32 research outputs found
Map of Uganda Showing the 12 Study Districts.
<p>The study districts are highlighted with red boundaries.</p
Impact of a Family Clinic Day intervention on paediatric and adolescent appointment adherence and retention in antiretroviral therapy: A cluster randomized controlled trial in Uganda
<div><p>Background</p><p>In 2013, Uganda adopted a test-and-treat policy for HIV patients 15 years or younger. Low retention rates among paediatric and adolescent antiretroviral therapy (ART) initiates could severely limit the impact of this new policy. This evaluation tested the impact of a differentiated care model called Family Clinic Day (FCD), a family-centered appointment scheduling and health education intervention on patient retention and adherence to monthly appointment scheduling.</p><p>Methods</p><p>We conducted a cluster randomized controlled trial, from October 2014 to March 2015. Forty-six facilities were stratified by implementing partner and facility type and randomly assigned to the control or intervention arm. Primary outcomes included the proportion of patients retained in care at 6 months and the proportion adherent to their appointment schedule at last study period scheduled visit. Data collection occurred retrospectively in May 2015. Six patient focus group discussions and 17 health workers interviews were conducted to understand perspectives on FCD successes and challenges.</p><p>Results</p><p>A total of 4,715 paediatric and adolescent patient records were collected, of which 2,679 (n = 1,319 from 23 control facilities and 1,360 from 23 intervention facilities) were eligible for inclusion. The FCD did not improve retention (aOR 1.11; 90% CI 0.63–1.97, p = 0.75), but was associated with improved adherence to last appointment schedule (aOR 1.64; 90% CI 1.27–2.11, p<0.001). Qualitative findings suggested that FCD patients benefited from health education and increased psychosocial support.</p><p>Conclusion</p><p>FCD scale-up in Uganda may be an effective differentiated care model to ensure patient adherence to ART clinic appointment schedules, a key aspect necessary for viral load suppression. Patient health outcomes may also benefit following an increase in knowledge based on health education, and peer support. Broad challenges facing ART clinics, such as under-staffing and poor filing systems, should be addressed in order to improve patient care.</p></div
The projected 4 year costs once the transport network is established.
<p>The projected 4 year costs once the transport network is established.</p
The recommended turnaround time measured as the time from collection of a sample to receipt of the results was about 28
<p>The recommended turnaround time measured as the time from collection of a sample to receipt of the results was about 28</p
The cost in 2010 before the network was started compared to when additional costs for start up of the transport network were added.
<p>The cost in 2010 before the network was started compared to when additional costs for start up of the transport network were added.</p
Location of Katwe Village in Uganda, where a cholera outbreak occurred during June–July 2015.
<p>(Map source: <a href="http://ian.macky.net/pat/map/ug/ug.html" target="_blank">http://ian.macky.net/pat/map/ug/ug.html</a>, public domain, accessed 20<sup>th</sup> November 2017).</p
Estimated costs different aspects of sample analysis.
<p>Estimated costs different aspects of sample analysis.</p
How Turnaround Time reduced; sample and result transit time dropped from 49 days before lab consolidation to 26 day and from 26 to 14 days due to the NSRTN.
<p>How Turnaround Time reduced; sample and result transit time dropped from 49 days before lab consolidation to 26 day and from 26 to 14 days due to the NSRTN.</p
The cost at each of the 19 hubs before and after the initiation of the National sample referral transport network (NSRTN).
<p>The cost at each of the 19 hubs before and after the initiation of the National sample referral transport network (NSRTN).</p