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Strength/weakness of design To their knowledge this was the first study to use two sequential cross-sectional surveys to compare implementation of policies on ART access and retention across six African countries with a generalised HIV epidemic. The conceptual framework that underpinned this study was developed prior to the first facility survey round and was based on a review of literature and policy in circulation up to 2015. Whilst comprehensive at the time, the pr

Major outcomes of study Although expansion of ART access was explicitly stated in all countries’ policies, most lacked policies that enhanced retention. The proportion of facilities that initiated ART at CD4 counts of 500 or less cells/mm 3 increased from 12% to 68%. Treatment stock-outs affected increase in ART enrolment. Facilities initiating patients onto 2013 WHO recommended ART-regimen increased from 42% to 87%. This report highlights the continuing gaps in AR

Study location Kenya, Malawi, South Africa, Tanzania, Uganda and Zimbabwe Angola, Botswana, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe Rural KwaZulu Natal, South Africa

Study focus Inclusion of the 2013 WHO HIV treatment recommendations The study analysed the levels of WHO guidelines implementation of ART initiation and how countries timeously changed and adopted country guidelines. The study aimed at describing ART initiation percentages in a large HIV programme according to the temporal changes of country ART eligibility guidelines from 2007 to 2012.

Type of study Cross- sectional survey Cross- sectional survey Cross- sectional study.

Study objectives The study assessed the uptake of the 2013 WHO recommendations related to the eligibility threshold for ART-initiation, the availability of first-line ART- regimens, and recommendations to improve retention. To understand the lag between guideline development and implementation, as well as the ART coverage gap, CDC assessed national HIV-guidelines and analysed Joint United Nations Programme on HIV and AIDS. Timeliness of WHO-ART gui

Theme identified Timely implementation of WHO and ART initiation policy guidelines at country level. Adoption of WHO and ART initiation policy guidelines at country level Barriers and facilitators to WHO-policy implementation Timely implementation of WHO and ART initiation policy guidelines at country level Adoption of WHO and ART initiation policy guidelines at country level Barriers and facilitators to WHO-policy implementation Adoption of WHO and ART initia

TABLE 1: Summary of studies. Guidelines Author year and year 2013 Paper 1 2013 Burrage Paper 2 2010 and 2013 Paper 3

et al. 13
Ambia
et al. 14
Plazy
2017
2018
http://www.sajhivmed.org.za 222 Open Access et al. 15 2015