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    Jan 23, 2021
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    Supervision, monitoring and evaluation of nationwide scale-up of antiretroviral therapy in Malawi

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    Authors
    Libamba, Edwin
    Makombe, Simon
    Mhango, Eustice
    de Ascurra Teck, Olga
    Limbambala, Eddie
    Schouten, Erik J
    Harries, Anthony D
    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
    2006-04-13
    
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    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.
    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
    ae974a485f413a2113503eed53cd6c53
    /S0042-96862006000400017
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

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