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Research Article Open access CC BY 3.0

Scaling Up Community ART Groups in Mozambique

T. Decroo, J. Lara, F. Rasschaert, EH. Bermudez-Aza, A. Couto, B. Candrinho, M. Biot, J. Maїkéré, K Jobarteh

International STD Research & Reviews · pp. 49–59 · Published 31 Oct 2013

10.9734/ISRR/2013/5867

Abstract

Aims: To describe the stepwise implementation and roll out of Community ART Groups (CAG) in Mozambique. Study Design: Descriptive study Place and Duration of Study: Mozambique, between February 2008 and December 2011. Methodology: Description of the stepwise implementation of a model for Anti-Retroviral Therapy (ART) delivery based on the principles of peer support and self-management. The program data on CAG were obtained through a chart review and routine data-collection. Results: To overcome patient reported barriers to monthly drug refills for ART the Tete Provincial Directorate of Health and Médecins Sans Frontières developed a community-based ART model or patient-centered model, through peer support groups named CAG. The first CAG commenced in 2008, in rural health facility catchment areas, where members of CAG shared transport costs to overcome distances to the ART clinics. In 2009, lessons learnt were exported in Tete province and CAG model was launched in semi-urban contexts to decrease time spent in the clinics. In 2011, retention rates as high as 97,5 % convinced a joint task force that included Ministry of Health and major partners to pilot the CAG strategy on a national scale. Conclusion: To respond to staggering attrition rates Ministry of Health in Mozambique and partners piloted an innovative patient-centered model for HIV care and exported good practices from local to provincial and national level. Success of scale up will depend on the collaboration and interaction between policymakers, donors, health-managers, caregivers, communities, and patients.

HIV antiretroviral therapy highly active task shifting health services accessibility patient participation peer group

References (18)

  1. 1 Patient retention in antiretroviral therapy programs up to three years on treatment in sub‐Saharan Africa, 2007–2009: systematic review [DOI]
  2. 2 Understanding pathways for scaling up health services through the lens of complex adaptive systems [DOI]
  3. 3 Lessons from community participation in health programmes: a review of the post Alma-Ata experience [DOI]
  4. 4 Barriers to access to antiretroviral treatment in developing countries: a review [DOI]
  5. 5 Task-Shifting of Antiretroviral Delivery From Health Care Workers to Persons Living With HIV/AIDS: Clinical Outcomes of a Community-Based Program in Kenya [DOI]
  6. 6 Patient‐reported barriers and drivers of adherence to antiretrovirals in sub‐Saharan Africa: a meta‐ethnography [DOI]
  7. 7 Distribution of Antiretroviral Treatment Through Self-Forming Groups of Patients in Tete Province, Mozambique [DOI]
  8. 8 Can the deployment of community health workers for the delivery of HIV services represent an effective and sustainable response to health workforce shortages? Results of a multicountry study [DOI]
  9. 9 Chronic Disease Self-Management and Adherence to HIV Medications [DOI]
  10. 10 Loss to Follow-Up of Adults in Public HIV Care Systems in Central Mozambique: Identifying Obstacles to Treatment [DOI]
  11. 11 Public-sector ART in the Free State Province, South Africa: Community support as an important determinant of outcome [DOI]
  12. 12 Home-Based Antiretroviral Care Is Associated With Positive Social Outcomes in a Prospective Cohort in Uganda [DOI]
  13. 13 Adherence Support Workers: A Way to Address Human Resource Constraints in Antiretroviral Treatment Programs in the Public Health Setting in Zambia [DOI]
  14. 14 One Year After ART Initiation: Psychosocial Factors Associated with Stigma Among HIV-Positive Mozambicans [DOI]
  15. 15 A model for extending antiretroviral care beyond the rural health centre [DOI]
  16. 16 Are Expert Patients an Untapped Resource for ART Provision in Sub-Saharan Africa? [DOI]
  17. 17 Patient Volume, Human Resource Levels, and Attrition From HIV Treatment Programs in Central Mozambique [DOI]
  18. 18 Risk factors and true outcomes for lost to follow-up individuals in an antiretroviral treatment programme in Tete, Mozambique [DOI]

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