Factors affecting retention in care of patients initiated on antiretroviral treatment at Umodzi Art Clinic, Blantyre
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Date
16-03-22
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Kamuzu University of Health Sciences
Abstract
Type of research study: The study is a cross-sectional analytical that will use mixed
methods.
Problem to be studied: The United Nations Programme on HIV/AIDS (UNAIDS) 95–95-95
target states that 95% of people living with HIV should know their status, 95% of people
living with HIV who know their status should be on treatment, and 95% of people on
treatment should be virally suppressed by 2025. Malawi strives to ensure that by the year
2030, she achieves this 95-95-95 target. However, only 69% of all people living with HIV
were virally suppressed in Malawi in the year 2018, plus, available data at Umodzi clinic
indicate that not all people that are initiated on ART are retained in care after 12 months
which puts the 3rd 95 at a far to reach place.
Broad Objective
The study will investigate factors affecting retention in care of clients initiated on
antiretroviral treatment at Umodzi ART clinic, Blantyre.
Specifically, the study will:
1. Describe the social, economic and demographic profiles of both retainers and nonretainers,
2. Describe the factors affecting retention in care of patients on antiretroviral treatment,
3. Determine ways through which clients can be retained in care from their own
perspective.
Methodology: Study population will include all clients that were initiated on ART from
January, 2017 to December, 2021 but did not retain in care. The sample size will be 172 and we will systematically enrol participants into the study. A checklist will be used to collect data from the files and an interviewer administered questionnaire will be used to have a deeper insight on the reasons for non-retention and ways that could help in improving retention of clients into care from their perspective. Collected data will be stored securely in computer data base that have a pass word and only limited access to key study team will be provided. Data analysis will be done using Stata software for quantitative data, and deductive analysis for the qualitative part. Informed consent will be obtained from each and every study participant before enrolment in the study and confidentiality will be ensured throughout the study period. Permission to undertake the study will be sought from QECH and ethical approval will be sought from the College of Medicine Research and Ethics Committee (COMREC).
Expected findings and their dissemination: We expect to describe the profile of those that
retain and that do not retain in care, find factors that lead to no-retention and find ways that will improve retention among those initiated on ART. These expected results will be
disseminated in writing and presentations as feedback made to Umodzi clinic, QECH and the District Health Management Team (DHMT) for Blantyre. Recommendations will be made to various levels of decision making including, Umodzi clinic, QECH, BDHO, MOH and other key implementing partners on improvements that need to be made to ensure that clients are retained in care in ART clinics.
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Keywords
Factors affecting retention in care of patients initiated on antiretroviral treatment