15 research outputs found
[Accepted Manuscript] Cash vs. food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania: a randomized trial.
We evaluated the effectiveness of short-term cash and food assistance to improve adherence to antiretroviral therapy (ART) and retention in care among people living with HIV in Tanzania.
At three clinics, 805 participants were randomized to three groups in a 3â:â3â:â1 ratio, stratified by siteâ:ânutrition assessment and counseling (NAC) and cash transfers (âź$11/month, nâ=â347), NAC and food baskets (nâ=â345), and NAC-only (comparison group, nâ=â113, clinicaltrials.gov NCT01957917). Eligible people living with HIV were at least 18 years, initiated ART 90 days or less prior, and food insecure. Cash or food was provided for 6 or less consecutive months, conditional on visit attendance. The primary outcome was medication possession ratio (MPR) at least 95% at 6 months. Secondary outcomes were appointment attendance and loss to follow-up (LTFU) at 6 and 12 months.
The primary intent-to-treat analysis included 800 participants. Achievement of MPR at least 95% at 6 months was higher in the NACâ+âcash group compared with NAC-only (85.0 vs. 63.4%), a 21.6 percentage point difference [95% confidence interval (CI): 9.8, 33.4, Pâ<â0.01]. MPR at least 95% was also significantly higher in the NACâ+âfood group vs. NAC-only (differenceâ=â15.8, 95% CI: 3.8, 27.9, Pâ<â0.01). When directly compared, MPR at least 95% was similar in the NACâ+âcash and NACâ+âfood groups (differenceâ=â5.7, 95% CI: -1.2, 12.7, Pâ=â0.15). Compared with NAC-only, appointment attendance and LTFU were significantly higher in both the NACâ+âcash and NACâ+âfood groups at 6 months. At 12 months, the effect of NACâ+âcash, but not NACâ+âfood, on MPR at least 95% and retention was sustained.
Short-term conditional cash and food assistance improves ART possession and appointment attendance and reduces LTFU among food-insecure ART initiates in Tanzania
How to do a good systematic review of effects in international development: a tool kit
We provide a âhow toâ guide to undertake systematic reviews of effects in international development, by which we mean, synthesis of literature relating to the effectiveness of particular development interventions. Our remit includes determining the review's questions and scope, literature search, critical appraisal, methods of synthesis including meta-analysis, and assessing the extent to which generalisable conclusions can be drawn using a theory-based approach. Our work draws on the experiences of the International Initiative for Impact Evaluation's (3ie's) systematic reviews programm