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: 2010 2011
Goals and Objectives
Routine monitoring of HIV transmission from mothers to their infants gives direct information on the quality of PMTCT programs and number of infections averted. It can serve as feedback for program improvement but also for projection of the burden of disease and for procurement forecasting. In order to monitor the ongoing PMTCT program expansion and quality improvement, we propose to establish 15 sites for HIV-transmission monitoring. All children <1month seen at these sites will be routinely tested for HIV in a standardized way using DNA PCR. Sites identified are already operational, but do not yet test in a standardized way. The activity will largely involve data abstraction at 'well baby clinics'.
Objectives
1. To capture the HIV-exposure status of all children born to HIV+ mothers using Mother-Child Follow-up Registers at the 15 sites.
2. To determine, using Mother-Child Follow-up Registers, the PMTCT intervention received by the mother-child pairs.
3. To establish the HIV-infection status for each HIV-exposed child, using DBS DNA PCR technology.
4. To calculate the mother-to-child transmission rate of HIV at study sites.
5. To compare the effectiveness of different PMTCT interventions at the sites.
Contributions to Health Systems Strengthening
Routine monitoring as part of program management and service provision serves as direct feedback and motivation for health care workers and decision makers. This is true especially in settings where the effectiveness of PMTCT interventions is doubted by many professionals and mothers are counseled accordingly. We expect that timely feedback on quality of interventions will improve motivation and effectiveness of health care staff at facilities as well as at planning level.
Cross-cutting programs and key issues
Establishment of this monitoring system will directly provide information on the effectiveness of PMTCT programs over time, especially in the light of the ongoing PMTCT initiative by OGAC and the Global Fund. However, further expansion of this monitoring platform could provide follow up information on a range of services received during antenatal care and labor and delivery and related to maternal and child health.
IM Strategy to become more cost-efficient over time
Best strategies and most cost-effective interventions will be identified and programs can be directed strategically in order to achieve maximum benefit.
Geographic coverage and target populations
The study will be conducted at 15 sites in 3 regions.
The target population will be all HIV+ pregnant women and their children.
How IM links to PF goals
Goal 1 of the PF is on maintenance and scale-up of quality services. Routine monitoring of HIV-transmission will directly inform decision makers on strategies for best quality scale up and maintenance of programs.
Goal 2 of the PF focuses on prevention, including PMTCT efforts. This project is in line with this goal, as it will directly measure infections averted.
Goal 4 of the PF addresses the HIV drug and commodity supply. Through monitoring transmission and interventions received, CDC TZ and its partners will be better able to better forecast the quantities of HIV drugs required for prophylactic interventions as well as the needs for pediatric HIV care and treatment. Determining which prophylaxis is the most effective will also have implications for future drug and commodity supply calculations.
Goal 6 of the PF aims to ensure evidence-based decision making and strategic planning. The results of this project will feed directly into future decision-making and strategic planning for PMTCT interventions.
M&E Plans
The objectives of this project reflect M&E objectives for PMTCT programming. The results will serve as an ongoing monitoring of the effectiveness of various PMTCT interventions as well as the level of coverage of PMTCT interventions .
