Fidelity of HIV programme implementation by community health workers in rural Mopani district, South Africa: a community survey
| العنوان: | Fidelity of HIV programme implementation by community health workers in rural Mopani district, South Africa: a community survey |
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| المؤلفون: | Gert Marincowitz, Jude Igumbor, Nireshni Naidoo, James McIntyre, Remco P. H. Peters, Helen Struthers, Jean Railton, Sellina N. Khosa, Nthabiseng Matlakala |
| المساهمون: | Department of Public Health and Family Medicine, Faculty of Health Sciences, RS: CAPHRI - R4 - Health Inequities and Societal Participation, MUMC+: DA MMI Staf (9) |
| المصدر: | BMC Public Health BMC Public Health, Vol 18, Iss 1, Pp 1-8 (2018) BMC Public Health, 18:1099. BioMed Central Ltd |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Rural Population, HIV Infections, Community, South Africa, 0302 clinical medicine, Epidemiology, 030212 general & internal medicine, Duration (project management), Program Development, SUB-SAHARAN AFRICA, 10. No inequality, media_common, Aged, 80 and over, Community Health Workers, Public health, biology, lcsh:Public aspects of medicine, 1. No poverty, Middle Aged, 3. Good health, Community health, Female, Research Article, COUNTRIES, Adult, medicine.medical_specialty, Adolescent, media_common.quotation_subject, 030231 tropical medicine, Fidelity, 03 medical and health sciences, Young Adult, Environmental health, medicine, Community health workers, Humans, Aged, business.industry, Public Health, Environmental and Occupational Health, HIV, Letaba, lcsh:RA1-1270, CARE, biology.organism_classification, PREVENTION, Cross-Sectional Studies, Health Care Surveys, Implementation, Rural Health Services, Biostatistics, business |
| الوصف: | Background South Africa has implemented a community health programme delivered by community health workers (CHWs) to strengthen primary healthcare services. Provision of community Human Immunodeficiency Virus (HIV) services constitutes an important component of this programme. To support effectiveness, we assessed fidelity of HIV programme implementation by CHWs from the community’s perspective in a rural South African setting. Methods A cross-sectional study was conducted targeting 900 randomly selected households in twelve wards of two sub-districts (Greater Giyani and Greater Letaba) of Mopani District (Limpopo Province, South Africa). Questionnaires were administered to the traditionally most appropriate adult member of the household. Included were questions related to the four standard components to measure implementation fidelity against local guidelines: coverage, frequency, duration and content of HIV programme implementation. Results Participants were enrolled at 534 households; in most other cases there was nobody or no adult member at home (n = 291). Reported coverage of 55% (141/253) and a frequency of 47% (66/140) were higher in Greater Giyani as compared to Greater Letaba (44%; 122/278 and 29%; 33/112, respectively, p = 0.007 for both comparisons). Coverage was not associated with the distance from the participant’s household to the facility (p = 0.93). Duration of programme delivery was reported to be high, where all CHW visits (253/253; 100%) were conducted within the last 6 months and the content delivered was adequate (242/253; 96%). Individuals reporting a CHW visit were more likely to know their HIV status than those not visited (OR = 2.0; 95% CI 1.06–3.8; p = 0.032). Among those visited by the CHW discussion of HIV was associated with knowing the HIV status (OR = 2.2; 95% CI 1.02–4.6; p = 0.044); in particular for women (OR = 2.9; 95% CI 1.5–5.4; p = 0.001). Conclusions This study demonstrates promising HIV programme implementation fidelity by CHWs in rural South Africa. Programme coverage and frequency should be improved whilst maintaining the good levels of duration and content. Resource investment, strengthening of operational structure, and research to identify other facilitators of programme implementation are warranted to improve programme effectiveness and impact. |
| وصف الملف: | application/pdf |
| تدمد: | 1471-2458 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::317cda5a7ffae7b7c4d3f58e5dcfa521Test https://pubmed.ncbi.nlm.nih.gov/30189855Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....317cda5a7ffae7b7c4d3f58e5dcfa521 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712458 |
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