Grading the Level of Adherence to the Care and Treatment of Providers and Clients on Antiretroviral Therapy Program in Dessie Referral Hospital, South Wollo, Ethiopia

Background: Antiretroviral therapy (ART) is one of the interventions implemented to reduce morbidity and mortality due to HIV/AIDS. The evaluation of implementation process and its fidelity can give insight in to the “black-box” of the program and give on time information for improvement of the program. Objectives of the evaluation: The general objective of the study was to evaluate the quality and level of Adherence to the care and treatment among clients receiving of Antiretroviral Therapy Dessie Referral Hospital, Ethiopia, 2016. Methods: The evaluation was conducted in Dessie Referral Hospital, Dessie. Adherence, quality of delivery, facilitating strategies, participant responsiveness, recruitment and context are the components of process evaluation measured. Case study design was employed and qualitative and quantitative methods were utilized. Results: The faithfulness of the implementation of the program was found to be 61.30%. As the selected indicators of adherence showed, 54.62% of the clients were given services in accordance with the national guideline. On average, only 46.46% of the clients on chronic care were receiving services for clinical or immunological assessment and 70.70% of the services related to prevention and management of common opportunistic infections were found adherent to the guidelines. Only 58.47% of the clients were initiated for antiretroviral therapy as needed by the guideline. Only 23.91% of the clients were given for Adherence assessment, counseling, and support. Conclusion and Recommendation: The adherence to implementation of the program was found low regardless to the high effort being delivered to the program by partners. It needs implementation urgent improvement packages by all relevant stakeholders.