Exploring Sustainability in the Era of Differentiated HIV Service Delivery in Sub-Saharan Africa: A Systematic Review.
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
received:
12
06
2020
accepted:
01
03
2021
pubmed:
27
3
2021
medline:
25
2
2023
entrez:
26
3
2021
Statut:
ppublish
Résumé
The World Health Organization recommends differentiated service delivery (DSD) to support resource-limited health systems in providing patient-centered HIV care. DSD offers alternative care models to clinic-based care for people living with HIV who are stable on antiretroviral therapy (ART). Despite good patient-related outcomes, there is limited evidence of their sustainability. Our review evaluated the reporting of sustainability indicators of DSD interventions conducted in sub-Saharan Africa (SSA). We searched PubMed and EMBASE for studies conducted between 2000 and 2019 assessing DSD interventions targeting HIV-positive individuals who are established in ART in sub-Saharan Africa. We evaluated them through a comprehensive sustainability framework of constructs categorized into 6 domains (intervention design, process, external environment, resources, organizational setting, and people involvement). We scored each construct 1, 2, or 3 for no, partial, or sufficient level of evidence, respectively. Interventions with a calculated sustainability score (overall and domain-specific) of >90% or domain-specific median score >2.7 were considered likely to be sustainable. Overall scores ranged from 69% to 98%. Top scoring intervention types included adherence clubs (98%) and community ART groups (95%) which comprised more than half of interventions. The highest scoring domains were design (2.9) and organizational setting (2.8). The domains of resources (2.4) and people involvement (2.3) scored lowest revealing potential areas for improvement to support DSD sustainability. With the right investment in stakeholder involvement and domestic funding, DSD models generally show potential for sustainability. Our results could guide informed decisions on which DSD intervention is likely to be sustainable per setting and highlight areas that could motivate further research.
Identifiants
pubmed: 33770063
doi: 10.1097/QAI.0000000000002688
pii: 00126334-202108010-00007
pmc: PMC8219088
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1055-1071Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding or conflicts of interest to disclose.
Références
J Int AIDS Soc. 2017 Mar 28;20(1):21374
pubmed: 28406273
Trop Med Int Health. 2016 Sep;21(9):1124-30
pubmed: 27371814
J Acquir Immune Defic Syndr. 2016 Jan 1;71(1):e16-23
pubmed: 26473798
BMJ Open. 2017 Jan 13;7(1):e013340
pubmed: 28087549
BMC Health Serv Res. 2018 Jul 25;18(1):584
pubmed: 30045741
PLoS One. 2019 Jan 16;14(1):e0210565
pubmed: 30650129
Int J Behav Nutr Phys Act. 2018 Aug 13;15(1):75
pubmed: 30103764
BMC Health Serv Res. 2021 Jan 7;21(1):34
pubmed: 33413357
J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21649
pubmed: 28770595
Prev Chronic Dis. 2014 Jan 23;11:130184
pubmed: 24456645
Implement Sci. 2020 Jan 6;15(1):4
pubmed: 31906983
Implement Sci. 2018 Feb 09;13(1):27
pubmed: 29426341
Am J Public Health. 2011 Nov;101(11):2059-67
pubmed: 21940916
Subst Use Misuse. 2007;42(12-13):1933-44
pubmed: 18075918
Malawi Med J. 2019 Sep;31(3):177-183
pubmed: 31839886
Health Res Policy Syst. 2019 Jan 15;17(1):8
pubmed: 30646911
Qual Health Res. 2018 Oct;28(12):1839-1857
pubmed: 30033857
South Afr J HIV Med. 2019 Jun 11;20(1):905
pubmed: 31308966
J Biosoc Sci. 2015 May;47(3):311-28
pubmed: 24406021
AIDS. 2011 Oct 23;25(16):2027-36
pubmed: 21997488
Trop Med Int Health. 2014 Aug;19(8):968-77
pubmed: 24889337
J Int AIDS Soc. 2019 Oct;22(10):e25403
pubmed: 31686432
J Int AIDS Soc. 2009 May 06;12:6
pubmed: 19419543
PLoS One. 2019 Jun 20;14(6):e0218340
pubmed: 31220116
Afr J AIDS Res. 2018 Mar;17(1):54-61
pubmed: 29504504
PLoS One. 2020 Jul 1;15(7):e0234184
pubmed: 32609775
J Epidemiol Community Health. 1998 Jun;52(6):377-84
pubmed: 9764259
BMJ Open. 2016 Jul 13;6(7):e011453
pubmed: 27412106
PLoS One. 2016 Jan 14;11(1):e0147156
pubmed: 26764467
Eval Rev. 2009 Apr;33(2):189-205
pubmed: 18708528
BMC Health Serv Res. 2019 Mar 19;19(1):177
pubmed: 30890134
Lancet. 2015 Jul 11;386(9989):171-218
pubmed: 26117719
BMJ Open. 2020 Feb 02;10(1):e033156
pubmed: 32014874
Int J Environ Res Public Health. 2011 Jul;8(7):2967-79
pubmed: 21845169
J Int Assoc Provid AIDS Care. 2017 Sep/Oct;16(5):499-505
pubmed: 28528560
J Int AIDS Soc. 2015 May 27;18:19984
pubmed: 26022654
J Int AIDS Soc. 2018 Nov;21(11):e25207
pubmed: 30450699
AIDS Patient Care STDS. 2008 Mar;22(3):173-4
pubmed: 18290750
Res Social Adm Pharm. 2021 Jun;17(6):1066-1071
pubmed: 32878714
Lancet Glob Health. 2017 Jul;5(7):e720-e726
pubmed: 28619230
PLoS Med. 2019 Jul 23;16(7):e1002874
pubmed: 31335865
Front Psychol. 2017 Dec 07;8:2135
pubmed: 29375413
Implement Sci. 2017 Sep 2;12(1):110
pubmed: 28865479
J Acquir Immune Defic Syndr. 2011 Feb 1;56(2):e39-44
pubmed: 21084990
Health Promot Pract. 2016 Nov;17(6):845-852
pubmed: 27371830
BMJ Qual Saf. 2012 Jan;21(1):13-20
pubmed: 21835762
Trop Med Int Health. 2010 Sep;15(9):1000-7
pubmed: 20636305
J Int AIDS Soc. 2018 Sep;21(9):e25183
pubmed: 30225946
J Int AIDS Soc. 2019 Aug;22(8):e25393
pubmed: 31454178
Trop Med Int Health. 2016 Sep;21(9):1115-23
pubmed: 27300077
PLoS Med. 2018 Sep 19;15(9):e1002659
pubmed: 30231024
PLoS One. 2009;4(5):e5483
pubmed: 19434234
BMC Infect Dis. 2017 Dec 13;17(1):766
pubmed: 29237401
J Acquir Immune Defic Syndr. 2010 Dec;55(4):483-90
pubmed: 20683336
PLoS One. 2018 Feb 23;13(2):e0192765
pubmed: 29474486
BMC Med. 2017 Dec 18;15(1):217
pubmed: 29249202
AIDS Behav. 2020 Apr;24(4):1197-1206
pubmed: 31560093
S Afr Med J. 2013 Jan 17;103(2):71-3
pubmed: 23374312
Int J Evid Based Healthc. 2015 Sep;13(3):179-87
pubmed: 26262565
J Acquir Immune Defic Syndr. 2017 Mar 1;74(3):326-331
pubmed: 27787343
PLoS Med. 2017 Aug 8;14(8):e1002374
pubmed: 28792502
Psychol Health Med. 2015;20(4):488-94
pubmed: 25168720
PLoS One. 2013;8(2):e56088
pubmed: 23418518
Int Health. 2013 Sep;5(3):169-79
pubmed: 24030268
Prev Chronic Dis. 2014 Jan 23;11:130185
pubmed: 24456644
Afr J AIDS Res. 2016;15(1):35-43
pubmed: 26785676
J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21650
pubmed: 28770594
J Int AIDS Soc. 2014 Oct 06;17:18910
pubmed: 25292158
Trop Med Int Health. 2014 Sep;19(9):1029-39
pubmed: 25041716
PLoS Med. 2011 Jul;8(7):e1001055
pubmed: 21811402
BMJ Glob Health. 2019 Mar 19;4(2):e001285
pubmed: 30997170
Healthc Q. 2009;12(1):89-96, 2
pubmed: 19142069
Trop Med Int Health. 2016 Jun;21(6):743-9
pubmed: 27097834
J Int AIDS Soc. 2019 Oct;22(10):e25396
pubmed: 31588668
Afr J Prim Health Care Fam Med. 2018 Jun 18;10(1):e1-e8
pubmed: 29943608
Implement Sci. 2019 Dec 19;14(1):108
pubmed: 31856861
PLoS Med. 2019 May 21;16(5):e1002808
pubmed: 31112543
South Afr J HIV Med. 2019 Jun 26;20(1):922
pubmed: 31308968
PLoS One. 2014 Mar 20;9(3):e91544
pubmed: 24651523
Trop Med Int Health. 2014 May;19(5):514-21
pubmed: 24898272