Imperial College London

Jeff Eaton

Faculty of MedicineSchool of Public Health

Senior Lecturer in HIV Epidemiology







Norfolk PlaceSt Mary's Campus






BibTex format

author = {Tlhajoane, M and Masoka, T and Mpandaguta, E and Rhead, R and Church, K and Wringe, A and Kadzura, N and Arinaminpathy, N and Nyamukapa, C and Schur, N and Mugurungi, O and Skovdal, M and Eaton, J and Gregson, S},
doi = {10.1186/s12961-018-0358-1},
journal = {Health Research Policy and Systems},
title = {A longitudinal review of national HIV policy and progress made in health facility implementation in eastern Zimbabwe},
url = {},
volume = {16},
year = {2018}

RIS format (EndNote, RefMan)

AB - BackgroundIn recent years, WHO has made major changes to its guidance on the provision of HIV care and treatment services. We conducted a longitudinal study from 2013 to 2015 to establish how these changes have been translated into national policy in Zimbabwe and to measure progress in implementation within local health facilities.MethodsNational HIV programme policy guidelines published between 2003 and 2013 (n = 9) and 2014 and 2015 (n = 5) were reviewed to assess adoption of WHO recommendations on HIV testing services, prevention of mother-to-child transmission (PMTCT) of HIV, and provision of antiretroviral therapy (ART). Changes in local implementation of these policies over time were measured in two rounds of a survey conducted at 36 health facilities in Eastern Zimbabwe in 2013 and 2015.ResultsHigh levels of adoption of WHO guidance into national policy were recorded, including adoption of new recommendations made in 2013–2015 to introduce PMTCT Option B+ and to increase the threshold for ART initiation from CD4 ≤ 350 cells/mm3 to ≤ 500 cells/mm3. New strategies to implement national HIV policies were introduced such as the decentralisation of ART services from hospitals to clinics and task-shifting of care from doctors to nurses. The proportions of health facilities offering free HIV testing and counselling, PMTCT (including Option B+) and ART services increased substantially from 2013 to 2015, despite reductions in numbers of health workers. Provision of provider-initiated HIV testing remained consistently high. At least one test-kit stock-out in the prior year was reported in most facilities (2013: 69%; 2015: 61%; p = 0.44). Stock-outs of first-line ART and prophylactic drugs for opportunistic infections remained low. Repeat testing for HIV-negative individuals within 3 months decreased (2013: 97%; 2015: 72%; p = 0.01). Laboratory testing remained low across both surve
AU - Tlhajoane,M
AU - Masoka,T
AU - Mpandaguta,E
AU - Rhead,R
AU - Church,K
AU - Wringe,A
AU - Kadzura,N
AU - Arinaminpathy,N
AU - Nyamukapa,C
AU - Schur,N
AU - Mugurungi,O
AU - Skovdal,M
AU - Eaton,J
AU - Gregson,S
DO - 10.1186/s12961-018-0358-1
PY - 2018///
SN - 1478-4505
TI - A longitudinal review of national HIV policy and progress made in health facility implementation in eastern Zimbabwe
T2 - Health Research Policy and Systems
UR -
UR -
VL - 16
ER -