引入多用途预防(MPT)方法的主要计划和政策考虑因素:南非医疗服务提供者和主要利益相关者的思考。

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Frontiers in reproductive health Pub Date : 2024-02-20 eCollection Date: 2024-01-01 DOI:10.3389/frph.2024.1249750
Alison Kutywayo, Paballo Mataboge, Nqaba Mthimkhulu, Catherine E Martin, Lorrein S Muhwava, Mbali Mazibuko, Nthabiseng Makalela, Khanyiswa Kwatsha, Vusile Butler, Saiqa Mullick
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引用次数: 0

摘要

导言:多用途预防技术 (MPT) 可同时预防 HIV、其他性传播感染和/或意外怀孕。在产品实施之前,关键守门人(医疗保健提供者(HCPs)和主要利益相关者)需要积极主动地参与进来。本手稿确定了在南非采用 MPTs 的 HCP 需求创造策略和主要利益相关者的考虑因素:在南非三个省的三个地区开展了形成性研究(2022 年 7 月至 11 月)。在医疗机构和流动研究地点开展口服 PrEP 的护士参加了 4 小时的参与式研讨会,探讨包括 MPTs 在内的 HIV 预防、需求创造策略以及首选 MPTs 培训包。对活动进行了观察、记录和主题分析。与关键信息提供者(KIs)(国家/地区计划实施者和技术负责人)进行了五次在线深入访谈(IDIs),并亲自参加了一次访谈,探讨了采用 MPT 的主要计划和政策考虑因素。IDI 长约 40 分钟,经过录音、转录和主题分析:21 名专业护士完成了研讨会:19 名女性。与 4 名设施经理、1 名国家卫生部代表和 1 名卫生部省级副主任进行了 6 次 IDI。所有参与者均为女性,年龄在 30-60 岁以上,从事性健康和生殖健康/艾滋病政策/宣传/研究工作 10 年以上。社区谈话和在诊所提供信息是卫生保健人员创造 MPT 需求的最佳方法。KIs 确定了未来实施 MPT 的五个考虑因素:HCP 培训;需求创造和信息传递;现行 PrEP 政策修订;为用户提供更多选择做好准备;以及持续提供 MPT:结论:在准备引入 MPT 时,应积极考虑避孕植入物和口服 PrEP 的实施经验。在引入 MPT 之前,HCP 培训和需求创造尤为重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Key programmatic and policy considerations for introducing multipurpose prevention (MPT) methods: reflections from healthcare providers and key stakeholders in South Africa.

Introduction: Multipurpose prevention technologies (MPTs) simultaneously prevent HIV, other sexually transmitted infections, and/or unintended pregnancy. Key gatekeepers, [healthcare providers (HCPs) and key stakeholders] require proactive engagement before product implementation. This manuscript identifies HCP demand creation strategies, key stakeholder considerations for the adoption of MPTs in South Africa.

Methods: Formative research was conducted in three districts in three South African provinces (July to November 2022). Nurses initiating oral PrEP at facility and mobile study sites participated in 4-hour participatory workshops, exploring HIV prevention, including MPTs, demand creation strategies, and preferred MPTs training packages. Activities were observed, transcribed, and thematically analysed. Five online in-depth interviews (IDIs) with Key informants (KIs) (National/district programme implementers and technical leads) and one in person, exploring key programmatic and policy considerations for MPT adoption. IDIs were approximately 40 min long, audio recorded, transcribed, and thematically analysed.

Results: Twenty-one Professional Nurses completed workshops: 19 female. Six IDIs were conducted with 4 Facility Managers, 1 NDoH representative and 1 DoH Provincial Deputy Director. All participants were females, aged 30-60+ years with >10 years' in SRH/HIV policy/advocacy/research. Community conversations and information at the clinic were the best MPT demand creation methods among HCPs. KIs identified five considerations for future MPT implementation: HCP training; demand creation and messaging; existing PrEP policy amendments; preparing users for additional choice; and sustaining MPT provision.

Conclusion: Contraceptive implant and oral PrEP implementation lessons learned should be proactively considered when preparing for MPT introduction. HCP training and demand creation are of particular importance before MPT introduction.

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