Purpose
The HIV Service Delivery Case Study Project, between, 2013 – 2016, Pangaea, in partnership with the Clinton Health Access Initiative (CHAI), with funding from the Bill and Melinda Gates Foundation, developed and costed a series of single descriptive case studies documenting effective approaches to HIV service delivery in Sub-Saharan Africa. The goal of the project was to improve uptake of and retention in effective HIV service delivery to improve treatment and prevention outcomes. The documentation of successful approaches to increase demand for and sustained use of HIV testing, treatment, prevention and support services provided a resource for country level program managers, program implementers, advocates and donors to better determine how to scale up programs effectively and gain maximum benefit from resource investments.
The case studies reflected intervention level reviews that described interventions that were particularly effective at addressing a component or multiple components of the continuum HIV prevention and treatment services. The selection of programs for the case studies presented information and cost estimates about a diverse set of programs, that look at both community- and facility-based services, programs addressing urban and rural populations, key affected populations, and programs that are well integrated with other areas of health services including primary care, sexual, reproductive, and maternal health7 services. Through this process, Pangaea sought to improve uptake and scale of HIV services and fill the gaps in the HIV treatment cascade.
Scope:
Case studies covered diverse HIV service models, including:
- Community-based services
- Facility-based services
- Rural & urban interventions
- Programs addressing key populations
- Models integrated with other health areas:
- Primary Health Care
- Sexual & reproductive health
- Maternal Health
Key Strategies
Focus Areas (HIV Continuum of Care). Selected case studies focused on interventions across:
- HIV Testing → Linkage to pre-ART care
- pre-ART care →ART initiation
- ART initiation →Retention & viral suppression
Case Study Selection Process: Two-step approach
Step 1: Preliminary Identification
1.Review of grey literature
2.Literature review using scoping methodology
3.Key stakeholder interviews with:
- Ministries of Health
- Donors (PEPFAR, Global Fund)
- UNAIDS, WHO
- World Bank
- Researchers
- Implementers
- Community networks
Step 2: Evaluation & Ranking
1.Desk-based review of available documentation
2.Communication with program leads (email/phone/in-person)
3.Initial screening: 70 programs
4.Secondary deep review: 20 programs
5.Final scoring criteria:
- Effectiveness
- Scalability
- Accessibility
- 6 final case studies selected
End of Study:
- Costed and documented case studies
- Intended audience:
1. National program managers
2. Implementers
3. Advocates
4. Donors
