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.
INTEGRATED ACTIVITY FLAG: HPCA will be working with PEPFAR partners FHI (#7584) and HOPE worldwide (#7608) in Palliative Care. This partner may benefit from the Partnership for Supply Chain Management ARV Drugs activity (#7935), which will explore current pain and symptom management practices, drug availability and cost, and provide recommendations.
SUMMARY: The Hospice and Palliative Care Association of South Africa (HPCA) currently has 76 member hospices throughout South Africa (SA), each an independent legal entity. The Mission of HPCA is to provide and enhance the provision of sustainable, accessible, quality palliative care. PEPFAR funds will strengthen the capacity of member hospices and other governmental and non-governmental organizations to provide quality services to HIV-infected persons.
BACKGROUND: HPCA strengthens existing services and develops new services through direct funding to member hospices to promote accessibility and availability of palliative care in SA, including work with religious leaders of member hospices that are faith-based organizations. HPCA personnel at national, provincial and district levels continue to provide the infrastructure and coordination to develop and strengthen palliative care programs within member hospices, and government and NGOs. Improved collaboration between HPCA and National Department of Health (NDOH) is a key objective, aimed at optimum utilization of scarce palliative care resources. FY 2006 funding has allowed the training of 7,166 health workers. The major focus of FY 2007 funding will be to provide direct palliative care to patients and their families, to assess quality of palliative care, assist in the development of new services, provide support to the care providers, and provide training in palliative care. HPCA, through a pilot site, will also focus on increasing male patients' participation in the fight against HIV and AIDS. An established referral system will assist in meeting the palliative care needs of OVC.
ACTIVITIES AND EXPECTED RESULTS: ACTIVITY 1: Provision of palliative care HPCA is funding members hospices to provide care to patients with HIV and their families. Sites providing palliative care include home-based care (HBC); day care centers, and; in-patient palliative care units for terminal patients. Services include elements of the preventive care package, management of OIs, pain and symptom management, clinical prophylaxis, treatment for TB, psychosocial and spiritual care, and bereavement support for families and friends. Increased participation by male patients will be encouraged by a "males only" day-care program at a pilot site. The critical role of men in the fight against HIV and AIDS is recognized, for the benefit of both genders.
Family care includes training in all aspects of patient care, infection control, prevention, nutrition, individual and family counseling and reduction of stigma. Bereavement care is integral to the provision of palliative care and is applicable throughout the course of the illness as well as after the death of the client. A key aspect of both individual counseling and hospice support group services is reduction of stigma and discrimination and reconciliation within families. Non-PEPFAR funding for nutritional support is provided. If OVCs are identified in the community, a referral system is in place to the appropriate organization.
ACTIVITY 2: Development of new palliative care sites This entails enhancing existing or establishing new palliative care services. HPCA Provincial Palliative Care Development Coordinators (PPCDCs) lead development teams (PPCDT) in 7 regions, comprising technical expertise from local hospices. The development team assists in identifying new development sites and providing non-financial resources and mentorship to help build capacity in these sites. The main criteria for development are community need and available resources. PEPFAR funded Regional Centers of Palliative Learning (CPLs) in 10 regions and mentor hospices will continue to develop new service delivery sites in FY 2007. The CPLs are attended by health professionals in the public and private sectors including doctors, nurses, pharmacists, and HBC workers. A mentor hospice receives some funding to provide technical expertise and meet mentorship needs in its region. Through these development activities, the total number of HPCA palliative care sites will be expanded and palliative care will be more accessible to currently under-resourced and under-served areas, increasing the availability of quality palliative care to many more HIV and AIDS patients and families. Sustainability of existing and new
sites is addressed through ongoing fundraising workshops, through increased quality of services and through increased human resources capacity. The integration of palliative care into existing non-hospice health services has become an important aspect of the expansion of palliative care.
ACTIVITY 3: Accreditation and quality improvement PEPFAR funding has facilitated the development of comprehensive HPCA and Cohsasa (Council for Health Services Accreditation of SA) Standards of Palliative Care, including minimum standards of management and governance, and clinical, psychosocial and spiritual care to ensure quality palliative care in service delivery. An accreditation and quality improvement program is based on these standards. FY 2007 funding will be used to continue the accreditation and quality improvement of existing member hospices based on compliance with these standards. Trained surveyors visit the hospices and an audit of the hospice standards is carried out. To date, ten hospices have received full accreditation, and many are in preparation. The hospices that are accredited through this process will be used as mentor hospices in Activity 2 above.
ACTIVITY 4: Human Capacity Development The objective of this training is to increase skills in delivery of quality palliative care services including elements of the preventive care package. A CPL is an established hospice which has either achieved, or is close to achieving, full accreditation and which has been selected because it has the best resources and expertise to provide training and promote awareness of palliative care. A multi-disciplinary approach is used in on-going training programs to ensure human capacity development. In partnership with higher education institutions, professional associations and the National and provincial Departments of Health, Social Development and Education, a wide range of accredited palliative care training programs are offered for volunteers, community health workers, nurses and doctors. In FY 2007 HPCA training expertise in Palliative Care will be shared with another PEPFAR partner (FHI), thus further expanding palliative care in SA.
ACTIVITY 5: Plus-Up funds will be used to expand HPCA's integrated palliative care activities at the HBC level with strong linkages to supervision and mentoring. The activity will also link closely to HPCA hospices and primary health care centers for up and down referral for pain and symptom management. Provision of care will include the provision of elements of the preventive care package, promoting ART adherence and caring for caregivers. Increased Palliative Care training needs will also be identified and addressed. Additional suitable service delivery sites will be identified and developed to expand services and reach additional patients in need of Palliative Care. This Plus Up Funding will enable HPCA to develop and build capacity in existing and new development sites in under-served areas.
Through these activities, HPCA supports the USG South Africa Five-Year Strategy to expand access to quality palliative care services and improve quality of palliative care and HBC services, and thereby contributing to the 2-7-10 goal of providing care to 10 million people affected by HIV.
SUMMARY The Hospice Palliative Care Association of South Africa (HPCA), founded in 1988, currently has 76 member hospices throughout South Africa (SA), each an independent legal entity. Our Mission is to provide and enhance the provision of sustainable, accessible, quality palliative care. PEPFAR funds will strengthen the capacity of member hospices and other governmental and non-governmental organizations to provide quality services. The target population is OVC, PLWHA, their families, community members, public and private health care providers. The emphasis areas are organizational development and the development of networks.
BACKGROUND HPCA strengthens existing services and develops new services through direct funding to member hospices to promote accessibility and availability of palliative care in SA. HPCA personnel at national, provincial and district levels continue to provide the infrastructure and coordination to develop and strengthen palliative care programs within member hospices, and government and non-government organizations. Improved collaboration between HPCA and National Department of Health (DoH) is a key objective, aimed at optimum utilization of scarce palliative care resources. Regular meetings are held in each of the regions between HPCA personnel and regional DoH representatives. FY 2006 PEPFAR funding has allowed the training of 7166 people between October 2005 and June 2006. The major focus of PEPFAR funding in FY 2007 is to provide direct palliative care to patients and their families, to assess quality of palliative care, assist in the development of new services, provide support to the care providers, and provide training in palliative care. Concerning gender, HPCA, through a pilot site, will also focus on increasing male patients' participation in the fight against HIV and AIDS. An established referral system will assist with regards OVC.
Activity #1: Plus Up funds for OVC will be used to expand and enhance Paediatric Palliative Care for HIV/AIDS OVC. Paediatric Palliative Care is comprehensive holistic care of children, between the ages of infancy to 17years of age, taking active total care of the child's body, mind and spirit. This includes assessment and treatment of pain and other physical symptoms, disease oriented treatment, and phycosocial support for grief, loss and bereavement. Other support activities are improving access to ARVs, monitoring and adherence of ARVs, prevention of Mother to Child transmission, nutritional interventions and facilitating improved access to grants. Granny-headed households and Child-headed households will also receive improved support. Funds will be used for direct funding for nurses/social workers/ and social auxiliary workers and for transport and admin costs of these human resources.
Special attention will be paid to the girl-child to further their human rights and to the role of the female caregiver, including Grandmothers' significant role in support of OVC. The objectives for these posts would be to focus on these services. Additional Paediatric Palliative Care training and supervision of these human resources would also be essential. Presently this program would be for five specific paediatric services and seven integrated paediatirc services, with at least one per province. This program will focus on strengthening of existing comprehensive and /or extensive paediatric programmes through direct funding. Where OVC support services are required which are outside the scope of hospice expertise, e.g. child protection, suitable partners will be sourced to provide these services who have the technical expertise to strengthen HPCA OVC programmes.
The Paediatric Palliative Care training will be strengthened to include the PEPFAR OVC indicators, gender issues, bereavement in children and present it to 300 health care workers, including professionals and non-professionals. HPCA will liaise with corporate social investment programmes and Government to strengthen and increase funding for the care and protection of OVC.
Through these activities, HPCA supports the vision outlined in USG's South African Five Year Strategy to expand access to quality OVC services thereby contributing to the 2-7-10 goal of providing care to 10 million people affected by HIV.
