Article ; Online: Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda.
2021 Volume 21, Issue 1, Page(s) 692
Abstract: Background: The notion of health-system resilience has received little empirical attention in the current literature on the Covid-19 response. We set out to explore health-system resilience at the sub-national level in Uganda with regard to strategies ... ...
| Abstract | Background: The notion of health-system resilience has received little empirical attention in the current literature on the Covid-19 response. We set out to explore health-system resilience at the sub-national level in Uganda with regard to strategies for dispensing antiretrovirals during Covid-19 lockdown. Methods: We conducted a qualitative case-study of eight districts purposively selected from Eastern and Western Uganda. Between June and September 2020, we conducted qualitative interviews with district health team leaders (n = 9), ART clinic managers (n = 36), representatives of PEPFAR implementing organizations (n = 6).In addition, six focus group discussions were held with recipients of HIV care (48 participants). Qualitative data were analyzed using thematic approach. Results: Five broad strategies for distributing antiretrovirals during 'lockdown' emerged in our analysis: accelerating home-based delivery of antiretrovirals,; extending multi-month dispensing from three to six months for stable patients; leveraging the Community Drug Distribution Points (CDDPs) model for ART refill pick-ups at outreach sites in the community; increasing reliance on health information systems, including geospatial technologies, to support ART refill distribution in unmapped rural settings. District health teams reported leveraging Covid-19 outbreak response funding to deliver ART refills to homesteads in rural communities. Conclusion: While Covid-19 'lockdown' restrictions undoubtedly impeded access to facility-based HIV services, they revived interest by providers and demand by patients for community-based ART delivery models in case-study districts in Uganda. |
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| MeSH term(s) | COVID-19 ; Communicable Disease Control ; Delivery of Health Care ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; SARS-CoV-2 ; Uganda |
| Language | English |
| Publishing date | 2021-07-13 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2050434-2 |
| ISSN | 1472-6963 ; 1472-6963 |
| ISSN (online) | 1472-6963 |
| ISSN | 1472-6963 |
| DOI | 10.1186/s12913-021-06607-w |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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