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: 2007
TITLE: Scaling-up PMTCT through Strengthened Linkages Between Prevention and Treatment
NEED: According to the 2003/04 the HIV indicator survey (THIS), 6.8% of pregnant women are living with
HIV, yet only 10% of those have access to PMTCT services. The mission to decentralize PMTCT, scale-up,
and develop strong linkages between PMTCT and care and treatment (C&T) holds considerable promise,
particularly where PMTCT activities are integrated into other reproductive health (RH) activities.
In recent past, through funding from EGPAF, EngenderHealth implemented comprehensive and integrated
PMTCT services including maternal and child health (MCH) affiliated voluntary counseling and testing
(VCT), antiretroviral (ARV) prophylaxis, strengthening referral linkages to care and treatment, integration of
VCT in family planning (FP) services and encouraging male involvement. The proposed project will build on
lessons learned and replicate best practices. EngenderHealth employs competent staff to backstop the
project. Our global HIV team will also provide technical assistance as needed.
In FY 2007, EngenderHealth received PEPFAR funding from USAID to initiate comprehensive and
integrated PMTCT services in 12 districts in Manyara and Iringa. In collaboration with council health
management teams (CHMTs), 48 sites were identified (five per district). EngenderHealth collaborates with
AIDS Relief in Manyara and Family Health International (FHI) in Iringa regions where the two agencies are
supporting C&T activities in hospitals. The project start-up activities, including participatory planning with
CHMTs, will start in August 2007.
ACTIVITIES: EngenderHealth plans to expand a comprehensive and integrated package of PMTCT
interventions to help strengthen maternal and child health (MCH) services and other care, treatment, and
support services in 60 new public sites, in addition to strengthening the program in 48 old sites in 12
districts in Manyara and Iringa regions (five districts in Manyara and seven in Iringa, respectively).
EngenderHealth's strength in facilities and operations management, with a strong systems approach, will
focus on the provision of technical assistance and establishment of PMTCT services in the two regions.
The proposed project aims to reduce the vertical transmission of HIV and enhance access to quality care,
treatment, and support services for women and their partners in the 12 districts of Manyara and Iringa
regions of Tanzania. This will be achieved through five key objectives:
1) integrating a core package of PMTCT interventions into reproductive and child health (RCH) clinics in 60
new sites, and strengthen the program in 48 sites;.
2) integration of family practice (FP) and HIV services for women attending FP, Child Welfare clinics, and
care and treatment services in 108 health facilities in 12 districts.
3) building capacity of health care providers in health facilities to provide quality PMTCT, VCT, and care and
4) strengthening referral mechanisms between higher and lower-level health facilities and between PMTCT,
VCT, and care and treatment services through an integrated network model approach.
5) building local partners' capacity for community-based care and support to address treatment adherence,
HIV/STI prevention, and care and support needs of HIV-positive women, their partners, and their children.
The project will build on previous lessons learned from implementation in Arusha and initiate PMTCT
activities where they do not currently exist using the following competencies: quality assurance and quality
improvement (QI) of services and service delivery through client-oriented, provider-efficient services
(COPE) methodology on PMTCT and C&T; establishment of PMTCT and VCT for women attending FP and
other RCH services as multiple entry points for greater utilization and saturation of C&T services; sensitivity
to clients' rights, equity and respect for a woman's informed choice throughout all program activities;
infection-prevention (including universal precautions) and reduction of HIV/AIDS-related stigma and
discrimination among health care workers; male involvement implemented through the men as partners
(MAP) approach seeking to use men's critical position as decision-makers to enhance uptake of
interventions; linkage to EngenderHealth's ACQUIRE project to strengthen family planning services and
FP/RH needs of HIV positive women and their partners; collaborate with district hospitals to conduct mobile
PMTCT services targeting hard to reach communities (e.g., nomadic populations in specific districts).
LINKAGES: The project will build strong referral networks of health facilities and existing community
structures to provide support and follow-up of HIV-positive mothers and their infants and link them to C&T
services. The project will also work with the facilities to develop strong service linkages between PMTCT
and family planning, and a follow-up program at the under five growth-monitoring clinic for exposed infants.
Other linkage interventions will include follow-up of HIV-positive mothers and their exposed infants at both
the facility and community levels. EngenderHealth will collaborate with FHI in Iringa region and AIDS Relief
in Manyara to create synergy and functional referrals between PMTCT and C&T. Additionally,
EngenderHealth will collaborate with partners in the area who have expertise to provide community and
home-based care, social and religious support groups, nutritional support, financial assistance/income
generation opportunities, and legal assistance.
The follow-up of exposed children will be linked to growth-monitoring programs and immunization clinics. All
exposed infants will receive cotrimoxazole syrup as early as 4 weeks. The project will give special attention
to young, married girls and adolescents with early pregnancies, and provide them with services tailored to
their needs The program will also apply the basic principles of human rights and gender equity to promote
sustainable and continuous prevention, care, support, treatment adherence, and referral for related services
for HIV-positive women, their partners, and children.
M&E: The project will adhere to PEPFAR reporting requirements. Sites will use national PMTCT
instruments to collect data based on PEPFAR indicators which include: number of service outlets providing
the minimum package of PMTCT services according to national and international standards; number of
pregnant women who received HIV counseling and testing for PMTCT and received their test results;
number of pregnant women provided with a complete course of antiretroviral prophylaxis for PMTCT;
number of health workers trained in the provision of PMTCT services according to national and international
Activity Narrative: standards; and number of HIV-positive pregnant women referred to care and treatment centers. Regional
and district RCH coordinators will receive training in writing reports, and subsequently submit monthly and
quarterly reports to EngenderHealth and MOHSW.
SUSTAINAIBLITY: The project will build on, and adapt best practices and lessons learned from
EngenderHealth's previous PMTCT projects in Arusha region. This will include participatory planning with
regional health management teams (RHMT) and CHMTs and integration of interventions into
comprehensive council health plans for sustainability. Since October 2003, EngenderHealth has received
field support from USAID to assist the MOHSW in expanding access to, and the utilization of, reproductive
health services in Tanzania. Presently, EngenderHealth through the ACQUIRE Project, works in all 21
regions and Zanzibar. This project will build onto sites proposed for the ACQUIRE family
planning/reproductive health project where EngenderHealth provides technical assistance to districts to
include these activities in their comprehensive council health plans to ensure sustainability.