Utilisation of the National Antiretroviral Therapy Guidelines among health care professionals working in Abuja treatment centres, Nigeria

Background: Access to and utilisations of the National Antiretroviral Treatment Guidelines (NATG) are valuable factors for effective programme implementation. The objective of this study was to investigate the accessibility of the NATG and their utilisation by health care professionals from fi ve treatment centres in Abuja, Nigeria. Method: A quantitative cross-sectional descriptive survey was conducted in 2007 using purposively sampled health care professionals. Questionnaires were self-administered to participants who consented in writing to participate in the survey. Results: 97 health care professionals participated in this study with about equal numbers of men and women: 48 (49.5%) women and 49 (50.5%) men. Of these, 21.6% were unaware of the existence of the NATG in their treatment centres. More than half (51.5%) reported that they did not have access to the NATG as opposed to those (48.5%) who had access to the guidelines. Furthermore, 16.5% of the participants confi rmed that they had access to an institutional copy of the NATG while 14.4% indicated that they had individual copies and only 3.1% stated that they had individual copies and access to the hospital copy as well. Regarding utilisation of the NATG, 41.2% rarely used them, 32.9% never used them and only 25.7% often used them. The most frequent use of the NATG was among pharmacists (38.1%) compared to the least frequent use among nurses (20.0%). Conclusion: Poor accessibility of the NATG may have a negative impact on guidelines utilisation among health care professionals in Nigeria. INTRODUCTION AND BACKGROUND Disease-specifi c initiatives for the management of particular diseases encourage adherence to evidencebased guidelines and ensure that such adherence is monitored. The goal is to maximise the benefi ts to patients with specifi c diseases by encouraging standardisation (i.e. guideline-driven prescription of medication) among providers of health care, which prevents variation of the patterns of practice among health care providers.1 Such guidelines are developed by national organisations and provide recommendations, including the use of a multidrug regimen for treatment of patients with a particular disease. In South Africa the National Antiretroviral Therapy Guidelines (NATG) are available to promote optimal therapy and good clinical outcomes for people with HIV/AIDS.2 Furthermore, the purpose of the NATG is to set standards as the basis for the use of antiretroviral therapy (ART) drugs upon which training and support programmes should be based. Similarly, in Nigeria the NATG are intended to serve as a basis for scaling-up and decentralisation of the ART initiative programme management and its implementation at different facility levels. In a bid to improve the quality of care and practice, the World Health Organization (WHO) and the governments of some countries have identifi ed the need to standardise the use of ARVs, which has serious fi nancial implications for world bodies and national governments, coupled with the fatal consequences of the misuse of these drugs. The Federal Government of Nigeria has put in place guidelines for the use of ARV drugs in Nigeria to ensure that quality care is delivered to all people living with HIV/AIDS (PLWHA) as part of the implementation of the National Antiretroviral Access Program.3 The guidelines provide essential and relevant information needed by health workers not only to understand HIV/AIDS but also to effectively treat and manage it. Health care professionals are expected to fully utilise the guidelines to ensure uniformity in the management of HIV/AIDS in Nigeria according to a set standard. The aim of this study was to identify the gaps in relation to the implementation of the NATG (i.e. the distribution and utilisation of the guidelines by health care professionals in Abuja).