In 2016, there were approximately 1.8 million children under the age of 15 and 1.8 million adolescents aged 10-19 living with HIV/AIDS. For both age groups, the majority of these cases can be found in sub-Saharan Africa. At the onset of The ELMA Foundation’s investments in the “unfinished business” (UB) of accelerating HIV testing, treatment, and retention in care for infants, children, and adolescents, three out of four children with HIV were not receiving treatment.
After a multi-year, multi-country series of investments, ELMA has commissioned Itad to undertake an evaluation to assess the impact of its contribution to paediatric and adolescent HIV treatment and care in South Africa and Uganda. The evaluation involves two components:
- an analysis of HIV testing, treatment, and retention data using the cascade of care as an organizing framework
- a complementary component that seeks to understand the program’s impact in-depth, using qualitative methods such as on-site observations, and interviews with the in-country program teams, implementing partners, facility and community staff, Ministry of Health and program beneficiaries in South Africa and Uganda.
Our approach to the evaluation is utilisation-focused – we are implementing it in a way that creates engagement and ownership at the outset of the process, generates co-created outputs among the intended users, and ensures timely and actionable findings, learning and recommendations. We are using a theory based evaluation design built around testing a Theory of Change (ToC) which lays out the objectives and activities of the ELMA Unfinished Business program and illustrates how they are designed to contribute to improved outcomes across the cascade of care for paediatric and adolescent HIV testing and treatment. Core components of the evaluation are then mapped against the ToC to facilitate investigation of what the Unfinished Business program has achieved as well as how this has (or has not) happened.
Image © ELMA Progress Report 2015-2016 Photo Credit: Jumba Martin, PATA