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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Measuring the degree of integrated tuberculosis and HIV service delivery in Cape Town, South Africa
Health Policy and Planning, Volume 29, No. 1, Year 2014
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Description
To address the considerable tuberculosis (TB)/HIV co-infected population in Cape Town, a number of clinics have made an effort of varying degrees to integrate TB and HIV services. This article describes the development of a theory-based survey instrument designed to quantify the extent to which services were integrated in 33 clinics and presents the results of the survey. Using principal factor analysis, eight factors were extracted and used to make comparisons across three types of clinics: co-located TB and antiretroviral therapy (ART) services, clinics with TB services only and clinics with ART only. Clinics with co-located services scored highest on measures related to integrated TB/ART service delivery compared to clinics with single services, but within group variability was high indicating that co-location of TB and ART services is a necessary but insufficient condition for integrated service delivery. In addition, we found almost all clinics with only TB services in our sample had highly integrated pre-ART services, suggesting that integration of these services across a large number of clinics is feasible and acceptable to clinic staff. TB clinics with highly integrated pre-ART services appear to be efficient sites for introducing ART given that co-infected patients are already engaged in care, and may potentially facilitate earlier access to treatment and minimize loss to follow-up. © 2012 The Author.
Authors & Co-Authors
Uyei, Jennifer
United States, New York
New York University
United States, New York
Nyu Steinhardt
Coetzee, David John
South Africa, Cape Town
University of Cape Town
Macinko, James A.
United States, New York
Nyu Steinhardt
Weinberg, Sharon Lawner
United States, New York
Nyu Steinhardt
Guttmacher, Sally J.
United States, New York
Nyu Steinhardt
Statistics
Citations: 22
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1093/heapol/czs131
e-ISSN:
14602237
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa