Accessibility of antiretroviral therapy in Ghana: Convenience of access

被引:9
作者
Addo-Atuah, Joyce [1 ]
Gourley, Dick
Gourley, Greta
White-Means, Shelley I. [2 ]
Womeodu, Robin J. [3 ]
Faris, Richard J.
Addo, Nii Akwei [4 ]
机构
[1] Touro Coll Pharm, New York, NY 10027 USA
[2] UT Coll Pharm, Hlth Outcomes & Policy Res Div, Austin, TX USA
[3] UT Coll Med, Austin, TX USA
[4] Natl AIDS STI Control Programme NACP, Accra, Ghana
关键词
antiretroviral therapy; ART; access; convenience of accessing ART; HIV/AIDS treatment and care; Ghana; HIV TREATMENT PROGRAMS; MEDICAL-CARE; ADHERENCE; CHALLENGES; MORTALITY; BARRIERS; OUTCOMES; AFRICA; IMPACT; AIDS;
D O I
10.1080/17290376.2012.683581
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. Waiting time to receive care was from 4 to 9 h. While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART, especially in Africa.
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页码:74 / 87
页数:14
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