Supervision, monitoring and evaluation of nationwide scale-up of antiretroviral therapy in Malawi

Hdl Handle:
http://hdl.handle.net/10144/116355
Title:
Supervision, monitoring and evaluation of nationwide scale-up of antiretroviral therapy in Malawi
Authors:
Libamba, Edwin; Makombe, Simon; Mhango, Eustice; de Ascurra Teck, Olga; Limbambala, Eddie; Schouten, Erik J; Harries, Anthony D
Journal:
Bulletin of the World Health Organization
Abstract:
OBJECTIVE: To describe the supervision, monitoring and evaluation strategies used to assess the delivery of antiretroviral therapy during nationwide scale-up of treatment in Malawi. METHODS: In the first quarter of 2005, the HIV Unit of the Ministry of Health and its partners (the Lighthouse Clinic; Médecins Sans Frontières-Belgium, Thyolo district; and WHO's Country Office) undertook structured supervision and monitoring of all public sector health facilities in Malawi delivering antiretroviral therapy. FINDINGS: Data monitoring showed that by the end of 2004, there were 13,183 patients (5274 (40%) male, 12 527 (95%) adults) who had ever started antiretroviral therapy. Of patients who had ever started, 82% (10 761/13,183) were alive and taking antiretrovirals; 8% (1026/13,183) were dead; 8% (1039/13,183) had been lost to follow up; <1% (106/13,183) had stopped treatment; and 2% (251/13,183) had transferred to another facility. Of those alive and on antiretrovirals, 98% (7098/7258) were ambulatory; 85% (6174/7258) were fit to work; 10% (456/4687) had significant side effects; and, based on pill counts, 96% (6824/7114) had taken their treatment correctly. Mistakes in the registration and monitoring of patients were identified and corrected. Drug stocks were checked, and one potential drug stock-out was averted. As a result of the supervisory visits, by the end of March 2005 recruitment of patients to facilities scheduled to start delivering antiretroviral therapy had increased. CONCLUSION: This report demonstrates the importance of early supervision for sites that are starting to deliver antiretroviral therapy, and it shows the value of combining data collection with supervision. Making regular supervisory and monitoring visits to delivery sites are essential for tracking the national scale-up of delivery of antiretrovirals.
Affiliation:
Clinical HIV Unit, Ministry of Health, Lilongwe, Malawi; The Lighthouse Clinic, Lilongwe, Malawi; Médecins Sans Frontières–Belgium, Malawi Office, Blantyre, Malawi; World Health Organization Country Office, Lilongwe, Malawi; HIV Coordinator, Ministry of Health, Lilongwe, Malawi
Issue Date:
13-Apr-2006
URI:
http://hdl.handle.net/10144/116355
DOI:
/S0042-96862006000400017
PubMed ID:
16628306
Additional Links:
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000400017&lng=en&nrm=iso&tlng=en
Type:
Article
Language:
en
ISSN:
0042-9686
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorLibamba, Edwinen
dc.contributor.authorMakombe, Simonen
dc.contributor.authorMhango, Eusticeen
dc.contributor.authorde Ascurra Teck, Olgaen
dc.contributor.authorLimbambala, Eddieen
dc.contributor.authorSchouten, Erik Jen
dc.contributor.authorHarries, Anthony Den
dc.date.accessioned2010-11-25T19:27:41Z-
dc.date.available2010-11-25T19:27:41Z-
dc.date.issued2006-04-13-
dc.identifier.citationBull. World Health Organ. 2006;84(4):320-6en
dc.identifier.issn0042-9686-
dc.identifier.pmid16628306-
dc.identifier.doi/S0042-96862006000400017-
dc.identifier.urihttp://hdl.handle.net/10144/116355-
dc.description.abstractOBJECTIVE: To describe the supervision, monitoring and evaluation strategies used to assess the delivery of antiretroviral therapy during nationwide scale-up of treatment in Malawi. METHODS: In the first quarter of 2005, the HIV Unit of the Ministry of Health and its partners (the Lighthouse Clinic; Médecins Sans Frontières-Belgium, Thyolo district; and WHO's Country Office) undertook structured supervision and monitoring of all public sector health facilities in Malawi delivering antiretroviral therapy. FINDINGS: Data monitoring showed that by the end of 2004, there were 13,183 patients (5274 (40%) male, 12 527 (95%) adults) who had ever started antiretroviral therapy. Of patients who had ever started, 82% (10 761/13,183) were alive and taking antiretrovirals; 8% (1026/13,183) were dead; 8% (1039/13,183) had been lost to follow up; <1% (106/13,183) had stopped treatment; and 2% (251/13,183) had transferred to another facility. Of those alive and on antiretrovirals, 98% (7098/7258) were ambulatory; 85% (6174/7258) were fit to work; 10% (456/4687) had significant side effects; and, based on pill counts, 96% (6824/7114) had taken their treatment correctly. Mistakes in the registration and monitoring of patients were identified and corrected. Drug stocks were checked, and one potential drug stock-out was averted. As a result of the supervisory visits, by the end of March 2005 recruitment of patients to facilities scheduled to start delivering antiretroviral therapy had increased. CONCLUSION: This report demonstrates the importance of early supervision for sites that are starting to deliver antiretroviral therapy, and it shows the value of combining data collection with supervision. Making regular supervisory and monitoring visits to delivery sites are essential for tracking the national scale-up of delivery of antiretrovirals.en
dc.language.isoenen
dc.relation.urlhttp://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000400017&lng=en&nrm=iso&tlng=enen
dc.rightsArchived with thanks to Bulletin of the World Health Organizationen
dc.subject.meshAcquired Immunodeficiency Syndromeen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshChilden
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMalawien
dc.subject.meshMaleen
dc.subject.meshMulticenter Studies as Topicen
dc.subject.meshNational Health Programsen
dc.subject.meshTreatment Outcomeen
dc.titleSupervision, monitoring and evaluation of nationwide scale-up of antiretroviral therapy in Malawien
dc.typeArticleen
dc.contributor.departmentClinical HIV Unit, Ministry of Health, Lilongwe, Malawi; The Lighthouse Clinic, Lilongwe, Malawi; Médecins Sans Frontières–Belgium, Malawi Office, Blantyre, Malawi; World Health Organization Country Office, Lilongwe, Malawi; HIV Coordinator, Ministry of Health, Lilongwe, Malawien
dc.identifier.journalBulletin of the World Health Organizationen

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