Strategies for Sustaining Facility-Based Antiretroviral Therapy (ART) Interventions in Resource-Limited Settings: Findings from a Survey of ART Clinic Managers in Uganda (2004-2013)

Henry Zakumumpa, Makerere University
Omar Galarraga, Brown University

The acceleration in access to antiretroviral therapy(ART)in Uganda has depended substantially on external donor support.The enduring global financial crisis and declining international funding for HIV treatment have thrown the long-term sustainability of ART programs into doubt.The study sought to elicit the strategies adopted by 195 health facilities in Uganda to sustain ART interventions beyond the seed-grants received between 2004 and 2009.A mixed-methods questionnaire was filled by 236 health facility managers in 42 districts of Uganda between December 2013 and April 2014.Qualitative data was analysed by coding and thematic analysis.Quantitative data was analyzed using STATA (version 12) based on descriptive statistics. Five overarching strategies which include; modifying ART interventions to suit context,integrating ART with other facility services, diversifying funding sources and optimizing resources within peer-provider networks, were identified.Consideration of the strategies elicited by the study may enhance the sustainment of ART interventions in resource- limited settings