IMPLEMENTING TOOLS TO PROMOTE ADHERENCE TO ANTIRETROVIRAL THERAPY AT FACILITIES IN KENYA

Area of Science:

• Public Health
• Health Services Research
• HIV/AIDS Management

Background:

• Adherence monitoring for anti-retroviral treatment (ART) is challenged by a lack of effective systems to track patient defaulters.
• An intervention introduced a facility-based appointment keeping system and a revised clinic form to improve ART adherence monitoring.

Purpose of the Study:

• To assess healthcare staff perceptions, motivation, and self-reported practices regarding the implementation of an adherence monitoring intervention.
• To evaluate the use of adherence-based indicators for informing performance improvement decisions.

Main Methods:

• A qualitative explorative study design was used to evaluate a quasi-experimental intervention.
• Data were collected through interviews with 36 clinic staff members across six health facilities in Kenya.
• Analysis followed the Pettigrew and Whipp framework.

Main Results:

• Healthcare providers felt empowered to manage daily workloads and identify patients missing appointments.
• Key factors for successful uptake included monitoring tools, adherence training, and supervisory support.
• Early identification of treatment defaulters enabled targeted patient support to improve appointment keeping.

Conclusions:

• The intervention successfully led to clinic-based changes that enhanced patient appointment keeping and ART adherence.
• The sustainability of observed changes is expected as providers were actively involved in data generation and indicator calculation for decision-making.