Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia
Abstract Background The focus of the community anti-retroviral therapy Group model is on drug refill, adherence and support groups. However, laboratory services are completely neglected in this model, and stable patient still have to go to the clinic for blood draws after drugs refills from the comm...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-019-4386-5 |
| _version_ | 1818878836029259776 |
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| author | Mpanji Siwingwa Selestine H. Nzala Bornwell Sikateyo Wilbroad Mutale |
| author_facet | Mpanji Siwingwa Selestine H. Nzala Bornwell Sikateyo Wilbroad Mutale |
| author_sort | Mpanji Siwingwa |
| collection | DOAJ |
| description | Abstract Background The focus of the community anti-retroviral therapy Group model is on drug refill, adherence and support groups. However, laboratory services are completely neglected in this model, and stable patient still have to go to the clinic for blood draws after drugs refills from the community. Due to the introduction of new ART drugs, the guidelines now recommend the use of viral loads to guide decision in switching all patients from NNRTI to dolutegravir based first line ART regimens. But the national viral load testing coverage stands at 37% and and falls short of meeting the global UNAIDS and phlebotomy delivery system is congested. The purpose of this study was to identify the perceptions in decentralizing phlebotomy services into the community anti-retroviral therapy Group model. Method A qualitative case study design was used. Data were collected through ten Focused group discussions among community anti-retroviral therapy Group members, community and health care workers at anti-retroviral therapy clinics and in-depth interviews with five key informants. Data were managed with the help of Nvivo version 10 and analyzed using thematic method. Results Positive perceptions were identified as those which contributed to decongesting phlebotomy rooms, reduced missing phlebotomy appointments, work Load, and lost results. Improved quality of phlebotomy service delivery and testing coverage, innovative access to laboratory services and encouraged patient’s accountability. The negative perceptions were compromised sample integrity, inability to perform prevention control and patients less contact with clinicians. Conclusion The study has demonstrated that decentralizing phlebotomy services within the CAG model has greater potential to improve the quality of services delivery for patients. In addition, it has perceived threats on the quality of specimen collected, patient’s safety, and health care. |
| first_indexed | 2024-12-19T14:20:30Z |
| format | Article |
| id | doaj.art-0f7630199498405394643128170edf83 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-19T14:20:30Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-0f7630199498405394643128170edf832022-12-21T20:17:47ZengBMCBMC Health Services Research1472-69632019-08-0119111110.1186/s12913-019-4386-5Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, ZambiaMpanji Siwingwa0Selestine H. Nzala1Bornwell Sikateyo2Wilbroad Mutale3Department of health policy and management, University of Zambia, School of public healthDepartment of medical education development, University of Zambia, School of MedicineDepartment of bioethics, University of Zambia, School of medicineDepartment of health policy and management, University of Zambia, School of public healthAbstract Background The focus of the community anti-retroviral therapy Group model is on drug refill, adherence and support groups. However, laboratory services are completely neglected in this model, and stable patient still have to go to the clinic for blood draws after drugs refills from the community. Due to the introduction of new ART drugs, the guidelines now recommend the use of viral loads to guide decision in switching all patients from NNRTI to dolutegravir based first line ART regimens. But the national viral load testing coverage stands at 37% and and falls short of meeting the global UNAIDS and phlebotomy delivery system is congested. The purpose of this study was to identify the perceptions in decentralizing phlebotomy services into the community anti-retroviral therapy Group model. Method A qualitative case study design was used. Data were collected through ten Focused group discussions among community anti-retroviral therapy Group members, community and health care workers at anti-retroviral therapy clinics and in-depth interviews with five key informants. Data were managed with the help of Nvivo version 10 and analyzed using thematic method. Results Positive perceptions were identified as those which contributed to decongesting phlebotomy rooms, reduced missing phlebotomy appointments, work Load, and lost results. Improved quality of phlebotomy service delivery and testing coverage, innovative access to laboratory services and encouraged patient’s accountability. The negative perceptions were compromised sample integrity, inability to perform prevention control and patients less contact with clinicians. Conclusion The study has demonstrated that decentralizing phlebotomy services within the CAG model has greater potential to improve the quality of services delivery for patients. In addition, it has perceived threats on the quality of specimen collected, patient’s safety, and health care.http://link.springer.com/article/10.1186/s12913-019-4386-5PhlebotomyCAGHIV/AIDSARTDecentralization |
| spellingShingle | Mpanji Siwingwa Selestine H. Nzala Bornwell Sikateyo Wilbroad Mutale Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia BMC Health Services Research Phlebotomy CAG HIV/AIDS ART Decentralization |
| title | Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia |
| title_full | Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia |
| title_fullStr | Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia |
| title_full_unstemmed | Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia |
| title_short | Perceptions on the feasibility of decentralizing phlebotomy services in community anti-retroviral therapy group model in Lusaka, Zambia |
| title_sort | perceptions on the feasibility of decentralizing phlebotomy services in community anti retroviral therapy group model in lusaka zambia |
| topic | Phlebotomy CAG HIV/AIDS ART Decentralization |
| url | http://link.springer.com/article/10.1186/s12913-019-4386-5 |
| work_keys_str_mv | AT mpanjisiwingwa perceptionsonthefeasibilityofdecentralizingphlebotomyservicesincommunityantiretroviraltherapygroupmodelinlusakazambia AT selestinehnzala perceptionsonthefeasibilityofdecentralizingphlebotomyservicesincommunityantiretroviraltherapygroupmodelinlusakazambia AT bornwellsikateyo perceptionsonthefeasibilityofdecentralizingphlebotomyservicesincommunityantiretroviraltherapygroupmodelinlusakazambia AT wilbroadmutale perceptionsonthefeasibilityofdecentralizingphlebotomyservicesincommunityantiretroviraltherapygroupmodelinlusakazambia |