دورية أكاديمية
Selecting implementation strategies to improve implementation of integrated PrEP for pregnant and postpartum populations in Kenya: a sequential explanatory mixed methods analysis
| العنوان: | Selecting implementation strategies to improve implementation of integrated PrEP for pregnant and postpartum populations in Kenya: a sequential explanatory mixed methods analysis |
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| المؤلفون: | Sarah Hicks, Ben Odhiambo, Felix Abuna, Julia C. Dettinger, Nancy Ngumbau, Laurén Gómez, Joseph Sila, George Oketch, Enock Sifuna, Bryan J. Weiner, Grace John-Stewart, John Kinuthia, Anjuli D. Wagner |
| المصدر: | Implementation Science Communications, Vol 4, Iss 1, Pp 1-12 (2023) |
| بيانات النشر: | BMC |
| سنة النشر: | 2023 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | HIV infections/prevention and control, Humans, Pregnancy and postpartum, Strategy prioritization, Nominal group technique, Medicine (General), R5-920 |
| الوصف: | Background There is a higher risk for HIV acquisition during pregnancy and postpartum. Pre-exposure prophylaxis (PrEP) is recommended during this period for those at high risk of infection; integrated delivery in maternal and child health (MCH) clinics is feasible and acceptable but requires implementation optimization. Methods The PrEP in Pregnancy, Accelerating Reach and Efficiency study (PrEPARE; NCT04712994) engaged stakeholders to prioritize determinants of PrEP delivery (using Likert scores) and prioritize PrEP delivery implementation strategies. Using a sequential explanatory mixed methods design, we conducted quantitative surveys with healthcare workers at 55 facilities in Western Kenya and a stakeholder workshop (including nurses, pharmacists, counselors, and county and national policymakers), yielding visual plots of stakeholders’ perceived feasibility and effectiveness of the strategies. A stepwise elimination process was used to identify seven strategies for empirical testing. Facilitator debriefing reports from the workshop were used to qualitatively assess the decision-making process. Results Among 146 healthcare workers, the strongest reported barriers to PrEP delivery were insufficient providers and inadequate training, insufficient space, and high volume of patients. Sixteen strategies were assessed, 14 of which were included in the final analysis. Among rankings from 182 healthcare workers and 44 PrEP policymakers and implementers, seven strategies were eliminated based on low post-workshop ranking scores (bottom 50th percentile) or being perceived as low feasibility or low effectiveness for at least 50% of the workshop groups. The top seven strategies included delivering PrEP within MCH clinics instead of pharmacies, fast-tracking PrEP clients to reduce waiting time, delivering PrEP-related health talks in waiting bays, task shifting PrEP counseling, task shifting PrEP risk assessments, training different providers to deliver PrEP, and retraining providers on PrEP delivery. All top ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2662-2211 |
| العلاقة: | https://doi.org/10.1186/s43058-023-00481-9Test; https://doaj.org/toc/2662-2211Test; https://doaj.org/article/107918de1ebb4e1180f96a43b44a0af9Test |
| DOI: | 10.1186/s43058-023-00481-9 |
| الإتاحة: | https://doi.org/10.1186/s43058-023-00481-9Test https://doaj.org/article/107918de1ebb4e1180f96a43b44a0af9Test |
| رقم الانضمام: | edsbas.13BF3A00 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 26622211 |
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| DOI: | 10.1186/s43058-023-00481-9 |