Towards universal ARV access: achievements and challenges in Free State Province, South Africa.
S Afr Med J
; 100(9): 589-93, 2010 Sep 07.
Article
em En
| MEDLINE
| ID: mdl-20822648
OBJECTIVE: To study the progress and challenges with regard to universal antiretroviral (ARV) access in Free State Province, South Africa. METHODS: Data from the first 4 years of the public sector ARV roll-out and selected health system indicators were used. Data were collected from the public sector ARV database in Free State Province for new patients on ARVs, average waiting times and median CD4 counts at the start of treatment. Information on staff training, vacancy rates and funding allocations for the ARV roll-out was obtained from official government reports. Projections were made of expected new ARV enrolments for 2008 and 2009 and compared with goals set by the National Strategic Plan (NSP) to achieve universal access to ARVs by 2011. RESULTS: New ARV enrolments increased annually to 25% of the estimated need by the end of 2007. Average waiting times to enrolment decreased from 5.82 months to 3.24 months. Median CD4 counts at enrolment increased from 89 to 124 cells/mm3. There is a staff vacancy rate of 38% in the ARV programme and an inadequate increase in budget allocations. CONCLUSION: The current vertical model of ARV therapy delivery is unlikely to raise the number of new enrolments sufficiently to achieve the goals of universal access by 2011 as envisaged by the NSP. The Free State is implementing a project (STRETCH trial) to broaden the ARV roll-out in an attempt to increase access to ARVs.
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Controle de Doenças Transmissíveis
/
Antirretrovirais
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Humans
/
Middle aged
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article