In resource-limited settings such as in sub-Saharan Africa where NVP is the mostly commonly used NNRTI, ALT monitoring is expensive and often technologically not feasible and its use in routine programmes needs to be carefully considered.
In our programme the criteria for offering ART were medical need, with no prerequisite to demonstrate adherence, making it more similar to routine programmes in industrialized countries.
Children were included in the analysis as they are included in our routine programmes and registered and treated using similar principles as in adults.
For routine programmes with vaccination each year this means some cohorts have incomplete follow-up in the model, although the effects of this are mostly mitigated through discounting future costs and benefits.
- The programme strategies could have supported attainment of all the NPA goals by national efforts in the form of advocacy, IEC, monitoring and a special focus on children of deprived families and / or groups / areas rather than service delivery for routine programmes.
A three phase approach Longer term routine activities 2008-2015 From 2008, the Sudan ACSI will also focus on systems improvements in community health care delivery, building human capacity and the development of routine programmes that tackle child and maternal mortality.
