ArticleBMC health services research2017
Identifying models of HIV care and treatment service delivery in Tanzania, Uganda, and Zambia using cluster analysis and Delphi survey.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04298905 (Leveraging mHealth to Enable and Adapt Community Health Worker Strategies to Improve TB/HIV Patient Outcomes in South Africa), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Leveraging mHealth to Enable and Adapt Community Health Worker Strategies to Improve TB/HIV Patient Outcomes in South Africa (LEAP-TB-SA) Trial
Who cites it
11 citing papers in PubMed.
- Applying a Three-Tier Approach to Address Gaps in Oral Pre-Exposure Prophylaxis Uptake and Continuity in Uganda: A Mixed Methods Approach.Global health, science and practice · 2024Article
- Use of genotypic HIV DNA testing: a DELPHI-type consensus.The Journal of antimicrobial chemotherapy · 2024Article
- Advanced HIV disease and health-related suffering-exploring the unmet need of palliative care.The lancet. HIV · 2023Review
- Task shifting healthcare services in the post-COVID world: A scoping review.PLOS global public health · 2023Article
- HIV care and treatment models and their association with medication possession ratio among treatment-experienced adults in three African countries.Tropical medicine & international health : TM & IH · 2021Article
- Hypertension care cascade at a large urban HIV clinic in Uganda: a mixed methods study using the Capability, Opportunity, Motivation for Behavior change (COM-B) model.Implementation science communications · 2021Article
- Clinical management of ageing people living with HIV in Europe: the view of the care providers.Infection · 2020Article
- Reimagining the role of the nursing workforce in Uganda after more than a decade of ART scale-up.Human resources for health · 2020Article
- A Qualitative Assessment of Provider and Client Experiences With 3- and 6-Month Dispensing Intervals of Antiretroviral Therapy in Malawi.Global health, science and practice · 2020Article
- Differentiated models of service delivery for antiretroviral treatment of HIV in sub-Saharan Africa: a rapid review protocol.Systematic reviews · 2019Article
- Integration of Early Infant Diagnosis of HIV Services Into Village Health Clinics in Ntcheu, Malawi: An Exploratory Qualitative Study.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundOrganization of HIV care and treatment services, including clinic staffing and services, may shape clinical and financial outcomes, yet there has been little attempt to describe different models of HIV care in sub-Saharan Africa (SSA). Information about the relative benefits and drawbacks of different models could inform the scale-up of antiretroviral therapy (ART) and associated services in resource-limited settings (RLS), especially in light of expanded client populations with country adoption of WHO's test and treat recommendation.
methodsWe characterized task-shifting/task-sharing practices in 19 diverse ART clinics in Tanzania, Uganda, and Zambia and used cluster analysis to identify unique models of service provision. We ran descriptive statistics to explore how the clusters varied by environmental factors and programmatic characteristics. Finally, we employed the Delphi Method to make systematic use of expert opinions to ensure that the cluster variables were meaningful in the context of actual task-shifting of ART services in SSA.
resultsThe cluster analysis identified three task-shifting/task-sharing models. The main differences across models were the availability of medical doctors, the scope of clinical responsibility assigned to nurses, and the use of lay health care workers. Patterns of healthcare staffing in HIV service delivery were associated with different environmental factors (e.g., health facility levels, urban vs. rural settings) and programme characteristics (e.g., community ART distribution or integrated tuberculosis treatment on-site).
conclusionsUnderstanding the relative advantages and disadvantages of different models of care can help national programmes adapt to increased client load, select optimal adherence strategies within decentralized models of care, and identify differentiated models of care for clients to meet the growing needs of long-term ART patients who require more complicated treatment management.
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