Anti Retroviral Therapy in Public Health Institutions of Oromia Region: A Qualitative Study
World Journal of Public Health
Volume 2, Issue 1, March 2017, Pages: 51-59
Received: Nov. 12, 2016;
Accepted: Dec. 12, 2016;
Published: Jan. 13, 2017
Views 2322 Downloads 124
Sileshi Garoma Abeya, Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
Abebe Megerso Adlo, Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
Tolesa Eticha Chaka, Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
Tilaye Workineh Abebe, Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
Worku Dugasa Girsha, Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
Dejene Gemechu Daba, Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
Mihretu Tarekegn Lencha, Oromia Region Health Bureau, Addis Ababa, Ethiopia
Zelalem Habtamu Jemal, Oromia Region Health Bureau, Addis Ababa, Ethiopia
Dereje Duguma Gemeda, Oromia Region Health Bureau, Addis Ababa, Ethiopia
Shalo Daba Hamuse, Oromia Region Health Bureau, Addis Ababa, Ethiopia
In Ethiopia, the HIV epidemic has remained a major public health problem, mainly affecting people of prime productive and reproductive age. Retention in care and adherence to the treatment is very important for the success of the program while the treatment is being scaled up. No national or regional study gives information on opinion of the Antiretroviral Therapy (ART) service providers. Thus, this study was aimed to explore the perception and opinion of the service providers on status of ART adherences, lost to follow up and associated factors. A total of 14 In-depth Interviews was conducted between February to April, 2015. Interviewees were purposefully selected from the health institutions providing ART services in Oromia Region. The analyses followed the procedure for qualitative thematic analysis using OpenCode qualitative software. Three themes (current statuses of ART adherences and Lost to follow up, reasons for poor adherences to ART and lost from the treatment, and suggested measures) were emerged. Most interviewees perceived, the current statuses of ART adherences are improving. Work overloads, religious influences, social stigma, and perceived fear of drug side effects were the reasons for poor ART adherences and lost from the treatment. The suggested measures were involving the concerned bodies in prevention and treatment of HIV/AIDS and giving special attention to the young people in learning institutions. More efforts are needed to improve adherences to ART and reduces lost to follow up. Providing professional, family and social support for the client is crucial.
Sileshi Garoma Abeya,
Abebe Megerso Adlo,
Tolesa Eticha Chaka,
Tilaye Workineh Abebe,
Worku Dugasa Girsha,
Dejene Gemechu Daba,
Mihretu Tarekegn Lencha,
Zelalem Habtamu Jemal,
Dereje Duguma Gemeda,
Shalo Daba Hamuse,
Anti Retroviral Therapy in Public Health Institutions of Oromia Region: A Qualitative Study, World Journal of Public Health.
Vol. 2, No. 1,
2017, pp. 51-59.
WHO. Antiretroviral therapy for HIV infection in adults and adolescents in resource limited settings: towards universal access. recommendations for a public health approach. 2006.
WHO. The use of antiretroviral therapy: a simplified approach for resource constrained countries. Retrieved from http://apps.searo.who.int/pds_docs/B0184.pdf. 2002.
Jane M, Simoni K, Amico R, Smith L, Nelson K. Antiretroviral Adherence Interventions: Translating Research Finding s to the Real World Clinic. DOI 10.1007/s11904-009-0037-5. Curr HIV/AIDS Rep, 2010.
Simoni JM, Kurth AE, Pearson CR, Pantalone DW, Merrill JO, Frick PA. Self-Report Measure of Antiretroviral Therapy Adherence: A Review with Recommendations for HIV Research and Clinical Management. AIDS behave, 2006. 10(3): 227.
ORHB, Oromia Regional Health Bureau Report. 2013/14.
Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K. Predictors of adherence to an tiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health, 2008. 8: 265.
Markos, E., A. Worku, and G. Dave. Adherence to ART in PLWHA at Yirgalem Hospital, South Ethiopia. Ethiop.J.Health Dev, 2008. 22 (2): 174-179.
Rosen S, Fox P, Gill J. Patient retention in antiretroviral therapy programs in sub-Saharan Africa: a systematic review. Plos Medicine, 2007. 4(10): 298.
Ethiopian monthly antiretroviral treatment report. June 2008. Addis Ababa.
WHO. 2011. HIV Drug resistance fact sheet. Retrieved from http://www.who.int/hiv/facts/drug_resistance/en/index.html.
WHO. The use of antiretroviral therapy: a simplified approach for resource-constrained countries: World Health Organization; 2002.
Karcher H, Omondi A,Odera J, Kunz A, Harms G. Risk factor for Treatment of denial and loss to follow up in an antiretroviral treatment cohort in Kenya. Tropical Medicine & International Health, 2007. 12 (687-694).
Calmy A, Pinoges L, Szumillin E, Zachariah R, Ford N, Ferradini L. On behalf of Médicins Sans Frontières. Generic fixed-dose combination antiretroviral treatment in resource-poor settings. Multicentric observational cohort. AIDS, 2006. 20 (1163-1169).
Jerene D, Næss A, Lindtjørn B. Antiretroviral therapy at a district hospital in Ethiopiaprevents death and tuberculosis in a cohort of HIV patients, 2006. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1475602&tool=pmcentrez
Debito T, Deyno S. Rate and Predictors of Adherence to Antiretroviral Therapy among Clients on Antiretroviral Therapy at Tepi Health Center, South-west Ethiopia. Sci. Technol. Arts Res. J, 2014. 3(3): 93-98.
Reda A, Biadgilign S. Determinants of Adherence to Antiretroviral Therapy among HIV-Infected Patients in Africa. AIDS Research and Treatment, doi:10.1155/2012/574656. 2012.
Alagaw A, Godana W, Taha M, Dejene T. Factors associated with antiretroviral treatment adherence among adult patients in Wolaita Soddo Hospital, Wolaita Zone, Southern Ethiopia. Science Journal of Public Health 2014. 2(2): 69-77.
YuJKL, Chen SCCC, Wang KY, Chang CS, Makombe SD, Schouten EJ, Harries AD. True outcomes for patients on antiretroviral th erapy who are “lost to follow-up” in Malawi. Bulletin of the World Health Organization,2007.85(7):550-54.
Agegnehu TA, Lennarth N. Risk factors for (predictors of) loss to antiretroviral therapy in holeta town,oromia, ethiopia. Umeå University Umeå International Schoolof Public Health Department of Epidemiology an d Public Health Sciences, A PhD desertation, 2010.
Deribe K, Hailekiros F, Biadgilign S, Amberbir A, Beyene BK. Defaulters from antiretroviral treatment in Jimma UniversitySpecialized Hospital, Southwest Ethiopia. Tropical Medicine & International Health,2008.13:328–33.
CSA: Statistical Abstract of Federal Democratic Republic of Ethiopia. CSA Addis Ababa, Ethiopia; 2010.
Dahlgren L,Winkvist A:Qualitative methodology for international public health. Umeå University press; 2007.
Graneheim UH, Lundman B. Qualitative content analysis procedures and measures to achieve trustworthiness. Nurse Education Today 2004.24:105-112.
Ulin P, Robinson E, Tolley E. Qualitative methods in public health: a field guide for applied research. Family Health International, 2005. [http:// www.josseybass.com].
Rothman FE, Hathaway J, Stidsen A, Heather FV: How Employment Helps Female Victims of Intimate Partner Violence: A Qualitative Study. J Occup Heal Psychol 2007. 12 (2):136-143.
Open Code 3.4. program: UMDAC and Division of Epidemiology and Public Health Sciences, Department of Public Health and Clinical medicine.: Umea University; 2007.
Corlien MV, Indra P, Ann B. Designing and Conducting Health Systems Research Projects. World Health Organization / International Development Research Centre 2003. email@example.com / www.idrc.ca.
Lincoln YS, Guba EG: Naturalistic Enquiry. London: Sage; 1985
World Health Organization: Determinants of Adherence to Antiretroviral Treatment: An Explorative Study at Health Facilities inEthiopia and Uganda, October 2008.
Lisan A, Anley H. Assessing Adherence of PLHIVto ART Treatment: The case of Yeka and Gullele Sub City in Addis Ababa, February 2013.
Roura M, Joanna B, Alison W, Doris M, Mark U, Basia Z. Barriers to Sustaining Antiretroviral Treatment in Kisesa, Tanzania: A Follow-Up Study to Understand Attrition from the Antiretroviral Program. AIDS Patient Care and STDs, 2009.23 (3): 1-8.
MekonnenY, Mela R, Rachel S, Senait T, Priya E. Equity and Access to ART in Ethiopia. Washington, DC: Futures Group, Health Policy Initiative, Task Order 1. 2010
Ckovics JR, Meads CS. Adherence to HAART among patients with HIV: Breakthroughs and barriers. AIDS Care, 2002. 14(3): 309-18.
Spire B, Duran S, Souville M. Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to a dynamic approach. Soc Sci Med,2002. 54:1481– 96.