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. 2014 May 27:10:43.
doi: 10.1186/1744-8603-10-43.

Scaling up antiretroviral treatment and improving patient retention in care: lessons from Ethiopia, 2005-2013

Yibeltal Assefa  1 , Achamyeleh Alebachew, Meskele Lera, Lut Lynen, Edwin Wouters, Wim Van Damme
Affiliations

Scaling up antiretroviral treatment and improving patient retention in care: lessons from Ethiopia, 2005-2013

Yibeltal Assefa et al. Global Health. .

Abstract

Background: Antiretroviral treatment (ART) was provided to more than nine million people by the end of 2012. Although ART programs in resource-limited settings have expanded treatment, inadequate retention in care has been a challenge. Ethiopia has been scaling up ART and improving retention (defined as continuous engagement of patients in care) in care. We aimed to analyze the ART program in Ethiopia.

Methods: A mix of quantitative and qualitative methods was used. Routine ART program data was used to study ART scale up and patient retention in care. In-depth interviews and focus group discussions were conducted with program managers.

Results: The number of people receiving ART in Ethiopia increased from less than 9,000 in 2005 to more than 439, 000 in 2013. Initially, the public health approach, health system strengthening, community mobilization and provision of care and support services allowed scaling up of ART services. While ART was being scaled up, retention was recognized to be insufficient. To improve retention, a second wave of interventions, related to programmatic, structural, socio-cultural, and patient information systems, have been implemented. Retention rate increased from 77% in 2004/5 to 92% in 2012/13.

Conclusion: Ethiopia has been able to scale up ART and improve retention in care in spite of its limited resources. This has been possible due to interventions by the ART program, supported by health systems strengthening, community-based organizations and the communities themselves. ART programs in resource-limited settings need to put in place similar measures to scale up ART and retain patients in care.

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Figures

Figure 1
Figure 1
Trend in number of people receiving antiretroviral treatment services in Ethiopia, 2007/8-2012/13.
Figure 2
Figure 2
Number of people tested for HIV in Ethiopia, 2005/6-2012/13.
See this image and copyright information in PMC

References

    1. Chan KC, Wong KH, Lee SS. Universal decline in mortality in patients with advanced HIV-1 disease in various demographic subpopulations after the introduction of HAART in Hong Kong, from 1993 to 2002. HIV Med. 2006;7:186–192. doi: 10.1111/j.1468-1293.2006.00352.x. - DOI - PubMed
    1. Braitstein P, Brinkhof MW, Dabis F, Schechter M, Boulle A, Miotti P, Wood R, Laurent C, Sprinz E, Seyler C, Bangsberg DR, Balestre E, Sterne JA, May M, Egger M. Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries. Lancet. 2006;367(9513):817–824. - PubMed
    1. Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD. Declining morbidity and mortality among patients with advanced human immune deficiency virus infection HIV Outpatient Study Investigators. N Engl J Med. 1998;338:853–860. doi: 10.1056/NEJM199803263381301. - DOI - PubMed
    1. Mocroft A, Vella S, Benfield TL. Changing patterns of mortality across Europe in patients infected with HIV-1 EuroSIDA Study Group. Lancet. 1998;352:1725–1730. doi: 10.1016/S0140-6736(98)03201-2. - DOI - PubMed
    1. UNAIDS. UNAIDS Report on the global AIDS epidemic | 2012. Geneva, Switzerland: UNAIDS; 2012.

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