The Fòs Feminista data index grades government agencies on policies and funding impacting family planning, maternal and child health, and HIV & AIDS foreign assistance.
Selecting a document will download the file
2018_DREAMS Report: Dreaming of an AIDS-Free FutureThe annual DREAMS report highlights the strengths, challenges, and future directions of the DREAMS program. The report was evidence-based and responsive to need, but lacked a clear
gender transformative stance. The DREAMS program does have concrete
gender transformative components, but they were not reflected in this report in a clear and substantial way. The report described harmful gender norms that affected HIV and AIDS prevention and treatment programs for adolescent girls and young women (AGYW), but did not mention how to address these barriers in a manner informed by human rights principles.
2018_PEPFAR 2018 Annual Report to CongressThe PEPFAR Annual Report to Congress provides an overview of the PEPFAR program to date and discusses future directions. The report was evidence-based, responsive to need, and included a description of how the Department of State will deliver on the mission of PEPFAR moving forward. The report also discussed factors that made HIV prevention and treatment complex for AGYW and for key populations; however, these programmatic concerns were framed within current constructed gender norms. The programming discussed in this report did not include
gender transformative components as a means to provide comprehensive HIV and AIDS services.
2018_PEPFAR 2018 Progress ReportThe PEPFAR Progress Report is issued annually to provide an overview of programs and illustrate PEPFAR priorities in the future. The report shared a program plan that was responsive to need and based in evidence and human rights principles. However, the document did not discuss gender norms or include a commitment to increase
gender transformative programming.
2018_PEPFAR 2018 Country Operational Plan Guidance for Standard Process CountriesReleased annually by the Office of the Global AIDS Coordinator, the Country Operational Plan (COP) Guidance outlines the plan for PEPFAR-funded global HIV and AIDS activities and provides the basis for the approval of annual bilateral HIV and AIDS funding for partner countries. The 2018 COP guidance was comprehensive and provided updates that were evidence-informed, responsive to need, and based in human rights principles. The 2018 COP Guidance took a holistic approach to PEPFAR programs and discussed intersecting issues, such as: gender-based violence, post-abortion care, contraceptive access, and comprehensive HIV prevention programs. The COP Guidance illustrated gender as a cross-cutting issue within PEPFAR but should have included specific guidance to increase
gender transformative programming across PEPFAR countries.
2018_PEPFAR Statement on Potential Safety Issue Affecting Women Living with HIV Using Dolutegravir at the Time of ConceptionThis press release contains PEPFAR's policy and technical guidance in response to data from a study in Botswana indicating a potential association between women of childbearing potential taking dolutegravir (DTG), an antiretroviral, at the time of conception and the risk of neural tube defects. The statement provided a nuanced overview of the data and concluded by issuing the guidance that all PEPFAR programs continue transitioning to a DTG-based regimen. The release recommended that "HIV-infected women who desire to become pregnant" should remain on efavirenz-based regimens until further data are available. The issuance of this statement was timely and provided an accurate explanation of the Botswana study preliminary findings; however, the Department of State's recommendation took away the choice of treatment from a population based solely on their ability or desire to become pregnant. This was in conflict with a human rights, individual-centered framework. It is also unclear from the press release if PEPFAR consulted with civil society or other relevant stakeholders before issuing this statement.
2018_Protecting Life in Global Health Assistance FAQs_September 2018The PLGHA FAQs provided detailed guidance on the implementation of the expanded Global Gag Rule for implementing partners as of September 2018. The document was responsive to need in that it clarified areas of the policy that partners had expressed are vague or unclear, but the FAQs were not evidence-based or based in human rights principles. The FAQs included a PEPFAR-specific section that provided detailed guidance on the implementation and monitoring of the impact of PLGHA on PEPFAR programs, specifically within DREAMS. However, this discussion of PEPFAR, aside from the mention of DREAMS, did not discuss gender norms or include
gender transformative language. This section emphasized the importance of minimizing disruption of HIV and AIDS care and treatment and therefore received a higher score within this domain compared to the other two domains, Family Planning and Maternal and Child Health.
2018_Protecting Life in Global Health Assistance Six Month ReviewThe PLGHA Six Month Review summarized the PLGHA policy and identified solutions to challenges that had arisen in the process of PLGHA implementation. The review was responsive to need in that it addressed concerns expressed by partners who are required to implement the policy, but it was not evidence-based, based in human rights principles, or
gender transformative. The Six Month Review received a higher grade within the HIV and AIDS domain because it discussed the importance of addressing the impact of PLGHA on HIV and AIDS programs and assured that efforts are being made to track the impact of this policy through PEPFAR programming. Still, the Six Month Review substantially hindered the Department of State's ability to support comprehensive HIV and AIDS programs.
2018_State and USAID Agency Priority Goal Action Plan_HIV/AIDSThe Agency Priority Goals (APGs) for HIV and AIDS hold PEPFAR accountable through quarterly reporting that includes details around the goals, strategies, milestones, indicators, and progress made towards controlling the HIV epidemic. Released by both the Department of State and USAID, these reports are useful for government transparency and are responsive to need, and based in evidence and human rights. The 2018 APGs reported on challenges faced by HIV and AIDS programs, but did not provide clear strategies to address them. One such challenge was high HIV and AIDS rates among AGYW and key populations. The APGs mentioned the importance of promoting layered core packages of services for AGYW through the DREAMS program and increasing access to HIV and AIDS services for key populations. However, the APGs did not include indicators specific to either population or data disaggregated by gender as a means to highlight progress made in these areas. As a result, the APGs moderately promoted the ability of the Department of State to support comprehensive HIV and AIDS programs.
2017_PEPFAR Country/Regional Operational Plan (COP/ROP) Guidance 2017The Country Operational Plan (COP) Guidance is an annual document released by the Office of the Global AIDS Coordinator. It outlines the plan for global HIV and AIDS activities funded by PEPFAR and provides the basis for the approval of annual bilateral HIV and AIDS funding for partner countries. The 2017 COP Guidance was evidence-informed and ensured continued community and government engagement in PEPFAR programs. It also discussed the intersection of gender-based violence with HIV and AIDS and the importance of including contraception and counseling into HIV and AIDS programs. This guidance moderately promoted SRHR because it was responsive to need and addressed the disproportionate impact of HIV and AIDS on adolescent girls and young women, men who have sex with men (MSM), female sex workers, and transgender individuals. The plan was gender accommodating, as it did not seek to dismantle existing gender differences and inequalities. Such guidance should instead outline how to change inequitable gender norms and dynamics and promote gender equity.
2017_PEPFAR Evaluation Standards of Practice (Version 3.0)The PEPFAR Evaluation Standards of Practice was released to increase the quality of evaluations conducted by all PEPFAR implementing agencies. These standards emphasized the importance of evidence-informed evaluation planning and provided a detailed explanation of the ethics and human rights principles that should be incorporated in all PEPFAR-funded evaluations, particularly for "children, prisoners, pregnant women, and other vulnerable groups." Additionally, these standards laid the groundwork for adaptive programming and the continued commitment of all key stakeholders, including community members and government personnel, in PEPFAR programs. Although the Standards of Practice acknowledged that evaluations should be “context-sensitive” and “culturally relevant,” they did not include a
gender transformative component. There was no mention of the gendered power dynamics and cultural barriers that may prevent people living with HIV, sex workers, or lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) persons from participating in evaluations. Despite this, the Standards of Practice were responsive to need and were based in evidence. The Standards moderately supported the ability of PEPFAR programs to promote SRHR.
2017_PEPFAR Monitoring, Evaluation, and Reporting Indicator Reference Guide_MER 2.0 (Version 2.1)The 2017 PEPFAR Monitoring, Evaluation, and Reporting (MER) Indicator Reference Guide provided guidance for monitoring and evaluating PEPFAR’s HIV and AIDS programs. The indicators were evidence-informed, based on human rights principles, and detailed the importance of sustained “district and community” engagement. The document included an extensive list of indicators for HIV and AIDS program evaluation, including the number of key and priority populations reached with specifically tailored HIV prevention programs, and the percentage of pregnant women living with HIV that receive antiretroviral therapy (ART) to reduce mother-to-child transmission. Though the Reference Guide listed sex workers, MSM, and transgender individuals as key populations, it did not address their distinctive needs when discussing how to evaluate interventions that were tailored for these populations. This lack of clarity can be harmful as evaluators may not understand how to meaningfully engage with these key populations during the evaluation, monitoring, and reporting processes. The indicators were somewhat
gender transformative, as they included a limited discussion of gender norms and related stigma, though this element should be standardized throughout the Reference Guide. The updates within this version of the MER Reference Guide were responsive to need and based in human rights norms and evidence, including WHO and UNAIDS indicators.
2016_Department of State Implementation Plan for the U.S. Adolescent Girls StrategyThe Department of State Implementation Plan for the U.S. Adolescent Girls Strategy was launched in partnership with three other U.S. implementing agencies as part of the first U.S. Global Strategy to Empower Adolescent Girls in 2015. This Plan moderately promotes sexual and reproductive rights (SRHR) because it discussed the importance of incorporating HIV prevention in all adolescent girls' empowerment programs, especially those that address girls’ political, civic, and economic participation and programs that increase peace and security. This Plan specifically acknowledged the relationship between girls who have undergone female genital cutting (FGC) and their increased risk of acquiring HIV. The Plan also mentioned HIV as a barrier to girls’ education and provided examples of existing Department of State programs that are responsive to need and grounded in human rights, including the President’s Emergency Plan for Aids Relief (PEPFAR). However, this Plan did not disclose how to support the needs of adolescent girls and young women (AGYW) who are living with HIV. It only discussed preventing HIV transmission to AGYW. The Plan is gender accommodating, not
gender transformative because it relied on existing gender norms and references unequal gender and age dynamics that put AGYW at a higher risk of HIV incidence.
2016_PEPFAR Country/Regional Operational Plan (COP/ROP) 2016 GuidanceThe Country Operational Plan (COP) Guidance is an annual plan that outlines global HIV and AIDS activities funded by PEPFAR and provides the basis for the approval of annual bilateral HIV and AIDS funding for partner countries. The fiscal year (FY) 2016 COP Guidance was responsive to need and addressed the disproportionate impact of HIV and AIDS on AGYW and other key populations such as men who have sex with men (MSM), female sex workers, pregnant women and infants living with HIV, and transgender individuals. The programming was evidence-informed and promoted community and government engagement. Although the Guidance discussed the intersection of gender-based violence (GBV) and HIV and AIDS, it failed to strongly incorporate the positive impact that comprehensive and integrated sexual and reproductive health (SRH) services can have on reducing HIV transmission amongst key populations.
