Does a blended learning implementation package enhance HIV index case testing in Malawi? A protocol for a cluster...

Area of Science:

• Public Health
• Implementation Science
• HIV Prevention and Treatment

Background:

• Index Case Testing (ICT) is crucial for identifying individuals needing HIV treatment and prevention.
• Malawi faces challenges in ICT delivery due to limited healthcare worker (HCW) capacity and clinical coordination.
• Digitizing training and quality improvement offers a solution to enhance ICT program implementation.

Purpose of the Study:

• To assess the impact of a blended learning implementation package on HCW ICT skills and quality improvement.
• To compare the blended learning package against the standard of care (SOC) in Malawi.
• To evaluate implementation, effectiveness, and cost-effectiveness outcomes of the intervention.

Main Methods:

• A cluster randomised controlled trial involving 33 clusters in Machinga and Balaka districts, Malawi.
• Intervention group received a blended learning package (digital and face-to-face); control group received SOC (face-to-face training and mentorship).
• Primary outcomes included HCW fidelity to ICT and service uptake (clients tested, contacts elicited, HIV-positive cases identified).

Main Results:

• The study is ongoing; primary results are not yet available.
• The blended learning package aims to improve HCW fidelity and service uptake metrics.
• Cost-effectiveness analysis will determine the incremental cost per person tested.

Conclusions:

• Blended learning presents a promising strategy to overcome challenges in delivering ICT services.
• This approach has the potential to strengthen HCW capacity and improve HIV program outcomes in resource-limited settings.
• Further dissemination of findings is planned through publications and presentations.