UNICEF

Improving HIV Service Delivery for Infants, Children and Adolescents: Towards a framework for collective action

In June 2019, UNICEF convened a group of about 40 global experts from 24 organizations and institutions to advance the collective thinking on paediatric HIV service delivery. The aim of this “think tank” consultation was to build consensus on the specific programme interventions that need to be scaled up to improve the quality of HIV treatment services and reach more infants, children and adolescents with these lifesaving medicines.

Participating organizations included:

Aidsfonds
Africaid-Zvandiri
African Network for the Care of Children Affected by HIV/AIDS
(ANECCA)
Baylor College of Medicine
Centers for Disease Control and Prevention (CDC)
Clinton Health Access Initiative (CHAI)
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)
ELMA Philanthropies
Health Innovations Kenya
FHI 360
ICAP at Columbia University
Joint United Nations Programme on HIV/AIDS (UNAIDS)
Kenya Ministry of Health
Office of the Global AIDS Coordinator (OGAC)
Pact
Pediatric-Adolescent Treatment Africa (PATA)
Positive Action for Children Fund (PACF) / ViiV Healthcare
Réseau Enfants et VIH en Afrique (EVA)
United Nations Children’s Fund (UNICEF)
University of Nairobi
United States Agency for International Development (USAID)
World Health Organization (WHO)
World Council of Churches – Ecumenical Advocacy Alliance (WCC–EAA)
Yale University

Experts addressed the gaps in the continuum of care which are causing children to be missed before they are tested, before they are given their test results and before they are provided with lifelong treatment and care. Read more about the evidence base and the call for action in the brief above.

Paediatric Service Delivery Framework


The paediatric service delivery framework presents strategies to address bottlenecks across the continuum of care for each population: infants, children and adolescents. This includes keeping mothers who receive interventions for the prevention of mother-to-child HIV transmission (PMTCT) and their infants in care; locating missing infants, children and adolescents through family and index testing; linking those diagnosed with HIV to services; treating them with efficacious regimens and retaining them on treatment to achieve viral suppression. It describes comprehensive and targeted service delivery models, which emphasize strong linkages between testing, treatment and care, and between communities and facilities.

The framework was developed by a group of global experts who were convened by UNICEF in June 2019 to advance the collective thinking on paediatric HIV service delivery. The partnership's analysis of current evidence and specific programme interventions that need to be scaled up to improve the quality of HIV treatment services and reach more infants, children and adolescents with these lifesaving medicines is presented here.

The full framework, policy briefs and supporting worksheets are available for download (updated July 2020).

All In to #EndAdolescentAIDS

To end the AIDS epidemic by 2030, specific—yet flexible—strategies are needed for different age groups, populations and geographical locations. Ending the epidemic among adolescents requires amplifying investments where they can make the most difference and fostering innovation by adolescents and youth themselves, as well as governments, international organizations, civil society and the private sector.

Measurement of mother-to-child transmission of HIV in countries with high HIV prevalence in women of reproductive age

This document outlines the fundamentals of PMTCT impact determination and provides considerations for development of pragmatic, streamlined and resource-efficient systems for MTCT estimate generation in high burden settings. The guidance attempts to acknowledge the current reality of PMTCT programme data and the need for reliable MTCT rates while also encouraging a forward-looking approach towards sustainable PMTCT programme data improvements.

Note that this document is intended for countries in sub-Saharan Africa with a high prevalence of HIV among women of reproductive age. Although many of the underlying principles are relevant to settings with a lower burden of HIV, the guidance is not targeted for those programmes.

The tools in appendix 2 can be accessed here.

Evaluation of Expansion and Scale-Up of HIV Sensitive Social Protection in Eastern and Southern Africa 2014-2018

This document evaluates the Expansion and Scale-Up of HIV-Sensitive Social Protection in Eastern and Southern Africa initiative, implemented by UNICEF in Malawi, Mozambique, Zambia and Zimbabwe from 2014-2018 with support from the Dutch government. It assesses the extent to which the initiative met its objectives and achieved the expected results and documents the successes, challenges and lessons learned in the implementation.

Under the initiative, UNICEF Eastern and Southern Africa Regional Office (ESARO) and UNICEF Country Offices provided technical assistance to the four priority countries, and documented cross-country learnings. Activities under this initiative differed in their design and execution, allowing for adaptation to country contexts. In Malawi, activities focused on monitoring and evaluation of the National Social Support Policy; designing and implementing a system to refer cash transfer beneficiaries to HIV-related social services; and creating demand for HIV services among adolescents. In Mozambique, activities focused on providing policy-level support to the operationalization of the new social protection strategy, strengthening community-based and statutory case management, and conducting social protection fairs. In Zambia, the Government and UNICEF evaluated and scaled up a package of services that aims to increase the utilization of HIV services by adolescents. In Zimbabwe, the initiative focused on strengthening the child protection case management system and ensuring linkages between the country’s flagship cash transfer programme and HIV-related services, by using payment days to deliver services. In addition, the initiative’s regional component, led by UNICEF ESARO, focused on documentation and dissemination of best practices and overall technical assistance to the country offices involved.