Self-reported adherence between clients counseled by HCWs compared to ASW after the ASW intervention was similar and not statistically significant (p>0.05).
Therefore we were able to compare outcomes before and after the ASW scheme and between ASWs and HCWs post ASW intervention.
Though some adherence counseling tasks shifted to ASWs, there was no statistical difference in the quality measures before and after the introduction of the ASW program as well as between ASWs and HCWs.
Five hundred patients on ART were interviewed using a structured questionnaire to compare the quality of adherence counseling before and after the ASW scheme was introduced at the selected sites and between ASWs and HCWs after the introduction of ASWs.
As indicated in Table 6, data was disaggregated for ART patients counseled by HCWs after the ASW intervention and compared to those counseled by ASWs across the quality elements above to determine differences.
Themes explored during the FGD centered on strengths and weaknesses of the ASW scheme, and recommendations on issues such as the role ASWs in addressing the human resource shortage problem, quality of adherence counseling and patient waiting times.
Table 3, shows that the responsibility for pre-treatment adherence counseling shifted from HCWs to ASWs; 72.4% of ART clients received counseling by HCWs before the ASW program, which declined to 52.0%.
This pattern in hydraulic gradients indicates that the generally younger, lower-arsenic groundwater in the shallow part of the aquifer near the ASW would tend to migrate farther down into the aquifer (likely making a greater contribution to water produced by the ASW) during the summer pumping season than during the winter pumping season.
And the dilution of the ASW role is seen in many quarters as an attack on social work values.
"That has to be a cultural issue, so we have to pay attention to them, and if we are going to replace the ASW, then that needs very close attention," he says.
Thus, the ASW medium which contributed to higher biomass production is also believed promising for ARA production by P. purpureum.
