Evidence map›Paper›PMID 39123198›Full record

ArticleBMC health services research2024

Strategies for scaling up pre-ART advanced HIV disease screening at a secondary referral hospital-Malawi: a qualitative study.

Brany Mithi, Evanson Z Sambala, Agatha Bula, Ziliro Jere, Emily Kumilonde, Grant Gondwe, Marion M Chikuse, Simion Manda, Adamson S Muula

Abstract read
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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Brany MithiDiagnostic Department, Rumphi District Hospital, Rumphi, Malawi. branytitus@gmail.com.
Evanson Z SambalaDepartment of Public Health, School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi.
Agatha BulaUniversity of North Carolina (UNC) Project -Malawi, Lilongwe, Malawi.
Ziliro JereDepartment of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Emily KumilondeClinical Department, Ntcheu District Hospital, Ntcheu, Malawi.
Grant GondweDiagnostic Department, Rumphi District Hospital, Rumphi, Malawi.
Marion M ChikuseRight To Care - Malawi, Mzuzu, Malawi.
Simion MandaART Department, Rumphi District Hospital, PO BOX 225, Rumphi, Malawi.
Adamson S MuulaDepartment of Public Health, School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi.

Funding

Malawi HIV Implementation Research Scientist Training Program (MHIRST)D43TW010060 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MINA CHRISTINE HOSSEINIPOUR, Victor Mwapasa · 2015 to 2026
$3.8M
FIC NIH HHS D43 TW010060
6 · The paper itself

Abstract

backgroundImplementation of the World Health Organization (WHO) recommended Advanced HIV Disease screening package, remains poor in most settings with limited resources. More than 50% of newly diagnosed-HIV clients are missed on screening as a result of implementation barriers. It is important to mitigate the existing barriers and leverage enablers' inorder to maximize uptake of the advanced HIV disease screening. This study aimed to identify strategies for scaling up implementation of advanced HIV disease screening among newly HIV-diagnosed clients in pre-ART phase using a Consolidated Framework for Implementation Research-Expert Recommendation for Implementing Change (CFIR-ERIC) guiding tool.

methodsA qualitative study was conducted at Rumphi district hospital in Malawi (August - September, 2023). Two sessions of Focus group discussions (FDGs) involving key stakeholders were facilitated to identify specific strategies following the initial study on exploration of barriers and facilitators of advanced HIV disease screening package. Participants comprised healthcare providers, purposively selected from key hospital departments. A deductive approach was used to analyze FDG transcripts where emerging themes were mapped with ERIC list of strategies. CFIR-ERIC Matching tool version 1.0, was used to generate an output of the most to least expert-endorsed Level 1 and Level 2 strategies.

findingsAbout 25 key healthcare workers participated in FDGs. Overall, 6 Level 1 strategies (≥ 50% expert endorsement score) and 4 Level 2 strategies (≥ 20%, ≤ 49% expert endorsement score) were identified, targeting barriers associated with availability of resources, intervention complexity, access to knowledge and information, communication; and implementation leads. Most of the reported strategies were cross-cutting and aimed at enhancing clinical knowledge of the intervention (distributing training materials, educational meetings), developing stakeholders' interrelations (network weaving) as well as improving clinical workflow (environmental restructuring). Use of evaluative and iterative strategies such as monthly data collection for evaluation were also recommended as part of continuous improvement while an AHD coordinator was recommended to be formally appointed inorder to spearhead coordination of AHD screening services.

conclusionThrough the involvement of key stakeholders and the use of CFIR-ERIC matching tool, this study has identified cross-cutting strategies that if well implemented, can help to mitigate contextual barriers and leverage enablers for an improved delivery of AHD screening package.

Indexed as

Focus GroupsHIV InfectionsMass ScreeningQualitative ResearchAdultFemaleHumansMalawiMaleReferral and ConsultationAdvanced HIV diseaseBarriers and facilitatorsCFIR domainsCFIR-ERIC Matching toolERIC strategies

Identifiers

PMID39123198
PMCPMC11312806

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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.