Addressing human resources for health needs to support HIV epidemic control: prioritizing site-level interventions in Democratic Republic of the Congo, 2018-2020

Abstract

Introduction: The United States President's Emergency Plan for AIDS Relief (PEPFAR) in Democratic Republic of the Congo (DRC) continues to fund programs aimed at achieving epidemic control in three provinces where 30 percent of people living with HIV/AIDS in the country reside. Challenges around human resources for health impede the delivery of quality HIV/AIDS services in DRC. Methods: In partnership with the United States Health Resources and Services Administration (HRSA), PEPFAR, and DRC Ministry of Health (MoH), Columbia University's International Center for AIDS Prevention (ICAP at Columbia University) worked with 16 PEPFAR-identified high-priority health facilities and developed specific interventions to address challenges in achieving PEPFAR 95-95-95 targets. Once interventions were selected and prioritized using a collaborative, criteria-driven approach, implementation of these human resources for health improvements began alongside care and treatment efforts already underway. This study began in October 2018, and high-priority interventions were launched in July 2019. Monthly reporting of key PEPFAR metrics continues for evaluation purposes. Results: All 16 high-priority health facilities participated fully. Of several hypothesized interventions, 12 were selected as highest priority, and budgets and task plans were developed for each. The interventions were launched for implementation and evaluation within six months of Ministry of Health approval. Conclusion: This assessment delineated necessary interventions to address site-specific human resources for health challenges/deficiencies. Downstream reporting of key PEPFAR 95-95-95 metrics, including Monitoring, Evaluation, and Reporting indicators, will allow intervention teams to conduct program evaluations and their impacts on targets.