South Africa has more than 2.6 million people on HIV treatment, but further expansion will be needed for the country to reach targets set by the World Health Organization. In light of that challenge, a new study co-authored by Boston University School of Public Health (BUSPH) researchers recommends that South Africa further expand an approach that allows nurses working at primary health clinics (PHCs) to initiate and manage ART treatment, rather than limiting ART provision to doctors at hospital-based HIV clinics.
They suggest that South Africa continue to invest in expanding ART treatment in primary health clinics, while also transforming hospital-based programs into “centralized, expert referral facilities that focus on complicated patients.
“We found that both models achieved similar proportions of patients alive and in care 12 months after initiation, but the primary health clinic model cost substantially less per patient treated, despite providing more months of patient care overall,” the study says. “The knowledge that PHCs can deliver equally good care, at much lower cost, will help the South African Government, neighboring governments, and their partners to make cost-effective decisions about program design.”
The authors recommend that South Africa policymakers develop guidelines for how to “triage” patients between routine PHC care and specialized hospital clinic care. They also suggest that the impact of incorporating HIV care into nurses’ workloads at PHCs be evaluated.
To read more about the study, go to: http://www.bu.edu/sph/2017/01/03/hiv-treatment-succeeds-at-primary-health-clinics/