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Most high HIV-prevalence countries in sub-Saharan Africa and elsewhere have scaled up different approaches to providing antiretroviral treatment (ART) for HIV that are tailored to specific groups of patients. Expectations for \u201cdifferentiated service delivery models\u201d (DSD) 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 have been tried and evaluated, there is still little evidence available on the big picture\u2014the 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.<\/p>\n
AMBIT was a multi-year research and evaluation project in sub-Saharan Africa launched in September 2018 and supported by the Bill & Melinda Gates Foundation, with a focus on South Africa, Malawi, and Zambia. It was implemented by the\u00a0<\/span>Health Economics and Epidemiology Research Office (HE2<\/sup>RO)<\/a>\u00a0<\/span>in South Africa, the Boston University School of Public Health in the U.S<\/a>., and the\u00a0<\/span>Clinton Health Access Initiative (CHAI)<\/a>\u00a0<\/span>in Malawi and Zambia. The project included data synthesis, data collection, data analysis, and modeling activities aimed at generating information for near- and long-term decision making and creating an approach and platform for ongoing evaluation. Activities include literature reviews, analysis of retrospective data and implementation reports, cost estimates, surveys, modeling, and primary data collection and analysis. Its overall goal was to evaluate the impact of DSD models for HIV treatment, including coverage, uptake, costs, and benefits for patients, providers, and health systems. The first phase of the project, AMBIT 1.0, was completed in 2022; the second phase, AMBIT 2.0, was completed in 2025.<\/p>\n