Abstract Background Many sub-Saharan Africa countries are scaling up differentiated service delivery (DSD) models for HIV treatment to increase access and remove barriers to care. We assessed factors associated with attrition after DSD model enrollment in Zambia, focusing on patient-level characteristics. Methods We conducted a retrospective record review using electronic medical records (EMR) of adults (≥15 years) initiated on antiretroviral (ART) between 01 January 2018 and 30
RESEARCH HIGHLIGHTS As the COVID-19 pandemic abated in 2022, the Health Economics and Epidemiology Research Office (HE²RO) continued to expand its research and evaluation projects in South Africa and its neighbouring countries. A follow on to the AMBIT (Alternative Models of ART Delivery) study was awarded, along with a supplementary budget to augment the AMBIT 2.0 study which is running in South Africa, Malawi and Zambia. Under this project implementation of the multi-country SENTINEL
Abstract Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted
Background Time and motion studies involve measuring the productivity of employees by directly observing how long it takes to complete required tasks. The purpose of this measurement is to assess efficiency, effectiveness and improve systems. This study examined the perspectives of healthcare workers on the novel electronic technology of wearable tags in order to determine the impact of visit length on the cost and quality of providing TB and HIVservices. These wearable tags are attached
The tuberculosis (TB) MATE study evaluated whether a differentiated care approach (DCA) based on tablet-taking data from Wisepill evriMED digital adherence technology could improve TB treatment adherence. The DCA entailed a stepwise increase in adherence support starting from short message service (SMS) to phone calls, followed by home visits and motivational counselling. We explored feasibility of this approach with providers in implementing
Tuberculosis (TB) stigma is a barrier to active case finding and delivery of care in fighting the TB epidemic. As part of a project exploring different models for delivery of TB contact tracing, we conducted a qualitative analysis to explore the presence of TB stigma within communities across South
Early pregnancy access to prenatal care is essential. Research has linked a lack of antenatal services to a risk of maternal mortality. Younger women typically share traits such as low socioeconomic position, lack of spousal support, work obligations, and unexpected pregnancies. In South Africa more than a third of births occur in young mothers aged <24 years. The influence of early maternal age and caregiving knowledge on pregnancy, birth, and early childhood outcomes is
A strong body of evidence demonstrates that the negative impacts of early adversity on child development in low- and middle-income countries (LMICs) can be mitigated through appropriate early-life interventions. Regular home visits by trained staff who support and counsel caregivers on a diversity of topics, including child health, nutrition, and play-based stimulation, have been shown to be particularly effective. However, important questions remain around how to effectively integrate
One barrier to ART treatment adherence in South Africa is intimate partner violence (IPV), which can also affect mental health. The Common Elements Treatment Approach (CETA) is an evidence-based intervention that addresses multiple mental health problems simultaneously including IPV. While the intervention has been successful in improving mental health outcomes it has yet to be tested at improving HIV
Early pregnancy access to prenatal care is essential Research has linked a lack of antenatal services to a risk of maternal mortality Younger women typically share traits such as low socioeconomic position, lack of spousal support, work obligations, and unexpected pregnancies During focused group discussions (FGD) with CHWs they stated that young women had poorer
The principles of infant and young child nutrition apply to all children, despite their HIV status. From the age of 6 months, breastfeeding is no longer able to meet all of the nutritional requirements of a developing child The nutritional status of children is influenced chiefly by caregivers Caregivers need to be able to provide adequate (in quantity and diversity) and frequent feedings 45% of children (8.9 million) were poor in 2018, and 33% (6.4 million) were below the food
Summary Background: Long-acting injectable cabotegravir pre-exposure prophylaxis (PrEP) is recommended by WHO as an additional option for HIV prevention in sub-Saharan Africa, but there is concern that its introduction could lead to an increase in integrase-inhibitor resistance undermining treatment programmes that rely on dolutegravir. We aimed to project the health benefits and risks of cabotegravir-PrEP introduction in settings in sub-Saharan Africa. Methods: With HIV Synthesis, an
