Odafe Solomon, Stafford Kristen A, Gambo Aliyu, Onotu Dennis, Swaminathan Mahesh, Dalhatu Ibrahim, Ene Uzoma, Ademola Oladipo, Mukhtar Ahmed, Ramat Ibrahim, Akipu Ehoche, Debem Henry, Boyd Andrew T, Sunday Aboje, Gobir Bola, Charurat Man E
Division of Global HIV/AIDS, Centre for Global Health, U.S. Centers for Disease Control & Prevention, Abuja, Nigeria.
Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, USA.
J AIDS HIV Treat. 2019;1(2):33-45.
We evaluated health workers' perspectives on the implementation of the 2016 HIV "Test and Treat" guidelines in Nigeria. Using semi-structured interviews, qualitative data was collected from twenty health workers meeting inclusion criteria in six study sites. Data exploration was conducted using thematic content analysis. Participants perceived that the "Test and Treat" guidelines improved care for PLHIV, though they also perceived possible congested clinics. Perceived key factors enabling guidelines use were perceived patient benefits, availability of policy document and trainings. Perceived key barriers to guidelines use were poverty among patients, inadequate human resources and stock-outs of HIV testing kits. Further improvements in uptake of guidelines could be achieved by effecting an efficient supply chain system for HIV testing kits, and improved guidelines distribution and capacity building prior to implementation. Additionally, implementing differentiated approaches that decongest clinics, and programs that economically empower patients, could improve guidelines use, as Nigeria scales "Test and Treat" nationwide.
我们评估了尼日利亚卫生工作者对2016年艾滋病毒“检测即治疗”指南实施情况的看法。通过半结构化访谈,从六个研究地点符合纳入标准的20名卫生工作者那里收集了定性数据。使用主题内容分析法进行数据探索。参与者认为“检测即治疗”指南改善了对艾滋病毒感染者的护理,不过他们也察觉到诊所可能会拥挤不堪。认为有助于指南实施的关键因素包括患者可获得的益处、政策文件的可用性以及培训。认为阻碍指南实施的关键障碍包括患者贫困、人力资源不足以及艾滋病毒检测试剂盒缺货。通过建立高效的艾滋病毒检测试剂盒供应链系统,以及在实施前改进指南分发和能力建设,可以进一步提高指南的采用率。此外,随着尼日利亚在全国范围内推广“检测即治疗”,实施能够缓解诊所拥挤状况的差异化方法以及使患者在经济上获得能力的项目,可能会提高指南的使用。