ehealth digital library

Digital library of
the Tanzania
health
community

A Comparative Analysis of National HIV Policies in Six African Countries with Generalized Epidemics

Church, K., Kiweewa, F., Dasgupta, A., Mwangome, M., Mpandaguta, E., Gómez-Olivé, F. X., Oti, S., Todd, J., Wringe, A., Geubbels, E., Crampin, A., Nakiyingi-Miiro, J., Hayashi, C., Njage, M., Wagner, R. G., Ario, A. R., Makombe, S. D., Mugurungi, O. and Zaba, B. A Comparative Analysis of National HIV Policies in Six African Countries with Generalized Epidemics. Bulletin of the World Health Organization, 93. pp. 457-467. ISSN 0042-9686

[img]
Preview
PDF
Kathryn_Church.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

Download (397kB)

Abstract

To compare national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries. We reviewed HIV policies as part of a multi-country study on adult mortality in sub-Saharan Africa. A policy extraction tool was developed and used to review national HIV policy documents and guidelines published in Kenya, Malawi, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe between 2003 and 2013. Key informant interviews helped to fill gaps in findings. National policies were categorized according to whether they explicitly or implicitly adhered to 54 policy indicators, identified through literature and expert reviews. We also compared the national policies with World Health Organization (WHO) guidance. There was wide variation in policies between countries; each country was progressive in some areas and not in others. Malawi was particularly advanced in promoting rapid initiation of antiretroviral therapy. However, no country had a consistently enabling policy context expected to increase access to care and prevent attrition. Countries went beyond WHO guidance in certain areas and key informants reported that practice often surpassed policy. Evaluating the impact of policy differences on access to care and health outcomes among people living with HIV is challenging. Certain policies will exert more influence than others and official policies are not always implemented. Future research should assess the extent of policy implementation and link these findings with HIV outcomes.

Item Type: Article
Keywords: HIV policies, HIV testing and treatment, Adult mortality, Antiretroviral therapy, sub-Saharan Africa
Subjects: HIV > Surveillance
HIV > Treatment
Divisions: Ifakara Health Institute > Impact Evaluation
Depositing User: Mr Joseph Madata
Date Deposited: 20 Aug 2015 06:28
Last Modified: 20 Aug 2015 06:28
URI: http://ihi.eprints.org/id/eprint/3247

Actions (login required)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics