Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112975

Jean Flatley McGuire, PhD, Institute on Urban Health Researhc, Northeastern University, Stearns 503 Northeastern University, 420 Huntington Ave, Boston, MA 02115, 617-373-7729, j.mcguire@neu.edu and Nomalanga Makwedini, RN, MPH, Director, HIV/AIDS Directorate, Eastern Cape Department of Health, Eastern Cape Province, South Africa.

Efforts to expand HIV treatment in developing countries have differentially focused on drug access concerns. Little attention and few resources have been committed to identifying and addressing service delivery challenges that can impede treatment success. A collaborative review of five ARV rollout sites in the Eastern Cape Province of South Africa provides a basis for assessing operational concerns and quality improvement opportunities through integrated formative and ongoing system evaluation. Variations in facility size, clinical capacity, and geographic location shaped differences in the scope of service delivery challenges, although the arenas of difficulty remained largely the same across settings: patient information management and record keeping; drug, specimen and other inventory management; clinical management; staff capacity, training, scope of responsibilities and redundancy; data collection and simplification; vendor and other external service management; and overall quality improvement. Particular attention will be paid to the distortions introduced by donor funding obligations. Recommended interventions and their current status will be reviewed. Contributions of a unique US-South Africa twinning arrangement is assessed.

Learning Objectives: At the conclusion of the session participants will be to

• Recognize operational barriers to HIV ARV delivery in low resource settings 2.Identify potential interventions
• Characterize rationales for improving the operational focus of global HIV service delivery and program evaluation efforts

Keywords: HIV/AIDS, Quality Improvement

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation