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Bhushan Rewari B, Agarwal R, Reddy Allam R, et al. Assessment of quality of antiretroviral therapy services in India, 2014-2015. Int Health. 2017;9(5):301-309doi: 10.1093/inthealth/ihx026.
Bhushan Rewari, B., Agarwal, R., Reddy Allam, R., Chava, N., & Rathore, A. S. (2017). Assessment of quality of antiretroviral therapy services in India, 2014-2015. International health, 9(5), 301-309. https://doi.org/10.1093/inthealth/ihx026
Bhushan Rewari, Bharat, et al. "Assessment of quality of antiretroviral therapy services in India, 2014-2015." International health vol. 9,5 (2017): 301-309. doi: https://doi.org/10.1093/inthealth/ihx026
Bhushan Rewari B, Agarwal R, Reddy Allam R, Chava N, Rathore AS. Assessment of quality of antiretroviral therapy services in India, 2014-2015. Int Health. 2017 Sep 01;9(5):301-309. doi: 10.1093/inthealth/ihx026. PMID: 28911124.
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Int Health. 2017 Sep 01;9(5):301-309. doi: 10.1093/inthealth/ihx026.

Assessment of quality of antiretroviral therapy services in India, 2014-2015.

International health

Bharat Bhushan Rewari, Reshu Agarwal, Ramesh Reddy Allam, Nalini Chava, A S Rathore

Affiliations

  1. Ex NPO(ART) WHO.
  2. Ex PO NACO.
  3. Public Health Research Division, SHARE India, Hyderabad, India, 500025.
  4. DDG, Care Support and treatment Division, National AIDS Control Organization, New Delhi, India, 110001.

PMID: 28911124 DOI: 10.1093/inthealth/ihx026

Abstract

BACKGROUND: Following a decade of provision of free antiretroviral therapy (ART) in India, a nationwide assessment of ART services was conducted to review quality of care at ART centers. This paper presents the methods and defines replicable model of undertaking large scale assessments.

METHODS: During the period January 2014-March 2015, 357 ART centers were reviewed under four domains, namely, operations, technical, monitoring and evaluation (M&E), and logistics. Mixed methods, comprising of desk review and on-site facility assessment; random sample of records, interviews with both health-care staff and people living with HIV (PLHIV) were used. Grading for each of the domain was done on a scale of 5, with 1 (Very poor) being the lowest and 5 (Excellent) as highest.

RESULTS: 1720 health-care staff and 1762 beneficiaries were interviewed; 34 600 patient cards were reviewed. Of the 357 centers assessed 60, 169 and 128 scored Excellent, Average and Poor, respectively, in operations domain; 147, 176, 34 in Technical domain; 215, 115, 27 in M&E domain; 263, 71, 23 centers in logistics domain scored Excellent, Average and Poor, respectively. About 95% (1698/1785) of PLHIV were satisfied with the care provided at ART centers.

CONCLUSION: The methodology used for the assessment of ART centers in India yielded insights on the different domains that impact implementation and quality of service delivery. The design of this exercise may inform other researchers and managers planning similar large-scale assessments.

© The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: [email protected].

Keywords: ART centers; Assessment; Data quality; HIV-TB co-infection; HIV/AIDS; India

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