Effect of PEPFAR funding policy change on HIV service delivery in a large HIV care and treatment network in Nigeria

Autor: Prosper Okonkwo, Elizabeth Bassi, Muktar H. Aliyu, Bolanle Banigbe, Olujide O. Arije, Carolyn M. Audet, Kenneth A. Freedberg, Kate Clouse, Melynda Simmons, Aima A. Ahonkhai
Jazyk: angličtina
Rok vydání: 2019
Předmět:
RNA viruses
Male
Closed-ended question
Research Facilities
National Health Programs
Service delivery framework
Cross-sectional study
Human immunodeficiency virus (HIV)
HIV Infections
030312 virology
medicine.disease_cause
Pathology and Laboratory Medicine
Ambulatory Care Facilities
Geographical Locations
0302 clinical medicine
Immunodeficiency Viruses
Surveys and Questionnaires
Medicine and Health Sciences
Public and Occupational Health
030212 general & internal medicine
Hiv treatment
0303 health sciences
Multidisciplinary
Health Policy
1. No poverty
HIV diagnosis and management
Vaccination and Immunization
Clinical Laboratory Sciences
3. Good health
Clinical Laboratories
Medical Microbiology
Viral Pathogens
Viruses
Medicine
Female
Pathogens
Research Laboratories
Viral load
Research Article
medicine.medical_specialty
Science Policy
Anti-HIV Agents
Science
Immunology
Staffing
MEDLINE
Nigeria
Antiretroviral Therapy
Research and Analysis Methods
Microbiology
Research Funding
03 medical and health sciences
Antiviral Therapy
Diagnostic Medicine
Retroviruses
medicine
Humans
Government Funding of Science
Microbial Pathogens
Organizations
Health Care Policy
business.industry
Lentivirus
Organisms
Biology and Life Sciences
HIV
Health Care
Cross-Sectional Studies
Family medicine
People and Places
Africa
Preventive Medicine
business
Delivery of Health Care
Government Laboratories
Zdroj: PLoS ONE
PLoS ONE, Vol 14, Iss 9, p e0221809 (2019)
ISSN: 1932-6203
Popis: The transition to PEPFAR 2.0 with its focus on country ownership was accompanied by substantial funding cuts. We describe the impact of this transition on HIV care in a large network of HIV clinics in Nigeria. We surveyed 30 comprehensive HIV treatment clinics to assess services supported before (October 2013-September 2014) and after (October 2014-September 2015) the PEPFAR funding policy change, the impact of these policy changes on service delivery areas, and response of clinics to the change. We compared differences in support for staffing, laboratory services, and clinical operations pre- and post-policy change using paired t-tests. We used framework analysis to assess answers to open ended questions describing responses to the policy change. Most sites (83%, n = 25) completed the survey. The majority were public (60%, n = 15) and secondary (68%, n = 17) facilities. Clinics had a median of 989 patients in care (IQR: 543-3326). All clinics continued to receive support for first and second line antiretrovirals and CD4 testing after the policy change, while no clinics received support for other routine drug monitoring labs. We found statistically significant reductions in support for viral load testing, staff employment, defaulter tracking, and prevention services (92% vs. 64%, p = 0.02; 80% vs. 20%, 100% vs. 44%, 84% vs. 16%, respectively, p
Databáze: OpenAIRE
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