Written by Meghan DiCarlo, Deputy Director – Program Acceleration, LINKAGES, and Lirica Nishimoto, Program Officer, LINKAGES


Caribbean acceleration
Caribbean Regional Acceleration Workshop 2017

When the USAID– and PEPFAR-supported LINKAGES project first started in June 2014, we expected a handful of countries to buy in to the global mechanism dedicated to meeting the HIV prevention, care, and treatment needs of key populations (KPs).  However, almost immediately, the demand exceeded our expectations. USAID missions in seven countries bought in to LINKAGES in the first six months, and in just over a year, LINKAGES was working in 19 countries! The exponential growth of the program across Africa, Latin America and the Caribbean, and Southeast Asia required us to re-evaluate how we could successfully deliver high-quality KP programming across such a large swath of countries, with more being added by the day.  We did not want to have disjointed country programs of varying quality. We wanted each program to be delivered efficiently and tailored to local context, but grounded in the critical, evidence-based elements of KP programming. As a global mechanism, we had a unique opportunity and an obligation to support countries to scale up quality KP programming that would achieve results.

Our answer was the program acceleration (acceleration) initiative, which was launched in December 2015. The goal of this initiative is to accelerate and strengthen service delivery for KPs at scale by providing training, capacity development, mentoring, and knowledge exchange to in-country LINKAGES staff, local implementing partners, and staff from ministries of health. One of the first steps we took under the acceleration initiative was to develop a common core KP program and guide to serve as the initiative’s foundation. The common core includes information on seven key program areas based on global guidance:

  • Engage key populations in population size estimation, mapping, and program planning
  • Key population empowerment and engagement in programs
  • Structural interventions
  • Peer outreach
  • Clinical services
  • Program management
  • Monitoring and data use

Next, we trained a core group of expert technical assistance providers and country implementers on the common core program and set up frequent, rapid, and targeted technical assistance to support countries in implementing high-quality KP programming.

Botswana acceleration
LINKAGES Botswana presents on the coupon system at the 2017 Africa Region Acceleration Workshop.

It has been almost two years since the acceleration initiative was established. Implemented in 17 countries to date, the initiative has been successfully supporting local staff and partners to deliver a comprehensive package of health services at speed, scale (within and across countries), and according to standards (a common core program).

We have documented the achievements and lessons from acceleration in two new resources. For more on how to rapidly deliver and scale up quality KP programming, see Accelerating the Implementation and Scale-up of Comprehensive Programs for HIV Prevention, Diagnosis, Treatment, and Care for Key Populations and Acceleration Country Success Stories.