原创力文档a study of patient attitudes towards decentralisation of hiv care in an urban clinic in south africa病人的研究态度分权的艾滋病毒在城市治疗诊所在南非.pdfVIP
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a study of patient attitudes towards decentralisation of hiv care in an urban clinic in south africa病人的研究态度分权的艾滋病毒在城市治疗诊所在南非
Mukora et al. BMC Health Services Research 2011, 11:205
/1472-6963/11/205
RESEARCH ARTICLE Open Access
A study of patient attitudes towards
decentralisation of HIV care in an urban clinic in
South Africa
1* 1 1 1 2
Rachel Mukora , Salome Charalambous , Maysoon Dahab , Robin Hamilton and Alan Karstaedt
Abstract
Background: In South Africa, limited human resources are a major constraint to achieving universal antiretroviral
therapy (ART) coverage. Many of the public-sector HIV clinics operating within tertiary facilities, that were the first
to provide ART in the country, have reached maximum patient capacity. Decentralization or “down-referral”
(wherein ART patients deemed stable on therapy are referred to their closest Primary Health Clinics (PHCs) for
treatment follow-up) is being used as a possible alternative of ART delivery care. This cross-sectional qualitative
study investigates attitudes towards down-referral of ART delivery care among patients currently receiving care in a
centralized tertiary HIV clinic.
Methods: Ten focus group discussions (FGDs) with 76 participants were conducted in early 2008 amongst ART
patients initiated and receiving care for more than 3 months in the tertiary HIV clinic study site. Eligible individuals
were invited to participate in FGDs involving 6-9 participants, and lasting approximately 1-2 hours. A trained
moderator used a discussion topic guide to investigate the main issues of interest including: advantages and
disadvantages of down-referral, potential motivating factors and challenges of down-referral, assistance needs from
the transferring clinic as well as from PHCs.
Results: Advantages include closeness to patients’ homes, transport an
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