Implementation of South Africa's Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation.

We used the Practical, Robust Implementation and Sustainability Model to evaluate implementation of South Africa's Central Chronic Medicine Dispensing and Distribution (CCMDD) program, a differentiated service delivery program which allows clinically stable HIV-positive patients to receive antiretro...

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Publicado en:AIDS & Behavior Vol. 26; no. 8; pp. 2600 - 2613
Autores principales: Bogart, Laura M., Shazi, Zinhle, MacCarthy, Sarah, Mendoza-Graf, Alexandra, Wara, Nafisa J., Zionts, Dani, Dube, Nduduzo, Govere, Sabina, Bassett, Ingrid V.
Formato: Journal Article
Publicado: Springer Nature Aug2022
Acceso en línea:Ver este registro en EBSCOhost
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          Bogart, Laura M.
          Shazi, Zinhle
          MacCarthy, Sarah
          Mendoza-Graf, Alexandra
          Wara, Nafisa J.
          Zionts, Dani
          Dube, Nduduzo
          Govere, Sabina
          Bassett, Ingrid V.
        affil: RAND Corporation, P.O. Box 2138, 1776 Main Street, 90407-2138, Santa Monica, CA, USA
      sug:
        subj:
          Drugs, Prescription Supply and Distribution
          Human Immunodeficiency Virus
          Program Implementation South Africa
          Drug Delivery Systems
          Qualitative Studies
          South Africa
          Antiretroviral Therapy, Highly Active
          Health Care Delivery
          Acquired Immunodeficiency Syndrome
          Implementation Science
          HIV-Positive Persons
          Anti-Retroviral Agents
          Semi-Structured Interview
          Stakeholder Participation
          Focus Groups
          Consumer Attitudes
          Health Services Accessibility
          Patient Education
          Feedback
          Data Analysis Software
          Human
      ab: We used the Practical, Robust Implementation and Sustainability Model to evaluate implementation of South Africa's Central Chronic Medicine Dispensing and Distribution (CCMDD) program, a differentiated service delivery program which allows clinically stable HIV-positive patients to receive antiretroviral therapy refills at clinic- or community-based pick-up points. Across ten clinics, we conducted 109 semi-structured interviews with stakeholders (pick-up point staff, CCMDD service providers and administrators) and 16 focus groups with 138 patients. Participants had highly favorable attitudes and said CCMDD decreased stigma concerns. Patient-level barriers included inadequate education about CCMDD and inability to get refills on designated dates. Organizational-level barriers included challenges with communication and transportation, errors in medication packaging and tracking, rigid CCMDD rules, and inadequate infrastructure. Recommendations included: (1) provide patient education and improve communication around refills (at the patient level); (2) provide dedicated space and staff, and ongoing training (at the organizational/clinic level); and (3) allow for prescription renewal at pick-up points and less frequent refills, and provide feedback to clinics (at the CCMDD program level).
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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