Virologic response of treatment experienced HIV-infected Ugandan children and adolescents on NNRTI based first-line regimen, previously monitored without viral load.

Background: Many HIV-infected African children gained access to antiretroviral treatment (ART) through expansion of PEPFAR programs since 2004 and introduction of "Test and Treat" WHO guidelines in 2015. As ART access increases and children transition from adolescence to adulthood, treatment failure is inevitable. Viral load (VL) monitoring in Uganda was introduced in 2016 replacing clinical monitoring.

Factors Determining Survival and Retention among HIV-Infected Children and Adolescents in a Community Home-Based Care and a Facility-Based Family-Centred Approach in Kampala, Uganda: A Cohort Study.

We describe factors determining retention and survival among HIV-infected children and adolescents engaged in two health care delivery models in Kampala, Uganda: one is a community home-based care (CHBC) and the other is a facility-based family-centred approach (FBFCA). This retrospective cohort study reviewed records from children aged from 0 to 18 years engaged in the two models from 2003 to 2010 focussing on retention/loss to follow-up, mortality, use of antiretroviral therapy (ART), and clinical characteristics. Kaplan Meier survival curves with log rank tests were used to describe and compare retention and survival.

Promoting unity of purpose in district health service delivery in Uganda through partnerships, trust building and evidence-based decision-making.

Context: The Uganda Program for Human and Holistic Development (UPHOLD), a USAID-funded project which supports health services in 34 Ugandan districts, was conceived at a time when promising interventions could not be expanded due to fragmented systems. This paper focuses on how the program addressed fragmentation to improve service delivery in the health sector.

Approach: UPHOLD achieved results by utilizing grants and technical support to strengthen capacity in a decentralized setting to foster institutional behavior change, promote strengthened partnerships among stakeholders in health, and produce increased transparency and accountability.

Indigenous NGO involvement in TB treatment programmes in high-burden settings: experiences from the Northern Cape province, South Africa.

Effective tuberculosis (TB) treatment delivery in high-burden countries increasingly requires a multisectoral approach. This paper examines the role two local non-governmental organisations (NGOs) play in TB care delivery in a high-burden setting, the Northern Cape province, South Africa. NGOs played a complementary role to the formal health sector in effecting TB treatment delivery by training facilitators and recruiting and training lay volunteers for directly observed treatment.

Community participation in primary health care (PHC) programmes: lessons from tuberculosis treatment delivery in South Africa.

Background: Currently, there is renewed interest in the role community participation can play in Primary Health Care (PHC) programmes such as the delivery of effective anti-TB treatment to patients in high-burden settings.

Objectives: To explore the feasibility of community participation in a high-burden Tuberculosis Control Programme and to establish how supervision of treatment by lay volunteers compares with other methods of tuberculosis treatment delivery in the Northern Cape province of South Africa.

Methods: Prospective study involving 769 patients with confirmed pulmonary TB who were followed-up over a one-year period.

Lay workers in directly observed treatment (DOT) programmes for tuberculosis in high burden settings: Should they be paid? A review of behavioural perspectives.

The current global tuberculosis (TB) epidemic has pressured health care managers, particularly in developing countries, to seek for alternative, innovative ways of delivering effective treatment to the large number of TB patients diagnosed annually. One strategy employed is direct observation of treatment (DOT) for all patients. In high-burden settings innovation with this strategy has resulted into the use of lay community members to supervise TB patients during the duration of anti-TB treatment.

Corporate response to the HIV/AIDS epidemic in Uganda - time for a paradigm shift?

The HIV/AIDS epidemic is likely to remain the pre-eminent global health concern for the foreseeable future. In Uganda, while significant progress has been made by the government over the past decade in bringing down the rate of new infections, the HIV/AIDS burden in the country remains huge and vigilant efforts must be continued if this burden is to further decrease. Traditionally the government, supported by its international partners as well as local non-government organizations and the community has borne the brunt of the costs of containing the epidemic in Uganda.

Combating tuberculosis: barriers to widespread non-governmental organisation involvement in community-based tuberculosis treatment in South Africa.

Objectives: To explore barriers to indigenous non-governmental organisation (NGO) involvement in community-based tuberculosis treatment delivery in high incidence areas.

Design: Qualitative study comprising in-depth interviews with key informants in non-government organisations and the formal health sector. Participant observation and documentary review methods were also employed.

Tuberculosis treatment delivery in high burden settings: does patient choice of supervision matter?

Setting: The Northern Cape Province, Republic of South Africa.

Objectives: To determine the effect of patient choice of treatment delivery option on the treatment outcomes of tuberculosis (TB) patients in a high burden setting under actual programme conditions.

Design: Cohort study involving 769 new and retreatment TB patients recruited from 45 randomly selected clinics.

What motivates lay volunteers in high burden but resource-limited tuberculosis control programmes? Perceptions from the Northern Cape province, South Africa.

Setting: The Northern Cape province, Republic of South Africa.

Objectives: To explore factors that motivate lay volunteers to join tuberculosis (TB) control programmes in high burden but resource-limited settings.

Design: A qualitative study consisting of three focus group discussions and a documentary review of the records of 347 lay volunteers involved in the tuberculosis programme in the Northern Cape province of South Africa.