Sustaining HIV epidemic control through efficient case finding and quality care and treatment services in malawi - malawi has one of the largest HIV burdens in southern africa, with an estimated…

Sustaining HIV epidemic control through efficient case finding and quality care and treatment services in malawi - malawi has one of the largest HIV burdens in southern africa, with an estimated 1.07 million plhiv and over 850,000 of these on antiretroviral therapy (art). Malawi's HIV epidemic is complicated by health systems challenges imposed by low resources. Over the last two decades, the country has made significant progress toward HIV/aids control being one of the few countries that achieved the unaids 90-90-90 targets. Malawi has also made tremendous progress towards eliminating mother to child transmission of HIV (MTCT) with transmission rate at 6 weeks currently below 2%. Despite the successes, challenges remain, with several key and vulnerable populations remaining hard to reach with important HIV services. Retaining patient on treatment is also problematic as less than 75% of persons starting art remain on the treatment 12 months after initiation. The government of malawi's priority has shifted to finding the remaining plhiv, starting and retaining them on art. Right to care (RTC NPC) in consortium with local partners; right to care malawi, dapp, yoneko proposes a multi-component evidence-based data driven programme that will improve access and uptake of quality HIV services, expanding the cohort of plhiv on art and accelerating progress towards the attainment of the unaids 95-95-95 targets for epidemic control in malawi. The consortium's approach consists of triple "a"- assessment, analysis, and action, helping to deliver innovative evidence driven patient-centred, differentiated HIV services. This approach is executed through a hub 'N' spoke strategy, using roving teams to provide site level technical support that include training, mentorship, and coaching. Contextually adapted innovative virtual mentorship strategy with the aid of video meeting platforms zoom and microsoft teams will be used by RTC technical specialist to support site level staff. These strategies will help to deliver the set of activities that have been designed to respond to the MOH priorities as set in the NSP 2020-2025 as well as the outcomes presented by CDC in the present RFA. Strategic objective one of this proposed programme will focus on implement efficient HIV case-finding strategies with immediate linkage to treatment for those newly diagnosed with HIV and prevention services for HIV-negative at-risk individuals. This is aimed at finding the remaining plhiv to bring them into the cohort on art. In strategic objective two, RTC consortium present activities that are designed to strengthen continuity and quality of HIV client-centered care including linking newly diagnosed plhiv to art, bringing back persons previously on art who defaulted and supporting the use of data to drive patient management. Strategic objective three of this proposed intervention provide training, supportive supervision, and mentorship at district level to support transitioning of programmes to local consortium partners, RTC malawi, dapp and yoneco and local government. The district health teams and mohp staff as well as local organizations will be supported through capacity building activities so that the programme can be successfully transition to local leadership for management. These activities cannot be implemented without reflection, accountability, and rethink where necessary. For this, RTC will be implementing robust performance monitoring and management using advanced analytic techniques to glean information from programme and providing timely feedback to both site level staff, district management teams as well as RTC programme managers, with a view to improving programme performance.