Situational analysis of varying models of adherence support and loss to follow up rates; findings from 27 treatment facilities in eight resource limited countries

Etienne, Martine; Burrows, Lisette; Osotimehin, Babatunde; Macharia, Thomas; Hossain, Babul; Redfield, Robert; Amoroso, Anthony

doi:10.1111/j.1365-3156.2010.02513.x

Cited by 29 publications

(38 citation statements)

References 19 publications

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“…Family Size: The positively significant relationships among household size and wasting, and underweight could be explained by the fact that the family meal is distributed among large numbers of household members resulting to inadequate diet for an extended period eventually causing malnutrition which is similar with the findings of other study conducted in Tanzania or Kenya [16].…”

Section: The Results Of Multivariate Probity Regressionsupporting

confidence: 81%

Determinants of Nutritional Status of Under-Five Children in Ethiopia: With Particular Reference to Anelmoworeda, Hadiya Zone, Southern Nations, Nationalities and Peoples Region

Temesgen

Haile

2017

Agriculture and Food Sciences Research

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Malnutrition is one of leading problem which affect children well-being and growth in the study area as well as in Ethiopia. However, insufficient scientific knowledge limits to understand the factors of nutritional status at community level for adequate intervention. Therefore, this study was undertaken to investigate the determinants of nutritional status of under-five children in Anlemo Woreda to tackle the malnutrition problems. A Purposive sampling followed by random sampling procedure was employed to draw 330 sample households from four Kebeles. A household survey was undertaken using structured questionnaires. Different characteristics of the households were investigated; anthropometric measurement of children was also measured. The data were analyzed using SPSS.v.22, for descriptive statistics, STATA14 for multivariate probit regression analysis and WHO anthrop v.3.2.2 software to convert raw nutritional data into Zscores. The result of multivariate probit analyses revealed that age of household head, water source, land size, complementary feeding, antenatal care, toilet, time elapse to fetch water and livestock ownership were significant and associated with child stunting. Sex of child, toilet, income, and source water was found to be significant and associated with child wasting, and child age, family size, livestock ownership, income and water source were significant and associated with underweight. The findings of this study revealed that the prevalence of stunting of children is 42.4%, underweight 16.1% and wasting 9.7% respectively. The Prevalence of stunting and wasting among children aged 6-59 months is relatively high but underweight is lower than national and regional prevalence. Malnutrition puts substantial burden on under five children in AnlemoWoreda. Local government of the Hadiya Zone and AnlemoWoreda Health Institution should design effective nutritional implementation on child stunting and wasting is a vital task for the community to reduce malnutrition.

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Section: The Results Of Multivariate Probity Regressionsupporting

confidence: 81%

Determinants of Nutritional Status of Under-Five Children in Ethiopia: With Particular Reference to Anelmoworeda, Hadiya Zone, Southern Nations, Nationalities and Peoples Region

Temesgen

Haile

2017

Agriculture and Food Sciences Research

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“…The seventh type of community support strategy is Directly Observed Therapy (DOT) for ART , employing a community member close to the patient to directly monitor the daily medication intake – a strategy modelled after an effective method for controlling tuberculosis [47,67]. The eighth group of community support providers, labelled adherence supporters , are trained to promote healthy behaviours, provide HIV/AIDS&ART-related knowledge and skills and promote adherence by providing psychosocial support [20,21,46,49,56,57]. The final form of community support is labelled home-based care volunteers .…”

Section: Resultsmentioning

confidence: 99%

Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

Wouters

Damme

Rensburg

et al. 2012

BMC Health Serv Res

130

103

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BackgroundTask-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART) scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority.MethodsWe reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched.ResultsThe reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1) the lack of integration of ART services into the general health system; (2) the growing need for comprehensive care, (3) patient empowerment, (4) and defaulter tracing; and (5) the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme.ConclusionsThe review demonstrates that community support initiatives are a potentially effective strategy to address the growing shortage of health workers, and to broaden care to accommodate the needs associated with chronic HIV/AIDS. The existing evidence suggests that community support programmes, although not necessarily cheap or easy, remain a good investment to improve coverage of communities with much needed health services, such as ART. For this reason, health policy makers, managers, and providers must acknowledge and strengthen the role of community support in the fight against HIV/AIDS.

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“…In Uganda, it was found that 1.2% of patients discontinued ART because of a belief in spiritual healing [57]. Programs with home- and community-based services had a lower loss to follow-up rate (1-5%) compared to programs without these services (10-14%) [58-63]. …”

Section: Discussionmentioning

confidence: 99%

Scaling up antiretroviral treatment and improving patient retention in care: lessons from Ethiopia, 2005-2013

Assefa

Alebachew

Lera

et al. 2014

Globalization and Health

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BackgroundAntiretroviral treatment (ART) was provided to more than nine million people by the end of 2012. Although ART programs in resource-limited settings have expanded treatment, inadequate retention in care has been a challenge. Ethiopia has been scaling up ART and improving retention (defined as continuous engagement of patients in care) in care. We aimed to analyze the ART program in Ethiopia.MethodsA mix of quantitative and qualitative methods was used. Routine ART program data was used to study ART scale up and patient retention in care. In-depth interviews and focus group discussions were conducted with program managers.ResultsThe number of people receiving ART in Ethiopia increased from less than 9,000 in 2005 to more than 439, 000 in 2013. Initially, the public health approach, health system strengthening, community mobilization and provision of care and support services allowed scaling up of ART services. While ART was being scaled up, retention was recognized to be insufficient. To improve retention, a second wave of interventions, related to programmatic, structural, socio-cultural, and patient information systems, have been implemented. Retention rate increased from 77% in 2004/5 to 92% in 2012/13.ConclusionEthiopia has been able to scale up ART and improve retention in care in spite of its limited resources. This has been possible due to interventions by the ART program, supported by health systems strengthening, community-based organizations and the communities themselves. ART programs in resource-limited settings need to put in place similar measures to scale up ART and retain patients in care.

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Situational analysis of varying models of adherence support and loss to follow up rates; findings from 27 treatment facilities in eight resource limited countries

Cited by 29 publications

References 19 publications

Determinants of Nutritional Status of Under-Five Children in Ethiopia: With Particular Reference to Anelmoworeda, Hadiya Zone, Southern Nations, Nationalities and Peoples Region

Determinants of Nutritional Status of Under-Five Children in Ethiopia: With Particular Reference to Anelmoworeda, Hadiya Zone, Southern Nations, Nationalities and Peoples Region

Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

Scaling up antiretroviral treatment and improving patient retention in care: lessons from Ethiopia, 2005-2013

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