ArticleGlobal health research and policy2018
Understanding the dynamic interactions driving the sustainability of ART scale-up implementation in Uganda.
Article in Global health research and policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Health worker perspectives on, and health system-level facilitators and barriers to early infant male circumcision for HIV prevention in a traditionally non-circumcising community, Northeastern Uganda: a cross-sectional qualitative study.BMC health services research · 2025Article
- Understanding Uganda's early adoption of novel differentiated HIV treatment services: a qualitative exploration of drivers of policy uptake.BMC health services research · 2023Article
- Identification of Key Components in Health System Using System Thinking Approach: A Scoping Review.Medical journal of the Islamic Republic of Iran · 2023Article
- Strategies to adapt and implement health system guidelines and recommendations: a scoping review.Health research policy and systems · 2022Article
- Transitioning health workers from PEPFAR contracts to the Uganda government payroll.Health policy and planning · 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
- Reimagining the role of the nursing workforce in Uganda after more than a decade of ART scale-up.Human resources for health · 2020Article
- Understanding implementation barriers in the national scale-up of differentiated ART delivery in Uganda.BMC health services research · 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
- Assessing the level of institutionalization of donor-funded anti-retroviral therapy (ART) programs in health facilities in Uganda: implications for program sustainability.Global health action · 2018Article
- Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption.Global public healthArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundDespite increasing recognition that health-systems constraints are the fundamental barrier to attaining anti-retroviral therapy (ART) scale-up targets in Sub-Saharan Africa, current discourses are dominated by a focus on
methodsThis study entailed qualitative organizational case-studies within a two-phased mixed-methods sequential explanatory research design. In Phase One, a survey of 195 health facilities across Uganda which commenced ART services between 2004 and 2009 was conducted. In Phase Two, six health facilities were purposively selected for in-depth examination involving i) In-depth interviews
resultsFive dynamic interactions in ART program sustainability drivers were identified; i) Failure to update basic ART program records contributed to chronic ART medicines stock-outs ii) Health workforce shortages and escalating patient volumes prompted adaptations in ART service delivery models iii) Broader governance issues manifested in poor road networks undermined ART medicines supply chains iv) Sustained financing for ART programs was influenced by external donors v) The values associated with the ownership-type of a health facility affected ART service delivery and coverage.
conclusionThe sustainability of ART programs at the facility-level in Uganda is a function of a complex interaction in elements of the health system and must be understood beyond sustaining international funding for ART scale-up
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