Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda

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dc.contributor.authorZakumumpa, Henry
dc.contributor.authorTumwine, Christopher
dc.contributor.authorMilliam, Kiconco
dc.contributor.authorpicer, Neil S
dc.date.accessioned2023-01-27T15:13:29Z
dc.date.available2023-01-27T15:13:29Z
dc.date.issued2021
dc.description.abstractThe notion of health-system resilience has received little empirical attention in the current literature on the Covid-19 response. We set out to explore health-system resilience at the sub-national level in Uganda with regard to strategies for dispensing antiretrovirals during Covid-19 lockdown. Methods: We conducted a qualitative case-study of eight districts purposively selected from Eastern and Western Uganda. Between June and September 2020, we conducted qualitative interviews with district health team leaders (n = 9), ART clinic managers (n = 36), representatives of PEPFAR implementing organizations (n = 6).In addition, six focus group discussions were held with recipients of HIV care (48 participants). Qualitative data were analyzed using thematic approach. Results: Five broad strategies for distributing antiretrovirals during ‘lockdown’ emerged in our analysis: accelerating home-based delivery of antiretrovirals,; extending multi-month dispensing from three to six months for stable patients; leveraging the Community Drug Distribution Points (CDDPs) model for ART refill pick-ups at outreach sites in the community; increasing reliance on health information systems, including geospatial technologies, to support ART refill distribution in unmapped rural settings. District health teams reported leveraging Covid-19 outbreak response funding to deliver ART refills to homesteads in rural communities. Conclusion: While Covid-19 ‘lockdown’ restrictions undoubtedly impeded access to facility-based HIV services, they revived interest by providers and demand by patients for community-based ART delivery models in case-study districts in Uganda.en_US
dc.identifier.citationZakumumpa, H., Tumwine, C., Milliam, K., & Spicer, N. (2021). Dispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Uganda. BMC health services research, 21(1), 1-11. https://doi.org/10.1186/s12913-021-06607-wen_US
dc.identifier.urihttps://doi.org/10.1186/s12913-021-06607-w
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7337
dc.language.isoenen_US
dc.publisherBMC health services researchen_US
dc.subjectAntiretroviralsen_US
dc.subjectCovid-19 lockdownen_US
dc.subjectCommunity-based ART delivery modelsen_US
dc.titleDispensing antiretrovirals during Covid-19 lockdown: re-discovering community-based ART delivery models in Ugandaen_US
dc.typeArticleen_US
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