How to Investigate Adherence to Antiretroviral Treatment. An Indicator-Based Approach
(2011; 158 pages)


Collecting data on adherence is vitally important because of the ever present threats of treatment failure and resistance. This is a manual for standardizing methods of collecting data on levels of adherence to antiretroviral medicine in health facilities. Standardization is needed so that rates can be compared over time and between facilities. It is critical to monitor adherence to improve patient outcomes, and data exist in facilities to do so.

This manual will enable programme managers giving antiretroviral medicines to patients to assess the performance of facilities under their responsibility with respect to levels of adherence to antiretrovirals (ARVs). It is a step by step guide on how to design and carry out a national or facility survey or a programme survey. With these methods, managers can identify facilities where they need to intervene to improve adherence levels. Managers can examine the causes of poor performance and work with the facilities to make improvements and then use the survey methods to assess whether improvement has occurred. Managers can also examine facilities that are doing well, to share lessons on how to achieve exceptional performance.

The main purpose therefore is to define a limited list of standardized adherence indicators and methods of measurement, enabling an assessment of:

  • How a facility is doing at that moment.
  • How it is doing over time
  • .
  • How it compares to other facilities.
  • The effectiveness of interventions to improve adherence levels.
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