TY - JOUR
T1 - Lessons learned during down referral of antiretroviral treatment in Tete, Mozambique
AU - Decroo, Tom
AU - Panunzi, Isabella
AU - das Dores, Carla
AU - Maldonado, Fernando
AU - Biot, Marc
AU - Ford, Nathan
AU - Chu, Kathryn
N1 - FTX; DOAJ
PY - 2009
Y1 - 2009
N2 - As sub-Saharan African countries continue to scale up antiretroviral treatment, there has been an increasing emphasis on moving provision of services from hospital level to the primary health care clinic level. Delivery of antiretroviral treatment at the clinic level increases the number of entry points to care, while the greater proximity of services encourages retention in care.In Tete City, Mozambique, patients on antiretrovirals were rapidly down referred from a provincial hospital to four urban clinics in large numbers without careful planning, resulting in a number of patients being lost to follow-up.We outline some key lessons learned to support down referral, including the need to improve process management, clinic infrastructure, monitoring systems, and patient preparation. Down referral can be avoided by initiating patients' antiretroviral treatment at clinic level from the outset.
AB - As sub-Saharan African countries continue to scale up antiretroviral treatment, there has been an increasing emphasis on moving provision of services from hospital level to the primary health care clinic level. Delivery of antiretroviral treatment at the clinic level increases the number of entry points to care, while the greater proximity of services encourages retention in care.In Tete City, Mozambique, patients on antiretrovirals were rapidly down referred from a provincial hospital to four urban clinics in large numbers without careful planning, resulting in a number of patients being lost to follow-up.We outline some key lessons learned to support down referral, including the need to improve process management, clinic infrastructure, monitoring systems, and patient preparation. Down referral can be avoided by initiating patients' antiretroviral treatment at clinic level from the outset.
U2 - 10.1186/1758-2652-12-6
DO - 10.1186/1758-2652-12-6
M3 - A1: Web of Science-article
C2 - 19419543
VL - 12
SP - 6
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
SN - 1758-2652
ER -