Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol

Introduction In 2015, WHO recommended immediate treatment for people living with HIV (PLHIV). As a result, the number of PLHIV needing antiretroviral therapy (ART) in sub-Saharan Africa (SSA) doubled from 12 million to over 25 million. This put a strain on already weak health systems and inspired th...

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Main Authors: Gabriela B Gomez, Nwanneka Ebelechukwu Okere, Lisa Urlings, Denise Naniche, Tobias F Rinke de Wit, Sabine Hermans
Format: Article
Language:English
Published: BMJ Publishing Group 2020-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/1/e033156.full
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author Gabriela B Gomez
Nwanneka Ebelechukwu Okere
Lisa Urlings
Denise Naniche
Tobias F Rinke de Wit
Sabine Hermans
author_facet Gabriela B Gomez
Nwanneka Ebelechukwu Okere
Lisa Urlings
Denise Naniche
Tobias F Rinke de Wit
Sabine Hermans
author_sort Gabriela B Gomez
collection DOAJ
description Introduction In 2015, WHO recommended immediate treatment for people living with HIV (PLHIV). As a result, the number of PLHIV needing antiretroviral therapy (ART) in sub-Saharan Africa (SSA) doubled from 12 million to over 25 million. This put a strain on already weak health systems and inspired the exploration of innovative service delivery models—differentiated service delivery (DSD). In DSD, services are tailored according to client clinical type and offer much-needed improvement in efficiency. The potential of achieving good outcomes for both clients and the health system plus the promise of sustainability motivates DSD promotion especially in low-income and middle-income countries. This review aims to evaluate the sustainability of DSD interventions.Methods and analysis We will systematically review peer-reviewed English literature published between 2000 and 2019 identified by searching PubMed and EMBASE databases. Main inclusion criteria comprise studies describing DSD interventions conducted in SSA focused on stable adult ART clients, whether described alone or compared with clinic-based service delivery. Quality of included studies will be assessed employing the Down and Black’s and Joanne Briggs Institute checklists for quantitative and qualitative studies, respectively. We will apply a comprehensive sustainability framework including 40 individual constructs to evaluate, score and rank each intervention for sustainability. Narrative and quantitative synthesis will be conducted as appropriate.Ethics and dissemination No ethical approval is required for this study as it is a review of published or publicly available data. Review results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration number CRD42019120891.
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spelling doaj-art-77d9b3ec0a1e437ba37fd7cfacaf9d652025-08-20T02:20:06ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-033156Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocolGabriela B Gomez0Nwanneka Ebelechukwu Okere1Lisa Urlings2Denise Naniche3Tobias F Rinke de Wit4Sabine Hermans51 Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK1 Global Health, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands2 Medicine, Amsterdam University Medical Centres, Amsterdam, Noord-Holland, The NetherlandsISGlobal (Barcelona Institute for Global Health) Hospital Clinic, University of Barcelona, Barcelona, Spain1 Global Health, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands1 Global Health, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The NetherlandsIntroduction In 2015, WHO recommended immediate treatment for people living with HIV (PLHIV). As a result, the number of PLHIV needing antiretroviral therapy (ART) in sub-Saharan Africa (SSA) doubled from 12 million to over 25 million. This put a strain on already weak health systems and inspired the exploration of innovative service delivery models—differentiated service delivery (DSD). In DSD, services are tailored according to client clinical type and offer much-needed improvement in efficiency. The potential of achieving good outcomes for both clients and the health system plus the promise of sustainability motivates DSD promotion especially in low-income and middle-income countries. This review aims to evaluate the sustainability of DSD interventions.Methods and analysis We will systematically review peer-reviewed English literature published between 2000 and 2019 identified by searching PubMed and EMBASE databases. Main inclusion criteria comprise studies describing DSD interventions conducted in SSA focused on stable adult ART clients, whether described alone or compared with clinic-based service delivery. Quality of included studies will be assessed employing the Down and Black’s and Joanne Briggs Institute checklists for quantitative and qualitative studies, respectively. We will apply a comprehensive sustainability framework including 40 individual constructs to evaluate, score and rank each intervention for sustainability. Narrative and quantitative synthesis will be conducted as appropriate.Ethics and dissemination No ethical approval is required for this study as it is a review of published or publicly available data. Review results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration number CRD42019120891.https://bmjopen.bmj.com/content/10/1/e033156.full
spellingShingle Gabriela B Gomez
Nwanneka Ebelechukwu Okere
Lisa Urlings
Denise Naniche
Tobias F Rinke de Wit
Sabine Hermans
Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol
BMJ Open
title Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol
title_full Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol
title_fullStr Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol
title_full_unstemmed Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol
title_short Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol
title_sort evaluating the sustainability of differentiated service delivery interventions for stable art clients in sub saharan africa a systematic review protocol
url https://bmjopen.bmj.com/content/10/1/e033156.full
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