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).

CROI Summary 2017 (Mar 2017)

A total of 105 participants from Uganda, Nepal, Iran, Zimbabwe, South Africa, Kenya, and many other countries attended the webinar on March 9th which featured new research on PMTCT and pediatric treatment presented at CROI 2017.

The links to the webinar, presentations, and webinar summary are below:

Content Bottom

Presented on March 9, 2017

Integrating Mental Health and TB Services into Primary Health Care in Kazakhstan: Lessons Learned and Future Prospects for Integration of HIV/AIDS Services into Primary Health Care

The assessment for HIV/AIDS integration in primary health care in Kazakhstan was undertaken in 2022. The overall objective of the assessment was to use findings and lessons learnt from TB and mental health integration to guide and support integration of HIV/AIDS into primary health care. A mixed methods approach combining both qualitative and quantitative assessment methods was used. Assessment report available in English and Russian.

 

 

HIV & SRHR SBC Toolkit for Adolescents and Young People in ESA Region: Question & answer resource documents

As part of the 2gether 4 SRHR joint UN programme, UNICEF ESARO in collaboration with Y+ Global and UNFPA ESARO, developed six key question and answer (Q&A) resource documents on HIV and SRH for adolescents and young people in ESA. The toolkit has been developed to assist country teams in improving knowledge and understanding, driving adolescent and youth engagement and behaviour change,​ and promoting uptake of services in ESA. The content has been developed with adolescents and young people. Part of a broader toolkit, the content is intended for adaptation and use across multiple SBC platforms, including digital approaches scripts for radio shows and peer counselling sessions.

Each Q&A has approximately 10 questions, and links to the other topic areas:

  • Healthy relationships
  • Staying safe
  • Sex and other stuff
  • All about HIV
  • Living with HIV
  • Being a young parent
  • Understanding Puberty
  • The HPV Vaccine
  • Talking with Your Children

Click and watch on how to access and use the toolkit

Care and Support for Adolescents Living with HIV/AIDS in School Settings: Perspectives of Teachers and Administrators in the Southern Highlands of Tanzania

Adolescents living with HIV (ALHIV) encounter diverse challenges in school settings that impact their well-being and academic performance. This UNICEF-supported study sought to delve into the viewpoints of teachers and administrators regarding the care and support accessible to ALHIV in schools in the Southern Highlands of Tanzania. 

Various forms of support for ALHIV in schools were identified. Schools had designated health teachers/matrons/ patrons responsible for addressing health-related issues, including those affecting ALHIV. Assistance for clinic visits and medication adherence was readily available. Peer clubs were established to combat stigma and discrimination while providing additional support. Nevertheless, challenges such as staff members’ limited knowledge and skills, reluctance to disclose, inadequate nutritional support, and insufficient backing from regional and district administrators persist.

The study also pinpointed areas for enhancement, such as capacity building for teachers and staff, bolstering support for disclosure, offering nutritious dietary options, reinforcing peer clubs, and fostering collaboration between the education and health sectors. These findings can inform the development of comprehensive interventions to support ALHIV in school settings better, ultimately advancing their well-being and academic achievements. 

Ending HIV for Every Child, Every Adolescent: An investment opportunity for the public and private sectors

This document highlights opportunities for both public and private sectors to engage in the global HIV response for infants, children, and adolescents in partnership with UNICEF. 

UNICEF is a key partner and leader in the AIDS response for children, adolescents, and women. It collaborates with governments and partners worldwide, offering innovation, technical expertise, data and evidence, programme excellence, coordination, and convening power.

UNICEF is 100 per cent voluntarily funded, and is seeking support to deliver ambitious HIV results for children and to ensure the world can reach Sustainable Development Goal Target 3.3, to end the epidemic of HIV by 2030. 

Spotlight on the UNICEF HIV/AIDS Fund: Results achieved in 2022 to achieve an AIDS-free future for children and adolescents

UNICEF’s HIV/AIDS Thematic Fund is a global flexible funding pool. It enables us to strengthen systems to ensure an AIDS-free future for children and adolescents. This offers donors an exciting opportunity to target funding specifically to HIV/AIDS outcomes, while also giving UNICEF the flexibility to allocate funds based on where the need is greatest for children, including critically underfunded priorities at the country level, humanitarian response activities, and where funds will have the greatest impact. Thanks to our generous donors UNICEF’s Global HIV/ AIDS Thematic Fund income in 2022 reached over $5.7 million.

This document features the results achieved in 2022, when supporters of the HIV/AIDS Thematic Fund enabled UNICEF to allocate resources to 45 countries and territories. Funds were allocated to countries based on several measures determining the burden of HIV/AIDS on the population. These included the number of AIDS-related deaths in the country and the number of new infections among children and adolescents in the country. Funds were also allocated to UNICEF’s regional and global headquarters, supporting the vital work that allows thematic funding to unlock wide-scale results and impact the world over.

Global standards for quality health-care services for adolescents: Standards and criteria

Global initiatives are urging countries to prioritize quality as a way of reinforcing human rights-based approaches to health. Yet evidence from both high- and low-income countries shows that services for adolescents are highly fragmented, poorly coordinated and uneven in quality. Pockets of excellent practice exist, but, overall, services need significant improvement and should be brought into conformity with existing guidelines.

The WHO/UNAIDS global standards for quality health-care services for adolescents aim to assist policy-makers and health service planners to improve the quality of health-care services, so that adolescents find it easier to obtain the health services that they need to promote, protect, and improve their health and well-being, according to their needs. 

This publication presents global standards for quality health-care services for adolescents, as well as an implementation guide and monitoring tools.