An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa

Introduction. The World Health Organization (WHO) recommends same-day initiation (SDI) of antiretroviral therapy (ART) for all individuals diagnosed with HIV irrespective of CD4+ count or clinical stage. Implementation of program is still far from reaching its goals. This study assessed the level o...

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Main Author: Sabina Hwenje
Format: Article
Language:English
Published: PAGEPress Publications 2023-12-01
Series:Journal of Public Health in Africa
Subjects:
Online Access:https://www.publichealthinafrica.org/jphia/article/view/2179
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author Sabina Hwenje
author_facet Sabina Hwenje
author_sort Sabina Hwenje
collection DOAJ
description Introduction. The World Health Organization (WHO) recommends same-day initiation (SDI) of antiretroviral therapy (ART) for all individuals diagnosed with HIV irrespective of CD4+ count or clinical stage. Implementation of program is still far from reaching its goals. This study assessed the level of implementation of same day ART initiation. Methods. A longitudinal study was conducted at four primary healthcare clinics in eThekwini municipality KwaZulu-Natal. Data was collected between June 2020 to October 2020 using a data extraction form. Data on individuals tested HIV positive, number of SDI of ART; and clinicians working on UTT program were compiled from clinic registers, and Three Interlinked Electronic Registers.Net (TIER.Net). Non-governmental organisations (NGO) supporting the facility and services information was collected. Results. A median of 55 (IQR, 50 -70) were initiated on ART on the same day of HIV diagnosis from the four facilities. There was a significant association between health facility and number of HIV positive individuals initiated on SDI (chi-square = 10.59; p-value = 0.008).  There was a significant association between facilities with all 7 organisations supporting them and ART SDI (chi-square = 10.18; p-value= 0.015. There was a significant association between staff provision in a facility and SDI (chi-square = 7.51; p value = 0.006). Urban areas clinics were more likely to have high uptake of SDI compared to rural clinics (chi-square =11,29; p-value = 0.003) Conclusion. Implementation of the Universal Test and Treat program varies by facility indicating the need for the government to monitor and standardize implementation of the policy if the program is to yield success.
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spelling doaj.art-1f7d02f1c74d44f3a679734e2284a52b2024-01-03T10:38:19ZengPAGEPress PublicationsJournal of Public Health in Africa2038-99222038-99302023-12-01141110.4081/jphia.2023.2179An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South AfricaSabina Hwenje0University of KwaZulu Natal Introduction. The World Health Organization (WHO) recommends same-day initiation (SDI) of antiretroviral therapy (ART) for all individuals diagnosed with HIV irrespective of CD4+ count or clinical stage. Implementation of program is still far from reaching its goals. This study assessed the level of implementation of same day ART initiation. Methods. A longitudinal study was conducted at four primary healthcare clinics in eThekwini municipality KwaZulu-Natal. Data was collected between June 2020 to October 2020 using a data extraction form. Data on individuals tested HIV positive, number of SDI of ART; and clinicians working on UTT program were compiled from clinic registers, and Three Interlinked Electronic Registers.Net (TIER.Net). Non-governmental organisations (NGO) supporting the facility and services information was collected. Results. A median of 55 (IQR, 50 -70) were initiated on ART on the same day of HIV diagnosis from the four facilities. There was a significant association between health facility and number of HIV positive individuals initiated on SDI (chi-square = 10.59; p-value = 0.008).  There was a significant association between facilities with all 7 organisations supporting them and ART SDI (chi-square = 10.18; p-value= 0.015. There was a significant association between staff provision in a facility and SDI (chi-square = 7.51; p value = 0.006). Urban areas clinics were more likely to have high uptake of SDI compared to rural clinics (chi-square =11,29; p-value = 0.003) Conclusion. Implementation of the Universal Test and Treat program varies by facility indicating the need for the government to monitor and standardize implementation of the policy if the program is to yield success. https://www.publichealthinafrica.org/jphia/article/view/2179Universal Test and Treat, Same day Antiretroviral treatment initiation, policy implementation, facility assessment, healthcare workers
spellingShingle Sabina Hwenje
An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa
Journal of Public Health in Africa
Universal Test and Treat, Same day Antiretroviral treatment initiation, policy implementation, facility assessment, healthcare workers
title An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa
title_full An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa
title_fullStr An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa
title_full_unstemmed An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa
title_short An assessment on the implementation of Same Day Antiretroviral Therapy initiation in eThekwini clinics, KwaZulu-Natal, South Africa
title_sort assessment on the implementation of same day antiretroviral therapy initiation in ethekwini clinics kwazulu natal south africa
topic Universal Test and Treat, Same day Antiretroviral treatment initiation, policy implementation, facility assessment, healthcare workers
url https://www.publichealthinafrica.org/jphia/article/view/2179
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