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.
JSI-Making Medical Injections Safer (MMIS) is a USAID funded project aimed at reduction of medical
transmission of HIV and other blood borne pathogens through the rapid reduction of unsafe and
unnecessary injections. In FY08, project interventions which include; training, on job supportive
supervision, provision of waste management commodities, and cross unit visits will cover a total of 25
districts, benefiting 1225 health units. A total of 2500 health workers will be trained. During the training,
policy documents and norms and standards on injection safety and health care waste management will be
widely distributed and standard precautions on infection prevention and control will be emphasized. The
benefiting districts will receive a total of 7,877,900 needles and syringes with re-use prevention features and
88,875 safety boxes. Waste segregation bins, bin liners, and protective gear for waste handlers will be
provided. The project will continue to create public awareness through radio messages, house to house
education of family members by village health teams, drama shows, and through film, and radio talk shows.
Local political and civic leaders will be involved in most of the awareness activities. Supervision data
collected so far shows that there is improved knowledge and skills of health workers, reduced exposure to
needle stick injuries and a significant reduction in unnecessary use of injections.
Contributions to overall program: According to the figures for distribution of commodities, the average
number of injections per person per year has dropped from three injections per person per year in 2005 to
1.5 - 2 injections per person per year in 2007. PEPFAR implementing sites have a cleaner working
environment with over 80% of the health units within the project area having medical waste/safe injection
programs in place. Findings of observations made during supervision show that 100 % of injection devices
used on clients come from new sterile packs. In consistency with the Ministry Of Health (MOH) plans of
introducing syringes with re-use prevention features nation wide, in FY 2008, the project will scale up
interventions in five expansion districts while sustaining desired practices in the FY 2007 twenty five
districts. An additional 450 health units with 2500 health workers will benefit from this expansion. All
information collected will be shared with the district health teams and individual feedback will be given to
each facility supervised by the project staff.
Intervention areas: Interventions used for the MMIS program include improving skills of injection providers,
ensuring full supply of injection commodities therefore eliminating the need to re-use, conducting behavior
change campaigns; promoting use of oral formulation, (this enforces compliance with oral treatment
regimes including ARVs and anti- TB drugs), and enhancing health care waste management. All
interventions are conducted by working within existing structures, improving program efficiency by looking
for cheaper alternatives, and using strong advocates. All health workers regardless of specialty are targeted
for behavior change.
It is estimated that there are 2500 health workers in the expansion areas targeted for 2008. The project will
work closely with the Ministry of Health to train 85% of all the workers both in public and private facilities in
safe injection practices, appropriate health care waste management, logistics management and
communication and behavior change. This will be achieved through the creation of a central team of trainers
who will train a team of district trainers in each district. The district trainers will then train health facility
based health workers within their districts. The W.H.O./AFRO/JSI facilitator's guide which was adapted in
the country will be used as the basis for all trainings. Desired practices will be further enhanced through on
job support supervision and cross unit visits. Targets for the training will include public and private health
workers including doctors, nurses, clinical officers, nursing assistants, waste handlers, logisticians and
Provision of technical assistance to districts to ensure injection device security:
Using a ratio of 1.5 injections per person per year; MMIS will assist the districts to order for adequate
needles, and syringes with re-use prevention features using their credit line funds. The project will improve
the districts' logistics capacity with the aim of ensuring that 80% of health facilities in the project districts
report no stock-outs through out the year. For facilities that may happen to get stock-outs, the duration of
stock-outs should not last more than 28 days. This will be achieved by training the health unit store
managers on timely forecasting and proper management of stores, and by liaising with Uganda national
medical stores (NMS) to streamline the distribution of commodities. This will give the project an opportunity
to strengthen the existing logistics system. Client exit interviews will be done from time to time to check
whether the last needle and syringe used on them came from a sealed pack.
Other planned activities:
All efforts will be put in place to establish an environment where health workers, patients and communities
are better protected against transmission of blood borne pathogens. Such activities will include, promotion
of health worker safety related policies like immunization of health workers, establishing exposure
management systems and provision of waste management commodities. Behavior change campaigns will
be launched targeting communities and prescribers with the major aim of reducing unnecessary injections.
All activities will be implemented in a manner that will offer men and women equal opportunity to access
information and services.
Provision of technical assistance to PEPFAR implementing partners in the area of health care waste
management funded through the country budget will complement these activities.