PEPFAR/USAID/PCI-E Partnership Report

Program Background

Ethiopia has made significant progress in its national HIV/AIDS response, but challenges remain in reaching key populations, ensuring treatment adherence, and providing comprehensive support to affected families. The PEPFAR/USAID-funded partnership between HEAL Ethiopia and PCI-E was designed to address these gaps through community-based approaches.

The program aimed to reduce new HIV infections, improve the quality of life for people living with HIV, and strengthen the capacity of local organizations and health systems to deliver sustainable HIV/AIDS services.

Key Achievements

Key Outcomes

Innovative Approaches

The partnership implemented several innovative approaches that contributed to its success:

• Index Case Testing: Systematically offering HIV testing to family members and partners of HIV-positive individuals, which increased case finding yield by 300%
• Community ART Groups: Establishing peer support groups for medication pickup and adherence support, reducing the burden on both clients and health facilities
• Economic Strengthening: Combining savings groups, skills training, and small business grants to improve household resilience and treatment adherence
• Case Management System: Implementing a comprehensive case management approach for OVC households, ensuring coordinated services across sectors
• Faith-Based Engagement: Working with religious leaders to reduce stigma and promote HIV testing and treatment

Challenges & Lessons Learned

The program faced several challenges and generated important lessons for future HIV programming:

• Stigma and discrimination: Despite progress, stigma remains a significant barrier to HIV testing and treatment, requiring continued community engagement
• Key populations: Reaching key populations requires specialized approaches and trust-building measures
• Service integration: Integrating HIV services with other health services improves efficiency and reduces stigma
• Economic factors: Addressing economic vulnerabilities is essential for treatment adherence and overall wellbeing
• Local ownership: Building the capacity of local organizations and government structures is critical for sustainability

Recommendations

Based on the program experience, the report makes the following recommendations:

1. Scale up index case testing and other targeted testing approaches to improve case finding efficiency
2. Expand differentiated service delivery models to reduce the burden on health facilities and improve client satisfaction
3. Integrate economic strengthening components into all HIV care and support programs
4. Strengthen community-facility linkages to improve referrals and follow-up
5. Invest in data systems that allow for real-time monitoring and adaptive management
6. Develop specialized approaches for adolescents living with HIV, who face unique challenges

Conclusion

The PEPFAR/USAID-funded partnership between HEAL Ethiopia and PCI-E has made significant contributions to Ethiopia's HIV/AIDS response. Through community-based approaches and innovative strategies, the program has improved HIV case finding, treatment outcomes, and the wellbeing of affected families.

The lessons learned and recommendations from this program provide valuable guidance for future HIV/AIDS programming in Ethiopia and similar contexts. HEAL Ethiopia remains committed to building on these achievements and addressing the remaining challenges in the national HIV response.