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Increasing access to anteretroviral therapy (ART):

Increasing access to anteretroviral therapy (ART):. implementing a system of down-referral of ART-stable patients to PHCs in Ekurhuleni district, Gauteng Province By Gugu Shongwe . Header. ART initiation sites were in hospitals and community health centres.

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Increasing access to anteretroviral therapy (ART):

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  1. Increasing access to anteretroviral therapy (ART): implementing a system of down-referral of ART-stable patients to PHCs in Ekurhuleni district, Gauteng Province By Gugu Shongwe

  2. Header • ART initiation sites were in hospitals and community health centres. • Ekurhuleni district, antenatal HIV prevalence of 31.5% in 2008, five ART initiating sites, January 2009. • High ART patient loads, over-crowded clinics and compromised quality of care.

  3. Description • ‘Down referral’, when stable patients who have been on ARV’s for 6 months, with an un-detectable viral load and an increased CD4 count are identified, prepared and referred to start collecting their ARV’s in health facilities close to their homes. • Training of a multi-disciplinary team of staff.

  4. Down referral process flow

  5. Results and future steps • Increased access to ART (over 25% of the sites were DR sites) • Improved quality of patient follow-up and reduced loss to follow-up • High numbers of Service providers trained even at the lowest level of care. • Integration is being enhanced • All sites must provide ART

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