Availability and readiness of public health facilities to provide differentiated service delivery models for HIV treatment in Zambia

Implications for better treatment outcomes

Datos Bibliográficos

ID22070026
AutoresPatrick Kaonga (0000-0003-0461-8361, University of Zambia, autor de correspondencia), Mutale Sampa (0000-0001-5845-9533, University of Zambia), Mwiche Musukuma (University of Zambia), Mulanda Joseph Mulawa (0000-0003-4224-0267, University of Zambia), Mataanana Mulavu (0000-0001-6096-4897, University of Zambia), Doreen Sitali (0000-0002-6650-4071, University of Zambia), Given Moonga (0000-0003-0062-1475, University of Zambia), Oliver Mweemba (0000-0002-6941-0193, University of Zambia), T F L Matenga (0000-0003-2145-002X, University of Zambia), Tulani Francis Matenga, Cosmus Zyambo (0000-0003-1913-3367, University of Zambia), Cosmas Zyambo, Twaambo E Hamoonga (0000-0001-7375-4610, University of Zambia), Twaambo Hamoonga, Henry Phiri (Ministry of Health), Hikabasa Halwindi (University of Zambia), Malizgani Paul Chavula (0000-0003-1189-7194, University of Zambia), Joseph Mumba Zulu (0000-0003-1480-4977, University of Zambia), Choolwe Jacobs (0000-0002-7741-1962, University of Zambia)
Año2024
Volumen12
Páginas1396590-1396590
Fecha de publicación2024-11-06
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaFrontiers in Public Health (JOURNAL)
Identificadores de la revistaISSN: 2296-2565 • E-ISSN: 2296-2565
EditorialFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1396590
PMID39568605
OpenAlexW4404229754
IdiomaEN
Citas recibidas2
Referencias citadas30

Background There is persistent pressure on countries with a high burden of HIV infection to reach desired targets for HIV treatment outcomes. This has led to moving from the “one-size-fits-all” model to differentiated service delivery (DSD) models, which are meant to be more patient-centered and efficient but without compromising on the quality of patient care. However, for DSD models to be efficient, facilities should have indicators of HIV services available and ready to provide the DSD models. We aimed to assess the availability of HIV service indicators and the readiness of facilities to provide DSD models for HIV treatment in selected public health facilities in Zambia. Methods We conducted a nationwide cross-sectional survey among public health facilities in Zambia that provide antiretroviral therapy (ART) services. We used an interviewer-administered questionnaire based on a World Health Organization (WHO) Service Availability Readiness Assessment (SARA) tool to assess the availability of HIV service indicators and the readiness of facilities to implement DSD models for HIV treatment. Availability and readiness were considered latent constructs, and therefore, we used structural equation modeling (SEM) to determine the correlations between them and their respective indicators. Results Of 60 public health ART facilities, the overall availability of HIV service indicators was 80.0% (48/60), and readiness to provide the DSD models was 81.7% (48/60). However, only 48 and 39% of the facilities had all indicators of availability and readiness, respectively. Retention in care for HIV multidisciplinary teams was more likely to occur in urban areas than in rural areas. SEM showed that the standardized estimate between availability and readiness was significantly and positively correlated ( r = 0.73, p < 0.0001). In addition, both availability and readiness were significantly and positively correlated with most of their respective indicators. Conclusion Although most facilities had available HIV service indicators and were ready to provide DSD models, most facilities did not have all indicators of availability and readiness. In addition, there were differences between rural and urban facilities in some indicators. There is a need for persistent and heightened efforts meant to implement DSD in HIV treatment, especially in rural areas to accelerate reaching the desired HIV treatment outcomes

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