NDLI: Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study

Content Provider	Springer Nature : BioMed Central
Author	Sande, Odala Burtscher, Doris Kathumba, Daneck Tweya, Hannock Phiri, Sam Gugsa, Salem
Abstract	Background Differentiated models of care (DMOC) are used to make antiretroviral therapy (ART) accessible to people living with HIV (PLHIV). In Malawi, Lighthouse Trust has piloted various DMOCs aimed at providing quality care while reducing personal and logistical barriers when accessing clinic-based healthcare. One of the approaches was community-based provision of ART by nurses to stable patients. Methods To explore how the nurse-led community ART programme (NCAP) is perceived, we interviewed eighteen purposively selected patients receiving ART through NCAP and the four nurses providing the community-based health care. Information obtained from them was complemented with observations by the study team. Interviews were recorded and transcribed. Data was analysed using manual coding and thematic analysis. Results Through the NCAP, patients were able to save money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations (although this required care providers to set clear boundaries and stick to schedule). Patients’ nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. Considerations for community-led healthcare programmes include the provision of transportation for care providers; the physical structure of community sites (in regard to private spaces); the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. Conclusions The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors – including staff transportation and workload – must be taken into consideration and purposefully planned.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-020-08721-6.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-020-08721-6
Journal	BMC Public Health
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-05-14
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health HIV ART Differentiated models of care Community-based Retention Malawi Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Evaluation of differentiated service delivery models on HIV treatment retention among key populations in Nigeria: a prospective cohort analysis

Adapting a community-based ART delivery model to the patients’ needs: a mixed methods research in Tete, Mozambique

A qualitative evaluation of hospital versus community-based management of patients on injectable treatments for tuberculosis

HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

Outcomes of community-based differentiated models of multi-month dispensing of antiretroviral medication among stable HIV-infected patients in Lesotho: a cluster randomised non-inferiority trial protocol

Patient and community experiences of tuberculosis diagnosis and care within a community-based intervention in Ethiopia: a qualitative study

Adapting a nurse-led primary care initiative to cardiovascular disease control in Ghana: a qualitative study

Examining teen club attendance and viral load suppression among adolescents under differentiated HIV care in Malawi: a sub-optimal scenario

Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study

Similar Documents

Evaluation of differentiated service delivery models on HIV treatment retention among key populations in Nigeria: a prospective cohort analysis

Adapting a community-based ART delivery model to the patients’ needs: a mixed methods research in Tete, Mozambique

A qualitative evaluation of hospital versus community-based management of patients on injectable treatments for tuberculosis

HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

Outcomes of community-based differentiated models of multi-month dispensing of antiretroviral medication among stable HIV-infected patients in Lesotho: a cluster randomised non-inferiority trial protocol

Patient and community experiences of tuberculosis diagnosis and care within a community-based intervention in Ethiopia: a qualitative study

Adapting a nurse-led primary care initiative to cardiovascular disease control in Ghana: a qualitative study

Examining teen club attendance and viral load suppression among adolescents under differentiated HIV care in Malawi: a sub-optimal scenario

Retention in HIV care and associated factors among youths aged 15–24 years in rural southwestern Uganda

Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study