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:
In addition to strengthening the implementation of prevention of mother-to-child transmission (PMTCT) dual
therapy, JHPIEGO endeavors to increase the uptake of PMTCT in the North West Province and Northern
Cape through Provider-Initiated Testing and Counseling (PITC). JHPIEGO proposes to strengthen PITC
through material adaptation, training providers and trainers using the onsite training approach at current and
PMTCT service provider sites to be added in the future.
------------------------------------
SUMMARY:
JHPIEGO will continue conducting monitoring and evaluation (M&E) training in PMTCT for staff from
National Department of Health (NDOH) and provinces. In FY 2007, JHPIEGO would have implemented
activities to strengthen PMTCT services in North West province. JHPIEGO will increase its geographic
depth by expanding the model PMTCT facility that will link essential PMTCT services among six feeder
primary healthcare clinics (PHC) and the district hospital in a targeted district in North West province. This
program will be used as a model of best practice for the province, and will be expanded to other districts in
FY 2008. JHPIEGO will also expand the Training Information Monitoring System (TIMS) to three additional
provinces. Emphasis areas are training, human resources, quality assurance and supportive supervision,
and strategic information. Target groups include adults, family planning clients, people living with HIV, HIV-
infected infants, public health workers and policy makers.
BACKGROUND:
Using PEPFAR funding, JHPIEGO has provided M&E training to the NDOH since FY 2004. In FY 2007,
JHPIEGO provided support and technical assistance to introduce an integrated model to adopt and support
a PMTCT service delivery facility in North West province. JHPIEGO will continue this work in FY 2008, and
will also expand this support to an additional district in the NWP. JHPIEGO proposes that the integrated
PMTCT model combine antenatal care (ANC)/delivery services at the district hospital level inclusive of its
feeder clinics, thereby increasing access and standardizing services. Currently, adequate referral systems
between the PHC feeder sites and district hospital are lacking. This model will improve comprehensive
PMTCT by addressing each pillar of the World Health Organization's (WHO) framework for PMTCT
services, including (1) primary prevention of HIV infection, (2) prevention of unintended pregnancy among
HIV-infected women, (3) prevention of transmission from HIV-infected women to their infants, and (4) care,
treatment, and support for HIV-infected women and infants. JHPIEGO will work closely with the North West
province Department of Health (NWDOH) HIV and AIDS directorate, and district health authorities to
develop an implementation plan that will include eventual transition away from donor funding and to full
support by the NWDOH. JHPIEGO may cover initial salaries of additional staff but will work with DOH
authorities to ensure that required positions are created and budgeted for. This will ensure sustainability by
permitting the NWDOH to eventually absorb these positions. JHPIEGO will work with the district hospital
and the six feeder clinics to ensure adequate forecasting of required drugs and supplies.
As cross-cutting support to address sustainability, JHPIEGO will introduce standards-based management
and recognition (SBM-R) for PMTCT that will encompass those interventions mentioned above as well as
others. JHPIEGO will support the rollout of couple counseling in this model program in an attempt to
increase men's role in PMTCT services. JHPIEGO will coordinate PMTCT activities with FHI, AED, and
other PEPFAR partners working in the same geographical area. Family planning, infant and young feeding
practices, and monitoring and evaluation topics are synthesized into the three respective training
curriculums so that the topics are not repeated and to ensure that clinic staff are not pulled off of the clinic
for redundant training.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Referrals & Linkages
The objective of this activity is to build strong linkages and referral systems between women's healthcare
services and PMTCT programs, thus eliminating missed opportunities for women and their families to
access PMTCT services. JHPIEGO will work to ensure that counseling and rapid testing services focusing
on risk reduction will be available to all PHC clients and their partners. JHPIEGO will mentor and support
personnel in PMTCT counseling and clinical interventions to reduce the risk of transmission during ANC,
postnatal care, labor and delivery. JHPIEGO will link with the provincial and national departments of health
to ensure that all providers who have not received adequate training are enrolled in the national PMTCT
and Infant Feeding Training. After providers have attended training, JHPIEGO will offer supportive
supervision and mentoring at the facility level and will facilitate the implementation of clinical staging for
antiretroviral treatment (ART) so eligible HIV-infected pregnant women can be immediately referred to ART
services. In accordance with South African Government PMTCT guidelines, JHPIEGO will ensure that all
providers are equipped with adequate knowledge on ART prophylaxis for PMTCT. In addition, JHPIEGO will
ensure that HIV-infected women and infants are not only referred for treatment but are tracked so they do
not fall through the cracks after delivery. Services provided in the postpartum period will include ongoing
monitoring for opportunistic infections, linkages with well-baby visits, HIV testing for infants and appropriate
referrals to treatment, care and support. Finally, women will be referred back to family planning counseling.
To increase men's role in PMTCT, JHPIEGO will work with facility staff to incorporate couple counseling,
including prevention with positives. JHPIEGO will link with Kagiso Educational Television, which implements
the "Grassroots Male Involvement in PMTCT" campaign, to include men in the catchment areas and to
foster linkages between the CT, PMTCT, treatment and family planning aspects of these programs,
JHPIEGO will work with community health workers, community-based organizations, and social services to
strengthen linkages and referral systems, including referral for infant feeding programs and mother to
mother-to-be support groups. JHPIEGO will work with facilities to measure performance, identify
performance gaps and develop action plans to address challenges in implementation. JHPIEGO will work
with staff and health authorities to use this tool as an internal and external supervision tool that can be used
Activity Narrative: to improve quality and sustainability of services. JHPIEGO will use its PMTCT performance and quality
improvement tool, which was developed to improve M&E from the service delivery level to the district level.
This will serve to strengthen data capture, monitoring, and evaluation, allowing the NWDOH to use data to
strengthen PMTCT services in the province.
By strengthening PMTCT services and building the capacity of healthcare workers, these activities
contribute to PEPFAR 2-7-10 goals, averting new infections among infants exposed to HIV as well as
increasing access to treatment care and support for HIV-infected women and their infants.
New/Continuing Activity: Continuing Activity
Continuing Activity: 21086
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
21086 21086.08 U.S. Agency for JHPIEGO 6605 242.08 ACCESS $491,750
International
Development
Emphasis Areas
Gender
* Increasing women's legal rights
Health-related Wraparound Programs
* Child Survival Activities
* Safe Motherhood
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $35,110
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.01:
Jhpiego, with approval from the South African National Department of Health (NDOH) will implement male
circumcision (MC) activities by supporting a Bio-medical Prevention Technical Advisor to the NDOH to help
spearhead and coordinate MC within the NDOH, and to continue piloting modules of the WHO MC toolkit.
For nearly two decades, researchers have been interested in the preventive effect that male circumcision
has on the risk of STIs, particularly chancroid and syphilis, as well as penile and cervical cancers.
Increasing attention and research has been devoted to the potential preventive effect MC has on HIV
transmission. From the interim results of three clinical trials that were conducted in South Africa, Kenya and
Uganda, it has been concluded that MC reduces HIV transmission from women to men, by 60% on
average. All three trials were interrupted before planned completion for ethical reasons once it was
established that a clear protective effect existed between circumcision and contracting HIV, so that the men
in the control groups could access this potentially life-saving intervention. Male circumcision is now
accepted by the global normative bodies as one aspect of an effective HIV prevention strategy. Modeling
studies estimate that making MC universal in Africa would prevent 5.7 million new infections and 3 million
deaths over the next 20 years.
Jhpiego has been supporting MC/Male Reproductive Health services in Zambia since 2003. The work in
Zambia informed the WHO/UNAIDS programs and the WHO toolkit. Jhpiego is a co-author with WHO and
UNAIDS of the Training Manual for Male Circumcision under Local Anesthesia. In Mozambique, Jhpiego,
through the FORTE Sade Consortium led by Chemonics and funded by USAID, has been recently asked to
be the technical leader in the implementation of initial MC activities in Mozambique.
ACTIVITY 1: Male Circumcision Technical Advisor at the NDOH
It is expected that during FY 2007, Jhpiego and the South African government will reach agreement on the
placement of a male circumcision technical advisor within the NDOH. FY 2008 funds will be used to
continue Jhpiego's technical assistance work with the NDOH. It is expected that the advisor will assist the
NDOH with coordinating MC activities among the various relevant portfolios within the NDOH and will assist
in the development of policies and guidelines that can be rolled out nationally. The technical advisor will
work closely with the NDOH to implement activities working on the development of linkages between
traditional healers/surgeons and safe clinical male circumcision.
ACTIVITY 2: WHO MC Toolkit
It is expected in FY 2009 that Jhpiego will be engaged in field testing various modules of the WHO MC
toolkit and implementing capacity building activities that take into account political and cultural sensitivities
of MC. The testing of these modules is based on ongoing consultation with the NDOH and UNAIDS. FY
2008 funds will be used to carry out these activities in coordination with the NDOH and other relevant
stakeholders
ACTIVITY 3: Development of a standard MC training curriculum
Only with the express consent of the NDOH will training and service delivery of MC activities be undertaken.
In preparation, and in consultation with the NDOH, a training course will be designed for clinical service
providers (physicians, nurses, and nurse-midwives) and aimed at producing individuals qualified to provide
male circumcision and reproductive health counseling services. The course will consist of classroom and
practical sessions focusing on Male Circumcision and reproductive health. Qualification will be based on
participants' achievement in two areas: Knowledge - score of at least 80% in the end of course knowledge
assessment and Skills - satisfactory performance of recommended procedures during simulated clinical
practice and with clients. The course is designed for five days but could be extended to 10 days in low-
volume circumcision clinics so that the participants can acquire adequate guided clinical practice. Topics will
include anatomy and physiology, male reproductive health needs, health education, counseling, male
circumcision methods, management of adverse events resulting from MC, infection prevention and
organizing and managing a male reproductive health clinic. The training will be provided by qualified MC
clinical trainers.
These activities will contribute to the 2-7-10 goals of PEPFAR by creating policies and guidelines that will
lead to increased prevention within South Africa.
With the NDOH approval, Jhpiego proposes the addition of developing and training health workers on
implementing a pre-service MC curriculum in FY 2009. Jhpiego is committed to building sustainable local
capacity in all areas of technical assistance. As MC is a new technical area in this COP year and Jhpiego
will first receive funding for these activities in October of 2008, the FY 2008 plan and targets were not pre-
populated.
This project supports NSP Priority area number two point 2.2. and 2.7 in that it assists in implementing
interventions targeted at reducing HIV infection in young people and in developing a comprehensive
package that promotes male sexual health. In addition, as the project begins with a situational analysis of
the MC environment within South Africa it enables the development and support of a research agenda on
HIV prevention technologies. As per the NSP, Jhpiego will address MC issues from a broader reproductive
health perspective and strategy.
New/Continuing Activity: New Activity
Continuing Activity:
* Addressing male norms and behaviors
Estimated amount of funding that is planned for Human Capacity Development $17,715
Table 3.3.07:
In line with the Basic Care Package, JHPIEGO is currently assisting in the development of a step-down
care/sub-acute care guideline, which would assist in the discussions around loss of patients on antiretorivral
therapy (ART) in follow-up of pre-ART and ART clients. If such guidelines are adopted by FY 2009,
JHPIEGO would see itself playing a role in training health care workers in these guidelines.
-----------------------------------
Since 2004, JHPIEGO has been working in HIV and AIDS service delivery areas, supporting human
capacity development strategies which include health care worker training and quality assurance that
improve provider performance. In FY 2008, JHPIEGO will support the expansion of palliative care services
through the provision of clinical and social care services for people living with HIV and AIDS (PLHIV) with
an emphasis on opportunistic infections and cancers in service delivery settings and social and legal care at
the NDOH. JHPIEGO will provide technical support to the NDOH by placing a HIV and AIDS Care Technical
Advisor and training within the NDOH HIV and AIDS Care and Support Unit. The major emphasis areas of
these activities are: 1) training, 2) networks/linkages/referral systems, and 3) human resources. Specific
target groups are HIV-infected individuals and their families, women of reproductive age, family planning
clients, pregnant women, and health care workers.
The JHPIEGO palliative care program is continuing from FY2006 to provide technical support to the NDOH
and to train health workers in state of the art HIV-related care issues. Despite social and legal program
successes in South Africa, technical support is required in the NDOH to address national-level social and
legal inequities and program gaps for PLHIV. In FY 2008 JHPIEGO will continue to also focus its support on
training and health worker skill for screening for opportunistic infections and AIDS-associated malignancies,
particularly cervical cancer. Protocols and materials for prophylaxis and treatment of OIs are widely
available throughout clinics in South Africa; however, training support is needed at primary health care
levels throughout the country. Given the high burden of HIV in South Africa, prevalence of AIDS-related
malignancies and the corresponding high incidence of cervical dysplasia among HIV-infected women a gap
exists in screening and treatment for AIDS-related cancers, especially cervical cancer. Recently published
studies (Moody et al. 2006) document an increased risk for squamous intraepithelial lesions (SIL), the
precursor to invasive cervical cancer, among HIV-infected women in Western Cape, confirming data from
other international studies. Cancer of the cervix continues to be the second commonest cancer among
South African women and is included as one of the defining conditions of the AIDS in South Africa. Studies
and clinic experience in South Africa continue to underscore the importance of developing locally relevant
cervical screening and management guidelines for HIV-infected women in South Africa. In collaboration
with the North West province provincial Department of Health, JHPIEGO will provide training and technical
support for OI prophylaxis and care for PLHIV and screening for cervical cancers in HIV-infected women
(key legislative area) at primary health care centers.
ACTIVITY 1: Support for National Department of HealthJHPIEGO will continue to provide technical support
to the NDOH by placing a HIV and AIDS Care Technical Advisor within the NDOH HIV and AIDS Care and
Support Unit to support and expand the government's programs for care of PLHIV. At the request of the
NDOH, emphasis is needed to support and expand legal and social support activities for PLHIV. Activities
in FY 2008 include activities to mitigate HIV and AIDS stigma in partnership with PLHIV, and training
paralegals on human rights for PLHIV. The advisor will have the full access to technical experts at
JHPIEGO and the experts based at Johns Hopkins University. This technical advisor will work closely with a
JHPIEGO sponsored advisor focusing on accreditation of primary health care facilities.
ACTIVITY 2: Training and technical support for OI prophylaxis and care for PLWHIV and screening for
cervical cancers in HIV-infected women at primary health care centersIn FY 2008, JHPIEGO will expand
care program in the North West province and work collaboratively with Columbia University in Eastern Cape
and KwaZulu-Natal.JHPIEGO will train facility-based health care workers on OI prophylaxis and care
(emphasis on cotrimoxazole prophylaxis, TB screening and OI treatment) and will include all elements of
the evidence-based adult and pediatric preventive care package, ART adherence and basic pain and
symptom management within the training program. Facility-based care also creates an entry point for
screening and treatment of human papilloma virus (HPV, the cause of 95% of cases of cervical dysplasia),
other sexually transmitted infections, cervical cancer itself and other AIDS-associated cancers which are
often overlooked in clinic settings. JHPIEGO will train and support district and primary health care level
health professionals working with PLHIV to appropriately screen, diagnose, treat and educate PLHIV and
their partners about HPV, other STIs, cervical dysplasia and other AIDS-associated malignancies as a
component of comprehensive care services for PLHIV. Protocol and material development, training,
supportive supervision and follow-up technical support will be provided. The program will be developed and
implemented in partnership with the North West province provincial Department of Health and is intended to
improve the capacity of the South African health system to provide holistic care of PLHIV, especially women
infected or at risk for both HIV and cervical cancer.This activity addresses gender issues by promoting
equal access to OI, STI and cancer care for both males and females and equipping health care workers
with skills to address HPV and cervical dysplasia in women, an important element of HIV and AIDS care for
HIV-infected women that is largely overlooked. Screening, messaging and referral on gender-based
violence will also be integrated into the program.
ACTIVITY 3: Development of linkages between facilities and servicesTo improve overall program
effectiveness and integrate elements of social care to the clinical care program (activity #2 above),
JHPIEGO will support and work with one district DOH in North West province to formalize referral systems
and develop linkages between health facilities, and within health facilities (service-to-service) as well referral
Activity Narrative: and counter-referral between the health system and social services as it relates to HIV-related palliative
care services.These results contribute to the PEPFAR 2-7-10 goals by improving access to and quality of
palliative care services that were not previously provided.
Continuing Activity: 13780
13780 7887.08 U.S. Agency for JHPIEGO 6605 242.08 ACCESS $720,000
7887 7887.07 U.S. Agency for JHPIEGO 4495 242.07 Capacity $220,000
International Building 1
* Increasing gender equity in HIV/AIDS programs
Estimated amount of funding that is planned for Human Capacity Development $40,807
Table 3.3.08:
NO FY 2009 FUNDING IS REQUESTED FOR THIS ACTIVITY:
This activity was approved in the FY 2008 COP, was funded with FY 2008 PEPFAR funds, and is included
here to provide complete information for reviewers. The funding mechanism from field support to a local
agreement for Jhpiego HTXS is changing in October 2009 therefore a COP entry is being made to reflect
this change in mechanism and activity number only. Jhpiego activities under HTXS are expected to
continue under the FY 2009 COP and funds are being requested in the new COP entry.
Continuing Activity: 13781
29397 29397.08 HHS/Health University of 6417 3583.08 I-TECH $200,000
Resources Washington
Services
Administration
29396 29396.08 HHS/Centers for Research Triangle 6439 1255.08 Expansion of $514,459
Disease Control & International Routine
Prevention Counseling and
Testing and the
Provision of
Basic Care in
Clinics and
Hospitals
29395 29395.08 HHS/Centers for Protecting 6438 679.08 Promoting $514,459
Disease Control & Families Against Extensive
Prevention AIDS Implementation
of Quality
Prevention of
Mother to Child
Transmission
(PMTCT)
29394 29394.08 HHS/Centers for To Be Determined 9388 9388.08 Multi-Country
Disease Control & PHEs
Prevention
29393 29393.08 HHS/Centers for To Be Determined 9388 9388.08 Multi-Country
29392 29392.08 U.S. Agency for To Be Determined 12014 12014.08 Technical
International Management
Development Agent/Civil
Society Fund
29391 29391.07 HHS/Centers for Voxiva, Inc. 12083 12083.07 Voxiva $399,611
Disease Control &
13781 2939.08 U.S. Agency for JHPIEGO 6605 242.08 ACCESS $0
7629 2939.07 U.S. Agency for JHPIEGO 4495 242.07 Capacity $2,725,000
2939 2939.06 U.S. Agency for JHPIEGO 2638 242.06 Capacity $480,000
Construction/Renovation
* Family Planning
* TB
Estimated amount of funding that is planned for Human Capacity Development $800,000
Table 3.3.09:
Building on the expansion of Training Information Monitoring System (TIMS) in FY 2008 to the National
PMTCT Unit, Northern Cape, KwaZulu-Natal, Department of Public Service and Administration and
Mpumalanga provinces, Jhpiego will continue to support the existing TIMS sites in FY 2009 by providing
technical assistance with intermittent troubleshooting. The on-site technical support will entail visiting sites
for support on data cleaning, generation of reports, and trouble-shooting for the sites established in 2008.
The technical support provided for sites established prior to 2007 is mainly trouble-shooting, depending on
site requests. Furthermore, Jhpiego will expand TIMS to Gauteng and Free State provinces in FY 2009.
In FY 2009 Jhpiego proposes to intensify PMTCT monitoring and evaluation (M&E) on-site supervision and
follow-up to four additional sites in the North West province. Jhpiego proposes to use the PMTCT M&E and
supervision tool developed in the Northern Cape, which outlines PMTCT M&E standards. This intervention
will be coupled with PMTCT program support aimed at capacity building and quality improvement in service
delivery within the North West province, bringing about synergy to Jhpiego's interventions. Facility-based
health-care workers will be assisted to implement interventions to improve M&E capacity. Jhpiego's TA will
focus on interventions such as record keeping, data quality, interpretation of data and reporting, as well as
the use of information for decision making. Jhpiego will encourage facilities to use the M&E performance
tool as an internal method for supervising their effectiveness for M&E.
-------------------------
JHPIEGO will continue (a) conducting monitoring and evaluation (M&E) training in PMTCT for staff from the
National Department of Health (NDOH) and provinces; and (b) implementing and expansion of the training
information monitoring system (TIMS). In addition, JHPIEGO will also strengthen PMTCT supervision skills
for provincial and district PMTCT program managers.
ACTIVITY 1: Monitoring and Evaluation
Since FY 2004, JHPIEGO has provided technical assistance in strengthening PMTCT M&E and has trained
approximately 250 HIV and AIDS program managers and coordinators from the NDOH and eight provincial
departments of health in M&E fundamentals. In FY 2007, JHPIEGO provided intensive on-site supervision
and follow-up to targeted sites in the Northern Cape using a supervision tool outlining PMTCT M&E
standards. JHPIEGO assisted facility-based health-care workers to implement interventions to improve
M&E capacity. Technical assistance focused on interventions such as record keeping, interpretation of data
and reporting. JHPIEGO encouraged facilities to use the M&E performance tool as an internal method for
supervising their effectiveness for M&E. PEPFAR funding will be used to support technical assistance costs
(M&E expert consultants) to facilitate this process at the site level. The activities will continue in FY 2008
and will be expanded to additional sites.
ACTIVITY 2: Training Information Monitoring System (TIMS)
Building on the expansion of TIMS in FY 2007 to the National PMTCT Unit, Northern Cape, and North West
provinces, JHPIEGO will continue to support TIMS in FY 2008 by providing technical assistance with
intermittent troubleshooting to the provinces and exploring web-based TIMS. As a result of this activity, the
NDOH PMTCT and TB units and three regional training centers in Gauteng, Mpumalanga and Limpopo will
be able to capture training data on both national and provincial levels. This data will permit them to assess
their progress and ongoing needs for capacity building. TIMS allows program planners to determine where
training needs are greatest and prioritize their investment of training resources accordingly.
ACTIVITY 3: Training in PMTCT Supervision
As partners under the USAID Population and Health Integrated Assistance project, JHPIEGO developed
and implemented supervision training for reproductive health supervisors in Kenya, Malawi and Ethiopia. In
FY 2008 JHPIEGO proposes to address training-related PMTCT supervision problems through the
adaptation and implementation of the supervision learning package. Supervision is an essential intervention
to maintain the performance of the healthcare provider, and improved supervision is unanimously
recognized as important for the delivery of quality HIV and AIDS services. The supervisor plays a critical
role in ensuring that members of the community receive quality healthcare services. To perform effectively,
the supervisor not only needs to acquire the knowledge and skills to do the job, but needs to work in an
environment that will allow the supervisor to have a positive effect on the quality of services. Most health
professionals charged with supervision responsibilities in the PMTCT program lack the full range of
knowledge and skills to perform their job effectively. Most supervisors are limited in this capacity because
they have received not received training in this area or any support or reference materials on supervision. In
addition to a lack of knowledge and skills, other causes of poor performance include: insufficient funds for
transportation, lack of supervision tools (to be addressed in part through the development of the supervision
learning package), infrequent supervision visits and inadequate national supervision guidelines. To
maximize the effect of the training interventions, it is essential that these other causes of poor performance
be addressed concurrently with the training of supervisors.
These activities will indirectly contribute to the overall PEPFAR objectives, as supervision will indirectly
increase access due to improved quality of service.
Continuing Activity: 21089
21089 21089.08 U.S. Agency for JHPIEGO 6605 242.08 ACCESS $242,500
Estimated amount of funding that is planned for Human Capacity Development $17,358
Table 3.3.17:
