OUTCOME EVALUATION

The Government of Nigeria, with support from the United States (U.S.) President’s Emergency Plan for AIDS Relief (PEPFAR) and other partners are drastically scaling-up ART treatment services using strategies that directly address important barriers to access and retention in care. These strategies are expected to facilitate achievement of the United Nation’s 90-90-90 targets of 90% of people living with HIV knowing their status, 90% of people with diagnosed HIV infection receive sustained ART and 90% of people receiving ART achieve viral suppression.

The SHIELD project evaluates treatment outcome of patients enrolled in ART through the following strategies:

Test and Start
Community ART

Test and Start

Goal:

The primary goal of test and start evaluation is to determine treatment outcomes and 12-month retention on ART for facility based patients initiated on ART immediately after identification/diagnosis of HIV, irrespective of baseline CD4 count or clinical staging at selected sites in Nigeria between October 2015 and October 2016. Data for this evaluation are obtained from 31 facilities located in 8 priority local government areas (LGAs) of Uyo, Buruku, Gwer West, Calabar South, Abuja Municipal, Ikeja, Mushin and Obio/Akpor.

Approach:

This study utilizes a mixed method design that involves quantitative (retrospective cohort-medical chart reviews) and qualitative (cross-sectional-key informant interviews) data collection from HIV-positive patients newly enrolled on ART and health care providers from the 31 selected facilities. Data are collected from medical chart review of 3432 eligible patients and individual interviews of 31 health care providers (one health care provider from each facility).

Expected outcome:

The findings from test and start evaluation are expected to support the implementation and scale-up of ART test and start treatment strategy nationwide by providing the stakeholders with evidence-based information on patient treatment outcomes and important facilitators and barriers to the program implementation in Nigeria.

Community ART

Goal:

To evaluate the performance of community-based ART program towards achieving the short-term goals of improving HIV treatment uptake and maintenance within the community

Approach:

Several models of community ART are currently implemented in priority LGAs by different implementing partners for PEPFAR program in Nigeria. The SHIELD project will utilize a mixed method design that involves quantitative (retrospective cohort-medical chart reviews) and qualitative (cross-sectional interviews) data collection to evaluate the individual models of community ART. Depending on the model’s maturity and data accrued at the time of the evaluation about 1153 medical charts of eligible patients will be reviewed in addition to direct interviews with patients, health care providers and program implementers for each model.

Expected outcome:

The findings from this study are expected to provide the government of Nigeria and PEPFAR program information on individual model’s service delivery, utilization and important barriers to successful implementation in addition to patient treatment outcomes. These findings will provide the stakeholders important information to support decision on scalability and model’s potential to contribution to improving HIV treatment uptake and maintenance within the community.

IDEA

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