Decentralizing Access to Antiretroviral Therapy for Children Living with HIV in Swaziland.

ABSTRACT:

Background

In 2007, Swaziland initiated a hub-and-spoke model for decentralizing antiretroviral therapy (ART) access for HIV-infected children (<15 years old). Decentralization was facilitated through (1) down referral of stable children on ART from overburdened central facilities (hubs) to primary healthcare clinics (spokes) and (2) pediatric ART initiation at spokes (spoke initiation).

Methods

We conducted a nationally representative retrospective cohort study among children starting ART during 2004-2010 to assess effect of down referral and spoke initiation on rates of loss to follow-up (LTFU), death and attrition (death or LTFU). Twelve of 28 pediatric ART hubs were randomly selected using probability-proportional-to-size sampling. Seven selected facilities had initiated

SUBMITTER: Auld AF 

PROVIDER: S-EPMC11552438 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature