Results from implementing updated 2012 World Health Organization Guidance on early-warning indicators of HIV drug resistance in Zimbabwe

Abstract

Objective: This study evaluated the performance of sentinel sites in preventing the emergence of HIVDR using Early WarningIndicators (HIVDR EWI) survey.

Methods: Adult and paediatric patient data on: On time pill pick up, Retention in care, Pharmacy stock-outs, and Dispensingpractices was collected. Information from pharmacy registers was verified using facility-held cards. This was a cross-sectionalanalysis of retrospectively collected data from 72 sites providing both adult and paediatric ART as well as two providing adultART only. All data were entered into and analysed using a WHO EWI data abstraction electronic tool.

Results: Twenty-one percent of sites providing adult and 4.2% of sites providing paediatric ART managed to meet the target foron time pill pick up. Retention in care indicator was met by 48.7% (95% CI: 36.9-60.6) of sites. ARV stock-outs occurred in81.1% (95% CI: 70-89.3) adult sites and 63.9% (95% CI: 50-78.6) paediatric sites. ARVs were appropriately dispensed by 86.5%(95% CI: 75.6-93.3) of adult sites and 84.7% (95% CI: 74.3-92.1) of paediatric sites.

Conclusions: Most sites had low performance in many indicators in this survey and failed to meet the recommended targets.Some policies such as the current buffer stock and storage outside Harare should be revised in order to improve site accessto ARVs. The country should prioritize the provision of viral load testing services in all provinces. The electronic patientmanagement system should be rolled out to all ART sites to improve patient tracking and monitoring by sites.