Development of a model for supervision and monitoring of AIDS work in hospitals by using integrated empowerment visits to develop access to antiretroviral drug Health Region 10

Abstract

This study aimed to develop a supervision model using integrated empowerment visits for AIDS prevention and control in Health Region 10. An action research methodology was employed, with a purposive selection of 29 hospitals, including all regional hospitals and provincial general hospitals as well as community hospitals in Health Region 10 with HIV treatment coverage below 80.0%. The target group consisted of hospital administrators and multidisciplinary teams. The study was conducted between October 2019, and September 2022. Quantitative data were collected through the NAP web report system and satisfaction surveys, while qualitative data were obtained from interviews, focus group discussions, document analysis, and lessons-learned reflections. The study resulted in the development of an integrated empowerment visit supervision model for Health Region 10, structured into four TDRC steps: (1) team, (2) data, (3) results, and (4) continuous. At the regional level, the proportion of people living with HIV receiving antiretroviral therapy (ART) increased from 80.0% in 2019 to 86.0% in 2022. At the hospital level, the number of hospitals that improved HIV treatment access for people living with HIV - shifting from the red level to yellow and green - rose to 23 facilities, accounting for 79.3%. The satisfaction level with the implementation of the model was high (Mean=4.36, SD=0.55). Key contributing factors included management, capacity building, budget allocation, and stakeholder engagement. It is recommended that supervisory teams further develop their policy communication skills to strengthen engagement with hospital executives.