ARVMAC is a European Union (EU) funded project, coordinated by the Division of International Health at Karolinska Institutet, Stockholm, Sweden with the main objective to assess the effects of the rapid scale-up of anti-retroviral therapy (ART) for HIV/AIDS on resource-limited health systems, maternal and child morbidity and mortality in three Subsaharan African countries.

Project partners are Makerere University Institute of Public Health, Uganda, the Swiss Tropical Institute, Switzerland, the Ifakara Health Institute, Tanzania, the Institute of Tropical Medicine, Belgium, University of Heidelberg, Germany, and the Nouna Health Research Centre, Burkina Faso. Apart from scientific and financial coordination, Karolinska Institutet is responsible for the workpackage on Equity and Access to ART, Maternal and Child health care (WP7).

The research is carried out in three Demographic Surveillance Sites (DSSs): Iganga-Mayuge DSS (Uganda), Nouna DSS (Burkina Faso) and Rufiji DSS (Tanzania) .  

A DSS collects information on key demographic and health events including: pregnancies, births, deaths, causes of death, migration, health seeking; health care access, socio-economic status and equity.

Aim

The project explores health system consequences of the rapid scale-up of HIV treatment programs, focusing on maternal and child health outcomes related to the Millennium Development Goals (MDGs) 4 and 5, in three Sub-Saharan African countries.

Objectives of the project

1. To conduct a national policy analysis of anti-retroviral treatment (ART) programmes and to study the implementation and integration with maternal and child health (MCH) policies.
2. To analyze the effects of large scale ART on human resources (i.e. availability, required skills/level of training, and distribution).
3. To explore performance capacity and quality of MCH and HIV related health services.
4. To analyze equity, accessibility and covarage of MCH and ART programs
5. To assess the impact of ART programs on maternal and child morbidity and mortality including the burden of HIV and AIDS.
6. To feedback to policy, decision makers and the DSS communities, the key observations and lessons emerging from the study at key moments.

Methodology

This is an observational study that will monitor and evaluate the actual health impact of the rapid scale-up of ART on the population, building on data from well-definied populations through demographic surveillance surveys. Both qualitative and quantitative analysis will be performed as well as policy analyses, and analyses of human resource requirements and constraints.

Potential impact of the project

While rapidly increasing access to ART is crucial and must proceed in Africa, there is no experience for taking this service to effective and equitable scale and there may be a risk of harming other parts of weak health systems due to resource redistribution.

ARVMAC creates a window of opportunity, in the beginning of the scaling up process to study the health systems effects and adjust ART programs in order to maximize the beneficial impact on maternal and child health.

ARVMAC will therefore provide examples from three different district level health systems in SubSaharan Africa that are highly relevant to national health policy makers as well as global actors such as the EU, the Global Fund and bilateral donors.

Organisational structure

Click image to enlarge or download this attached PPT-file. For more information, contact each partner.

Organisational structure

Workpackages