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
Research Triangle Institute (RTI International) is an international, independent not-for-profit organization
dedicated to improving the human condition through multidisciplinary technical assistance, training and
research services that meet the highest standards of professional performance.
During FY 2008, RTI initiated AB interventions as a new program area. The program is aimed at combating
HIV infections among specific target populations which include: patients, youth (in-school and out of school)
and adults in the supported districts. These target populations receive AB needs assessments and
community education through outreaches and drama activities. RTI scaled-up AB activities by partnering
with health facilities and community based organizations (CBOs) through sub-grants. However, due to the
delay in the release of funds, this activity reached a much lower number of people, compared to the original
anticipated figures.
During FY 2009, RTI proposes to reach 75,000 individuals with AB prevention messages. AB activities will
be conducted in a two pronged approach. First, RTI will offer small grants to health workers at supported
facilities, local community based organizations (CBOs), and PHA networks; the CBOs and PHA networks
will implement project activities that include outreaches and prevention education activities in their
catchment areas. Second, in selected communities, a team of health educators partnered with the district
health education (DHE) offices will be deployed within their catchment areas. The health educators will
conduct health talks which emphasize HIV prevention using the AB methods. All grantees and health
educators will be selected in a competitive and transparent manner and their activities will be rigorously
evaluated on a regular basis to ensure quality.
RTI will also assess the readiness of supported health facilities to roll out AB programs given their staffing
levels. RTI project staff will perform routine monitoring and provide supervision of activities including, sitting
in on a sampling of outreach sessions conducted by the partners. To further verify the number of persons
reached in the outreach sessions, grantees will take pictures at community meetings, per attaining the
permission of participants. Each health educator and grantee will be expected to submit detailed activity
reports covering accomplished work and the corresponding funds utilized for outreaches. Disbursement of
funds will be made in quarterly installments; subsequent releases will be tied to grantee performance and
their timely submission of the detailed activity reports, from their work in the previous quarter. All reports will
be done according to guidelines provided by RTI project staff. A partner with unsatisfactory performance or
issues with fiscal irresponsibility will be disqualified from obtaining further support.
New/Continuing Activity: Continuing Activity
Continuing Activity: 13312
Continued Associated Activity Information
Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds
System ID System ID
13312 8540.08 HHS/Centers for Research Triangle 6439 1255.08 Expansion of $180,000
Disease Control & International Routine
Prevention Counseling and
Testing and the
Provision of
Basic Care in
Clinics and
Hospitals
8540 8540.07 HHS/Centers for Research Triangle 4872 1255.07 Routine $82,000
Disease Control & International Counseling and
Prevention Testing in Two
District Hospitals
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Increasing women's legal rights
* Reducing violence and coercion
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development $5,000
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.02:
In FY 2008, RTI expanded OP services in health facilities. These OP services have reached 19,066 HIV-
positive individuals and their community members with positive with prevention (PWP) messages (Semi
Annual Report 2008). RTI continues to implement several activities aimed at increasing risk perception for
HIV transmission; especially among HIV+ positive individuals and their families. Health workers at
supported facilities and PHA networks provide educational activities on risk perception including:
counseling of patients on disclosure of sero-status to sexual partners, partner testing, use of family planning
methods to reduce vertical HIV transmission, promotion of behavior change emphasizing the correct and
consistent condom use among sero-discordant couples and populations that engage in high-risk behaviors.
During FY 2009, RTI will assist health facilities with the setting up of clinic-based support groups and post-
test clubs including; a discordant couple clubs, which will assist in providing post-test counseling and
psychosocial support to HIV-positive individuals. RTI proposes to reach 30,000 individuals with OP
messages. The project also will increase the role of PHA leaders and networks through the provision of
small grants; helping to strengthening their capacity to reach members in their networks by utilizing PWP
approaches.
Continuing Activity: 13313
13313 9636.08 HHS/Centers for Research Triangle 6439 1255.08 Expansion of $100,000
9636 9636.07 HHS/Centers for Research Triangle 4872 1255.07 Routine $40,000
Table 3.3.03:
research services that meet the highest standards of professional performance. RTI is partnering with AIDS
Healthcare Foundation (AHF) to support the Uganda Ministry of Health (MOH) in providing Routine HIV
Counseling and Testing (RCT) and basic care (BC) services to patients in district hospitals and health
center (HC) IV facilities. In this partnership, RTI contributes to the national response by addressing the
significant service gaps in the provision of HIV counseling and testing (HCT) and basic palliative care
services.
In FY 2008, RTI expanded its palliative care (PC) services to 16 facilities in four new districts, as part of
program scale-up. By July 30, 2008, 19,613 HIV-positive clients had been identified. The clients were
started on septrin prophylaxis (Cotrimoxazole) and then linked to RTI supported health facilities. At these
facilities, continual PC services are provided, including septrin prophylaxis, basic care kits and specialized
care. RTI's capacity building efforts have led to the strengthening of the referral system for HIV-positive
persons; approximately half of the identified HIV+ persons enroll in the HIV clinics within three months after
diagnosis. However, over the past year, RTI observed that the level of support provided in this program
area needed further strengthening. In light of this finding, the project proposes to strengthen PC services in
38 existing health facilities and initiate PC services in three additional facilities for a total of 41 health units,
during FY 2009. Referrals will be made primarily in chronic care clinics and health facilities where RTI
operates. When necessary, existing chronic care clinics will be supported through the sponsorship of
chronic care management courses for medical and clinic officers. Furthermore, the project will provide
comprehensive support to six HIV clinics (two in each region) during 2009. This support will include
supporting CD-4 testing for patients, ensuring no stock out of septrin at the clinics and instituting quality
improvement measures in service delivery. Similarly, RTI will collaborate with other partners to perform
specialized PC services; including psychosocial counseling, support to prevent sexual HIV transmission,
and STI treatment and family planning.
Due to the existing human resource gaps in the health facilities, volunteer health workers and PHAs will be
recruited and trained. PHAs will be selected and trained to work as ‘expert clients' to provide on-going
support to HIV-positive individuals, couples and groups. They will support the provision of the following on-
going PC needs: counseling, psychosocial support, help patients to develop safer sexual behaviors, and
assist with drafting individual care and treatment plans in order to prevent HIV transmission and improve
treatment adherence. All new health care workers employed in the RTI supported health facilities (including
the three new facilities), will be trained to provide facility-based palliative care and be able to refer HIV-
positive individuals for further assessment and specialized care. Refresher training and technical support
supervision will be provided as needed, to ensure quality delivery of PC services. The project will also
distribute MOH standard operating procedures, protocols and job aids on PC to all supported health
facilities. In order to minimize stock-outs, RTI will support health unit staff to enable them forecast and
requisition for the right amounts of septrin and other basic care supplies.
Continuing Activity: 13314
13314 4044.08 HHS/Centers for Research Triangle 6439 1255.08 Expansion of $550,000
8517 4044.07 HHS/Centers for Research Triangle 4872 1255.07 Routine $350,000
4044 4044.06 HHS/Centers for Research Triangle 3184 1255.06 Routine $233,000
Health-related Wraparound Programs
* Child Survival Activities
* Family Planning
* Malaria (PMI)
* Safe Motherhood
* TB
Table 3.3.08:
During FY 2008, the project continued to make significant progress with the integration of TB and HIV
management. All project-supported facilities now have linkages between CT service delivery points, chronic
care clinics and the TB clinics. This activity has been expanded to more than 12 new health facilities, and is
expected to provide another 1,500 individuals with coordinated TB/HIV services by the end of September
2008.
FY 2009, RTI will further consolidate the provision of TB/HIV services in the 38 supported health facilities.
The consolidation will cover an estimated 1,000 individuals between October 1, 2009 and September 30,
2010. An assessment of laboratory capacities at all targeted facilities has been completed, and key areas
requiring priority attention have been identified. Building on the TB/HIV initiatives started in FY 2008, RTI
will strengthen the capacity of the health units, by instructing them on the policies and guidelines for
integrating TB/HIV interventions. This training will lead to better management of TB/HIV co-infected
patients, maximize TB case detection, increase treatment completion rates and strengthen ART literacy. TB
Infection control measures in HIV care settings will be enhanced via literacy campaigns for patients and
staff, triage of symptomatic patients and enhanced TB case-finding.
The program will continue to provide cross-referrals and integrate diagnosis, treatment and support services
for TB and HIV clients in target facilities. HIV+ positive individuals will be actively screened and treated for
TB at initial diagnosis and during follow up appointments at the chronic care clinics. HIV counseling and
testing will be offered to all patients in the TB clinics. Health facility staff will be trained in data management
and analysis; which will provide better monitoring of patients' adherence to treatment regiments and to track
their progress. RTI will also collaborate with MoH to ensure a constant supply of medications (TB drugs,
septrin and ARVs) for individuals who are TB/HIV co-infected are available.
Continuing Activity: 13315
13315 8539.08 HHS/Centers for Research Triangle 6439 1255.08 Expansion of $100,000
8539 8539.07 HHS/Centers for Research Triangle 4872 1255.07 Routine $60,000
Table 3.3.12:
research services that meet the highest standards of professional performance. During FY 2008, RTI in
partnership with AIDS Healthcare Foundation (AHF) continued to support the Uganda Ministry of Health
(MOH) to scale up provision of Routine HIV Counseling and Testing (RCT) and basic care (BC) services to
patients in district hospitals and health center IVs in the districts of Kaberamaido, Kasese, Kabarole,
Masindi, Mubende, Mpigi and Pallissa. By September 2008, the program will have extended to facilities in
Mityana, Sembabule, Iganga and Kyenjojo districts, leading to a total of 38 health facilities providing RCT
and BC services with program support.
Since the inception of the program in March 2005, a number of accomplishments have been made in the
program area of Counseling and Testing (CT): (a) as of July 2008, an estimated 191,470 persons had
accessed CT services and received their results. By the end of FY 2008, under current program funding,
more than 210,000 persons will have been provided with CT services; (b) In collaboration with several other
partners in the country, RTI contributed to the development of materials for use in training health workers in
the implementation process of RCT activities. These materials include training manuals, provider cue
cards, standard operating procedures and implementation protocols; the tools have been extremely useful
in the coordination of HCT training programs for health workers around the country; (c) More than 2,000
health workers have been trained in RCT/BC implementation since program inception in March 2005; (d)
The project has also conducted several information, education and communication (IEC) activities to
increase program awareness. IEC materials were produced in English and local languages; materials were
distributed and posted in prominent places throughout supported health facilities. Similarly, IEC will further
inform the target audience about the program via sensitization meetings with health facilities, and with
district and community leaders; (e) The project has adapted MOH health management information (HMIS)
tools to generate accurate RCT/BC data.
FY 2009 is the fourth year of implementing the RTI CT project. During this fiscal year, RTI will consolidate
the CT services offered in their thirty-eight supported health facilities. The program will also expand to three
new facilities, increasing the total number of supported facilities to forty-one. This expansion activity is
expected to reach 150,000 individuals with CT services between October 1, 2009 and September 30, 2010.
In FY 2010, the program will scale back and consolidate activities since the project period ends in March
2010. FY 2008 is the second to last year of the program; all three of the new facilities have been selected to
scale up, ensuring the rapid initiation of CT activities. RTI project staff will provide in-service training and
technical support supervision to health workers working in current and new facilities. During this time, the
program will also identify counselor supervisors. These individuals will strengthen facility-based services by
supporting the health worker staff. This strategy will guarantee the delivery of consistent high quality CT
services at all supported facilities; including those affected by the closing-out phase in FY 2010. Quality
Assurance for the counseling and testing process will be emphasized and external quality control for HIV
testing will be conducted. Facilities that maintain more than 95% concordance on a sufficient numbers of re-
tested samples for three consecutive months, will gradually transition from conducting external monthly re-
tests to providing RTI with a quarterly report.
RTI will also train and provide technical support supervision to health facility waste management
committees, adhering to guidelines related to proper management and disposal of medical waste. Standard
operating procedures and protocols for implementation of RCT and waste disposal will be distributed to the
new sites. RTI will focus primarily on providing materials for managing medical waste, at points of waste
generation (testing points and wards). RTI will also facilitate the start up of clinic-based support groups and
post-test clubs; as both groups will assist in providing post-test counseling and psychosocial support to
persons who test for HIV. Health workers will be equipped to support clients who need couple counseling,
disclosure of HIV testing results to partners and support for discordant couples. In the case of infant testing
and testing for pregnant women, the program will partner with other implementing agencies working in this
area; more specifically, with the Pediatric Infectious Diseases Clinic (PIDC) and Protecting Families against
HIV/AIDS (PREFA) to provide CT services to children. RTI's support in these areas will vary, depending on
level of presence of PIDC, PREFA and or similar partners in the supported facilities. In each case, RTI will
clearly delineate the roles of the various partners to avoid duplication of support. The project will also be
partnering with lower level health facilities to transport specimens to referral laboratories, in order to conduct
(PCR) and HIV testing on the dry blood spot (DBS) samples; RTI will submit the results back to the facilities.
Where there is discordance between the health facility and reference laboratory results, RTI will conduct
refresher training for the health facility staff.
RTI will work closely with the district health teams (DHT) and health unit CT point persons, to enhance
ownership and sustainability of the services, in order to increase program utilization. Likewise, RTI will also
continue to produce IEC/CT materials in English and the various local languages; the materials will be
disseminated in the various health facilities, and to community leaders and clients. RTI will collaborate with
MOH, National Medical Stores (NMS) and Supply Chain Management Systems (SCMS) to strengthen
logistics management to minimize stock-outs. The technical assistance will also improve upon data
collection, analysis, and distribution to inform and improve program activities.
Additionally, RTI will open 18 of its 41 sites for a proposed two-year multi-country Public Health Evaluation
Process entitled ‘HIV Counseling and Testing to Optimize Client Enrollment (COPE)', which is pending
review and approval. During this PHE, RTI will serve as the Uganda country RCT implementing partner;
there are other partners in this role in Tanzania, South Africa and Cote d'Ivoire. The study will be a group
randomized trail, based at clinic level. The study will have three arms: 1) Enhanced provider referral to VCT,
2) HIV testing and counseling during consultation and 3) HIV testing and counseling prior to clinical
consultation. The specific objectives of this evaluation are: 1) To demonstrate whether outpatient
departments are appropriate settings in which to provide HIV counseling and testing; 2) To determine if HIV-
infected persons are identified in outpatient departments or are referred at an earlier stage of infection; or
upon entering care and treatment versus patients referred from other sources; 3) Determine which model of
HIV testing and counseling (HTC) in out-patient departments shows the greatest increase of outpatients
who receive an HIV test.
Activity Narrative: Study outcomes include: 1) The number of HIV positive patients who are newly diagnosed, 2) The
percentage of HIV-positive patients identified in or referred from out-patient departments who register for
care and treatment, 3) The percentage of patients whose HIV test results are noted in their OPD medical
chart prior to or during clinical consultation so that test results can be used for diagnosis of the presenting
problem and the patient's knowledge of HIV status, and 4) Availability of care and appropriate prevention
strategies based on HIV status.
Continuing Activity: 13316
13316 4045.08 HHS/Centers for Research Triangle 6439 1255.08 Expansion of $850,000
8518 4045.07 HHS/Centers for Research Triangle 4872 1255.07 Routine $750,000
4045 4045.06 HHS/Centers for Research Triangle 3184 1255.06 Routine $233,000
Estimated amount of funding that is planned for Human Capacity Development $155,000
Table 3.3.14:
