Evaluation of the National Adherence Guidelines for Chronic Diseases in South Africa
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World Bank, Washington, DC
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This report presents the result of the
qualitative evaluation to understand the implementation of
five adherence interventions from the provider perspective
in four South African provinces. The research is part of the
evaluation of the new Adherence Guidelines for HIV, TB and
other chronic diseases. The study sought to answer four key
questions: 1. What are the barriers to and facilitators of
implementing the minimum package interventions from the
perspective of the providers? 2. What are the strengths and
weaknesses of each intervention for HIV positive patients
from the perspective of providers? 3. How could
implementation of adherence interventions and the minimum
package of interventions be improved? 4. What additional
strategies do providers feel would be helpful in improving
treatment adherence? The report presents the thematic
analysis of the qualitative interview transcripts under each
of the four questions. Emerging themes are illustrated with
quotes from respondents at intervention and control clinics.
The results show that providers were generally positive
about all the interventions, though they had mixed comments
about the Direct Medicine Delivery and Tracing and
Retention-in-Care models, largely because they were not
always well implemented or providers felt they did not have
the resources to implement them at scale. Additionally,
providers' views were mixed on their perceived
effectiveness of Adherence Clubs.
Palabras clave
EVALUATION, SURVEYS, HEALTHCARE, SERVICE DELIVERY, HEALTH INTERVENTIONS, ANTIRETROVIRAL THERAPY, TUBERCULOSIS, HIV AIDS, CHRONIC DISEASE