ArticleBMC health services research2025
Mapping health policies for optimum service delivery to adolescents on HIV treatment in Zambia: a document review.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Alcohol and other drug use among HIV-affected adolescents and young adults in Zambia: a qualitative study of multilevel drivers and preferences for prevention and treatment approaches.SSM. Mental health · 2026Article
- Health services and programmatic responses to improving adolescent HIV care in Lusaka, Zambia: A descriptive qualitative study.African journal of primary health care & family medicine · 2026Article
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3 authors.
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Abstract
introductionDespite significant advances in HIV treatment regimens, adolescents living with HIV (ALHIV) report lower rates of viral suppression compared to other age groups, reflecting sub-optimal adherence and lower engagement in care. In Zambia, adolescents lag behind in meeting the 95-95-95 targets for HIV care, when compared to adults. It is imperative that the specific needs of ALHIV are addressed in health policies that direct service delivery. This paper reports on Zambian health policies (policy documents and guidelines) that direct the provision of HIV care and treatment services for ALHIV, by assessing their alignment with recommendations for global best practice as presented in global health policies. We contextualize the policy review within the problem that exists in Zambia with respect to poor performance of the adolescents on the HIV cascade.
methodsWe conducted a document review of national health policies and guidelines (N = 10) that relate to HIV service delivery for ALHIV in Zambia and assessed these against the global health policies (N = 6) of which Zambia is a signatory using the four-step READ methodology for document review in health policy research. We used thematic content analysis to develop key themes that describe the components of health service delivery according to the World Health Organization's (WHO) health systems framework, and comparative analysis to map national health policy against global health policies.
resultsThe Zambian policies are aligned with global recommendations for health service delivery for ALHIV by including psychosocial support, peer support, mental health services and sexual and reproductive health education in their offering. In addition, Zambian health legislation advocates for a change in the age of consent for health services and comprehensive sexual education in schools, as globally recommended. However, there is a lack of deliberate involvement of adolescents, caregivers and community stakeholders in policy development. With respect to health financing, the national policies promote the integration of HIV financing with other health financing mechanisms but lack dedicated funding for adolescent HIV services. While community involvement is emphasised through youth advisory boards, training, and support groups, there is a notable absence of intentional adolescent engagement at the high-level program design stage.
conclusionsZambian health policies and guidelines align with global recommendations to optimize health service delivery for ALHIV in four of the six WHO Health Systems building blocks, as evidenced in the relevant global health policies. However, significant gaps remain in areas such as health legislation, financing and community engagement.
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