Objective 1: Build Strong Beginnings

Recognizing the increased health risks for children in adversity, the U.S. Government’s Global Health Initiative, Feed the Future, and the U.S. President’s Emergency Plan for AIDS Relief include goals to develop, evaluate, and implement approaches to reach chronically underserved children. In light of the mounting evidence of the long-term effects of severe adversity in early childhood,1 comprehensive strategies that incorporate promotion of secure and stimulating relationships, safeguarding against malnutrition during the critical 1,000 days between pregnancy and age 2, and other lifesaving health services are essential to the future success of communities and nations.2 Programs that are designed to target and support critical periods in development and are scalable to a national level lay the foundation for a healthy society in which children have greater opportunities to grow up as healthy and productive adults.3

To support these outcomes, relevant U.S. Government departments and agencies have committed to taking certain actions, which are listed below:

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  • Outcome 1:1

    The percentage of children achieving age-appropriate growth and developmental milestones is increased.

    Promote investments in pregnant women, young children, and caregivers to encourage healthy growth and development.

    • Department/Office: Department of State, Secretary’s Office of Global Women’s Issues (S/GWI), Women’s Health Innovation Program
    • Activity: Empower vulnerable and expectant mothers with evidence-based, culturally appropriate pregnancy information, education, and social support, in an effort to improve maternal and child health and literacy. Work will be implemented with local partners and government agencies. The partnership will support and coordinate the work of front-line healthcare providers and policymakers by fostering collaboration, increasing capacity and ensuring that health information is accurate, comprehensive and readily available and accessible. 
    • Country Focus: Bangladesh, Liberia (pilot countries)     
    • Outcome/Indicator: To provide evidence-based, culturally appropriate pregnancy and parenting materials to underserved families that are attractive, comprehensive and easy to read, and serve as a catalyst for learning and family literacy;  to empower and educate low-income expecting women so they have the skills and the support they need to advocate for themselves, their babies, families and communities;  to teach healthcare providers, educators and communities how to respectfully engage, communicate and educate low-income mothers during their pregnancy and childbirth; and to build initiatives to bring communities together to support pregnant and new mothers’ learning, and ensuring families receive compassionate information and timely care. A small grants component will be awarded to local grassroots organizations to implement the program using the country-specific Baby Basics tools and curriculum.           
    • Time Frame: 2012 –2014 
    • Budget: Funded through the Secretary’s International Fund for Women and Girls, $1.75 million has been spent to date.

     

    • Department/Office: USAID, Bureau for Global Health (GH) Office of Health, Infectious Diseases, and Nutrition (HIDN), Nutrition Division          
    • Activity: Reduce the prevalence of undernutrition in focus countries by 20%, through the following pathways:
    • Global Development: Build capacity to design, implement, and report on food and nutrition programs and strengthen coordination and integration.
    • Research and Development:  Expand the evidence base for nutrition to strengthen programs, guide policy, improve measurement, and promote innovation.
    • Implementation: Introduce and expand comprehensive evidence-based practices of interventions to prevent and treat undernutrition.               
    • Country Focus: 18 countries: Bangladesh, Cambodia, DR Congo, Ethiopia, Ghana, Guatemala, Haiti, Kenya, Liberia, Malawi, Mali, Mozambique, Nepal, Rwanda, Senegal, Tanzania, Uganda, Zambia.
    • Outcome/Indicator: Outcome: Reduce the prevalence of undernutrition in focus food insecure countries by 20%. Measurement/Indicators: Reduction in underweight, and indicator for MDG1 and stunting. Additional outcome indicators to measure progress include wasting, child and maternal anemia, underweight women, and measurements of diet across the 1,000 day window of opportunity.
    • Time Frame: 2012-2017
    • Budget: FY2012 $90,000,000

     

    • Department/Office: CDC, National Center for Birth Defects and Development Disabilities (NCBDDD) (In Collaboration with CARE, Save the Children, and USAID)
    • Activity: Develop and implement the Essential Package (EP) - a comprehensive and integrated framework to support developmental, health, nutrition, protection and livelihoods of young vulnerable children and their caregivers. Prenatal to age 8. Create E-Learning modules for USAID on child development and disability.
    • Country Focus: Currently: Malawi, Mozambique, and Zambia. Being adapted for India, Honduras and El Salvador. USA – but integrated into the EP globally.
    • Outcome/Indicator: Outcomes -- child developmental status, caregiver status and caregiving environment. EP has an evaluation and measurement component. Each module has a learning objective knowledge test. Aims to provide tools and resources on developmental milestones so children can get services and treatment and families can be aware of development.
    • Time Frame: Roll out on-going. Continuing to work on e-learning modules as needs arise.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: CDC, Center for Global Health (CGH), Global Immunization Division (GID)
    • Activity: Provide technical assistance (TA) on tetanus immunization of pregnant women, polio immunization, and monitoring progress toward achieving hepatitis B control goals. Work to control and eliminate measles and rubella. Provide guidance to countries in strengthening routine immunization programs and increasing vaccination coverage.
    • Country Focus: GID works in all countries by supporting WHO HQ and WHO regional offices.
    • Outcome/Indicator: Maintain and strengthen surveillance of tetanus and polio.
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: CDC, Center for Global Health (CGH), Division of Parasitic Diseases and Malaria
    • Activity: Assist national malaria control programs to increase the number of women covered by scaling-up effective interventions. Collaborate with research partners to improve drug combinations for preventive treatment during pregnancy as well as monitoring & surveillance.             
    • Country Focus: Africa: U.S. President’s Malaria Initiative (PMI) Angola, Benin, Senegal, Liberia, Ghana, Mali, Nigeria, Kenya, Tanzania, Malawi, Mozambique, Madagascar, Uganda, and Zambia. Greater Mekong Subregion.
    • Outcome/Indicator: PMI target: By 2015, achieve a 70 percent reduction in malaria burden (morbidity and mortality) in the original 15 PMI focus countries.       
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: Division of Parasitic Diseases and Malaria
    • Activity: Assess optimal frequency of deworming for soil-transmitted helminths in high prevalence areas. Evaluate impact of NTD interventions on preschool-aged children. Assist in development of global policies and guidelines for NTD programs. Identify optimal methods for delivering and monitoring schistosomiasis programs (collaborate with Schistosomiasis Consortium for Operational Research Evaluation).
    • Country Focus: Africa: Kenya.
    • Outcome/Indicator: Data for prevention, control, and elimination program guidelines and policies.     
    • Time Frame:  All activities are on-going.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: CDC, National Center for Emerging Zoonotic Infectious Diseases (NCEZID); Division of Foodborne, Waterborne, and Environmental Diseases
    • Activity: Integrate safe drinking water and hygiene promotion programs with other health-related programs (PEPFAR, maternal and child health, and antenatal care programs) and key community institutions. Develop, evaluate, and refine new and existing technologies for point-of-use water treatment, safe water storage, and handwashing. Integrate point-of-use water treatment and hygiene promotion into disaster and epidemic preparedness and response activities. Evaluate the health impact of combined WASH programs, including infrastructure.
    • Country Focus: All PEPFAR countries are supported by the MCHB. Countries currently being worked in include: Africa: Angola, Botswana, Cameroon, Côte d'Ivoire, Democratic Republic of the Congo, Dominican Republic, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, Sierra Leone, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. Americas: Haiti, Guatemala.
    • Outcome/Indicator: Evaluate the combined impact of water, sanitation, and hygiene on major MCH challenges, including diarrheal disease, soil-transmitted helminthiasis, and respiratory illness.
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: CDC, National Center for Emerging Zoonotic Infectious Diseases (NCEZID); Division of Food, Waterborne, Enteric Diseases
    • Activity: Conduct studies to integrate diarrhea prevention strategies with antenatal care (ANC). Integrate water treatment and hygiene promotion and commodities with basic care packages in PMTCT programs.  
    • Country Focus: Africa: Malawi, Kenya, Zambia, Ethiopia. Also of note: We have programmatic platforms in 25 countries in sub-Saharan Africa, South Asia, and Haiti with PSI, which include funding mechanisms.
    • Outcome/Indicator: Basic care package evaluation.
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: CDC, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP); Division of TB Elimination
    • Activity: Provide TA, collaborate on operations research, and contribute to development of international policy/guidance. Scale-up activities in childhood and MCH TB and TB/HIV.
    • Country Focus:  Africa: Botswana, Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and South Africa. Americas: Peru.
    • Outcome/Indicator: Plan to increase activities in select countries in sub-Saharan Africa, South-East Asia and Caribbean, pending funding. CDC focuses on policy-relevant operational research in TB epidemiology/ surveillance, TB case finding/diagnosis, integrated service delivery, and TB prevention. Better describing the epidemiology of TB and MDR TB among children. Improving diagnosis of TB among children through use of traditional and novel screening and diagnostic methods. Evaluating the ability of surveillance systems to accurately describe burden of TB among children.
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Reproductive Health
    • Activity: Support activities to address MDGs 3, 4, 5, 6. Provide TA for design, implementation, analysis, and data utilization of large population-based, multi-topic reproductive health surveys. Develop a toolkit to assess reproductive health status and needs in crisis settings (multiple countries). Develop the global evidence base for family planning guidance (with WHO). Establish MCH component in FELTP programs in low income countries. Support GHI’s Women, Girls and Gender Equality task force. Assist countries to implement evidence-based gender programs. Improve access to safe EmONC. Promote safe breastfeeding for HIV infected women. Promote optimal prophylaxis for pregnant HIV-infected women, including those with co-infections (e.g., hepatitis B). Improve data quality and surveillance systems. Test interventions Implement effective behavior change program to reduce risk of HIV.
    • Country Focus: Africa: Ethiopia, Kenya, Malawi, Tanzania. Asia: Afghanistan. Americas: Colombia, El Salvador, Guatemala, Paraguay, Uruguay. Other: Eastern Europe, Rep. of Georgia, Russia, Ukraine.
    • Outcome/Indicator: Community and clinic based prevalence of gender-based violence. Measurement of maternal mortality and its causes. Use and impact of EmONC on maternal and neonatal morbidity and mortality. Contraceptive prevalence rate, including long-acting contraception. HIV/STI prevalence. Knowledge of HIV status among 15-24, pregnant women, and key populations. Condom use and use of ARV for both pregnant and HIV-infected women.        
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: National Center for Environmental Health (NCEH), Office of the Director
    • Activity: HHS (CDC and NIH) Signed on as one of 16 Founding Members of the Global Alliance for Clean Cookstoves. CDC is supporting three field projects that focus on the effectiveness of clean cookstoves as a potential health intervention.  
    • Country Focus: Africa: Kenya. Asia: India, Americas: Guatemala.
    • Outcome/Indicator: Surveillance for adverse associated child outcomes, including infection, chronic disease, and injury
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.

     

    • Department/Office: PEPFAR. Agencies/Departments involved in PEPFAR activities listed in this plan include: Department of State, Office of the Global AIDS Coordinator; Peace Corps, Office of Global Health & HIV; Centers for Disease Control and Prevention, Division of Global HIV/AIDS; USAID Headquarters, Office of HIV & AIDS and USAID missions.
    • Activity: Expansion of Center Based and School Based ECD for pregnant and young mothers. Foster home visits for pregnant mothers and parents with young children with consistency and high enough frequency and dose. Promote mothers and mothers-to-be educational and support groups.  
    • Country Focus: The actions will be tailored to fit country context and prioritization but the objectives are currently and will continue to be a part of PEPFAR programming in all PEPFAR countries with OVC portfolios. For PEPFAR priority countries see www.pepfar.gov.
    • Outcome/Indicator: Globally, PEPFAR programs report "the number of eligible adults and children provided with a minimum of one care service." The Office of the Global AIDS Coordinator is currently leading the development of a PEPFAR Monitoring, Evaluation, and Reporting Strategy and Operational Guidance that will likely result in changes to the existing M&E guidance, including the addition of several new indicators that will in large part be outcome indicators derived from the OVC Program Evaluation Toolkit. In addition to globally reported indicators, PEPFAR OVC programs are also guided by the PEPFAR Program Evaluation Toolkit which provides measurement of comprehensive child and caregiver well-being outcomes. The toolkit can be accessed at http://www.cpc.unc.edu/measure/our-work/ovc/ovc-program-evaluation-tool-kit.
    • Time Frame: Ongoing.
    • Budget: Budget for PEPFAR Ongoing Programming for all three of the above objectives is 10% of PEPFAR programming budget at country level (differs by fiscal year). Because PEPFAR programs and projects are integrated and comprehensive and address multiple objectives simultaneously, it is not possible to break the funding down by objective.
  • Support the use and development, if necessary, of simple tools to assess, document, and promote actions to encourage age-appropriate growth and development through health clinics, schools, and community services.

    • Department/Office: PEPFAR
    • Activity: Promote parental involvement and home visits integrated into ECD programs; Parenting Groups with Health & Nutrition Information; Support Day Care centers for young children.
    • Country Focus: The actions will be tailored to fit country context and prioritization but the objectives are currently and will continue to be a part of PEPFAR programming in all PEPFAR countries with OVC portfolios. For PEPFAR priority countries see www.pepfar.gov.
    • Outcome/Indicator: Globally, PEPFAR programs report "the number of eligible adults and children provided with a minimum of one care service." The Office of the Global AIDS Coordinator is currently leading the development of a PEPFAR Monitoring, Evaluation, and Reporting Strategy and Operational Guidance that will likely result in changes to the existing M&E guidance, including the addition of several new indicators that will in large part be outcome indicators derived from the OVC Program Evaluation Toolkit. In addition to globally reported indicators, PEPFAR OVC programs are also guided by the PEPFAR Program Evaluation Toolkit which provides measurement of comprehensive child and caregiver well-being outcomes. The toolkit can be accessed at http://www.cpc.unc.edu/measure/our-work/ovc/ovc-program-evaluation-tool-kit.
    • Time Frame: Ongoing.
    • Budget: Budget for PEPFAR Ongoing Programming for all three of the above objectives is 10% of PEPFAR programming budget at country level (differs by fiscal year). Because PEPFAR programs and projects are integrated and comprehensive and address multiple objectives simultaneously, it is not possible to break the funding down by objective.
    • Department/Office: USAID, Bureau for Global Health (GH), Office of Health, Infectious Diseases, and Nutrition (HIDN)
    • Activity: Convene an Evidence Summit on Population-Level Behavior Change to Promote Child Survival and Development.
    • Country Focus: Lower- and middle-income countries. Pre-Summits were held in Ethiopia and India.
    • Outcome/Indicator: Implementation of an evidence-to-action strategy informed by published reviews and recommendations on evidence-based population-level behavior change to promote child survival and development.
    • Time Frame: FY 2013.
    • Budget: 
  • Support interventions and systems that identify as early as possible the needs of children who are not reaching growth and development milestones within normative timeframes, and enable families to access appropriate services as needed.

    • Department/Office: CDC, National Center for Environmental Health (NCEH), Division of Emergency and Environmental Health Services
    • Activity: Support partnerships for an International ban of Lead. Support environmentally sound metal mining. Respond directly to emergencies involving lead poisoning. Build country capacity in to recognize, manage, and prevent lead poisoning in children and adults from workplace activities, environmental pollution and lead in products like toys and jewelry (with China). Resolve lead exposure among internally displaced Roma in Kosovo (with USAID, WHO, UNICEF and the MOH). Resolve an outbreak of lead poisoning in Zamfara province, Nigeria related to small sector gold mining that has killed hundreds of children (with WHO and other partners). Conduct a lead prevalence study in Jakarta that will establish the prevalence of elevated blood lead levels and identify the most prominent sources (with EPA). 
    • Country Focus: Asia: China, Indonesia, Thailand. Africa: Nigeria. Americas: Peru. Europe: Kosovo.
    • Outcome/Indicator: Prevalence of elevated blood lead levels and associated risk factors.
    • Time Frame: Ongoing.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.
  • Outcome 1:2

    The percentage of children under 5 years of age demonstrating secure attachment with a primary caregiver is increased.

    Support the development and use of simple tools to assess and document aspects of attachment through health clinics or other service delivery options.

    • Department/Office: PEPFAR
    • Activity: Integrate PS care for HIV exposed or infected young children into other clinical, social and nutritional services. Support early childhood enrichment programs, where possible integrated or co-located with clinics and pediatric programs.
    • Country Focus: TBD
    • Outcome/Indicator: Globally, PEPFAR programs report "the number of eligible adults and children provided with a minimum of one care service." The Office of the Global AIDS Coordinator is currently leading the development of a PEPFAR Monitoring, Evaluation, and Reporting Strategy and Operational Guidance that will likely result in changes to the existing M&E guidance, including the addition of several new indicators that will in large part be outcome indicators derived from the OVC Program Evaluation Toolkit. In addition to globally reported indicators, PEPFAR OVC programs are also guided by the PEPFAR Program Evaluation Toolkit which provides measurement of comprehensive child and caregiver well-being outcomes. The toolkit can be accessed at http://www.cpc.unc.edu/measure/our-work/ovc/ovc-program-evaluation-tool-kit.
    • Time Frame:
    • Budget: Budget for PEPFAR Ongoing Programming for all three of the above objectives is 10% of PEPFAR programming budget at country level (differs by fiscal year). Because PEPFAR programs and projects are integrated and comprehensive and address multiple objectives simultaneously, it is not possible to break the funding down by objective.
    • Department/Office: CDC, National Center for Birth Defects and Developmental Disabilities (NCBDDD) (In Collaboration with CARE, Save the Children, and USAID)
    • Activity: Develop and implement the Essential Package (EP) - a comprehensive and integrated framework to support developmental, health, nutrition, protection and livelihoods of young vulnerable children and their caregivers. Prenatal to age 8.
    • Country Focus: Currently: Malawi, Mozambique, and Zambia. Being adapted for India, Honduras and El Salvador.
    • Outcome/Indicator: # of health clinics using the EP intervention with caregivers.
    • Time Frame: Roll out on-going.
    • Budget: CDC obligations for FY 2013 are not final. Specific funding levels are not yet known.
  • Support programs that help health and social service professionals educate caregivers about positive parenting practices that foster healthy social and emotional development, including secure attachment with a primary caregiver.

    • Department/Office: PEPFAR, Orphans and Vulnerable Children Programs
    • Activity: Support evidence-based and context-appropriate and parent training programs. Support human resource quality improvement: caregiver training, teacher training, materials for ECD. Facilitate consistent and frequent home visits for pregnant mothers and parents with young children. Adjust home visit purpose and frequency to context and household/community preferences.
    • Country Focus: PEPFAR priority countries.
    • Outcome/Indicator:
    • Time Frame: 2012-2017.
    • Budget: Approximately 10 % of the PEPFAR budget supports OVC programs. In FY 2012, this amounted to approximately $300,000,000.
    • Department/Office: Bureau for Global Health (GH), Office of Population and Reproductive Health (PRH), Service Delivery Improvement (SDI)
    • Activity: Support an enhanced focus on first time adolescent mothers to ensure improved spacing practices for better child health and HIV prevention through better use of postpartum family planning and PMTCT programs.
    • Country Focus: Guinea, Benin, Madagascar, the Philippines, Bangladesh.
    • Outcome/Indicator: Increase in uptake of family planning services. Improve spacing practices. Increase of PMTCT services (potential).
    • Time Frame: 2013-2017.
    • Budget: An aggregated budget is not possible due to varying separate funding sources.
  • Support interventions and systems that address delayed social and emotional development through primary caregiver support, education, counseling, and the development of appropriate referral services.

    • Department/Office: CDC, National Center for Birth Defects and Developmental Disabilities (NCBDDD) (In Collaboration with CARE, Save the Children, and USAID)
    • Activity: Develop and implement the Essential Package (EP) - a comprehensive and integrated framework to support developmental, health, nutrition, protection and livelihoods of young vulnerable children and their caregivers. Prenatal to age 8.
    • Country Focus: Currently: Malawi, Mozambique, and Zambia. Being adapted for India, Honduras and El Salvador.
    • Outcome/Indicator: # of children and caregivers referred for supportive services and receiving treatment.
    • Time Frame: Roll out on-going.
    • Budget: CDC obligations for FY 2013 are not final.  Specific funding levels are not yet known.
    • Department/Office: Bureau for Global Health (GH), Office of Population and Reproductive Health (PRH), Service Delivery Improvement (SDI)
    • Activity: Support an enhanced focus on first time adolescent mothers to ensure improved spacing practices for better child health and HIV prevention through better use of postpartum family planning and PMTCT programs.
    • Country Focus: Guinea, Benin, Madagascar, the Philippines, Bangladesh.
    • Outcome/Indicator: Increase in uptake of family planning services. Improve spacing practices. Increase of PMTCT services (potential).
    • Time Frame: 2013-2017.
    • Budget: An aggregated budget is not possible due to varying separate funding sources.
  • Outcome 1:3

    The number of U.S. Government-funded programs that integrate health, nutrition, developmental protections, and caregiving support is increased.

    Implement a maternal and child health “plus” agenda that integrates maternal, newborn, infant, and young child nutrition, and developmental services and protections for children into health, education, and social protection services.

    • Department/Office: PEPFAR
    • Activity: Support early childhood enrichment programs (including nutrition, developmental protections, attachment), where possible integrated or co-located with clinics, PMTCT and pediatric programs.
    • Country Focus: The actions will be tailored to fit country context and prioritization but the objectives are currently and will continue to be a part of PEPFAR programming in all PEPFAR countries with OVC portfolios. For PEPFAR priority countries see www.pepfar.gov.
    • Outcome/Indicator: Globally, PEPFAR programs report "the number of eligible adults and children provided with a minimum of one care service." The Office of the Global AIDS Coordinator is currently leading the development of a PEPFAR Monitoring, Evaluation, and Reporting Strategy and Operational Guidance that will likely result in changes to the existing M&E guidance, including the addition of several new indicators that will in large part be outcome indicators derived from the OVC Program Evaluation Toolkit. In addition to globally reported indicators, PEPFAR OVC programs are also guided by the PEPFAR Program Evaluation Toolkit which provides measurement of comprehensive child and caregiver well-being outcomes. The toolkit can be accessed at http://www.cpc.unc.edu/measure/our-work/ovc/ovc-program-evaluation-tool-kit.
    • Time Frame: Ongoing.
    • Budget: Budget for PEPFAR Ongoing Programming for all three of the above objectives is 10% of PEPFAR programming budget at country level (differs by fiscal year). Because PEPFAR programs and projects are integrated and comprehensive and address multiple objectives simultaneously, it is not possible to break the funding down by objective.

  • At the community level, facilitate birth registration systems to be used by community workers and health care providers to enable all children to have access to comprehensive primary health prevention and care services and the protections and rights of citizenship.

    • Department/Office: PEPFAR
    • Activity: Use existing groups and structures to disseminate information, such as health teams, youth organizations, religious institutions, and police. Advocate for and work with government offices to make changes in birth registration legislation. Support public information campaigns, mass rallies/registrations, radio, and television messages, and community theater                  .
    • Country Focus: The actions will be tailored to fit country context and prioritization but the objectives are currently and will continue to be a part of PEPFAR programming in all PEPFAR countries with OVC portfolios. For PEPFAR priority countries see www.pepfar.gov.
    • Outcome/Indicator: Globally, PEPFAR programs report "the number of eligible adults and children provided with a minimum of one care service." The Office of the Global AIDS Coordinator is currently leading the development of a PEPFAR Monitoring, Evaluation, and Reporting Strategy and Operational Guidance that will likely result in changes to the existing M&E guidance, including the addition of several new indicators that will in large part be outcome indicators derived from the OVC Program Evaluation Toolkit. In addition to globally reported indicators, PEPFAR OVC programs are also guided by the PEPFAR Program Evaluation Toolkit which provides measurement of comprehensive child and caregiver well-being outcomes. The toolkit can be accessed at http://www.cpc.unc.edu/measure/our-work/ovc/ovc-program-evaluation-tool-kit.
    • Time Frame: Ongoing.
    • Budget: Budget for PEPFAR Ongoing Programming for all three of the above objectives is 10% of PEPFAR programming budget at country level (differs by fiscal year). Because PEPFAR programs and projects are integrated and comprehensive and address multiple objectives simultaneously, it is not possible to break the funding down by objective.

Footnotes

  1. Shonkoff , J.P., et al. (2012). Technical Report: The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1). pp. e232–e246. http://pediatrics.aappublications.org/content/129/1/e232.full.pdf+html.
  2. Prado, E. and Dewey, K. (2012). Insight Technical Brief: Nutrition and brain development in early life. Alive & Thrive. (Issue 4). Washington, D.C.; Prado E. and Dewey, K. (2010). Insight Technical Brief: Why stunting matters. Alive & Thrive. (Issue 2). Washington, D.C.
  3. Shonkoff , J.P., et al. (2012). Technical Report: The lifelong eff ects of early childhood adversity and toxic stress. Pediatrics, 129(1). pp. e232–e246. http://pediatrics.aappublications.org/content/129/1/e232.full.pdf+html; Fox, S.E., et al. (2010). How the timing and quality of early experiences infl uence the development of brain architecture. Child Development, 81(1). pp. 28-40; Vanderwert, R.E., et al. (2010). Timing of intervention affects brain electrical activity in children exposed to severe psychosocial neglect. PLoSOne, 5(7).

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