A Qualitative Assessment of a Community Antiretroviral Therapy Group Model in Tete, Mozambique

摘要: Background To improve retention on ART, Medecins Sans Frontieres, the Ministry of Health and patients piloted a community-based antiretroviral distribution adherence monitoring model through Community ART Groups (CAG) in Tete, Mozambique. By December 2012, almost 6000 had formed groups whom 95.7% were retained care. We conducted qualitative study to evaluate relevance, dynamic impact CAG patients, their communities healthcare system. Methods Between October 2011 May we 16 focus group discussions 24 in-depth interviews with major stakeholders involved model. Audio-recorded data transcribed verbatim analysed using grounded theory approach. Results Six key themes emerged from data: 1) Barriers access HIV care, 2) functioning actors involved, 3) Benefits for members, 4) Impacts beyond 5) Setbacks, 6) Acceptance future expectations The provides cost time savings, certainty mutual peer support resulting better treatment. Through active role information could be conveyed broader community, leading an increased uptake services positive transformation identity people living HIV. Potential pitfalls included limited those most vulnerable defaulting, some inequity individual care high dependency counsellors. Conclusion The resulted patient involvement empowerment, creation supportive environment improving retention. It also sparked reorientation towards community strengthened actions. Successful implementation scalability requires (a) acceptance as partners health, (b) adequate resources, (c) well-functioning management system.