2017 ICT4D Conference

In line with its geographical pivot, PEPFAR focused its scale-up interventions in 32 sub-national units (SNUs) in Nigeria. This pivot is a result of PEPFAR 3.0’s commitment to focus investments on interventions with potentially significant epidemiological impact. Whether the 32 SNUs truly account for 13% of the entire HIV burden in Nigeria and the magnitude of alignment of community-based OVC program within the pivot remains unclear. This study was conducted to map the catchment areas of the comprehensive HIV care and treatment facilities in the scale-up SNUs to determine whether community-based OVC programs are being appropriately located and if not, estimate a measure for the misalignment.

Records of 26,365 PLHIVs were sampled from 167 PEPFAR-supported comprehensive HIV care and treatment facilities in 31 scale-up SNUs. The sample was calculated from the number of adults and children reported to be currently receiving ARV as at September 2015. An electronic data collection tool, survey123 for ArcGIS on android-based handheld devices, was used to collect data. Analysis of data was done using power pivot extension in Microsoft Excel 2016, automated into python and mapped using ArcGIS software

The study revealed that, 27.5% of all clients sampled access services outside of their SNUs of residence. The results show a statistically significant 3.5% more male than females accessing services outside of their LGAs of residence. Clients less than 15 years old tend to receive services in LGAs other than where they reside 4.3% times more than clients 15 years of age or older. Enrollment rates for clients residing within same LGAs as the health facilities into clinical care and treatment were positively associated with progression in time from September 2014.

The study concluded that prioritizing community based interventions using facility-based burden of HIV may be counterproductive for epidemic control. We recommended the boundaries for community-based HIV services to be reconsidered based on the catchment data.