Finally, in terms of learning performance, Aaron & Lipton (2017: 10) state that " digital devices and a nonrestrictive classroom policy on the use of those devices contributed to poorer retention of classroom material".
The challenges encountered by LHWs may also contribute to poor retention rates for this cadre and may, in some settings, also impact on recruitment.
Furthermore stigma associated with HIV care facilities contributed to poor linkage and retention rates.
Poor working conditions and management systems in the public sector contribute to poor staff retention, especially in rural areas (14).
The inefficiencies of health facilities such as delays in service delivery and long queues were raised as factors contributing to poor linkage and retention.
Consistent with other studies in the region [ 9- 11], our findings revealed various aspects associated with patient satisfaction with care such as delays at the clinic, long queues, favoritism, health provider's attitudes, poor provider-patient communication, and lack of confidentiality among health providers as contributing to poor linkage and retention.
Previous studies have reported factors such as being male, younger in age, fears of drug side effects, busy schedules, transport costs and distance, stigma and fear of disclosure, staff shortages, and delays at the health facility as contributing to poor linkage and retention in the region [ 3, 9- 11].
