Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

Area of Science:

• Public Health
• Global Health
• Health Services Research

Background:

• Essential public health response needed for HIV/AIDS patients and families in sub-Saharan Africa.
• US PEPFAR program commissioned a Public Health Evaluation to assess HIV care and support in East Africa.
• Evidence-based direction for future HIV care programming is required.

Purpose of the Study:

• To appraise current HIV care and support provision in East Africa.
• To provide evidence-based direction for future HIV care programming.
• To describe the nature and scope of HIV care and support services.

Main Methods:

• A 2-phase international mixed-methods study protocol.
• Utilized longitudinal outcome measurement, surveys, and qualitative interviews (patients, families, staff).
• Included health economics and document analysis of facilities in Kenya and Uganda.

Main Results:

• Phase 1: Cross-sectional survey of 10% of PEPFAR-funded facilities in Kenya and Uganda.
• Phase 1: Assessed service configuration, patient demographics, and essential drug availability.
• Phase 2: Longitudinal study of 1200 patients, qualitative interviews, and cost driver analysis.

Conclusions:

• A novel mixed-methods protocol for transparent presentation of subsequent results.
• Offers a substantive model for protocol design in disease management.
• Underpins a public health approach to disease management in low-income settings.