decentralization

Decentralizing ART Supply for Stable HIV Patients to Community-Based Distribution Centers: Program Outcomes From an Urban Context in Kinshasa, DRC

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Yes
Author
Florian Vogt, Lucien Kalenga, Jean Lukela, Freddy Salumu, Ibrahim Diallo, Elena Nico, Emmanuel Lampart, Rafael Van den Bergh, Safieh Shah, Olumide Ogundahunsi, Rony Zachariah, Johan Van Griensven

Facility-based antiretroviral therapy (ART) provision for stable patients with HIV congests health services in resource-limited countries. We assessed outcomes and risk factors for attrition after decentralization to community-based ART refill centers among 2603 patients with HIV in Kinshasa, Democratic Republic of Congo, using a multilevel Poisson regression model. Death, loss to follow-up, and transfer out were 0.3%, 9.0%, and 0.7%, respectively, at 24 months. Overall attrition was 5.66/100 person-years.

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Combatting Global Infectious Diseases: A Network Effect of Specimen Referral Systems

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Yes
Author
Peter N. Fonjungo George A. Alemnji Yenew Kebede Alex Opio Christina Mwangi Thomas J. Spira R. Suzanne Beard John N. Nkengasong

The recent Ebola virus outbreak in West Africa clearly demonstrated the critical role of laboratory systems and networks in responding to epidemics. Because of the huge challenges in establishing functional laboratories at all tiers of health systems in developing countries, strengthening specimen referral networks is critical. In this review article, we propose a platform strategy for developing specimen referral networks based on 2 models: centralized and decentralized laboratory specimen referral networks.

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How to Help Community-Based mHealth Programs Collect High-Quality Data

As health programs are relying more on decentralized models of care, mHealth has made it easier to collect, manage and store community-level health data. This data can feed into national health information systems and be used to inform decision making for improved service delivery at the community level. But how can we ensure that our community-based mHealth programs are collecting accurate, high-quality data that will help us deliver the right services to the right places at the right time?

Author
Michelle Li
Source
MEASURE Evaluation

Implementation and Operational Research: Evaluation of Eswatini's Hub-and-Spoke Model for Decentralizing Access to Antiretroviral Therapy Services

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Yes
Author
Auld, Andrew F; Kamiru, Harrison; Azih, Charles; Baughman, Andrew L.; Nuwagaba-Biribonwoha, Harriet; Ehrenkranz, Peter; Agolory, Simon; Sahabo, Ruben; Ellerbrock, Tedd V.; Okello, Velephi; Bicego, George

Background: In 2007, Swaziland initiated a hub-and-spoke model for decentralizing antiretroviral therapy (ART) access. Decentralization was facilitated through (1) down-referral of stable ART patients from overburdened central facilities (hubs) to primary health care clinics (spokes) and (2) ART initiation at spokes (spoke initiation).

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Providing antiretroviral therapy closer to patients homes to improve access to care in lower- and middle-income countries

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Yes
Author
Kredo T, Ford N, Adeniyi FB, Garner P

Many people living with HIV who need antiretroviral therapy are unable to access or remain in care. This is often because of the time and cost required to travel to health centres. One approach to facilitating access and retention in care is to provide antiretroviral therapy close to people’s homes, ‘decentralising’ treatment from hospitals to health centres or even to the community. 

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Rwanda's Mixed Epidemic: Results-based Strategy Refocuses Prevention Priorities

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Yes
Author
AIDSTAR-One

Data from a 2009 modeling exercise suggested that Rwanda has a mixed HIV epidemic, meaning that transmission occurs within both most-at-risk populations as well as the general population. This case study documents how Rwanda, with support from PEPFAR, created one of Africa's first comprehensive HIV programs, covering prevention, care, treatment, and impact mitigation.

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Decentralizing ART Services at Primary Health Care Facilities

Is the resource available on the Internet?
Yes
Author
AIDSTAR-One

Many countries have begun to decentralize HIV treatment to primary health care (PHC) centers to decrease the burden of providing HIV services at existing facilities while increasing access to treatment. The purpose of this technical brief is to assist national program planners, stakeholders, and implementers in designing, planning, and implementing the decentralization process and in providing ART services at PHC facilities, with the ultimate goal of achieving universal access to treatment and care in generalized HIV epidemic settings.

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Health System Strengthening (HSS) Project - Lesotho

The National Institute for Health and Welfare (THL) Finland is implementing a health sector development project funded by the Millennium Challenge Corporation, U.S. foreign aid agency. HSS is part of a broader MCC Health Sector Project in Lesotho funded with USD 122 million for the five-year period 2008–2013, which also includes consultancies in Health Infrastructure Development and Medical Waste Management. HSS Partners are the Health System Trust of South Africa and InDevelop-IPM from Sweden.
Physical address
Maseru, Lesotho
Email address
Telephone code and number
+266 22325973
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