Afya I, Improving ART Care Adherence Using Social Norms and Priming

Using a patient- centered design approach that deployed research methodologies to rapidly test approaches to facilitate a  co designing process with end beneficiaries to address the drivers of poor adherence to ART treatment. Finally the project designed an intervention which had two prongs; clinic based and home based.

The clinic-based component was an interactive poster that rewarded appointment attendance. Patients who attended three consecutive on-time visits were congratulated and given a colored sticker to place on a poster that was publicly displayed at the clinic.

We developed two take-home components, first, take-home component was a 2015 calendar in Kiswahili that contained the priming Baobab image and idiom. The calendar contained six images, inspired by the photography exercise, that were confirmed in focus groups to be associated with health, strength, and well-being, such as carrying water, children in school uniforms, farming, and infants. The calendar had the potential secondary benefit of helping people keep track of their appointments. second, take-home component was a small plastic pillbox featuring the Baobab logo and idiom. We hypothesized that a simple pillbox (<$0.50) may alleviate some of the stress associated with inadvertent HIV disclosure, therefore improving adherence. We selected a 4-compartment case (1 3/8″ x 2 3/4″ x 5/8″) that could hold several ART doses (depending on regimen). The pill case could fit in a pocket and was intentionally shaped like a feature phone, another measure to prevent inadvertent disclosure of HIV status.

Results from this intervention indicated that the intervention was associated with better retention in care and potentially a higher proportion of PLHIV achieving MPR≥95% over a short 6-month follow-up period. These promising findings suggest that the application of innovative, low-cost approaches from behavioral economics and psychology, such as social norms and priming, may enhance the HIV care continuum and bolster the effectiveness of ART programs


Sexual & Reproductive Health

Using a patient- centered design approach to facilitate a co designing process with end beneficiaries to address the drivers of poor adherence to ART treatment.

Discover Learning

Developing adolescents in partnership with Save the Children Tanzania, Dalberg, Health for a Prosperous Nation, & supported by Bill & Melinda Gates Foundation.

Afya II, Improving ART care adherence

This project tests the known fact that financial incentives and food security can motivate behavior change and improve outcomes along the HIV care continuum.