HIV Service Delivery Case Study
About HIV Service Delivery Case Study
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.
Design
The identification, evaluation, and ranking process began with a review of grey literature, a scoping literature review, and key stakeholder interviews involving Ministries of Health, donors such as PEPFAR and the Global Fund, UNAIDS, WHO, the World Bank, researchers, implementers, and community networks. This was followed by a desk-based review of available documentation and consultations with program leads through email, phone, and in-person discussions. An initial screening of 70 programmes was narrowed to 20 through a secondary in-depth review, after which programmes were assessed based on effectiveness, scalability, and accessibility, resulting in the selection of six final case studies.
Key Strategies and Scope of Selected Case Studies
The selected case studies showcased a diverse range of differentiated HIV service delivery models implemented across community- and facility-based settings in both rural and urban areas. They included interventions tailored to key populations and approaches integrated with broader health services such as primary health care, sexual and reproductive health, and maternal health. The case studies highlighted innovative strategies across the HIV continuum of care, focusing on increasing HIV testing and strengthening linkage to pre-ART care, facilitating the transition from pre-ART care to ART initiation, and improving retention on treatment to achieve sustained viral suppression. These approaches demonstrated how integrated, accessible, and people-centred service models can enhance HIV prevention, treatment uptake, and long-term health outcomes.
Study Outcomes
A key outcome of the study was the development of costed and well-documented case studies that captured effective approaches and lessons learned. These case studies were designed to inform and support national programme managers, implementers, advocates, and donors in making evidence-based decisions on the design, funding, scale-up, and implementation of health interventions. 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 health services. Through this process, Pangaea sought to improve uptake and scale of HIV services and fill the gaps in the HIV treatment cascade.
