Implementing antiretroviral therapy in rural communities: the Lusikisiki model of decentralized HIV/AIDS care.

Hdl Handle:
http://hdl.handle.net/10144/22615
Title:
Implementing antiretroviral therapy in rural communities: the Lusikisiki model of decentralized HIV/AIDS care.
Authors:
Bedelu, M; Ford, N; Hilderbrand, K; Reuter, H
Journal:
The Journal of Infectious Diseases
Abstract:
Health worker shortages are a major bottleneck to scaling up antiretroviral therapy (ART), particularly in rural areas. In Lusikisiki, a rural area of South Africa with a population of 150,000 serviced by 1 hospital and 12 clinics, Médecins Sans Frontières has been supporting a program to deliver human immunodeficiency virus (HIV) services through decentralization to primary health care clinics, task shifting (including nurse-initiated as opposed to physician-initiated treatment), and community support. This approach has allowed for a rapid scale-up of treatment with satisfactory outcomes. Although the general approach in South Africa is to provide ART through hospitals-which seriously limits access for many people, if not the majority of people-1-year outcomes in Lusikisiki are comparable in the clinics and hospital. The greater proximity and acceptability of services at the clinic level has led to a faster enrollment of people into treatment and better retention of patients in treatment (2% vs. 19% lost to follow-up). In all, 2200 people were receiving ART in Lusikisiki in 2006, which represents 95% coverage. Maintaining quality and coverage will require increased resource input from the public sector and full acceptance of creative approaches to implementation, including task shifting and community involvement.
Affiliation:
Médecins Sans Frontières, Lusikisiki, South Africa.
Publisher:
Infectious Diseases Society of America
Issue Date:
1-Dec-2007
URI:
http://hdl.handle.net/10144/22615
DOI:
10.1086/521114
PubMed ID:
18181695
Additional Links:
http://www.journals.uchicago.edu/toc/jid
Language:
en
ISSN:
0022-1899
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorBedelu, M-
dc.contributor.authorFord, N-
dc.contributor.authorHilderbrand, K-
dc.contributor.authorReuter, H-
dc.date.accessioned2008-04-08T15:29:29Z-
dc.date.available2008-04-08T15:29:29Z-
dc.date.issued2007-12-01-
dc.identifier.citationImplementing antiretroviral therapy in rural communities: the Lusikisiki model of decentralized HIV/AIDS care. 2007, 196 Suppl 3:S464-8 J. Infect. Dis.en
dc.identifier.issn0022-1899-
dc.identifier.pmid18181695-
dc.identifier.doi10.1086/521114-
dc.identifier.urihttp://hdl.handle.net/10144/22615-
dc.description.abstractHealth worker shortages are a major bottleneck to scaling up antiretroviral therapy (ART), particularly in rural areas. In Lusikisiki, a rural area of South Africa with a population of 150,000 serviced by 1 hospital and 12 clinics, Médecins Sans Frontières has been supporting a program to deliver human immunodeficiency virus (HIV) services through decentralization to primary health care clinics, task shifting (including nurse-initiated as opposed to physician-initiated treatment), and community support. This approach has allowed for a rapid scale-up of treatment with satisfactory outcomes. Although the general approach in South Africa is to provide ART through hospitals-which seriously limits access for many people, if not the majority of people-1-year outcomes in Lusikisiki are comparable in the clinics and hospital. The greater proximity and acceptability of services at the clinic level has led to a faster enrollment of people into treatment and better retention of patients in treatment (2% vs. 19% lost to follow-up). In all, 2200 people were receiving ART in Lusikisiki in 2006, which represents 95% coverage. Maintaining quality and coverage will require increased resource input from the public sector and full acceptance of creative approaches to implementation, including task shifting and community involvement.en
dc.language.isoenen
dc.publisherInfectious Diseases Society of Americaen
dc.relation.urlhttp://www.journals.uchicago.edu/toc/jiden
dc.rightsArchived on this site with permission and copyright 2007 by the Infectious Diseases Society of Americaen
dc.subject.meshAcquired Immunodeficiency Syndromeen
dc.subject.meshAnti-Retroviral Agentsen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Plan Implementationen
dc.subject.meshHumansen
dc.subject.meshPoliticsen
dc.subject.meshPrimary Health Careen
dc.subject.meshRural Populationen
dc.subject.meshSouth Africaen
dc.titleImplementing antiretroviral therapy in rural communities: the Lusikisiki model of decentralized HIV/AIDS care.en
dc.contributor.departmentMédecins Sans Frontières, Lusikisiki, South Africa.en
dc.identifier.journalThe Journal of Infectious Diseasesen

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