Exploring perceived effects from loss of PEPFAR support for outreach in Kenya and Uganda

• Published in: Globalization and health Vol. 17; no. 1; p. 80
• Main Authors: Qiu, Mary, Paina, Ligia, Rodríguez, Daniela C, Wilhelm, Jess A, Eze-Ajoku, Ezinne, Searle, Alexandra, Zakumumpa, Henry, Ssengooba, Freddie, MacKenzie, Caroline, Bennett, Sara
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17-07-2021; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - prevention & control; AIDS; Beliefs, opinions and attitudes; Budget rescission; Budgets; Community outreach; Costs; Data collection; Donor transition; Economic aspects; Emergency plans; Finance; Funding; Government Programs; Health aspects; Health care facilities; Health systems; HIV; HIV Infections - prevention & control; HIV patients; HIV testing; HIV/AIDS; Human immunodeficiency virus; Humans; Kenya; Medical care; Medical personnel; Outreach services; PEPFAR; Psychological aspects; Qualitative analysis; Trends; Uganda; Kenya; Uganda; Community outreach; HIV/AIDS; Donor transition; Health systems; PEPFAR; Uganda; Kenya
• ISSN: 1744-8603; 1744-8603
• DOI: 10.1186/s12992-021-00729-w

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.
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.
In both countries, the loss of outreach support affected community-based HIV/AIDS education, testing, peer support, and defaulter tracing.
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.
Development partners should consider how to mitigate potential consequences of transition policies to prevent negative effects at the community level.