Exploring perceived effects from loss of PEPFAR support for outreach in Kenya and Uganda

Globalization and Health

Mary Qiu¹  Alexandra Searle¹  Ligia Paina¹  Sara Bennett¹  Jess A. Wilhelm¹  Ezinne Eze-Ajoku¹  Daniela C. Rodríguez¹  Caroline MacKenzie²  Freddie Ssengooba³  Henry Zakumumpa³ 

[1] Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;Ipsos Kenya, Nairobi, Kenya;Makerere University School of Public Health, Kampala, Uganda;

关键词: HIV/AIDS;    Community outreach;    Health systems;    PEPFAR;    Donor transition;    Uganda;    Kenya;   

DOI  :  10.1186/s12992-021-00729-w

来源: Springer

【 摘 要 】

IntroductionIn 2015, the President’s Emergency Plan for AIDS Relief undertook policy shifts to increase efficiencies in its programming, including transitioning HIV/AIDS funding away from low burden areas. We examine the impact of these changes on HIV outreach in Kenya and Uganda.MethodsQualitative data collection was conducted as a part of a broader mixed-methods evaluation. Two rounds of facility-level case studies and national-level interviews were conducted in Kenya and Uganda, with health facility, sub-national and central Ministry of Health staff, HIV clients, and implementing partners.ResultsIn both countries, the loss of outreach support affected community-based HIV/AIDS education, testing, peer support, and defaulter tracing.DiscussionLoss of external support for outreach raises concerns for countries’ ability to reach the 90–90-90 UNAIDS target, as key linkages between vulnerable communities and health systems can be adversely affected.ConclusionDevelopment partners should consider how to mitigate potential consequences of transition policies to prevent negative effects at the community level.

【 授权许可】

CC BY