Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

• Published in: Bulletin of the World Health Organization Vol. 88; no. 10; pp. 788 - 791
• Main Authors: DUBE, Christopher, NOZAKI, Ikuma, HAYAKAWA, Tadao, KAKIMOTO, Kazuhiro, YAMADA, Norio, SIMPUNGWE, James B
• Format: Journal Article
• Language: English
• Published: Genève Organisation mondiale de la santé 01.10.2010; World Health Organization
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Anti-HIV Agents - therapeutic use; Biological and medical sciences; Clinical outcomes; Community support; Counseling; Female; General aspects; Health facilities; Health Services Accessibility; Health Services Needs and Demand; Health Status Disparities; HIV; HIV Infections - drug therapy; Hospitals; Human immunodeficiency virus; Human resources; Humans; Indigent care; Laboratories; Lessons from the Field; Male; Medical sciences; Miscellaneous; Mobile Health Units - organization & administration; Population; Public health. Hygiene; Public health. Hygiene-occupational medicine; Rural areas; Rural Health Services - organization & administration; Support groups; Zambia; Zambia; Africa; Chemotherapy; Treatment; Health center; Rural environment; Tropical medicine; Expansion; Public health; WHO
• ISSN: 0042-9686; 1564-0604
• DOI: 10.2471/BLT.09.063982

Despite the Government's effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. The Mumbwa district health management team introduced mobile ART services using human resources and technical support from district hospitals, and community involvement at four rural health centres in the first quarter of 2007. This paper discusses the uptake of the mobile ART services in rural Mumbwa. Mumbwa is a rural district with an area of 23 000 km² and a population of 167 000. Before the introduction of mobile services, ART services were provided only at Mumbwa District Hospital. The mobile services improved accessibility to ART, especially for clients in better functional status, i.e. still able to work. In addition, these mobile services may reduce the number of cases "lost to follow-up". This might be due to the closer involvement of the community and the better support offered by these services to rural clients. These mobile ART services helped expand services to rural health facilities where resources are limited, bringing them as close as possible to where clients live.