Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field
Background: Human Immunodeficiency Virus (HIV) infection continues to have a profound humanitarian and public health impact in western and central Africa, a region that risks being left behind in the global response to ending the AIDS epidemic. In Liberia, where the health system is being rebuilt fo...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2021-11-01
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| Series: | Annals of Global Health |
| Subjects: | |
| Online Access: | https://annalsofglobalhealth.org/articles/3246 |
| _version_ | 1831810866880708608 |
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| author | Mukhtar A. Adeiza Ian Wachekwa Cecilia Nuta Sean Donato Freda Koomson Jane Whitney Chelsea Plyler Lila Kerr Godsway Sackey Elizabeth Dunbar Kristina Talbert-Slagle Robin Klar Regan H. Marsh Samretta Caldwell Julia Toomey Onyema Ogbuagu |
| author_facet | Mukhtar A. Adeiza Ian Wachekwa Cecilia Nuta Sean Donato Freda Koomson Jane Whitney Chelsea Plyler Lila Kerr Godsway Sackey Elizabeth Dunbar Kristina Talbert-Slagle Robin Klar Regan H. Marsh Samretta Caldwell Julia Toomey Onyema Ogbuagu |
| author_sort | Mukhtar A. Adeiza |
| collection | DOAJ |
| description | Background: Human Immunodeficiency Virus (HIV) infection continues to have a profound humanitarian and public health impact in western and central Africa, a region that risks being left behind in the global response to ending the AIDS epidemic. In Liberia, where the health system is being rebuilt following protracted civil wars and an Ebola virus disease outbreak, the Resilient and Responsive Health System (RRHS) is assisting with quality HIV services delivery through support from PEPFAR and HRSA but gaps remain across the cascade of care from diagnosis to viral load suppression. Objective: To highlight gaps in HIV service delivery in Liberia, identify opportunities and offer recommendations for improving the quality of service delivery. Methods: A narrative review of relevant literature was conducted following a search of all local and online databases known to the authors. Findings: Antiretroviral therapy (ART) has transformed the HIV response in Liberia by averting deaths, improving quality of life, and preventing new HIV infections but critical gaps remain. These include weak HIV prevention and testing strategies; suboptimal ART initiation and retention in care; low viral load testing volumes, commodity supply chain disruptions and a HIV workforce built on non-physician healthcare workers. In the context of the prevailing socioeconomic, heath system and programmatic challenges, these will impact achievement of the UNAIDS targets of 95-95-95 by 2030 and ending the epidemic. Conclusion: Combination prevention approaches are necessary to reach the most at risk populations, while a robust health workforce operating through facilities and communities will be needed to reach people with undiagnosed HIV earlier to provide efficient and effective services to ensure that people know their HIV status, receive and sustain ART to achieve viral suppression to maintain a long and healthy life within the framework of overall health system strengthening, achieving universal health coverage and the sustainable development goal. |
| first_indexed | 2024-12-22T21:07:23Z |
| format | Article |
| id | doaj.art-50f84ca760df48f48eb2f6c1ee9943ef |
| institution | Directory Open Access Journal |
| issn | 2214-9996 |
| language | English |
| last_indexed | 2024-12-22T21:07:23Z |
| publishDate | 2021-11-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Annals of Global Health |
| spelling | doaj.art-50f84ca760df48f48eb2f6c1ee9943ef2022-12-21T18:12:38ZengUbiquity PressAnnals of Global Health2214-99962021-11-0187110.5334/aogh.32462697Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the FieldMukhtar A. Adeiza0Ian Wachekwa1Cecilia Nuta2Sean Donato3Freda Koomson4Jane Whitney5Chelsea Plyler6Lila Kerr7Godsway Sackey8Elizabeth Dunbar9Kristina Talbert-Slagle10Robin Klar11Regan H. Marsh12Samretta Caldwell13Julia Toomey14Onyema Ogbuagu15Yale School of Medicine, John F. Kennedy Medical CenterJohn F. Kennedy Medical CenterJohn F. Kennedy Medical CenterUNICEF Supply DivisionYale School of Medicine, University of Liberia, Redemption HospitalYale School of MedicineYale School of MedicineBrigham and Women’s Hospital, Partners In HealthBrigham and Women’s Hospital, Partners In HealthResilient and Responsive Health System, University of WashingtonYale School of MedicineNew York University Rory Meyers College of NursingBrigham and Women’s Hospital, Partners In HealthLiberia National AIDS and STI Control ProgramLiberia National AIDS and STI Control ProgramYale School of MedicineBackground: Human Immunodeficiency Virus (HIV) infection continues to have a profound humanitarian and public health impact in western and central Africa, a region that risks being left behind in the global response to ending the AIDS epidemic. In Liberia, where the health system is being rebuilt following protracted civil wars and an Ebola virus disease outbreak, the Resilient and Responsive Health System (RRHS) is assisting with quality HIV services delivery through support from PEPFAR and HRSA but gaps remain across the cascade of care from diagnosis to viral load suppression. Objective: To highlight gaps in HIV service delivery in Liberia, identify opportunities and offer recommendations for improving the quality of service delivery. Methods: A narrative review of relevant literature was conducted following a search of all local and online databases known to the authors. Findings: Antiretroviral therapy (ART) has transformed the HIV response in Liberia by averting deaths, improving quality of life, and preventing new HIV infections but critical gaps remain. These include weak HIV prevention and testing strategies; suboptimal ART initiation and retention in care; low viral load testing volumes, commodity supply chain disruptions and a HIV workforce built on non-physician healthcare workers. In the context of the prevailing socioeconomic, heath system and programmatic challenges, these will impact achievement of the UNAIDS targets of 95-95-95 by 2030 and ending the epidemic. Conclusion: Combination prevention approaches are necessary to reach the most at risk populations, while a robust health workforce operating through facilities and communities will be needed to reach people with undiagnosed HIV earlier to provide efficient and effective services to ensure that people know their HIV status, receive and sustain ART to achieve viral suppression to maintain a long and healthy life within the framework of overall health system strengthening, achieving universal health coverage and the sustainable development goal.https://annalsofglobalhealth.org/articles/3246hiv, service delivery, liberia, gaps, opportunities |
| spellingShingle | Mukhtar A. Adeiza Ian Wachekwa Cecilia Nuta Sean Donato Freda Koomson Jane Whitney Chelsea Plyler Lila Kerr Godsway Sackey Elizabeth Dunbar Kristina Talbert-Slagle Robin Klar Regan H. Marsh Samretta Caldwell Julia Toomey Onyema Ogbuagu Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field Annals of Global Health hiv, service delivery, liberia, gaps, opportunities |
| title | Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field |
| title_full | Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field |
| title_fullStr | Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field |
| title_full_unstemmed | Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field |
| title_short | Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field |
| title_sort | gaps and opportunities in hiv service delivery in high volume hiv care centers in liberia lessons from the field |
| topic | hiv, service delivery, liberia, gaps, opportunities |
| url | https://annalsofglobalhealth.org/articles/3246 |
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