Submission ID 130353
| Issue/Objective | Background: Children living with HIV are estimated at 1.4 million globally, with 86% residing in African countries. Despite significant progress in prevention and treatment, AIDS-related mortality still accounts for nearly 15% of all deaths among children in the region. To address pediatric HIV challenges, UNICEF proposed integrating the 2019 Service Delivery Framework (SDF) into national health systems using the HIV Pediatric Breakthrough Partnership model. This study explores the perceptions and experiences of healthcare providers and service users in the adoption of the SDF in Uganda, Mozambique, and Nigeria. |
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| Methodology/Approach | Methods: The SDF emphasizes four core strategies: Locating, Linking, Treating, and Retaining children in HIV care. A qualitative evaluation was conducted from January 2021 to December 2023 across six districts/states: Isingiro and Mubende (Uganda), Masinga and Morrumbene (Mozambique), and Taraba and Rivers (Nigeria). Using the Consolidated Framework for Implementation Research (CFIR), we conducted 19 focus group discussions with health workers, 56 in-depth interviews with service users (adolescents, caregivers, and pregnant mothers), and 41 key informant interviews with national and international stakeholders. Transcripts were analyzed using NVivo v14. |
| Results | Results: One hundred-sixteen participants, 102(53%) female, 89(47%) male, were interviewed. Health workers viewed SDF as a more adolescent-targeted model due to its age aggregation, addressed the lost to follow-up through its rigorous monitoring indicators, and collaborative engagement. Adolescents reported that SDF improved Peer-to peer HIV testing and linkage to care, strengthened parent-child relationships, and scaled up psycho-social care. Caregivers and pregnant mothers reported improved lives and those of their children through adherence, caregivers' literacy, and Family-Centered HIV prevention approaches. National and international core members reported that the SDF was well-accepted, easily adopted, scalable, and reduced budget duplication among the partners. However, increased paper workload and sustainability concerns, were also reported. |
| Discussion/Conclusion | Conclusion: The adoption of the 2019 SDF improved pediatric HIV care, retention, and health outcomes across three African countries. Sustainability strategies, including targeted resource mobilization and system integration, are essential. This study highlights the relevance of evidence-based implementation frameworks and improving child and adolescent health, aligning with the CCGH 2026 theme on global health innovation and health system resilience. |
| Presenters and Affiliations | Brenda Okech Uganda Virus Research Institute - International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Program. Gertrude Nanyonjo Uganda Virus Research Institute - International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Program Geoffrey Basalirwa Uganda Virus Research Institute - International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Program Ronald Mulebeke Mildmay Research centre Uganda Susan Nakubulwa Mildmay Research centre Uganda Barbara Mukasa Mildmay Hospital Uganda Chinye Osa-Afiana International Research Center of Excellence, Institute of Human Virology Nigeria. Nadia A. Sam-Agudu International Research Center of Excellence, Institute of Human Virology Nigeria. Herminio Cossa Manhiça Health Research Centre (Centro de Investigação em Saúde de Manhiça, (CISM). Patience Kukundakwe Mildmay Hospital Uganda |
