Academic Model for Providing Access to Healthcare (AMPATH)

Category 2

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.

Goal of the Practice
  • 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.
Core Components
  • 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
Noteworthy Results
  • 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.
Lessons Learned
  • 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.
Focus Areas
Counseling and Testing
Treatment
Implemented By
Indiana University School of Medicine, the Moi University School of Medicine, and the Moi Teaching and Referral Hospital in Eldoret, Kenya
Participating Organization
N/A
Region
Africa
Country
Kenya
Environment
Clinic/Health facility
Setting
Other/Non-specified
Target Population
People Living with HIV (PLWH)
Scope
> 50000
Implementation Years
11/2001 - ongoing