ArticleBMJ global health2017
Decentralising and integrating HIV services in community-based health systems: a qualitative study of perceptions at macro, meso and micro levels of the health system.
Article in BMJ global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Intervention strategies to improve adherence to treatment for selected chronic conditions in sub-Saharan Africa: a systematic review.Journal of the International AIDS Society · 2024Pooled it
- Barriers and facilitators of rendering HIV services by community health workers in sub-Saharan Africa: a meta-synthesis.Family medicine and community health · 2021Pooled it
- From Accra to America: Putting development first in global health.PLOS global public health · 2026Article
- Community Perspectives on Optimizing Community Health Volunteer Roles for HIV Prevention Services in Kenya and Uganda.AIDS patient care and STDs · 2025Article
- Stakeholder perspectives on the barriers and facilitators to integrating cardiovascular disease and diabetes management at primary care in Kenya.PLOS global public health · 2025Article
- Do targeted intergovernmental fiscal transfers improve health outcomes? Evidence from Kenyan decentralization using the difference-in-differences technique.Health research policy and systems · 2024Article
- Exploring acceptability, opportunities, and challenges of community-based home pregnancy testing for early antenatal care initiation in rural Kenya.BMC public health · 2024Article
- Perspectives on Perioperative Team-Based Morbidity and Mortality Conferences: A Mixed Methods Study.Joint Commission journal on quality and patient safety · 2024Article
- The role of health plans in addressing the opioid crisis: A qualitative study.Journal of substance use and addiction treatment · 2023Article
- Young people's access to sexual and reproductive health prevention services in South Africa during the COVID-19 pandemic: an online questionnaire.BMJ paediatrics open · 2023Article
- Article
- Changes of working conditions and job-related challenges due to the SARS-CoV-2 pandemic for medical assistants in general practices in Germany: a qualitative study.BMC primary care · 2022Article
- "You have a self-testing method that preserves privacy so how come you cannot give us treatment that does too?" Exploring the reasoning among young people about linkage to prevention, care and treatment after HIV self-testing in Southern Malawi.BMC infectious diseases · 2022Article
- Exploring perceived effects from loss of PEPFAR support for outreach in Kenya and Uganda.Globalization and health · 2021Article
- The impact of loss of PEPFAR support on HIV services at health facilities in low-burden districts in Uganda.BMC health services research · 2021Article
- How do decision-makers use evidence in community health policy and financing decisions? A qualitative study and conceptual framework in four African countries.Health policy and planning · 2020Article
- Article
- "The number of clients is increasing but the supplies are reducing": provider strategies for responding to chronic antiretroviral (ARV) medicines stock-outs in resource-limited settings: a qualitative study from Uganda.BMC health services research · 2019Article
- Understanding the persistence of vertical (stand-alone) HIV clinics in the health system in Uganda: a qualitative synthesis of patient and provider perspectives.BMC health services research · 2018Article
- Appraising the value of evidence generation activities: an HIV modelling study.BMJ global health · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHIV services at the community level in Kenya are currently delivered largely through vertical programmes. The funding for these programmes is declining at the same time as the tasks of delivering HIV services are being shifted to the community. While integrating HIV into existing community health services creates a platform for increasing coverage, normalising HIV and making services more sustainable in high-prevalence settings, little is known about the feasibility of moving to a more integrated approach or about how acceptable such a move would be to the affected parties.
methodsWe used qualitative methods to explore perceptions of integrating HIV services in two counties in Kenya, interviewing national and county policymakers, county-level implementers and community-level actors. Data were recorded digitally, translated, transcribed and coded in NVivo10 prior to a framework analysis.
resultsWe found that a range of HIV-related roles such as counselling, testing, linkage, adherence support and home-based care were already being performed in the community in an ad hoc manner. However, respondents expressed a desire for a more coordinated approach and for decentralising the integration of HIV services to the community level as parallel programming had resulted in gaps in HIV service and planning. In particular, integrating home-based testing and counselling within government community health structures was considered timely.
conclusionsIntegration can normalise HIV testing in Kenyan communities, integrate lay counsellors into the health system and address community desires for a household-led approach.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.