Title : Contextual factors influencing retention to care at Sinda Zonal rural health centre in Sinda District in Zambia
Abstract:
Background: HIV prevalence amongst adults aged 15 and above in Zambia was 11.0% (ZAMPHIA 2022). Prevalence of viral load suppression amongst adults aged 15 and above living with HIV in Zambia was 86.2% at Sinda Zonal Health Centre by 2022. However, because of this burden, combined antiretroviral treatment (cART) has proved to be helpful to the people living with HIV (PLHIV), this has come with a lot of Challenges for Recipients of care (Rocs) to adhere to treatment hence the gaps to meet the set targets. Notably, not much research has been performed to identify factors relating to poor adherence Despite effective free life-prolonging combined antiretroviral therapy (cART) in Government clinics and hospitals in Zambia since 2005 and the recognized effectiveness of cART.
Method: A sample of 68 participants were enrolled, by using facility ART registers, an electronic smart care system, a pharmacy daily activity register, and patient locator forms, 68 participants who were on ART at the time and missed a Clinical Appointment were randomly selected, all were from Sinda Zonal Health Centre but coming from different communities. Participants who were not able to come to the clinic and had an active number were contacted by phone, and those who did not have phones were followed up by an assigned CHW and interviewed one on one.
Results:
1. Individual Factors: Among the 68 clients 12 (17.6%) complained of side effects and alcohol abuse.
2. Community Factors: 13 (19.1%) complained about distance to facility, food shortage, and 10 (14.7%) were sharing Medication with spouses.
3. Institutional Related Factors: Gaps found were essential medication stock-out, and 33 (48.5%) complained of long waiting times, travel distance.
Conclusion: Retention in ART care is an important indicator that contributes to the attainment of 95/95/95; therefore, it is essential to have a strong community follow-up and Client support systems for all RoCs in Sinda district.
Recommendations:
- Rapid follow-up of RoCs who miss appointments by use of phone calls, texts home visit and adequate documentation in respected ART register by a client care officer and CHWs immediately they miss an appointment.
- 6 months’ dispensation, CAAPs and use of DSD model such as scholar model and family centered approach every time you have a visit for stable clients.
