Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010

dc.contributor.authorNgandu, Nobubelo Kwanele
dc.contributor.authorMaduna, Vincent
dc.contributor.authorSherman, Gayle
dc.contributor.authorNoveve, Nobuntu
dc.contributor.authorChirinda, Witness
dc.contributor.authorRamokolo, Vundli
dc.contributor.authorLombard, Carl
dc.contributor.authorGoga, Ameena Ebrahim
dc.date.accessioned2020-07-10T13:08:07Z
dc.date.available2020-07-10T13:08:07Z
dc.date.issued2019-09-16
dc.descriptionAdditional file 1: Number of facilities using each transportation system within each province, in 2010.en_ZA
dc.description.abstractBACKGROUND : In June 2015, South Africa introduced early infant HIV diagnosis (EID) at birth and ten weeks postpartum. Guidelines recommended return of birth results within a week and ten weeks postpartum results within four weeks. Task shifting was also suggested to increase service coverage. This study aimed to understand factors affecting return of EID results to caregivers. METHODS : Secondary analysis of data gathered from 571 public-sector primary health care facilities (PHCs) during a nationally representative situational assessment, was conducted. The assessment was performed one to three months prior to facility involvement in the 2010 evaluation of the South African programme to prevent mother-tochild HIV transmission (SAPMTCTE). Self-reported infrastructural and human resource EID-related data were collected from managers and designated staff using a structured questionnaire. The main outcome variable was ‘EID turnaround- time (TAT) to caregiver’ (caregiver TAT), measured as reported number of weeks from infant blood draw to caregiver receipt of results. This was dichotomized as either short (≤3 weeks) or delayed (> 3 weeks) caregiver TAT. Logit-based risk difference analysis was used to assess factors associated with short caregiver TAT. Analysis included TAT to facility (facility TAT), defined as reported number of weeks from infant blood draw to facility receipt of results. RESULTS : Overall, 26.3% of the 571 PHCs reported short caregiver TAT. In adjusted analyses, short caregiver TAT was less achieved when facility TAT was > 7 days (versus ≤7 days) (adjusted risk difference (aRD): − 0.2 (95% confidence interval − 0.3-(− 0.1)), p = 0.006 for 8–14 days and − 0.3 (− 0.5-(− 0.1)), p = 0.006 for > 14 days), and in facilities with staff nurses (compared to those without) (aRD: − 9.4 (− 16.6-(− 2.2), p = 0.011). CONCLUSION : Although short caregiver TAT for EID was only reported in approximately 26% of facilities, these facilities demonstrate that achieving EID TAT of ≤3 weeks is possible, making timely ART initiation within 3 weeks of diagnosis feasible within the public health sector. Our adjusted analyses underpin the need for quick return of results to facilities. They also raise questions around staff mentoring: we hypothesise that facilities with staff nurses were likely to have fewer professional nurses, and thus inadequate senior support.en_ZA
dc.description.departmentPaediatrics and Child Healthen_ZA
dc.description.librarianam2020en_ZA
dc.description.sponsorshipThe South African Medical Research Councilen_ZA
dc.description.urihttps://bmcinfectdis.biomedcentral.comen_ZA
dc.identifier.citationNgandu, N.K., Maduna, V., Sherman, G. et al. 2019, 'Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010', BMC Infectious Diseases, vol. 19, art. 785, suppl. 1, pp. 1-9.en_ZA
dc.identifier.issn1471-2334 (online)
dc.identifier.other10.1186/s12879-019-4337-0
dc.identifier.urihttp://hdl.handle.net/2263/75128
dc.language.isoenen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.en_ZA
dc.subjectTurn-around timesen_ZA
dc.subjectLaboratory transportation systemen_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectPrevention of mother-to-child transmission (PMTCT)en_ZA
dc.subjectSouth Africa (SA)en_ZA
dc.subjectSouth African programme to prevent mother-to child HIV transmission (SAPMTCTE)en_ZA
dc.subjectTurnaround-time (TAT)en_ZA
dc.subjectEarly infant diagnosis (EID)en_ZA
dc.subjectAntiretroviral therapy (ART)en_ZA
dc.titleInfrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010en_ZA
dc.typeArticleen_ZA

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