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A comparative analysis of national HIV policies in six African countries with generalized epidemics

OBJECTIVE: To compare national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. METHODS: We reviewed HIV policies as part of a multi-country study on adult mortality in sub-Saharan Africa. A policy extraction t...

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Autores principales: Church, Kathryn, Kiweewa, Francis, Dasgupta, Aisha, Mwangome, Mary, Mpandaguta, Edith, Gómez-Olivé, Francesc Xavier, Oti, Samuel, Todd, Jim, Wringe, Alison, Geubbels, Eveline, Crampin, Amelia, Nakiyingi-Miiro, Jessica, Hayashi, Chika, Njage, Muthoni, Wagner, Ryan G, Ario, Alex Riolexus, Makombe, Simon D, Mugurungi, Owen, Zaba, Basia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Health Organization 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490813/
https://www.ncbi.nlm.nih.gov/pubmed/26170503
http://dx.doi.org/10.2471/BLT.14.147215
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author Church, Kathryn
Kiweewa, Francis
Dasgupta, Aisha
Mwangome, Mary
Mpandaguta, Edith
Gómez-Olivé, Francesc Xavier
Oti, Samuel
Todd, Jim
Wringe, Alison
Geubbels, Eveline
Crampin, Amelia
Nakiyingi-Miiro, Jessica
Hayashi, Chika
Njage, Muthoni
Wagner, Ryan G
Ario, Alex Riolexus
Makombe, Simon D
Mugurungi, Owen
Zaba, Basia
author_facet Church, Kathryn
Kiweewa, Francis
Dasgupta, Aisha
Mwangome, Mary
Mpandaguta, Edith
Gómez-Olivé, Francesc Xavier
Oti, Samuel
Todd, Jim
Wringe, Alison
Geubbels, Eveline
Crampin, Amelia
Nakiyingi-Miiro, Jessica
Hayashi, Chika
Njage, Muthoni
Wagner, Ryan G
Ario, Alex Riolexus
Makombe, Simon D
Mugurungi, Owen
Zaba, Basia
author_sort Church, Kathryn
collection PubMed
description OBJECTIVE: To compare national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. METHODS: We reviewed HIV policies as part of a multi-country study on adult mortality in sub-Saharan Africa. A policy extraction tool was developed and used to review national HIV policy documents and guidelines published in Kenya, Malawi, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe between 2003 and 2013. Key informant interviews helped to fill gaps in findings. National policies were categorized according to whether they explicitly or implicitly adhered to 54 policy indicators, identified through literature and expert reviews. We also compared the national policies with World Health Organization (WHO) guidance. FINDINGS: There was wide variation in policies between countries; each country was progressive in some areas and not in others. Malawi was particularly advanced in promoting rapid initiation of antiretroviral therapy. However, no country had a consistently enabling policy context expected to increase access to care and prevent attrition. Countries went beyond WHO guidance in certain areas and key informants reported that practice often surpassed policy. CONCLUSION: Evaluating the impact of policy differences on access to care and health outcomes among people living with HIV is challenging. Certain policies will exert more influence than others and official policies are not always implemented. Future research should assess the extent of policy implementation and link these findings with HIV outcomes.
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spelling pubmed-44908132015-07-13 A comparative analysis of national HIV policies in six African countries with generalized epidemics Church, Kathryn Kiweewa, Francis Dasgupta, Aisha Mwangome, Mary Mpandaguta, Edith Gómez-Olivé, Francesc Xavier Oti, Samuel Todd, Jim Wringe, Alison Geubbels, Eveline Crampin, Amelia Nakiyingi-Miiro, Jessica Hayashi, Chika Njage, Muthoni Wagner, Ryan G Ario, Alex Riolexus Makombe, Simon D Mugurungi, Owen Zaba, Basia Bull World Health Organ Research OBJECTIVE: To compare national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. METHODS: We reviewed HIV policies as part of a multi-country study on adult mortality in sub-Saharan Africa. A policy extraction tool was developed and used to review national HIV policy documents and guidelines published in Kenya, Malawi, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe between 2003 and 2013. Key informant interviews helped to fill gaps in findings. National policies were categorized according to whether they explicitly or implicitly adhered to 54 policy indicators, identified through literature and expert reviews. We also compared the national policies with World Health Organization (WHO) guidance. FINDINGS: There was wide variation in policies between countries; each country was progressive in some areas and not in others. Malawi was particularly advanced in promoting rapid initiation of antiretroviral therapy. However, no country had a consistently enabling policy context expected to increase access to care and prevent attrition. Countries went beyond WHO guidance in certain areas and key informants reported that practice often surpassed policy. CONCLUSION: Evaluating the impact of policy differences on access to care and health outcomes among people living with HIV is challenging. Certain policies will exert more influence than others and official policies are not always implemented. Future research should assess the extent of policy implementation and link these findings with HIV outcomes. World Health Organization 2015-07-01 2015-04-28 /pmc/articles/PMC4490813/ /pubmed/26170503 http://dx.doi.org/10.2471/BLT.14.147215 Text en (c) 2015 The authors; licensee World Health Organization. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
spellingShingle Research
Church, Kathryn
Kiweewa, Francis
Dasgupta, Aisha
Mwangome, Mary
Mpandaguta, Edith
Gómez-Olivé, Francesc Xavier
Oti, Samuel
Todd, Jim
Wringe, Alison
Geubbels, Eveline
Crampin, Amelia
Nakiyingi-Miiro, Jessica
Hayashi, Chika
Njage, Muthoni
Wagner, Ryan G
Ario, Alex Riolexus
Makombe, Simon D
Mugurungi, Owen
Zaba, Basia
A comparative analysis of national HIV policies in six African countries with generalized epidemics
title A comparative analysis of national HIV policies in six African countries with generalized epidemics
title_full A comparative analysis of national HIV policies in six African countries with generalized epidemics
title_fullStr A comparative analysis of national HIV policies in six African countries with generalized epidemics
title_full_unstemmed A comparative analysis of national HIV policies in six African countries with generalized epidemics
title_short A comparative analysis of national HIV policies in six African countries with generalized epidemics
title_sort comparative analysis of national hiv policies in six african countries with generalized epidemics
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490813/
https://www.ncbi.nlm.nih.gov/pubmed/26170503
http://dx.doi.org/10.2471/BLT.14.147215
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