How to investigate levels of Adherence to antiretroviral ... - INRUD

How to Investigate Adherence to Antiretroviral Treatment:
An Indicator-Based Approach
It is also helpful if at least two members of the team have the ability to enter data onto a
computer quickly and reliably.
Plan data collection visits schedule
As stated above, the team of three or four data collectors with a team leader can manage one
facility in one day and double-enter the data on the laptop (if available) the same day.
However, they need to arrive at the facility at or before opening time, so that they can begin
to draw the retrospective sample and the corresponding notes before the clinic becomes very
busy. This means that the team needs to sleep near the facility.
If the required sample is 20 facilities then four teams of data collectors can manage that in
five working days (or two teams in 10 days), provided that the facilities are reasonably close
together and they can spend the night near the next day’s facility. So logistically, the 20
facilities need to be divided into four groups and one team assigned to each group. At the
end of the day of data collection, the team needs to travel towards the next facility and sleep
there. This requires careful planning and a dedicated vehicle for each team for the duration.
The teams should stay together at night so that they can easily assemble and go to the
facility as a group. If the team does not arrive early, the whole day can easily be off schedule
because the staff members are too busy to collaborate.
It is important that the survey day is also the day patients are expected. This means that
apart from geographic proximity, each facility’s clinic schedule needs to be taken into
account. To find this out, it will be necessary to call the facility’s ARV clinic to find which
days they expect enough patients to do the exit interviews. Without careful preparation, it is
all too common that some facilities have no patients on the day of data collection.
Every facility should be told in advance when to expect data collectors' visits. When funds
permit, it can be useful to "hire" one or more staff at each facility to assist the data collectors
in finding records and deciphering handwriting.
For each facility chosen, the survey team should contact the head of the facility to explain
the purpose of the work, provide a letter from the National AIDS Control Programme, and
ask the facility for consent and assistance.
Create the medicines lists
The coordinators will need to create lists for essential adult ARVs, paediatric ARVs, and
non-ARV key medicines. These lists should all be prepared in conjunction with the team
leaders before the field work begins. First-line ART treatment medicines for adults and for
children are recommended for the two ART lists; and treatment guidelines for the common
opportunistic infections should be used to construct the key medicines list. Staff from the
NACP may assist with this task. See the previous chapter for how to modify the forms.
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