差异化抗逆转录病毒分发:在南非五个地区实施。

IF 1.7 Q4 PRIMARY HEALTH CARE
Justin Engelbrecht, Chandbi Tajeer, Cara O'Connor, Kate Rees
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引用次数: 0

摘要

背景:国家卫生部介绍了差异化服务交付(DSD)模式,以提高在护理和减少拥挤的医疗设施的保留。Anova保健研究所支持在南非的五个地区执行发展与可持续发展准则。目的:本研究旨在描述DSD政策中包含的模型是如何运作的。环境:南非的五个区,两个大都市区,两个混合区和一个农村区。方法:我们采用混合方法,包括2023年为期2天的参与性研讨会和对常规规划数据的回顾性回顾。一项测绘工作被用来了解五个研究区慢性药物提供的所有模式,并描述操作上的差异。我们还报告了每个设施的选择数量以及医疗保健提供者对益处和局限性的看法。结果:外部接点和设施接点是最常用的模式。三个关键主题是:便利和额外支持之间的权衡,控制客户服务和外包任务之间的权衡,以及工作人员干部之间的工作分配。Sedibeng区每个设施提供的选择最多,57%的设施有三种可能的选择。开普敦提供的选择最少,50%的设施只提供一种选择。结论:健康和环境背景指导所提供的DSD模式的选择。有可能在南非的环境中为客户提供选择。贡献:本研究强调了DSD模型实施的上下文特定性质以及客户选择的重要性。从客户的角度进一步研究可用性和选项将是有用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Differentiated antiretroviral distribution: Implementation in five South African districts.

Differentiated antiretroviral distribution: Implementation in five South African districts.

Background:  The National Department of Health introduced Differentiated Service Delivery (DSD) models to improve retention in care and decongest healthcare facilities. Anova Health Institute supported the implementation of DSD guidelines in five districts of South Africa.

Aim:  The study aimed to describe how the models contained in DSD policies are operationalised.

Setting:  Five districts of South Africa - two metropolitan, two mixed and one rural.

Methods:  We used a mixed-methods approach, incorporating a 2-day participatory workshop in 2023 and a retrospective review of routine programmatic data. A mapping exercise was used to understand all models of chronic medication provision in the five study districts and to describe differences in operationalisation. We also report on the number of options per facility and healthcare provider perspectives of benefits and limitations.

Results:  External and facility pick-up points were the most commonly implemented models. Three key themes were: the trade-off between convenience and additional support, the trade-off between controlling client care and outsourcing tasks and the distribution of work between cadres of staff. Sedibeng District provided the most options per facility, with 57% of facilities having three possible options. Cape Town provided the fewest, with 50% of facilities offering only one option.

Conclusion:  Health and environmental contexts guide the choice of DSD modalities offered. It is possible to offer clients options in South African settings.Contribution: This study highlights the context-specific nature of DSD model implementation and the importance of client choice. Further research into availability and options from a client perspective would be useful.

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来源期刊
CiteScore
3.30
自引率
10.00%
发文量
81
审稿时长
15 weeks
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