Improving performance of Zambia Defence Force antiretroviral therapy providers: evaluation of a standards-based approach
| Autor: | Bruno Benavides, Adrienne Kols, Webby Kanjipite, Stephanie Reinhardt, Maya Tholandi, Eva Bazant, Joseph Banda, Panganani Dalisani Njobvu, Supriya Sarkar, Young Mi Kim, Cyndi Hiner |
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| Rok vydání: | 2013 |
| Předmět: | |
| Zdroj: | Global Health, Science and Practice |
| ISSN: | 2169-575X |
| Popis: | A detailed standards-based performance approach modestly improved providers' performance and facility readiness to offer antiretroviral therapy. The approach included mutually reinforcing activities: (1) training, (2) supportive supervision, (3) assessments of service quality, and (4) facility-based action plans. Background: The Zambia Defence Force (ZDF) has applied the Standards-Based Management and Recognition (SBM-R®) approach, which uses detailed performance standards, at some health facilities to improve HIV-related services offered to military personnel and surrounding civilian communities. This study examines the effectiveness of the SBM-R approach in improving facility readiness and provider performance at ZDF facilities. Methods: We collected data on facility readiness and provider performance before and after the 2010–2012 intervention at 4 intervention sites selected for their relatively poor performance and 4 comparison sites. Assessors observed whether each facility met 16 readiness standards and whether providers met 9 performance standards during consultations with 354 returning antiretroviral therapy (ART) clients. We then calculated the percentages of criteria achieved for each readiness and performance standard and conducted bivariate and multivariate analyses of provider performance data. Results: Facilities' ART readiness scores exceeded 80% before the intervention at both intervention and comparison sites. At endline, scores improved on 4 facility readiness standards in the intervention group but on only 1 standard in the comparison group. Multivariate analysis found that the overall provider performance score increased significantly in the intervention group (from 58% to 84%; P |
| Databáze: | OpenAIRE |
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