Logo image
Back
Evaluation of the effectiveness of an outreach clinical mentoring programme in support of paediatric HIV care scale-up in Botswana
Journal article   Open access   Peer reviewed

Evaluation of the effectiveness of an outreach clinical mentoring programme in support of paediatric HIV care scale-up in Botswana

Gelane Workneh, Leah Scherzer, Brianna Kirk, Heather R. Draper, Gabriel Anabwani, R. Sebastian Wanless, Haruna Jibril, Neo Gaetsewe, Boitumelo Thuto and Michael A. Tolle
AIDS care, v 25(1), pp 11-19
01 Jan 2013
DOI: https://doi.org/10.1080/09540121.2012.674096
PMID: 22533352
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc3426665?pdf=renderView
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Biomedical Social Sciences Health Care Sciences & Services Health Policy & Services Life Sciences & Biomedicine Psychology Psychology, Multidisciplinary Public, Environmental & Occupational Health Respiratory System Science & Technology Social Sciences Social Sciences, Biomedical
Clinical mentoring by providers skilled in HIV management has been identified as a cornerstone of scaling-up antiretroviral treatment in Africa, particularly in settings where expertise is limited. However, little data exist on its effectiveness and impact on improving the quality-of-care and clinical outcomes, especially for HIV-infected children. Since 2008, the Botswana-Baylor Children's Clinical Centre of Excellence (COE) has operated an outreach mentoring programme at clinical sites around Botswana. This study is a retrospective review of 374 paediatric charts at four outreach mentoring sites (Mochudi, Phutadikobo, Molepolole and Thamaga) evaluating the effectiveness of the programme as reflected in a number of clinically-relevant areas. Charts from one visit prior to initiation of mentoring and from one visit after approximately one year of mentoring were assessed for statistically-significant differences (p<0.05) in the documentation of clinically-relevant indicators. Mochudi showed notable improvements in all indicators analysed, with particular improvements in documentation of pill count, viral load (VL) results, correct laboratory monitoring and correct antiretroviral therapy (ART) dosing (p<0.0001, p<0.0001, p<0.0001 and p<0.0001, respectively). Broad and substantial improvements were also seen in Molepolole, with the most improvement in disclosure documentation of all four sites. At Thamaga, improvements were restricted to CD4 documentation (p<0.001), recent VL and documented pill count (p<0.05 and p<0.05, respectively). Phuthadikobo showed the least amount of improvement across indicators, with only VL documentation and correct ART dosing showing statistically-significant improvements (p<0.05 and p<0.0001, respectively). These findings suggest that clinical mentoring may assist improvements in a number of important areas, including ART dosing and monitoring; adherence assessment and assurance; and disclosure. Clinical mentoring may be a valuable tool in scale-up of quality paediatric HIV care-and-treatment outside specialised centres. Further study will help refine approaches to clinical mentoring, including assuring mentoring translates into improved clinical outcomes for HIV-infected children.

Metrics

17 Record Views
35 citations in Web of Science
41 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
International collaboration
Web of Science research areas
Health Policy & Services
Psychology, Multidisciplinary
Public, Environmental & Occupational Health
Respiratory System
Social Sciences, Biomedical
Logo image