Adherence Support Workers: A Way to Address Human Resource Constraints in Antiretroviral Treatment Programs in the Public Health Setting in Zambia

• DOI: 10.1371/journal.pone.0002204
• Publication Date: 2008-05-21T16:11:20Z
• Authors: Kwasi E. Torpey; Mushota E. Kabaso; Liya N. Mutale; Mpuma K. Kamanga; Albert J. Mwango; James Simpungwe; Chiho Suzuki; Ya Diul Mukadi
• Keywords: Counseling; Male; Anti-HIV Agents; Science; Health Personnel; Q; R; 610; Zambia; HIV Infections; 3. Good health; 03 medical and health sciences; Cross-Sectional Studies; Public Health Practice; Medicine; Humans; Patient Compliance; Female; 0305 other medical science; Research Article

BackgroundIn order to address staff shortages and improve adherence counseling for people on antiretroviral therapy (ART), the Zambia Prevention, Care Treatment Partnership (ZPCT) developed an innovative strategy of training community volunteers provide support at health facility levels. The objective this study was assess effectiveness these 'adherence workers' (ASWs) in counseling, treatment retention addressing inadequate human resources facilities.Methodology/Principal FindingsThe used quantitative qualitative research techniques five selected ART sites four provinces Zambia. Five hundred patients were interviewed using a structured questionnaire compare quality before after ASW scheme introduced between ASWs HCWs introduction ASWs. In addition, 3,903 4,972 electronic records all new accessing time period 12 months respectively, analyzed loss follow-up rates. Two focus group discussions with care workers (HCWs) conducted each clinic. Key informant interviews clinics also conducted. There marked shift workload from without any compromise counseling. Quality by comparable their introduction. findings suggest that deployment helped reduce waiting times Loss rates clients declined 15% 0% ASWs.ConclusionAdherence tasks can be shifted lay cadres like compromising Follow-up within is necessary ART.