TY - JOUR T1 - Applying the iDARE Methodology in Uganda, Kenya, and Tanzania to Improve Health Outcomes During the COVID-19 Pandemic JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-21-00623 VL - 10 IS - 3 SP - e2100623 AU - Amanda Ottosson AU - Joyce Draru AU - Luseka Mwanzi AU - Stella Kasindi Mwita AU - Sara Pappa AU - Krista Odom AU - Taroub Harb Faramand Y1 - 2022/06/29 UR - http://www.ghspjournal.org/content/10/3/e2100623.abstract N2 - Key FindingsThe iDARE methodology promotes locally led transformation that produces long-lasting, community-based change.During the ongoing COVID-19 pandemic, individuals and communities need to be met with cultural humility and equipped with innovative, participatory tools that enable them to design and achieve meaningful behavior change to improve outcomes.iDARE was rapidly and sustainably institutionalized in 3 country contexts with different targeted health outcomes, and improvement occurred in all outcomes.Key ImplicationsProgram managers (including civil society organizations, implementing partners, governments, and donors) may use the iDARE methodology for guidance on critical thinking on locally identified issues and developed solutions, leveraging existing resources, regularly monitoring progress, navigating challenges, and adhering to a “do no harm” principle, especially during the COVID-19 pandemic.Introduction:We introduce the iDARE methodology and present the results of iDARE implementation in Uganda, Kenya, and Tanzania during the coronavirus disease (COVID-19) pandemic.iDARE Methodology:iDARE drives locally led solutions that address barriers to achieving improved health outcomes. WI-HER supported the governments of Uganda, Kenya, and Tanzania, to design and implement solutions to improve (1) HIV health outcomes, (2) gender-based violence identification and response, and (3) mass drug administration coverage, respectively.Results:In Uganda, the iDARE team at Nagongera Health Center IV increased viral load suppression (VLS) among actively enrolled men in care from 65% to 95% and increased VLS among actively enrolled children in care from 60% to 96% in 12 months. In 11 months, the Mulanda Health Center IV iDARE team increased VLS among actively enrolled men in care from 85% to 93% and actively enrolled children in care from 73% to 96%. In Kenya, 8 facility iDARE teams improved identification, management, and response for gender-based violence survivors by a monthly average of 642% in 10 months. Additionally, the identification, management, and response for male survivors of gender-based violence increased from an average of 8 to 188 men per month and from an average of 81 to 364 women per month. In Tanzania, the government applied iDARE to improve mass drug administration (MDA) access and uptake among school-age children. Eighteen percent of the children (equal male and female) had missed or refused treatment during school-based MDA. After 1 month of application of iDARE, the 4 schools achieved 99% MDA uptake among registered children (enrolled and nonenrolled).Discussion:Due to the various lockdowns, restrictions, and safety implications during the COVID-19 pandemic, iDARE was used to rapidly adjust from planned in-person to sometimes virtual engagements. Despite these challenges, iDARE demonstrated improvements in Uganda, Kenya, and Tanzania. ER -