Lazarus Jere1*, Bwalya Chiti2 and Joseph Zulu1
Lazarus Jere1*, Bwalya Chiti2 and Joseph Zulu1Fulltext PDF
In 2015, the Zambian Ministry of Health through Center for Infectious Disease Research in Zambia (CIDRZ) piloted a Community Adhere Group (CAG) model to help improve art patient’s retention in to care. The models were piloted in two facilities of eastern province, one facility in Lusaka province and two facilities in Southern province. This was to overcome patient barriers to accessing antiretroviral therapy ART treatment, and to improve patient retention. Six stable ART patients would agree to self-form a group which operates by patients taking turns to collect ART refills. One of the six group members go to the health facility to collect drugs and share when they reach the community. A qualitative study was conducted to evaluate from patients and Health Care Workers (HCW) what led to two facilities having huge differences in patient’s retention in care under CAG models. Data were collected from purposively selected participants in two sites which had highest and lowest retention rates respectively. The study had two study samples which are People Living with HIV (PLWH) and HCW. The PLWH were selected from CAG group and HCW were selected from those who were working with CAG model. A total of eight Focus Group Discussions (FGD) and six In-Depth Interviews (IDIs) were conducted with a total of 64 participants. All the participants were purposively selected. Narratives were audio-recorded, transcribed and translated to English and data was analyzed thematically. What triggered high retention rates at one site which had high retention rate included a reduced frequency of clinic visits, resulting in reduced transportation costs, peer to peer support through sharing challenges, experience and knowledge. However, conflict of CAG interventions activities and livelihood activities triggered low patient retention rate at the site which had low retention rate. CAGs were perceived as practical models of improving ART patient retention because of reduced frequenting the health facility, freed up time, peer to peer HIV knowledge sharing. Despite CAG addressing practical barriers of improve ART patients’ retention, some participants at another site saw it as not compatible to their situation because accessing ART using CAG was in conflict with people’s livelihood activities. Therefore, it can be said that CAGs are practical models of improving ART patient retention though there is no “one size fit all” in interventions meant to improve patients’ retention.
CAG; Retention; Mechanisms; Context
Jere L, Chiti B, Zulu J. Patients and Healthcare Workers Views on Patients Retention Outcomes of Community Adherence Group (CAGs) Model for HIV/AIDS Treatment in Zambia: A Qualitative Study. Open J Public Health. 2020;2(2):1016..