A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.

<h4>Background</h4>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 patient...

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Autores principales: Freya Rasschaert, Barbara Telfer, Faustino Lessitala, Tom Decroo, Daniel Remartinez, Marc Biot, Baltazar Candrinho, Francisco Mbofana, Wim Van Damme
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spelling oai:doaj.org-article:15dc311d4e2548efbfcbb9bc9edbcfb32021-11-18T08:27:00ZA qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.1932-620310.1371/journal.pone.0091544https://doaj.org/article/15dc311d4e2548efbfcbb9bc9edbcfb32014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24651523/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Freya RasschaertBarbara TelferFaustino LessitalaTom DecrooDaniel RemartinezMarc BiotBaltazar CandrinhoFrancisco MbofanaWim Van DammePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 3, p e91544 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Freya Rasschaert
Barbara Telfer
Faustino Lessitala
Tom Decroo
Daniel Remartinez
Marc Biot
Baltazar Candrinho
Francisco Mbofana
Wim Van Damme
A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.
description <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
format article
author Freya Rasschaert
Barbara Telfer
Faustino Lessitala
Tom Decroo
Daniel Remartinez
Marc Biot
Baltazar Candrinho
Francisco Mbofana
Wim Van Damme
author_facet Freya Rasschaert
Barbara Telfer
Faustino Lessitala
Tom Decroo
Daniel Remartinez
Marc Biot
Baltazar Candrinho
Francisco Mbofana
Wim Van Damme
author_sort Freya Rasschaert
title A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.
title_short A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.
title_full A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.
title_fullStr A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.
title_full_unstemmed A qualitative assessment of a community antiretroviral therapy group model in Tete, Mozambique.
title_sort qualitative assessment of a community antiretroviral therapy group model in tete, mozambique.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/15dc311d4e2548efbfcbb9bc9edbcfb3
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