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Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia

Overview of attention for article published in BMC Public Health, August 2016
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  • Good Attention Score compared to outputs of the same age (70th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (58th percentile)

Mentioned by

twitter
9 tweeters

Citations

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17 Dimensions

Readers on

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207 Mendeley
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Title
Randomized evaluation and cost-effectiveness of HIV and sexual and reproductive health service referral and linkage models in Zambia
Published in
BMC Public Health, August 2016
DOI 10.1186/s12889-016-3450-x
Pubmed ID
Authors

Paul C. Hewett, Mutinta Nalubamba, Fiammetta Bozzani, Jean Digitale, Lung Vu, Eileen Yam, Mary Nambao

Abstract

Provision of HIV prevention and sexual and reproductive health services in Zambia is largely characterized by discrete service provision with weak client referral and linkage. The literature reveals gaps in the continuity of care for HIV and sexual and reproductive health. This study assessed whether improved service delivery models increased the uptake and cost-effectiveness of HIV and sexual and reproductive health services. Adult clients 18+ years of age accessing family planning (females), HIV testing and counseling (females and males), and male circumcision services (males) were recruited, enrolled and individually randomized to one of three study arms: 1) the standard model of service provision at the entry point (N = 1319); 2) an enhanced counseling and referral to add-on service with follow-up (N = 1323); and 3) the components of study arm two, with the additional offer of an escort (N = 1321). Interviews were conducted with the same clients at baseline, six weeks and six months. Uptake of services for HIV, family planning, male circumcision, and cervical cancer screening at six weeks and six months were the primary endpoints. Pairwise chi-square and multivariable logistic regression statistical tests assessed differences across study arms, which were also assessed for incremental cost-efficiency and cost-effectiveness. A total of 3963 clients, 1920 males and 2043 females, were enrolled; 82 % of participants at six weeks were tracked and 81 % at six months; follow-up rates did not vary significantly by study arm. The odds of clients accessing HIV testing and counseling, cervical cancer screening services among females, and circumcision services among males varied significantly by study arm at six weeks and six months; less consistent findings were observed for HIV care and treatment. Client uptake of family planning services did not vary significantly by study arm. Integrated services were found to be more efficiently provided than vertical service provision; the cost-effectiveness for HIV/AIDS and cervical cancer was high in the enhanced service models. Study results provide evidence for increasing the linkages and integration of a selection of HIV and sexual and reproductive health services. The study provided cost-effective service delivery models that enhanced the likelihood of clients accessing some additional needed health services. ISRCTN84228514 Retrospectively registered. The study was retrospectively registered in the ISRCTN clinical trials registry on 06 October 2015. The first recruitment of participants occurred on 17 December 2013.

Twitter Demographics

The data shown below were collected from the profiles of 9 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 207 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
South Africa 1 <1%
Unknown 206 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 38 18%
Researcher 30 14%
Student > Ph. D. Student 20 10%
Student > Bachelor 17 8%
Student > Doctoral Student 11 5%
Other 34 16%
Unknown 57 28%
Readers by discipline Count As %
Medicine and Dentistry 47 23%
Nursing and Health Professions 36 17%
Social Sciences 25 12%
Economics, Econometrics and Finance 8 4%
Psychology 7 3%
Other 23 11%
Unknown 61 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 September 2016.
All research outputs
#5,014,894
of 18,255,134 outputs
Outputs from BMC Public Health
#5,365
of 12,281 outputs
Outputs of similar age
#80,111
of 272,773 outputs
Outputs of similar age from BMC Public Health
#8
of 17 outputs
Altmetric has tracked 18,255,134 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 12,281 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.9. This one has gotten more attention than average, scoring higher than 56% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 272,773 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 58% of its contemporaries.