How to investigate Adherence to Antiretroviral Treatment ... - INRUD

How to Investigate Adherence to Antiretroviral Treatment in Health Facilities: Adherence Indicators
(few days covered by medicine dispensed), then it means that patients are coming after their
pills have run out but are coming within 3 days.
These reasons need to be investigated. They could be because—
• The counselling sessions may not emphasize the importance of patients keeping their
appointments
• Appointments may not be given at the times the patients are able to come
• The date of the appointment may not be being made clear to the patients
Indicators 4 and 5 are low
With both 4 and 5 low, many patients are missing their appointments, not attending within 3
days, but attending in less than 30 days after their appointment. Again, the reasons need
investigating. It could easily be that the clinic is only open once a week, so if the appointment
is missed the patient cannot attend again for seven days.
Dissemination of Results to Key Stakeholders
After the survey has been finished, it is advisable to hold a meeting of key stakeholders at
each facility where there seems to be a problem. At this meeting present the results and
discuss the possible causes to suggest recommendations for interventions to improve the
situation.
Wherever possible, provide feedback at all the facilities including those performing well. By
congratulating and reinforcing positive results, you may maintain or improve their
performance. In addition, you may learn the reasons for their good performance which can be
shared with less well performing facilities.
The advantages of this approach will be that there is a strong possibility of finding reasons for
the results and, in addition, will create motivation to design and adopt needed interventions.
76