Attachment_2_-_Expenditure_Analysis_Guifance.pdf

The President’s Emergency Plan for AIDS Relief

Expenditure Analysis of PEPFAR Programs Guidance FY 2015

This guidance is designed to assist

PEPFAR-implementing partner organizations collect and submit relevant program information and financial data for the PEPFAR Expenditure Analysis

Initiative. The subsequent instructions and operational definitions refer to the data collection template provided by the

PEPFAR Coordinator/Secretariat.

PEPFAR FINANCE

AND ECONOMICS

WORK GROUP

(FEWG)

DRAFT FY 2015 EA Guidance

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TABLE OF CONTENTS

Expenditure Analysis of PEPFAR Programs Guidance FY 2015 1 Table of contents 2 Acronyms and Abbreviations 3 Getting Started for Implementing Partners 5

1.0 Summary 6

1.1 Timeline 6

1.2 Confidentiality 6

1.3 Not an Audit 6

1.4 Feedback 7

1.5 Requested Data 7

1.6 Definitions of Program Areas and Cost Categories 10

2.0 Data Collection 18

2.1 Instructions 19

2.2 Expenditures—Site-level 19

2.3 Expenditures—Strategic Information and Surveillance 21

2.4 Expenditures—Health Systems STrengthening 22

2.5 Expenditures—Program Management 26

3.0 Allocation Methods for Shared Site-Level and Above Site-Level Expenditures 28

3.1 Allocating Shared Expenditures Across Program Areas at the Site-Level 28

3.2 Allocating Shared Expenditures Across Sub-National Units at the Site-Level 29

3.3 Allocating Site-Level Expenditures Across Points-Of-Service 30

3.4 Allocating Above Site-Level Expenditures Across Program Areas 31

3.5 Allocating Between Site-level and Above Site-Level Activities 34

3.6 Allocating Training 34

4.0 Data Submission and Technical Support 38

4.1 Accessing PROMIS and Submitting Data 38

4.2 Technical Assistance 38

Appendix A: Currency Conversion Table 39

Appendix B: Frequently Asked Questions 40

Appendix C: How S/APR Results Align to EA Program Areas 54

Appendix D: Data Quality Checks 58 file:///U:/2015%20EA%20Guidance%20v1.docx%23_Toc427842212

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ACRONYMS AND ABBREVIATIONS

AOR Agreement officer’s representative

APR Annual program results

ARVs Antiretroviral drugs

ART Antiretroviral therapy

BS Blood safety

CBCTS Community-based care, treatment, and support

CBTC Community-based testing and counseling

CDC United States Centers for Disease Control and Prevention

CHW Community health worker

COAG Cooperative agreement

COP Country operational plan

COR Contracting officer’s representative

FEWG Finance and Economics Work Group

FSW Female sex worker

EA Expenditure analysis

ECD Early childhood development

FAQ Frequently asked questions

FBCTS Facility-based care, treatment, and support

FY Fiscal year

GBV Gender-based violence

GP General population

HR Human resources

HSS Health system strengthening

HTC HIV testing and counseling

HQ Headquarters

IC Infection control

IM Implementing mechanism

INGO International non-governmental organization

IP Implementing partner

LAB Laboratory

KP Key populations

M&E Monitoring and evaluation

MAT Medication assisted therapy

MER Monitoring, evaluation, and reporting

MSMTG Men who have sex with men and transgendered individuals

NASA National AIDS Spending Assessment

NHA National Health Accounts

NGI Next Generation Indicators

NGO Non-governmental organization

OMB The Office of Management and Budget

OST Opioid substitution therapy

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OVC Orphans and vulnerable children

PC/S PEPFAR Coordinator/Secretariat

PEP Post-exposure prophylaxis

PEPFAR President’s Emergency Plan for AIDS Relief

PIMS Partnership information management system

PITC Provider-initiated testing and counseling

PP Priority Population

PROMIS PEPFAR Records and Organization Management Information System

PM Program management

PMTCT Preventing mother-to-child transmission

PWID Persons who inject drugs

ROP Regional operational plan

QA/QI Quality assurance/quality improvement

SAPR Semi-annual program results

SHA System of Health Accounts

SI Strategic information

SNU Sub-national unit

TA Technical assistance

TBA Traditional birth attendant

UGM Umbrella grants manager

UNAIDS The Joint United Nations Programme on HIV/AIDS

US United States

USAID United States Agency for International Development

USD United States dollar

USG United States Government

VCT Voluntary counseling and testing

VMMC Voluntary medical male circumcision

WHO World Health Organization

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GETTING STARTED FOR IMPLEMENTING PARTNERS

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1.0 SUMMARY

The United States Government (USG) is conducting an Expenditure Analysis (EA) of PEPFAR programs for fiscal year (FY) 2015, 01

October 2014–30 September 2015. The goal of this interagency exercise is to better understand the costs the USG incurs to provide a broad range of HIV services and support and subsequently use this information to improve program planning. Your organization is being asked to report program information and total expenditures for FY 2015 by program area, cost category (as defined by

PEPFAR) and geography. Data should be collected and submitted using the PEPFAR Records and Organization Management

Information System (PROMIS) or other specified data system. This guidance provides instructions for accessing the PROMIS website;

downloading, completing, uploading, and submitting the Excel-based data collection template; and requesting technical assistance

(TA). Further, this guidance provides operational definitions for PEPFAR program areas and cost categories, and recommended methods for categorizing and allocating expenditures. After data collection and the cleaning is complete, your organization will receive a summary report of the analyzed data.

1.1 TIMELINE

Data collection will commence on 01 October 2015. Your organization is requested to complete and submit the data collection template via PROMIS (or other specified data system) no later than 13 November 2015. New data will not be accepted beyond this date.

The EA initiative is an ongoing PEPFAR activity and is being institutionalized as part of routine PEPFAR reporting. If your organization continues to be a PEPFAR implementing partner in future fiscal years, your organization will be asked to report on PEPFAR expenditures in a similar format in each fiscal year in which you spend PEPFAR funds.

1.2 CONFIDENTIALITY

Identifiable mechanism-specific program and expenditure information you submit will be shared with your USG project manager

(i.e., AOR, COR, Activity Manager, Project Officer) and USG country teams. In addition, the USG Expenditure Analysis Advisor for the country, the USG Expenditure Analysis headquarters coordination team, the contracted Technical Assistance Provider for your country, and the PROMIS development team will have access to your identifiable, mechanism-specific data for purposes of providing technical assistance, IT troubleshooting, and data analysis to generate results reports.

Data may be shared with other USG agency staff at headquarters and other stakeholders (e.g., host country governments, UNAIDS) as appropriate.

1.3 NOT AN AUDIT

Validating FY 2015 budgets with EA data is not an objective of this activity. Instead, the goal of this exercise is to better understand all of the actual USG costs associated with providing HIV services to beneficiaries in order to improve program planning.

Understanding that PEPFAR budget codes do not align directly to EA program area categories and that disbursement are often delayed from the fiscal year in which funds are obligated.

It is understood that completion of the EA data collection template may involve estimation of how funds were spent for which explicit documentation is not available, although it is highly recommended that all estimation procedures should be explained and justified in the comments section of the data collection template, especially if they differ from the recommended guidance.

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1.4 FEEDBACK

Your feedback on the data collection template and process is highly valued. You will have several opportunities to share your experience and provide feedback so that in the future, this process minimizes burden and maximizes the usefulness of results, both for your organization and USG agencies. You are encouraged to provide feedback to your country’s USG EA Advisor or PEPFAR

Coordinator/Secretariat, which will be share with the FEWG.

1.5 REQUESTED DATA

You are requested to provide EA-specific program information and comprehensive expenditure data on your PEPFAR-supported programs for FY 2015. Some standard categories and descriptions for program outputs and expenditures are listed below; however, some data may be requested that are unique to each program area.

FUNDING SOURCES TO BE REPORTED

1. Only PEPFAR funds should be reported to EA.

Your organization may receive funding from sources other than PEPFAR, including other non-PEPFAR USG funds for other health areas such as family planning, malaria, tuberculosis, or nutrition. Any non-PEPFAR expenditures should NOT be reported to EA.

Even if the non-PEPFAR funds are received under the same Cooperative Agreement or contract as PEPFAR funds, you must report only the PEPFAR funds spent to EA. If you are not sure which of the funds that your organization receives are from

PEPFAR, please immediately contact your USG project manager (AOR/COR/Activity Manager/Project Officer) to clarify this before completing your EA template.

2. PEPFAR funds programmed in a Country Operational Plan (COP) or Regional Operational Plan (ROP) that were spent during

FY 2015 should be reported to the 2015 EA. Funds programmed in any COP or ROP year can be reported to the 2015 EA so long as the funds were actually expended between 01 October 2014 and 30 September 2015.

The most common category of PEPFAR funding for an implementing partner are funds that originate from the Country

Operational Plan (COP) or Regional Operational Plan (ROP) process, which serves as the annual basis for U.S. Congressional notification, allocation, and tracking of budgets and targets. Funds budgeted through this process are affiliated with a prime implementing partner (organization), and an implementing mechanism (agreement) with an affiliated “Mechanism ID” that is recorded in the U.S. State Department’s FACTSInfo system of record. Spending associated with funds budgeted for your organization in any year’s COP/ROP that were spent during FY 2015 are required to be reported to EA 2015. This includes

COP/ROP funds that are used to “buy in” to a centrally-held Cooperative Agreement or contract that is managed out of USG agency headquarters.

3. Beginning in EA 2015, certain central funds that support site-level activities that are not programmed in a COP/ROP should also be reported.

Spending associated with the following funds SHOULD be reported in this exercise:

TB/HIV funds

Key Population Challenge Fund

PMTCT Acceleration Funds

Rapid Test Kit Reserve Funds

VMMC Reserves

Contraceptive Fund

Accelerating Children’s HIV/AIDS Treatment (ACT)

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Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) women.

All other central or other special initiative funding should be excluded. If you are not sure if your PEPFAR funds should be included in 2015 EA, please immediately contact your USG project manager (AOR/COR/Activity Manager/Project Officer) to clarify this before completing your EA template.

4. Eligible funds spent during FY15 must be reported to EA by implementing mechanism, based on the implementing mechanism number recorded in the FACTSInfo system of record.

When PEPFAR country teams submit their COPs/ROPs, they record an implementing mechanism number, name, and prime partner in a USG system called FACTSInfo. This PEPFAR implementing mechanism usually corresponds to a specific Cooperative

Agreement or contract; however, the implementing mechanism number and name as entered in FACTSInfo may be different from the Cooperative Agreement or contract number and name, or the informal project name used in country. The implementing mechanism is the unit of analysis in EA and therefore data must be submitted separately for each implementing mechanism.

If your organization is a prime partner for more than one implementing mechanism, your organization is required to submit EA data for each mechanism individually (i.e. one Excel template per COP-funded implementing mechanism that spent funds in FY 2015).

This includes situations where your organization is implementing a project that is extended under a new implementing mechanism number; even if it is the same project from an implementation perspective, the spending must be reported by mechanism as programmed in the COP/ROP and recorded in FACTSInfo.

If your organization receives both COP/ROP and central initiative funding via the same mechanism, please record all expenditures for together in one template.

If you are not sure what your implementing mechanism number is, please immediately contact your USG project manager

(AOR/COR/Activity Manager/Project Officer) to clarify this before completing your EA template. If you do not have a mechanism ID, please contact your EA advisor along with EA global coordinators Ramona Godbole (rgodbole@usaid.gov) and Jeffrey Bale

(wol3@cdc.gov)

5. Headquarters Operational Plan (HOP), other central funding (with the exception of list above), and country-level

Management and Operations funds should not be reported to EA 2015.

If you have questions regarding categorizing your organization’s PEPFAR funding per the above guidance, please contact your

USG Contracting Officer or Activity Manager for more information.

PROGRAM INFORMATION

Most program information used for EA will be taken directly from indicator data routinely supplied to PEPFAR through the Semi-annual and Annual Program Results (S/APR), and will be obtained from DATIM. You are requested to report some program information required for the analysis is requested that has not already been supplied to PEPFAR (see Table 3).

EXPENDITURES

Your organization is requested to report total PEPFAR expenditures (as defined above under “Funding Sources to be Reported” section) for FY 2015 by implementing mechanism, program area, cost-category, point-of-service, and geography. Expenditures are first classified as those that occur at the point of service delivery or site-level (e.g., in facilities or communities) or those that occur above site-level (e.g., support the broader program or health system). Expenditures at the site-level are categorized first by geography, next by point-of-service category, then the relevant program area, and lastly by common cost categories associated with mailto:rgodbole@usaid.gov mailto:wol3@cdc.gov

- 9 -each program area (e.g., vehicles, personnel, office equipment, etc.). PEPFAR expenditures incurred above site-level for program management (PM), strategic information (SI), and surveillance are categorized first by geography, then by cost category, and lastly by program area (using a percentage estimate of level of effort). Health systems strengthening (HSS) is first categorized by geography, cost category, functional area, and program area.

The goal in reporting expenditure information is to account for every COP/ROP-funded and Central/Special Initiative-funded PEPFAR dollar spent over the fiscal year. Expenditures should not be reported by PEPFAR budget code, but according to how PEPFAR dollars were actually spent to deliver services and/or support. Any site-level expenditures should be classified by geography, program area, and reported according to the appropriate cost category (e.g., vehicles, personnel, office equipment, etc.). For some program areas

(e.g., community-based care, treatment, and support), additional disaggregation of expenditures or program effort may be needed as appropriate to enhance interpretation and usability of results. Any expenditure that did not originate at the site or the point of service should be recorded as program management (PM), strategic information (SI), surveillance, or health system strengthening expenditure (HSS). Full descriptions of each expenditure category can be found in sections 2.2–2.5. If an implementing mechanism reports indicators to PEPFAR, it is expected that expenditures are allocated to the associated program areas.

CURRENCY CONVERSION

Please report all expenditures in United States dollars (USD). If your accounting software does not already track your transactions in

USD, please use the average exchange rates listed in Appendix A to convert your local currency to USD.

SHARED EXPENDITURES

Some common types of expenditures may be shared across program areas, such as personnel who work on both care and treatment and HIV testing and counseling activities; while others may be shared across geography, such as a vehicle used across a country.

Shared expenditures such as these must be allocated to the appropriate program area and geography in order to accurately estimate expenditures for specific HIV services and target populations. This guidance provides some general illustrative examples of methods for allocating shared expenditures in section 3.0. Each organization is different and there is no single method for allocation that will accurately define the program for all organizations supplying data. Technical assistance (TA) will be available in-person and remotely to help your organization work through specific challenges pertaining to allocation. Information on requesting TA can be found in section 4.2.

ACCOUNTING METHOD

For the purposes of this analysis we ask your organization to use the cash basis of accounting and recognize disbursements as expenditures. This means record all COP/ROP-funded PEPFAR dollars as they were spent during the last fiscal year. Hence, "financial expenditures" are cash disbursements from the perspective of the prime contractor or awardee.

Examples of transactions that would be considered a financial expenditure for this analysis:

Cash paid for an asset (e.g., vehicle, equipment, etc.), regardless of the asset's useful life

Prepayment for rent, supplies, or utilities

Transactions that would not be considered a financial expenditure for this analysis:

An asset purchased and received, for which payment has yet to be made

Expenditures accrued but not yet paid

Issuance of a note or other promise to pay cash at a time in the future

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EXPENDITURE ANALYSIS RULE OF THUMB FOR REPORTING EXPENDITURES BY GEOGRAPHY

For the purposes of reporting expenditures by geography, there is a rule of thumb in EA which states: “report the expenditures at the location where they are consumed”. In short, regardless of where a transaction occurs, the expense should be reported where the resource is consumed. The exception to this rule is training, please see section 3.6 for a detailed explanation of how to report training expenditures.

Example: A vehicle is purchased in the capital city, which will be utilized to provide services and support in another province. The dollars were consumed in the capital city but the resource on which the dollars were spent – the vehicle – will be consumed, i.e., used, in the province. Therefore, although the transaction occurred in the capital, the full expenditure on the vehicle should be reported in the province in which it will be utilized.

Example: A foreign consultant is hired to conduct a national-level evaluation in the country. The consultant spends 50% of her time outside the country for study preparation and report writing and 50% of her time in the country for data collection. The consultant is paid via wire transfer to her bank outside the country. The dollars were consumed outside the country but the resource on which the dollars were spent – the consultant’s time – was consumed 50% outside the country and 50% in the country. Therefore, the expenditure on the consultant should be reported as 50% above national and 50% national.

Special note for Department of Defense Partners: For Department of Defense partners that provide military-to-military services, expenditure analysis data is not required to be disaggregated to sub-national units within a country due to special considerations around confidentiality. A separate template has been created for these partners and can be accessed by contacting mailto:Brittney.n.shook.ctr@mail.mil or Catherine.ramirez4.ctr@mail.mil.

FUNDS DISBURSED TO SUB-GRANTEES

Some organizations may have funds they disbursed to sub-grantee partners over FY 2015. The prime implementing partner is responsible for capturing expenditure data attributable to each sub-grantee organization and including those data in the prime partner’s EA template submission.

Special note for Umbrella Grants Managers (UGMs) reporting in South Africa: For UGMs, prime implementing partners may help their sub-partners collect the requested data, but unlike traditional prime/sub-prime arrangements, each UGM sub-partner should report data as an individual unit. In other words, funds disbursed through UGM subs should not be included in the UGM submission, but should be reported as individual, separate mechanisms. The UGM prime partner should therefore only report expenditures by their own organization, such as program management and any technical assistance or systems strengthening expenditures for managing sub-recipients.

1.6 DEFINITIONS OF PROGRAM AREAS AND COST CATEGORIES

Throughout this guidance and the Excel EA data collection template there will be references to EA program areas and cost categories. The definitions of those terms can be found in Table 1 and 2 respectively. These program areas and cost categories in EA are exhaustive and exclusive encompassing the nature of PEPFAR support and therefore it is intended that each dollar is able to fit in the associated category.

Please note that the definitions for EA program areas differ from the PEPFAR budget codes used to program funds to your organization through the COP/ROP process.

mailto:Brittney.n.shook.ctr@mail.mil mailto:Catherine.ramirez4.ctr@mail.mil

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Table 1. EA Program Areas and Descriptions

Program Area Description

Facility-based care, treatment, and support (FBCTS)

Clinical care, support, and antiretroviral therapy (ART) provided in a health facility. Effort related to supportive supervision and mentoring of healthcare workers providing care and treatment services in a health facility as well as patient-directed TB services in a health facility should be reported under this program area. This program area also includes nutrition support, psychological and other supportive interventions, linkage and retention activities1, and quality improvement measures that occur within a health facility.

Community-based care, treatment, and support (CBCTS)

Care, support, and ART provided in a community setting, outside of a traditional health facility. This includes any clinical care provided outside health facilities, as well as nutrition support, psychological, social, or spiritual care, and economic strengthening activities. Effort related to supportive supervision and mentoring of healthcare workers providing care and treatment services in a community or home-based setting should be reported under this program area. This program area also includes linkage and retention activities1 and quality improvement measures that occur within a community or home-based setting.

Prevention of mother-to-child transmission (PMTCT)

Services for pregnant women and exposed infants which include HIV testing and results;

access to care, ART and prophylaxis for those found positive; and information on ways to protect themselves if negative. Note that classifying expenditures reported for supporting Option B+ will depend on your country-specific implementation of Option B+. Specifically, effort expended to support women who are on treatment (currently pregnant or not) who are still counted as receiving Option B+ should be reported as PMTCT. When your organization continues to support those women on lifelong treatment beyond their being considered an Option B+ beneficiary, those expenditures should be classified as FBCTS.

HIV testing and counseling (HTC)

Services providing HIV testing and results to individuals as well as counseling on how to remain negative for those who test negative and information on seeking care, treatment, and prevention services for those who test positive. Note: HIV testing done in a laboratory setting should be recorded under the LAB program area.

Voluntary medical male circumcision

(VMMC)

The provision of surgical circumcision and support services. Expenditures related to the provision of HTC services which often accompany VMMC procedures should be reported under the VMMC program area rather than the HTC program area.

Post-exposure prophylaxis (PEP)

Services providing prophylaxis for both occupational and non-occupational exposure to HIV.

Blood safety (BS)

Services and support for the collection and testing of blood units to ensure a safe and adequate blood supply.

1 Linkage and retention activities may include such innovations as using a buddy system, drug drop-offs and pick-up points, m-health (text, follow-up calls), transport help, mobile service schemes, and other facilitation actions that retain clients in the continuum of services.

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Infection control (IC)

Investments in renovating facilities and training health care workers to reduce the spread of infectious disease. This includes renovations and training for TB-HIV mitigation, however, patient-directed TB services should be recorded under FBCTS.

Laboratory (LAB)

Provisions of diagnostic services related to HIV clinical interventions (e.g., lab-based HIV testing, CD4 counts, viral load, hematology, chemistry, and tuberculosis testing), early infant diagnosis, quality improvement/quality assurance, safety and employee infection control, and site-level system development support efforts to maintain, renovate, train, and otherwise expand laboratory capacity and quality.

Orphans and vulnerable children

(OVC)

Services that target OVC needs in the areas of medical care (not facility-based), educational support, spiritual care, psychological care, social care and food and nutrition. Expenditures related to HIV testing for OVC should be reported under the HIV Testing and Counselling (HTC) program area.

General population prevention (GP-

PREV)

Behavioral prevention and structural prevention interventions targeted to the general population rather than specific key-populations or other vulnerable populations.

Key population prevention-persons who inject drugs (KP-PWID)

Behavioral prevention and structural prevention interventions targeted to persons who inject drugs including harm reduction services, needle exchange and condom distribution.

Expenditures related to the provision of medication, such as methadone, to PWIDs should be estimated and reported under the Medication Assisted Therapy (MAT) program area.

Expenditures related to HIV testing for key populations should be reported under the HIV Testing and Counselling (HTC) program area.

Key population prevention- female sex workers (KP-FSW)

Behavioral prevention and structural prevention interventions targeted to female sex workers. Expenditures related to HIV testing for key populations should be reported under the HIV Testing and Counselling (HTC) program area.

Key population prevention- men who have sex with men and transgender

(KP-MSMTG)

Behavioral prevention and structural prevention interventions targeted to men who have sex with men and transgender populations. Expenditures related to HIV testing for key populations should be reported under the HIV Testing and Counselling (HTC) program area.

Priority Population Prevention (PP-

PREV)

Behavioral prevention and structural prevention interventions targeted to other vulnerable populations which are not PWID, FSW, or MSMTG specifically. Depending on the country context, this may include but not be limited to: miners, migrant workers, truck drivers, fisher folks, mobile men with money, or enlisted military. Expenditures related to HIV testing for key populations should be reported under the HIV Testing and Counselling (HTC) program area.

Medication Assisted Therapy (MAT)

Provision of opiates such as methadone for PWIDs. Expenditures related to outreach, mobilization, and other ancillary services provided to opioid substitution therapy (OST) clients should be estimated and reported under the SORP-PWID program area.

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In the site level sheet of the data collection template, there are fifteen cost categories common to each of the program areas. In the

PM, SI, and HSS sheets of the data collection template, the cost categories are streamlined into four common categories (five in the case of HSS). Definitions for these cost categories can be found in Table 2.

Table 2. EA Cost Categories and Descriptions

Cost Category Description

Investment expenditures: Site-level program expenditures, both human and capital, that have a useful life of more than one year

Training (in-service)

Expenditures in this category should include all expenditures related to training, such as materials, per diem, travel, facilitators and venue. In-service training supports the capacity development of existing health workers and program staff at the site level. Training that supports the creation of new health workers or supports the capacity development for government employees at the national level should be entered on the HSS worksheet.

Training is also the exception to the EA rule of thumb: “report expenditures based on the location in which they are consumed”. A complete description of how to classify training expenditures is provided in section 3.6.

Construction and renovation

Site-level expenditures for construction and renovation of health facilities or program offices. Construction and renovation that benefits multiple program areas will need to be allocated across the different program area columns.

Vehicles Expenditures for the purchase of vehicles only. Fuel and maintenance expenditures should be recorded as recurrent expenditures under travel/transport.

Equipment and furniture

Site-level expenditures for the purchase of clinical and office equipment and furniture, including computers. Office supplies that are purchased and used up within a year should be recorded as recurrent expenditures.

Other investment expenditures

Site-level investment expenditures otherwise not categorized. Explanations are required in the comments section of the template for this category to complete the submission.

Recurrent expenditures: Site-level program expenditures that are consumed as part of normal routine program operations

Personnel

All expenditures related to site-level personnel. This includes salary, fringe benefits, top-up salary, stipends, and reimbursement for overtime.

Antiretroviral drugs (ARVs)

Expenditures for the purchase of ARVs. Only report in this category if your organization procured ARVs with PEPFAR funds over the EA timeframe.

Non-ARV drugs and reagents

Expenditures for the purchase of any drugs not classified as ARVs and the purchase of reagents for laboratory diagnostics.

HIV test kits

Expenditures for the purchase of rapid HIV test kits

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Condoms

Expenditures for the purchase of condoms

Other supplies

Expenditures related to the purchase of any commodities or supplies that are otherwise not classified

Food supplements

Expenditures for the purchase of food supplements

Building rental and Utilities Expenditures for the renting of building space and any utility including electricity, internet, cellular data and cellular talk time.

Travel and transport

This category includes all travel-related expenditures such as airfare, bus fare, per diem, and vehicle fuel and maintenance. The purchase of mobile equipment, such as vehicles, should be categorized as investment expenditures.

Other recurrent expenditures

Site-level recurrent expenditures otherwise not categorized. Explanations are required in the comments section of the template for this category to complete the submission

Program management, strategic information, surveillance, and health system strengthening cost categories

Personnel

All expenditures related to personnel that support the program but do not work in sites.

This includes salary, fringe benefits, top-up salary, and reimbursement for overtime.

Consultants (external)

All expenditures related to contracted services and consultant services (external to your organization).

Construction and renovation (for HSS only)

Expenditures related to the construction and renovation of non-service delivery structures owned by the host-national government, such as the renovation of a Ministry of Health Headquarters building.

Transport/travel

This category includes all travel related expenditures for above site-level personnel, such as airfare, bus fare, per diem, and vehicle fuel and maintenance.

Other general and administrative

This category includes all above-site-level expenditures not otherwise categorized as personnel, consultants, or transport/travel.

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Within certain program areas some additional information is required on further disaggregation of expenditures or program effort.

Explanations for these categories and their affiliated EA program areas are provided below in Table 3.

Table 3. EA Program Areas with Additional Information Requested

Facility-Based Care, Treatment & Support

The additional information on programmatic service delivery for beneficiary populations receiving facility-based care, treatment and support services is used by the EA team to allocate expenditures between care and treatment patient types. This data was formerly located on the Program Information sheet, but now is at the end of the FBCTS section on the Expenditures Site-Level sheet.

In general, if your organization has or will report on the clinical care and treatment indicators (number of people currently receiving a care service or currently on ART) in APR 2014, S/APR 2015, or APR 2015: you are required to fill this sheet out; otherwise, you are asked not to report into this section. Please only complete data entry fields that pertain to your organization’s programs and operations. If you are unsure if a specific category pertains to your organization, please request TA (section 4.2).

Clinic Visits: Estimate the average number of times over the year each patient-type received a clinic visit

Adult pre-ART patients (15+ years) For each patient type supported with FBCTS, please indicate the average number of times each patient received a clinic visit over the course of the year. Fractions are acceptable. Estimate using clinical records or program staff input on actual service delivery, not just guidelines. For example, consider an average pre-ART patient who you support in a facility, on average how frequently did this patient come in for a clinical exam during FY 2015. Please do not enter the actual number of individuals you support in this section. The purpose of this information is to allocate resources between the patient types so that more accurate and specific unit expenditure estimates can be generated.

Pediatric pre-ART patients (< 15 years)

Current adult ART patient s (15+ years)

Current pediatric ART patients (<15 years)

Lab Tests: Estimate the average number of times over the year each patient-type received a lab test, including CD4 tests, biochemical panels, hematology tests, and viral load assessments.

Adult pre-ART patients (15+ years) For each patient type supported with FBCTS, please indicate the average number of times each patient received a lab test over the course of the year.

This estimate should include all lab tests received and each test should be counted separately, even if the tests resulted from the same specimen or clinic visit. Fractions are acceptable. Estimate using clinical records or program staff input on actual service delivery, not just guidelines. For example, consider an average pre-ART patient who you support in a facility, on average how many lab tests (of any kind) did this patient receive during FY 2015. Please do not enter the actual number of individuals you support in this section. The purpose of this information is to allocate resources between the patient types so that more accurate and specific unit expenditure estimates can be generated.

Pediatric pre-ART patients (< 15 years)

Current adult ART patients (15+ years)

Current pediatric ART patients (<15 years)

Community-Based Care, Treatment & Support

Medical Care (not-facility based)

The amount of site-level expenditures for Community-Based Care, Treatment & Support which can be allocated to each of these service categories. The sum of these amounts must equal the sum of investment and recurrent expenditures for Community-Based Care, Treatment & Support.

A brief description of each of the service categories is listed below:

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Economic Strengthening

Medical Care (not-facility based): May include community-based services such as: linkage and retention activities to connect and keep patients in care and treatment; referral of patients for care or treatment in a health facility; home-based monitoring of PLHIV;

community-based distribution of ART; management of TB;

coordination with malaria prevention activities; safe water, sanitation, and hygiene (WASH) services to reduce diarrheal illness in PLHIV’ mental health services; pain and symptom management;

and end-of-life-care

Economic Strengthening: May include community-based services such as income-generating activities and livelihood support activities.

Social, Psychological & Spiritual Care: May include community-based services such as support groups for PLHIV, counseling, prevention for PLHIV/Positive Health, Dignity, and Prevention (PHDP) services, mental health services, and legal services.

Nutrition & Food Security: May include community-based nutritional assessment, counseling, and support (NACS) services, including nutrition assessment and referral to clinical care and referral to economic strengthening and livelihood services and support to improve food security and household resilience.

Social, Psychological & Spiritual Care

Nutrition & Food Security

Preventing Mother-to-Child Transmission

Percent Effort for HIV Testing of Pregnant Women

The percentage of staff time and program effort that is used to support each of these PMTCT services. This is a best estimate of how shared expenditures, such as personnel, building rental & utilities, and travel/transport are used to support these activities. Percent effort must sum to 100%

Percent Effort for HIV Testing of Exposed Infants

Percent Effort for Prevention and Care for Pregnant Women (Option A, B or B+ Services)

Percent Effort for Prevention and Care for Exposed Infants

Test Kits for Pregnant Women Disaggregation of the HIV Test Kit Cost Category. The sum of expenditures for test kits for pregnant women and infants should equal the value for HIV Test Kits for PMTCT. Test Kits for Exposed Infants

ARVs for Pregnant Women Disaggregation of the ARV Cost Category. The sum of expenditures for ARVs for pregnant women and infants should equal the value for ARVs for PMTCT.

ARVs for Exposed Infants

HIV Testing & Counseling

Provider-Initiated Testing & Counseling The amount of site-level expenditures for HIV Testing & Counseling which can be allocated to each of these testing modalities. The sum of these amounts must equal the sum of investment and recurrent expenditures for HIV Testing & Counseling.

Voluntary Testing & Counseling

Community-Based Testing & Counseling

Laboratory

Percent Effort for ART Lab Services The percentage of staff time and program effort that is used to support each of these Lab services. This is a best estimate of how shared expenditures, such as personnel, building rental & utilities, and travel/transport are used to support these activities. ART Lab Services includes lab-based HIV testing, CD4, viral load, hematology, and biochemical panels. Percent effort must

Percent Effort for TB Diagnostics

Percent Effort for Early Infant Diagnosis

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Percent Effort for Quality Assurance/Improvement sum to 100%.

Non-ARV Drugs & Reagents for ART Lab Services

Disaggregation of the Non-ARV Drugs & Reagents Cost Category. The sum of expenditures for Non-ARV Drugs & Reagents for these 4 services should equal the value for Non-ARV Drugs & Reagents overall for Lab.

Non-ARV Drugs & Reagents for TB Diagnostics

Non-ARV Drugs & Reagents for Early Infant Diagnosis

Non-ARV Drugs & Reagents for Quality Assurance/Improvement

Supplies for ART Lab Services

Disaggregation of the Other Supplies Cost Category. The sum of expenditures for Supplies for these 4 services should equal the value for Other Supplies for Lab.

Supplies for TB Diagnostics

Supplies for Early Infant Diagnosis

Supplies for Quality Assurance/Improvement

Orphans & Vulnerable Children

Health Access & Health Promotion

The amount of site-level expenditures for Orphans & Vulnerable Children which can be allocated to each of these service categories. The sum of these amounts must equal the sum of investment and recurrent expenditures for Orphans & Vulnerable Children.

A brief description of each of the service categories is listed below:

Health Access & Health Promotion: Interventions to monitor holistic health outcomes, build health knowledge and skills in caregivers, and facilitate access to key health services including HIV testing, care and treatment and services for OVC. Direct HIV care and treatment services should be recorded under FBCTS or CBCTS.

Educational Support & ECD: Support to children and adolescents affected by and vulnerable to HIV to overcome barriers to accessing education including enrollment, attendance and progression. This category also includes interventions to improve the safety of children and adolescents at home and at school. Also includes activities related to ECD, defined as the physical, cognitive, social, and emotional maturation of human beings from conception to eight years but which impacts a lifetime.

Economic Strengthening: Economic strengthening (including social protection) interventions that reduce economic instability in adolescents and families affected by and vulnerable to HIV

Psychosocial Support: Services and interventions that support psychosocial and mental well-being for children and families affected by HIV

Nutrition & Food Security: Services and interventions related to nutrition screening and referral, building health and nutrition knowledge and skills in caregivers, and incorporating the community aspects of nutrition assessment, counseling, and support

Child Protection: Services and interventions that OVC programs support to prevent and mitigate maltreatment of children and adolescents including gender-based violence.

Case Management: Case management activities which ensure children, adolescents and families have access to a continuum of prevention, mitigation, care and treatment

Educational Support and Early Childhood Development (ECD)

Economic Strengthening

Psychosocial Support

Nutrition & Food Security

Child Protection

Case Management

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2.0 DATA COLLECTION

Data will be captured using an Excel based data collection template which will be uploaded into PROMIS, a web-based data management system. Please use the following link to access the website, download data collection templates, and submit data:

https://pepfarpromis.net/promisea/ea

The data collection template is in Excel 2007 format (with “.xlsx” file extension). Please note, if the template is opened and saved using an earlier version of Excel, PROMIS will not accept that file format, and data will need to be re-keyed into a new template for a successful submission. If you have any difficulties with Excel versioning, please contact your TA provider for assistance (see section

4.2 for requesting TA).

Information on each worksheet in the data collection template is provided below. Please complete each worksheet and data field that pertains to your organization. If data entry cells are left blank, the default value will be zero. Please do not adjust the structure of the template/worksheets or adjust any formula, this will result in a failed PROMIS upload.

DATA COLLECTION TEMPLATE OVERVIEW

TIP: Please open the Excel template while reviewing this section for ease of understanding.

For each data entry row on the site-level, PM, SI, and HSS sheets, select the geographic location2 from the pre-populated drop down list in column D that corresponds to the expenditures you are reporting. For countries with many SNUs, there may be a preliminary dropdown in column C with the SNU level above the reporting SNU level. If this is the case, select the SNU which contains the desired reporting SNU in column C and then select the reporting SNU in column D. There should be a separate row for each geographic location in which your organization provides services and support. Note that all figures entered on a row will be analyzed as occurring in the location identified in column D. Also note that the buttons in column A do not in any way correspond with data entered on those rows, they are only intended to be used as navigation buttons between program areas on the same sheet. Any figure entered into a cell without a corresponding geography in column D will be rejected upon upload to PROMIS.

Each worksheet also contains buttons to fields for entering comments that may help explain your submission. Your organization should use these text fields to further explain the data, especially for expenditures classified under an “Other” cost category, or if an equation was used to allocate shared expenditures that differs from the recommended method.

You may utilize another Excel file as a working document for calculations, or various source files, to generate the figures which will be entered into the EA data collection template. In doing so, you will need to enter that data into the EA data collection template.

Take great care in doing so. There are many hidden columns and rows in the EA template, and pasting data into the file can have the unintended result of populating hidden cells. Keep your eye on the column labeling of the EA file and take note of places where the column names skip over letters (e.g., In the site-level sheet the columns jump from HV to IA, where columns HW-HZ are hidden) and

2 Special note for Department of Defense Partners: For Department of Defense partners that provide military-to-military services, expenditure analysis data is not required to be disaggregated to sub-national units within a country due to special considerations around confidentiality. A separate template has been created for these partners and can be accessedby contacting mailto:Brittney.n.shook.ctr@mail.mil or Catherine.ramirez4.ctr@mail.mil.

https://pepfarpromis.net/promisea/ mailto:Brittney.n.shook.ctr@mail.mil mailto:Catherine.ramirez4.ctr@mail.mil

- 19 -paste your data in appropriately. Also be sure to avoid pasting equations or other non-numerical values into the EA Excel file (i.e., $, %, -, etc.).

Sections 2.1–2.5 provide detailed descriptions of the requested data for each worksheet in the data collection template. Should your organization have specific questions, please request TA (section 4.2).

TIP: Enter expenditure data on the site-level worksheet first. This will help provide the information needed to accurately allocate expenditures on other worksheets.

2.1 INSTRUCTIONS

The Instructions worksheet provides information on naming the data collection template, as well as the submission process. Please refer to this guidance for assistance with entering the requested data, including operational definitions and allocation methods. The

Partner Info worksheet requests your organization’s name, contact information, and mechanism. Please ensure each partner information field is complete. If you do not know your mechanism ID, please contact your USG A/COR to retrieve the number. If you do not have a mechanism ID, please contact EA coordinators Ramona Godbole (rgodbole@usaid.gov) and Jeffrey Bale

(wol3@cdc.gov)

2.2 EXPENDITURES—SITE-LEVEL

You should complete this worksheet if your organization uses any PEPFAR funding to provide services or support at the facility/site/implementation-level. Expenditures reported on this sheet may support a wide range of services across different program areas, with the similarity that they occur at the facility/site/implementation-level.

Site-level expenditures must be tied to a sub-national geographic unit in your country (note that there is no “National” or “Above

National” option on this sheet). For EA 2015, you may be required to input site-level data at a lower sub-national unit than in previous years. The pre-populated drop down list found in column D is comprehensive of the locations which you can select, and deviation from this list (i.e., pasting a location over it) will result in a failed upload to PROMIS. Expenditures reported on this sheet are also required to be linked to a program area (see table 1), cost category (see table 2), and point-of-service type (see table 4).

Please contact your EA advisor if you have questions regarding the decision of which geographic level being used in your country.

When entering site-level data into the ‘Expenditures—Site-level’ worksheet:

Select the sub-national unit where the expenditures occurred in column C and sub-sub-national unit in column D (if applicable/available)

Select the point-of-service type in column E

Enter the expenditure data in the appropriate cost category and program area column.

mailto:wol3@cdc.gov

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Examples of activities that would be recorded on the site-level sheet include:

Purchase of HIV rapid test kits to be used at a stand-alone clinic would be categorized in the “HTC” program area, under the

“HIV test kits” cost category in the sub-national unit the clinic is in.

A computer purchased to perform accounting activities of a hospital providing treatment services would be categorized in the

“FBCTS” program area, under the “equipment and furniture” cost category in the sub-national unit the hospital is in.

Training costs for an individual who enters routine M&E data at an antenatal care (ANC) site would be categorized in the

“PMTCT” program area, under the “in-service training” cost category in the sub-national unit the ANC site is in.

Salaries for staff that provide supportive supervision and mentoring to health care workers providing anti-retroviral treatment

(ART) in facilities would be…