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.
Subdivisions of Program Areas, these track general higher level sub-classifications of expenditure.
Subdivisions of Major categories, these are the most detailed expenditure data.
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
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
World Vision (WV) is expanding OVC care activities by increasing the coverage, scope, and quality of
services to family members of HIV-infected individuals and older OVC. Emphasis areas are community
mobilization, training, and development of linkages and referral systems. The target populations are people
living with HIV and AIDS.
World Vision is a non-profit organization established in 1967 working in 14 Area Development Programs
(ADPs) in six provinces of the country, reaching over 42,000 children with holistic development support.
World Vision has already identified and is providing community-led support to 4,439 OVC in these ADPs.
With PEPFAR funding this number will be increased to 17,500 children through the OVC project. For this
project, the target will be to address the needs of primary caregivers of OVC and older OVC which are not
covered by OVC funding. By working with community partnerships through their Community Care Coalitions
(CCC) model, World Vision enhances their ability to prevent, mitigate and alleviate the impact of HIV and
AIDS. Care at the home and community level is a strategy within the South African Government National
World Vision will continue to strengthen access to integrated services as a part of a comprehensive care
package for PLHIV and their families in Free State, Limpopo and Eastern Cape provinces, with expansion
to at least 2 ADPs in Kwazulu-Natal province. The activities reinforce and expand services provided by
Community-based Organizations (CBOs) and government care programs, such as basic hygiene, wound
care, screening for pain and symptoms, nutrition assessment and support, spiritual care and support,
psychological care and promotion of the HIV preventive care package. With FY 2008 funding, World Vision
will further institutionalize the program within government and CBOs, while also expanding its reach. World
Vision will emphasize capacity building and local skills transfer, and assist HBC programs to develop
strategies to alleviate the care burden on girls. These strategies will specifically address gender sensitive
counseling, community outreach and couple counseling furthermore World Vision will ensure quality of
community-based services, and identify/apply lessons learned.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Home-based care program
The majority (over 70%) of care workers (home visitors - HVs) in OVC programs are women (while two
thirds of the adult beneficiaries of the current home care programs are also women. In many cases, care
workers may also be recognized as traditional healers. World Vision will work to increase the involvement of
men in care giving. As part of psychosocial support trainings, care workers will engage men by focusing on
such topics as family violence, anger management, fathering and parenting skills. A stipend provided to
care workers and volunteers through the HBC program is an important source of household income.
Regular financial training seeks to improve the capacity and economic advancement of care workers in the
program. In addition to the psychosocial support training HVs will be trained on Palliative Community
Caregiving by Hospice.
Trained HVs provide a minimum standard of care focusing on physical, psychological, spiritual and social
interventions. In addition to sharing integrated HIV-related palliative care messages with HIV-infected
individuals and their families, care workers will use a family-centered approach to client assessment. Based
on the need, clients will be referred to partner clinics and hospitals for pain management, treatment of OIs
including cotrimoxazole prophylaxis, family planning or other issues as observed. Home visitors will monitor
referrals to ensure appropriate follow-up and ongoing care and support. All clients will be counseled on
prevention with positives and family members will be referred for counseling and testing. Outreach to the
community and referrals are part of the HBC activities. An additional key activity of care workers is
monitoring of adherence to TB and HIV treatment. Elements of the preventive care package for adults and
children are also included during interaction between the care worker and the client. Special emphasis
during training will ensure HVs have a comprehensive understanding of referrals and linkages with other
services, including linkages with health and social welfare sectors for grants, legal aid, micro-finance,
spiritual support, CT, ARVs, and FP. With FY 2008 funding, World Vision will also seek to include bicycle
transport options for care workers to further improve coverage and support.
ACTIVITY 2: Psychosocial support training
In addition to home visitors, World Vision will also continue to identify and train supervisors and group
leaders to provide psychosocial support services. In districts where psychosocial support will be
established, community group leaders will be trained to reach family members of PLHIV and OVC, adults,
and their households through group counseling. At each site, qualified and trustworthy community members
to guide support group activities will be identified. These community-based group leaders will lead weekly
support sessions for the group members and conduct home visits to families of OVC. WV's Regional
Psychosocial Advisor will train supervisors as well as selected World Vision staff on a training curriculum
based on successful modules designed to address the particular needs of children and of adults. The
training will equip supervisors to assist and support others in care of the carer. At all levels, care of the carer
and care support training will focus on psychosocial interventions, including assessment, basic counseling,
group facilitation, and advocacy. Complementing health and nutrition lessons, training will ensure that all
trainees are able to recognize general physical as well as psychosocial health problems associated with
HIV and AIDS in children, and to make appropriate referrals to Child and Family Wellness clinics, Health
Centers and PHC Centers as needed.
Support group meetings led by trained group leaders using interactive and participatory techniques will be
held regularly with HVs. Working with churches/FBOs, and CBOs, World Vision will invite community
members to form psychosocial support groups. Group members will also be identified through assessment
interviews and information provided by relevant community members. During these support group sessions,
HVs and volunteers will learn to enhance coping skills to accomplish activities of daily living. Members will
carry out tasks designed to enhance relationships and build self-esteem. Positive living is reinforced as
group members develop emotional resilience. At the end of the project's first year, groups will be
Activity Narrative: encouraged to continue meeting, with ongoing guidance from World Vision's staff. The positive impacts of
psychosocial support will extend to group members' households, and family members will benefit indirectly
from the support group's second year of activities.
In all of the above activities, OVC will be counted only in the OVC program area. Palliative care to family
members of PLHIV or OVC will be provided in at least two or the five categories of palliative care services.
PLHIV will receive at least one clinical and one other category of palliative care service.
These activities will contribute to the PEPFAR goal of reaching 10 million HIV-infected and affected
individuals with care.
World Vision (WV), together with the Christian AIDS Bureau of South Africa (CABSA), will mobilize and
strengthen a community led response to protect and care for orphans and vulnerable children (OVC) and
their families. The program is active in the Free State, Limpopo and the Eastern Cape provinces and with
will expand to the KwaZulu-Natal province. The major emphasis area is human capacity development
(training). The target population is OVC.
WV works in six provinces in South Africa (SA) in collaboration with CBOs, FBOs and government entities
to support over 42,000 sponsored children including 4,439 OVC registered at present. Currently, PEPFAR
supports Area Development Programs (ADPs in three and this will be expanded to four additional sites
within KwaZulu-Natal province. WV partners with CABSA to empower faith communities to develop projects
addressing HIV and AIDS. WV will use the CABSA curriculum (Channels of Hope (CoH)) to address
churches and FBOs to deal effectively with HIV and AIDS. The South African Government (SAG) Policy
Framework for OVC asserts that NGOs should assist in rolling out innovative and tested models to mobilize,
strengthen and support community led OVC efforts. With FY 2008 funding, WV will continue to assist
targeted communities to establish structures through which the community can care for and support OVC.
One element of an enabling environment for OVC support is the sustainability of community-based
organizations (CBO) such as Community Care Coalitions (CCC) which are equivalent to Child Care
Forums. WV will implement an organizational capacity building guide that includes self-assessment, training
based on the assessment and the follow-up support. WV will facilitate a process of sustainable community
involvement through this training to enable communities to develop and support their OVC. The WV
program will continue to work toward gender equity in service deliver by offering short gender courses to
NGOs and CBOs to improve their knowledge about child protection and how to address the factors that
keep girls out of school. FY 2008 additional funding, will expand activities under the Networks of Hope
program that they currently support expanding from 3 provinces to 4 with the addition of Kwazulu-Natal.
ACTIVITIES AND EXPECTED RESULTS:
ACTIVITY 1: Human Capacity Development
WV will conduct workshops, utilizing the CABSA CoH curriculum. A two-day Leaders Workshop will be held
with interested religious leaders The workshop will help religious leaders understand the urgency of the HIV
and AIDS crisis, to address negative and discriminatory attitudes and to work towards compassionate and
effective responses in congregations and communities. These leaders return to their congregations and to
FBOs to identify interested members who will in turn attend a four day workshop, which give attention to
best practice models for prevention, care for OVC, home-based care, voluntary counseling and testing and
advocacy. As a result of the four-day workshop, WV will work with each FBO to develop action plans to
address congregational and community, as well as confront gender discrimination, promoting gender equity
in communities. Trained congregation and FBO members will form Hope Teams which WV will support with
ongoing training and mentorship. In turn, these Hope teams will develop and carry out action plans relating
to the protection and care of OVC. The Hope Teams will work closely with the CCCs. 111 Hope Teams
have already been formed, training at this level will continue in FY 2008.
ACTIVITY 2: Community Mobilization
Through CCCs, WV will mobilize community stakeholders, including FBOs, CBOs, local government,
traditional leaders, school committees, health representatives, women groups, associations of people living
with HIV (PLHIV) and OVC. A two day stakeholder workshop will be held to identify gaps, and select the
CCC structure most appropriate to the local context. WV and CCCs will recruit new Home visitors (HV) to
visit OVC in their homes. CCCs will be encouraged to link and play an active role within the District Action
Committee for Children affected by HIV and AIDS (DACCA). Together with the CCC the HV will receive
training on Child Rights and Protection, access to education, health and nutrition, HIV prevention, Life Skills,
psychosocial support (PSS) and succession planning over five days. As a result, each identified OVC will
receive support from HV ranging from direct material provision to greater livelihood security.
ACTIVITY 3: Care and Support
After the workshops for CCCs and HVs, each OVC will receive a basic minimum package of services and
support. The services will include child monitoring and protection, PSS, agricultural inputs, facilitating
access to education, health care, basic nutrition training, HIV prevention, home-based care for chronically ill
adults and children, succession planning and supervised recreation. Direct support will include school fees,
vocational training, school uniforms, books and supplies, facilitation with transport for primary health care
checkups, improved diets/livelihoods through, clothing shoes, bedding and blankets.
ACIVITY 4: Local Organizational Capacity Development
WV developed an Organizational Capacity Building (OCB) guide to build organizational capacity. The OCB
process begins with an organizational self-assessment, training based on the result of the assessment and
follow-up support. The training may include Organizational Purpose, Planning, Procedures, Group
dynamics, Monitoring, Evaluation and Reporting, Finance, Resource Mobilization and external relations.
Through this activity WV will build the capacity of local organizations to operate effectively in providing
adequate protection and care to OVC and their families. WV will partner with CABSA to establish resource
centers in each ADP; stocked with relevant HIV and AIDS materials. The resource centers will be used by
the CCCs and community assisting them in the development of an adequate response to the OVC issues
facing their community.
ACIVITY 5: Referrals and linkages
WV works in collaboration with the DOSD, the Departments of Health, Education, Agriculture, private
companies, FBOs and CBOs. These partnerships will be expanded to ensure that all OVC are provided with
a full package of care and referred for appropriate treatment and care services. In addition to establishing a
program of 'community conversations', the project will integrate a gender component and advocacy into all
activities. The aim of these activities is to build stronger, more gender-equitable relationships with better
communication between partners utilizing participatory learning to improve the health, well-being and
resilience of adolescent OVC (Boys and Girls). Emphasis is place on options to delay sexual activity.
In FY 2008 the following activities will be added:
Activity Narrative: ACTIVITY 6: Community conversations
Facilitated community conversations will focus on raising awareness of social-economic and cultural
inequalities that put women at a disadvantage and how this contributes to the spread of HIV and AIDS.
Specifically, discussions will focus on how to strengthen the negotiating powers of women and girls in
sexual relationships and on raising the awareness of men about the role they play in sexual relationships.
This gender equality dialogue will emphasize the positive aspects of changing the behaviors that increase
the risk of becoming HIV-infected and using best practices. WV will benefit from participatory research
conducted demonstrating that these open and frank but sensitive "community conversations" help cement
new positive attitudes among youth and reduce gender-biased stereotypes. The majority of care workers
(Home visitors/HV) in OVC programs are women (over 70%). WV will work to increase the involvement of
men in care-giving of OVC. As part of the CCC (Community Care Coalition) trainings, HV's will engage men
by focusing on such topics as family violence, anger management, fathering and parenting skills. Training
materials will include discussion of power relations between girls and boys, women and men, and will give
girls skills in refusal and negotiation. CoH training will also emphasize addressing gender from a standpoint
of context and attitudes. WV will focus on men and boys as agents of change in this process of awareness
building, mobilizing and spreading HIV prevention messages.
ACTIVITY 7: Peer-support groups and Youth AIDS clubs
Peer support groups and Youth AIDS clubs will be targeted toward adolescents. WV will connect with these
adolescent OVC through schools and churches. Training in Youth prevention strategies will target boys and
girls. Using a participatory process, OVC will identify role models (including positive deviants) to serve as
the peer support leaders. The adolescents will form peer-education groups and these groups will form the
critical catalysts for the community social discourse on healthy norms and avoidance of risk behavior. The
anticipated outcome of this process is a re-emergence of AB as a community norm and a reduction in the
practice of cross-generational sex, transactional sex and multiple casual sex partnerships, etc.
In all WVSA ADP PEPFAR-funded sites there are sponsored children, funded by donors from different
countries, many of whom are OVC. WV requires at least quarterly visits to each of these children by
Development Workers. Through this process WVSA identifies the education, health, spiritual and other
needs of the children and their families. WV field staff provides a proactive role in identifying the needs of
OVC and the subsequent delivery of services, justifying the allocation of WV Matching funding to the budget
allocated by PEPFAR.
The WV OVC activities will contribute to the PEPFAR 2-7-10 goal by improving access to quality care to 10
million people including OVC.