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Factors influencing access of ART services in Children living with HIV Background Under the Paediatric Centres of Excellence

for paediatric care various services viz., management of complicated Opportunistic Infections, delivery of care and support to infected children including specialised laboratory services, early diagnosis of I! among infants, "#$ to children infected %ith I!, counseling on adherence and nutrition, etc are conducted. "s on &ecember '()', nearly ),)',*+, Children -iving %ith I!."I&/0C- I!1 are registered in I! care at "#$ centres of %hom *2,*34 are receiving free "#$. Paediatric formulations of "#! drugs are available at all "#$ centres. $he proportion of Children -iving %ith I! 0C- I!1 accessing and receiving care at "#$ centres is lo%. !arious factors influence lo% enrollment %hich could be health care related, logistic related and patient related. It is essential to understand and address these factors to optimise the paediatric care. $here is a need to maximise children5s adherence to first6line "#$. Key question s! ). o% do "#$ centers assess ris7 factors of adherence to "#$ 0facilitators and barriers for optimal paediatric care18 '. o% is adherence of at6ris7 "#$ clients monitored8 *. o% can "#$ adherence among "#$ clients be promoted and -9U among C- I! be prevented 2. :hat are the %ays by %hich these ;at6ris7< clients could be lin7ed to community resources to ensure continuum of care8 ,. #ecommendations to the programme to increase service access to children 3. Explore any innovative model to improve effectiveness 0eg. $amil =adu1 "ethodology # $a%&le si'e( $a%&ling design( study &o&ulation( )eogra&hical sco&e( $econdary data sources if any! " multi6centric, cross sectional mixed method study. Inclusion criteria 6 "ll "#$ plus centres "#$ centres %ith C- I! load of more than ,( initiation and functioning for more than ' years. Exclusion criteria 6 "#$ centres %ith C- I! load of less than ,( initiation and functioning for less than ' years. >ac7ground information of the "#$ centres %ill be obtained 0infrastructure, #, turnover rate1. " semi6structured ?uestionnaire %ill be prepared to be administered at IC$C and %ith healthcare provider 0/@O.@O, counselor and "#$ team1 covering Ano%ledge and attitude of the service providers 0diagnosis, clinical care B OI<s, nutritional, development, treatment eligibility, initiation and monitoring, treatment failure, support available, staff turnover, other issues1 and patient related issues. " semi6structured ?uestionnaire for Exit intervie%s %ith clients to assess the attitude of caregivers and assess the barriers in accessing healthcare %ould also be prepared. $he study component involving exploration of innovative models %ould be exploratory in nature. $tudy duration ) year 3 months *sti%ated +udget ,( la7hs