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.
The purpose of this program is to scale up a comprehensive and integrated package of HIV prevention interventions and services in selected districts in the republic of Uganda. Those districts include but are not limited to: Kalangala, Mubende, Mityana, Luwero, Nakaseke, Wakiso, Nakasongola, Apach and are selected because of high HIV prevalence (>8%) and are currently implementing district-wide door to door HIV confidential counselling and testing (HCT) programs through PEPFAR support. Door to door HCT is an excellent approach for accessing confidential HIV counselling and testing services to couples and families. It identifies many discordant couples, improves disclosure of sero-status, reduces stigma and therefore has a significant impact on HIV prevention.
The comprehensive HIV prevention strategy will be based on the synergies obtained from the door to door VCT program and other HIV/AIDS program activities in these districts. The awardee of this program will develop and implement a broad range of HIV prevention services and activities as a "package" to be delivered to the population of these districts in a consistent manner.
The comprehensive prevention package of services will address the major risk factors, behaviors, populations and social contextual factors that drive the HIV epidemic in Uganda following national guidelines for HIV prevention. The program activities will focus on sexual prevention and Male Medical Circumcision (MMC) interventions targeting general population and high risk groups where the epidemic is concentrated based on the needs of each district.
The overall goal of this program is to reduce the number of new HIV infections and sexually transmitted infections (STI's) in these districts and specifically to;
counsel and provide of safe medical male circumcision services as part of a comprehensive prevention intervention
improve the capacity of health facilities and health service providers to be able to avail services for medical male circumcision in the districts.
promote knowledge of one's sero-status and actively facilitate mutual disclosure to sexual partners and appropriate household members
work with communities to determine how to reduce the number of multiple sexual partners
promote consistent and correct Condom use with any sexual partner whose sero-status is not known
promote safer sexual behaviors and sexual norms
work with health facilities to improve diagnosis and treatment of sexually transmitted infections
integrate new technologies and for HIV prevention if they are approved by WHO during the project period
The successful applicant of this award will work with the district HIV/AIDS structures that will be responsible for the implementation of this project through sub-granting mechanism; and will provide financial, programmatic and technical assistance as appropriate.
The program will collaborate and integrate with Home-based HCT, ART, OVC, PITC, HSS, Care and Support programs being implemented in the districts and the following principles will guide the implementation of this program and contribute to health systems strengthening, cost efficiency and sustainability:
Multi-sectoral approaches bringing on board all potential stakeholders and actors
Mainstreaming and integration to facilitate comprehensive and multi-pronged approaches to assure a continuum of social, health and HIV/AIDS services
Partnerships and common approaches to eliminate fragmentation and duplication of efforts while emphasizing delivery of common messages and utilization of all existing systems for wider coverage
Evidence-based approaches that take into account dynamics of the epidemic and contexts of population groups to enhance service targeting
Quality assurance informed by central policy guidelines and standards
Accelerating HIV/AIDS prevention in the context of universal access to prevention, treatment, care and services
Human rights, equity and gender
Partnerships with PHAs for their greater involvement in the national response
Monitoring and Evaluation
The awardee of this program will provide regular TA for M &E through site visits to monitor and supervise the process of program implementation, identify strengths and weaknesses and improve program implementation. Secondly the awardee will develop and maintain capacity for a robust plan for conducting both quantitative and qualitative evaluations of this project's performance.
According to the Modes of Transmission studies (2008) there were about 91,500 new adult HIV infections reported in Uganda in 2008. A spectrum estimate of the number of new infections due to Mother to Child HIV Transmission during the same period was approximately 21,500. The total number of new infections in 2008 was therefore estimated to be 113,000. This level of infections is unacceptably high and requires innovative evidence proven cost-effective approaches such as medical male circumcision to reduce them in the population. In Uganda the proportion of adult men that are circumcised is estimated at only 25%. REDACTED.
Within this TBD mechanism, MMC will be integrated as part of the comprehensive HIV prevention package which includes the provision of HIV testing and Counseling and Prevention with Positives interventions within the clinical settings. In 2010 program will cover the 6 districts in the central region and will provide MMC services to 10,000 adults through 15 facilities following the catch up strategy. Funds under this budget code will be used specifically for the following activities:
Training of health service providers including medical officers, clinical officers, nurses, surgical assistants, counselors and support staffs in hospitals, HC IVs
MMC service delivery
Providing MMC information to women (spouses) and use MMC activities as an opportunity to address gender norms such as polygamy, multiple sexual partners and early marriages
Supporting the development of long-term sustainable and integrated VMMC capacity in health facilities within the targeted districts, including capacity for provision of neo-natal and pediatric MC services in PMTCT and MCH settings in line with national policy/guidelines.
Improving the capacity of health facilities and health service providers to be able to avail services for medical male circumcision in the districts
Facilitating referrals and linkages of Voluntary MMC services to other HIV/AIDS prevention, care and treatment services.
Supporting the Health Ministry towards the development of MMC policy guidelines and strengthening of an effective and efficient M&E system for the VMMC program
Developing health infrastructure to sustain role out of male medical circumcision at the health facilities
Implementing IEC/BCC mobilization campaigns for MMC
Supervision and quality assurance
The proportion of adult Ugandan men that are circumcised is estimated at only 25%. REDACTED.
The objectives of this funding are to scale up delivery of MMC services, integrated as part of the comprehensive HIV prevention package which includes the provision of HIV testing and counseling, offer of MMC targeting HIV negative males, risk reduction counseling including knowing partners HIV sero-status, partner reduction. In FY 2010 the program will cover the 8 high HIV prevalence districts in the central and northern region and will provide MMC services to 10,000 adults through 15 facilities using the catch up strategy. Funds under this budget code will specifically be used for the following activities:
Training of health service providers including medical officers, clinical officers, nurses, surgical assistants, counselors and support staffs in hospitals, and HCIVs in the provision of safe medical circumcision services within a frame work of comprehensive HIV prevention services
Providing MMC information to women (spouses) and use MMC activities as an opportunity to address gender norms such as polygamy, multiple sexual partners, and early marriages
Supporting the development of long-term sustainable and integrated VMMC capacity in health facilities within the targeted districts, including capacity for provision of neonatal and pediatric MC services in PMTCT and MCH settings in line with national policy/guidelines.
Improving the capacity of health facilities to provide MMC services in the supported districts
Facilitating referrals and linkages of voluntary MMC services to other HIV/AIDS prevention services.
Developing health infrastructure to sustain role out of male medical circumcision at supported health facilities
Implementing IEC/BCC mobilization campaigns for MMC in partner districts
Strengthen M&E, supervision, and quality assurance of MMC services
The National Strategic Plan 2007-12 recommends implementation of a two pronged strategy that maintains the well established comprehensive ABC approach complemented with a refocus on the most cost effective prevention interventions balancing care, treatment and support costs and embracing new prevention technologies. This program TBD will strengthen comprehensive programming for sexual prevention for adults and out schools in the in the high HIV prevalence districts in the Central region. The program will build on the work existing USG supported activities especially the district wide door to door HCT program and the new Comprehensive care and treatment program- TBD. The grantee will focus on developing targeted prevention intervention for out of school youth and adults in the general population. The program will promote community dialogue and behavior change campaign in the general population with a view to address risk taking behaviors such as the increase in the number of concurrent sexual partners, low and inconsistent condom use among others. Training will be provided to stakeholders including civil society groups, faith based organization, PHA networks and private sector organizations to support the rapid roll out of prevention activities in communities, work place and facility levels. In addition, the program will district systems for coordination of HIV prevention activities to ensure comprehensive proper targeting, comprehensive program and leveraging resources across programs. Through community dialogue and mapping, the program will support the district to develop programs that are tailored to the needs of the targeted community groups. To ensure comprehensive programming, this activity is linked to corresponding activities in the Other Sexual Prevention and Male Medical Circumcision technical areas.
The National Strategic Plan 2007-12 recommends implementation of a two pronged strategy that maintains the well established comprehensive ABC approach complemented with a refocus on the most cost effective prevention interventions balancing care, treatment and support costs and embracing new prevention technologies. This program TBD will strengthen comprehensive programming for sexual prevention for adults and out schools in the in the high HIV prevalence districts in the Central region. The program will build on the work existing USG supported activities especially the district wide door to door HCT program and the new Comprehensive care and treatment program- TBD. The grantee will focus on developing targeted prevention intervention for out of school youth and adults in the general population. The program will develop behavior change communication interventions that discourage risky taking behaviors such as; excessive alcohol consumption, concurrent multiple sexual partnerships, low and inconsistent condom use. In addition to programs for the general population, interventions for known high risk groups including; commercial sex workers and their partner, truckers, Men who have sex with men , security personnel and vulnerable groups like boda boda riders, students in higher institutions of learning and street children will be supported and implemented with other stakeholders in area. The program will strengthen coordination of HIV programming through district systems in order to increase coverage, proper targeting and efficiency resource utilization... This activity is linked to corresponding activities in the Other Prevention and Male Medical Circumcision sections.
