Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda
Background: The notion of health-system resilience has received little empirical attention in the current literature on the Covid-19 response. We set out to explore health-system resilience at the sub-national level in Uganda with regard to strategies for dispensing antiretrovirals during Covid-19...
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BMC Health Services Research
2022
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| Online Access: | http://hdl.handle.net/20.500.12493/549 |
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| author | Henry, Zakumumpa Christopher, Tumwine Kiconco, Milliam Spicer, Neil |
| author_facet | Henry, Zakumumpa Christopher, Tumwine Kiconco, Milliam Spicer, Neil |
| author_sort | Henry, Zakumumpa |
| collection | KAB-DR |
| description | Background: The notion of health-system resilience has received little empirical attention in the current literature
on the Covid-19 response. We set out to explore health-system resilience at the sub-national level in Uganda with
regard to strategies for dispensing antiretrovirals during Covid-19 lockdown.
Methods: We conducted a qualitative case-study of eight districts purposively selected from Eastern and Western
Uganda. Between June and September 2020, we conducted qualitative interviews with district health team leaders
(n = 9), ART clinic managers (n = 36), representatives of PEPFAR implementing organizations (n = 6).In addition, six
focus group discussions were held with recipients of HIV care (48 participants). Qualitative data were analyzed using
thematic approach.
Results: Five broad strategies for distributing antiretrovirals during ‘lockdown’ emerged in our analysis: accelerating
home-based delivery of antiretrovirals,; extending multi-month dispensing from three to six months for stable
patients; leveraging the Community Drug Distribution Points (CDDPs) model for ART refill pick-ups at outreach sites
in the community; increasing reliance on health information systems, including geospatial technologies, to support
ART refill distribution in unmapped rural settings. District health teams reported leveraging Covid-19 outbreak
response funding to deliver ART refills to homesteads in rural communities.
Conclusion: While Covid-19 ‘lockdown’ restrictions undoubtedly impeded access to facility-based HIV services, they
revived interest by providers and demand by patients for community-based ART delivery models in case-study
districts in Uganda. |
| format | Article |
| id | oai:idr.kab.ac.ug:20.500.12493-549 |
| institution | KAB-DR |
| publishDate | 2022 |
| publisher | BMC Health Services Research |
| record_format | dspace |
| spelling | oai:idr.kab.ac.ug:20.500.12493-5492024-01-17T04:44:33Z Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda Henry, Zakumumpa Christopher, Tumwine Kiconco, Milliam Spicer, Neil Dispensing antiretrovirals, Covid-19, lockdown, re-discovering community-based, delivery models Background: The notion of health-system resilience has received little empirical attention in the current literature on the Covid-19 response. We set out to explore health-system resilience at the sub-national level in Uganda with regard to strategies for dispensing antiretrovirals during Covid-19 lockdown. Methods: We conducted a qualitative case-study of eight districts purposively selected from Eastern and Western Uganda. Between June and September 2020, we conducted qualitative interviews with district health team leaders (n = 9), ART clinic managers (n = 36), representatives of PEPFAR implementing organizations (n = 6).In addition, six focus group discussions were held with recipients of HIV care (48 participants). Qualitative data were analyzed using thematic approach. Results: Five broad strategies for distributing antiretrovirals during ‘lockdown’ emerged in our analysis: accelerating home-based delivery of antiretrovirals,; extending multi-month dispensing from three to six months for stable patients; leveraging the Community Drug Distribution Points (CDDPs) model for ART refill pick-ups at outreach sites in the community; increasing reliance on health information systems, including geospatial technologies, to support ART refill distribution in unmapped rural settings. District health teams reported leveraging Covid-19 outbreak response funding to deliver ART refills to homesteads in rural communities. Conclusion: While Covid-19 ‘lockdown’ restrictions undoubtedly impeded access to facility-based HIV services, they revived interest by providers and demand by patients for community-based ART delivery models in case-study districts in Uganda. Kabale University 2022-01-08T13:46:02Z 2022-01-08T13:46:02Z 2021 Article http://hdl.handle.net/20.500.12493/549 application/pdf BMC Health Services Research |
| spellingShingle | Dispensing antiretrovirals, Covid-19, lockdown, re-discovering community-based, delivery models Henry, Zakumumpa Christopher, Tumwine Kiconco, Milliam Spicer, Neil Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda |
| title | Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda |
| title_full | Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda |
| title_fullStr | Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda |
| title_full_unstemmed | Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda |
| title_short | Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda |
| title_sort | dispensing antiretrovirals during covid 19 lockdown re discovering community based art delivery models in uganda |
| topic | Dispensing antiretrovirals, Covid-19, lockdown, re-discovering community-based, delivery models |
| url | http://hdl.handle.net/20.500.12493/549 |
| work_keys_str_mv | AT henryzakumumpa dispensingantiretroviralsduringcovid19lockdownrediscoveringcommunitybasedartdeliverymodelsinuganda AT christophertumwine dispensingantiretroviralsduringcovid19lockdownrediscoveringcommunitybasedartdeliverymodelsinuganda AT kiconcomilliam dispensingantiretroviralsduringcovid19lockdownrediscoveringcommunitybasedartdeliverymodelsinuganda AT spicerneil dispensingantiretroviralsduringcovid19lockdownrediscoveringcommunitybasedartdeliverymodelsinuganda |