{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:14:02Z","timestamp":1788459242158,"version":"build-2803163510"},"reference-count":76,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite major progress in HIV epidemic control, children in sub-Saharan Africa, particularly in Malawi, continue to experience poorer HIV outcomes than adults. While Malawi has made substantial progress toward the UNAIDS 95-95-95 targets, only 55% of children living with HIV are virally suppressed compared with 87% of adults. This study aims to identify and develop strategies to improve children`s access to HIV services in Malawi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Guided by the Socio-Ecological Model and the HIV care cascade framework, this multi-method study comprises four sub-studies: (1) secondary analysis of national HIV program data and spectrum estimates (2012\u20132023) to assess trends and progress toward the 95-95-95 targets; (2) a scoping review of health system interventions that improve paediatric HIV service access in sub-Saharan Africa (2015\u20132025). (3) a modified e-Delphi process with 15\u201330 experts to develop a context-appropriate intervention package and (4) a feasibility and acceptability assessment of the package at Kabudula Community Hospital, Lilongwe, Malawi, involving healthcare workers, community health workers, and caregivers using questionnaires and qualitative interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Ethical considerations<\/jats:title>\n                    <jats:p>Ethical approval will be obtained from Stellenbosch University Health Research Ethics Committee (HREC) and the Malawi National Health Sciences Research Ethics Committee. Written informed consent and confidentiality will be ensured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study will identify gaps in HIV care access among children, synthesize evidence on effective interventions, and develop a feasible, context-specific intervention package to strengthern children`s access to HIV services and accelerate Malawi`s progress toward achieving UNAIDS 95-95-95 targets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357408","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:25:21Z","timestamp":1788456321000},"page":"e0357408","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating strategies to enhance access to HIV services among children in Malawi: A multifaceted research approach, study protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1202-0524","authenticated-orcid":true,"given":"Bilaal Wilson","family":"Matola","sequence":"first","affiliation":[{"name":"Stellenbosch University","place":["Stellenbosch, South Africa"],"department":["Division of Health Systems and Public Health"]},{"name":"Ministry of Health","place":["Lilongwe, Malawi"],"department":["Department of HIV, STIs and Viral Hepatitis"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-6302","authenticated-orcid":true,"given":"Juliet Charity Yauka","family":"Nyasulu","sequence":"additional","affiliation":[{"name":"Stellenbosch University","place":["Stellenbosch, South Africa"],"department":["Division of Health Systems and Public Health"]},{"name":"AFRIQUIP, Health Systems Strengthening","place":["Johannesburg, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Nicol","sequence":"additional","affiliation":[{"name":"Stellenbosch University","place":["Stellenbosch, South Africa"],"department":["Division of Health Systems and Public Health"]},{"name":"South Africa Medical Research Council","place":["Cape Town, South Africa"],"department":["Burden of Disease Research Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"pone.0357408.ref001","unstructured":"Unaids. 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