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    Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services

    85529.pdf (329.3Kb)
    Access Status
    Open access
    Authors
    Howard, B.N.
    Van Dorn, R.
    Myers-Franchi, Bronwyn
    Zule, W.A.
    Browne, F.A.
    Carney, T.
    Wechsberg, W.M.
    Date
    2017
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Howard, B.N. and Van Dorn, R. and Myers, B.J. and Zule, W.A. and Browne, F.A. and Carney, T. and Wechsberg, W.M. 2017. Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services. BMC Health Services Research. 17 (1): Article No. 746.
    Source Title
    BMC Health Services Research
    DOI
    10.1186/s12913-017-2669-2
    ISSN
    1472-6963
    Faculty
    Faculty of Health Sciences
    School
    EnAble Institute
    Remarks

    © The Author(s). 2017 Published in BMC Health Services Research. This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/. Please refer to the licence to obtain terms for any further reuse or distribution of this work.

    URI
    http://hdl.handle.net/20.500.11937/85710
    Collection
    • Curtin Research Publications
    Abstract

    Background: Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women's Health CoOp (WHC) in clinics and substance abuse rehab settings in Cape Town, South Africa.

    Methods: We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs.

    Results: All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities.

    Conclusions: In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women's risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to implementing the WHC successfully must be addressed before the program can be fully integrated into the services delivered by healthcare facilities. Trial registration: Clinical trials NCT02733003. Date of Registration: January 21, 2016, registered retroactively after participant enrollment.

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