Exploring perceived effects from loss of PEPFAR support for outreach in Kenya and Uganda
Mary Qiu, Ligia Paina, Daniela C. Rodríguez, Jess A. Wilhelm, Ezinne Eze-Ajoku, Alexandra Searle, Henry Zakumumpa, Freddie Ssengooba, Caroline MacKenzie & Sara Bennett
2021. BMC Globalization and Health. 17: 80
Introduction: In 2015, the President’s Emergency Plan for AIDS Relief undertook policy shifts to increase efficiencies in its programming, including transitioning HIV/AIDS funding away from low burden areas. We examine the impact of these changes on HIV outreach in Kenya and Uganda.
Methods: Qualitative data collection was conducted as a part of a broader mixed-methods evaluation. Two rounds of facility-level case studies and national-level interviews were conducted in Kenya and Uganda, with health facility, sub-national and central Ministry of Health staff, HIV clients, and implementing partners.
Results: In both countries, the loss of outreach support affected community-based HIV/AIDS education, testing, peer support, and defaulter tracing.
Discussion: Loss of external support for outreach raises concerns for countries’ ability to reach the 90–90-90 UNAIDS target, as key linkages between vulnerable communities and health systems can be adversely affected.
Conclusion: Development partners should consider how to mitigate potential consequences of transition policies to prevent negative effects at the community level.