Thesis & Dissertations

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Browsing Thesis & Dissertations by Author "Chihana, Rachel"

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    Facilitators and barriers of same-day linkage to ART Care of newly diagnosed HIV adults in health facilities: A cross sectional study from primary health facilities in urban Malawi
    (Kamuzu University of Health Sciences, 2022-03-01) Chihana, Rachel
    The Malawi national HIV guidelines recommend same-day antiretroviral therapy (ART) initiation. In Malawi, only 88.6 % of those that tested HIV positive are on ART(1). Factors that facilitate and hinder successful linkage to ART among newly-diagnosed HIV-positive individuals have not been fully described. The study described client based, health system and health facility infrastructural factors of successful same-day ART initiation at two health centers in Blantyre, Malawi. A crosssectional study was conducted at South Lunzu (semi-urban) and Limbe (urban), in Blantyre City, from March to July 2020. Eligibility criteria included: recently diagnosed HIV infection and age ≥18 years. A structured questionnaire and checklist were used for data collection. The study outcome was same day ART initiation which was verified by checking health passport books of study participants. About 321 participants gave informed consent. Their mean age (standard deviation) was 33(10) and 59% were females. Of these participants, 315 (98.2%) were successfully initiated on same day ART. Four of the six participants who failed to initiate ART reported that they were not mentally prepared to do so. Most study participants had very positive views of the service delivery and infrastructure at the facilities which may have facilitated linkage to care. Primary health facilities supported by expert clients successfully linked to ART newly diagnosed HIV positive clients. Mental unpreparedness likely contributed to unsuccessful linkage to ART. Good health facility service delivery and conducive infrastructure appeared to facilitate linkage to ART.