Best Practices and Innovations Meetings

The South Africa National Department of Health (NDOH) and PEPFAR have established a collaboration to disseminate best practices and innovations in HIV and TB program implementation.  Through a series of thematic workshops key leaders and implementers share innovations, best practices, and lessons learned about high impact implementation strategies.

An Implementer’s Guide to the Tenofovir Disoproxil Fumarate-Lamivudine Dolutegravir (TLD) Transition.

Objective: This best practice symposium provided a forum for National Department of Health, partners and local stakeholders to interact with counterparts from regional countries (Botswana, Malawi, Zambia and Malawi) to discuss experiences and showcase strategies and plans that will enable the roll out of Dolutegravir and to discuss strategies for monitoring outcomes in patients exposed to TLD.

Session themes included:

1) Dolutegravir roll out: anticipated challenges and lessons learnt from the experiences of others.

  • TLD roll out in Malawi
  • Enhanced monitoring of Tenofovir-Lamivudine-Dolutegravir (TLD) replacing first-line ARTin Chiradzulu District, Malawi
  • Dolutegravir CSF Perspective

2) The implementation of pharmacovigilance systems, including pregnancy exposure registries and birth outcomes surveillance in monitoring outcomes of patients exposed to TLD.

  • Birth Surveillance
  • Pharmacovigilance
  • Experiences with the Pregnancy Registry in South Africa
  • Drug Safety Surveillance
  • Pregnancy Registry Protocol
  • Birth Registry

View the Presentations »

Toward HIV Epidemic Control: Lessons from Research to Practice

Satellite Session held at the 9th SA AIDS Conference on 11 June 2019


Objective:  The workshop featured connections between the PopART study and the South Africa HIV program objectives to increase people living with HIV (PLHIV) on treatment and reduce HIV incidence. Population Effects of Antiretroviral Therapy to Reduce HIV Transmission (PopART) is a cluster-randomized trial of the impact of a combination prevention package on population-level HIV incidence in Zambia and South Africa.

The prevention interventions included universal voluntary HIV counseling and testing provided at household level, linkage of HIV infected individuals to care and early initiation of antiretroviral therapy (ART) for all those testing HIV-positive. To measure the impact of the intervention, a Population Cohort, consisting of a representative sample of approximately 2,300 adults aged 18–44 years, was recruited from the general population of each of the 21 communities (an overall total of 48,500 across all communities) and was followed up once a year for three years to measure HIV incidence and other outcomes.

The South Africa PEPFAR program and the South Africa National Department of Health are currently involved in an intensive program improvement effort, known as Siyenza, with a goal to significantly increase the numbers of PLHIV on treatment and increase the PLHIV retained in care.

The workshop described the PopART study and considered what results and program implementation lessons from the PopART study can help inform the Siyenza initiative and the scale-up of HIV treatment. The workshop featured an “expo” session with practical demonstrations of current tools.

Session themes include:

  • Community Engagement to Increase PLHIV on Treatment
  • Efforts to Reach Target Populations

Specific areas include:

  • PopART Primary Results and Implementation Lessons
  • Siyenza HIV Treatment Acceleration Results and PEPFAR CHW Support
  • NDOH 10-Point Plan
  • PopART Experience with Community Workers/CHIPS:  Impact, and Practical Lessons Learned
  • City of Cape Town Experience with Enablers and Barriers to “External” Projects Embedding in Government Systems
  • Linkage to HIV Treatment (Linkage Officers and Linkage Initiatives)
  • Adherence and Retention – Adherence Clubs and Support Groups
  • Reaching Men (PopART)
  • Reaching Men and Reaching Youth (Adolescents/AGYW)
  • Increasing HIV Testing Among Men
  • Extended Hours, Youth Zones, and Welcome Back Campaign (NDOH)
  • Drug Delivery and Pick-Up Points

Note: Report of the meeting to be made available soon.

Presentations for the Meeting »

HIV Patient Linkage and Return Back to Care

28 March 2019

Brief Summary: NDoH and PEPFAR organized a practical workshop focused on how the Departments of Health at all levels, implementing partners, and PEPFAR can effectively improve and sustain the treatment cascade and specifically target linkage to care and loss to follow up. The goal of this workshop was to identify successful best practices, systems and tools that improve successful linkage to care, defaulter tracing and return back to care for different groups of People Living with HIV (PLHIV).

Session Themes Include:

  • Effective linkage to Antiretroviral Treatment (ART) and same day ART initiation
  • The role of community health workers/Ward Based Primary Healthcare Outreach Teams (WBPHCOTs) and peer support in linkage to ART and defaulter tracing
  • Approaches to implement the Welcome Back Campaign
  • The role of community health workers/WBPHCOTs and peer support in re-engaging PLHIV aware of their status but not in care
  • Targeted strategies for men, Adolescent Girls and Young Women (AGYW), paediatrics, and adolescent boys
  • Data quality assurance and quantifying true loss to follow up
  • Identifying reasons for poor linkages and Loss to Follow Up (LTFU) for specific populations
  • Implementation and systems to improve tracking, tracing and return back to care

Presentations for the Meeting »

Filling the Gaps in Best Practices and Innovations for HIV Programming

16-17 May 2018

Theme 1: Community Health Worker Programs that Support HIV Prevention and Treatment Services
Theme 2: Reaching High Risk Men with HIV Prevention, Testing and Treatment Services

Specific Areas of Interest Include:

Theme 1: Community Health Worker Programs that Support HIV Prevention and Treatment Services 

  • Facility-community engagement to increase demand for HIV Testing Strategies (HTS) and Antiretroviral Therapy (ART)
  • Community-based HIV service delivery
  • Screening, Brief Intervention and Referral to Treatment (SBIRT) for alcohol and substance abuse
  • Successes in Ward Based Outreach Teams and other community structures
  • Faith-Based Organizations and community structures mobilizing and shaping influential community perceptions related to HIV
  • Monitoring, mentoring, and supervision to enhance qualitative and quantitative performance of Community Health Workers (CHWs)
  • Active linkage of People Living with HIV (PLHIV) from community settings to facilities to initiate ART
  • Active re-linkage for ART defaulters and Lost to Follow Up (LTFU)
  • Care and support for patients on ART, including retention, adherence, and loss to follow up
  • Educational services offered at adherence clubs, social services, and Centralised Chronic Medicines Dispensing and Distribution (CCMDD) pick-up points
  • Training and mentoring for Community Health Workers
  • Standardized scopes of work
  • Care of the caregivers: Safety of Community Health Workers in communities
  • Performance expectations and management of Community Health Workers
  • Monitoring and Evaluation systems for Community Health Workers efforts

Theme 2: Reaching High Risk Men with HIV Prevention, Testing and Treatment Services 

  • Men’s health seeking behavior and demand creation
  • VMMC, including HTS and linkage for men testing positive
  • Optimized HIV testing and treatment strategies, including linkage to care, adherence and retention
  • Same day, same site initiation in men
  • Differentiated service delivery models
  • Expanded access to ART
  • Franchise models
  • General Practitioner models
  • Men’s clinics
  • Workplace programs
  • Addressing alcohol and substance abuse
  • Linkages with other men’s health issues (NCDs, sexual and reproductive health)

 Presentations for the meeting >>

Best Practices and Innovations in Paediatric HIV and TB Care and Treatment

02-03 November 2017

Specific Areas of Interest Include:

  • Post-Natal Follow Up
  • Linking Children and Adolescents to Treatment
  • Case Finding
  • Paediatric Healthcare Delivery and Management
  • TB and HIV Innovations
  • Data Use Applications: NHLS Results for Action in Urban and Rural Settings
  • Data Use in Paediatric Programmes
  • Drug Resistance and Virological Failures in Paediatric Patients
  • Early Childhood Healthcare
  • Screening Tools in HIV Case FindingRetention in Care

In recent years South Africa, and countries in the South and East Africa region, have made important strides in addressing new HIV infections among children. In 2015, the Government of South Africa reported that coverage for HIV testing of pregnant women was now close to 100%, Prevention of Mother-to-Child Transmission (PMTCT) programs were offered in 98% of all health facilities, and HIV-positive pregnant women on Antiretroviral HIV Treatment (ART) was reported at 87.1% (National Department of Health, 2015). While there have been many successes in the country, there are lessons that the local government and implementing partners can learn from each other and from partners outside of the country.

The Best Practices and Innovations in Paediatric HIV and TB Care and Treatment meeting focused on best practices, evidence-based strategic and operational approaches, policies, and guidelines to address the treatment gap among children with HIV. This meeting provided a forum for implementing partners to showcase strategies that help achieve index testing, linkage, treatment, and retention targets.

Attendees of this meeting include the Paediatric-Adolescent Treatment Africa (PATA), UNICEF, WHO, ELMA Philanthropies, representatives from the South Africa Ministry of Health at the national and provincial levels, and other PEPFAR implementing partners.

At the conclusion of the main meeting, we convened a half-day meeting for a smaller group of invited partners and government counterparts to propose actions and recommendations based on scalable best practices and innovations.

Data Use Innovations and Best Practices Meeting

September 6, 2017

This Data Use Innovations and Best Practices Workshop illustrated programmatic and clinical data tools and analytics in support of the 90-90-90 goals for South Africa.  The workshop highlighted practices and tools that could be integrated into routine practices and harmonized with PEPFAR (District Support Partners) work plans and District Implementation Plans.  Presenters shared programmatic tools and dashboards that illustrate how managers at all levels use data to make better decisions on improving HIV programmatic effectiveness.

The workshop focused on data sources and usage for monitoring performance toward key goals and for program management and how these have in real life helped improve performance.  The meeting was an information sharing platform, to help reduce redundancies and promote efficiencies between stakeholders.  Presenters shared tools and data used routinely to review performance, including recent improvements to disaggregate data for age and sex, where available. PEPFAR DSPs shared their best practices, dashboards, successes in partnering with District and facility management, and challenges in the capturing, cleaning, and validation of routine program data.

Best Practices and Innovations in Reaching and Linking Adolescent Girls and Young Women (AGYW)

26-27 October 2016

There are multiple opportunities for program innovations focused on Adolescent Girls and Young Women (AGYW). On 26-27 October 2016, the South African Government and PEPFAR hosted a dissemination meeting to provide national, provincial, district teams and academic and development partners an opportunity to showcase innovations, best practices and lessons learned that will help achieve the goal of reducing HIV infection among AGYW in priority areas within South Africa.

Specific areas of interest in the meeting include:

  1. AGYW Risk and Vulnerability
  2. South Africa’s Response to the HIV Risk in AGYW
  3. Sexual and Reproductive Health Interventions Targeting AGYW
  4. Social Protection, PrEP, and GBV Interventions Focused on AGYW
  5. Youth Clubs and Parenting Interventions
  6. Innovative Technology and Monitoring and Evaluation for AGYW Programs
  7. Community Dialogue with AGYW members from local Youth Clubs

This program was planned in conjunction with PEPFAR and DREAMS partners, She Conquers, the South African National Department of Health, Department of Education and Department of Social Development.


Best Practices and Innovations in Linkage to Care,  HIV Treatment, and Viral Suppression

May-June 2016

The third meeting in the 90-90-90 series focused on linkage from HIV testing to viral suppression, spanning the care and treatment cascade.  This meeting was held 31 May – 01 June 2016 in Pretoria, South Africa.

Key topics for the meeting include:

  • Community and Clinic Best Practices in Care and Antiretroviral Treatment Initiation
  • Community and Clinical Approaches for Improved Adherence, Retention, and Differentiated Care
  • Universal Test and Treat – Policy Informing Practice
  • Achieving Viral Suppression for HIV Infected Patients

Participants shared experiences and recommendations that can be adapted and scaled up in support of the second and third 90-90-90 goals.


Reaching 90-90-90 Part 1: Best Practices and Innovations in HIV Counseling and Testing (HCT) and Linkage Innovations

November 2015

On November 30, 2015, the second meeting in the series took place in Pretoria, South Africa.  Over 180 attendees from the South African and U.S. governments, research institutions, academia, PEPFAR implementing partners, World Health Organization (WHO), and donor organizations participated.  Participants shared experiences and recommendations that can be adapted and scaled up in support of UNAIDS 90-90-90 goals, including:

  • Finding the right people
    • Target Setting
    • Targeted Demand Creation
    • Targeted HIV Counselling and Testing (HCT) Services and Maximizing Testing Yield
  • Providing the Right HCT Services and the Right Quality
    • Innovative Models of Service Delivery and Quality Assurance
  • The Next Steps
    • Integration of the NDOH District Implementation Plans
    • Taking Findings to Scale

Presentations for the meeting are listed here >>

Reaching 90-90-90 in South Africa: Innovations and Best Practices

June 2015

The initial meeting occurred on the margins of the June 2015 South African AIDS Conference in Durban, South Africa.   Themes of the meeting included:

  • Reaching the First 90: Finding and Testing Persons at Risk
  • Reaching the Second 90: Active Linkage to Care and Initiation of Treatment
  • Reaching the Third 90: Achieving Optimal Treatment Outcomes
  • Data Use Innovations

Government and non-government implementers submitted over 120 abstracts related to reaching 90-90-90 goals, and 19 were selected for presentation. This successful workshop was attended by over 200 participants, and demonstrated the opportunity to share high quality best practices in program implementation.  Many of the submitted abstracts have been included in subsequent meetings.

Presentations for the meeting >>