Academic Model for Providing Access to Healthcare (AMPATH)
AMPATH is amongst the largest and most comprehensive HIV/AIDS-control systems in sub-Saharan Africa, providing a complete system of care that has been described as a model of sustainable development. Delivery of services occurs in the public sector through hospitals and health centers run by Kenya's Ministry of Health. AMPATH'S model of care includes: community engagement; education; promotion of safe-sex practices; experience-sharing by persons living with HIV/AIDS; counseling and testing; prevention activities.
AMPATH touches the lives of millions in a wide geographic area.
- The overriding goal of AMPATH is to establish and assess a working model of both urban and rural comprehensive HIV preventive and treatment services. AMPATH has structured its patient care programs to simultaneously serve as a virtual laboratory for HIV-related teaching and research. Its major objectives since November 2001 have been the following:
- Establish adult and pediatric HIV treatment services simultaneously in an urban (MTRH) and rural setting.
- Demonstrate cost-effective initial workups, treatment strategies and monitoring of HIV-infected adults and children.
- Develop a fully computerized medical record and data repository.
- Train medical school faculty, clinical officers and nursing staff in providing comprehensive multidisciplinary care of HIV-infected patients.
- ARV treatment; clinical treatment for HIV/AIDS; community engagement
- Education; promotion of safe-sex practices; experience-sharing by persons living with HIV/AIDS
- Counseling and testing; food security program; antenatal services for PMTCT
- An outcome evaluation of AMPATH demonstrated that: among 1766 (86%) patients evaluated for adherence to their antiretroviral regimen, 78% reported perfect adherence to treatment medications at every visit.
- CD4 cell counts increased by a mean of 109 cells/ml during the first 6 weeks of therapy and increased more slowly thereafter, resulting in overall CD4 cell count increases of 160, 225 and 297 cells/ml at 12, 24, and 36 months respectively.
- Patients with and without perfect adherence to treatment medications gained weight,with gains being greater in the perfect adherence group.
- Home visits can boost treatment adherence when patients miss appointments performance-based incentives.
- Attention to the morale of HCWs is central to program success, including limiting hours worked and patient load, and providing performance-based incentives.
- Creating an ambitious initial ARV program is of utmost importance.