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
The proposed project will take place in Kyaka II settlement of Kyenjonjo district. The area of implementation
has 27,609 people, 10,540 are host population and 17,069 (UNHCR, August 2007) are refugees,
predominantly Congolese. Females make up 50% of the total population in the settlement. GTZ (German
Development and Technical Cooperation) is implementing health services for UNHCR in Kyaka II
settlement through one health center, which offers curative, preventive, VCT, PMTCT, palliative care and
ART services with support from IMC. The clinic records delivery of 35-45 babies per month, an equal
number of births is estimated at homes, with the assistance of TBAs. In the 2007 FY, IMC will provide HIV
counseling and testing services to 1,500 pregnant women through its single service outlet. Community
mobilization and awareness through use of information campaigns, dramas & door to door visits e.t.c to
increase PMTCT uptake will be done including encouragement of spouses to attend PMTCT services. An
estimated number of 75 HIV positive mothers will receive preventive ARVS during FY 2007.
In FY 2008, IMC plans to expand PMTCT services to one other health center II in Mukondo as well as
improve the quality of PMTCT services outlined below. Antenatal care will continue to provide an entry into
the PMCT program. On antenatal clinic day, all expectant mothers will be sensitized on the benefits of
taking HIV test, mother to child HIV transmission, general HIV/AIDS prevention information, infant feeding
practices, and family planning. Group HIV pre-test counseling will be conducted and consenting mothers will
be provided with an HIV test and given results. Incentives like t-shirts and mosquito nets will be used to
motivate couples who attend antenatal care services as part of the process of increasing men's enrolment
into the PMTCT program. In addition, a special antenatal clinic day will be set aside to attend to couples.
Through HIV post-test counseling, HIV positive expectant mothers will be identified, informed about the
PMTCT services and other HIV and AIDS care and support services available and enrolled on to the
program. Specific services provided to HIV positive expectant mothers will include HIV specific infant
feeding education, provision of micro nutrient supplements like iron, OI management, nutrition counseling,
education on good hygiene practices, personal and home care. Reproductive health services such as
treatment of sexually transmitted disease, family planning / child spacing, intermittent preventive treatment
of malaria, postnatal care e.t.c will be integrated into PMTCT programs through education and provision of
services. HIV positive mothers will also be provided with preventive ARVs (basic regimen, combined
regimen or HAART using MOH PMTCT guidelines). In addition IMC will support HIV positive mothers by
taking their blood samples to the JCRC in Fort Portal where CD4 counts can be conducted. Follow up care
and support for mother and baby will be done after delivery in order to increase uptake of PMTCT services.
IMC will conduct a rigorous PMTCT campaign using film vans, IEC materials and door to door sensitization.
The PMTCT awareness campaign will highlight the benefits of PMTCT services to girls, pregnant women,
their partners, parents and communities as well as the need for male partners to provide appropriate
support. IMC and GTZ will conduct refresher trainings for existing Traditional Birth Attendants (TBAs) on
PMCT to provide PMCT awareness and also to ensure that they refer HIV positive mothers to the health
centers for delivery. TBAs will also ensure that ARV prophylaxis is administered for both the baby and the
mother since many women opt to deliver outside the health centers because of the distances involved.
IMC will also establish a home-based PMTCT program to follow up on expectant mothers not accessing
ANC services and PMTCT clients who drop out. They will be followed up in their homes and provided with
related information and drugs. Linkages with other existing programs that support vulnerable populations
like the Maternal Child Health Nutrition program and the Basic Care Package Program by PSI will be
strengthened.
Through PMTCT services, IMC will link babies exposed to HIV to other prevention, care and treatment
services. An early infant diagnosis (EID) and pediatric care program will be established. HIV positive
babies will be enrolled in the ART program. HIV specific infant feeding counseling to HIV+ mothers will
continue after delivery and during further postnatal visits, soon after delivery and at 5 to six months when
babies are expected to be weaned. IMC will promote exclusive breastfeeding since it is the most viable
option in this context. Awareness on early cessation of breast feeding and rapid weaning will be done
during the home visits. The families of HIV positive mothers will be supported to strengthen or set up
income generating activities for purposes of raising money to manage complementary feeding.
Other activities include provision of related medical supplies, additional staff to be recruited and trained
(midwife/counselor) to ensure the clinic team will be able to manage the additional workload. This activity is
expected to reach 1700 women with PMTCT services between September 1, 2008 to September 1 2009.
GTZ will continue providing these services after the project phases out with a long term plan of the health
sub district taking it on when the camp is closed.
HIV prevalence, according to the 2004/2005 National HIV/AIDS Sero Behavioral survey, is 6% among
adults aged 15-49 years of age. Prevalence among women is higher (8%) than that of men (5%). The
same survey reports that 76% of new infections are attributable to sexual transmission, of this amount, 42%
where within marriage (largely due to extra marital sex but also entering marriage relationships without
testing and mutual disclosure of results). In Kyaka II, prevalence is slightly higher than national figures
(6.8%). This higher rates is mainly attributed to youth not embracing messages of abstinence. Secondly,
marital infidelity is legitimatized especially for men in the community. There is also a big number of youth
especially girls who drop out of school and engage in prostitution (IMC Baseline survey, 2006). Alcoholism
is also another predisposing factor to the spread of HIV in the camps.
In FY 2006 and 2007, IMC has stepped up HIV awareness in Kyaka II through door to door visits,
impromptu discussions, community meetings, video and film shows, drama, and public information
campaigns. Schools were specifically targeted through training peer counselors, organizing debates and
seminars, an essay writing competition on abstinence and through inter school drama competitions. 6
schools were targeted with a population of 4000 students. The last annual review conducted in July 2007
reported that 99% of the refugee population had basic knowledge about HIV and considered it to be a big
threat to their lives/health. This knowledge, however has not translated into the required behavioral change.
In FY 2008, the proposed project will take place in Kyaka II settlement of Kyenjonjo district where 27,609
people reside (10,540 are host population and 17,069 are refugees). IMC will shift to translating existing
HIV knowledge into the desired behavioral change using the health belief model within the context of
HIV/AIDS. The model involves providing comprehensive HIV knowledge, assessing risk for HIV and
consequences, identifying alternatives to risky behavior and drawing action plans to reach desired behavior.
Life skills training for the youth (in and out of school) is also a key component of this model. This model will
be tailored to promote abstinence and marital fidelity. IMC will continue promoting the use of the PIASCY
(Presidential Initiative For AIDS Strategy on Communication to Youth) in order to provide comprehensive
HIV/AIDS knowledge for the youth. In each school, life skills clubs will be supported to set up an HIV/AIDS
garage which provides information on an ongoing basis to students as well as provide an environment
where students can be allowed to share experiences or ask any questions and seek answers. This will be
done by putting an HIV question/suggestion box in the HIV garage where children can drop questions at
their convenience and the club can provide answers as and when they meet or during a school assembly.
In addition, door to door visits will be conducted by community educators targeting families to improve
communication between parents and children hence motivating positive and responsible behaviors.
Behavioral change campaigns will be conducted around World AIDS Day, Day of the African Child and
World refugee day. These campaigns will also provide avenues to provide public information about HCT,
OVC care and ART. HIV counseling and testing will be conducted at the celebration sites. IMC will also
support establishment of one group of PHA, and train them to carry out HIV/AIDS awareness. IMC will also
work with faith based institutions to create awareness on abstinence and promote marital fidelity. The
existing GBV program implemented by IMC will provide an opportunity to promote girl child education and
also create awareness on gender and gender based violence to facilitate the creation of more stable
homes. The community centers will be furnished with games to reduce idleness of the out of school youth.
IMC will recruit and train 8 new community educators to work among the host populations. HIV/AIDS talks
will be organized in schools, using guest speakers from the church, other health centers, district and, NGO
staff.
settlement through one health center, which offers curative, preventive, VCT, PMTCT, Palliative care and
ART services.
Condom use is one of the strategies for combating the spread against HIV and other sexually transmitted
diseases. According to the Uganda National HIV/AIDS Sero Behavioral Survey (UNHSBS), men (16%)
were more likely to have used a condom than women 9% during their last sexual encounter. Respondents
aged 15-19 years were by far the most likely age group to have used a condom at last sexual encounter.
The same survey reports that reasons given for not using a condom varied among men and women; men
trusted their partners did not have HIV while women said they did not like them or the partner refused. In
Kyaka II Refugee Settlement, consistent condom use is still low, many Congolese had never heard about
condoms before coming to Uganda while others say it's not culturally appropriate to discuss issues around
sex and condom use.
In FY 2007, IMC started awareness activities in Kyaka II refugee settlement focused on the benefits of
condoms and making them available in the community via the establishment of condom dispensers.
Following negotiations communities agreed to install the dispensers at or near bars. 103 bar owners were
sensitized on condom use and also trained on proper usage of dispensers which has led to an increase in
the number of condoms being taken out of the dispensers. However more efforts need to be done to
change misconceptions surrounding condoms and to promote consistent use. Training of community
educators on STI management was conducted and equipment for diagnosing STIs procured.
In FY 2008, IMC will continue with condom promotion, integration of RH and STI management, prevention
with positives activities and, promotion of HCT as a prevention strategy. IMC will launch a rigorous condom
promotion campaign in addition to ongoing door to door sensitization by community educators. The
condom outlets will be increased from 42 to 52 to fully cover the host population. IMC and GTZ will
undertake an operational research to assess condom use. STI prevention and treatment will be
strengthened through outreach testing, community sensitization, training of community workers, training of
health staff in syndromic management of OIs, IEC materials and provision of a broad spectrum of
antibiotics. Adolescent friendly reproductive services will be instituted at one health center through the
training of health staff, providing related supplies and materials, school talks and providing straight talk
newspapers. One group of PHAs will be formed and trained on positive living and prevention of STIs
including prevention of re-infection. They will also be encouraged and supported to carry out HIV/AIDS
awareness including condom use. During public information campaigns, HCT will be promoted as a
prevention strategy. During HCT and condom awareness, communities will be informed about discordance
and the need for discordant couples to use condoms consistently. Awareness on male circumcision within
the context of HIV will be done through door to door sensitization by community educators, IEC materials
and routine health education. Those in need of circumcision services will be referred to Kyegegwa HC III.
The existing Gender Based Violence Program will implement interventions aimed at changing unequal
decision making powers at household level and other gender norms. This will provide an opportunity to
discuss issues around negotiation for safer sex among couples. Alcoholism is a major impediment to
practicing safer sex and accelerates sexual coercion. The project will therefore raise awareness about the
linkage between alcohol, HIV and GBV in the communities through drama, community meetings and
impromptu discussions conducted by educators. IMC will also work with the OPM and the refugee welfare
leaders to enact and enforce by-laws regulating drinking hours and operations of bars in order to reduce
alcohol consumption
.The proposed project will take place in Kyaka II settlement of Kyenjonjo district. The area of implementation
ART services. In FY 2006-2007 IMC and GTZ started a palliative care program which provides clinical,
psychological and preventive services. To date, 107 of 381 HIV positive individuals have been enrolled in
the facility/home based care program.
In FY 2008, IMC will expand the continuum of care to include clinical, psychological, social and, prevention
services. IMC will use the family care model in providing palliative care. Under clinical management, health
staff will undertake clinical diagnosis, review of the clients and their family members. In addition they will
provide cotrimoxazole prophylaxis and pain killers to prevent opportunistic infections and manage pain
respectively. Clients in need of further clinical care will be referred to the health center. IMC will continue to
work with PSI to provide commodities like ITNs, safe water vessels, water and guard. Health education
including family planning, good hygiene practices, STI prevention and management, and prevention of re-
infection or infection to others will be provided to all family members. Condoms and contraceptives will be
provided to HIV clients and family members. Nutritional assessments will be made by health staff; those
clients identified as having severe nutritional problems will be referred to the GTZ nutritionist for further care
within the GTZ supplementary and therapeutic feeding program. During the home visits, clients together
with their families will be trained by the health staff on good and appropriate nutritional care for PHAs using
the GOU guidelines for Feeding People Living with HIV/AIDS. Any skill and knowledge gaps identified in
the health staff on nutritional care for PHAs will be addressed through training and information
dissemination by IMC staff. PHA groups and/or the care givers will be trained on back yard gardening and
provided with vegetable seeds as well as fast growing fruit trees to empower them to improve their diets.
Psychological/emotional support will also be provided through counseling of clients and family members.
Health staff will be trained by trainers from hospice in comprehensive palliative care, who will in turn train
PHAs, care givers and other service providers. IMC together with GTZ will initiate a pediatric palliative care
program. This will mainly support babies born to HIV positive mothers, HIV positive babies and, those with
symptoms of HIV/AIDS. Support provided will include follow up care; diagnosis, treatment and growth
monitoring, and support HIV positive mothers to practice safe infant feeding practices. Babies with severe
nutritional requirements will be referred to the GTZ nutritionist to access nutritional care. Health staff will be
trained and taken for exposure visits to institutions already involved in pediatric HIV care like Mild May.
Cotrimoxazole prophylaxis will also be provided at six weeks of age to newborns. This activity will reach
1,083 individuals (currently 381 HIV positive plus an additional 342 in FY 2007 and 360 in 2008 who join the
program) between September 1, 2008 to September 1, 2009.
psychological and preventive services to HIV positive individuals. To date, 107 of 381 HIV positive
individuals have been enrolled in the facility/home based care program. The TB clinic currently has 16
individuals receiving TB treatment, of these 16, 3 are HIV positive. TB/HIV palliative care has included TB
diagnosis, clinical monitoring, treatment and prevention of tuberculosis and referral of TB clients for HIV
testing.
In FY 2008, IMC/GTZ will expand TB/HIV interventions to Mukondo HCII increasing the service outlets from
one to two. To ensure a continuing high standard of care, IMC will provide a refresher training to 10 health
professionals to provide clinical prophylaxis, TB diagnosis, treatment protocol and elements of Community
based Directly Observed Treatment Short-course (TB-DOTS). Training will be conducted by TB staff from
the district that have substantial knowledge on national TB and ACP programs. IMC will identify and train
18 community health workers as TB/HIV focal persons on CB-DOTS using national TB/HIV collaborative
guidelines and provide them with relevant materials and logistical support to improve drug adherence and
defaulter tracing. Communities will be sensitised about respiratory tract infections in general & T.B in
particular - issues related to indoor smoke pollution, over-crowding, and the risks of drinking partially boiled
milk during community gatherings. A TB campaign will be conducted on World Tuberculosis Day (March
24) which will help to improve case finding, reduce stigma and defaulter rates as well as promote preventive
and care aspects of tuberculosis. TB reagents and prevention therapy will continue to be accessed at
Kyegegwa Health Sub district. However, IMC will procure TB related supplies like pipettes, and microscope
sputum slides for the Mukondo HCII. All new TB patients are sensitized on TB/HIV integration, counseled
and tested for HIV if they have not already been tested via the RTC. All new TB/HIV patients will be
enrolled in the HIV/AIDS care and support program including nutritional support. Additional staff including a
laboratory technician and a nurse will be required to initiate TB/HIV services in Mukondo HCII. This activity
will support 40 (based on number of TB clients registered at the health centre in the last six months with an
addition of 10%) individuals with TB/HIV care between September 1, 2008 to September 1, 2009.
In FY 2006 and FY 2007, IMC, with support from Community Services, undertook a registration exercise of
OVC and registered 729 in school and 103 out of school. Following the assessment which documented
scholastic materials as a need, in school children were provided with various school supplies. 200 out of
the 832 OVC were assessed to be more vulnerable because they come from child headed families, have
single mothers or one parent who is chronically ill. These were provided with agricultural support to improve
nutrition and also raise household incomes. However the approach of group OVC gardens has not worked
well as some of the OVC and care givers abandoned the gardens because of a feeling of lack of ownership.
IMC has adjusted future programming in accordance with this lesson learned and will now focus on family
centered gardens.
In FY 2008 IMC will strengthen OVC programs using a family centered approach where OVC are targeted
within their families to ensure adequate monitoring, support and, ownership of program. To address the
psychosocial needs of these OVC and their families/caregivers, a refresher training will be conducted for 10
volunteers trained in child counseling during FY07 and IMC provide ongoing supportive supervision to these
individuals. The Counselor Trainer will be responsible for providing psychosocial care directly to those OVC
with particular needs when referred by the 10 trained counselors. In close coordination with focal persons
within IMC's SGBV program, the Counselor Trainer would work with other agencies providing assistance to
vulnerable children in the settlement to identify and respond to the changing needs of OVC. Existing child
rights committees at zonal level will be trained to integrate OVC care in their child rights education programs
in the communities as well as monitor the conditions of OVC in their zones.
This activity will also continue to improve the food security and ability of OVC and their caretakers to secure
livelihoods through the provision of seedlings, cultivation tools and training. The IMC Agricultural Trainer will
be responsible for supporting the OVC families to make an assessment of crops to grow or animals to rear
that would generate income and are central to maintaining a nutritious diet. The agriculturalist will make
recommendations to IMC for support and will also be expected to provide routine monitoring and training in
agricultural and marketing skills to the OVC families. A total of 75 of the neediest OVC families will be
selected by IMC together with the Community Services Office using an established assessment and
selection criterion developed by the Community Services Office and OVC Zonal Committees.
IMC will also provide scholastic materials to 729 OVC in school. However the materials will be distributed at
household level to reduce stigma associated with distribution in schools. This will be complemented by an
awareness-raising campaign coordinated by the Community Educators aimed at changing the attitudes of
families/care givers to promote children's right to education, particularly those younger girls currently
undertaking traditional ‘female roles' in the household. Through community dialogue with social forums,
drama groups and door-to-door visits, this campaign will also emphasize the negative affects of domestic
violence, neglect and exploitation of vulnerable children and will serve to reinforce IMC's ongoing campaign
against under-age sex and early marriages as part of the sexual and gender-based violence program and
the abstinence/be faithful activity in this program. This activity will also link up with other HIV/AIDS related
services. For example the Community Educators through the door to door visits will raise awareness on
HIV, HCT, PMTCT and other services available and will make any needed referrals. Likewise the health
workers will refer any OVC identified within the HIV/AIDS setting to the OVC care program. This activity
therefore proposes to reach 832 OVC between September 1, 2008 to September 1, 2009.
settlement through one health center, which offers curative, preventive, VCT, PMTCT, and ART services.
From FY 2006 to FY 2007, IMC extended HCT services to over 7,000 refugees using one service outlet and
9 community outreaches.
In FY 2008, the project will expand services to Mukondo HCII, therefore having 2 service outlets and 9
community outreaches. VCT will continue to be the primary point for delivering HVCT services although
RCT will continue to be used within the context of PMTCT. In addition routine testing and counseling (RTC)
will be offered as part of clinical evaluation along with any other tests or investigations recommended by
health providers. Health staff will receive refresher trainings on HIV counseling as well as ethical issues
associated with RTC and routine counseling and testing (RCT). Selected individuals will be trained as
Counseling Aides to support the HVCT unit to better the counselor-client ratio and improve the quality of
HVCT provided, especially at outreach sites where many people turn up demanding for counseling and
testing services. HIV test kits and related materials will be obtained from the health sub-district but IMC and
GTZ will procure some to prevent stock outs. In addition to promoting the available services, periodic
community awareness campaigns especially around key international events like World AIDS Day -
December 1st, will address issues related to disclosure of status to partners and families and the need for
couple counseling and testing. In order to promote and better provide couple counseling, health staff will be
trained to carry out couple counseling. In addition tokens in the form of T-shirts, fast services, refreshments
etc. will be provided to couples that turn up for HVCT. Community Educators will emphasize the importance
of testing for children at risk of infection as part of this campaign. HVCT for children will be done mainly
within the PMTCT context where babies born to HIV positive mothers or those with symptoms of HIV/AIDS
will be tested at 18 months. GTZ will also explore the possibility of working with JCRC in Fort Portal to
provide PCR in the long run. Other children will be tested as part of clinical evaluations while those above
12 years will be sensitized in school or during community sensitizations. In addition those above 12 years
can access VCT at the different outlets or outreaches. Market days and church activities will continue to
provide an entry point to HVCT. Links between the ongoing SGBV program and market/church activities will
be key to the promotion of increased gender equity, challenging of male norms and behaviors conducive to
HIV and STIs transmission, and the reduction of violence and coercion. All individuals who test HIV positive
will be counseled and informed about available care and support services for PHAs including treatment for
OIs, ART, PMTCT and palliative care services and enrolled on to the care and support program. All
expectant mothers who present at VCT sites will be referred to the health centers to receive ANC services
and PMTCT services. This activity will reach out to 4000 individuals between September 2008 and
September 2009.
