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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique
PLoS ONE, Volume 9, No. 3, Article e91544, Year 2014
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Description
Background: To improve retention on ART, Médecins Sans Frontières, the Ministry of Health and patients piloted a community-based antiretroviral distribution and adherence monitoring model through Community ART Groups (CAG) in Tete, Mozambique. By December 2012, almost 6000 patients on ART had formed groups of whom 95.7% were retained in care. We conducted a qualitative study to evaluate the relevance, dynamic and impact of the CAG model on patients, their communities and the healthcare system. Methods: Between October 2011 and May 2012, we conducted 16 focus group discussions and 24 in-depth interviews with the major stakeholders involved in the CAG model. Audio-recorded data were transcribed verbatim and analysed using a grounded theory approach. Results: Six key themes emerged from the data: 1) Barriers to access HIV care, 2) CAG functioning and actors involved, 3) Benefits for CAG members, 4) Impacts of CAG beyond the group members, 5) Setbacks, and 6) Acceptance and future expectations of the CAG model. The model provides cost and time savings, certainty of ART access and mutual peer support resulting in better adherence to treatment. Through the active role of patients, HIV information could be conveyed to the broader community, leading to an increased uptake of services and positive transformation of the identity of people living with HIV. Potential pitfalls included limited access to CAG for those most vulnerable to defaulting, some inequity to patients in individual ART care and a high dependency on counsellors. Conclusion: The CAG model resulted in active patient involvement and empowerment, and the creation of a supportive environment improving the ART retention. It also sparked a reorientation of healthcare services towards the community and strengthened community actions. Successful implementation and scalability requires (a) the acceptance of patients as partners in health, (b) adequate resources, and (c) a well-functioning monitoring and management system. © 2014 Rasschaert et al.
Authors & Co-Authors
Rasschaert, Freya
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Telfer, Barbara L.
Switzerland, Geneva
Medecins Sans Frontieres
Lessitala, Faustino
Switzerland, Geneva
Medecins Sans Frontieres
Decroo, Tom
Switzerland, Geneva
Medecins Sans Frontieres
Remartínez, Daniel
Switzerland, Geneva
Medecins Sans Frontieres
Biot, Marc
Belgium, Brussels
Medecins Sans Frontieres, Brussels
Candrinho, Baltazar Neves
Mozambique
Tete
Mbofana, Francisco S.
Unknown Affiliation
van Damme, Wim
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Statistics
Citations: 63
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0091544
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Grounded Theory
Study Approach
Qualitative
Study Locations
Mozambique