Building integrated clinical and operational capacity to reduce maternal and neonatal mortality at Ridge Regional Hospital at Accra, Ghana

living in the same commune as the hospital (HR, 1.89, 95% CI, 1.54-2.33;P < 0.001).Hospital site, earlier year of ART start, spending less time enrolled in HIV care prior to ART initiation, receiving a nonstandard ART regimen, lacking counseling prior to ART initiation, and higher body mass index were also associated with attrition risk. Summary/Conclusion:The findings suggest quality improvement interventions at the two hospitals, including enhanced retention support and transportation subsidies for patients accessing care from remote areas; counseling for all patients prior to ART initiation; timely outreach to patients who miss ART pick-ups; "bridging services" for patients transferring care to alternative facilities; routine screening for anticipated interruptions in future ART pick-ups; and medical case review for patients placed on nonstandard ART regimens.Using data from the iSanté electronic data system to analyze ART attrition provided valuable insights on potential areas for quality improvement at the two hospitals studied.The findings are also relevant for policymaking on decentralization of ART services in Haiti.

Abstract licence: CC BY

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