Barriers to Access to Antiretroviral Treatment in Mozambique, as Perceived by Patients and Health Workers in Urban and Rural Settings

Abstract

This study identifies, ranks, and compares factors perceived as barriers to accessing antiretroviral treatment (ART) in urban and rural settings in Mozambique. Data were collected between March and July 2008. It consisted of 13 focus group discussions and a structured questionnaire administered to 252 people living with HIV/AIDS (PLWHA) and 28 health workers in the districts of Beira and Buzi. Data analysis was performed using content analysis, factor analysis, and percentages of the maximum attainable scores. The data analysis revealed six clusters of factors, which were ranked according to the percentages of the maximum attainable scores between brackets: (1) patient resource availability, in which distance from home to the health facility, transportation and food availability were rated below 40%; (2) community information (47%), and (3) service availability (53%), in which the waiting time to receive the results of CD4 analysis and the sufficiency of doctors/nurses at the health facility were both rated at 45%; (4) patient information and attitudes toward treatment (74%); family support (77%) and health personnel confidentiality (79%). Policy makers, in efforts to further improve the access to ART may decide to target their attention in designing interventions to improve specific aspects of patient resource availability, community information, and service availability in both urban and rural settings.

The Effect of Community-Based Support Services on Clinical Efficacy and Health-Related Quality of Life in HIV/AIDS Patients in Resource-Limited Settings in Sub-Saharan Africa

“…Common structural barriers to adherence include the high cost of antiretrovirals, lack of transportation, long distances to health facilities, and long wait times. [32][33][34] Moreover, fear of disclosure, stigma, and lack of social support have been shown to play a significant role in low adherence-particularly in sub-Saharan Africa. [32][33][34][35][36][37][38] Community-based care and support ART programs, more so than programs based in health facilities, have the capacity to mitigate such social barriers in addressing the psychosocial needs of ART patients and their families.…”

Creating and sustaining healthy work environment for professional advancement in health care institutions: a case study of nursing students’ clinical posting in Abia State

“…This agrees with earlier findings. 34,37 The students' exposure to inter-professional clinical practice helped them to widen the scope of their knowledge and skills as well as gaining the experiences of working with other professionals. The periodic and repetitive structure of the seminars provided to the students before and after clinical experience, enhanced awareness on their expected roles while on posting.…”

“…[27][28][29][30][31] The health care system advocates sharing accommodation to ensure better interaction and enhanced skills for professional advancement. 36,37 This study aimed to introduce nursing students on clinical experience to relevant skills that can promote interprofessional and interpersonal relationships for professional advancements in hospital settings. The study examined how inter-professional collaboration can enhance students' clinical performances.…”

The impact of a food assistance program on nutritional status, disease progression and food security among people living with HIV in Uganda

“…Food insecurity remains a critical barrier to both access [48][49][50] and adherence [51][52][53] to ART. This study demonstrates the benefit of food assistance in the absence of ART, and highlights the potential for food assistance programming to be part of the standard of care for PLHIV in areas of widespread food insecurity.…”