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 2009
ACTIVITY HAS BEEN MODIFIED IN THE FOLLOWING WAYS:
1. Elaboration of activities
While the John Snow, Inc. Making Medical Injection Safer (MMIS) project is coming to an end, the Rwanda
program will institute and emphasize sustainable strategies that will have an impact beyond the life of the
current program. From October 2008 to September 2009, MMIS is focusing on transferring competencies to
local institutions and their staff. Activities focused on transferring competencies include the following:
training (trainers, in-service training, and pre-service training); supervision; sharing best practices among
districts; planning for the management of medical waste; recruiting a BCC focal person at the district level;
continuing to purchase safety syringes and sharps containers; and integrating safe injections and the
management of medical waste into the Rwanda national health system. MMIS collaborates with the Ministry
of Health (MOH), BUFMAR, CAMERWA, COPED, Rwanda Association of Diabetics and professional
associations of health in undertaking its activities. In FY 2008, a transition plan is being developed for the
continuation of injection services by the Ministry of Health's Environmental Health Division and by a partner
that is yet to be identified.
MMIS plans to train 29 trainers from reference hospitals, 1,457 healthcare workers and 514 waste handlers
on safe injections and the management of medical waste. To strengthen pre-service training, MMIS is
training 175 students in their final year of nursing school in safe injection and the management of medical
waste. In addition, prior to September 2009, MMIS is sensitizing 194 students in their second year to the
practice of safe injection and the management of medical waste. Further, MMIS is implementing an
orientation module for new, permanent healthcare staff that has not been trained on safe injections and the
management of medical waste.
As a continuing activity, MMIS is planning eighteen visits to districts with the goal of exchanging best
practices in safe injections and management of medical waste. More specifically, in order to assure the
good management of safety syringes and sharps containers at the district pharmacies and health facilities,
MMIS is organizing combined supervisory visits with the Pharmacy Task Force of the MOH on the utilization
of these material at the health center level and will conduct pharmacy visits in the districts to exchange best
practices and put in place an orientation module on the logistics at new pharmacies in the districts and in
hospitals. Also, to strengthen competencies in the quantification and procurement of supplies at the central
level, MMIS is assisting CAMERWA and BUFMAR to roll out a process of payment for safety syringes and
sharps containers in order to guarantee the availability of these products.
To promote BCC strategies, MMIS plans to train 40 BCC focal points at the district hospital level (previously
identified) on the importance of safe injection practices. This training is also being extended to focal points
at the health center level. The focal points at the health centers are identified by the local health authorities
in collaboration with the BCC focal person based at the district hospital. MMIS supports the Rwanda
Association of Diabetics in the sensitization of diabetics on good injection practices and the management of
used syringes at each of its 16 sites. To prevent infection through phlebotomy, MMIS is producing a guide
book for health workers and a separate guide book is being developed for waste handlers.
In order to promote correct management of medical waste during the combined supervisory visits, MMIS
actively sensitizes the health authorities of the districts to create a budget line at the health facility level to
collect and transport sharps containers from health centers to hospitals for destruction. MMIS continues its
support to the MOH, not only for the supervision of De Montfort incinerators already in use, but also for the
identification, construction and supervision of new incinerators for health facilities (hospitals and health
centers). MMIS encourages la Compagnie Pour la Protection de l'Environnement et Développement
(COPED) to introduce syringes into its system of recycling plastic waste. In this same collaboration with
COPED, MMIS will provide technical support to COPED to make sharps containers from recycled waste.
To reinforce the system of medical waste management at the health center level, MMIS will provide waste
receptacles to 400 health centers (two per health center) and will install three separate waste pits and a
grinder for containers in 150 health centers.
In the area of monitoring and evaluation, MMIS in collaboration with MOH, provides supervision at the
health facility level. MMIS is elaborating a performance evaluation tool for health facilities that will focus on
safe injections and management of medical waste and link injection safety and waste management
practices to performance based financing (PBF). Lastly, MMIS holds quarterly meetings with the members
of the Task Force in order to evaluate the progress of activities, their needs and implement corrective
actions. MMIS proposes, in addition to its monitoring exposure to biological liquids and accidental
punctures, to sensitize the MOH on the integration of these activities into their system of data collection.
New/Continuing Activity: Continuing Activity
Continuing Activity: 17255
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
17255 2804.08 HHS/Centers for John Snow, Inc. 7708 133.08 Safe Injection $1,785,808
Disease Control &
Prevention
7209 2804.07 HHS/Centers for John Snow, Inc. 4336 133.07 Safe Injection $0
2804 2804.06 HHS/Centers for John Snow, Inc. 2575 133.06 Safe Injection $2,115,000
Emphasis Areas
Construction/Renovation
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $100,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Estimated amount of funding that is planned for Education $50,000
Water
Table 3.3.05:
