Barriers and facilitators to implementing six monthly multi-month dispensing of antiretroviral therapy in two urban HIV clinics during the COVID-19 Era in Malawi
2024

Barriers and facilitators to implementing six-monthly multi-month dispensing of antiretroviral therapy in HIV clinics during the COVID-19 Era in Malawi

Sample size: 77 publication 10 minutes Evidence: moderate

Author Information

Author(s): Rachel Chamanga, Agatha Bula, Denview Magalasi, Stella Mahuva, Mulinda Nyirenda, Kwasi Torpey, Thulani Maphosa, Mitch Matoga

Primary Institution: Malawi HIV Implementation Scientist Training Program, Lilongwe, Malawi

Hypothesis

What are the barriers and facilitators to implementing six-monthly multi-month dispensing of antiretroviral therapy in Malawi during the COVID-19 pandemic?

Conclusion

The study identified low drug supply and lack of understanding of the policy as major barriers to implementing six-monthly multi-month dispensing of antiretroviral therapy, while facilitators included orientation meetings, teamwork, and the use of electronic medical records.

Supporting Evidence

  • 96% of healthcare workers reported that transitioning to six-monthly dispensing helped reduce patient visits to the clinic.
  • 88% noted that the six-monthly dispensing strategy helped reduce the workload at the health facility.
  • 73% of the healthcare workers who participated in the surveys were female.

Takeaway

This study looked at how giving out six months' worth of HIV medicine at once can help patients and healthcare workers during the COVID-19 pandemic, but there were some problems like not having enough medicine and some workers not understanding the rules.

Methodology

A cross-sectional study using quantitative surveys and qualitative key informant interviews conducted at two high-volume primary health facilities in Blantyre, Malawi.

Potential Biases

Potential bias due to the selection of healthcare workers who were already familiar with the 6-MMD policy.

Limitations

The study was limited to two urban health facilities, which may not represent the experiences in rural or semi-urban settings.

Participant Demographics

Of the 77 healthcare workers, 73% were female and 29% were nurses.

Digital Object Identifier (DOI)

10.1371/journal.pgph.0003900

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