Evaluation of the Antiretroviral Therapy Program at Wilkins Hospital in Zimbabwe

Aim: To evaluate the Opportunistic Infection/Anti-Retro-Viral Therapy program at a Referral health facility in Zimbabwe.

Methods: This was a descriptive cross sectional study using the logic framework evaluation method from August 2012 to July 2013. Key informant interviews, patient records reviews and checklists were used to collect data.

Results: Over 90% of the patients got counseling when they were tested and at least 50% attended more than one counseling session before initiation of ART. The key informant reported two stocks out episodes for 2nd line salvage drugs. Patients were initiated on ART in line with 2007 ART guidelines. There was no waiting list. The staff indicated that they had been working for the OI/ART program for periods which ranged from as short as 2 days to as long as 8 years, with the majority 11(57%) having been working there for less than a year. Over 70% of the health care providers have received both protocol training and ART delivery training at the clinic and were providing counseling as required. Over 15% did not receive ART delivery training while data was not available for slightly over 10% of the care givers.

Conclusion: Wilkins Hospital is offering most services expected of a level 4 facility. Physical space and staff patient ratio fell within expected levels. However, adequate drug stocks must be maintained, a patient follow up mechanism be put in place, there is need for decentralization of stable patients to help address space inadequacy. Repairing vital equipment such as the CD4 count and the viral load machines may compromise reliability and validity of results, therefore with urgency, a continuous assessment for reliability and validity of such equipment is necessary.