Engendering health systems in response to national rollout of dolutegravir-based regimens among women of childbearing potential: a qualitative study with stakeholders in South Africa and Uganda

• DOI: 10.1186/s12913-020-05580-0
• Publication Date: 2020-08-01T09:04:36Z
• Authors: Yussif Alhassan; Adelline Twimukye; Thoko Malaba; Catherine Orrell; Landon Myer; Catriona Waitt; Mohammed Lamorde; Andrew Kambugu; Helen Reynolds; Saye Khoo; Miriam Taegtmeyer
• Keywords: Dolutegravir

Abstract Background In the era of rapid dolutegravir rollout, concerns about neural tube defects have complicated health systems response among women childbearing potential. This qualitative study, which was nested within DolPHIN-2 clinical trial, examined current and future system opportunities challenges associated with transition to dolutegravir-based regimen as first line antiretroviral therapy potential in South Africa Uganda . Method Semi-structured in-depth interviews members guideline development groups affiliates were conducted. Thirty-one participants purposively selected for including senior officials from Ministry Health National Drug Regulatory Authority well health-sector partners, activists, researchers workers. A thematic approach used analyse data. Findings Despite differences contexts, several common identified Uganda. both contexts national stakeholders ensuring gender equity roll out due teratogenicity dolutegravir, paucity data on use pregnancy, stock effective contraceptives, poorly integrated contraception services, limited pharmacovigilance pregnancy. Participants that could be harnessed accelerate transition, high stakeholder interest commitment approval licensure a generic tenofovir/lamivudine/dolutegravir regimen, availability network providers, strong desire newer more tolerable regimens. Conclusion The regimens has strengthen low- middle-income countries engender equitable access optimised women. There is need multi-sectoral effort harness addresses bottlenecks initiate extensive community engagement alongside individual institutional capacity strengthening. Improvements pregnancy counselling family planning services are critical successful