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 2012 2013
The Centre for Infectious Disease Research in Zambia (CIDRZ) Tuberculosis (TB) program aims to reduce TB mortality by improving diagnosis and co-management of TB and HIV in co-infected patients. The program also aims to reduce the spread of TB, particularly in HIV clinics. Primary TB program objectives are to:
1. Improve clinical screening and management of TB/HIV co-infected patients in HIV, TB, outpatient, and maternal-child health clinics.
2. Improve TB diagnostic capacity through microscopy, specimen referral, and training.
3. Provide technical support to the Zambian Ministry of Health (MOH) TB program and support its surveillance and training initiatives.
4. Support infection prevention activities through clinic renovations and training.
5. Improve community knowledge of and demand for TB screening and HIV testing through outreach activities.
We support 195 TB clinics in 11 districts in Lusaka, Southern, and Western Provinces. These are Lusaka, Chongwe, Kafue, Luangwa, Choma, Mazabuka, Gwembe, Kalomo, Kaoma, Lukulu and Kalabo. The target population is all TB/HIV co-infected patients (male and female, adult and pediatric).
Cost-efficiency strategies include piloting the use of lay counselors to counsel and test TB patients for HIV, in order to reduce overtime costs for clinic staff to conduct diagnostic counseling and testing (DCT) in high volume clinics. The light-emitting diode (LED) microscopes piloted by the program will reduce the staff time required for TB smear microscopy, thus making laboratory staff functions more cost efficient. Earlier diagnosis will reduce morbidity and thus patient care costs.
We will use MOH data collection tools, including SmartCare HIV patient data, and MOH TB Program quarterly reports, to monitor intensified TB screening in HIV clinics and TB program activities on a quarterly basis. We will provide ongoing clinical mentoring in HIV clinics, using routinely collected patient data and CIDRZ quality assurance (QA) improvement reports. In Lusaka TB clinics, we will conduct quarterly supportive supervision visits, using MOH program data to review activities, and begin to transition these functions to the District Health Office (DHO). In the other 10 focus districts, we will meet with the DHO and participate in district data review meetings and TB and HIV coordinating body meetings on a semi-annual basis. As part of prevention with positives we will train lay counselors and health workers to assess sexual activity, provide condoms (from district supplies) at each visit, identify discordance, provide or refer for partner and/or child testing, and assess need for referral to enroll in ART care or a community-based program.
In FY 2009 CIDRZ was funded to improve TB diagnosis and management in TB/HIV co-infected persons and establish referral systems in the 11 focus districts. This has been largely achieved and we will improve on this, further align, and add value to DHO partner activities in FY 2010. We will continue submission of high quality quarterly reports compiled using MOH TB and HIV monitoring and evaluation frame work and tools with the revised indicators.
CIDRZ TB program has adequate staff to carry out the proposed activities which will be sustained through skills transfer to MoH staff. Objectives of this project include:
To improve TB screening in HIV and out-patient clinics and clinical care for co-infected patients, we will provide clinical training in diagnosis and management to 60 health care workers and training in intensified TB screening to 85 HIV clinic staff; conduct quarterly workshops with HIV and TB clinic staff; and hold semi-annual data review meetings with eight districts.
To improve TB and HIV diagnosis and management in maternal-child health (MCH) clinics, we will pilot a protocol for TB screening in MCH.
To increase HIV testing for TB patients, we will continue to support TB/HIV peer educators in 22 Lusaka sites; conduct DCT training for 40 TB clinic staff; and provide supportive supervision in the 11 focus districts.
To improve TB infection prevention, we will renovate two HIV clinics to reduce nosocomial TB transmission and train 70 health workers from the 11 focus districts in TB infection control.
To improve TB diagnostics, we will train 150 health workers from the 11 target districts in sputum collection, fixing, and transportation procedures; support the national QA system for TB microscopy sites; provide refresher training in TB smear microscopy; pilot LED fluorescent microscopy in two Lusaka District sites; and procure transport equipment to support specimen referral systems.
Technical support will be offered to the MOH TB program through the national TB prevalence survey; national, provincial and district TB/HIV coordinating bodies; committees; and guideline reviews. Community knowledge will be heightened by supporting MOH community sensitization, printing and distributing information, education, and communication materials.
