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Human-centered design of an adapted differentiated service delivery model for pregnant and postpartum women living with HIV in Kenya

Bibliographic Data

ID19442337
AuthorsJohn Humphrey (0000-0003-3156-1065, Indiana University School of Medicine, corresponding author), Bett Kipchumba (0000-0003-3587-1917, Moi University School of Medicine), James G Carlucci (0000-0002-3969-8544, Indiana University School of Medicine), Roselyne Midiwo (AMPATH), Edwin Were (0000-0002-4783-0795, Moi University School of Medicine), Alan B McGuire (Health Services Research & Development), Alan McGuire (Indiana University-Purdue University), Julia Songok (0000-0002-6431-0505, Moi University School of Medicine), Winstone Nyandiko (0000-0002-7639-9287, Moi University School of Medicine), Gregory Zimet (Indiana University School of Medicine), Gregory D Zimet (0000-0003-3835-937X, University School), Kara Wools-Kaloustian (Indiana University School of Medicine), Violet Naanyu (0000-0003-0182-1719, Moi University School of Arts and Social Science)
Year2025
Volume37
Issue9
Pages1434-1449
Publication date2025-09-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2025.2485397
PMID40168585
OpenAlexW4409119199
LanguageEN
Citations received1
References cited17

Differentiated service delivery (DSD) models for pregnant and postpartum women living with HIV (WLH) are lacking despite guidelines recommending DSD for this population. We used human-centered design (HCD) to develop a DSD model for pregnant and postpartum WLH at the Academic Model Providing Access to Healthcare (AMPATH) in Kenya. We conducted co-creation workshops with 11 postpartum women, 9 male partners and 9 providers from three AMPATH-affiliated facilities to develop a DSD model, refined by program/county health officials. The workshops used WHO building blocks for DSD to determine eligibility criteria and strategies for clinical encounters, antiretroviral therapy (ART) distribution, and psychosocial support. We used nominal group techniques and thematic analyses to identify DSD attributes, themes and preference heterogeneity. Workshops yielded a facility-based DSD model with these attributes: eligibility criteria including age ≥18 years, not primigravida, retention in care, viral load <50 copies/mL, no active maternal/child comorbidities; monthly clinical encounters during pregnancy and 6 months postpartum, then every 2-3 months aligned with immunization/HIV testing schedules; flexible ART refills every 1-6 months; psychosocial counseling by mentor mothers as needed. This model was acceptable to stakeholders with perceived feasibility/scalability. Engaging end-users through HCD generated a person-centered DSD model for integrated MCH clinics in Kenya

Biology · Business · Environmental health · Family medicine · Population · Postpartum period · Pregnancy · Program evaluation · Psychiatry · Psychosocial · Qualitative research · Service delivery framework · Thematic analysis · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology

  • Perspectives on enhancing peer support services for mothers living with HIV in Kenya

    Open Access•James G Carlucci, Rosa Chemwey Ndiema et al.•PLOS Global Public Health•2026

  • The Adapt-ITT Model

    Gina M Wingood, Ralph J Diclemente•JAIDS Journal of Acquired Immune…•2008

  • Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis

    Open Access•Beck Taylor, Catherine Henshall et al.•BMJ Open•2018

  • A refined compilation of implementation strategies

    Open Access•Byron J Powell, Thomas J Waltz et al.•Implementation Science•2015

  • Improving the reporting of health research involving design

    Open Access•Alessandra N Bazzano, Shirley D Yan et al.•BMJ Global Health•2020

  • A qualitative study of the barriers and enhancers to retention in care for pregnant and postpartum women living with HIV

    Open Access•John Humphrey, Danièle Maubon et al.•PLOS Global Public Health•2021

  • Differentiated HIV care in sub-Saharan Africa

    Jill M Hagey, Xuan Li et al.•AIDS Care•2018

  • High HIV prevalence predicts less HIV stigma

    Hongfei Du, Peilian Chi et al.•AIDS Care•2018

  • Investigating the implementation of differentiated HIV services and implications for pregnant and postpartum women

    Open Access•Rujeko Samanthia Chimukuche, Alison Wringe et al.•Global Public Health•2020

  • Retention in care and viral suppression in the PMTCT continuum at a large referral facility in western Kenya

    Open Access•John Humphrey, Julia Songok et al.•AIDS and Behavior•2022

Unique citing works1
Citations per year1
Citation span2026 - 2026 (1)
Citation velocitycurrent
Highly citedNo
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