| Autor: |
Hassan, Frank Eric, Grace Soka, Esther Ngadaya1, Kimambo, Happiness, Silvan, Boniface, Maokola, Werner, Senkoro, Mbazi, Donard, Francis, Omollo, Justin, Filbert, Doreen, Mfinanga, Sayoki, Kahwa, Amos, Kimaro, Godfather |
| Zdroj: |
Tanzania Journal of Health Research; Jul2023, Vol. 24 Issue 3, p207-223, 17p |
| Abstrakt: |
Background: Starting Antiretroviral Treatment (ART) on time and being retained in care reduces the risk of HIV transmission, impoverishment of chronic end-organ effects of untreated viremia, and an overall increase in life expectancy. This study aimed at establishing available strategies for the linkage and retention of HIV clients as well as the costs associated with the strategy. Method: A retrospective cross-sectional design was conducted in eight regions of Tanzania mainland. A total of 60 facilities and affiliated communities providing linkage and ART services were involved. Mixed methods of collecting data were used with comprehensive document review. Information collected was for the period between 1st January to 31st December 2019. Cost evaluation was based on both patient and provider perspectives. Results: In general, 91% of the clients were successfully linked to care and the cost per client linked was $14.0 across regions. The cost of facility linkage strategy was $14.73 with personnel, commodities and supplies and training costs emerging as the cost drivers. The cost for client linkage to care using the community strategy was lower ($11.89) than the facility strategy ($14.73). The overall retention rate was 99% with no difference between retention strategies. The Cost of retention per client in facilities without outreach services was $14.73 while in facilities with outreach, the cost was $11.89. Personnel cost was the primary costs’ driver in both strategies. Of 1,039 participants involved, to establish patient incurred cost for retention to care. Females were 65.4% and 57.8% of participants were from rural settings. Clients incurred annual out-of-pocket payments was $12.06. Conclusion: There is no difference in the yield of the HIV-positive and overall percentage of clients successfully linked to care based on facility and community strategies. However, there is regional variations in terms of per-client cost for HIV linkage and retention services. The overall cost per client linked using the facility strategy was higher than the community strategy and personnel cost was the main cost driver in both linkage and retention costs. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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