Duke University and the Clinton Health Access Initiative (CHAI), in partnership with the
Ministries of Health (MoH) of Ghana, Malawi, Rwanda, Zambia, and Zimbabwe, aim to assess
the implementation and impact of COVID-19 test -and -treat (T&T) demonstration programs,
titled "COVID-19 Quick Start Program". The MoHs in collaboration with CHAI will implement
SARS-CoV-2 antigen testing programs linked to patient triage and initiation of eligible
patients on a complete course of oral antivirals for COVID-19. The eligibility criteria
and treatment regimens/duration may vary by country and over time depending on changes to
guidelines.

This mixed method study will leverage data from three independent data collection
activities to guide implementation:

1. Programmatic monitoring: A formative evaluation of the implementation of test and
treat (T&T) programs to identify implementation gaps and help implementers make
evidence-based decisions and course-correct as needed.

2. Collection of retrospective, patient-level data from treatment facility registers to
understand impact of T&T implementation on testing and treatment initiation rates,
as well as costs of treatment initiation for cost modeling.

3. Qualitative Semi-structured interviews with key stakeholders including MoH and
public sector personnel, healthcare workers, and patients to understand the
feasibility and acceptability of the program.

Data from this operational research study will help to ensure optimized delivery of T&T
programs in low- and middle-income countries as the availability of therapeutics for
COVID-19 scales up globally.