Rwanda - FY 2009 Approved Funding by Program Area, Agency and Funding Source

Rwanda - FY 2009 Approved Funding by Program Area, Agency and Funding Source

*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.

PEPFAR programming in Rwanda exemplifies strong government-to-government collaboration resulting in the PEPFAR program reaching and exceeding important targets, including reaching over 63,000 OVCs and nearly 870,000 individuals with counseling and testing. Key strengths of this program also include a well-conceived network model with decentralization of services, strengthening district capacity and expansion of community services, and training of community health workers (CHWs). A strong sexual prevention portfolio responds to key issues of gender, male involvement, alcohol, gender-based violence (GBV), reaching a wide range of MARPs. The Rwanda program also exemplifies several emerging best practices, including performance-based financing to improve quality of care, local ownership and cost efficiencies, leading to greater access, use and sustainability of services. Additionally, the program has made very good use of wrap-around programming with PMI, food programs and economic strengthening activities.

PEPFAR Rwanda places strong emphasis on linkages between prevention, counseling and testing, care, and treatment. Prevention activities in Rwanda include PMTCT, prevention of sexual transmission, biomedical prevention, and integrated CT services. Three key areas of focus in the FY 2009 PMTCT program will be improving PMTCT referral systems, providing follow-up for mother-infant pairs, and scale-up of early infant diagnosis. The USG will continue to implement a range of behavioral and biomedical prevention interventions, including the promotion of abstinence and delayed sexual debut among youth; enhanced condom distribution and promotion; targeted BCC; MC in the military; prevention for PLWHA; improved integration with family planning services; increased male involvement in prevention; and scaled up CT, with an emphasis on couples CT.

Care and support activities in Rwanda include the provision of basic health care and support for adults and children, support for integrated TB/HIV services, and programs for OVC. The USG will work to ensure that all PLWHAs receive support through a comprehensive network of district hospitals, health centers and community services. Clinical activities will include prevention and treatment of opportunistic infections and sexually transmitted infections (STIs), positive living and prevention counseling, nutritional counseling and assistance, support for treatment adherence, CD4 testing, general clinical staging and monitoring, family planning support, and linkages to community services. "One-stop service" TB/HIV management activities will be scaled up to provide comprehensive services for all TB patients with HIV/AIDS. In addition, the USG will target support towards child-headed households and the most vulnerable orphans to provide a menu of services including HIV prevention activities, formal education, health, psychosocial support, nutrition, and economic interventions.

Treatment activities will include ART programs and laboratory support. The USG will assist the Government of Rwanda in increasing program quality and sustainability through national and district-level support. The USG will continue to provide a standardized package of ART services through a coordinated network of HIV/AIDS services linking ART with PMTCT, TB, maternal child health, and other services. Laboratory support will focus on key reference laboratory functions, including training, quality assurance, and developing in-country expertise for HIV-related care and treatment. PEPFAR will emphasize the strengthening of linkages in the tiered laboratory system and the scale up of the early infant diagnosis program. Finally, the USG will continue to provide direct support to the Rwandan Center for Essential Drug Procurement for the procurement, storage, and distribution of all medicines, equipment, and laboratory supplies.

Strategic information and health systems strengthening are key components of FY 2009 programming. Efforts will focus on improving data quality, enhancing data utilization and coordinating reporting systems, including supporting the implementation of the national health management information system and strategy and the national HIV/AIDS monitoring and evaluation system. These activities will strengthen national health sector financing, increase the availability of skilled human resources and provide institutional capacity building for local organizations.

Additionally, PEPFAR funds will support the development and negotiation of the Partnership Framework and the Partnership Framework Implementation Plan.

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