Effect of PEPFAR funding policy change on HIV service delivery in a large HIV care and treatment network in Nigeria

Bolanle Banigbe, Carolyn M Audet, Prosper Okonkwo, Olujide O Arije, Elizabeth Bassi, Kate Clouse, Melynda Simmons, Muktar H Aliyu, Kenneth A Freedberg and Aima A Ahonkhai

PLOS ONE, 2019, vol. 14, issue 9, 1-12

Abstract: The transition to PEPFAR 2.0 with its focus on country ownership was accompanied by substantial funding cuts. We describe the impact of this transition on HIV care in a large network of HIV clinics in Nigeria. We surveyed 30 comprehensive HIV treatment clinics to assess services supported before (October 2013-September 2014) and after (October 2014-September 2015) the PEPFAR funding policy change, the impact of these policy changes on service delivery areas, and response of clinics to the change. We compared differences in support for staffing, laboratory services, and clinical operations pre- and post-policy change using paired t-tests. We used framework analysis to assess answers to open ended questions describing responses to the policy change. Most sites (83%, n = 25) completed the survey. The majority were public (60%, n = 15) and secondary (68%, n = 17) facilities. Clinics had a median of 989 patients in care (IQR: 543–3326). All clinics continued to receive support for first and second line antiretrovirals and CD4 testing after the policy change, while no clinics received support for other routine drug monitoring labs. We found statistically significant reductions in support for viral load testing, staff employment, defaulter tracking, and prevention services (92% vs. 64%, p = 0.02; 80% vs. 20%, 100% vs. 44%, 84% vs. 16%, respectively, p

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0221809

DOI: 10.1371/journal.pone.0221809

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