President’s Emergency Program for AIDS Relief (PEPFAR)
In Ethiopia, HIV prevalence is estimated at 2.4 percent overall and 7.7 percent in urban and transport-corridor settings; these rates are largely driven by lack of awareness, mobility, and risky behavior in most-at-risk populations. USAID works to build upon PEPFAR’s successes, focusing on developing sustainable country programs through three key programmatic areas: prevention, support for orphans and vulnerable children, care and treatment, including support of health systems.
The PEPFAR prevention program in Ethiopia focuses on prevention of mother-to-child transmission (PMTCT), persons engaged in high-risk behaviors, and discordant couples. PEPFAR supports the Government of Ethiopia in the development of specific intervention programs for various most at risk populations. It also addresses critical gender issues that exacerbate the HIV problem, including early marriage, sexual coercion, and cross-generational sex. The PMTCT program provides support to the Government of Ethiopia to prioritize facilities in areas of high HIV prevalence, building upon the opportunity provided through the deployment of over 3,000 urban health extension workers. PEPFAR also continues to strengthen coordination of HIV counseling and testing programs in urban, peri-urban, and selected rural “hot-spots.”
The HIV/AIDS pandemic strikes at the heart of family and community support structures. It is estimated that there are 5.5 million orphans in Ethiopia, which is around 15 percent of the total child population. Of these, 16 percent were orphaned due to HIV/AIDS. Orphans and vulnerable children are at increased risk for neglect, abuse, malnutrition, poverty, illness and discrimination and – as they get older, are much more vulnerable to HIV infection. The President’s Emergency Plan for Aids Relief , in partnership with the Government of Ethiopia, employs a comprehensive and multi-sectoral approach that builds on community and family support structures, and engages communities in taking action to care for and track the welfare of affected children. Together they work in each of the nine administrative regions and two city administrations to provide comprehensive and coordinated quality services for 500,000 highly vulnerable children in each year of the five year program.
PEPFAR care, treatment and support activities focus on infrastructure improvement, training, and commodity support including the distribution of basic health care services, nutritional care and support to people living with HIV/AIDS. PEPFAR also supports the national laboratory system, including the procurement of laboratory reagents and supplies for antiretroviral therapy, monitoring, infrastructure support, quality assurance, and site supervision for the National Referral Laboratory and nine regional labs.
Support for health systems strengthening and human resources for health emphasizes: leadership and management of service delivery; human and organizational capacity-building; broad expansion of private sector engagement; and expanding pre-service training in support of the national plan. PEPFAR continues to work with the National HIV/AIDS Prevention and Control Office to design a community-based system to capture community level sector inputs into HIV/AIDS programs.
- Communication for Change (C-CHANGE): Develop innovative social and behavior change communication strategies and materials and build expertise on communication for HIV prevention.
- Community PMTCT: Define the parameters and objectives for a prevention of mother-to-child transmission of HIV/AIDS program to improve the quality of maternal and child health services for pregnant women in Ethiopia through community-based approaches. Follow-up on HIV exposed babies and HIV positive mothers to ensure they receive appropriate care and treatment.
- HIV Prevention for Vulnerable Adolescent Girls: Address social norms that contribute to the transmission of HIV by averting HIV transmission in girls who are married to older men, divorced or girls who migrate to Addis Ababa.
- MULU Prevention Program for At-risk Populations (MULU Prevention): Contribute to the national target of reducing new HIV infections by 50 percent by 2014.
- Prevention and Care Services for At Risk Mobile Populations (TransACTION): Prevent new HIV infections among at risk populations and strengthen linkages to care and support services in towns and commercial hotspots along or linked with major transportation corridors.
- Ethiopian Network for HIV and AIDS Treatment, Care and Support (ENHAT-CS) Program: Expand therapy services to combat HIV/AIDS; enhance maternal, newborn, and child health, TB, and other services; and develop Ethiopia’s capacity to sustain the use of and demand for such health care services.
- Food and Nutrition Technical Assistance (FANTA) II: Provide technical assistance in nutrition training at national and regional levels. Provide technical assistance in reviewing and updating national HIV/AIDS nutrition policy and guidelines.
See also: Nutrition
- Food by Prescription: Provide therapeutic and complementary feeding for adults and children affected by HIV/AIDS.
See also: Nutrition
- Grants Solicitation and Management: Ensure the goals are met under each grant awarded to selected Ethiopian organizations to provide HIV/AIDS prevention and care services in high prevalence areas, while simultaneously assuring the growth and development of grantee organizations.
- Health Infrastructure Program (HIP): Design and construct Government of Ethiopia standard health centers and regional warehouses, and renovate health centers experiencing serious infrastructure problems in facilities with high antiretroviral therapy patient loads and in areas of high HIV prevalence.
- Preventive Care Package (PCP) Program: Mitigate the impact of HIV/AIDS in Ethiopia and improve the quality of life of people living with HIV (PLHIV), their families, and the community through sustainable, comprehensive, and coordinated evidence-based interventions.
- Private Health Sector Program: Increase access of at risk populations to HIV counseling and testing by improving the quality and production of health services at private clinics. Consolidate the integration of HIV counseling and testing, antiretroviral therapy, and tuberculosis, sexually transmitted infections, family planning and malaria services in the private sector.
See also: Tuberculosis
- Strengthening Pediatric Case Finding Utilizing Community and Facility Approaches: Provide pediatric HIV care and treatment training for health care service providers. Provide clinical mentorship for pediatric HIV care, treatment and psychosocial care and counseling. Develop and produce additional job aides and resource materials. Increase the uptake of pediatric HIV/AIDS services.
- Urban HIV/AIDS Food and Nutrition Assistance: Advance the nutritional status and quality of life of food-insecure people living with HIV/AIDS and receiving Home Based Care, Antiretroviral Therapy, and Prevention of Mother to Child Transmission Services. Increase school enrollment and attendance of orphans and vulnerable children in urban communities affected by HIV/AIDS.
See also: Nutrition
HIGHLY VULNERABLE CHILDREN
- "Yekoke Berhan HIghly" Vulnerable Children Care and Support Program: Reduce vulnerability among orphans and vulnerable children and their families by strengthening systems and structures to deliver quality essential services and increase resiliency.
- Strengthening the Federal Level Response to Highly Vulnerable Ethiopian Children through the Development of a Child-Focused Social Welfare System: Mitigate the impact of HIV/AIDS on children through improved Ethiopian systems and structures.
U.S.Government Action Plan on Children in Adversity [PDF, 2.51mb]