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: 2010
Pact Implementing Mechanism Narrative
Pact's goals reflect breadth across key technical and cross-cutting areas, as well as Pact's capacity to support and mobilize local partners including CBOs, private partners, and provincial governments involved in the HIV/ AIDS response. As per the cooperative agreement (CoAg), the general goal is to "enhance the scale, quality, and effectiveness of the HIV prevention, care, support, and treatment interventions in the region through the efficient provision of grants along with organizational capacity building (OCB)."
Each year, Pact submits a detailed annual work plan to USAID RDM/A. The work plan includes updated results frameworks that incorporate the latest USG program direction. More detailed objectives from RDMA's partners are closely linked to RDM/A's evolving regional and country-specific strategies and translated immediately into action on the ground. This flexibility was critical for the GFATM, VCT, and care and support initiatives developed by USAID in FY 2009.
Strategic Objectives, Geographic Coverage, and Target Populations
For FY 2010, Pact's three strategic objectives for Thailand are listed below; and, the target populations include MSM and PLHA.
1. Reduce HIV transmission among MSM in Thailand by ensuring access to comprehensive prevention services, building a continuum of MSM-friendly prevention, care, and support services, and strengthening regional HIV/AIDS initiatives for MSM.
2. Improve the quality of life of MARPs and PLHA and their families in Thailand by increasing livelihood skills and income generating opportunities, and enabling access to prevention, care, and support services.
3. Develop, document, and disseminate effective models and methodologies for HIV prevention, care, and support for MSM and PLHA/MARPS livelihoods.
Pact provides an efficient grants mechanism for CBOs at a low 3% overhead rate to ensure funds are quickly mobilized to organizations delivering critical services. At the same time, Pact provides a tailored OCB program for these organizations.
Organizational Capacity Building (OCB) Approach
Pact works to improve service delivery performance of CBOs through tailored OCB support plans using highly participatory methods including self-assessment, facilitation and small group coaching, and mentoring by specialized providers. In Thailand, this includes OCB support for organizational sustainability for key local organizations serving the country's MSM community. Key OCB content areas include strategic planning, program management, organizational structure and governance, teamwork, human resources, financial management, resource mobilization, and M&E. Pact's OCB work strengthens the community response in Thailand.
In addition, Pact works to develop the emerging technical area of community systems strengthening (CSS), which includes:
Technical innovation in the intersection of the fields of livelihoods and HIV/ AIDS.
Effective linkages between comprehensive prevention and community care and support pilots for MARPs.
Strong support for strategic information including Pact's approach to MERL (Monitoring, Evaluation, Reporting, and Learning) strengthening at the CBO level.
Strong documentation of replicable models.
Strategic linkages between USG pilot programs and scale up with GFATM programs in Thailand.
Cost Effectiveness and Efficiency
Pact's Community REACH strategy is to achieve efficient and cost-effective programming through a coordinated community response that combines grants with OCB for CBOs to become more sustainable and resilient, rooted in community assets and social capital. In addition, Pact provides needed coordination for efficient HIV/ AIDS programming across a multi-donor portfolio. For example, Pact works to:
Strengthen partners' use of data from their financial systems to improve budgeting and resource allocation decisions.
Ensure smooth coordination with GFATM that avoids duplication and enhances the technical value of USAID-funded programs.
Leverage USAID-developed models and scales them up with GFATM funds.
Develop cost-effective approaches to TA from local providers for a more sustainable support for the CBO response.
Support USG in making more rational resource allocation decisions for multi-country programming in the GMR.
Monitoring and Evaluation Plans
Pact develops M&E plans at the project and partner level. For example, Pact used state-of-the-art methods with the Population and Development Association in the Positive Partnership Project (PPP) in Thailand to measure stigma reduction over time as a result of PPP programming. At the partner level, through our regional and local advisors, Pact works intensively with local CBO partners for improvement of data quality, and ensures timely and quality reporting to USAID. Pact also actively coordinates and implements harmonized M&E frameworks with key local partners including government technical staff. Pact develops detailed MERL operational guidelines for HIV/AIDS prevention, care and support, and livelihoods interventions. Pact provides TA to CBOs, NGOs, and government-funded programs on how to monitor and evaluate HIV/AIDS and livelihoods interventions for continuous improvements in targeting, implementation, and effectiveness.
Adult Care and Support
Budget Code Narrative for Pact
Continuing Adult Care and Treatment Activities for HIV-Positive MSM
In FY 2010 and FY 2011, Pact grantees will better define the service package for community care, increase coverage levels of HIV-positive MSM through the Continuum of Care, strengthen economic activities for HIV-positive MSM, and build linkages with other Pact livelihood programs in the region.
Community- and Home-Based Care for and by HIV-Positive MSM
Pact will continue its work in community- and home-based care and "positive health" for HIV-positive MSM linked to publicly provided ART/OI treatment in Bangkok, Chiang Mai, and Pattaya. Pact will support Sisters, SWING, and Violet Home to make referrals to MSM community-based TC and HIV-positive MSM community-based care and support.
Psychosocial Support and Counseling for HIV-Positive MSM
Pact is developing several models, including 1) drop-in centers for HIV-positive MSM that provide social support, 2) peer buddies that provide advocacy and support to HIV-positive MSM accessing and adhering to publicly-delivered treatment services, 3) web-based outreach, 4) home visits, and 5) more integrated models for HIV-positive MARPs and members of the general population.
Positive Health for MSM
Pact will work with other NGOs (like APN+, Poz, and Violet Home) to develop norms and adjust curricula for positive health, dignity, and prevention, including shared responsibility for preventing HIV transmission, and human rights advocacy for marginalized populations for healthy sexuality and male sexual health. Attention will focus on providing appropriate psychosocial support, assisting HIV-positive MSM in acceptance of diagnosis, supporting disclosure of status to loved ones, and increasing knowledge in treatment literacy and adherence.
Referrals and Linkages
Pact will focus on promoting linkages among all stakeholders for HIV counseling, voluntary testing, and STI and HIV/AIDS treatment and care. Pact partners will advocate for improved access for low-income MSM to the government 30-Baht health scheme, particularly for those living away from home as is the case of many HIV-positive MSW.
Counseling and Testing
Pact is supporting two important USG pilot initiativescommunity-based VCT with same-day results (six sites), and community-based care and support for HIV-positive MSM (Bangkok and Pattaya)that were initiated in FY 2009. Pact's role includes facilitating partnerships necessary for the success of the pilots (including MoUs with provincial government authorities, action plans, and sub-agreements with CBOs), and coordinating work plans for TA from specialized providers, such as FHI and others. Pact also works directly with local partners to ensure high-quality routine monitoring and QI approaches for MSM-targeted services. At the conclusion of the pilots, Pact will document the results for dissemination to national and regional authorities, and support scale up by other CBOs.
In FY 2010 and FY 2011, Pact will continue direct support for the rapid HIV TC with same day results pilots for MSM, MSW, and TG in three USAID locations (Bangkok, Chiang Mai, and Pattaya), and indirect support in three CDC/TUC locations (KhonKaen, Phuket, and Udon). Pilots will be conducted at government clinics, CBOs, and private providers. All pilots will follow the USG/TUC program-approved algorithm for rapid testing with same day results in close consultation with DDC. The role of CBOs will be to promote the service in the MSM communities, make referrals to/from prevention and treatment as well as community care, and support other CBOs serving MSM who are HIV-positive. Pact will ensure strong routine monitoring, and collaborate with FHI and others for program evaluation. Pact will work with RSAT to ensure the successful models are documented, disseminated, and scaled up in Phase 1 and Phase 2 of GFATM Round 8 as appropriate. Finally, Pact will work closely with Provincial Health Offices to sign MoUs and involve them in the pilot programs to ensure ownership.
17-HVSI Strategic Information
Pact will focus on improving M&E capacities among NGOs and CBOs as a critical component of the Community-based System Strengthening (CSS) project for USAID and Global Fund Round 8 partners, including the SR for MSM implementation RSAT.
Pact has designed and implemented organizational strengthening activities with each partner, which resulted in the use of standardized definitions, clear data collection protocols, and enhanced use of data to improve the quality of service delivery. This was achieved by linking coaching and systems development in M&E with broader organizational strengthening strategies that support teamwork, standard setting, and strategic planning.
Pact will continue to strengthen M&E systems and build learning agendas with partners to improve the quality of HIV prevention services. This will involve working with partners to respond to issues of effective coverage, program intensity, strengthening referral mechanisms, using information locally for decision-making, and improving efforts by front-line outreach workers. Pact works intensively with local CBO partners in all six USG-supported provinces on improving data quality, and will ensure the timely reporting of quality data to USAID and the GFATM.
Pact will support the documentation, packaging, replication, and scale-up of proven USG-funded models in Thailand. Many of the Pact partners will become sub-grantees under the Global Fund Round 8 proposal, and will be in a position to scale-up between FY 2011-FY 2012. This will require better documentation and replication of lessons learned and more advanced systems development.
Pact utilizes a participatory approach to build community buy-in for improving M&E. Pact will strengthen this approach by including the development of local learning agendas with TA from Pact's regional office. These activities will continue in FY 2011 with a greater emphasis on tracking service delivery performance and packaging models with key lessons learned incorporated into the materials for use by others to improve community-based services and strategies.
18-OHSS Health Systems Strengthening
Continuing Activities in Community Systems Strengthening
One of Pact's core competencies is to improve organizational effectiveness of its NGO/CBO grantees, resulting in strengthened organizations capable of strategic planning, project management, financial accountability, and complete and accurate M&E with enhanced reporting and learning. Pact is instrumental in strengthening the MSM community response to the HIV epidemic through improved services, better access to services, and more sustainable organizations rooted in the community.
Pact will work to support the development of an effective, sustainable response to HIV/AIDS in Thailand resulting in behavior change in MSM through services provided by local partners from the affected communities. Pact will work with NGOs to identify which capacity-building services and technical resources are needed, and which are already available in the community. Pact will also develop a more coordinated response in consultation with local governments and other TA providers.
Pact will organize a mix of training, TA, and coaching to strengthen the management capacity of NGOs/CBOs from the following menu:
M&E and reporting with learning (MERL)
Organizational structure improvements
Teamwork for decision-making
Quality improvement of service delivery
Approach to Sustainability
Pact's approach to sustainability is to develop long-term organizational capacity building (OCB) plans focusing first on quality of services, and then on comprehensive systems development to ensure sound management. Different kinds of sustainabilityorganizational, financial, and programmaticare viewed as concurrent objectives that can be pursued through tailored OCB plans made with each partner with a high degree of buy-in.
03-HVOP Sexual Prevention:
Other Sexual Prevention
Pact's Community REACH Asia Program targets MSM, including MSW and TG, in Thailand who are at risk for unprotected anal sex and multiple concurrent partners.
Small Grants for CBOs Serving MSM, MSW, and TG
Pact's small grants mechanism directly funds MSM HIV prevention services, including peer education and outreach, behavior change communications, distribution of condoms and lube, targeted media, referrals for STI treatment, and counseling and testing. In FY 2010 and FY 2011, Pact will work in six urban locationsthe original USAID sites of Bangkok, Chiang Mai and Pattaya plus three CDC sites in Khon Kaen, Phuket, and Udon Thani.
OCB Services for CBOs in HIV Prevention for MSM
Pact provides organizational capacity building (OCB) for CBOs to develop skills, leadership, and management systems in strategic planning, program management, human resource management, M&E, and finance and resource mobilization. In FY 2009, Pact supported three CBOs to develop strategic plans; efforts will continue in FY 2010 to use the plans to achieve targeted sustainability objectives and make specific improvements in services.
Pact's Work with RSAT and GFATM Round 8
One important platform for HIV prevention for MSM in Thailand is the GFATM Round 8 program, where Pact's partner RSAT serves as the SR for the national MSM response in Thailand through an umbrella mechanism supporting up to 19 IAs in Phase 1 from July 2009 to June 2011. RDMA anticipates that the USG-supported pilot interventions for MSM will be scaled-up in GFATM Phase 2 from 2011-2013. In FY 2010 and FY 2011, Pact will continue funding RSAT on OCB. Pact will also offer TA and OCB services through RSAT to additional MSM SSRs and IAs working with RSAT on the GFATM project.
Innovation in MERL
In 2009, Pact designed and implemented organizational strengthening activities, and one deliverable was a set of "indicator protocols" that explained in precise terms what data is collected and how it is collected, collated, transcribed, verified, analyzed, and reported. In FY 2010 and FY 2011, Pact will introduce the innovative MERL approach to build community buy-in for improving M&E, and strengthen participatory approaches including development of local learning agendas.