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From policy to practice: exploring the implementation of antiretroviral therapy access and retention policies between 2013 and 2016 in six sub-Saharan African countries

Overview of attention for article published in BMC Health Services Research, November 2017
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (66th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (57th percentile)

Mentioned by

policy
1 policy source
twitter
1 tweeter

Citations

dimensions_citation
17 Dimensions

Readers on

mendeley
113 Mendeley
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Title
From policy to practice: exploring the implementation of antiretroviral therapy access and retention policies between 2013 and 2016 in six sub-Saharan African countries
Published in
BMC Health Services Research, November 2017
DOI 10.1186/s12913-017-2678-1
Pubmed ID
Authors

Julie Ambia, Jenny Renju, Alison Wringe, Jim Todd, Eveline Geubbels, Jessica Nakiyingi-Miiro, Mark Urassa, Tom Lutalo, Amelia C. Crampin, Daniel Kwaro, Catherine Kyobutungi, Natsayi Chimbindi, F. Xavier Gomez-Olive, Malebogo Tlhajoane, Brian Njamwea, Basia Zaba, Paul Mee

Abstract

Understanding the implementation of 2013 World Health Organization (WHO) consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection at the facility level provides important lessons for the roll-out of future HIV policies. A national policy review was conducted in six sub-Saharan African countries to map the inclusion of the 2013 WHO HIV treatment recommendations. Twenty indicators of policy adoption were selected to measure ART access (n = 12) and retention (n = 8). Two sequential cross-sectional surveys were conducted in facilities between 2013/2015 (round 1) and 2015/2016 (round 2) from ten health and demographic surveillance sites in Kenya, Malawi, South Africa, Tanzania, Uganda and Zimbabwe. Using standardised questionnaires, facility managers were interviewed. Descriptive analyses were used to assess the change in the proportion of facilities that implemented these policy indicators between rounds. Although, expansion of ART access was explicitly stated in all countries' policies, most lacked policies that enhanced retention. Overall, 145 facilities were included in both rounds. The proportion of facilities that initiated ART at CD4 counts of 500 or less cells/μL increased between round 1 and 2 from 12 to 68%, and facilities initiating patients on 2013 WHO recommended ART regimen increased from 42 to 87%. There were no changes in the proportion of facilities reporting stock-outs of first-line ART in the past year (18 to 11%) nor in the provision of three-month supply of ART (43 to 38%). None of the facilities provided community-based ART delivery. The increase in ART initiation CD4 threshold in most countries, and substantial improvements made in the provision of WHO recommended first-line ART regimens demonstrates that rapid adoption of WHO recommendations is possible. However, improved logistics and resources and/or changes in policy are required to further minimise ART stock-outs and allow lay cadres to dispense ART in the community. Increased efforts are needed to offer longer durations between clinic visits, a strategy purported to improve retention. These changes will be important as countries move to implement the revised 2015 WHO guidelines to initiate all HIV positive people onto ART regardless of their immune status.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter 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 113 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 113 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 23 20%
Researcher 15 13%
Student > Ph. D. Student 10 9%
Other 7 6%
Student > Postgraduate 7 6%
Other 22 19%
Unknown 29 26%
Readers by discipline Count As %
Medicine and Dentistry 32 28%
Nursing and Health Professions 17 15%
Social Sciences 10 9%
Biochemistry, Genetics and Molecular Biology 3 3%
Business, Management and Accounting 3 3%
Other 16 14%
Unknown 32 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. 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 01 March 2019.
All research outputs
#4,163,619
of 14,544,183 outputs
Outputs from BMC Health Services Research
#2,090
of 4,964 outputs
Outputs of similar age
#131,799
of 399,173 outputs
Outputs of similar age from BMC Health Services Research
#228
of 540 outputs
Altmetric has tracked 14,544,183 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 4,964 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one has gotten more attention than average, scoring higher than 57% 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 399,173 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 66% of its contemporaries.
We're also able to compare this research output to 540 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 57% of its contemporaries.