An Evaluation Thesis Submitted to the School of Public Administration and Management in Partial Fulfilment of the Requirements for Award of the Degree of Masters of Science in Health Monitoring and Evaluation of Mzumbe University
The aim of this evaluative study was to determine the factors associated with high rate of adults lost to follow up on HIV/AIDS care and treatment. This cross-sectional study was conducted in Kyerwa-Kagera beginning January up to March 2016 involved 295 clients who were alive and recorded as lost to follow from October, November and December 2015. Semi structured questionnaire with yes and no responses was used for the interview. The questions focused mainly on service accessibility and availability, health system and individual related factors. A Multivariate logistic regression model was used to determine factors that were significantly associated with lost to follow-up. This study revealed that 75.6% of the participants completed standard seven, 99.7% were unemployed, 93.9% had the monthly income ranging between 0 to 5,000 Tanzanian shillings and 77.6% were in stage I and II. The analysis showed that 15.3% were not comfortable with longer time spent waiting for services, and it was evident that 19.3% of participants do not understand benefits of good ART adherence. The factors found to have significant association with patient lost to follow up with (P- value less than 0.05) were approachability of health staff (Odds ratio = 0.00, 95% CI: 2.79 - 0.01), awareness of whether health facility check CD4 (Odds ratio=265.3, 95% CI: 11.02 - 6384), health provider adherence to first in first out principle (Odds ratio = 802.02, 95% CI: 50.71 - 12691), understanding benefits of good adherence (Odds ratio = 20.78, 95% CI: 5.67 - 76.2), use of herbs as alternative medication (Odds ratio=0.01, 95% CI: 0.002-0.099), and participants that stopped ARV due to religious beliefs ( Odds ratio = 0.00, 95% CI: 7.76 - 0.088). Conclusively after adjusting for other studied factors that were studied and included in the model it was found that factors such as provider approachability, participant’s awareness on checking CD4, use of alternative medicine and stopping medication due to faith were more likely to contribute failure of the participant attend care and treatment services as needed. Thus more studies need to be done to determine the magnitude of their effects.