Scaling-up antiretroviral therapy in Malawi.
Bull World Health Organ
; 94(10): 772-776, 2016 Oct 01.
Article
em En
| MEDLINE
| ID: mdl-27843168
ABSTRACT
PROBLEM:
In Malawi, health-system constraints meant that only a fraction of people infected with human immunodeficiency virus (HIV) and in immediate need of antiretroviral treatment (ART) received treatment.APPROACH:
In 2004, the Malawian Ministry of Health launched plans to scale-up ART nationwide, adhering to the principle of equity to ensure fair geographical access to therapy. A public health approach was used with standardized training and treatment and regular supervision and monitoring of the programme. LOCALSETTING:
Before the scale-up, an estimated 930 000 people in Malawi were HIV-infected, with 170 000 in immediate need of ART. About 3000 patients were on ART in nine clinics. RELEVANT CHANGES By December 2015, cumulatively 872 567 patients had been started on ART from 716 clinics, following national treatment protocols and using the standard monitoring system. LESSONS LEARNT Strong national leadership allowed the ministry of health to implement a uniform system for scaling-up ART and provided benchmarks for implementation on the ground. New systems of training staff and accrediting health facilities enabled task-sharing and decentralization to peripheral health centres and a standardized approach to starting and monitoring ART. A system of quarterly supervision and monitoring, into which operational research was embedded, ensured stocks of drug supplies at facilities and adherence to national treatment guidelines.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Antirretrovirais
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Guideline
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Africa
Idioma:
En
Revista:
Bull World Health Organ
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Malauí