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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services

Authors: Brittni N. Howard, Richard Van Dorn, Bronwyn J. Myers, William A. Zule, Felicia A. Browne, Tara Carney, Wendee M. Wechsberg

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women’s Health CoOp (WHC) in clinics and substance abuse rehab settings in Cape Town, South Africa.

Methods

We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs.

Results

All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities.

Conclusions

In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women’s risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to implementing the WHC successfully must be addressed before the program can be fully integrated into the services delivered by healthcare facilities.

Trial registration

Clinical trials NCT02733003. Date of Registration: January 21, 2016, registered retroactively after participant enrollment.
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Metadata
Title
Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services
Authors
Brittni N. Howard
Richard Van Dorn
Bronwyn J. Myers
William A. Zule
Felicia A. Browne
Tara Carney
Wendee M. Wechsberg
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2669-2

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