Identifying gaps in HIV service delivery across the diagnosis-to-treatment cascade: findings from health facility surveys in six sub-Saharan countries

Kathryn Church, Kazuyo Machiyama, Jim Todd, Brian Njamwea, Mary Mwangome, Vicky Hosegood, Janet Michel, Samuel Oti, Constance Nyamukapa, Amelia Crampin, Nyaguara Amek, Gertrude Nakigozi, Denna Michael, F Xavier Gómez-Olivé, Jessica Nakiyingi-Miiro, Basia Zaba and Alison Wringe Journal of the International AIDS Society, 2017; Read full paper online

Despite the rollout of antiretroviral therapy (ART), challenges remain in ensuring timely access to care and treatment for people living with HIV. As part of a multi-country study to investigate HIV mortality, teams conducted health facility surveys within 10 health and demographic surveillance system sites across six countries in Eastern and Southern Africa to investigate clinic-level factors influencing:

  1. use of HIV testing services
  2. use of HIV care and treatment
  3. patient retention on ART

The study identfied a high standard of health facility performance in delivering strategies that may support progression through the continuum of HIV care. HIV testing policy and practice was particularly weak. Inter- and intra-country differences in quality and coverage represent opportunities to improve the delivery of comprehensive services to people living with HIV.

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