Analysis of the implementation of an antiretroviral treatment programme in KwaZulu- Natal province
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Date
2019
Authors
Journal Title
Journal ISSN
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Publisher
University of the Western Cape
Abstract
The rapid expansion of the ART programme in South Africa has placed an additional
service demand on an already stretched public health infrastructure. The main aim of this
study was therefore to analyse the implementation of the ART programme in KwaZulu-
Natal province using the Donabedian Model of structure, process and outcome in order
to develop an ART delivery model. Ethical approval to conduct this research was issued by
the University’s Senate Research Committee. The first phase of the study used a
descriptive quantitative approach to review existing data from government departments
to analyse the ART programme. A checklist with the list of indicators for the three
elements of the study; the structure, process and outcome were used to collect data. A
pilot study was conducted and the Cronbach Alpha test was used to determine the rigour
of the study. In the second phase, a systematic review of studies on implementation of
the existing models of ART programme was conducted using quantitative descriptive
approach. The Quality Appraisal Tool was used to determine the validity of the research
findings from the literature. In phase 3, both qualitative and quantitative approaches
were used to conduct the Delphi study which included a group of experts in the field of
HIV and ART programme. Responses from the participants were modified to determine
the reliability of the study. The study found that there were structural problems such as
shortages of antiretroviral drugs and delays in the return of laboratory results. The
systematic literature review found that there were only two community-based ART
models in South Africa, namely; the adherence clubs and community-based adherence
clubs. These two models of ART delivery were implemented only in Cape Town.
Description
Philosophiae Doctor - PhD
Keywords
Analysis, Implementation, Delphi technique, Model development, KwaZulu-Natal (KZN)