Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010

dc.contributor.authorNgandu, Nobubelo K
dc.contributor.authorMaduna, Vincent
dc.contributor.authorSherman, Gayle
dc.contributor.authorNoveve, Nobuntu
dc.contributor.authorChirinda, Witness
dc.contributor.authorRamokolo, Vundli
dc.contributor.authorLombard, Carl
dc.contributor.authorGoga, Ameena E
dc.date.accessioned2019-10-10T09:00:21Z
dc.date.available2019-10-10T09:00:21Z
dc.date.issued2019-09-16
dc.date.updated2019-09-22T03:32:55Z
dc.description.abstractAbstract Background In June 2015, South Africa introduced early infant HIV diagnosis (EID) at birth and ten weeks postpartum. Guidelines recommended return of birth results within a week and ten weeks postpartum results within four weeks. Task shifting was also suggested to increase service coverage. This study aimed to understand factors affecting return of EID results to caregivers. Methods Secondary analysis of data gathered from 571 public-sector primary health care facilities (PHCs) during a nationally representative situational assessment, was conducted. The assessment was performed one to three months prior to facility involvement in the 2010 evaluation of the South African programme to prevent mother-to-child HIV transmission (SAPMTCTE). Self-reported infrastructural and human resource EID-related data were collected from managers and designated staff using a structured questionnaire. The main outcome variable was ‘EID turn-around-time (TAT) to caregiver’ (caregiver TAT), measured as reported number of weeks from infant blood draw to caregiver receipt of results. This was dichotomized as either short (≤3 weeks) or delayed (> 3 weeks) caregiver TAT. Logit-based risk difference analysis was used to assess factors associated with short caregiver TAT. Analysis included TAT to facility (facility TAT), defined as reported number of weeks from infant blood draw to facility receipt of results. Results Overall, 26.3% of the 571 PHCs reported short caregiver TAT. In adjusted analyses, short caregiver TAT was less achieved when facility TAT was > 7 days (versus ≤7 days) (adjusted risk difference (aRD): − 0.2 (95% confidence interval − 0.3-(− 0.1)), p = 0.006 for 8–14 days and − 0.3 (− 0.5-(− 0.1)), p = 0.006 for > 14 days), and in facilities with staff nurses (compared to those without) (aRD: − 9.4 (− 16.6-(− 2.2), p = 0.011). Conclusion Although short caregiver TAT for EID was only reported in approximately 26% of facilities, these facilities demonstrate that achieving EID TAT of ≤3 weeks is possible, making timely ART initiation within 3 weeks of diagnosis feasible within the public health sector. Our adjusted analyses underpin the need for quick return of results to facilities. They also raise questions around staff mentoring: we hypothesise that facilities with staff nurses were likely to have fewer professional nurses, and thus inadequate senior support.
dc.identifier.apacitationNgandu, N. K., Maduna, V., Sherman, G., Noveve, N., Chirinda, W., Ramokolo, V., ... Goga, A. E. (2019). Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010. http://hdl.handle.net/11427/30564en_ZA
dc.identifier.chicagocitationNgandu, Nobubelo K, Vincent Maduna, Gayle Sherman, Nobuntu Noveve, Witness Chirinda, Vundli Ramokolo, Carl Lombard, and Ameena E Goga "Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010." (2019) http://hdl.handle.net/11427/30564en_ZA
dc.identifier.citationBMC Infectious Diseases. 2019 Sep 16;19(Suppl 1):785
dc.identifier.ris TY - Journal Article AU - Ngandu, Nobubelo K AU - Maduna, Vincent AU - Sherman, Gayle AU - Noveve, Nobuntu AU - Chirinda, Witness AU - Ramokolo, Vundli AU - Lombard, Carl AU - Goga, Ameena E AB - Abstract Background In June 2015, South Africa introduced early infant HIV diagnosis (EID) at birth and ten weeks postpartum. Guidelines recommended return of birth results within a week and ten weeks postpartum results within four weeks. Task shifting was also suggested to increase service coverage. This study aimed to understand factors affecting return of EID results to caregivers. Methods Secondary analysis of data gathered from 571 public-sector primary health care facilities (PHCs) during a nationally representative situational assessment, was conducted. The assessment was performed one to three months prior to facility involvement in the 2010 evaluation of the South African programme to prevent mother-to-child HIV transmission (SAPMTCTE). Self-reported infrastructural and human resource EID-related data were collected from managers and designated staff using a structured questionnaire. The main outcome variable was ‘EID turn-around-time (TAT) to caregiver’ (caregiver TAT), measured as reported number of weeks from infant blood draw to caregiver receipt of results. This was dichotomized as either short (≤3 weeks) or delayed (> 3 weeks) caregiver TAT. Logit-based risk difference analysis was used to assess factors associated with short caregiver TAT. Analysis included TAT to facility (facility TAT), defined as reported number of weeks from infant blood draw to facility receipt of results. Results Overall, 26.3% of the 571 PHCs reported short caregiver TAT. In adjusted analyses, short caregiver TAT was less achieved when facility TAT was > 7 days (versus ≤7 days) (adjusted risk difference (aRD): − 0.2 (95% confidence interval − 0.3-(− 0.1)), p = 0.006 for 8–14 days and − 0.3 (− 0.5-(− 0.1)), p = 0.006 for > 14 days), and in facilities with staff nurses (compared to those without) (aRD: − 9.4 (− 16.6-(− 2.2), p = 0.011). Conclusion Although short caregiver TAT for EID was only reported in approximately 26% of facilities, these facilities demonstrate that achieving EID TAT of ≤3 weeks is possible, making timely ART initiation within 3 weeks of diagnosis feasible within the public health sector. Our adjusted analyses underpin the need for quick return of results to facilities. They also raise questions around staff mentoring: we hypothesise that facilities with staff nurses were likely to have fewer professional nurses, and thus inadequate senior support. DA - 2019-09-16 DB - OpenUCT DP - University of Cape Town KW - Early infant diagnosis of HIV KW - Turn-around times KW - Laboratory transportation system KW - Human resources KW - SAPMTCTE KW - PMTCT LK - https://open.uct.ac.za PY - 2019 T1 - Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010 TI - Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010 UR - http://hdl.handle.net/11427/30564 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-019-4337-0
dc.identifier.urihttp://hdl.handle.net/11427/30564
dc.identifier.vancouvercitationNgandu NK, Maduna V, Sherman G, Noveve N, Chirinda W, Ramokolo V, et al. Infrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010. 2019; http://hdl.handle.net/11427/30564.en_ZA
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.subjectEarly infant diagnosis of HIV
dc.subjectTurn-around times
dc.subjectLaboratory transportation system
dc.subjectHuman resources
dc.subjectSAPMTCTE
dc.subjectPMTCT
dc.titleInfrastructural and human-resource factors associated with return of infant HIV test results to caregivers: secondary analysis of a nationally representative situational assessment, South Africa, 2010
dc.typeJournal Article
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