TABLE 2.

Summary of Strategies to Address Challenges Identified During Scale-Up

ChallengesSolutions
Some C/ALHIV had incomplete or outdated information in the electronic patient tracking system
  • Health facilities allowed COVida staff to use patients’ physical files/records to complete pending information.

  • Timeline for D2C activities was adjusted to happen after clinical partner’s data cleaning.

Case managers’ supervisors lacked time to conduct the D2C intervention in high volume sites
  • The COVida project allocated a full-time pediatric HIV supervisor in each district, whose salary was paid by the project, to facilitate and support the intervention and the updating of C/ALHIV data, monitor the progress of C/ALHIV, and provide specialized support for the most challenging cases.

Some clinical partners and health facilities’ staff expressed resistance to collaborate in implementing the D2C intervention
  • After the successful pilot experience in Inhambane, the COVida project presented the D2C standard operating procedures and tool to the USAID/Mozambique mission.

  • To support the scale-up of this approach, the USAID/Mozambique Mission organized a meeting with clinical and OVC partners to promote the approach and requested that all clinical partners collaborate with OVC partners to scale it up.

  • Abbreviations: C/ALHIV, children and adolescents living with HIV; D2C, Data to Care; OVC, orphans and vulnerable children; USAID, U.S. Agency for International Development.