Table 1: The assess-implement-evaluate phases of the VL intervention among CLHIV in SIDHAS-supported LGAs in Akwa Ibom State, Nigeria.
Phase 1: Assessment (January 18-22, 2021) |
|
1. 1. |
Developed concept note including quality assessment parameters |
2. 2. |
Formed pediatric task force team |
3. 3. |
Audited baseline folder of 315 unsuppressed CLHIV |
4. 4. |
Identified gaps in ART care and treatment for CLHIV (including service delivery process gaps) |
5. 5. |
Developed individualized action plans to close identified gaps, assigning individuals responsible and establishing timelines |
6. 6. |
Developed monitoring indicators and plan to measure progress |
7. 7. |
Developed a communication channel for granular-level data review, gap analysis, and remedial action plan |
Phase 2: Implementation (January 18-July 31, 2021) |
|
1. 1. |
Mentored facility- and community-level ART site managers on pediatric regimen optimization and dosing |
2. 2. |
Provided pediatric ARV, Tuberculosis preventive therapy, cotrimoxazole dosing charts for appropriate weight-based dosing by health care providers |
3. 3. |
Profiled pediatric ARV stock on hand to guide transition to age-appropriate regimen |
4. 4. |
Provided information, education, and communication (IEC) materials and cues for adherence counseling, adverse drug reaction monitoring |
5. 5. |
Activated callback of children in the cohort for optimal service provision |
6. 6. |
Activated home visits and return to the facility for CLHIV whose caregivers’ phone contacts were unavailable |
7. 7. |
Provided services to CLHIV based on case-by-case package of care plans made in phase 1 (e.g., correcting inappropriate regimen, screening for opportunistic infections, support for disclosure) |
8. 8. |
Incentivized high performance |
Phase 3: Evaluation (January 18-July 31, 2021) |
|
1. 1. |
Pediatric task force teams provided update on individualized plan via virtual meetings with QI task force. |
2. 2. |
Compared patient-level updates with data from electronic medical records to ensure concurrence |
3. 3. |
Documented and shared what was learned |