1. Project HEART Update 8 th Annual CDC/HRSA Track 1.0 Meeting Nicole Buono, Project Director

2. Project HEART Overview Where we work Results- Adult and ped care and treatment and PMTCT Ped counselors in Zambia in improving enrollment and retention Program quality data Data quality PY8 priorities

3. Where We Work: Côte d’Ivoire Site Map

4. Where We Work: Mozambique Site Map

5. Where We Work: South Africa Site Map

6. Where We Work: Tanzania Site Map

7. Where We Work: Zambia Site Map

8. Trends in Number of Active Care and Treatment Sites, Project HEART *Q1-4 numbering refers to calendar quarter (ie Q2 2010=Apr-Jun 2010)

9. Number and percent of PY6 target achieved: Patients ever started on ART during PY6 (April 2009-March 2010)

10. Number and percent of PY6 target achieved: New children started on ART during PY6 (April 2009-March 2010)

11. PY6 PMTCT Targets and Achievements

12. Percent distribution of children ever started on ART by age group by the end of the quarter, April – June 2010

13. Zambia pediatric counselors and impact on enrollment and retention of children Pediatric ART enrollment and retention challenging 103 counselors in Zambia were trained using the two- week ANECCA/CRS pediatric counseling course Used program data- the difference between 2008 and 2009 enrollment and attrition of children and adults Statistical analysis using paired t tests. Among 64 sites, 47 met the criteria for the enrollment analysis and 55 for attrition, 30 sites with trained pediatric counselors

14. Zambia Experience: Results

15. Zambia Experience: Results (2)

16. Zambia Experience: Conclusions The number of children enrolled in ART increased more in ART treatment sites with trained pediatric counselors than in sites without counselors, outpacing adult enrollment; attrition also decreased more in these sites. Limitations include inter-site variability and difficulty identifying and controlling for confounders. A larger matched case-control study is recommended to control for site variations.

17. Tanzania Performance 2009-2010

18. Côte d’Ivoire Quality Improvement 2007-2009

19. Zambia Quality Improvement Performance 2009-2010

20. Data Quality Update

21. Data Quality Update (2)

22. PY8 Priorities Prepare for smooth transition of programs in all countries Advance transition objectives, monitor and document transition Continue to improve program quality Continue to focus on improved data quality Initiate project closeout (starts in PY7)

23. Acknowledgements CÔTE D’IVOIRE Anna Likos, Alexandre Ekra, and the CDC/CI team MOH CI, regional and district authorities Joseph Essombo, Anthony Tanoh and the EGPAF/CI team EGPAF Global Rose McCulloughh Nicole Buono Stephen Lee Richard Marlink Theresa Wolters Rozalin Wise Stephanie Calves Shauna Eisenberg Solome Paulos Elizabeth Flanagan Nick Hellmann Trish Karlin Anja Giphart Shobana Ramachandran Eric Nawar Penny Smith Andrea Wahl Dorace Trottier Ashley Thompson Sean Maher Amelie Sow-Dia ……..AND ALL OF OUR PATIENTS, PARTNERS, STAFF AND DONORS MOZAMBIQUE Lisa Nelson, Kebba Jobarteh, Charity Alfredo, Paula Morgan and CDC/Moz MOH Moz, provincial and district authorities Nancy Fitch, Cathrien Alons, and the EGPAF/Moz team SOUTH AFRICA Thurma Goldman, Jeff Klausner, Lerato Lesole, and CDC/SA DOH SA and provincial and district authorities Kuku Appiah, Pumla Lupondwana and the EGPAF/SA team TANZANIA John Vertefeuille, Thomas Finkbeiner, Mohamed Mfaume and CDC/TZ MOH TZ, regional and district authorities Anja Giphart, Jeroen van Padt Bosch and the EGPAF/TZ team ZAMBIA Larry Marum, Deborah Connor, Isaac Zulu and CDC/Zambia Susan Strasser and the EGPAF/Zambia team MOH Zambia, provincial and district authorities Jeff Stringer, Elizabeth Stringer, Carolyn Bolton, Stewart Reid and the entire CIDRZ team CDC/ Atlanta Tedd Ellerbrock Diane Flournoy Bud Bowen Janna Brooks Josef Amman Elliot Raizes Tom Spira Angeli Achrekar Carla Johnson Laura Porter Joe Barker John Aberle-Grasse OUR PARTNERS HERE THIS WEEK CIDRZ (Zambia) Geoffrey Siliwizya Health Services Payment Authority (Cote d’Ivoire ) Kone Idrissa District Medical Officer (Tanzania) Cristo Nkya Gauteng Province Medical Advisor (South Africa) Zukiswa Pinini

25. This presentation was made possible through support provided by the U.S. Centers for Disease Control and Prevention (CDC), through the President’s Emergency Plan for AIDS Relief (PEPFAR), as part of the Elizabeth Glaser Pediatric AIDS Foundation's International Family AIDS Initiatives (“Project HEART”/Cooperative Agreement No. U62/CCU123451). The opinions expressed herein are those of the authors and do not necessarily reflect the views of CDC.