The USAID/West Africa, Cameroon field office requested a mid-term performance evaluation in 2017 to determine which approaches are best contributing towards the USAID-funded “Continuum of Prevention, Care and Treatment (CoPCT) of HIV/AIDS with Most at-Risk Populations in Cameroon (CHAMP)” program’s purpose to “improve the Government’s and civil society technical capacity to implement evidence-based prevention, care and treatment services to key populations (KPs) in Cameroon,” and the extent to which this program purpose will likely be achieved at the end of the program in 2019. This Executive Summary presents highlights of the evaluation findings and summarized recommendations, followed by the full report which includes further detail.
Review of findings from this mid-term evaluation show that the USAID and PEPFAR-supported CHAMP program has made significant strides in expanding services to key populations in Cameroon over the life of the project to date, despite significant challenges and violence directed towards KPs. While CHAMP’s predecessor program, the USAID HIV/AIDS Prevention Program (HAPP), focused on the provision of prevention services from 2009-2013, CHAMP has since 2014 expanded services across the full cascade from HIV/AIDS prevention to treatment and retention. While HAPP had a relatively small budget under $1 million a year, CHAMP is an $18.5 million program over 5 years, with concurrent scale-up of key populations reached with prevention, testing, linkage to, and retention in treatment in Yaoundé, Douala, and Bamenda city clusters. The Global Fund and PEPFAR are the major donors for KPs in Cameroon and have worked closely to align and harmonize efforts and monitoring approaches, including a joint PEPFAR/Global Fund KP cascade assessment in 2016 that was organized through the LINKAGES project working through CHAMP.
Particularly notable advancements are the introduction of enhanced peer education and mobilization (EPEM) models for outreach and extensive microplanning used to identify new individuals and new networks beyond traditional peer to peer contacts for intensified case finding, and key populations living with HIV (KPLHIV) receive extensive support from peer navigators, counselors and linkage and retention agents in both community-based drop-in-centers (DICs) and in linked referral health facilities providing ART initiation and tertiary care. The drop-in center “one-stop shop” model now has added community based ART dispensation at the DIC, and there has been systematic engagement, collaborative training
and partnership between CHAMP and the Government of the Republic of Cameroon, other PEPFAR agencies including CDC and DOD, and the Global Fund, to reinforce the provision of improved quality services to KPs and to build capacity and coverage and data within the national program. Prevention efforts led by CHAMP and the Global Fund have contributed to a documented decline in HIV prevalence among female sex workers in Cameroon in recent years. Moreover, CHAMP’s research initiatives have produced high-quality data to document the KP epidemics in Cameroon, allowing for far more accurate measurement and tracking of results of prevention, care and treatment approaches.