The scale-up of HIV care and treatment services in Zambia over the last 10 years has resulted in vastly increased access to HIV care and treatment services for adults and children. However, overstretched human resources and physical infrastructure has required individual patients to regularly travel long distances to fixed clinics and endure long wait times with minimal community support. The study is conducted in close collaboration with the Government of the Republic of Zambia and aims to develop and evaluate the effectiveness of innovative models of care delivery designed to reduce health systems barriers to care, and leverage community support to improve retention in HIV care and treatment (ART) programs.
The mixed-methods approach of survey research, discrete choice experiments, interviews, and focus group discussions are complemented by concurrent implementation of four differentiated care models incorporating innovative systems approaches to information technology, community support, real-time monitoring, and quality framed by rigorous impact evaluation. This process will yield insights into these models’ overall quality, feasibility, cost, cost-effectiveness, and fit within the Zambian health system.
AIR is contributing to the impact evaluation design, costing and cost-effectiveness, general survey of needs and preferences for ART patients, and in the design of the discrete choice experiments.