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    Apr 18, 2021
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    Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review

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    Authors
    Decroo, Tom
    Rasschaert, Freya
    Telfer, Barbara
    Remartinez, Daniel
    Laga, Marie
    Ford, Nathan
    Affiliation
    Médecins Sans Frontières, Av. Eduardo Mondlane 38 - CP 262, Tete, Mozambique.
    Issue Date
    2013-09-05
    
    Metadata
    Show full item record
    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.
    Publisher
    Oxford University Press
    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
    ae974a485f413a2113503eed53cd6c53
    10.1093/inthealth/iht016
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

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