Publication: Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa: The Impact of Differentiated Care Models on Short-Term Indicators in HIV Patients
Loading...
Files in English
210 downloads
Published
2017-10
ISSN
Date
2018-02-28
Author(s)
Editor(s)
Abstract
This report describes the short-term outcomes of an evaluation study for five different HIV cohorts using routinely collected data. The evaluation study is a collaboration between the National Department of Health of South Africa, the National Health Laboratory Service (NHLS) and the World Bank. Boston University/Health Economics and Epidemiology Research Office (HE2RO) is the academic partner in the evaluation. The overall aims of the evaluation are to assess the impact of South Africa`s Adherence Guideline interventions on HIV patients’ treatment outcomes; estimate the costs of the interventions; and describe the cascade of care for TB, hypertension, and diabetes at the same clinics. The short-term endpoints reported on herein concern ART initiation among FTIC eligible patients, ARV medication pick-up among AC and DMD eligible patients, retention in care among TRIC eligible patients, and viral load suppression among EAC eligible patients. The final outcomes of this evaluation will be reported on separately, once patients have been follow-up for one year and routine data on viral load suppression and retention in care become available
Link to Data Set
Citation
“World Bank. 2017. Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa: The Impact of Differentiated Care Models on Short-Term Indicators in HIV Patients. © World Bank. http://hdl.handle.net/10986/29396 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa(World Bank, Washington, DC, 2017-06)This report presents the result of the qualitative evaluation to understand the implementation of five adherence interventions from the provider perspective in four South African provinces. The research is part of the evaluation of the new Adherence Guidelines for HIV, TB and other chronic diseases. The study sought to answer four key questions: 1. What are the barriers to and facilitators of implementing the minimum package interventions from the perspective of the providers? 2. What are the strengths and weaknesses of each intervention for HIV positive patients from the perspective of providers? 3. How could implementation of adherence interventions and the minimum package of interventions be improved? 4. What additional strategies do providers feel would be helpful in improving treatment adherence? The report presents the thematic analysis of the qualitative interview transcripts under each of the four questions. Emerging themes are illustrated with quotes from respondents at intervention and control clinics. The results show that providers were generally positive about all the interventions, though they had mixed comments about the Direct Medicine Delivery and Tracing and Retention-in-Care models, largely because they were not always well implemented or providers felt they did not have the resources to implement them at scale. Additionally, providers' views were mixed on their perceived effectiveness of Adherence Clubs.Publication Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data(World Bank, Washington, DC, 2016-10-31)This report describes enrollment into the cohorts for protocol 1 for the Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data. The study is evaluating short-term and long-term effects of five interventions being implemented by the National Department of Health (NDoH) in South Africa to improve adherence to HIV care and chronic disease care in general: Fast track initiation counselling, decentralized medicine delivery, adherence clubs, early patient tracing and enhanced adherence counselling. The study uses a randomized evaluation design to compare sites where the intervention was rolled out with control sites providing standard of care. Enrollment began in June 2016 and was uneven in time and by province, as expected in a process using routine data and relying on programmatic implementation. Enrollment of HIV clients into cohorts will enable the NDoH to understand the short-term and long-term impacts of interventions to improve HIV treatment initiation, adherence and retention in care.Publication Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data(World Bank, Washington, DC, 2017-01-31)This report describes enrollment into the cohorts for protocol 1 for the Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data. The study is evaluating short-term and long-term effects of five interventions being implemented by the National Department of Health (NDoH) in South Africa to improve adherence to HIV care and chronic disease care in general: Fast track initiation counselling, decentralized medicine delivery, adherence clubs, early patient tracing and enhanced adherence counselling. The study uses a randomized evaluation design to compare sites where the intervention was rolled out with control sites providing standard of care. Enrollment began in June 2016 and was uneven in time and by province, as expected in a process using routine data and relying on programmatic implementation. Enrollment of HIV clients into cohorts will enable the NDoH to understand the short-term and long-term impacts of interventions to improve HIV treatment initiation, adherence and retention in care.Publication Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa(World Bank, Washington, DC, 2017-06)This report presents the result of the qualitative evaluation to understand the implementation of five adherence interventions from the patient perspective in four South African provinces. The research is part of the evaluation of the new Adherence Guidelines for HIV, TB and other chronic diseases. The study sought to answer four key questions: questions: 1. How does patient satisfaction with care at the intervention sites compare to the control sites among HIV positive patients? 2. What are the barriers to and facilitators of ART initiation and adherence among HIV-positive patients eligible for each intervention? 3. What are the strengths and weaknesses of each intervention for HIV positive patients from the patient perspective? 4. What additional strategies do patients feel would be helpful in improving treatment adherence? The report presents the triangulated qualitative and quantitative data from patient surveys and focus group discussions under each of the four questions. The results show that from the patient perspective, each intervention has promise and supported either ART initiation or adherence, however each could be improved. Detailed illustrative quotes are provided for each intervention according to the main themes identified. Specifically, patients had very positive feelings about Adherence Clubs and Decentralized Medication Delivery in focus group discussions.Publication Evaluation of the Adherence Guidelines for Chronic Diseases in South Africa Using Routinely Collected Data(World Bank, Washington, DC, 2018-07)This report describes the findings of a study on the continua of care for tuberculosis, hypertension and diabetes in South Africa forming part of an evaluation of the National Adherence Guidelines for Chronic Diseases. Conducted by the National Department of Health in collaboration with the National Health Laboratory Service, the World Bank, and Boston University/Health Economics and Epidemiology Research Office, the study used routine data from 24 health facilities in Gauteng, KwaZulu-Natal, Limpopo, North West provinces. Observational cohorts of patients were created using clinic records and applying eligibility criteria. In the screening cohort of 3600 patients, 46 percent of eligible patients had a TB screen (83 percent of HIV patients) with 8 percent having positive screens. For hypertension, 72 of eligible patients were screened and 19 percent positive. For diabetes, 56 percent of eligible patients had evidence of screening in the past three years and 4 percent were positive. In the diagnosed cohort of 1,096 patients, treatment initiation was 98 percent for TB, 92 percent for hypertension and 82 percent for diabetes. Treatment success was 71 percent for TB, 22 percent for hypertension 18 percent for diabetes. The results demonstrated that considerable efforts are made to find cases and retain them in care, but that there is room for further improvement to maximize patient outcomes in chronic care.
Users also downloaded
Showing related downloaded files
Publication Lebanon Economic Monitor, Fall 2022(Washington, DC, 2022-11)The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.Publication MIGA Annual Report 2021(Washington, DC: Multilateral Investment Guarantee Agency, 2021-10-01)In FY21, MIGA issued 5.2 billion US Dollars in new guarantees across 40 projects. These projects are expected to provide 784,000 people with new or improved electricity service, create over 14,000 jobs, generate over 362 million US Dollars in taxes for the host countries, and enable about 1.3 billion US Dollars in loans to businesses—critical as countries around the world work to keep their economies afloat. Of the 40 projects supported during FY21, 85 percent addressed at least one of the strategic priority areas, namely, IDA-eligible countries (lower-income), fragile and conflict affected situations (FCS), and climate finance. As of June 2021, MIGA has also issued 5.6 billion US Dollars of guarantees through our COVID-19 Response Program and anticipate an expansion to 10–12 billion US Dollars over the coming years, a testament to the countercyclical role that MIGA can play in mobilizing private investment in the face of the pandemic. A member of the World Bank Group, MIGA is committed to strong development impact and promoting projects that are economically, environmentally, and socially sustainable. MIGA helps investors mitigate the risks of restrictions on currency conversion and transfer, breach of contract by governments, expropriation, and war and civil disturbance, as well as offering credit enhancement on sovereign obligations.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.