HIV/AIDS information
from the SCMS/Voxiva web portal, surveys and other sources. The DQA workshop will cover data quality
tools to improve IP reporting including training appropriate SI field staff in the quality assurance tool to
address the upstream and downstream framework for target setting and results reporting as well as double-
counting. The IP will initially conduct DQA site-visits to determine existing levels of data quality and related
issues, and provide supportive technical assistance. These site-visit results will guide subsequent data
quality workshops which are expected to enhance and broaden IPs and GoN skills in providing TA to the
lower levels (states and facilities).
SECONDARY ANALYSIS: The IP will continue to participate in design and data analysis of national
outcome evaluation studies such as the Nigeria AIDS and Reproductive Health Survey, Integrated
Behavioral Sentinel Survey and the Nigeria Demographic and Health Survey and routine information from
NNRIMS as needed.
SI SUPPORT TO USG: The IP will continue to assist USG to prepare semi-annual/annual PEPFAR reports.
The IP will continue to actively participate on the SI working group established and coordinated by USG
Nigeria. Overall, the proposed workshops will reach 250 trainees. Combined with other assistance, the
expected result is improved HIV/AIDS M&E capacity and improved quality of HIV/AIDS data. With funding
from the OVC program area, this IP will provide TA to FMoWASD, several selected IPs, and other national
and state level stakeholders in the adaptation and implementation of the Child Status Index (CSI) tool
developed by MEASURE Evaluation to monitor the status of individual children. Anticipated training targets
described in the OVC narrative number 125 individuals, thus bringing the total target to 375.
CONTRIBUTIONS TO OVERALL PROGRAM AREA: Focused TA to an anticipated five agencies (NACA,
NASCP, a local University, and 2-3 SACAs) in SI and FMoWASD in CSI tool implementation and analysis of
data (described in the OVC narrative), collaboration with SCMS/Voxiva, and the capacity-building
workshops will build on existing work from previous years under the MEASURE Evaluation Project, and are
expected to improve M&E capacity among public sector partners and USG IPs. With improved capacity,
partners will be more likely to report HIV/AIDS information consistently, with better data quality, and use
information for effective decision making. The proposed activities will contribute significantly to the USG
Nigeria objective of promoting and improving data demand and information utilization with the goal of
strengthening program management and decision-making. This TA will contribute to and promote the Third
One—one national M&E framework—as well as contribute to the sustainability of the national information
system. Ultimately, this activity will provide USG with a better understanding of progress toward a broad
range of desired HIV/AIDS outcomes, as well as more accurate and streamlined reporting, allowing for
improved planning and management of multiple PEPFAR supported HIV/AIDS activities.
LINKS TO OTHER ACTIVITIES: TA to NACA, states, NASCP, the Federal Ministry of Women Affairs and
Social Development and PEPFAR partners is directly linked to system strengthening and policy
development. Linkages between TA in data collection, analysis and utilization of information will strengthen
the capacity of the organizations and personnel to generate reliable, timely and accurate information that
improves the ability of health managers and providers at all levels to plan activities, set priorities, and
allocate human and financial resources in response to needs.
POPULATIONS BEING TARGETED: Orphans and Vulnerable Children is a population being targeted
under this activity.
EMPHASIS AREAS: The emphasis areas for this activity are local organization capacity building and SI.