TABLE 1.

Challenges Identified Through the Data to Care Intervention and Corrective Actions Taken by the COVida Project

ChallengeCorrective/Improvement Actions Taken
Some C/ALHIV who were enrolled in the COVida project were not registered as ART patients in any of the health facilities in the 5 districts.

  • Case workers and their supervisors reviewed names in case management records, cross-checking with names on patient treatment cards, and then communicated findings to the health facilities. 

Some HIV-positive children were registered as adults in the health facilities’ database, indicating discrepancies in children’s ages in the COVida project and the health facility databases.

  • Case workers and their supervisors cross-checked children’s age with their birth certificates and shared the correct information with the ESCALA data entry specialist based in the health facility. COVida project’s case management records were also corrected as needed.

Some C/ALHIV enrolled in the COVida project reported that they were taking their medications as prescribed yet were registered as being lost to follow-up in the health facilities.

  • Community case management workers were provided with lists of C/ALHIV designated as lost to follow-up by the health facilities and were able to find the C/ALHIV and bring them back to the health facilities to restart ART.

Some C/ALHIV registered by the COVida project as not being on ART were actually on ART and registered in a different health facility (to which they had transferred themselves).

  • COVida project updated its case management records to register the name of the new health facility.

Only about half of C/ALHIV had VL data.

  • The COVida project invited ESCALA staff to train the community case management workers to educate caregivers on VL testing and to encourage them to request this service in the health facility.

  • The ESCALA project facilitated access to VL data in health facilities for COVida case managers to track children’s VL.

Only about half of those with VL results were virally suppressed.

  • The ESCALA project, with the COVida project, trained community case workers on ART adherence to improve monitoring of ART adherence and adherence counseling.

  • Messaging on ART adherence for children and their caregivers was reinforced during home visits.

  • Abbreviations: ART, antiretroviral therapy; C/ALHIV, children and adolescents living with HIV; VL, viral load.