Global Health: Science and Practice最新文献

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People that Deliver: Established to Address the Health Supply Chain Workforce Gap. 提供服务的人:为解决医疗供应链劳动力缺口而建立。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-23-00366
Dominique Zwinkels, Andrew Brown, Francis Aboagye-Nyame
{"title":"People that Deliver: Established to Address the Health Supply Chain Workforce Gap.","authors":"Dominique Zwinkels, Andrew Brown, Francis Aboagye-Nyame","doi":"10.9745/GHSP-D-23-00366","DOIUrl":"10.9745/GHSP-D-23-00366","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Supply Chain Workforce: The Foundation of Health Supply Chains. 供应链劳动力:卫生供应链的基础。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-24-00444
Dominique Zwinkels, Lloyd Matowe, Domina Asingizwe, Andrew N Brown, Jonathan Moody
{"title":"The Supply Chain Workforce: The Foundation of Health Supply Chains.","authors":"Dominique Zwinkels, Lloyd Matowe, Domina Asingizwe, Andrew N Brown, Jonathan Moody","doi":"10.9745/GHSP-D-24-00444","DOIUrl":"https://doi.org/10.9745/GHSP-D-24-00444","url":null,"abstract":"","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"13 Suppl 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Presenting a Framework to Professionalize Health Supply Chain Management. 提出卫生供应链管理专业化框架。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-23-00119
Andrew N Brown, Barry Chovitz, Richard Dos Santos, Michael Egharevba, Bridget McHenry, Erin Meier, Dominique Zwinkels
{"title":"Presenting a Framework to Professionalize Health Supply Chain Management.","authors":"Andrew N Brown, Barry Chovitz, Richard Dos Santos, Michael Egharevba, Bridget McHenry, Erin Meier, Dominique Zwinkels","doi":"10.9745/GHSP-D-23-00119","DOIUrl":"10.9745/GHSP-D-23-00119","url":null,"abstract":"<p><strong>Introduction: </strong>Many countries have an insufficient supply of adequately skilled supply chain workers to manage health commodities, and no global standards in education or experience exist for the supply chain management (SCM) workforce managing health products. We present a professionalization framework for the health SCM workforce that provides a systematic process that countries can use to standardize and elevate the health SCM profession.</p><p><strong>Methods: </strong>In 2019, semistructured interviews were conducted with individuals from 10 leading organizations supporting in-country public health supply chains to explore approaches for an SCM professionalization framework. Interview data were analyzed using direct thematic analysis. Findings were then validated through a validation workshop with 11 individuals from 8 leading SCM organizations.</p><p><strong>Results: </strong>Four associated components of this framework were developed: (1) The Library of Competencies and Designations contains management competencies grouped in 7 domains and supply chain technical competencies assigned to 5 professional designations; (2) The Collection of Roles and Job Descriptions contains 96 sample job descriptions; (3) The Mapping of Education displays the education offerings relevant to each competency across the 5 professional designations; and (4) The Implementation Approach for Health Supply Chains leads project teams to systematically apply these 3 tools in the supply chain context of a country.</p><p><strong>Conclusion: </strong>The SCM Professionalisation Framework provides a valuable tool to increase the supply of and demand for health SCM workers, increasing the recognition and use of SCM professionals within national health systems. Its utilization is a critical step in addressing the current workforce gap, particularly in low- and middle-income countries, and ensuring that the health SCM workforce possesses the right competencies, skills, and qualifications to fulfill its roles. The comprehensive framework can be used by governments, employers, and education institutions to define and align SCM professional standards, competencies, and curricula with job requirements.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Role of Gender in the Public Health Supply Chain Workforce in Low- and Middle-Income Countries. 探讨性别在低收入和中等收入国家公共卫生供应链劳动力中的作用。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-24-00232
Susan Truog, Katie Reynolds, Rebecca Alban, Louis Tshituka, Tafwirapo Chihana, Mariam Zameer, Amanda Pain, Bvudzai P Magadzire, Sierra Petrosky
{"title":"Exploring the Role of Gender in the Public Health Supply Chain Workforce in Low- and Middle-Income Countries.","authors":"Susan Truog, Katie Reynolds, Rebecca Alban, Louis Tshituka, Tafwirapo Chihana, Mariam Zameer, Amanda Pain, Bvudzai P Magadzire, Sierra Petrosky","doi":"10.9745/GHSP-D-24-00232","DOIUrl":"https://doi.org/10.9745/GHSP-D-24-00232","url":null,"abstract":"<p><p>This article describes exploratory research conducted to understand pathways to entering the public health supply chain (PHSC) workforce in low- and middle-income countries (LMICs) to identify potential barriers for women working in this field and gather suggestions on how to improve gender equity in the PHSC workforce. Key informant interviews were conducted in the Democratic Republic of Congo and Malawi with health sciences students, health science education professionals, individuals currently working in the PHSC workforce, and global stakeholders. An online survey was conducted with responses from PHSC professionals across 26 countries. The survey and interviews revealed that respondents perceived that there were gender imbalances and inequities at all levels of the PHSC workforce. Respondents reported on barriers for women to receive the education, training, mentorship, and leadership opportunities needed to advance in this profession, barriers to traveling for work due to cultural norms and safety concerns, and a lack of policy and structural support for women to feel safe and supported at work. To improve gender equity in the PHSC workforce, we recommend strengthening career pathways for women; fostering mentorship opportunities among women; making recruitment practices more gender sensitive; implementing gender-sensitive policies; improving access to financial, physical, and technological resources; collecting and using gender-disaggregated data; and increasing the number of women in leadership positions.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"13 Suppl 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Applying a Theory of Change for Human Resources Development in Public Health Supply Chains in Rwanda. 在卢旺达公共卫生供应链中应用人力资源开发变革理论。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-23-00062
Erin Meier, Andrew N Brown, Bridget McHenry, Joseph Kabatende, Inès K Gege Buki, Joyce Icyimpaye
{"title":"Applying a Theory of Change for Human Resources Development in Public Health Supply Chains in Rwanda.","authors":"Erin Meier, Andrew N Brown, Bridget McHenry, Joseph Kabatende, Inès K Gege Buki, Joyce Icyimpaye","doi":"10.9745/GHSP-D-23-00062","DOIUrl":"10.9745/GHSP-D-23-00062","url":null,"abstract":"<p><strong>Background: </strong>The health supply chain (SC) system in Rwanda experienced a number of workforce-related challenges, including insufficient skilled supply chain management (SCM) professionals with the necessary competencies. The Human Resources for Supply Chain Management (HR4SCM) Theory of Change (TOC) provides a methodology to assess human resources (HR) management systems by explaining the preconditions required to achieve optimized workforce performance. We applied this model to design interventions to strengthen the Rwanda health SC workforce.</p><p><strong>Methods: </strong>We compared conditions in the health SC HR system in Rwanda with the 60 outcomes described as necessary for optimized workforce performance in the HR4SCM TOC model. We used a survey and participatory workshop at the central level, followed by structured interviews (N=35) with SC professionals in health centers, hospitals, and regional warehouses (N=20) in Southern Province and Kigali City to identify which outcomes already existed in the Rwandan HR system and which outcomes required strengthening through targeted interventions. We used focus groups (N=2) to refine interventions.</p><p><strong>Findings: </strong>We identified that 31 of the 60 outcomes were not sufficiently in place in the Rwandan health SC HR system. SCM workers had gaps in the technical and managerial competencies and did not have access to adequate training and professional development opportunities for certain required competencies. An SCM career path did not exist, and education was not available for all required SCM qualifications. Fourteen of these outcomes were prioritized for strengthening. We designed 20 workforce interventions with the Ministry of Health to address these deficiencies and selected indicators to monitor the interventions.</p><p><strong>Conclusion: </strong>Applying this HR TOC model enabled a systematic process to identify gaps, develop and prioritize interventions, and select indicators. Practitioners designing and evaluating SC workforce interventions should consider applying this methodology to design more effective, theory-driven interventions to improve SC workforce performance.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
People that Deliver Theory of Change for Building Human Resources for Supply Chain Management: Applications in sub-Saharan Africa and Southeast Asia. 为供应链管理人力资源建设提供变革理论的人:在撒哈拉以南非洲和东南亚的应用。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-23-00467
Pamela Steele, Hilary Claire Frazer, Gashaw Mekonnen
{"title":"People that Deliver Theory of Change for Building Human Resources for Supply Chain Management: Applications in sub-Saharan Africa and Southeast Asia.","authors":"Pamela Steele, Hilary Claire Frazer, Gashaw Mekonnen","doi":"10.9745/GHSP-D-23-00467","DOIUrl":"10.9745/GHSP-D-23-00467","url":null,"abstract":"<p><p>The Theory of Change for Building Human Resources for Supply Chain Management (TOC) offers a practical framework outlining 4 interdependent pathways-staffing, skills, working conditions, and motivation-to manage the workforce quantity and capability necessary to operate health supply chains effectively. We conducted a desk review of project reports on applications of the TOC as a diagnostic and analytical framework for health supply chains in Cameroon, Ethiopia, Malawi, Rwanda, and the Philippines. We compared approaches to program development, project management, and implementation to reach conclusions and make recommendations based on experience in each country. The TOC can be applied in multiple country contexts, is useful in highlighting supply workforce challenges, and provides a framework that allows governments and technical partners to readdress them.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"13 Suppl 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Creating a Career Development Path for Young Supply Chain Professionals: Three Case Studies in Benin, Kenya, and South Africa. 为年轻的供应链专业人员创造职业发展道路:贝宁、肯尼亚和南非的三个案例研究。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-23-00320
Rachel Msimuko, Ricardo Sedomedji Missihoun, Chloe Peebles, Jenny Froome, Lloyd Matowe, Pamela Steele
{"title":"Creating a Career Development Path for Young Supply Chain Professionals: Three Case Studies in Benin, Kenya, and South Africa.","authors":"Rachel Msimuko, Ricardo Sedomedji Missihoun, Chloe Peebles, Jenny Froome, Lloyd Matowe, Pamela Steele","doi":"10.9745/GHSP-D-23-00320","DOIUrl":"https://doi.org/10.9745/GHSP-D-23-00320","url":null,"abstract":"<p><p>Low and middle-income countries (LMICs) continue to have a limited supply of skilled supply chain (SC) management professionals in the public sector. In addition, the SC workforce lacks the competencies demanded by new technologies and markets. Young people may be an untapped resource for the procurement and SC management workforce. We present 3 use cases in which career development paths were created for young SC professionals in Benin, Kenya, and South Africa. In Benin, with advocacy from L'Association des Logisticiens Béninois, the professional body of logisticians, career development opportunities were made through creating specific programs like the Young Logisticians Professionals Program. SAPICS, the professional body for SC management in South Africa, has been providing opportunities for career development by giving students and young professionals access to subject matter experts, conferences, site visits, and various industry-specific training and networking opportunities, as well as general \"job readiness\" training through coaching and mentorship programs. In Kenya, the Girls on the Move program focuses on introducing SC management as a career path to girls through internships, skills training, and mentorship, all aimed at equipping them for successful work placements. The COVID-19 pandemic underscored the critical importance of SC management and highlighted vulnerabilities that demand greater responsiveness and resilience. In the post-COVID era, it is imperative for the public SC sector to build an agile and skilled workforce capable of addressing immediate needs and supporting long-term pandemic preparedness. The cases presented show how opportunities for training, mentorship, and work experience were made available to young professionals and highlight some of the positive outcomes of these initiatives. The cases also illustrate innovative approaches to developing career pathways for youth in LMICs that aim to expand the pool of skilled professionals who can strengthen public SCs and enhance their capacity to respond to future challenges.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":"13 Suppl 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Promising Practices in Capacity Development for Health Supply Chains in Resource-Constrained Countries. 资源有限国家卫生供应链能力发展的可行做法。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-05-09 DOI: 10.9745/GHSP-D-23-00208
Mahama Duwiejua, Pamela Steele, Paul Lalvani, Dorothy Leab, Lloyd Matowe, Jonathan Moody
{"title":"Promising Practices in Capacity Development for Health Supply Chains in Resource-Constrained Countries.","authors":"Mahama Duwiejua, Pamela Steele, Paul Lalvani, Dorothy Leab, Lloyd Matowe, Jonathan Moody","doi":"10.9745/GHSP-D-23-00208","DOIUrl":"10.9745/GHSP-D-23-00208","url":null,"abstract":"<p><p>Performance gaps in health supply chains in low- and middle-income countries contribute significantly to inefficiencies and underperformance of their health systems. Some significant factors hindering the performance of supply chains in low and middle-income countries include low human resource capacity and capability, weak structures for monitoring supply chain performance, weak in-service and pre-service training programs, chronic underfunding, lack of transparency and an overdependence on obsolete methods, like manual data gathering, record-keeping, and analyses. Although proven health supply chain strengthening techniques exist, the level of adoption of these practices has varied across countries, resulting in multiple capacity gaps and underperforming supply chains. The resulting challenges require complementary and needs-based practices to address the gaps. While it is recognized that there is no \"one-size-fits-all\" solution to these issues, we demonstrate that real benefits can be achieved by using \"promising practices\"-that is, using targeted, innovative interventions. To demonstrate the potential of using promising practices in the health supply chain in Africa and the breadth of possible solutions available, we present 3 case studies from different contexts and with different objectives.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Building Public Health Quantitative Methods Capacity and Networks in sub-Saharan Africa: An Evaluation of a Faculty Training Program. 在撒哈拉以南非洲建立公共卫生定量方法能力和网络:对教员培训计划的评价。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-01-16 DOI: 10.9745/GHSP-D-22-00507
Oleosi Ntshebe, Sarah Anoke, Jesca M Batidzirai, Chris Guure, Beatrice Muganda, Marcello Pagano, Muhammed Semakula, Elysia Larson
{"title":"Building Public Health Quantitative Methods Capacity and Networks in sub-Saharan Africa: An Evaluation of a Faculty Training Program.","authors":"Oleosi Ntshebe, Sarah Anoke, Jesca M Batidzirai, Chris Guure, Beatrice Muganda, Marcello Pagano, Muhammed Semakula, Elysia Larson","doi":"10.9745/GHSP-D-22-00507","DOIUrl":"https://doi.org/10.9745/GHSP-D-22-00507","url":null,"abstract":"<p><strong>Introduction: </strong>There is a shortage of individuals trained in using quantitative methods in biomedical research in sub-Saharan Africa (SSA). Improving public health in SSA requires new ways to promote quantitative knowledge and skills among faculty in biomedical research and better-integrated network systems of support.</p><p><strong>Methods: </strong>We describe the development, implementation, and evaluation of an innovative faculty training and support program in SSA from December 2017-June 2020, using courses in monitoring and evaluation, data management, and complex surveys as prototypical examples. Indicators were selected to follow the 4 levels outlined in the Kirkpatrick evaluation model: reaction, learning, behavior, and results. We used survey data from faculty fellows and students and reported median change and interquartile ranges (IQR).</p><p><strong>Results: </strong>The training program created an international community of 26 faculty members working collaboratively to lead the training of 3 quantitative methods courses. The program increased faculty members' knowledge of the course content (median increase 17 percentage points [IQR: 0, 20]). Faculty members, in turn, trained 380 students at institutions of higher education in 8 SSA countries (Botswana, Ethiopia, Ghana, Nigeria, Rwanda, South Africa, Tanzania, and Uganda).</p><p><strong>Conclusion: </strong>The program relied on collaborative funding from participating institutions and focused on individual capacity-strengthening. In the future, the program will be scaled to include other emerging areas, such as data science, will integrate institutional support and feedback, and will move some of the training and mentoring activities to an online platform. Finally, to ensure that faculty have both improved confidence and improvement in competence, in future iterations, the program will include competency evaluation at the start and end and pair fellows who need additional training with those who excelled to co-teach.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa. 加强对南非约翰内斯堡住院和最近出院的艾滋病毒感染者的抗逆转录病毒治疗。
IF 2.5 3区 医学
Global Health: Science and Practice Pub Date : 2025-01-14 DOI: 10.9745/GHSP-D-24-00017
Natasha Davies, Melanie Bisnauth, Kate Rees
{"title":"Enhancing Antiretroviral Therapy Initiation for Hospitalized and Recently Discharged People Living With HIV in Johannesburg, South Africa.","authors":"Natasha Davies, Melanie Bisnauth, Kate Rees","doi":"10.9745/GHSP-D-24-00017","DOIUrl":"https://doi.org/10.9745/GHSP-D-24-00017","url":null,"abstract":"<p><strong>Background: </strong>Despite increased antiretroviral therapy (ART) access in South Africa, HIV testing and ART initiation are suboptimal in hospital settings. Key gaps include in-hospital case finding, ART initiation support, and primary health care (PHC) facility linkage after discharge.</p><p><strong>Intervention development and description: </strong>We identified weaknesses in hospital processes by comparing them with PHC HIV services and developed a quality improvement model for implementation in 5 Johannesburg hospitals. We introduced dedicated teams of HIV testing counselors for structured case finding and ART-trained nurses and linkage officers to provide in-hospital or post-discharge ART initiation and support to strengthen PHC facility linkage. Monitoring data (May 2020-March 2021) was used to measure initiation rates.</p><p><strong>Lessons learned: </strong>Over 11 months, despite COVID-19 pandemic-related disruptions, our model achieved 74% (5,201/7,025) ART linkage within 28 days post-discharge and 87% (6,087/7,025) overall, including all initiations (i.e., all newly diagnosed, known not on ART and reinitiating individuals). The 2 highest-performing hospitals achieved 97% (2,096/2,170) linkage overall, demonstrating the potential of implementing this quality improvement model with fidelity. Over half (58%, 4,092/7,025) of patients initiated ART within 7 days, with 39% (2,748) initiating on the same day. Women and men achieved similar initiation rates (3,010/4,015, 75%; 2,186/3,003, 73%, respectively). Combining rapid (<7 days) in-hospital ART initiation with 28-day post-discharge follow-up supported high ART initiation rates. Using the model mitigated initiation gaps for men and older people, engaging stakeholders supported implementation, and using a team-based approach founded on clear roles and responsibilities improved service delivery.</p><p><strong>Conclusion: </strong>This model achieved above-average ART linkage rates in a large hospitalized population. We recommend considering introducing this model or adaptations of it to hospitals across South Africa and similar settings where hospital-to-PHC ART service gaps are identified to optimize case finding, ART initiation, and post-discharge linkage support.</p>","PeriodicalId":12692,"journal":{"name":"Global Health: Science and Practice","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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