Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review

Hdl Handle:
http://hdl.handle.net/10144/302801
Title:
Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review
Authors:
Decroo, Tom; Rasschaert, Freya; Telfer, Barbara; Remartinez, Daniel; Laga, Marie; Ford, Nathan
Journal:
International Health
Abstract:
In sub-Saharan Africa models of care need to adapt to support continued scale up of antiretroviral therapy (ART) and retain millions in care. Task shifting, coupled with community participation has the potential to address the workforce gap, decongest health services, improve ART coverage, and to sustain retention of patients on ART over the long-term. The evidence supporting different models of community participation for ART care, or community-based ART, in sub-Saharan Africa, was reviewed. In Uganda and Kenya community health workers or volunteers delivered ART at home. In Mozambique people living with HIV/AIDS (PLWHA) self-formed community-based ART groups to deliver ART in the community. These examples of community ART programs made treatment more accessible and affordable. However, to achieve success some major challenges need to be overcome: first, community programs need to be driven, owned by and embedded in the communities. Second, an enabling and supportive environment is needed to ensure that task shifting to lay staff and PLWHA is effective and quality services are provided. Finally, a long term vision and commitment from national governments and international donors is required. Exploration of the cost, effectiveness, and sustainability of the different community-based ART models in different contexts will be needed.
Affiliation:
Médecins Sans Frontières, Av. Eduardo Mondlane 38 - CP 262, Tete, Mozambique.
Publisher:
Oxford University Press
Issue Date:
5-Sep-2013
DOI:
10.1093/inthealth/iht016
PubMed ID:
24030268
Additional Links:
http://inthealth.oxfordjournals.org/cgi/reprint/5/3/169?ijkey=uDc.mIasla/8o&keytype=ref&siteid=inthealth
Language:
en
Description:
To access this article, click on "Additional Links"
ISSN:
1876-3413
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorDecroo, Tomen_GB
dc.contributor.authorRasschaert, Freyaen_GB
dc.contributor.authorTelfer, Barbaraen_GB
dc.contributor.authorRemartinez, Danielen_GB
dc.contributor.authorLaga, Marieen_GB
dc.contributor.authorFord, Nathanen_GB
dc.date.accessioned2013-10-05T14:58:50Z-
dc.date.available2013-10-05T14:58:50Z-
dc.date.issued2013-09-05-
dc.identifier.citationCommunity-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review. 2013, 5 (3):169-79 Int Healthen_GB
dc.identifier.issn1876-3413-
dc.identifier.pmid24030268-
dc.identifier.doi10.1093/inthealth/iht016-
dc.descriptionTo access this article, click on "Additional Links"-
dc.description.abstractIn sub-Saharan Africa models of care need to adapt to support continued scale up of antiretroviral therapy (ART) and retain millions in care. Task shifting, coupled with community participation has the potential to address the workforce gap, decongest health services, improve ART coverage, and to sustain retention of patients on ART over the long-term. The evidence supporting different models of community participation for ART care, or community-based ART, in sub-Saharan Africa, was reviewed. In Uganda and Kenya community health workers or volunteers delivered ART at home. In Mozambique people living with HIV/AIDS (PLWHA) self-formed community-based ART groups to deliver ART in the community. These examples of community ART programs made treatment more accessible and affordable. However, to achieve success some major challenges need to be overcome: first, community programs need to be driven, owned by and embedded in the communities. Second, an enabling and supportive environment is needed to ensure that task shifting to lay staff and PLWHA is effective and quality services are provided. Finally, a long term vision and commitment from national governments and international donors is required. Exploration of the cost, effectiveness, and sustainability of the different community-based ART models in different contexts will be needed.en_GB
dc.language.isoenen
dc.publisherOxford University Pressen_GB
dc.relation.urlhttp://inthealth.oxfordjournals.org/cgi/reprint/5/3/169?ijkey=uDc.mIasla/8o&keytype=ref&siteid=inthealth-
dc.subjectHIV/AIDSen_GB
dc.subjectModels of Careen_GB
dc.subjectKenyaen_GB
dc.subjectMozambiqueen_GB
dc.subjectUgandaen_GB
dc.titleCommunity-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic reviewen
dc.contributor.departmentMédecins Sans Frontières, Av. Eduardo Mondlane 38 - CP 262, Tete, Mozambique.en_GB
dc.identifier.journalInternational Healthen_GB
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