Project Objectives

Most high HIV-prevalence countries in sub-Saharan Africa and elsewhere are experimenting with and scaling up targeted service delivery approaches, or “differentiated models of care,” for providing antiretroviral treatment (ART) for HIV. Hopes for such approaches include better access to and outcomes of treatment for patients, increased clinic capacity and quality, and lower costs for providers and patients. Although many specific models of care are being evaluated, there is little evidence available on the “big picture”—the proportion of clinics offering alternative models, eligibility criteria, numbers of patients eligible under those criteria, number of patients actually participating, program-wide outcomes, resource utilization and costs compared to traditional care, fidelity to guidelines, financial sustainability, and other system-wide indicators.

AMBIT’s five main components address COVERAGE (current extent of alternative model implementation); ALLOCATION (development of a mathematical model to optimize distribution of alternative models at national level); BENEFITS AND COSTS (empirical estimates of the overall potential costs and benefits of large-scale adoption of alternative models in the focus countries); GAPS (limited primary research in the focus countries to strengthen the evidence base); and PARTNERSHIPS AND DISSEMINATION (integration of AMBIT with other related projects, establishment of partnerships, and widespread dissemination of results).