Philosophiae Doctor - PhD (School of Public Health)

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Evaluation of a community-based antiretroviral therapy delivery program for adults in Okongo district, Namibia: 2007-2017
(University of the Western Cape, 2024) Shoopala, Naemi N; Brian, Van Wyk
Namibia implemented a community-based ART (C-BART) delivery program in the Okongo District of the Ohangwena Region in northern Namibia in 2007. A C-BART site is a fixed, designated place in the community where ART services are provided on scheduled dates. The WHO recommends differentiated models of ART service delivery for stable patients at the facility and community levels. C-BART models are reported to increase patients' adherence and retention in care, with the ultimate goal of achieving viral suppression (VS). By the end of April 2017, eighteen (18) C-BART sites were established in the Okongo district. At the time of the study, the effectiveness of the C-BART program had not been evaluated. Aim: The study aimed to assess the effectiveness of the C-BART program on improving treatment outcomes (adherence to ART, retention in care, viral load suppression and survival) in comparison to facility-based ART(F-BART) and to describe patients' and healthcare providers' experiences of and challenges with implementing C-BART in the Okongo district.