IPHASA grants

Applications are now closed.

The International Paediatric HIV Symposium in Africa (IPHASA) convened for the first time in November 2021 at a virtual meeting with the theme, Leaving no child with HIV behind: Efficiencies, innovation and stakeholder engagement in service delivery. The Ministry of Health of Uganda leads the IPHASA Organizing Committee in partnership with the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) of IAS – the International AIDS Society – and representatives of several ministries of health and leading organizations in paediatric HIV.

IPHASA aims to enable discussion of the latest science and build the capacity of healthcare workers and policy makers in implementing evidence-based approaches in the response to paediatric HIV across Africa. The overall objective is to facilitate the translation of evidence and good practices in the paediatric HIV response for implementation and adaptation across the African continent.

IPHASA is providing two new implementation science grants: a peer learning visit grant; and an implementation science research grant. To be eligible, the applicant must come from a low- or middle-income country in Africa according to the World Bank classification. In line with IPHASA objectives, these grants aim to support knowledge sharing and help close the know-do gap (the gap between what we know works [evidence-based interventions] and what we do in practice) by identifying and addressing the barriers and solutions that affect the delivery of health interventions and evidence-based practices in paediatric HIV prevention, care, and treatment.

Supporting resources

Peer Learning Visit Grant

This is a travel grant to support one African country team of 3-5 people in visiting another country team that has successfully implemented a strategy and/or programme of interest that was presented at IPHASA 2021. The applying team should be able to indicate the gap in its programme and how the strategy and/or programme of interest learnt at IPHASA 2021 will help address the gap. Teams are encouraged to work with at least one Ministry of Health official responsible for a paediatric HIV programme in their home country. We have no restrictions on how many applications per country can be submitted. This support will include funding to attend the 2nd IPHASA (2023) to report on progress and results.

This request for proposals serves to invite interested:

  • Ministry of Health teams
  • Academics
  • Community researchers
  • Non-governmental organizations
  • Other implementers

Proposed visit should identify and address a gap in their programme and how a peer learning visit to another African country could help address that gap. The study should also indicate how the results could help develop a research application, updating the existing programme with a robust evaluation.

To be eligible, the team leader must:

  • Hold an MSc, MD, MBChB, MBBS, PhD or equivalent degree at time of grant
  • Currently work with a public health institution (for example, Ministry of Health or within a hospital) or public health organization within one of the eligible countries. Applicants with research skills in public health and implementation science are also welcome to apply.
  • Have a strong interest in public health research focused on paediatric HIV
  • Provide a letter of support from the applicant’s institution
  • Have a research mentor, preferably in a low- or middle-income country with extensive experience in the field of paediatric HIV or expertise in implementation science
  • Be able to report back on progress at the next IPHASA in Q4 of 2023

The application can be submitted only through the online submission system and in the format provided. Applications not submitted through the online system will not be accepted. We welcome applications written in English or in French. Please note that as you complete your application online, you will be able to save your modifications and go back to the updated version of your form later. The application must include the following sections:

  • Introduction and background
  • Description of the country team
  • Proposed timelines
  • Specification of the gap in their programme and how the strategy and/or programme of interest could be implemented in their home country
  • Budget
  • Excepted takeaways from the trip
  • Expectations for the intended outcomes after the travel
Apply now

Implementation Science Research Grant

IPHASA will award three grants worth USD 12,500, for African researchers to conduct implementation science projects to address implementation gaps in their countries paediatric HIV prevention, care and treatment program. Each grantee will be invited to connect to one IPHASA mentor from the organizing committee who will provide technical support throughout the period of implementation of the research. This grant includes additional funding for the three grant recipients to attend IPHASA 2023 to present research findings.

This request for proposals serves to invite interested Ministry of Health teams and academic and community researchers to evaluate paediatric HIV interventions, policies and programmes using an implementation science framework to improve the implementation of paediatric HIV care and/or prevention.

Proposed studies should identify and address implementation gaps in existing evidence-based interventions, policies and/or programmes across the paediatric HIV care and/or prevention continuum. Implementation gaps in the following areas should be considered:

  • Paediatric HIV case identification
  • Linkage to care
  • Prevention of mother-to-child transmission
  • ART initiation and optimization
  • Retention in care
  • Viral load suppression
  • Psychosocial support
  • Community engagement and support
  • Integration of non-communicable diseases in HIV, including mental health
  • Health system strengthening for improved paediatric HIV services
  • Positive HIV prevention among adolescent living with HIV

To be eligible, applicants (principal investigator) must:

  • Hold an MSc, MD, MBChB, MBBS, PhD or equivalent degree at time of grant
  • Currently work with a public health institution (for example, Ministry of Health or within a hospital) or public health organization within one of the eligible countries. Applicants with research skills in public health and implementation science are also welcome to apply.
  • Have a strong interest in public health research focused on paediatric HIV
  • Have a research mentor, preferably in a low- or middle-income country with extensive experience in the field of paediatric HIV or expertise in implementation science. (the IPHASA committee can help identify an in country mentor)
  • Be able to complete the proposed research within the 18-month grant period (mid-2022 to end-2023), providing evidence resulting from the research, and to report back at the next IPHASA in Q4 of 2023.
  • Provide a letter of support from the applicant’s institution, as well as a copy of the applicant’s degree or diploma

The application can be submitted only through the online submission system and in the format provided. Applications not submitted through the online system will not be accepted. We welcome applications written in English or in French. Please note that as you complete your application online, you will be able to save your modifications and go back to the updated version of your form later. The application must include the following sections:

  • Introduction and background
  • Specific aims
  • Specification of the evidence-based intervention and evidence of gaps in implementation
  • Implementation framework, outcomes and methodology
  • Data evaluation and analysis plan
  • Proposed timelines
  • Budget
  • Intended deliverables, including a plan to disseminate results to relevant stakeholders
Apply now

Meet the IPHASA grantees

Maureen King’e

Kenya

Implementation Science Research Grant

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Phiwe Babalo Nota

South Africa

Implementation Science Research Grant

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Bonniface Oryokot

Uganda

Implementation Science Research Grant

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Berthe Amélie Angoue

Gabon

Peer Learning Visit Grant

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Project title: Evaluation of factors affecting neurodevelopmental surveillance of children with perinatal HIV exposure aged 0-2 accessing child welfare services in Kenya

The issue

Of the ~15 million children with perinatal HIV exposure, 90% reside on the African continent. These children are more likely to have poorer neurodevelopmental and behavioural outcomes than their unexposed counterparts. Over 90% of the human brain develops by age five, with the majority of this development and plasticity to early intervention occurring in the first three years. In Kenya, there is significant underreporting of developmental surveillance activities and underutilization of the developmental milestone tracking tool, with at least one completed item with data available reported for only 9% of children compared with 87% for immunization items.

The IPHASA project

Implementation science methods can help address the know-do gap and provide a better understanding of how the healthcare system can support sustainable developmental care for children with perinatal HIV exposure. The aim is to characterize the completion rate (penetration) of developmental milestone screening among children under two years in child welfare clinics (CWCs) and/or vertical transmission clinic settings in three Kenyan counties by assessing the developmental milestones tracking tool in the mother-child handbooks and clinic registers. We will also determine the impact of maternal HIV status on completion of infant developmental milestone assessments. Using the Consolidated Framework for Implementation Research (CFIR), we will seek to identify facility- and individual-level barriers and facilitators to acceptability, feasibility, penetration, coverage and fidelity of developmental milestone screening in CWCs in Kenya.

The impact

To plan for services, interventions, treatment and care, it is important to understand the cognitive abilities and developmental milestones of children with perinatal HIV exposure. Strengthening developmental surveillance activities is thus an important prerequisite. The documented risk factors from HIV exposure are similar to the risks for cognitive or developmental delay. Thus, identification of why delays occurs may help in early identification of HIV-related white matter disease, chronic illnesses like tuberculosis, or children who have newly acquired HIV or are most socially vulnerable. Understanding the majorly affected domains is also important to the planning of the spectrum of services and allied health professionals required to rehabilitate these children and get them back on track.

Project title: Strengthening the Integrated School Health Policy: Examining Coordination to Provide Sexual and Reproductive Health Services for Adolescent Girls in Public Secondary Schools in King Cetshwayo District, KwaZulu-Natal Province

The issue

In many instances, adolescent girls in South Africa do not access the services they need to prevent HIV, unintended pregnancy and gender-based violence (GBV); nor do they access psychosocial support. Additionally, research has established that there is a significant gap in linking adolescents who have newly acquired HIV to testing, treatment and care. Those who manage to test face additional challenges in initiating antiretroviral therapy. In South Africa, adolescents have larger gaps in the HIV continuum of care than adults, resulting in lower levels of viral suppression.

Schools offer platforms to identify vulnerable adolescent girls and unreached adolescents living with HIV, potentially linking them to services they need. School-going adolescents spend most of their time in school, making schools ideal places for reaching this vulnerable population group. In 2012, the South African government initiated the Integrated School Health Policy (ISHP), which aims to improve the health of school-going children and their communities. The goal of this policy is to contribute to the improvement of the general health of school-going children, as well as environmental conditions in schools, and address health barriers to learning to improve health and educational outcomes.

At the school level, implementation of the ISHP needs a coordinated and comprehensive approach. Coordination is specifically needed between the district-based support teams (DBSTs), school-based support teams (SBSTs) and learner support agents (LSAs). Schools, like other service sectors, are faced with an implementation gap where there is often slow adoption or uneven implementation of policy and evidence-based practices as part of routine service delivery; this limits efforts to promote improved learner health outcomes. However, implementation of the ISHP requires robust intersectoral collaboration on the part of key role players.

The implementation of successful school health programmes depends on strong partnerships between education and health sectors, teachers and health workers, schools and community groups and learners and persons responsible for school health programmes. Unfortunately, research in South Africa has revealed that there has been an absence of collaboration from key stakeholders, resulting in the poor adoption and implementation of the ISHP. This has resulted in a missed opportunity to reach vulnerable adolescent girl learners in the school setting for HIV prevention, treatment and care.

The IPHASA project

The aim of this study is to examine the role of the department of basic education-instituted coordinating bodies, including the SBSTs, DBSTs and LSAs, in facilitating access to HIV services, as mandated by the ISHP, in public secondary schools in the King Cetshwayo District, KwaZulu-Natal.

The objectives

  • To explore the role of the SBST, DBST and LSAs in identifying learner health needs and facilitating access to sexual and reproductive health services, including HIV services
  • To explore learner health needs and engagement with SBST and LSAs and experiences  of linkage to care
  • To provide recommendations that will: (i) strengthen coordination between the DBSTs, SBSTs and LSAs in implementing the ISHP; (ii) strengthen the identification of vulnerable learners; and (iii) improve adolescent linkage to HIV prevention, treatment and care
  • To improve linkage of vulnerable adolescents to HIV prevention, treatment and care

Project title: The adaptation and evaluation of the Operation Triple Zero model to improve HIV viral suppression among children and adolescents served by TASO Uganda using RE-AIM framework of implementation science research

The issue

HIV viral load (VL) suppression among children and adolescents living with HIV remains sub-optimal in many settings, including Uganda. At The AIDS Support Organization (TASO) Uganda, VL suppression in this sub-population similarly remains far below 95%. For example, by the end of March 2022, four TASO Uganda service centres all had VL suppression among children and adolescents living with HIV of less than 90%, despite several efforts, including implementation of the youth and adolescent support (YAPS) intervention.

We propose adapting and integrating the Operation Triple Zero (OTZ) model into existing interventions to enhance VL suppression among children and adolescents living with HIV. OTZ aims to attain zero missed pill, zero missed appointment and zero viral load. It was first implemented successfully in Kenya in 2016, starting with 70 beneficiaries in one health unit and expanding to more than 29,795 in 27 counties. OTZ empowers children and adolescents living with HIV and health workers, including peers and caregivers, through training and using carefully designed national packages. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework of implementation science will be used to aid the adaptation and evaluation of the model in the Ugandan setting.

The overall goal of the project is to improve HIV VL suppression and health outcomes among the children and adolescents living with HIV in TASO Uganda.

Project title: Integrated platform for the follow up and care of children and adolescents living with HIV

The issue

In Gabon, UNAIDS estimates reveal that in 2020, 46,000 people were living with HIV, 1,000 people had newly acquired HIV and 1,000 people had died from AIDS-related illnesses. Faced with this alarming assessment for Gabon, a country of fewer than two million inhabitants, measures are being taken to limit the number of new acquisitions with an emphasis on vertical transmission; hence, steps to prevent vertical transmission of HIV are being monitored. This programme brings together all the medical and surgical means that contribute to reducing the likelihood of vertical HIV transmission.

To know the pattern of drug resistance, understand the reasons for treatment discontinuation in our children and promote better policies, we undertake to carry out this study. It would serve as a precept study, aimed at improving the care of children and adolescents by supporting community health workers and other health personnel involved in awareness, prevention and therapeutic management.

Objectives

  • Find 25 people lost to follow up with the help of community health workers (CHWs).
  • Conduct laboratory investigation for mutations in 25 adolescents with treatment failure plus 25 lost to follow up (50 in total).
  • Monitor 30 infants born to mothers living with HIV at M1, M6, M9 and M18 for the development of HIV in agreement with the paediatric department.
  • Popularize viral load testing and healthy living among adolescents with the help of CHWs by producing information brochures.
  • Specification of evidence-based intervention and evidence of gaps in implementation

To date, studies on paediatric HIV are limited to those carried out on vertical transmission. Therefore, carrying out a study involving children and adolescents will allow us to make a projection on the response policies that will have to be adopted to achieve the SDGs and particularly, the 95-95-95 targets.

CHWs are not always involved in the care of people living with HIV, particularly in paediatric settings. Their involvement in our study will allow health authorities to draw up a legal framework for their recognition and role in the response, as mentioned by UNAIDS. On the other hand, the integration of CHWs in this study could help us harmonize and energize the care of paediatric populations living with HIV who have, so far, been submerged in care intended for adults; this care has not been adapted to these populations, as recommended by UNAIDS in 2021 (https://www.unaids.org/fr/keywords/gabon).

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