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From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa
Incorrect classification of silent transfer (STF) patients as lost to follow-up (LTF) negatively impacts accurate assessment of retention in care for antiretroviral (ART) programmes. Understanding reasons why patients STF and what proportion of LTF patients constitute this silent transfer phenomenon...
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| Format: | Thesis |
| Language: | English |
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Department of Public Health and Family Medicine
2016
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| _version_ | 1867613236677836800 |
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| access_status_str | Open Access |
| author | Hennessey, Claudine |
| author2 | Stinson, Kathryn |
| author_browse | Hennessey, Claudine Stinson, Kathryn |
| author_facet | Stinson, Kathryn Hennessey, Claudine |
| author_sort | Hennessey, Claudine |
| collection | Thesis |
| description | Incorrect classification of silent transfer (STF) patients as lost to follow-up (LTF) negatively impacts accurate assessment of retention in care for antiretroviral (ART) programmes. Understanding reasons why patients STF and what proportion of LTF patients constitute this silent transfer phenomenon is necessary to ensure patient continuity of care. We attempted to identify STF patients using the routine government electronic monitoring systems. Furthermore, we sought to identify potential reasons for the STF phenomenon through patient surveys and healthcare provider interviews, in order to guide policy and improve programmatic outcomes. In this mixed methods approach, we selected patients identified as LTF between 2008-2012 in three health facilities from Khayelitsha, Western Cape. Identified patients were subsequently searched for using a combined provincial patient data set. Once consent was obtained, sampling of patients and healthcare providers, using convenience and snowballing methods respectively, were selected for participation. Ninety percent of patients believe it necessary to inform facility staff of the intent to transfer, 56% of patients interviewed cited fear of negative attitudes from staff regarding transfer request (65%), family situations (30%), and long waiting times (11%) as contributing factors to silently transferring care between facilities. Healthcare providers cited stigma, family obligations and/or support, and migration to the Eastern Cape as main reasons for patients transferring. Healthcare providers cited incomplete or lack of transfer documentation as the biggest barrier to timeous treatment of the transfer patient. Incorrect reporting of patients as lost to follow-up negatively affects the treatment programmes retention in care. Negative staff attitudes and poor operational services prevent patients informing staff of transfer intent. The treatment programme must adapt current transfer policies in order to facilitate the transfer process for all patients, including those experiencing emergencies and life events. Linked electronic patient monitoring systems will improve accurate retention in care reporting and improve fluidity of transferring of patients between health services. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/20494 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:56.154Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2016 |
| publishDateRange | 2016 |
| publishDateSort | 2016 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/20494 From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa Hennessey, Claudine Stinson, Kathryn Public Health Incorrect classification of silent transfer (STF) patients as lost to follow-up (LTF) negatively impacts accurate assessment of retention in care for antiretroviral (ART) programmes. Understanding reasons why patients STF and what proportion of LTF patients constitute this silent transfer phenomenon is necessary to ensure patient continuity of care. We attempted to identify STF patients using the routine government electronic monitoring systems. Furthermore, we sought to identify potential reasons for the STF phenomenon through patient surveys and healthcare provider interviews, in order to guide policy and improve programmatic outcomes. In this mixed methods approach, we selected patients identified as LTF between 2008-2012 in three health facilities from Khayelitsha, Western Cape. Identified patients were subsequently searched for using a combined provincial patient data set. Once consent was obtained, sampling of patients and healthcare providers, using convenience and snowballing methods respectively, were selected for participation. Ninety percent of patients believe it necessary to inform facility staff of the intent to transfer, 56% of patients interviewed cited fear of negative attitudes from staff regarding transfer request (65%), family situations (30%), and long waiting times (11%) as contributing factors to silently transferring care between facilities. Healthcare providers cited stigma, family obligations and/or support, and migration to the Eastern Cape as main reasons for patients transferring. Healthcare providers cited incomplete or lack of transfer documentation as the biggest barrier to timeous treatment of the transfer patient. Incorrect reporting of patients as lost to follow-up negatively affects the treatment programmes retention in care. Negative staff attitudes and poor operational services prevent patients informing staff of transfer intent. The treatment programme must adapt current transfer policies in order to facilitate the transfer process for all patients, including those experiencing emergencies and life events. Linked electronic patient monitoring systems will improve accurate retention in care reporting and improve fluidity of transferring of patients between health services. 2016-07-20T06:59:10Z 2016-07-20T06:59:10Z 2016 Master Thesis Masters MPH http://hdl.handle.net/11427/20494 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Public Health Hennessey, Claudine From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa |
| thesis_degree_str | Master's |
| title | From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa |
| title_full | From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa |
| title_fullStr | From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa |
| title_full_unstemmed | From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa |
| title_short | From lost to found: the silent transfer of patients on Antiretroviral Therapy in Khayelitsha, South Africa |
| title_sort | from lost to found the silent transfer of patients on antiretroviral therapy in khayelitsha south africa |
| topic | Public Health |
| url | http://hdl.handle.net/11427/20494 |
| work_keys_str_mv | AT hennesseyclaudine fromlosttofoundthesilenttransferofpatientsonantiretroviraltherapyinkhayelitshasouthafrica |