scholarly journals Social Networks and Barriers to ART Adherence Among Young Adults (18–24 years) Living with HIV at Selected Primary Health Facilities of South-Western Uganda: A Qualitative Study

2021 ◽  
Vol Volume 13 ◽  
pp. 939-958
Author(s):  
Noble Ajuna ◽  
Brian Tumusiime ◽  
Joseph Amanya ◽  
Sharon Awori ◽  
Godfrey Rukundo ◽  
...  
Keyword(s):  
Social Networks ◽  
Young Adults ◽  
Qualitative Study ◽  
Health Facilities ◽  
Art Adherence ◽  
Primary Health ◽  
Living With Hiv ◽  
Western Uganda ◽  
Primary Health Facilities

scholarly journals Improving Tanzanian childbirth service quality

2018 ◽  
Vol 31 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Jennie Jaribu ◽  
Suzanne Penfold ◽  
Cathy Green ◽  
Fatuma Manzi ◽  
Joanna Schellenberg
Keyword(s):  
Health Facility ◽  
Low Income ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Rural District ◽  
Local Data ◽  
Content Type ◽  
Primary Health ◽  
Primary Health Facilities ◽  
Childbirth Care

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

scholarly journals “How am I going to live?”: exploring barriers to ART adherence among adolescents and young adults living with HIV in Uganda

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Sarah MacCarthy ◽  
Uzaib Saya ◽  
Clare Samba ◽  
Josephine Birungi ◽  
Stephen Okoboi ◽  
...  
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Art Adherence ◽  
Living With Hiv

scholarly journals Call For Life, Uganda: Acceptability Of A Mobile Phone Support To Promote Adherence To Anti-Retroviral Therapy For Young Adults In A Randomised Control Trial: A Qualitative Review (Preprint)

2019 ◽  
Author(s):  
Agnes Bwanika Naggirinya
Keyword(s):  
Human Immunodeficiency Virus ◽  
Young Adults ◽  
Mobile Phone ◽  
Interactive Voice Response ◽  
Text Messages ◽  
Randomised Control Trial ◽  
People Living With Hiv ◽  
Art Adherence ◽  
Immunodeficiency Virus ◽  
Living With Hiv

BACKGROUND : Adherence to treatment is critical to obtain successful treatment outcomes. While factors influencing antiretroviral therapy (ART) adherence vary, young adults are less likely to adhere because of psychosocial issues such as stigma, ART-related side effects as well as lack of access to treatment. Call for Life mHealth tool (C4LU), is a mobile phone- based technology that provides text messages or Interactive Voice Response (IVR) functionalities, through a web-interface and offers four modules including pill reminders, clinic visit reminders, health tips and symptom self-reporting support. Within a randomised control trial, we assessed perspectives and experiences of young adults living with human immunodeficiency virus towards the C4LU- system, with the objective to improve ART adherence among young people living with HIV with help of mHealth tool. OBJECTIVE To improve ART adherence among young people living with HIV through use of mHealth tool. METHODS This was an exploratory qualitative design at two study sites nested within an open label randomized controlled trial (RCT) entitled: “Improving outcomes in human immunodeficiency virus (HIV) patients using mobile phone based interactive software support “Call for Life study A total of 600 participants were randomly assigned 1:1 to either Standard of Care (SoC)- face-to-face counsellor adherence support or SoC plus mHealth call for life system (C4LU). C4LU uses Interactive voice response or text messages delivered via mobile phone. The qualitative study explored perspectives and experiences of young adults (18-24 years) towards the mHealth tool “C4LU”. A purposive sample of twenty-one vulnerable youth, seventeen from the intervention and four from the SoC arm were selected. We used semi-structured interviews to facilitate an in-depth exploration of experiences of young adults regarding C4LU-System. Thirteen in-depth interviews and one focus group discussion were conducted. The young adults were from four categories of population of interest that were targeted to be offered specialised care: young adults on PMTCT, switching to / or on second line ART, positive partners in a discordant relationship and initiating 1st line ART. Data was managed using Nvivo version 11 and analysed thematically. RESULTS C4LU-mHealth tool was perceived as an acceptable intervention for young adults. While on the system, participants reported: improvement in medication adherence, strengthened doctor /clinician -patient relationships, increased health knowledge through educative health tips. Appointment reminders and symptom reporting were singled out as beneficial because the system would address and manage the problems of forgetfulness, and stigma related issues. CONCLUSIONS The system was described as an acceptable and feasible strategy to improve ART adherence and retention among young adults in resource limited settings CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT 02953080

scholarly journals Heterogeneity in Average Cost per Patient with type 2 Diabetes at Primary Health Facilities in Mexico: Comparing Comprehensive Diabetes Management Medical Offices with General Practice

2020 ◽  
Author(s):  
M. Arantxa Colchero ◽  
Rousellinne Gómez ◽  
Ruy López-Ridaura ◽  
Daniel López-Hernández ◽  
Iyari Sánchez-Díaz ◽  
...  
Keyword(s):  
General Practice ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Unit Cost ◽  
Health Facilities ◽  
Patient Knowledge ◽  
Factors Associated ◽  
Unit Costs ◽  
Primary Health ◽  
Primary Health Facilities

Abstract Background. Despite the high health and financial burden imposed by diabetes in Mexico, few studies have estimated the cost per patient treated. The objective of this study was to estimate the average annual cost per patient (unit cost) with diabetes among 60 primary health facilities in Mexico comparing comprehensive diabetes management medical offices (MIDE) and those from general practice (Non-MIDE). Methods. We described the variation in unit costs across these two types of medical offices and explored factors associated. Unit costs were the sum of staff, medications, laboratory tests, and equipment. We show descriptive statistics to analyze the heterogeneity of unit costs, and the distribution of total costs by input and the distribution of staff costs by personnel all by medical office. We estimated a multivariate linear regression model to explore factors associated with the unit costs. Results. Unit costs vary from $267.2 USD in Non-MIDE offices to $410.6 for MIDE. Unit costs were negatively associated with scale, Non-MIDE offices, medical competence, patient knowledge of diabetes and positively associated with comorbidities. Conclusions. Results from this study might help design more efficient programs for diabetes care in primary health facilities to reduce the burden of diabetes in the system. Investing in staff training and educational interventions to increase patient knowledge of diabetes could be promising interventions to reduce diabetes care costs in primary care settings.

scholarly journals Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Robin Altaras ◽  
Anthony Nuwa ◽  
Bosco Agaba ◽  
Elizabeth Streat ◽  
James K. Tibenderana ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Rural Health ◽  
Health Workers ◽  
Rapid Test ◽  
Health Facilities ◽  
Test Results ◽  
Western Uganda

The Beat Goes On: Stimulant Use and HIV in the Era of COVID-19 (Preprint)

2021 ◽  
Author(s):  
Mariya Petrova ◽  
Michael Miller-Perusse ◽  
Sabina Hirshfield ◽  
Adam Carrico ◽  
Keith Horvath
Keyword(s):  
Data Analysis ◽  
Antiretroviral Therapy ◽  
Qualitative Study ◽  
Vulnerable Populations ◽  
Art Adherence ◽  
Racially Diverse ◽  
Differential Impact ◽  
Stimulant Use ◽  
Virtual Focus Groups ◽  
Living With Hiv

UNSTRUCTURED This qualitative study identified how coronavirus pandemic has affected stimulant use and antiretroviral therapy (ART) adherence among a sample of MSM living with HIV (LWH). Twelve ethnically/racially diverse men over the age of 25 participated in two virtual focus groups. A general inductive approach was used to analyze the data. Analysis revealed that the COVID-19 pandemic had different effects on stimulant use and ART adherence for men LWH who use stimulants. Results showcase that the COVID-19 pandemic is having differential impact on MSM’s stimulant use and ART adherence and highlight the need for comprehensive support to vulnerable populations.

scholarly journals The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 290
Author(s):  
Khabo Mahlangu ◽  
Perpetua Modjadji ◽  
Sphiwe Madiba
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Nutritional Status ◽  
Health Facilities ◽  
The Body ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.

scholarly journals Implementing standard antenatal care interventions: health system cost at primary health facilities in Tanzania

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Amisa Tindamanyile Chamani ◽  
Amani Thomas Mori ◽  
Bjarne Robberstad
Keyword(s):  
Standard Model ◽  
Antenatal Care ◽  
Health System ◽  
Health Facilities ◽  
System Cost ◽  
Primary Health ◽  
Health System Cost ◽  
The Standard Model ◽  
Health Centres ◽  
Primary Health Facilities

Abstract Background Since 2002, Tanzania has been implementing the focused Antenatal Care (ANC) model that recommended four antenatal care visits. In 2016, the World Health Organization (WHO) reintroduced the standard ANC model with more interventions including a minimum of eight contacts. However, cost-implications of these changes to the health system are unknown, particularly in countries like Tanzania, that failed to optimally implement the simpler focused ANC model. We compared the health system cost of providing ANC under the focused and the standard models at primary health facilities in Tanzania. Methods We used a micro-costing approach to identify and quantify resources used to implement the focused ANC model at six primary health facilities in Tanzania from July 2018 to June 2019. We also used the standard ANC implementation manual to identify and quantify additional resources required. We used basic salary and allowances to value personnel time while the Medical Store Department price catalogue and local market prices were used for other resources. Costs were collected in Tanzanian shillings and converted to 2018 US$. Results The health system cost of providing ANC services at six facilities (2 health centres and 4 dispensaries) was US$185,282 under the focused model. We estimated that the cost would increase by about 90% at health centres and 97% at dispensaries to US$358,290 by introducing the standard model. Personnel cost accounted for more than one third of the total cost, and more than two additional nurses are required per facility for the standard model. The costs per pregnancy increased from about US$33 to US$63 at health centres and from about US$37 to US$72 at dispensaries. Conclusion Introduction of a standard ANC model at primary health facilities in Tanzania may double resources requirement compared to current practice. Resources availability has been one of the challenges to effective implementation of the current focused ANC model. More research is required, to consider whether the additional costs are reasonable compared to the additional value for maternal and child health.

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