Barriers to Integrating Antiretroviral Therapy Services Into Community Health Centre: A Qualitative Study in Badung Regency
DOI:
https://doi.org/10.53638/phpma.2015.v3.i1.p12Keywords:
primary health centre, barriers, antiretroviral therapy, HIV/AIDS, integrationAbstract
Background and purpose: Increasing of HIV+ cases resulted in the increasing demand for antiretroviral (ARV) and access to ART services. This study aims to explore barriers of integrating ART services into primary health centres in Badung District.
Methods: Explorative interviews were conducted with CST officers at Badung District Hospital, puskesmas (health centres), NGOs, policy makers, community leaders and PLWHA. Data were collected by conducting indepth interviews, focus group discussion and observation. Data were thematically analysed.
Results: The study found that there were variations in internal barriers across different puskesmas in Badung District to be a satellite site. The main internal barriers perceived by health officers particularly in relation to issues around the availability of human resources, lack of competencies and increase of workload. Internal capacity of puskesmas which also perceived as barriers including the availability of laboratory facilities, absent of operational procedures, limited information system and source of funds that predominantly still from donor agencies. External barriers perceived by respondent were stigma and discrimination.
Conclusions: Barriers to integrate ART services into puskesmas consist of structural barriers from internal puskesmas as well as external barriers such as stigma and discrimination towards PLWHA.
References
Kementerian Kesehatan RI. Pedoman Nasional Tatalaksana Klinis Infeksi HIV dan Terapi Antiretroviral Pada Orang Dewasa. Jakarta: 2011:1-2 .
WHO. Global Health Sector strategy on HIV/AIDS 2011- 2015, Genewa-Switzerland; 2011. Available at: www.who. int.
UNAIDS. World AIDS Day 2014 Report. Genewa: UNAIDS; 2014. Available from: http://www.unaids.org/en/resources/campaigns/World-AIDS-Day-Report-2014.
Kementerian Kesehatan RI. Laporan Perkembangan HIV/ AIDS Triwulan III. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Jakarta; 2014.
Zachariah R, Teck R, Buhendwa L, Fitzerland M, Labana S, Chinji C, et al. Community support is associated with better antiretroviral treatment outcomes in a resourcelimited rural district in Malawi. 2007. [cited 2015 Jun 20]. Available from: http://trstmh.oxfordjournals.org/content/101/1/79.
Bassett IV and Walensky RP. Integrating HIV screening into routine health care in resource-limited settings. 2010. Available from: http://cid.oxfordjournals.org.
Eaton JW, Menzies NA, Stover J, Cambiano V, Chindelevitch L, Cori A, et al. Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models. Lancet Global Health; 2014;2(1). Available from: http://www.ncbi.nlm.nih.gov/pubmed.
Kemeterian Kesehatan RI. Peraturan Menteri Kesehatan RI, Nomor 21 Tahun 2013 Tentang Penanggulangan HIV dan AIDS. Jakarta; 2013.
KPAN, WHO, UNAIDS. Odha dan Akses Pelayanan Kesehatan Dasar: Penelitian Partisipatif. Editor: Yatim D I. Jakarta; 2011.
Kementerian Kesehatan RI. Pedoman Penerapan Layanan Komprehensif HIV-IMS Berkesinambungan. Jakarta; 2012.
Presiden RI. Peraturan Presiden Republik Indonesia No. 72 Tahun 2012 Tentang Sistem Kesehatan Nasional. Jakarta; 2012.
Mujiati, Jerico FP, Syaripuddin M. Evaluasi Pelaksanaan Layanan Perawatan, Dukungan dan Pengobatan (PDP) HIV/AIDS di Jawa Barat dan Papua. Jurnal Kesehatan Reproduksi. 2012: 2( 5). Available from: http://www.bpk.litbang.depkes.go.id.
Angkasawati, Widjiartini, Arifin A. Kesiapan Petugas Puskesmas dalam Penanggulangan Infeksi Menular Seksual dan HIV / AIDS pada Pelayanan Antenatal. Buletin Penelitian Sistem Kesehatan. 2009; 12(17):403–408.
Stephani MT, Julien MC, Matimba, Evelin M, et al,. Integrating HIV Treatment with Primary Care Outpatient Service: opportunities and challenges from a scaled-up model in Zambia. Health Policy Plan.;2013;28(4):347–57. Available from: http://heapol.oxfordjournals.org.
Modiba P, Schneider H, Weiner R, Blaauw D, Gilson L, Zondi T, et al. The Integration of HIV / AIDS Care and Support into Primary Health Care in Gauteng Province. Center for Health Policy School of Public Health University of the Withwatersrand, Johannesburg; 2002.
Uebel K, Guise A, Georgeu D, Colvin C, Lewin S. Integrating HIV care into nurse-led primary health care services in South Africa: a synthesis of three linked qualitative studies; 2013. Available from: http://www.biomedcentral.com.
Mullen S. Assessment of Primary Health Care Facilities for Decentralization of HIV/AIDS Services in Nigeria. Negeria; 2012.
Parker R. and Aggleton P. HIV/AIDS-related Stigma and Discrimination : A Conceptual ramework and an Agenda for Action. Horizons Program; United State; 2002.
Eka SR, Syafar M, Natsir S. Hambatan terhadap Perilaku Pencegahan HIV dan AIDS pada Pasangan Odha Serodiskordan di Kota Makasar. Fakultas Kesehatan Masyarakat Universitas Hasanuddin; Makasar; 2010.
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