Finding What Works: Identification of Implementation Strategies for the Integration of Methadone Maintenance Therapy and HIV Services in Vietnam

June 2016 - Combination Prevention

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Go, V.F., Morales, G.J., Mai, N.T., et al. Implementation Science (April 2016), 11(1): 54, doi: 10.1186/s13012-016-0420-8.

Between December 2014 and February 2015, the authors used a two-phase process, adapted from the Expert Recommendations for Implementing Change (ERIC) protocol, to assess barriers and facilitators to methadone maintenance therapy (MMT)/HIV integration; and used this assessment to identify appropriate implementation strategies in Vietnam. In Phase 1, they conducted 16 in-depth interviews with stakeholders and developed matrices to display barriers to integration. In Phase 2, they selected implementation strategies that addressed the barriers identified in Phase 1, and conducted a poll to determine the most important and feasible strategies. Overall, participants were receptive to service integration, noting the benefits to both patients and the health system. The most important benefit identified was better access to services and care for MMT and HIV patients. Barriers were grouped into five main domains: two at the policy level (service and staffing structures) and three at the programmatic level (technical assistance for clinic staff, staff accountability, and local commitment). Strategies selected during Phase 2 included technical assistance, building staff accountability, and securing local commitment to address the barriers identified earlier. The authors concluded that this process for identifying implementation strategies was simple, low-cost, and potentially replicable in other settings.

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