Reach: reaching epidemic control through access to a comprehensive clinical and community-based HIV approach - the international rescue committee (IRC) with consortium partner health alliance cote…

Reach: reaching epidemic control through access to a comprehensive clinical and community-based HIV approach - the international rescue committee (IRC) with consortium partner health alliance cote d'ivoire (HA-CI) proposes reaching epidemic control through access to a comprehensive clinical and community-based HIV approach (reach) project, in alignment with pepfar cote d'ivoire country operational plan 2022. Reach will build on pepfar accomplishments in cote d'ivoire to ensure continuity of comprehensive HIV/aids services to existing and new clients, including HIV/aids prevention, case finding, linkage to care, support and/or treatment. Reach will leverage IRC and HA-CI's combined 27 years of HIV/aids programming experience in côte d'ivoire through evidence-based, client-centered and adaptable approaches. Since 2008, IRC and HA-CI have consistently been the top-performing community and clinical CDC pepfar implementing partners against MER indicator targets and regularly scoring nearly 100% on external quality assessments (EQA). They will thus provide strong HIV technical expertise and supervision to nine local ngos that will each implement the full continuum of clinical and community care, ensuring data integrity and sharing between clinical and community HIV services. Through reach, IRC proposes a sustainable, cost-efficient, and high-yielding project, guided by evidence and improved metrics, that will strengthen the capacity of decentralized government entities and community-based organizations in order to help achieve epidemic control in côte d'ivoire. Reach will build the capacity of, and transition activities to, its team of local organizations, including HA-CI and nine already identified local sub-partners, health districts and social centers with rigorous, routine, and thorough support and monitoring. Reach, through local field experience, geographic positioning and strong existing relationships with the ministry of health, public hygiene and universal health coverage (MOH) and the ministry of women, family, and children is optimally positioned for rapid scaling. In year 1 of reach, 69% of funding will go to local organizations. Reach will address 50% of the pepfar COP22 MER indicator targets and cover 50% of the pepfar-supported health centers. IRC and its consortium will place a heavy emphasis on case-finding and viral load suppression through community-based approaches, working to increase the first and third unaids 95 targets. Increased case-finding will place pressure on clinical care and treatment services to scale rapidly and initiate more patients on care, which IRC will meet through partnerships with highly experienced HA-CI and local sub-partners. Reach will be implemented following coivd-19 mitigation measures and pepfar technical guidance for service provision during the covid-19 pandemic. To improve outcomes for people living with HIV, reach will build on community-based commitments and trust to ensure outreach, initiation of care, and support for art adherence in the community. Reach will increase and continue facility-based testing of those presenting with non-HIV related illnesses, and scale community-based approaches including index-testing, self- and dried blood spot testing, as well as early infant diagnosis with viral load testing. IRC will reduce the large prevention and viral load control gaps facing adolescent girls and young women (agyw), key populations, pregnant and breastfeeding women (pbfw) and orphans and vulnerable children (OVC), who face increased risk of HIV but have lower access to testing and treatment, largely because of stigmatization and security, social and economic barriers. A particular focus on pre-exposure prophylaxis (prep) among these high-risk groups will be emphasized, including through the determined, resilient, empowered, aids-free, mentored and safe (dreams) program, which has struggled to increase use of prep among agyw. Reach will optimize human resources for healt