Evaluation of PEPFAR (2013) / Chapter Skim
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6 Care and Treatment-Main Messages
6 Care and Treatment-Main Messages
Pages 237-242
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From page 237... ...
However, challenges remain in achieving adequate coverage of testing services, especially in scaling up and improving access to testing for infants and children and testing for pregnant women who do not attend antenatal care or deliver in health facilities. For those who test positive, challenges also remain in consistently ensuring they are linked to care and treatment as well as to prevention services to reduce HIV transmission.
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From page 238... ...
PEPFAR has also made a notable contribution in its support for advancing policies and systems for TB/HIV integration in partner countries. However, prog ress in this area has come more slowly than in other clinical services for HIV, and challenges persist in achieving adequate coverage of both HIV screening for TB patients and TB screening for HIV patients, as well as in ensuring and monitoring subsequent referral and retention in treatment for both infections.
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From page 239... ...
Recommendations Presented in This Chapter Recommendation 6-1: To improve the implementation and assessment of nonclinical care and support programs for adults and children, in cluding programs for orphans and vulnerable children,1 the Office of the U.S. Global AIDS Coordinator should shift its guidance from specifying allowable activities to instead specifying a limited number of key out comes.
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From page 240... ...
should pro vide general guidance for country programs on continuous program evaluation and quality improvement to help them measure and moni tor achievement of the key outcomes. This guidance may include, for example, template evaluation plans and methodological guidance.
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From page 241... ...
• This data-collection effort should be designed by first identifying and prioritizing the key questions that require longitudinal data and then focusing on relevant key outcomes with measures that are stan dardized across the sample. Priorities should include core outcomes related to clinical care and treatment, including adherence and reten tion; outcomes related to the reduction of HIV transmission through biomedical and behavioral prevention interventions for people living with HIV; quality measures; and program measures, such as the costs of services, that can help inform strategies for efficiencies, sustainable management, and resource planning for the trajectory of need.
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From page 242... ...
242 EVALUATION OF PEPFAR • There may also be opportunities for an established data collection effort of this kind to serve as a synergistic platform for targeted imple mentation research studies in subset samples to assess innovations and advance those best practices that are most ready for translation and scale-up. • addition to implementing this approach prospectively, OGAC should In explore working with and coordinating Track 1.0 partners to pool data for retrospective outcome analyses.
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