Assessment of Drivers of HIV Outcomes

Author(s): Zulfiya Charyeva, Allison Davis, Lauren Morris, Nena do Nascimento, Jenifer Chapman, Daan Velthausz, Rotafina Donco

Year: 2019

Abstract:

In Mozambique, more than a million children are HIV-positive or otherwise vulnerable because of HIV. In response to this crisis, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) funds programs that serve orphans and vulnerable children (OVC) affected by HIV. These programs employ caseworkers who provide services to OVC and their families to their reduce vulnerability to HIV—such as by linking OVC to HIV testing services and HIV-positive children and adults to HIV care. PEPFAR seeks to understand how the operationalization of case management can be improved to increase knowledge of HIV status and encourage retention on antiretroviral therapy.

The COVida program was the context of this study. COVida supports roughly 300,000 OVC and caregivers per year to access high-quality comprehensive services nationally.

The purpose of this study was to learn more about the features of the COVida case management system and to make recommendations for improving the effectiveness and efficiency of case management in improving beneficiary outcomes. The study also estimated costs of conducting case work and identified the cost drivers of case management. It produced evidence-informed, actionable recommendations to programs in Mozambique on how to shift their strategies, and ultimately, their resources, to optimally balance quality and cost.