Evidence map›Paper›PMID 36206224›Full record

ReviewPloS one2022

Health system opportunities and challenges for PrEP implementation in Kenya: A qualitative framework analysis.

Kaitlyn Atkins, Abednego Musau, Mary Mugambi, Geoffrey Odhyambo, Soud Ali Tengah, Mercy Kamau, Ruth Kumau, Jason Reed, Daniel Were

Abstract readReview
In one paragraph

Review in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kaitlyn AtkinsSocial and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID 0000-0001-8302-542X
Abednego MusauJhpiego Kenya, Nairobi, Kenya.
Mary MugambiNational AIDS Control Program, Kenya Ministry of Health, Nairobi, Kenya.ORCID 0000-0002-3684-7161
Geoffrey OdhyamboJhpiego Kenya, Nairobi, Kenya.
Soud Ali TengahJhpiego Kenya, Nairobi, Kenya.
Mercy KamauJhpiego Kenya, Nairobi, Kenya.
Ruth KumauJhpiego Kenya, Nairobi, Kenya.
Jason ReedJhpiego Corporation, Baltimore, Maryland, United States of America.
Daniel WereJhpiego Kenya, Nairobi, Kenya.ORCID 0000-0002-6538-002X

Funding

The Brown Initiative in HIV and AIDS Clinical Research for Minority CommunitiesR25MH083620 · NIMH · MIRIAM HOSPITAL · PI NUNN, AMY STEWART · 2008 to 2025
$3.7M
Intersectional Stigma and Pre-Exposure Prophylaxis Continuation among Female Sex Workers in NamibiaF31MH124583 · NIMH · JOHNS HOPKINS UNIVERSITY · PI ATKINS, KAITLYN M · 2020 to 2022
$81k
Bill & Melinda Gates Foundation INV-007340NIMH NIH HHS F31 MH124583
6 · The paper itself

Abstract

backgroundAs pre-exposure prophylaxis (PrEP) scales up in sub-Saharan Africa, governments and implementers need to understand how to best manage national programs. Kenya's national PrEP program offers an opportunity to review elements of program success within the health system and evaluate the utility of a national implementation framework. We explored health system considerations for PrEP implementation to understand how Kenya's national PrEP implementation priorities align with those of PrEP service providers, peer educators, and program or county managers.

methodsWe conducted twelve key informant interviews (KII) and nine focus group discussions (FGDs) with PrEP program and county managers (n = 12), peer educators (n = 44), and PrEP service providers (n = 48). We recruited participants across a variety of cadres and experiences with PrEP programs. KIIs and FGDs focused on PrEP service delivery and program implementation. Data were collected by trained study staff, audio recorded, translated into English, and transcribed. We used framework analysis methods to systematically apply Kenya's 2017 National PrEP Implementation Framework to the data and summarized findings according to the seven Implementation Framework domains.

resultsAll respondents emphasized the important role of communication, coordination, training, and leadership in PrEP implementation. PrEP service providers and program and county managers highlighted the importance of efficient data collection and utilization, and improved resource allocation. Commodity security and research, while key elements of the PrEP Implementation Framework, were less commonly discussed, and research was less prioritized by respondents. Respondents highlighted the importance of coordinated PrEP service delivery across sites and programs to improve overall client experiences.

conclusionIn the context of a nationally-scaled PrEP program, PrEP service providers, peer educators, and program and county managers value strong leadership, close coordination of services across sites, and expedient use of data to improve strategies and services. Kenya's PrEP Implementation Framework aligns closely with the priorities of individuals involved in PrEP service delivery and management, and provides a comprehensive overview of health system considerations for effective implementation of a PrEP program at scale.

Indexed as

Anti-HIV AgentsHIV InfectionsPre-Exposure ProphylaxisFocus GroupsGovernment ProgramsHumansKenyaMedical AssistanceAnti-HIV Agents

Identifiers

PMID36206224
PMCPMC9543691

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.