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The impact of PEPFAR transition on HIV service delivery at health facilities in Uganda

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  • Jess Alan Wilhelm
  • Mary Qiu
  • Ligia Paina
  • Elizabeth Colantuoni
  • Moses Mukuru
  • Freddie Ssengooba
  • Sara Bennett

Abstract

Background: Since 2004, the President’s Emergency Plan for AIDS Relief (PEPFAR) has played a large role in Uganda’s HIV/AIDS response. To better target resources to high burden regions and facilities, PEPFAR planned to withdraw from 29% of previously-supported health facilities in Uganda between 2015 and 2017. Methods: We conducted a cross-sectional survey of 226 PEPFAR-supported health facilities in Uganda in mid-2017. The survey gathered information on availability, perceived quality, and access to HIV services before and after transition. We compare responses for facilities transitioned to those maintained on PEPFAR, accounting for survey design. We also extracted data from DHIS2 for the period October 2013–December 2017 on the number of HIV tests and counseling (HTC), number of patients on antiretroviral therapy (Current on ART), and retention on first-line ART (Retention) at 12 months. Using mixed effect models, we compare trends in service volume around the transition period. Results: There were 206 facilities that reported transition and 20 that reported maintenance on PEPFAR. Some facilities reporting transition may have been in a gap between implementing partners. The median transition date was September 2016, nine months prior to the survey. Transition facilities were more likely to discontinue HIV outreach following transition (51.6% vs. 1.4%, p

Suggested Citation

  • Jess Alan Wilhelm & Mary Qiu & Ligia Paina & Elizabeth Colantuoni & Moses Mukuru & Freddie Ssengooba & Sara Bennett, 2019. "The impact of PEPFAR transition on HIV service delivery at health facilities in Uganda," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-14, October.
    • Handle: RePEc:plo:pone00:0223426
    DOI: 10.1371/journal.pone.0223426
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    References listed on IDEAS

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    1. Bennett, Sara & Ozawa, Sachiko & Rodriguez, Daniela & Paul, Amy & Singh, Kriti & Singh, Suneeta, 2015. "Monitoring and evaluating transition and sustainability of donor-funded programs: Reflections on the Avahan experience," Evaluation and Program Planning, Elsevier, vol. 52(C), pages 148-158.
    2. Rachel Silverman, 2018. "Projected Health Financing Transitions: Timeline and Magnitude," Working Papers 488, Center for Global Development.
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