Improving HIV Service Delivery for Infants, Children and Adolescents: Towards a framework for collective action

In June 2019, UNICEF convened a group of about 40 global experts from 24 organizations and institutions to advance the collective thinking on paediatric HIV service delivery. The aim of this “think tank” consultation was to build consensus on the specific programme interventions that need to be scaled up to improve the quality of HIV treatment services and reach more infants, children and adolescents with these lifesaving medicines.

Participating organizations included:

Aidsfonds
Africaid-Zvandiri
African Network for the Care of Children Affected by HIV/AIDS
(ANECCA)
Baylor College of Medicine
Centers for Disease Control and Prevention (CDC)
Clinton Health Access Initiative (CHAI)
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)
ELMA Philanthropies
Health Innovations Kenya
FHI 360
ICAP at Columbia University
Joint United Nations Programme on HIV/AIDS (UNAIDS)
Kenya Ministry of Health
Office of the Global AIDS Coordinator (OGAC)
Pact
Pediatric-Adolescent Treatment Africa (PATA)
Positive Action for Children Fund (PACF) / ViiV Healthcare
Réseau Enfants et VIH en Afrique (EVA)
United Nations Children’s Fund (UNICEF)
University of Nairobi
United States Agency for International Development (USAID)
World Health Organization (WHO)
World Council of Churches – Ecumenical Advocacy Alliance (WCC–EAA)
Yale University

Experts addressed the gaps in the continuum of care which are causing children to be missed before they are tested, before they are given their test results and before they are provided with lifelong treatment and care. Read more about the evidence base and the call for action in the brief above.

Paediatric Service Delivery Framework

The paediatric service delivery framework presents strategies to address bottlenecks across the continuum of care for each population: infants, children and adolescents. This includes keeping mothers who receive interventions for the prevention of mother-to-child HIV transmission (PMTCT) and their infants in care; locating missing infants, children and adolescents through family and index testing; linking those diagnosed with HIV to services; treating them with efficacious regimens and retaining them on treatment to achieve viral suppression. It describes comprehensive and targeted service delivery models, which emphasize strong linkages between testing, treatment and care, and between communities and facilities.

The framework was developed by a group of global experts who were convened by UNICEF in June 2019 to advance the collective thinking on paediatric HIV service delivery. The partnership's analysis of current evidence and specific programme interventions that need to be scaled up to improve the quality of HIV treatment services and reach more infants, children and adolescents with these lifesaving medicines is presented here.

The full framework, policy briefs and supporting worksheets are available for download (updated July 2020).

Strengthening capacity in translating evidence to action: Data mentoring and the journey to triple elimination of HIV, syphilis, and hepatitis B

The report outlines the progress and achievements in the triple elimination of vertical transmission of HIV, syphilis, and hepatitis B in Eastern and Southern Africa (ESA) over the last two decades. The data mentorship programme aims to strengthen national health management information systems, improve data quality, and build the analytical skills of government staff working towards elimination. It employs a unique partnership model with the private sector, academia, and government officials, focusing on capacity building through virtual and in-person mentoring, online learning platforms, and workshops. The programme has shown early successes, with mentees from various countries implementing operational plans to improve data quality and analysis in their respective countries.

Empowered mentees are taking up leadership roles that directly support national programmes and 'Path to Elimination' validation processes. The geographical expansion of the programme and the continuous exposure of mentees to technical learning opportunities will further enhance each country’s preparedness towards the 'Path to Elimination' and validation. The design, approach and delivery of this programme can be used as a blueprint for building national and regional capacity, skills building, and mentorship. While this particular data mentorship programme focuses on vertical transmission and the Path to Elimination, the principles of data quality, data sources, collection and reporting, data visualisations, and data use remain consistent across healthcare programmes and can be applied more broadly to build data use capacity in maternal, newborn, child and adolescent health and sexual and reproductive health.

Ending the AIDS Epidemic Among Young People in the Middle East and North Africa

This advocacy report discusses the HIV epidemic among young people in the Middle East and North Africa (MENA) region, particularly among key populations. The report emphasizes the challenges faced in collecting HIV-related data and the need for comprehensive efforts to address the epidemic, including targeted prevention programmes, improved access to testing and treatment, and addressing social and structural factors. It also discusses the presence of punitive and obstructive laws that contribute to stigma and discrimination and calls for their removal or reform. The report advocates for increased investment in HIV programmes, improved access to sexual and reproductive health services, comprehensive sexuality education, and community engagement. It highlights the importance of community health systems, data collection, and involving young people in the development of HIV and other health programmes.  ​