Community-Led Research

Missing the Target (MTT)

Missing the Target (MTT) is a community-led research report series that seeks to contributes a unique perspective to global health advocacy. Rather than waiting to get the attention of outside researchers or development institutions, the MTT model puts the power in the hands of affected communities to document their issues. The model is unique in empowering communities affected by HIV to develop research methodology and undertake community-led research. As a result, critical gaps in the HIV response are exposed earlier and people empowered to advocate for relevant solutions.
MTT is part of ITPC’s Watch What Matters campaign, a community monitoring and research initiative to gather data on access to, and quality of HIV treatment globally. Watch What Matters aims to streamline and standardize treatment access data that communities collect. Watch What Matters helps to empower communities to systematically collect and analyse qualitative and quantitative data, analyse it and use it to guide advocacy and promote accountability.
To date, there have been 12 reports developed under the MTT. Here are some of our previous reports:

Global Treatment Survey

The changing context in HIV care created by the 2015 WHO “treat all” guidelines and the implementation and expansion of innovative policies (e.g. differentiated service delivery and decentralization which promote community delivery of ART) have reshaped the access to HIV care environment. These recent changes demonstrate the need to update current knowledge about access to HIV care and its related barriers among both recipients of care and health care providers. To this end, ITPC developed the Global Treatment Survey to assess the state of access to quality HIV treatment and document the barriers along the HIV care cascade. These barriers will be documented from both the demand side (i.e. PLHIV) and the supply side (i.e. health care provider) perspectives. Accordingly, this study has the following three sub-objectives:
  • Measuring access to each step of the care cascade among PLHIV;
  • Identifying barriers to each step of the care cascade experienced among PLHIV;
  • Describing the challenges encountered by health care workers and other stakeholders involved in HIV care.
We conducted a mixed-method study using one quantitative survey and one qualitative survey. The quantitative survey evaluated access and barriers related to the HIV care cascade among PLHIV whereas the qualitative survey described challenges encountered by PLHIV in accessing care and health care workers in delivering HIV care.

mHealth

Although over half of the people living with HIV have access to antiretroviral therapy (ART), nearly a million of them died in 2017. AIDS-related deaths are on the rise in the Middle East and North Africa (MENA) region, and have not decreased in the Eastern Europe and Central Asia (EECA) region. In 2017, 59% of all HIV-positive people were accessing ART, but glaring – and deadly – regional disparities persisted: coverage was unacceptably low in the MENA region at 29%; it was only 36% in the EECA region, and just 40% in the Central and West Africa region. Even in South Asia, Latin America and the Caribbean, where ART coverage is higher, HIV prevention and treatment are clearly not reaching key and ISPs, who account for nearly half of 2017’s 1.8 million new infections.

It is within this context that ITPC’s treatment access agenda still remains relevant. While interventions that drive demand creation and promote quality treatment access are necessary (i.e. community education, advocacy, evidence-gathering, etc), innovative solutions are also essential to eliminate persistent barriers and promote better health outcomes among people living with HIV.

In 2018, ITPC undertook work to assess barriers that recipients of care often encounter in accessing HIV services and treatment, and recommend potential mHealth solutions. ITPC used a participatory approach to execute this assignment, to ensure that the voice and solutions of the community were integral in the development of this report. It is critical that ROCs should be at the center of not only identifying the issues, but being part of the solution development.

A four-step approach was used to undertake this work:

  • Literature review and landscape audit of existing mHealth initiatives
  • Needs assessment surveys (online survey and focus group discussions)
  • Data analysis
  • Report and product development plan

The findings of this work were published in a full report in 2019.

See ITPC’s full mHealth Strategy Report here.