The New Structure The New Structure of theof the

Child Survival and HealthChild Survival and HealthPrograms FundPrograms Fund

The New Structure The New Structure of theof the

Child Survival and HealthChild Survival and HealthPrograms FundPrograms Fund

Accounts, Guidance, and CodingAccounts, Guidance, and Coding

October, 2002

ByBy

Richard Cornelius, PPCRichard Cornelius, PPC

PAY ATTENTIO

N!

First things First things

first...first...

First things First things

first...first...

What’s New?What’s New?

Section 1Section 1

So What’s New?So What’s New?So What’s New?So What’s New?• New Name• New Account

Structure • New Notwithstanding

Authority • New HIV/AIDS

Operational Plan including the new Commodity Promotion Fund

• New Name• New Account

Structure • New Notwithstanding

Authority • New HIV/AIDS

Operational Plan including the new Commodity Promotion Fund

New NameNew Name

In FY 2002, the name of the Child Survival and Disease (CSD) Programs Fund was changed to the Child Survival and Health (CSH) Programs Fund to reflect modifications in the account’s structure.

In FY 2002, the name of the Child Survival and Disease (CSD) Programs Fund was changed to the Child Survival and Health (CSH) Programs Fund to reflect modifications in the account’s structure.

• Child Child Survival/Maternal Survival/Maternal Health (CS/MH)Health (CS/MH)

• Vulnerable ChildrenVulnerable Children

• HIV/AIDSHIV/AIDS

• Infectious DiseasesInfectious Diseases

• Family Planning & Family Planning & Reproductive Health Reproductive Health (FP/RH) (FP/RH) formerly formerly “POP”“POP”

• Child Child Survival/Maternal Survival/Maternal Health (CS/MH)Health (CS/MH)

• Vulnerable ChildrenVulnerable Children

• HIV/AIDSHIV/AIDS

• Infectious DiseasesInfectious Diseases

• Family Planning & Family Planning & Reproductive Health Reproductive Health (FP/RH) (FP/RH) formerly formerly “POP”“POP”

New CSH Budget New CSH Budget CategoriesCategories

New CSH Budget New CSH Budget CategoriesCategories

• Child Survival and Child Survival and

Maternal HealthMaternal Health

• Vulnerable Vulnerable

ChildrenChildren

• HIV/AIDSHIV/AIDS

• Infectious DiseasesInfectious Diseases

• Basic Education Basic Education

for Childrenfor Children

• Child Survival and Child Survival and

Maternal HealthMaternal Health

• Vulnerable Vulnerable

ChildrenChildren

• HIV/AIDSHIV/AIDS

• Infectious DiseasesInfectious Diseases

• Basic Education Basic Education

for Childrenfor Children

OLDOLD NEW

NEWNEWNEWNEW

OUTOUT

• New expanded authority allows for the New expanded authority allows for the use of CSH funds for “child survival use of CSH funds for “child survival activities or disease programs…activities or disease programs…notwithstanding any other provision of notwithstanding any other provision of lawlaw [e.g., procurement regulations, [e.g., procurement regulations, personnel regulations, competitive personnel regulations, competitive process standards, etc.]process standards, etc.].”.” Previous Previous legislation limited this provision to legislation limited this provision to overcoming country prohibitions only.overcoming country prohibitions only.

• IMPORTANT: This new provision IMPORTANT: This new provision does notdoes not extend to the use of FP/RH (“POP”) funds.extend to the use of FP/RH (“POP”) funds.

• New expanded authority allows for the New expanded authority allows for the use of CSH funds for “child survival use of CSH funds for “child survival activities or disease programs…activities or disease programs…notwithstanding any other provision of notwithstanding any other provision of lawlaw [e.g., procurement regulations, [e.g., procurement regulations, personnel regulations, competitive personnel regulations, competitive process standards, etc.]process standards, etc.].”.” Previous Previous legislation limited this provision to legislation limited this provision to overcoming country prohibitions only.overcoming country prohibitions only.

• IMPORTANT: This new provision IMPORTANT: This new provision does notdoes not extend to the use of FP/RH (“POP”) funds.extend to the use of FP/RH (“POP”) funds.

New Notwithstanding New Notwithstanding AuthorityAuthority

New Notwithstanding New Notwithstanding AuthorityAuthority

New Commodity Promotion

Fund

New Commodity Promotion

FundThis fund is intended to increase condom availability and use for HIV/AIDS prevention by making the condoms free of charge to Missions according to select criteria and by freeing up Mission funds for other critical HIV/AIDS activities

This fund is intended to increase condom availability and use for HIV/AIDS prevention by making the condoms free of charge to Missions according to select criteria and by freeing up Mission funds for other critical HIV/AIDS activities

What’s What’s NOTNOT New? New?((The 4 Commandments of The 4 Commandments of

CSH)CSH)

What’s What’s NOTNOT New? New?((The 4 Commandments of The 4 Commandments of

CSH)CSH)• THOU SHALT always confirm that any use

of CSH funds is consistent with guidance for that fiscal year. This includes ensuring that activities demonstrate– Direct and Measurable Impact– Optimal Use of Funds

• THOU SHALT use earmarked funds fortheir intended purpose - no substitutions!

• THOU SHALT document your decisions!• THOU SHALT remember to use proper

coding!

• THOU SHALT always confirm that any use of CSH funds is consistent with guidance for that fiscal year. This includes ensuring that activities demonstrate– Direct and Measurable Impact– Optimal Use of Funds

• THOU SHALT use earmarked funds fortheir intended purpose - no substitutions!

• THOU SHALT document your decisions!• THOU SHALT remember to use proper

coding!

Congressional Interest

Congressional Interest

Section 2Section 2

• Congressional Interest– Increased funding– Annual reporting

• Strong Interest Groups

• Frequent Hill Inquiries– Appropriate use of CSH funds– Integrated programs (e.g., CS/MH

and FP/RH)• GAO/IG Audits

• Congressional Interest– Increased funding– Annual reporting

• Strong Interest Groups

• Frequent Hill Inquiries– Appropriate use of CSH funds– Integrated programs (e.g., CS/MH

and FP/RH)• GAO/IG Audits

The Hill is Interested and The Hill is Interested and Watching!Watching!

The Hill is Interested and The Hill is Interested and Watching!Watching!

“…and this means what to

me?…”

“…and this means what to

me?…”

It Means…It Means…Coding is Important!Coding is Important!

It Means…It Means…Coding is Important!Coding is Important!

Proper coding...•Tells the story of USAID’s programs

–Congress –Other partners

•Reveals implications of funding cuts

•Answers frequent questions without special field reporting, such as–How much for immunization?–How much for maternal health funding?

Proper coding...•Tells the story of USAID’s programs

–Congress –Other partners

•Reveals implications of funding cuts

•Answers frequent questions without special field reporting, such as–How much for immunization?–How much for maternal health funding?

Faulty coding undermines USAID’s

credibility!

Faulty coding undermines USAID’s

credibility!

It Also Means…It Also Means…Use Funds Appropriately!Use Funds Appropriately!

It Also Means…It Also Means…Use Funds Appropriately!Use Funds Appropriately!

• Congressionally-mandated elements have been established within each of the budget categories of the CSH Programs Fund. These elements are...

– Earmarks: fixed $ amounts– Directives: no fixed $ amounts

• Congressionally-mandated elements have been established within each of the budget categories of the CSH Programs Fund. These elements are...

– Earmarks: fixed $ amounts– Directives: no fixed $ amounts

CSH Programs Fund Structure

CSH Programs Fund Structure

Section 3Section 3

Child Survival and Maternal Child Survival and Maternal HealthHealth

Child Survival and Maternal Child Survival and Maternal HealthHealth

• Primary causes of mortality and morbidity

• Polio• Micronutrients• Iodine Deficiency Disorder• Global Alliance for

Vaccines and Immunizations (GAVI)

• Primary causes of mortality and morbidity

• Polio• Micronutrients• Iodine Deficiency Disorder• Global Alliance for

Vaccines and Immunizations (GAVI)

Infant and child health and nutrition Infant and child health and nutrition improved and infant and child mortality improved and infant and child mortality reducedreduced

Deaths, nutrition insecurity, and adverse Deaths, nutrition insecurity, and adverse health outcomes to women as a result of health outcomes to women as a result of pregnancy and child birth reducedpregnancy and child birth reduced

Infant and child health and nutrition Infant and child health and nutrition improved and infant and child mortality improved and infant and child mortality reducedreduced

Deaths, nutrition insecurity, and adverse Deaths, nutrition insecurity, and adverse health outcomes to women as a result of health outcomes to women as a result of pregnancy and child birth reducedpregnancy and child birth reduced

Vulnerable ChildrenVulnerable ChildrenVulnerable ChildrenVulnerable Children

• Displaced Orphans and Children Fund

• Blind Children• Other Vulnerable

Children– Programming in

consultation with USAID/W

• Vulnerable Children Affected by HIV/AIDS

• Displaced Orphans and Children Fund

• Blind Children• Other Vulnerable

Children– Programming in

consultation with USAID/W

• Vulnerable Children Affected by HIV/AIDS

NEWNEWNEWNEW

Infant and child health and nutrition improved and infant and child mortality reduced

Infant and child health and nutrition improved and infant and child mortality reduced

MOVEDMOVED

HIV/AIDSHIV/AIDS HIV/AIDSHIV/AIDS

• HIV/AIDS Prevention• Children Affected by HIV/AIDS• Mother-to-Child Transmission• Use of NGOs/PVOs• Microbicides Research• International Organizations

– IAVI– UNAIDS– Global Fund

• HIV/AIDS Prevention• Children Affected by HIV/AIDS• Mother-to-Child Transmission• Use of NGOs/PVOs• Microbicides Research• International Organizations

– IAVI– UNAIDS– Global Fund

NEWNEWNEWNEW

Transmission and the impact of the HIV/AIDS pandemic reduced

Transmission and the impact of the HIV/AIDS pandemic reduced

HIV/AIDSHIV/AIDS HIV/AIDSHIV/AIDS Special Considerations

•Commodities (Commodity Promotion Fund)

•Co-Programming and Multi-sectoral Programs

•Addressing HIV/AIDS in Military Agencies

only if:

–Part of a larger public health initiative;

–Same as that for civilian groups; and

–Cannot be readily adaptable for military purposes.

Special Considerations•Commodities (Commodity Promotion Fund)

•Co-Programming and Multi-sectoral Programs

•Addressing HIV/AIDS in Military Agencies

only if:

–Part of a larger public health initiative;

–Same as that for civilian groups; and

–Cannot be readily adaptable for military purposes.

NEWNEWNEWNEW

• Tuberculosis• Malaria• Other Infectious

Diseases• Focus Areas

– Prevention & Treatment – Antimicrobial Resistance– Surveillance

• Tuberculosis• Malaria• Other Infectious

Diseases• Focus Areas

– Prevention & Treatment – Antimicrobial Resistance– Surveillance

Infectious DiseasesInfectious DiseasesInfectious DiseasesInfectious Diseases The threat of infectious diseases The threat of infectious diseases

of major public health of major public health importance reducedimportance reduced

Family Planning & Family Planning & Reproductive Health Reproductive Health

(FP/RH)(FP/RH)

Family Planning & Family Planning & Reproductive Health Reproductive Health

(FP/RH)(FP/RH)

• New FP/RH budget category with its accompanying new “FP/RH Guidance”

• Clarification on co-funding integrated activities with FP/RH funds

• NOTE: Tiahrt, Mexico City, and other related FP/RH restrictions remain in force

• New FP/RH budget category with its accompanying new “FP/RH Guidance”

• Clarification on co-funding integrated activities with FP/RH funds

• NOTE: Tiahrt, Mexico City, and other related FP/RH restrictions remain in force

Unintended and mistimed Unintended and mistimed pregnancies reducedpregnancies reduced

Unintended and mistimed Unintended and mistimed pregnancies reducedpregnancies reduced

Co-funding QuestionsCo-funding QuestionsCo-funding QuestionsCo-funding Questions

Section 4…almost done!Section 4…almost done!

Question: What About Co-funding Integrated

Activities?

Question: What About Co-funding Integrated

Activities?Joint funding of Joint funding of integrated activities integrated activities is encouraged.is encouraged.

However, the funds However, the funds mustmust be used for be used for their intended their intended purposes.purposes.

Joint funding of Joint funding of integrated activities integrated activities is encouraged.is encouraged.

However, the funds However, the funds mustmust be used for be used for their intended their intended purposes.purposes.

Integrated Integrated

ProgramProgram

Step 1: What is Step 1: What is Appropriate?Appropriate?

Step 1: What is Step 1: What is Appropriate?Appropriate?

• You You CANNOT use funds from one CSH use funds from one CSH funding category to make up for funding category to make up for shortfalls in another.shortfalls in another.

• You CANNOT use CS/MH funds for purchasing contraceptives.*

• You CAN use funds from more than one CSH funding category for integrated programs, but you must ensure that the balance of funds is proportionate to the types of activities.

• You You CANNOT use funds from one CSH use funds from one CSH funding category to make up for funding category to make up for shortfalls in another.shortfalls in another.

• You CANNOT use CS/MH funds for purchasing contraceptives.*

• You CAN use funds from more than one CSH funding category for integrated programs, but you must ensure that the balance of funds is proportionate to the types of activities.

* HIV/AIDS funds may be used to purchase condoms * HIV/AIDS funds may be used to purchase condoms for for HIV/AIDS prevention activitiesHIV/AIDS prevention activities within an within an integrated programintegrated program

What is Appropriate? (cont.)

What is Appropriate? (cont.)

• You CAN use CS/MH funds for birth spacing if spacing efforts are part of a predominantly child survival program and part of objective to reduce infant/child mortality.

• You CAN use CS/MH funds for maternal health interventions, including maternal survival.

• You CAN use FP/RH funding for reproductive health interventions related to maternal health within context of larger FP/RH programs.

• You CAN use either FP/RH or CS/MH funds for breastfeeding programs.

• You CAN use CS/MH funds for birth spacing if spacing efforts are part of a predominantly child survival program and part of objective to reduce infant/child mortality.

• You CAN use CS/MH funds for maternal health interventions, including maternal survival.

• You CAN use FP/RH funding for reproductive health interventions related to maternal health within context of larger FP/RH programs.

• You CAN use either FP/RH or CS/MH funds for breastfeeding programs.

Step 2: Balance of Funds?

Step 2: Balance of Funds?

Q: Once I’ve determined thatco-funding is appropriate,What is the appropriate mixof funds to support myintegrated program?

A: The appropriate mix of funds from respective CSH Budget Categories and/or Other Accounts is determined by the relevant activities within a program…funding must be proportionate to the relevant outputs of the program.

Q: Once I’ve determined thatco-funding is appropriate,What is the appropriate mixof funds to support myintegrated program?

A: The appropriate mix of funds from respective CSH Budget Categories and/or Other Accounts is determined by the relevant activities within a program…funding must be proportionate to the relevant outputs of the program.

??

Step 3: Proportionality

Step 3: Proportionality

When determining the appropriate funding levels for an integrated program, you should…

1) Determine the main outputs

2) Quantify those outputs3) Classify these quantities according to their respective CSH funding

categories4) DOCUMENT YOUR DECISION!

When determining the appropriate funding levels for an integrated program, you should…

1) Determine the main outputs

2) Quantify those outputs3) Classify these quantities according to their respective CSH funding

categories4) DOCUMENT YOUR DECISION!

Step 4: When You’re Still Unsure

Step 4: When You’re Still Unsure

• Read the current CSH Guidance• Read it again!…only try to stay

awake this time

If that doesn’t work…• Contact your friendly

PPC team for help.That’s why we’re here!

• Read the current CSH Guidance• Read it again!…only try to stay

awake this time

If that doesn’t work…• Contact your friendly

PPC team for help.That’s why we’re here!

ReneRene

FeliceFelice

DickDick

MarkMark

What if a Planned What if a Planned Activity Falls Outside Activity Falls Outside

CSH Guidance?CSH Guidance?

What if a Planned What if a Planned Activity Falls Outside Activity Falls Outside

CSH Guidance?CSH Guidance?• Operating units must receive

prior written approval from PPC and GH, concurrence by Regional Bureau technical staff, and clearance from GC

• PPC will coordinate and facilitate the approval process

• Remember, the Hill is watching us closely.

• Operating units must receive prior written approval from PPC and GH, concurrence by Regional Bureau technical staff, and clearance from GC

• PPC will coordinate and facilitate the approval process

• Remember, the Hill is watching us closely.

ConclusionConclusion

Section 5…finally!Section 5…finally!

Take Home MessageTake Home MessageTake Home MessageTake Home Message• Read the current CSH Guidance (May 2002)• Correct coding is important…very important• Use earmarked funds for their intended purposes• Document your decisions• Document your decisions• Document your decisions• get the point?

• Read the current CSH Guidance (May 2002)• Correct coding is important…very important• Use earmarked funds for their intended purposes• Document your decisions• Document your decisions• Document your decisions• get the point?

Happy programming!!Happy programming!!